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1.
Seyed Alireza Ebadi Parichehr Darvish Ali Jamshidi Fard Behnam Safarpour Lima Omid Gharoei Ahangar 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):893-896
Aims
Hypoglycemia can be considered the most common complication of Diabetes Mellitus treatment. So far, controversial studies have been carried out to examine the impacts of hypoglycemia on the cognitive function.Methods
This study was conducted as case-control. The case group was 35 patients with Diabetes Mellitus Types I or II hospitalized in Imam Hussein Hospital, Tehran, Iran, who have experienced hypoglycemic attacks (glucose level below 70?mg/dl). The control group consisted of diabetic patients hospitalized in hospital, but they had no history of hypoglycemia. As the blood glucose level became in normal range and the patients’ Mental status became stable, the brain cognitive function was examined using Mini-Mental State test.Results
The mean age of the subjects in the case and control groups was 56.77, 53.73 years old, respectively. The mean cognitive score in the control and hypoglycemic groups was 29.09 and 25.29, respectively. The mean MMSE cognitive score was significantly diminished in the hypoglycemic group (p?<?0.001).Conclusions
This study indicated that incidence of hypoglycemia in diabetic patients is associated with cognitive disorders. Further, there is a linear association between cognitive disorders and hypoglycemia, age and diabetes mellitus complication. 相似文献2.
Deepak Gahlan Rajesh Rajput Pratibha Gehlawat Rajiv Gupta 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):333-336
Background
Patients of diabetes mellitus experience psychological difficulties associated with their disease which remains unrecognized involving several states related to coping with diabetes. Diabetes distress is a distinct condition which is often mistaken for depression and is related to adverse disease outcomes.Aims and objective
To study the prevalence and predictors of diabetes distress in patients of Type 2 Diabetes mellitus (T2DM) in a tertiary care centre.Materials and methods
This cross-sectional study was conducted over a period of one year at Endocrine OPD of Pt. B.D. Sharma PGIMS, Rohtak, a tertiary care centre in northern India. 410 consecutive patients having T2DM attending the endocrine OPD were screened for psychiatric disorders and 189 diabetic patients with no underlying psychiatric disorders were included in the study. Their socio-demographic and relevant clinical variables were recorded. Diabetes Distress Scale (DDS) was used to measure distress due to the disease in these patients.Results
It was found that the prevalence of diabetes distress was 18.0%; among them 16.1% had emotion related distress, 5.6% regimen related distress, 1.5% interpersonal related distress and 1.2% physician related diabetes distress. The major predictors for high diabetes distress scores among diabetic cases were low education level, retinopathy, neuropathy and hypertension.Conclusion
The present study suggests that emotion related diabetes distress was more prevalent among diabetic patients. Lower education level and the presence of diabetic complications contribute as risk factors for high diabetes distress. 相似文献3.
Rodrigo Nunes Lamounier Bruno Geloneze Silmara Oliveira Leite Renan MontenegroJr. Lenita Zajdenverg Milene Fernandes Fabiano de Oliveira Griciunas Mariana Narbot Ermetice António Roberto Chacra HAT Brazil study group 《Diabetology & metabolic syndrome》2018,10(1):83
Background
Hypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). The Hypoglycemia Assessment Tool study in Brazil aimed to determine the proportion of patients experiencing hypoglycemic events and to characterize patient awareness and fear about hypoglycemia, among insulin-treated T1DM or T2DM patients.Methods
This was a non-interventional, multicenter study, with a 6-month retrospective and a 4-week prospective evaluation of hypoglycemic events. Patients completed a questionnaire at baseline and at the end of the study, and also a patient diary. The answers ‘occasionally’ and ‘never’ to the question ‘Do you have symptoms when you have a low sugar level?’ denoted impaired hypoglycemia awareness. Fear was reported on a 10-point scale, from ‘not afraid at all’ to ‘absolutely terrified’.Results
From 679 included patients, 321 with T1DM and 293 T2DM, median age of 33.0 and 62.0 years, 59% and 56% were female, and median diabetes duration was 15.0 and 15.0 years, respectively. Median time of insulin use was 14.0 and 6.0 years. During the prospective period, 91.7% T1DM and 61.8% T2DM patients had at least one hypoglycemic event. In the same period, 54.0% T1DM and 27.4% T2DM patients had nocturnal hypoglycemia, 20.6% T1DM and 10.6% T2DM patients had asymptomatic hypoglycemia, and severe events occurred in 20.0% and 10.3%, respectively. At baseline, 21.4% T1DM and 34.3% T2DM had hypoglycemia unawareness. The mean score of hypoglycemia fear was 5.9?±?3.1 in T1DM and 5.4?±?3.9 in T2DM. The most common attitude after hypoglycemic events were to increase calorie intake (60.3%) and blood glucose monitoring (58.0%) and to reduce or skip insulin doses (30.8%).Conclusions
Referred episodes of hypoglycemia were high, in both T1DM and T2DM insulin users. Patient attitudes after hypoglycemia, such as reduction in insulin and increase in calorie intake, can affect diabetes management. These findings may support clinicians in tailoring diabetes education and insulin treatment for patients with diabetes, in order to improve their glycemic control while reducing the risk of hypoglycemic events.4.
Maaz Ozair Saba Noor Alok Raghav Sheelu Shafiq Siddiqi Anjum Mirza Chugtai Jamal Ahmad 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):301-304
Background
Type 2 diabetes mellitus (T2DM) is a major health burden worldwide with many patients encountering thyroid dysfunction later in their life. Various studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexists. However, the prevalence of thyroid dysfunction and associated clinical variables in these patients has not been investigated.Objectives
The study aimed at determining the incidence and prevalence of thyroid dysfunction in patients with T2DM in relation to age, sex, metabolic syndrome and other co-morbid conditions.Research designs & methods
In this cross-sectional study, 250 Type 2 DM patients were enrolled aged between 40 and 75 years. All the patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH. These subjects were also investigated for fasting blood sugar (FBS), post prandial glucose (PPG) glycosylated hemoglobin (HbA1c), serum cholesterol, serum triglycerides, high density lipoprotein (HDL), low density lipoprotein(LDL), very low density lipoprotein(VLDL), blood urea, serum creatinine and presence of other co-morbid conditions. The observations and interpretations were recorded and results obtained were statistically analyzed.Results
A high prevalence of thyroid dysfunction (28%) was observed in type 2 diabetic patients with subclinical hypothyroidism (18.8%) as the commonest thyroid disorder. Thyroid dysfunction was more prevalent in females, with presence of dyslipidemia, retinopathy, poor glycemic state (HbA1c ≥7) and longer duration of diabetes as significant contributing factors associated.Conclusions
In addition to glycemic status, screening of thyroid disorder should be routinely done in type 2 diabetic subjects along with other comorbid conditions. 相似文献5.
Reem M. Al Haj Ahmad Hayder A. Al-Domi 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):1091-1094
Introduction
Dementia and type 2 diabetes mellitus (T2DM) are two of the epidemics of our time; in which insulin resistance (IR) is playing the central role. Epidemiological studies found that different types of dementia development may be promoted by the presence of T2DM.Objectives
We aimed in this review to highlight the role of insulin and the IR in the brain as a pathophysiological factor of dementia development and also to expand our understanding of T2DM as a mediator of IR in the brain and to review the possible mechanisms of action that may explain the association.Methodology
A critical review of the relevant published English articles up to 2018, using PubMed, Google Scholar, Science Direct, ADI, and WHO database was carried out. Keywords were included insulin resistance, T3DM, T2DM, dementia, brain insulin resistance were used.Conclusion
The rapidly increased prevalence of dementia concurrently with T2DM and obesity need urgent action to illustrate guidelines for prevention, modifying, and treatment based on mechanistic studies. 相似文献6.
Heitham Awadalla Sufian K. Noor Wadie M. Elmadhoun Sarra O. Bushara Ahmed O. Almobarak Amel Abdalrhim Sulaiman Mohamed H. Ahmed 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):961-964
Background
Diabetes mellitus (DM) is a major health problem in Sudan and is a leading cause of morbidity and mortality. Dyslipidemia is a major complication of diabetes and an important risk factor for cardiovascular disease (CVD). The objective of this study was to determine the prevalence of dyslipidemia and its co-relation with the glycemic control in individuals with diabetes in River Nile State, Sudan.Methods
Individuals with diabetes attended, Naserudin Karamalla Diabetic (NKDM) Centre, in Atbara teaching hospital during study period, who volunteered to participate were included. Only those on treatment for DM for at least one year were included. Venous samples were collected for cholesterol, triglycerides, HDL, LDL, blood glucose and Glycosylated hemoglobin. Participants were interviewed using standardized pretested questionnaire to record medical history and sociodemographic characteristics. Blood pressure, body mass index (BMI) and waist circumference were measured.Results
A total of 188 individuals were included. The mean age was 49.5?+?13.9 and (128) 68.1% were females. Most patients were having DM for at least 3–5 years 69 (36.7%). Poor diabetes control (HbA1c >7) was recorded in 87.2%, hypercholesterolemia, hypertriglyceridemia and high LDL were identified in 36.6%, 27.7% and 26.6% respectively. In addition, HDL was low in 61.2% of patients.Conclusion
Low HDL is a prominent feature in two thirds of individuals with diabetes, while high cholesterol and high triglyceride were seen in over one quarter. 相似文献7.
Rula Ghandour Nahed Mikki Niveen M.E. Abu Rmeileh Lars Jerdén Margareta Norberg Jan W. Eriksson Abdullatif Husseini 《Primary Care Diabetes》2018,12(6):547-557
Background
Type 2 diabetes mellitus (T2DM) is a growing pandemic that will lead, if not managed and controlled, to frequent complications, poor quality of life, and high rates of disability and death. Little is known about T2DM complications in Palestine. The aim of this study is to estimate the prevalence of T2DM complications in Ramallah and al-Bireh governorate of Palestine.Methods
The study was conducted in eleven primary healthcare clinics offering services for persons with T2DM. Macrovascular complications were assessed using the Diabetes complication index. Microvascular complications were measured by physical examinations and laboratory tests. Questionnaires, laboratory tests, and physical examinations were used to assess socio-demographic characteristics, co-morbidities and other risk factors.Results
517 adult men and nonpregnant women participated in the study (166 men, 351 women). The response rate was 84%. Mean age and mean duration of diabetes were 58.1 and 9.4 years respectively. Prevalence of diagnosed microvascular and macrovascular complications was 67.2% and 28.6% respectively. 78.2% of the participants had poor glycemic control (HbA1c ≥ 7.0%).Conclusion
Significant proportions of persons with T2DM had macro- and microvascular complications and poor metabolic control. These findings are important for policy development and the planning of health services. 相似文献8.
A.O. Grøn E.-M. Dalsgaard A.R. Ribe S. Seidu G. Mora A.M. Cebrián-Cuenca M. Charles 《Primary Care Diabetes》2018,12(4):289-304
Background and aim
Individuals with severe mental illness (SMI) who suffer from type 2 diabetes (T2DM) are likely to be sub-optimally treated for their physical condition. This study aimed to review the effect of interventions in this population.Methods
A systematic search in five databases was conducted in July 2017.Results
Seven studies on multi-faced interventions were included. These comprised nutrition and exercise counselling, behavioural modelling and increased disease awareness aiming to reduce HbA1c, fasting plasma glucose, body mass index and weight.Conclusion
Non-pharmacologic interventions in individuals with SMI and T2DM could possibly improve measures of diabetes care, although with limited clinical impact. 相似文献9.
Tarek Mohamed Ali Ahmad El Askary 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):1045-1050
Background
Inconsistent results have been described regarding the part of fetuin-A and testosterone in arterial stiffness in type 2 diabetes mellitus (T2DM).Aim
To look into the links of serum fetuin-A and testosterone levels with brachial-Ankle pulse wave velocity (baPWV), a marker of arteriosclerosis and common carotid intima media thickness (ccIMT), a marker of early atherosclerosis, in diabetic Saudi men patients.Subjects and methods
One hundred and fifty adult male patients with T2DM and 60 non-diabetic control subjects were enrolled from different Saudi Arabia Taif hospitals. Biochemical analysis, anthropometric measurements, blood pressure, baPWV and ccIMT were investigated.Results
Stepwise regression in diabetic patients revealed that the most important predictor of ba-PWV was serum fetuin-A followed by serum glucose and the most important predictor of ccIMT was serum fetuin-A followed by serum HDL then serum triglycerides.Conclusions
Only fetuin-A levels not testosterone are negatively associated with early markers of atherosclerosis. 相似文献10.
S.V. Madhu G. Sandeep B.K. Mishra M. Aslam 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(6):923-927
Aim
The burden of diabetes is very high in our country particularly in the urban metros. The present survey was planned to ascertain the current prevalence of diabetes and prediabetes in Delhi since the available prevalence estimates are over a decade old.Methods
The present study was conducted in urban area of east Delhi and followed a multistage random sampling design. The prevalence of known diabetes was ascertained based on self reporting and prevalence of newly detected diabetes and prediabetes was based on oral glucose tolerance test (OGTT).Results
We surveyed 470 households and included 1317 individuals. Prevalence of diabetes was 18.3% (known 10.8% and newly detected 7.5%). Prevalence of prediabetes was 21% as per WHO criteria and 39.5% as per ADA criteria. The ratio of known to unknown diabetes was 1.44:1. Every third household (35.77%) had at least one known case of diabetes. High rates of obesity and central obesity were also observed in the study population.Conclusion
The present study found a strikingly high prevalence of diabetes, prediabetes and obesity in Delhi. This calls for urgent and effective preventive measures to prevent diabetes. 相似文献11.
12.
Ana Márcia Tomé Camargos Ana Carolina Oliveira Gonçalves Maurílio de Souza Cazarim Cristina Sanches Leonardo Régis Leira Pereira André Oliveira Baldoni 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):279-283
Introduction
DM spending in the world is high, and Brazilian studies of public spending caused by DM are scarce.Objective
To estimate the annual direct cost for the municipal health sphere, related to DM2 treatment, in patients with and without glycemic control.Method
A cross-sectional study carried out in a city in the interior of Minas Gerais state, with patients with DM2, being municipal PHS users. Data were collected from the computerized system of the municipality and patient records, and analyzed using the IBM SPSS v.19 statistical package. The response variable was categorized into controlled A1c (≤7%) and uncontrolled A1c (>7%).Results
Glycemic control in 56.6% of the patients was unsatisfactory; the mean cost of pharmacotherapy for DM2 was US$ 3.14 per year for patients in the control group and US$ 45.54 per year for uncontrolled patients.Conclusion
Patients with unsatisfactory glycemic control are more expensive for the municipal health system. 相似文献13.
Garland Castaneda Taft Bhuket Benny Liu Robert J. Wong 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):5-8
Aims
Better understanding risk factors for metabolic syndrome (MetS) will allow early targeted intervention to mitigate long term risk. We aim to determine the disparate impact of each individual MetS component on overall risk of developing MetS, stratified by sex, race/ethnicity, and age.Methods
Using data from the 2003–2014 National Health and Nutrition Examination Survey (NHANES), MetS prevalence among adults (age ≥18) was stratified by sex, race/ethnicity, age, and by individual MetS components (e.g. hypertension (HTN), diabetes mellitus (DM), waist circumference, serum high density lipoprotein (HDL), serum triglycerides (TG). Mutlivariate logistic regression models were used to evaluate the disparate impact of each risk factor on MetS risk.Results
Overall MetS prevalence was 33.3%, with the highest prevalence among older individuals, among women, and among Hispanics. When stratified by each individual component of MetS, low serum HDL was the strongest predictor of MetS risk overall and among both men and women, among all race/ethnic groups, and among all age groups (overall: OR 20.1, 95% CI 18.6–21.7). While presence of DM also increased an individual’s risk of MetS, DM was the weakest predictor of MetS.Conclusions
Among U.S. adults, low serum HDL carries the strongest risk in predicting development of MetS. This effect was seen among men and women, among all race/ethnic groups, and among all age groups, highlighting the importance of low serum HDL as a marker of MetS risk. 相似文献14.
Carlos H. Orces Carlos Lorenzo 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):147-153
Aims
To examine the prevalence of prediabetes and diabetes among subjects aged 60 years and older in Ecuador.Materials and methods
The present study used data from the National Survey of Health, Wellbeing, and Aging to describe the prevalence of prediabetes and diabetes among older adults. Logistic regression models were assembled to examine the association between certain demographic and health characteristics of participants and prediabetes and diabetes prevalence rates.Results
Of 2298 participants, the prevalence of prediabetes and diabetes was 36.9% (95% CI: 34.2%–39.6%) and 16.7% (95% CI: 14.9%–18.7%) among older adults in Ecuador, respectively. Notably, higher diabetes prevalence rates were seen among women, black subjects, residents in the urban coastal region, and obese participants than those without. In general, the prevalence of diabetes widely varied across provinces of the country, with higher rates seen in provinces along the coastal region of the country. After adjustment for age, gender, and BMI, residents in the urban coast, subjects with greater number of comorbidities, and those classified as having hypertension, and hypertriglyceridemia had significantly higher odds of having diabetes than those without.Conclusions
Prediabetes and diabetes are prevalent among older adults in Ecuador. The increased prevalence of these metabolic disorders was particularly associated with obesity. Thus, the present findings may assist health care authorities to implement healthy lifestyle interventions among older Ecuadorians at risk for diabetes. 相似文献15.
Vimal Upreti Vijay Maitri Pawan Dhull Ajay Handa M.S. Prakash Anil Behl 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(4):509-512
Context
Vitamin D supplementation in type 2 diabetes mellitus patients may lead to improved glycemic control by improving insulin secretion and decreasing insulin resistance.Aims
To investigate effect of oral vitamin D supplementation on glycemic control, in patients with type 2 diabetes mellitus and coexisting hypovitaminosis D.Settings and design
Randomized, Parallel Group, Placebo Controlled Trial carried out in a tertiary care hospital of Indian Armed Forces.Methods and material
Sixty patients with coexisting type 2 diabetes mellitus and hypovitaminosis D were randomized into cases and controls and were supplemented with oral Vitamin D and microcrystalline cellulose respectively for six months. Subjects' HbA1c and vitamin D levels were monitored at the beginning and end of the study, fasting plasma glucose (FPG) & post prandial plasma glucose (PPPG) during monthly OPD visits.Statistical analysis used
Intra-group comparison was made by paired t test & unpaired t test was used for inter-group (A v/s B) comparisons. Repeated measures ANOVA was undertaken to compare values over time.Results
The two groups were comparable for all parameters at baseline. Case group showed significant decrease in mean HbA1c levels (7.29% to 7.02%; P?=?0.01), mean FPG levels (131.4 to 102.6?mg/dl; P?=?0.04) and mean PPPG levels (196.2 to 135.0?mg/dl; P?<?0.001). Incidentally, significant improvement in systolic as well as diastolic blood pressure and total cholesterol was also noted in the cases, while for LDL cholesterol improvement tended towards significance (p?=?0.05).Conclusions
We found that oral vitamin D supplementation was associated with improved glycemic control and other metabolic parameters in patients with type 2 diabetes mellitus. Supplementation to achieve normal levels of vitamin D can be a promising adjuvant therapy for T2DM patients & coexisting hypovitaminosis D. 相似文献16.
Jéssica Azevedo Aquino Nayara Ragi Baldoni Cristina Rabelo Flôr Cristina Sanches Cláudia Di Lorenzo Oliveira Geisa Cristina Silva Alves Amaury Lelis Dal Fabbro André Oliveira Baldoni 《Primary Care Diabetes》2018,12(2):97-110
Aims
To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM).Methods
A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used.Results
Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet. Glycemic Hemoglobin (HbA1c) was used to evaluate the effectiveness of the strategies, and 45.4% of the studies also used the Diabetes Empowerment Scale. Five studies (45.5%) showed significant improvements in HbA1c reduction, improvements in self-efficacy (18.2%), knowledge levels of DM (18.2%), quality of life (18.2%). However, after meta-analysis, no statistically significant improvement was found for HbA1c.Conclusion
This systematic review showed that individual strategies for DM empowerment were not effective in reducing HbA1c, despite contributing to improvements in psychosocial parameters. Therefore, individual strategies need to be reviewed so that they become effective in DM control. 相似文献17.
Johanna E.M. Vinken Helen E. Mol Theo J.M. Verheij Sanne van Delft Marion Kolader Miquel B. Ekkelenkamp Guy E.H.M. Rutten Berna D.L. Broekhuizen 《Primary Care Diabetes》2018,12(1):80-86
Aims
To determine if type 2 diabetes mellitus (T2DM) is associated with the spectrum of uropathogens and antimicrobial resistance in urinary tract infections (UTI) in primary care.Methods
A cross-sectional study in female outpatients ≥30 years with positive urine cultures. T2DM patients were 1:1 matched to controls by age group and general practitioner (GP). GPs were sent questionnaires for additional data. Uropathogens and resistance patterns were compared between patients with and without T2DM. Multivariable regression analysis was performed to assess the independent association between T2DM and resistance to first line treatments, defined as resistance to nitrofurantoin, trimethoprim, fosfomycin, ciprofloxacin, amoxicillin/clavulanic acid and/or trimethoprim/sulfamethoxazole.Results
In 566 urine cultures, 680 uropathogens were found. Resistance to first line treatment antibiotics was present in 62.5% of patients. Frequencies and resistance rates of uropathogens did not differ between both groups of patients. Previous UTI and previous hospital admission were independent risk factors for resistance, but T2DM was not.Conclusions
In this study T2DM was not an independent risk factor for antimicrobial resistance in UTI in primary care. Previous UTI and hospitalisation are drivers of resistance and should be included in the decision to perform a urine culture to target first line UTI treatment. 相似文献18.
Alessandra M. Mantovani Cristina E.P.T. Fregonesi Mariana R. Palma Fernanda E. Ribeiro Rômulo A. Fernandes Diego G.D. Christofaro 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2017,11(1):47-50
Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention.
Aim
To evaluate the relationship between amputation and risk factors in people with diabetes mellitus.Materials and method
All participants included in this study (n = 165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007–2014) and all information for this study was extracted from their clinical records.Results
The prevalence of amputation in patients with diabetes with four risk factors was up to 20% higher when compared to those with only one risk factor. The main predictive risk factors for amputation in this population were the presence of an ulcer and smoking.Conclusion
The risk factors for amputation can be predicted for people with diabetes mellitus and, in the present study, the main factors were the presence of an ulcer and the smoking habit. 相似文献19.
20.