Clinical Implications of Anxiety in Diabetes: A Critical Review of the Evidence Base

Introduction:Substantial literature supports clinically important associations between anxiety and chronic medical conditions. Diabetes is among the most psychologically and behaviorally demanding chronic medical illnesses. Anxiety has been associated with poor glycemic control, regimen adherence, and with accelerated rates of coronary heart disease in diabetic patients.Aim:The aim of this study is to provide an overview of the role of clinically significant anxiety in patients with diabetes mellitus.Methods:MEDLINE, EMBASE and PSYCINFO databases were searched using the combined search terms diabetes, diabetes mellitus, anxiety symptoms and anxiety disorders. Published reference lists were also examined. In total 25 studies were identified that fulfilled the inclusion criteria.Results:Anxiety was present in 41.7% of diabetic patients. There was no significant difference between those with Types 1 and types 2 diabetes. The rate of elevated symptoms was significantly higher in diabetic women than in diabetic men. General anxiety disorder was the most prevalent of the clinical disorders and was found in 13.2% of the diabetic patients. The rates of the other anxiety disorders were within the range of those reported in community studies. Treatment of anxiety was associated with improved glycemic control, particularly in the subgroup of patients with severe anxiety.Conclusions:Emerging data offer a strong argument for the role of anxiety in diabetes. Psychological interventions and/ or pharmacological treatments in patients with diabetes are needed, in order to increase treatment adherence and control of the disease and improve patients’ functioning and quality of life.

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A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n9p98 ◽

2019 ◽

Vol 9 (9) ◽

pp. 98 ◽

Cited By ~ 1

Author(s):

Kisokanth G. ◽

Indrakumar J. ◽

Prathapan S. ◽

Joseph J. ◽

Ilankoon I.M.P.S.

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Management Education ◽

Self Management ◽

Rank Test ◽

Diabetic Patients ◽

Effective Measure ◽

Before And After ◽

Patients With Diabetes ◽

Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

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The Prevalence of Giardia Intestinalis in Dyspeptic and Diabetic Patients

ISRN Gastroenterology ◽

10.5402/2011/580793 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Gözde Derviş Hakim ◽

Şafak Kızıltaş ◽

Hilmi Çiftçi ◽

Şafak Göktaş ◽

İlyas Tuncer

Keyword(s):

Diabetes Mellitus ◽

Giardia Intestinalis ◽

Diabetic Patients ◽

Elisa Method ◽

Number Of Patients ◽

Significant Difference ◽

Patients With Diabetes ◽

Stool Specimens ◽

Positive Results ◽

Healthy Persons

Background and Aims. We aimed to investigate the prevalence of Giardiasis in patients with dyspepsia and patients with diabetes mellitus. Methods. 400 patients and 100 healthy persons were included in this clinical prospective study. The number of patients in each group was equal, 200 dyspeptic and 200 diabetic, respectively. The antigen of G. lntestinalis was determined in the stool specimens by ELISA method. Results. The frequency of Giardiasis was 7% in dyspeptic and 15% in diabetic patients. There was no positive results in any of the healthy persons. There was a significant difference in prevalence rate of Giardiasis between patients with dyspepsia and diabetes mellitus (P<0.05). Conclusions. These results revealed that the prevalence of Giardiasis in dyspepsia and with diabetes mellitus was high in our country. This is the first study investigating the prevalence of Giardiasis in diabetic patients. To investigate Giardiasis in diabetic patients, who have dyspepsia or not, may be a good approach for public health.

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PREVALENCE OF NEPHROPATHY AND ITS PARAMETERS IN PATIENTS WITH DIABETES MELLITUS- A PROSPECTIVE STUDY IN A CENTRAL INDIAN POPULATION

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v5i1.749 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Suresh Kumar Sethi ◽

Rajesh Kumar

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Diabetic Nephropathy ◽

Serum Creatinine ◽

Diabetic Patients ◽

Early Screening ◽

Patients With Diabetes ◽

Mdrd Formula ◽

A Prospective Study

Background: Hyperglycemia is an important risk factor for the development of diabetic nephropathy. In the initial stages ie micro albuminuria the DKD is clinically detectable and can even be reversed. Hence early screening of diabetic patients is important. Hence the aim of this study was to evaluate the prevalence of nephropathy in a cross section of diabetic patients. Objectives: The Aim of our study was to evaluate the prevalence of nephropathy in recently detected diabetic patients by evaluating microalbuminuria, serum creatinine and creatinine clearance. Methods: A total of 120 patients above 18 years were included in the study and were divided into three groups according to age and were further divided into three groups as per the duration of diseases Patients were again divided into two groups according to the gender. The GFR was calculated as per the MDRD formula and the patients were divided further as per the stage of CKD. Serum Creatinine levels were calculated and the variables associated with CKD were adjusted by Logistic Regression. Results: Our results suggests that 41.25% of subjects were in mild to severe nephropathy out of which 16.25 % were within the three years of diagnosis, thus suggesting the role of early and routine investigation in diabetic patients. Conclusion: Hence the role of life style is clearly emphasized by our results. Although when the variables were adjusted with the logistic regression the occupation was not that significant. Keywords: Albuminuria, Diabetes mellitus (DM), Diabetic Kidney Disease (DKD), Diabetic nephropathy (DN), Serum Creatinine.

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PREVALENCE OF NEPHROPATHY AND ITS PARAMETERS IN PATIENTS WITH DIABETES MELLITUS- A PROSPECTIVE STUDY IN A CENTRAL INDIAN POPULATION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i1.1672 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Suresh Kumar Sethi ◽

Rajesh Kumar

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Diabetic Nephropathy ◽

Serum Creatinine ◽

Diabetic Patients ◽

Early Screening ◽

Patients With Diabetes ◽

Mdrd Formula ◽

A Prospective Study

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Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s118437 ◽

2017 ◽

Vol Volume 10 ◽

pp. 13-17 ◽

Cited By ~ 1

Author(s):

Elizabeth M Lamos ◽

Marniker Wijesinha ◽

Seba Ramhmdani ◽

Laurence S Magder ◽

Kristi D Silver

Keyword(s):

Diabetes Mellitus ◽

Renal Transplantation ◽

Glycemic Control ◽

Patients With Diabetes

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Teleconsultation for pediatric patients with type 1 diabetes mellitus during the COVID-19 pandemic: experience of a university hospital in Brazil

10.21203/rs.3.rs-603528/v1 ◽

2021 ◽

Author(s):

Yasmin Eugênia Santana ◽

Thais Milioni Luciano ◽

Ana Carolina Maia Teodózio ◽

Amanda Maria Barradas Monteiro Santana ◽

Letícia Rodrigues Ramos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Admission Rate ◽

University Hospital ◽

Diabetic Patients ◽

Hospital Admission Rate ◽

Patients With Diabetes ◽

Reference Hospital ◽

Control And Prevention ◽

The Impact

Abstract Introduction: The SARS-CoV-2 pandemic expanded rapidly around the world in 2020 and health services needed to be reconfigured to meet the new demand and ensure the care of patients with chronic diseases. For patients with diabetes mellitus, the teleconsultation stood out as a tool for clinical management in this period. Objective: Evaluate the impact of teleconsultation on glycemic control and prevention of acute complications related to diabetes mellitus in children and adolescents treated in a reference hospital during the COVID-19 pandemic in 2020. Method: Descriptive study of data from pediatric diabetic patients who received teleconsultation between April and September 2020. Results: During this period, 143 diabetic patients were evaluated, with a median of 3.4 teleconsultations per patient in the studied period; requiring adjustment of insulin doses in 84.6% of cases. The hospital admission rate was 8,4% due to diabetic decompensation. The metabolic control (HbA1c) became worsen in 46% of the sample and improved in 37%. Conclusion: The teleconsultation promoted health care for patients with diabetes mellitus during the COVID-19 pandemic, but was not able to guarantee adequate glycemic control.

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STUDY ON LEVEL OF ANTI GAD AND ICA AUTOANTIBODIES IN PATIENTSWITH DIABETES MELLITUS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2015.6.12 ◽

2016 ◽

pp. 78-85

Author(s):

Thi Minh Phuong Phan ◽

Dinh Thanh Truong

Keyword(s):

Diabetes Mellitus ◽

Statistical Significance ◽

Enzyme Linked Immunosorbent Assay ◽

Acid Decarboxylase ◽

Diabetic Patients ◽

Significant Difference ◽

Patients With Diabetes ◽

Positive Rate ◽

The Difference ◽

The One

Background: Autoantibodies anti GAD and ICA associated to the autoimmune process of patients with diabetes. Detection of these antibodies in progessive diabeticpatients is very necessary because the presence of anti GAD and ICA can predict the progression of the disease to insulin-dependent diabetes in the future. This study was carried out with aims: (1) to define the positive rate, anti GAD and ICA level in patients with diabetes. (2) to evaluate the correlation between anti GAD and ICA with several clinical and paraclinical features of diabetic patients. Materials and method: 88 patients diagnosed of diabetes by the criteria of ADA 2014, withfasting glucose ≥ 126 mg/dL or≥ 7,0 mmol/L) and HbA1C> 6.5%. Indirect enzyme linked immunosorbent assay (ELISA) was used to measure those autoantibodies of anti GAD and ICA, kits were supplied by DRG company, Germany. Results: the anti GAD positive rate was 10.2%; mean of level of anti GAD was 1.44±0.25 U/mL. ICA positive ratewas 9.1%; mean of level of ICA was 1.44±0.12 U/mL. Positive rate with anti GAD and/or ICA was 19.3%. About the correlation between level of anti GAD, ICA with some of clinical features, we found only the statistically significant difference with p<0.05 between blur vision in the group of ICA level > 1.25U/mL with group of ICA level< 1.25U/mL. About the paraclinical features, the difference with statistical significance (p<0.05) of HbA1C>6.5% was found between the group with anti GAD> 1.05U/mLand the one with anti GAD< 1.00U/mLand also betweenthe group of ICA > 1.25 U/mL and ICA < 1.25 U/mL. Key words: autoantibody anti glutamic acid decarboxylase, islet cell autoantibodies, diabetes mellitus.

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Study of TSH level at the time of diagnosis of Hypothyroidism in patients with Diabetes Mellitus- A Retrospective Study

Journal of Diabetes and Endocrine Association of Nepal ◽

10.3126/jdean.v4i2.34592 ◽

2020 ◽

Vol 4 (2) ◽

pp. 24-28

Author(s):

Indu K.C. ◽

S Ghimire ◽

R Deo

Keyword(s):

Diabetes Mellitus ◽

Diabetic Kidney Disease ◽

P Value ◽

Diabetic Patients ◽

Significant Difference ◽

Other Information ◽

Patients With Diabetes ◽

History Of ◽

The Mean ◽

The Difference

Background: To evaluate the difference in the level of TSH in diabetic and non diabetic patients at the time of the diagnosis of hypothyroidism. Methods: 100 diagnosed cases of hypothyroidism, 50 with diabetes and 50 without diabetes were studied. The level of TSH at the time of diagnosis and other information were obtained from the medical records. Results: The mean TSH in patients with the history of diabetes at the diagnosis of hypothyroidism was 19.9616±26.990 and in those without the history of the diabetes was 10.4797±6.503 (p value 0.018). The females with diabetes had higher level of TSH level at the time of diagnosis of hypothyroidism than females without diabetes (p value 0.045). There was no statistically significant difference in the level of TSH in males with and without diabetes at the time of diagnosis of hypothyroidism. Conclusion: Patients with diabetes mellitus had higher level of TSH at the time of diagnosis of hypothyroidism in comparison to those without diabetes. Early identification of the raised TSH levels in diabetic patients and timely intervention will help to reduce the chances of adverse cardiovascular outcomes and diabetic kidney disease in this group of patients.

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Patients With Type 2 Diabetes: Anesthetic Management in the Ambulatory Setting. Part 1: Pathophysiology and Associated Disease States

Anesthesia Progress ◽

10.2344/0003-3006-63.4.208 ◽

2016 ◽

Vol 63 (4) ◽

pp. 208-215 ◽

Cited By ~ 2

Author(s):

Bryant W. Cornelius

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Anesthetic Management ◽

Multiple Organ ◽

Ambulatory Setting ◽

Diabetic Patients ◽

Ambulatory Anesthesia ◽

Disease States ◽

Organ Systems ◽

Patients With Diabetes

The increasing prevalence of diabetes mellitus in the general population has many implications for the ambulatory anesthesia provider. Complications, particularly associated with poor glycemic control, can affect multiple organ systems and jeopardize the safety of any planned anesthetic. It is essential that anesthesiologists and sedation providers have in-depth knowledge of the pathophysiology of diabetes mellitus and the comorbid conditions that commonly accompany it. Anesthesiologists and sedation providers must also understand certain surgical and anesthetic considerations when planning an effective and safe anesthetic for diabetic patients. This is a 2-part series concerning perioperative glycemic control for patients with diabetes mellitus. Part 1 will focus on the physiology of diabetes and its associated disease states. Part 2 will address the pharmacology associated with the wide variety of medications used to treat the disorder and the most recent guidelines for blood glucose management in ambulatory surgical patients.

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Atrial Fibrillation and Diabetes Mellitus: the Control of Thromboembolic Risk

Kardiologiia ◽

10.18087/cardio.2020.7.n1146 ◽

2020 ◽

Vol 60 (7) ◽

pp. 108-114

Author(s):

A. G. Obrezan ◽

N. V. Kulikov

Keyword(s):

Diabetes Mellitus ◽

Atrial Fibrillation ◽

Meta Analysis ◽

Oral Anticoagulants ◽

Factor Xa ◽

Diabetic Patients ◽

Thromboembolic Risk ◽

Patients With Diabetes ◽

Meta Analyses

Atrial fibrillation is one of the most common concomitant diseases in patients with diabetes mellitus (DM). Meta-analyses of multiple studies have shown that the risk of AF is higher for diabetic patients with impaired glucose homeostasis than for patients without DM. Patients with AF and DM were younger, more frequently had arterial hypertension, chronic kidney disease, heart failure, and ischemic heart disease, and stroke and were characterized with a more severe course of AF. The article discusses possible mechanisms of the mutually aggravating effects of DM and AF, scales for evaluating the risk of bleeding (CHADS2, CHA2DS2‑VASc, HAS-BLED), and the role of anticoagulants. A meta-analysis of 16 randomized clinical studies, including 9 874 patients, has demonstrated the efficacy of oral anticoagulants in prevention of stroke with an overall decrease in the relative risk by 62 % compared to placebo (95% confidence interval, from 48 to 72 ). For prevention of complications in patients with AF and DM, current antithrombotic therapies can be used, specifically the oral factor Xa inhibitor, rivaroxaban, which is the best studied in patients with AF and DM and represents a possible alternative to warfarin in such patients.

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