Efficacy of different prediabetes program models in improving clinical outcomes in people with prediabetes

AbstractBackground:Educational programs in general seem to have a clinically significant beneficial effect among the T2DM population in terms of improved glycaemic control. However, few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken.Objective:The present study evaluates for the first time, the differences in the effectiveness of the different educational programs [intensive lifestyle modification (Group Education Program, GEP), supervised education through social media (WhatsApp Education Group, WEP) and standard care via PHCCs (Control Group, CG)], among Saudi females with pre-diabetes.Methods:This was a 6-month, multi-center, 3-arm cluster, randomised, controlled (1:1:1), multi-intervention study conducted from July 2018 until March of 2019 in Riyadh, SA. A total of 1140 females from SA were cluster randomised equally to three groups, out of which only 253 [N = 100 GEP, N = 84 WEP and N = 69 CG] received intervention. Participants completed questionnaires including demographic, dietary and physical activity data. Anthropometrics, blood samples and dietary intake were collected at baseline and 6 months. A total of 120 [37 CG (age 50.9 ± 7.1 years; body mass index (BMI) 31.6 ± 5.8kg/m2), 40 GEP (age 42.9 ± 12.2 years; BMI 34.8 ± 9.0kg/m2) and 43 WEP (age 43.7 ± 8.1 years; BMI 30 ± 5.1kg/m2)] participants completed the study.Results:Haemoglobin A1c (HbA1c; primary endpoint) significantly improved in all groups over time, with no difference in between-group comparisons. Between group comparisons adjusted for age revealed a clinically significant reduction in BMI in favour of GEP (p = 0.02) post-intervention. A clinically significant reduction was also observed in favour of GEP in terms of weight (p = 0.003), waist circumference (p = 0.017), systolic and diastolic blood pressure (p-values < 0.01), triglycerides (p < 0.001) and caloric intake (p < 0.005) over time.Conclusion:Prediabetes education programs of 6-month duration, whether delivered through an intensive lifestyle modification, social media or standard care, are equally efficacious in improving HbA1c levels among Saudi women with prediabetes, but intensive lifestyle is superior in terms of weight reduction and over-all cardiometabolic improvement.

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Identification of Education Models to Improve Health Outcomes in Arab Women with Pre-Diabetes

Nutrients ◽

10.3390/nu11051113 ◽

2019 ◽

Vol 11 (5) ◽

pp. 1113 ◽

Cited By ~ 6

Author(s):

Rasha Al-Hamdan ◽

Amanda Avery ◽

Andrew Salter ◽

Dara Al-Disi ◽

Nasser M. Al-Daghri ◽

...

Keyword(s):

Primary Care ◽

Lifestyle Modification ◽

Intervention Group ◽

Density Lipoprotein ◽

Control Group ◽

Haemoglobin A1c ◽

Activity Data ◽

The Impact ◽

Modification Intervention ◽

Group Comparisons

Few evaluations of interventions to delay or prevent type 2 diabetes mellitus (T2DM) in Saudi Arabia (SA) have been undertaken. The present study evaluates the impact of a 6-month intensive lifestyle modification intervention delivered in primary care. Females from SA with prediabetes, aged 18–55 years, were recruited with 190 participants eligible following screening and randomly allocated to receive a 3-month one-on-one, intensive lifestyle modification (intervention group (IG) n = 95) or standard guidance (control group (CG) n = 95). Participants completed questionnaires including demographic, dietary and physical activity data. Blood samples were collected at baseline, 3 and 6 months. A total of 123 (74 IG (age 40.6 ± 9.8 years; body mass index (BMI) 31.2 ± 7.0 kg/m2) and 49 CG (age 40.6 ± 12.7 years; BMI 32.3 ± 5.4 kg/m2)) participants completed the study. After 6 months, haemoglobin A1c (HbA1c; primary endpoint) significantly improved in the IG than CG completers in between-group comparisons (p < 0.001). Comparison between groups showed significant improvements in overall energy intake, total and high density lipoprotein (HDL)-cholesterol in favour of IG (p-values < 0.001, 0.04 and <0.001, respectively). BMI and weight change were not clinically significant in between group comparisons. A 6-month, intense one-on-one intervention in lifestyle modification significantly improves glycaemic and cardio metabolic profile of females living in SA with pre-diabetes delivered in a primary care setting. Longer duration studies, using the same intervention, may determine whether a meaningful weight loss secondary to improved diet can be achieved.

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Quality of Life in Long-Term Breast Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2012.48.1903 ◽

2013 ◽

Vol 31 (28) ◽

pp. 3540-3548 ◽

Cited By ~ 62

Author(s):

Tina Hsu ◽

Marguerite Ennis ◽

Nicky Hood ◽

Margaret Graham ◽

Pamela J. Goodwin

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Cancer Survivors ◽

Distant Recurrence ◽

Longitudinal Change ◽

Control Group ◽

Clinically Significant ◽

Over Time

Purpose There is considerable interest in the quality of life (QOL) of long-term breast cancer (BC) survivors. We studied changes in QOL from time of BC diagnosis to long-term survivorship and compared QOL in long-term survivors to that of age-matched women with no history of BC. Patients and Methods In all, 535 women with localized BC (T1-3N0-1M0) were recruited from 1989 to 1996 and followed prospectively, completing QOL questionnaires at diagnosis and 1 year postdiagnosis. Between 2005 and 2007, those alive without distant recurrence were recontacted to participate in a long-term follow-up (LTFU) study. A control group was recruited from women presenting for screening mammograms, and both groups completed LTFU QOL questionnaires. Longitudinal change in BC survivors and differences between BC survivors and controls were assessed in eight broad categories with clinically significant differences set at 5% and 10% of the breadth of each QOL scale. Results A total of 285 patients with BC were included in the study, on average 12.5 years postdiagnosis. Longitudinally, clinically significant improvements were observed in overall QOL by 1 year postdiagnosis with further improvements by LTFU. Some clinically significant improvements over time were seen in all categories. A total of 167 controls were recruited. Deficits were observed in self-reported cognitive functioning (5.3% difference) and financial impact (6.3% difference) in BC survivors at LTFU compared with controls. Conclusion Long-term BC survivors show improvement in many domains of QOL over time, and they appear to have similar QOL in most respects to age-matched noncancer controls, although small deficits in cognition and finances were identified.

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Slow-Stroke Back Massage Compared With Music Therapy for Leukemia-Related Pain and Fatigue: A Randomized Controlled Trial

JCO Oncology Practice ◽

10.1200/op.21.00156 ◽

2021 ◽

pp. OP.21.00156

Author(s):

Mojtaba Miladinia ◽

Joachim G. Voss ◽

Shahram Molavynejad ◽

Amal Saki Malehi ◽

Kourosh Zarea ◽

...

Keyword(s):

Acute Leukemia ◽

Music Therapy ◽

Standard Care ◽

Rating Scales ◽

Controlled Trial ◽

Adult Patients ◽

Self Report ◽

Care Group ◽

Control Group ◽

Over Time

PURPOSE: Comparison of two safe complementary medicine methods to treat cancer-related pain and fatigue in adult patients with acute leukemia during active treatment with chemotherapy. METHODS: A randomized trial with three groups (light massage, music therapy, and standard care) in Ahvaz, Iran, between 2018 and 2019. A total of 104 participants of the massage and music therapy groups received 15-minute intervention sessions, thrice weekly for 4 weeks, and participants of the control group received standard care. Cancer-related pain and fatigue intensity were measured by numeric self-report rating scales. During the 4 weeks of the interventions, pain and fatigue intensity were measured weekly. All the groups were followed up for 2 weeks after the end of the intervention. RESULTS: Pain and fatigue intensity decreased significantly over time between the intervention groups compared with the standard care group. In the massage and music therapy groups, a progressive reduction of pain and fatigue intensity over time (from the baseline to the fourth week) was observed. Fatigue intensity did not differ between the two intervention groups. Pain intensity decreased more in the massage group compared with the music therapy group. The durable effects of the massage therapy were greater compared with the music therapy 2 weeks after the intervention was completed. CONCLUSION: Light massage was more effective and persisted longer than the music therapy for controlling leukemia-related pain and fatigue in adult patients with acute leukemia.

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Scalable solution for delivery of diabetes self-management education in Thailand (DSME-T): a cluster randomised trial study protocol

BMJ Open ◽

10.1136/bmjopen-2020-036963 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036963

Author(s):

Chaisiri Angkurawaranon ◽

Iliatha Papachristou Nadal ◽

Poppy Alice Carson Mallinson ◽

Kanokporn Pinyopornpanish ◽

Orawan Quansri ◽

...

Keyword(s):

Primary Care ◽

Cardiovascular Risk ◽

Low Income ◽

Standard Care ◽

Management Education ◽

Randomised Trial ◽

Self Management ◽

Haemoglobin A1c ◽

Culturally Tailored ◽

Cluster Randomised

IntroductionType 2 diabetes mellitus is among the foremost health challenges facing policy makers in Thailand as its prevalence has more than tripled over the last two decades, accounting for considerable death, disability and healthcare expenditure. Diabetes self-management education (DSME) programmes show promise in improving diabetes outcomes, but this is not routinely used in Thailand. This study aims to test a culturally tailored DSME model in Thailand, using a three-arm cluster randomised controlled trial comparing a nurse-led model, a peer-assisted model and standard care. We will test which model is effective and cost effective to improve cardiovascular risk and control of blood glucose among people with diabetes.Methods and analysis21 primary care units in northern Thailand will be randomised to one of three interventions, enrolling a total of 693 patients. The primary care units will be randomised (1:1:1) to participate in a culturally-tailored DSME intervention for 12 months. The three-arm trial design will compare effectiveness of nurse-led, peer-assisted (Thai village health volunteers) and standard care. The primary trial outcomes are changes in haemoglobin A1c and cardiovascular risk score. A process evaluation and cost effectiveness evaluation will be conducted to produce policy relevant guidance for the Thai Ministry of Public Health. The planned trial period will start in January 2020 and finish October 2021.Ethics and disseminationEthical approval has been obtained from Thailand and the UK. We will share our study data with other researchers, advertising via our publications and web presence. In particular, we are committed to sharing our findings and data with academic audiences in Thailand and other low-income and middle-income countries.Trial registration numberNCT03938233.

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Prevalence of drug-drug interactions in older people before and after hospital admission: analysis from the OPERAM trial

BMC Geriatrics ◽

10.1186/s12877-021-02532-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lorène Zerah ◽

Séverine Henrard ◽

Ingeborg Wilting ◽

Denis O’Mahony ◽

Nicolas Rodondi ◽

...

Keyword(s):

Older People ◽

Hospital Admission ◽

Drug Interactions ◽

Medication Review ◽

Hospital Admissions ◽

Point Prevalence ◽

Control Group ◽

Clinically Significant ◽

Potentially Clinically Significant ◽

Over Time

Abstract (N = 351) Background Drug-drug interactions (DDIs) are highly prevalent in older patients but little is known about prevalence of DDIs over time. Our main objective was to assess changes in the prevalence and characteristics of drug-drug interactions (DDIs) during a one-year period after hospital admission in older people, and associated risk factors. Methods We conducted a sub-study of the European OPERAM trial (OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people), which assessed the effects of a structured medication review (experimental arm) compared to usual care (control arm) on reducing drug-related hospital readmissions. All OPERAM patients (≥70 years, with multimorbidity and polypharmacy, hospitalized in four centers in Bern, Brussels, Cork and Utrecht between December 2016 and October 2018, followed over 1 year) who were alive at hospital discharge and had full medication data during the index hospitalization (at baseline i.e., enrolment at admission, and at discharge) were included. DDIs were assessed using an international consensus list of potentially clinically significant DDIs in older people. The point-prevalence of DDIs was evaluated at baseline, discharge, and at 2, 6 and 12 months after hospitalization. Logistic regression models were performed to assess independent variables associated with changes in DDIs 2 months after baseline. Results Of the 1950 patients (median age 79 years) included, 1045 (54%) had at least one potentially clinically significant DDI at baseline; point-prevalence rates were 58, 57, 56 and 57% at discharge, and 2, 6 and 12 months, respectively. The prevalence increased significantly from baseline to discharge (P < .001 [significant only in the control group]), then remained stable over time (P for trend .31). The five most common DDIs –all pharmacodynamic in nature– accounted for 80% of all DDIs and involved drugs that affect potassium concentrations, centrally-acting drugs and antithrombotics. At 2 months, DDIs had increased in 459 (27%) patients and decreased in 331 (19%). The main factor predictive of a change in the prevalence of DDIs was hyperpolypharmacy (≥10 medications). Conclusions DDIs were very common; their prevalence increased during hospitalization and tended to remain stable thereafter. Medication review may help control this increase and minimize the risk of adverse drug events.

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Social Media Use and Students’ Health-Lifestyle Modification in University of Calabar, Nigeria

European Journal of Interdisciplinary Studies ◽

10.26417/ejis.v5i1.p47-54 ◽

2019 ◽

Vol 5 (1) ◽

pp. 47

Author(s):

Ntongha Eni Ikpi ◽

Veronica Akwenabuaye Undelikwo

Keyword(s):

Social Media ◽

Undergraduate Students ◽

Lifestyle Modification ◽

Media Use ◽

Survey Design ◽

Health Sector ◽

Positive Health ◽

Social Media Use ◽

Health Lifestyle ◽

Use Of Social Media

The use of social media platforms has over the years become a veritable tool for individuals, groups, institutions and corporate bodies for the promotion of health and wellness. In recent times, social media has become one of the most potent agents of the media through which health issues are addressed as well as generated and disseminated to different populations in society. The study was conducted to examine social media use and students’ health lifestyle modification in the University of Calabar, Nigeria. It sought to determine the extent to which students’ use of social media (Facebook, Twitter, and WhatsApp) influences the modification of their health-related lifestyles such as eating habits, sexual behaviour, cigarette and alcohol consumption, drug use and the engagement in fitness activities. The study adopted a randomized descriptive survey design and used a sample of 300 undergraduate students. The questionnaire was the main instrument used for collection of data while simple percentages and means were used to determine the difference between the expected mean of 2.50 and the observed means across various items in the questionnaire. The results showed that apart from Twitter, social media use by University of Calabar students has significantly influenced the modification of their health lifestyles. Since social media has become a veritable tool for the promotion of positive health lifestyle, effort should be made by government through the health sector to create more awareness among students and the entire population of social media users, on the health benefits accruing from use of social media.

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Role of Nutrition Counseling and Lifestyle Modification in Managing Prediabetes

Food and Nutrition Bulletin ◽

10.1177/03795721211025434 ◽

2021 ◽

pp. 037957212110254

Author(s):

Harleen Kaur ◽

Neerja Singla ◽

Rohini Jain

Keyword(s):

Hemoglobin A1c ◽

Lifestyle Modification ◽

Fasting Blood Glucose ◽

Nutrition Intervention ◽

Control Group ◽

Population Prevalence ◽

Significant Difference ◽

And Control ◽

Experimental Group

Objective: India is the second country after China having the highest population prevalence of diabetes. Several research studies investigating diabetes have been done, but not much work has been done on prediabetes. The purpose of this study was to investigate the effect of nutrition and lifestyle modification on prediabetic females. Methods: A total of 120 prediabetic females from Ludhiana city were divided into 2 matched groups: control group (n = 60) and experimental group (n = 60). Impact of nutrition intervention for dietary and lifestyle modification (for 3 months) was assessed on the anthropometric, dietary, biochemical parameters, and diabetes risk score of the experimental group and control group (no intervention). Results: All the selected 120 subjects completed the study (experimental group = 60; control group = 60). There was significant difference in the changes between the 2 groups throughout the study. The fasting blood glucose and glycated hemoglobin A1c levels of the experimental group subjects reduced significantly ( P ≤ .01). However, no change was observed among the control group subjects. The lipid profile of the experimental group showed a significant improvement ( P ≤ .01). Conclusion: Nutrition counselling of the prediabetics regarding dietary and lifestyle modification is recommended so as to improve their metabolic control, thus preventing them from being diabetics.

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Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum

International Journal of Obesity ◽

10.1038/s41366-021-00835-0 ◽

2021 ◽

Author(s):

Sharon A. Simpson ◽

Elinor Coulman ◽

Dunla Gallagher ◽

Karen Jewell ◽

David Cohen ◽

...

Keyword(s):

Weight Management ◽

Healthy Eating ◽

Primary Outcome ◽

Intervention Group ◽

Control Group ◽

Risky Drinking ◽

Management Intervention ◽

Cluster Randomised ◽

Secondary Outcomes ◽

Weight Management Intervention

Abstract Objective To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth. Methods Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m2 (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined. Interventions Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy. Results Mean (SD) BMI at 12 months postpartum was 36.0 kg/m2 (5.2) in the control group, and 37.5 kg/m2 (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was −0.02 (95% CI −0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds. Conclusions There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking. Trial registration: Current Controlled Trials ISRCTN25260464.

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Salmonella Bacterin Vaccination Decreases Shedding and Colonization of Salmonella Typhimurium in Pigs

Microorganisms ◽

10.3390/microorganisms9061163 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1163

Author(s):

Eduarda Alexandra Gonçalves de Oliveira Moura ◽

Daniela Gomes da Silva ◽

Caio Henrique Turco ◽

Thainara Vitoria Carnevalli Sanches ◽

Gabriel Yuri Storino ◽

...

Keyword(s):

Salmonella Typhimurium ◽

Blood Count ◽

Control Strategies ◽

Control Group ◽

Blood Samples ◽

Commercial Vaccine ◽

Serum Igg ◽

And Control ◽

Experimental Group ◽

Over Time

Since the occurrence of swine salmonellosis has increased over time and control strategies other than biosecurity are highly recommended, the present study aimed to evaluate the efficacy of vaccination with Salmonella Choleraesuis and Salmonella Typhimurium bacterins in pigs. Two experimental groups were formed: G1, animals immunized with two doses of a commercial vaccine (n = 20); G2, control group (n = 20). After vaccination, all pigs were orally challenged (D0) with 108 CFU of Salmonella Typhimurium and evaluated for 40 days. Every 10 days after D0, five piglets from each experimental group were euthanized and submitted to the necroscopic examination, when organ samples were collected. Blood samples and rectal swabs were collected before the first dose of the vaccine (D−42), before the second dose (D−21), before the challenge (D0), and thereafter, every three days until D39. Blood count, serum IgG measurement by ELISA, and the excretion of Salmonella Typhimurium in feces were evaluated. While the results from blood count and serum IgG concentration did not differ, the detection and excretion of Salmonella between G1 and G2 differed (p < 0.05). Therefore, it was observed that this vaccine partially protected the animals against experimental infection with Salmonella Typhimurium, reducing the excretion of bacteria in feces.

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Patterns of anxiety and distress over 12 months following participation in HPV primary screening

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054780 ◽

2021 ◽

pp. sextrans-2020-054780

Author(s):

Laura A V Marlow ◽

Emily McBride ◽

Deborah Ridout ◽

Alice S Forster ◽

Henry Kitchener ◽

...

Keyword(s):

Positive Result ◽

Short Form ◽

Cervical Screening ◽

General Health Questionnaire ◽

Psychological Impact ◽

Control Group ◽

Abnormal Cytology ◽

Normal Cytology ◽

Time Specific ◽

Over Time

ObjectivesMany countries are now using primary human papillomavirus (HPV) testing for cervical screening, testing for high-risk HPV and using cytology as triage. An HPV-positive result can have an adverse psychological impact, at least in the short term. In this paper, we explore the psychological impact of primary HPV screening over 12 months.MethodsWomen were surveyed soon after receiving their results (n=1133) and 6 (n=762) and 12 months (n=537) later. Primary outcomes were anxiety (Short-Form State Anxiety Inventory-6) and distress (General Health Questionnaire-12). Secondary outcomes included concern, worry about cervical cancer and reassurance. Mixed-effects regression models were used to explore differences at each time point and change over time across four groups according to their baseline result: control (HPV negative/HPV cleared/normal cytology and not tested for HPV); HPV positive with normal cytology; HPV positive with abnormal cytology; and HPV persistent (ie, second consecutive HPV-positive result).ResultsWomen who were HPV positive with abnormal cytology had the highest anxiety scores at baseline (mean=42.2, SD: 15.0), but this had declined by 12 months (mean=37.0, SD: 11.7) and was closer to being within the ‘normal’ range (scores between 34 and 36 are considered ‘normal’). This group also had the highest distress at baseline (mean=3.3, SD: 3.8, scores of 3+ indicate case-level distress), but the lowest distress at 12 months (mean=1.9, SD: 3.1). At 6 and 12 months, there were no between-group differences in anxiety or distress for any HPV-positive result group when compared with the control group. The control group were less concerned and more reassured about their result at 6 and 12 months than the HPV-positive with normal cytology group.ConclusionsOur findings suggest the initial adverse impact of an HPV-positive screening result on anxiety and distress diminishes over time. Specific concerns about the result may be longer lasting and efforts should be made to address them.

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