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1.
Mohammed R. Halawa Yara M. Eid Rana A. El-Hilaly Mona M. Abdelsalam Amr H. Amer 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):99-104
Introduction
Foot disease is a common complication of type 2 diabetes that can have tragic consequences. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot.Aim
To examine Relationship of Planter Pressure and Glycemic Control in Type 2 Diabetic Patients with and without Neuropathy.Materials and methods
The study was conducted on 50 type 2 diabetic patients and 30 healthy volunteers. BMI calculation, disease duration, Hemoglobin A1c and presence of neuropathy (by history, foot examination and DN4 questionnaire) were recorded. Plantar pressure was recorded for all patients using the Mat-scan (Tekscan, Inc.vers. 6.34 Boston USA) in static conditions (standing) and dynamic conditions (taking a step on the Mat-scan). Plantar pressures (kPa) were determined at the five metatarsal areas, mid foot area, medial and lateral heel areas and medial three toes.Results
Static and dynamic plantar pressures in both right and left feet were significantly higher in diabetic with neuropathy group than in control group in measured areas (P < 0.05). Static and dynamic pressures in right and left feet were significantly higher in diabetic with neuropathy group than in diabetic without neuropathy group in measured areas (P < 0.05). On comparison between controls and diabetic without neuropathy group there was a significant difference in plantar pressures especially in metatarsal areas (P < 0.05). No significant correlations were present between the studied variables age, disease duration, BMI and HbA1c and plantar pressures in all studied areas.Conclusion
Persons with diabetic neuropathy have elevated peak plantar pressure (PPP) compared to patients without neuropathy and control group. HbA1c% as a surrogate for glycemic control had no direct impact on peak planter pressure, yet it indirectly impacts neuropathy evolution through out disease duration eventually leading to the drastic planter pressure and gait biomechanics changes. 相似文献2.
Kurt Azzopardi Alfred Gatt Nachiappan Chockalingam Cynthia Formosa 《Primary Care Diabetes》2018,12(2):111-115
Aim
Diabetic peripheral neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of diabetic peripheral neuropathy results in fewer foot ulcers and amputations. The aim of this study was to compare different screening modalities in the detection of diabetic peripheral neuropathy in a primary care setting.Method
A prospective non-experimental comparative multi-centre cross sectional study was conducted in various Primary Health Centres. One hundred participants living with Type 2 diabetes for at least 10 years were recruited using a convenience sampling method. The Vibratip, 128 Hz tuning fork and neurothesiometer were compared in the detection of vibration perception.Results
This study showed different results of diabetic peripheral neuropathy screening tests, even in the same group of participants. This study has shown that the percentage of participants who did not perceive vibrations was highest when using the VibraTip (28.5%). This was followed by the neurothesiometer (21%) and the 128 Hz tuning fork (12%) (p < 0.001).Conclusion
Correct diagnosis and treatment of neuropathy in patients with diabetes is crucial. This study demonstrates that some instruments are more sensitive to vibration perception than others. We recommend that different modalities should be used in patients with diabetes and when results do not concur, further neurological evaluation should be performed. This would significantly reduce the proportion of patients with diabetes who would be falsely identified as having no peripheral neuropathy and subsequently denied the benefit of beneficial and effective secondary risk factor control. 相似文献3.
Siyu Chen Xuhong Hou Yu Sun Gang Hu Xiaoyan Zhou Huijuan Xue Peizhu Chen Jingzhu Wu Yuqian Bao Weiping Jia 《Primary Care Diabetes》2018,12(3):231-237
Aims
To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.Methods
985 adults with diabetes in the Shanghai Taopu community health service center were enrolled at baseline and 907 subjects completed the follow-up. The follow-up levels of the metabolic profiles were assessed by their averages during the follow up period.Results
After a mean 7-year follow-up period, heamoglobin A1c, systolic and diastolic blood pressure levels decreased by 0.6%, 5.7 mmHg, and 1.5 mmHg, respectively (all P < 0.001). There was a non-significant difference in low-density lipoprotein cholesterol, while high-density lipoprotein cholesterol increased 1.9 mg/dL and triglycerides decreased 28.3 mg/dL, respectively (all P < 0.001). The percentage of patients with diabetes who met any one of three Chinese Diabetes Society goals (heamoglobin A1c <7.0%, blood pressure <140/80 mmHg, and low-density lipoprotein cholesterol <100 mg/dL) increased from 58.2% to 70.1%. The chronic diabetes complication screening rates (diabetic retinopathy, diabetic neuropathy, diabetic nephropathy) have significantly increased, from almost zero to 12–78%.Conclusions
This long-term program has increased the proportions of attaining major cardiovascular risk factors control goals and diabetic chronic complication screening rates among patients with diabetes. 相似文献4.
Xiandong Gu Xuming Luo Xiongbiao Wang Jihong Tang Wei Yang Zhuying Cai 《Primary Care Diabetes》2018,12(5):460-466
Background
The aim of this study was to explore the correlation between obstructive sleep apnea (OSA) and diabetic neuropathy.Materials and methods
After working out searching strategy, literatures were screened from the electronic databases: PubMed, Embase, and the Cochrane library. R 3.12 was utilized to perform meta-analysis, and odds ratio (OR) and its 95% confidence interval (CI) were used to present effect size. Heterogeneity was assessed by χ2-based Q test and I2 statistics. Publication bias was estimated by Egger’s test and sensitivity was evaluated by leave one out methods.Results
According to the criteria, a total of 11 studies with 1842 patients were enrolled in this study. With a significant heterogeneity (Q = 31.83, I2 = 68.60%), the random effects model was utilized to assess the effect size of pooled data. A remarkable correlation was identified OSA and diabetic neuropathy (OR = 1.84, 95% CI: 1.18–2.87) without publication bias (t = 1.68, P = 0.13). Meanwhile, the result of leave one out performed a well sensitivity. Moreover, the subgroup analyses presented that OSA was significantly correlated with type 1 diabetic neuropathy (OR = 1.97, 95% CI: 1.19–3.25), but no remarkable correlation was identified between OSA and type 1 (OR = 1.84, 95% CI: 0.86–3.93) or 1 + 2 (OR = 1.30, 95% CI: 0.43–3.92) diabetic neuropathy.Conclusion
OSA was significantly correlated with neuropathy in type 1 diabetes, but not in type 2 and type 1 + 2 diabetes. 相似文献5.
Osama B. Albasheer Mohammed S. Mahfouz Yahia Solan Duaa A. Khan Mohammed A. Muqri Haneen A. Almutairi Ali M. Alelyani Hussain A. Alahmed 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):117-121
Purpose
To determine the prevalence of depression and related risk factors among type 2 diabetes mellitus patients (T2DM) in Jazan area, Saudi Arabia.Method
A cross sectional, self-administered questionnaire study was conducted among T2DM patients in Jazan area, Saudi Arabia. A total of 385 patients were selected at randomly. The Patient Health Questionnaire (PHQ-9) was utilized to measure symptoms and signs of depression.Results
The overall prevalence of depression among T2DM patients was 37.6%. Of them, 24.2% were mildly depressed, 9.6% were moderately severely depressed, and 4.2% were severely depression. Significant predictors of depression include the presence of diabetic foot (P = 0.000), cardio-vascular diseases (P = 0.000), eye complication (P = 0.073), and erectile dysfunction (P = 0.090). The prevalence of depression was not significantly associated with the age (P = 0.375) and gender (P = 0.374). Similarly no association was found with duration of diabetes (P = 0.475) and HbA1c (P = 0.555).Conclusion
The study revealed that diabetes complications are strong predictors of the rate of depression among T2DM patients. Therefore, early depression screening is needed to improve the quality of life of diabetic patients. 相似文献6.
7.
Aims
To assess circulating fetuin-B concentrations in subjects with different degrees of glucose tolerance and to analyze the association of fetuin-B concentrations with insulin resistance and the first phase of glucose-stimulated insulin secretion.Methods
Plasma fetuin-B concentrations were analyzed in 149 subjects with normal glucose tolerance (NGT, n = 54), impaired glucose regulation (preDM, n = 42) and newly diagnosed type-2 diabetes mellitus (nT2DM, n = 53). Intravenous glucose tolerance tests (IVGTTs) and biochemical parameters were also assessed in all participants.Results
Plasma fetuin-B concentrations were significantly higher in nT2DM patients compared with NGT and preDM subjects (both P < 0.001) and positively correlated with FPG, 2hPG, HOMA-IR, HbA1c, hsCRP, FINS and TG (P < 0.05), but negatively correlated with AIR, AUC, GDI and fasting Belfiore index (P < 0.01). After adjusting for age and gender, all correlations remained statistically significant (P < 0.05). Multivariate logistic regression analysis revealed that plasma fetuin-B concentrations were significantly correlated with nT2DM after controlling for age, gender, BMI, WHR, blood pressure and lipid profiles.Conclusion
Patients with nT2DM have significantly higher concentrations of plasma fetuin-B compared with NGT subjects and plasma fetuin-B is strongly associated with glucose and lipid metabolism, chronic inflammation and first-phase glucose-stimulated insulin secretion and insulin resistance. 相似文献8.
Hamideh Lari Rahim Tahmasebi Azita Noroozi 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):45-50
Background
By high prevalence of inactivity, particularly in diabetic patients, the need to effective interventions to promote physical activity is essential. The aim of this study was to determine the effects of education based on health promotion model (HPM) through multimedia on the physical activity in diabetic patients.Method
In this quasi-experimental study, 76 patients with type II diabetes were evaluated (40 patents in intervention group and 36 patients in control group). The intervention group members and a friend or a family member, that could be supportive in physical activity, received teaching CD based on health promotion model. Both group members at the beginning of the study, two weeks and three months after the training, completed questionnaires. After data collection, statistical analysis was conducted using independent T-test, chi-square test, and repeated measurement of ANOVA.Results
Finding showed that self-efficacy (P < 0.001), health status (p = 0.032), benefits (P < 0.001) and friends support in physical activity (P < 0.001) were perceived to be higher, and barrier of physical activity (P < 0.001) was perceived to be lower in multimedia group compared to control group 3 months after training. There was a significant difference in average of metabolic equivalent of task (MET) between two groups after the intervention (P < 0.001).Conclusion
Planning of education based on the HPM and implementation through multimedia can change belief about physical activity and increase participation in physical activity. 相似文献9.
Ramya Kateel Alfred J. Augustine Shivananda Prabhu Sheetal Ullal Manohar Pai Prabha Adhikari 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):27-30
Aim
To evaluate the clinical and microbiological profile of diabetic foot ulcer patients admitted to a tertiary care hospital.Methodology
This study recruited 120 diabetic foot ulcer patients of all grade. Their medical records were evaluated retrospectively.Results
We found that median age of patient was 60(52, 67.75) years. 68.3% of patients were males. Median duration of diabetes mellitus was 15(10, 20) years. Mean HbA1C and fasting glucose was 10.3 ± 2.3 and 167.6 ± 52.42 respectively. Neuropathy (35%) and peripheral vascular disease (23.3%) was major micro vascular and macro vascular complication associated. Different locations of ulcers were toe (23.3%), sole (20%), dorsum (18.3%), shin (16.6%), heel (13.3%), and ankle (8.3%). Bacterial infection was seen in 81.66% patients out of which 23.3% had poly microbial infection.Conclusion
Diabetic foot ulcer patient had poor blood glucose control with elevated HbA1C and fasting blood glucose level. Neuropathy and peripheral vascular disease, hypertension were major complications. Staphylococcus aureus, Pseudomonas aeruginosa were common infecting bacteria. 相似文献10.
11.
Marilina Santero Daniela Morelli Analía Nejamis Luz Gibbons Vilma Irazola Andrea Beratarrechea 《Primary Care Diabetes》2018,12(6):510-516
Aim
To evaluate the one-year post effect of the implementation of a diabetes program that includes mHealth interventions on the quality of diabetic care in public primary care centers.Method
It is a quasi-experimental study with outcome measurements at baseline, 6 and 12 months. The program includes primary care team training, a diabetes registry with a decision support tool in an app. and text messages for patients.Results
At baseline, 947 patients were included in the registry, 62.3% women with a mean age of 53.6 ± 11.5 years and 92% with type 2 diabetes. Common comorbidities were hypertension (61.3%) and obesity (59%). Only 16.9% had one HbA1c and 48.9% a cholesterol lab in the last year, 61.9% were screened for diabetic peripheral neuropathy, and 29.0% had one eye exam in the previous year. With respect to blood sugar, lipid and blood pressure control: 44.4% of those with HbA1c measurements had levels ≥8%, total cholesterol was over 200 mg/dL in 40.6% and 48.2% had uncontrolled blood pressure values.Conclusion
Patients with diabetes received a low quality of care at public primary care clinics. A diabetes registry allowed us to draw an epidemiological profile of diabetic patients and determine the quality of care provided. 相似文献12.
L.-X. Tang X.-J. Yang P.-P. Wang W.-T. Ge J. Zhang Y.-L. Guo J. Lu J. Tai Y.-M. Zhang X. Ni 《Allergologia et immunopathologia》2018,46(2):107-111
Background
The safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in China, the research on efficacy and safety in young and older children with allergic rhinitis (AR) is still rare.Objective
The aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae drops in pre-school and school-age children with AR.Methods
A total of 282 subjects aged 2–13 years with AR received a two-year course of sublingual immunotherapy along with pharmacotherapy. According to the age, patients were defined as the pre-school group (2–6 years old, n = 116) and school-age group (7–13 years old, n = 166). Total nasal rhinitis symptom scores (TNSS), visual analogue score (VAS) and total medication scores (TMS) were evaluated at four time points: baseline, after SLIT for half a year, one year and two years. The adverse events (AEs) were evaluated at each visit.Results
After two-year SLIT, the four rhinitis symptom scores, TNSS, VAS and TMS scores were significantly lower than baseline (all P < 0.05). The comparison of efficacy between one and two-year duration showed no significant difference in global clinical outcomes (all P > 0.05). In addition, there were no significant differences between the pre-school and school-age group in TNSS (all P > 0.05), VAS (all P > 0.05) and TMS scores (P > 0.05) after SLIT for half a year, one year and two years. No severe systemic AEs were reported.Conclusion
SLIT with D. farinae drops is clinically effective and safe in pre-school and school-age patients with house dust mites (HDMs)-induced AR. 相似文献13.
Aim
This study investigates the role of muscle strength as a predictive factor for reduced pulmonary function in diabetes.Methods
Data from the NHANES 2011–2012 were analyzed. Lung function was assessed with spirometry (FEV1, FVC). Diabetes was assessed with an oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), or fasting plasma glucose (FPG). Muscle strength was measured by a grip test using a handgrip dynamometer.Results
A total of 3521 people were suitable to be included for analysis in this study. Lung function was reduced in diabetes—after adjustment for covariates, the impact of diabetes on FVC was estimated as ?331 mL (SE 48) for known diabetes and ?282 mL (SE 41) for undiagnosed diabetes (P < 0.001). Grip strength was also reduced in diabetes. After adjustment for covariates, the impact of diabetes was estimated as ?5.9 kg (SE 0.8) for known diabetes (P < 0.001). An association between lung capacity and grip strength in people with known diabetes was observed (R = 0.7, P < 0.001). The adjusted impact on FVC from grip strength was estimated as 13.1 mL (SE 3.4) per kg (P < 0.001).Conclusions
Muscle strength appears to be reduced in people with known diabetes, and this seems to affect the respiratory muscles as an independent factor. 相似文献14.
Alfred Gatt Kevin Cassar Owen Falzon Christian Ellul Kenneth P. Camilleri Jean Gauci Stephen Mizzi Anabelle Mizzi Cassandra Sturgeon Nachiappan Chockalingam Cynthia Formosa 《Primary Care Diabetes》2018,12(4):312-318
Aims
The purpose of this study was to investigate whether heat emitted from the feet of patients with type 2 diabetes (DM) and peripheral arterial disease (PAD) differed from those with type 2 diabetes without complications (DM).Methods
A non-experimental, comparative prospective study design was employed in a tertiary referral hospital. Out of 223 randomly selected participants (430 limbs) who were initially tested, 62 limbs were categorized as DM + PAD and 22 limbs as DM without PAD. Subjects with evidence of peripheral neuropathy were excluded. Participants underwent thermographic imaging. Automatic segmentation of regions of interest extracted the temperature data.Results
A significant difference in temperature in all the toes between the two groups was found (p = 0.005, p = 0.033, p = 0.015, p = 0.038 and p = 0.02 for toes 1–5 respectively). The mean forefoot temperature in DM + PAD was significantly higher than that in DM (p = .019), with DM + PAD having a higher mean temperature (28.3 °C) compared to DM (26.2 °C). Similarly, the toes of subjects with DM + PAD were significantly warmer than those of subjects with DM only.Conclusions
Contrary to expectations the mean toe and forefoot temperatures in DM patients with PAD is higher than in those with DM only. This unexpected result could be attributed to disruption of noradrenergic vasoconstrictor thermoregulatory mechanisms with resulting increased flow through cutaneous vessels and subsequent increased heat emissivity. These results demonstrate that thermography may have potential in detecting PAD and associated temperature differences. 相似文献15.
Leonardo Lorente María M. Martín Pedro Abreu-González Antonia Pérez-Cejas Raquel Ortiz López José Ferreres Jordi Solé-Violán Lorenzo Labarta César Díaz Celina Llanos Alejandro Jiménez 《Enfermedades infecciosas y microbiología clínica》2018,36(9):544-549
Objective
Higher serum melatonin levels have previously been found in patients with severe sepsis who died within 30 days of diagnosis than in survivors. The objective of our study were to determine whether serum melatonin levels during the first seven days of severe sepsis diagnosis could be associated with sepsis severity and mortality.Methods
Multicentre study in eight Spanish Intensive Care Units which enrolled 308 patients with severe sepsis. We determined serum levels of melatonin, malondialdehyde (as biomarker of lipid peroxidation) and tumor necrosis factor-alpha at days 1, 4 and 8 of severe sepsis diagnosis. The study's primary endpoint was 30-day mortality.Results
A total of 103 patients had died and 205 survived at 30 days of severe sepsis diagnosis, with the non-survivors presenting higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001) and 8 (p < 0.001) of severe sepsis diagnosis than the survivor patient group. The multiple logistic regression analysis found that serum melatonin levels at days 1, 4 and 8 of severe sepsis diagnosis (p < 0.001, p = 0.01 and p = 0.001, respectively) were associated with mortality adjusted for age, serum lactic acid, SOFA score and diabetes mellitus.Conclusions
The novel and more interesting findings of our study were that serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality. 相似文献16.
17.
T.-T. Li A.-P. Wang J.-X. Lu M.-Y. Chen C.-C. Zhao Z.-H. Tang L.-X. Li W.-P. Jia 《Diabetes & metabolism》2018,44(5):437-443
Aim
As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.Methods
This cross-sectional study was performed with newly diagnosed Chinese patients with diabetes, including 39 T1D, 165 ketosis-onset and 173 non-ketotic T2D, with 30 non-diabetics included as controls. NAFLD was determined by hepatic ultrasonography, then its clinical features were analyzed and its associated risk factors evaluated.Results
NAFLD prevalence in patients with ketosis-onset diabetes (61.8%) was significantly higher than in controls (23.3%; P = 0.003) and in T1D patients (15.4%; P < 0.001). However, there was no difference in prevalence between ketosis-onset and non-ketotic T2D patients (52.6%; P = 0.229), although BMI and alanine aminotransferase (ALT) proved to be independent risk factors for the presence of NAFLD in both these groups whereas, in T1D patients, serum uric acid levels were independent risk factors.Conclusion
NAFLD prevalence and risk factors in ketosis-onset diabetes were similar to those in non-ketotic T2D, but different from those in T1D. These data provide further evidence that ketosis-onset diabetes should be classified as a subtype of T2D rather than idiopathic T1D. 相似文献18.
Aims
rs5219 is in Potassium inwardly-rectifying channel, subfamily J, member 11 (KCNJ11) E23K gene, located at 11p15.1. Researches on the association between rs5219 gene polymorphism with type 2 diabetes mellitus (T2DM) were performed extensively, but the results remain controversial. To investigate the relationship, a meta-analysis involving 21,464 individuals was conducted.Methods
Odds ratios (OR) and 95% confidence intervals (CI) were used to assess the strength of this association. Publication bias was evaluated with Begg’s test. Our research includes three gene models: allelic genetic model (K-allele vs. E-allele), recessive genetic model (KK vs. EK + EE) and dominant genetic model (EE vs. EK + KK).Results
In allelic genetic model, subgroup analysis demonstrated rs5219 K-allele was relevant to T2DM risk in Caucasian (OR: 1.16, 95% CI: 1.09–1.24, P = 0.000) and East Asian (OR: 1.19, 95% CI: 1.13–1.26, P = 0.000), recessive genetic model indicated rs5219 KK genotype was related to T2DM risk in Caucasian, East Asian, South Asian, and North African (OR: 1.27, 95% CI: 1.17–1.38, P = 0.000), dominant genetic model pointed out rs5219 EE genotype was an opposite association with T2DM risk in Caucasian (OR: 0.86, 95% CI: 0.78–0.94, P = 0.001). No obvious evidence of publication bias was found.Conclusions
There was a believable evidence to verify that rs5219 variation was associated with T2DM. 相似文献19.
Rebecka Husdal Andreas Rosenblad Janeth Leksell Björn Eliasson Stefan Jansson Lars Jerdén Jan Stålhammar Lars Steen Thorne Wallman Ann-Marie Svensson Eva Thors Adolfsson 《Primary Care Diabetes》2018,12(1):23-33
Aims
To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).Methods
People with T2DM attending 846 PHCCs (n = 230 958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.Results
After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (?0.02 mmol/mol for each additional credit; P < 0.001) and length of regular visits to RNs (?0.19 mmol/mol for each additional 15 min; P < 0.001). Organisational features associated with HbA1c level were having a diabetes team (?0.18 mmol/mol; P < 0.01) and providing group education (?0.20 mmol/mol; P < 0.01).Conclusions
In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM. 相似文献20.
Henry Córdova Cristina Sánchez-Montes Pedro G. Delgado-Guillena Victor J. Morales Oriol Sendino Begoña González-Suárez Andrés Cárdenas Maria Pellisé Isis K. Araujo Àngels Ginés Josep Llach Gloria Fernández-Esparrach 《Gastroenterologia y hepatologia》2017,40(9):587-594