Self-Reported Depressive Symptoms Might be Associated with Sudomotor Dysfunction in Chinese T2DM Patients

2019 ◽  
Author(s):  
Lijin Ji ◽  
Yuanpin Zhang ◽  
Qi Zhang ◽  
Hangping Zheng ◽  
Wanwan Sun ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Hba1c Level ◽  
Point Of Care ◽  
Community Health Center ◽  
Laboratory Data ◽  
Patient Health ◽  
Michigan Neuropathy Screening Instrument ◽  
The Mean ◽  
Hands And Feet

Abstract Aims To determine the relationships of sudomotor functions, nerve conductions and self-reported depressive symptoms in Chinese type 2 diabetes (T2DM) patients. Methods T2DM patients in a single community health center were included in this study. Demographic, medical and laboratory data were collected. Michigan Neuropathy Screening Instrument (MNSI) examination was conducted in all patients. SUDOSCAN test and Point-of-care Nerve Conduction Device (DPN-check) were conducted and all the patients finished the Patient Health Questionnaire-9 (PHQ-9). Results A total of 162 T2DM patients (74 males and 88 females) were included. The mean age was 69.0±7.2 years and the mean course of diabetes was 10.5±8.0 years with a mean HbA1c level of 7.3±1.4%. Thirty of them (18.5%) had self-reported depressive symptoms (PHQ-9 scores≥5). Diabetic peripheral neuropathy (DPN) was diagnosed according to the MSNI examination in 74 patients. Electrochemical skin conductance (ESC) values of both hands and feet were significantly lower in patients with depressive symptoms (Hands ESC: 60.63±18.92 vs. 67.64±16.02 μS, p<0.05; Feet ESC: 59.60 ± 15.19 vs. 66.19±14.99 μS, p<0.05). The proportion of patients with moderate to severe depressive symptoms were significantly higher in those with ESC values<60 μS (13.33% vs. 3.846%, p<0.05). Hands ESC values were negatively related to PHQ-9 scores (r =− 0.168, p<0.05). After adjusting for variables, hands and feet ESC values remained negatively related with depressive symptoms (β =− 0.036 and−0.038, p<0.05). Female were positively related to depressive symptoms with odds ratio 3.4 (95%CI 1.1–10.5, p<0.05). Conclusion Self-reported depressive symptoms might be associated with sudomotor dysfunction in Chinese T2DM patients.

Depression Symptoms in Patients with Diabetic Peripheral Neuropathy

2020 ◽  
Vol 16 (1) ◽  
pp. 35-40
Author(s):  
Rahab Marhoon Alghafri ◽  
Alfred Gatt ◽  
Cynthia Formosa
Keyword(s):  
Depressive Symptoms ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Neurological Complications ◽  
Depression Symptoms ◽  
Low Mood ◽  
Patients With Diabetes ◽  
Patient Health ◽  
The Mean

AIM: The study aimed to investigate the possible relationship between diabetic peripheral neuropathy (DPN) and the development of depressive symptoms in patients with type 2 diabetes mellitus (T2D). METHODS: A comparative nonexperimental study was conducted. Ninety-five T2D individuals aged 65 years and more were recruited. The sample was divided into two groups: 50 participants with T2D and without DPN and 45 participants with T2D and DPN. The Patient Health Questionnaire 9 (PHQ-9) was used to collect information about low mood and depression symptoms in the subjects recruited. RESULTS: Participants with DPN recorded higher scores on PHQ-9 than those with T2D only. The mean PHQ-9 score for the DPN group (6.09) was significantly higher than that for the T2D only group (2.24) (p < 0.001). Participants with DPN were more likely to have mild to moderate or moderately severe low mood and depression symptoms than T2D only participants who exhibited minimal to no low mood and depressive symptoms. CONCLUSIONS: The association between DPN and depression is confirmed by this study, with significant depressive symptoms found in patients with neuropathy when compared to diabetes patients with no neurological complications. It is therefore important that discomfort and emotional problems caused by DPN should be taken seriously and addressed closely in the management of DPN in order to prevent depression. Also, a change in screening practices to identify patients with diabetes and depressive symptoms is required.

scholarly journals The relation of anatomical distribution of symptomatic peripheral arterial disease (PAD) with HbA1c level in patients with type 2 diabetes mellitus

2021 ◽  
Vol 12 ◽  
pp. 204201882110005
Author(s):  
Nawaf J. Shatnawi ◽  
Nabil A. Al-Zoubi ◽  
Hassan M. Hawamdeh ◽  
Yousef S. Khader ◽  
Mowafeq Heis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Hba1c Level ◽  
Arterial Disease ◽  
Anatomical Distribution ◽  
The Mean ◽  
Peripheral Arterial

Aims: Increased level of glycated hemoglobin (HbA1c) is associated with an increased prevalence of peripheral arterial disease (PAD). This study aimed to assess the relationship between the anatomical distribution of symptomatic PAD lesions in patients with type 2 diabetes and HbA1c levels at the time of PAD diagnosis. Patients and methods: A retrospective study was conducted at King Abdullah University Hospital during the period August 2011 to December 2015. Consecutive patients with type 2 diabetes presented with symptomatic PAD confirmed by computed tomography-angiography (CTA) were included in this study. CTA images were reviewed. Relevant information including demographic data, PAD symptoms, comorbidities, HbA1c level, lipid profile, C-reactive protein and the mean platelets volume were retrieved from medical records. Results: A total of 332 patients with type 2 diabetes (255 males and 77 females) were included in this study. The mean HbA1c at the time of PAD diagnosis was 8.68% (±2.06%). The prevalence of hemodynamic relevant atherosclerotic lesions of the superficial femoral artery, popliteal artery, leg vessels, femoro-popliteal, and crural segments was significantly higher in patients with HbA1c >7.5% compared with patients with HbA1c ⩽7.5%. Conclusion: The anatomical distribution of symptomatic PAD in patients with type 2 diabetes mellitus differed significantly according to HbA1c level at the time of PAD diagnosis.

Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study

2020 ◽  
Vol 20 (7) ◽  
pp. 1090-1096
Author(s):  
Yusuf Bozkuş ◽  
Umut Mousa ◽  
Özlem T. İyidir ◽  
Nazlı Kırnap ◽  
Canan Ç. Demir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Intervention Group ◽  
Control Group ◽  
Metformin Monotherapy ◽  
The Mean ◽  
Hba1c Levels

Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3±14.4 pmol/L to 87.4±43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3±0.7% vs. 6.4±0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9±12.6 vs. 95.5±52.5, p=0.026), but the HbA1c levels did not change (6.0±0.4 % vs. 5.9±0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 ± 26.7 vs. 36.1 ±23.3, p=0.367), but there was an increase in HbA1c levels (6.1 ± 0.50 vs. 6.4 ± 0.60, p=0.01). Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.

The effectiveness and safety of the supplementation of therapy with oral hypoglycemic agents by basal insulin in the patients with type 2 diabetes mellitus. Results of the SOLOS observational program

2013 ◽  
Vol 59 (4) ◽  
pp. 65-68
Author(s):  
M G Pavlova ◽  
I V Glinkina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Glargine ◽  
Hba1c Level ◽  
Combined Therapy ◽  
Fasting Blood Glucose ◽  
Hypoglycemic Agents ◽  
The Mean

The results of numerous clinical investigations carried out during the last years provide convincing evidence of the high effectiveness and safety of early initiation of insulin therapy. Of special interest are the studies conducted under conditions of real clinical practice. One of them is the Russian SOLOS observational program designed to evaluate the influence of intensification of the treatment of type 2 diabetes mellitus with oral hypoglycemic agents (OHA) supplemented by using insulin glargine in the patients who failed to be adequately compensated by OHA therapy alone. Another objective of this program was to find out the opinion of the patients and physicians about the SoloStar pen employed for injecting insulin glargine. The data concerning 1309 patients at the mean age of 59.5±8.8 years with type 2 diabetes mellitus and the mean duration of the disease 6.9±5.0 years were available for the analysis. The overwhelming majority of the patients presented with severe decompensation of carbohydrate metabolism, the mean fasting blood glucose level being 10.7±2.4 mmol/l and the HbA1c level varying from 7.2 to 18.2% (mean 9.6±1.5%). Supplementation of OHA therapy with insulin glargine caused the significant reduction of the HbA1c level to 8.1±1.0% (p<0.001) within 3 months after the onset of the combined treatment. The HbA1c level fell down to 7.2±0.9% (p<0.001) after 6 months 40.6% of the patients had HbA1c at the level below 7%. Fasting blood glucose levels decreased to 7.4±1.4 mmol/l and 6.3±1.0 mmol/l (p<0.001) at 3 and 6 months after the onset of insulin administration respectively. The number of daytime and nocturnal hypoglycemic episodes under effect of insulin glargine injections significantly decreased by the end of the study. Severe hypoglycemic episodes suffered initially by 8 (0.5%) patients totally disappeared 6 months after the initiation of the combined therapy. Most patients did not need hospitalization after supplementation of OHA treatment with insulin. The results of combined therapy with the use of disposable SoloStar pens were positively assessed by the overwhelming majority of both the patients and the physicians involved in the study.

scholarly journals Depressive Symptoms Amongst People with Podoconiosis and Lower Limb Lymphoedema of Other Cause in Cameroon: A Cross-Sectional Study

2019 ◽  
Vol 4 (3) ◽  
pp. 102 ◽  
Author(s):  
Maya Semrau ◽  
Gail Davey ◽  
Amuam Andrew Beng ◽  
Winston Patrick Chounna Ndongmo ◽  
Abdel Jelil Njouendou ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Lower Limb ◽  
Mental Distress ◽  
Neglected Tropical Diseases ◽  
Psychosocial Interventions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Health ◽  
The Mean

Evidence is emerging that shows elevated mental distress and disorder amongst people with several neglected tropical diseases (NTDs). This study aimed to establish the prevalence of depressive symptoms amongst people with podoconiosis and lower limb lymphoedema of other cause in Cameroon. The study was part of a larger research piece that mapped the geographical distribution of podoconiosis in Cameroon. The Patient Health Questionnaire (PHQ-9; mean) was employed to determine the prevalence of depressive symptoms amongst people with lower limb lymphoedema. Linear regression was used to assess the association between socio-demographic characteristics of participants and depressive symptoms. Internal consistency of the PHQ-9 was estimated through Cronbach’s alpha (α = 0.651). The mean PHQ-9 score among people with lower limb lymphoedema was 3.48 (SD ± 3.25). Using a PHQ-9 score of 5 or above as the cut-off score, 32 participants (38.6%) displayed at least mild depressive symptoms. Unemployment was the only factor that was significantly associated with more depressive symptoms overall. This study shows that depressive symptoms are common amongst people with lower limb lymphoedema in Cameroon. The findings provide support for the integration of psychosocial interventions into packages of care for the management of lower limb lymphoedema.

scholarly journals Modern approaches to the treatment of type 2 diabetes mellitus and its complications

2012 ◽  
Vol 58 (3) ◽  
pp. 61-64
Author(s):  
A S Ametov ◽  
E V Doskina
Keyword(s):  
Diabetes Mellitus ◽  
Hba1c Level ◽  
Platelet Adhesion ◽  
International Diabetes Federation ◽  
The Other ◽  
The World ◽  
The Mean ◽  
The One ◽  
Hba1c Levels

According to the International Diabetes Federation, there are over 366 mln subjects suffering diabetes mellitus (DM) in the world. This figure is expected to reach 552 mln by 2030. The patients are treated with preparations acting on different components of DM pathogenesis on the one hand and with medicines facilitating prophylaxis of the disease on the other hand. Diabeton MB decreases the mean HbA1c level of 7-8% by 0.9%. Also, it causes reduction of the initial HbA1c levels of 8-9% and 10% by 1.7% (2.6---??) and 4.2% respectively. Diabeton MB produces a number of other effects besides the hypoglycemic activity; specifically, it reduces the intensity of LDLP oxydation, platelet adhesion and aggregation, adhesion of monocytes, etc.

Abstract P195: The Association Of Psychological Stress Measures With Allostatic Load Among African Americans With Hypertension

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Anika L Hines ◽  
Ebony Boulware ◽  
Sherita H Golden ◽  
Joshua J Joseph ◽  
Dingfen Han ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
African Americans ◽  
Perceived Stress ◽  
Allostatic Load ◽  
Patient Characteristics ◽  
Inflammatory Factors ◽  
Cvd Risk ◽  
Diabetes Status ◽  
Patient Health ◽  
The Mean

African Americans experience disproportionate stress over the life course, which has been posited as an explanatory mechanism underlying racial disparities in CVD risk. We studied associations between measures of self-reported psychosocial stress and allostatic load (AL) (elevated or fluctuating endocrine or neural responses resulting from chronic stress) among 74 participants of the Achieving Blood Pressure (BP) Control Together (ACT) study—a randomized control trial to improve BP self-management and control among African Americans. We examined ancillary AL biomarkers (i.e., DHEA-S, cortisol, CRP, IL-6) in addition to ACT study measures (i.e., HbA1c, diabetes status, total cholesterol, HDL-C, triglycerides, hyperlipidemia, urinary microalbumin) collected at 12-months follow-up. We used linear univariable and multivariable regression to estimate correlations between ratings of the Perceived Stress Scale (PSS-10), the Everyday Discrimination Scale, and the Patient Health Questionnaire (PHQ-8) with total AL score (1 point per aforementioned component measure threshold achieved) and its components. Ninety-three percent of the sample reported moderate to severe stress; the mean discrimination score was 14.9 (SD: 7.4) (of a possible 39 points); 22% had moderate to severe depressive symptoms. The mean AL score was 3 of a possible total of 11. Perceived stress was negatively associated with CRP adjusting for other components and patient characteristics. Discrimination was associated with increases in inflammatory factors; however, this association diminished after adjusting for other AL components and patient characteristics. Depressive symptoms were positively associated with inflammatory factors and triglycerides adjusting for other AL components and patient characteristics. In conclusion, the findings from this study of African Americans with hypertension suggest correlations between self-reported psychological stressors and AL components, but not total AL score.

Effect of Study Design and Survey Instrument to Identify the Association Between Depressive Symptoms and Physical Activity in Type 2 Diabetes, 2000-2018: A Systematic Review

2019 ◽  
Vol 46 (1) ◽  
pp. 28-45 ◽  
Author(s):  
Jusung Lee ◽  
Timothy Callaghan ◽  
Marcia Ory ◽  
Hongwei Zhao ◽  
Margaret Foster ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Diabetes Management ◽  
Evidence Base ◽  
Online Databases ◽  
Patient Health ◽  
Study Characteristics

Introduction Previous studies have used a variety of survey measurement options for evaluating the association between physical activity (PA) and depressive symptoms, raising questions about the types of instruments and their effect on the association. This study aimed to identify measures of PA and depressive symptoms and findings of their association given diverse instruments and study characteristics in type 2 diabetes (T2DM). Methods Online databases, Medline, Embase, CINAHL, and PsycINFO were searched on July 20, 2018, and January 8, 2019. Our systematic review included observational studies from 2000 to 2018 that investigated the association between PA and depressive symptoms in T2DM. Results Of 2294 retrieved articles, 28 studies were retained in a focused examination and comparison of the instruments used. There were a range of standard measures, 10 for depressive symptoms and 7 for PA, respectively. Patient Health Questionnaire (PHQ) for depressive symptoms and study-specific methods for PA were the most popular. Overall, 71.9% found a significant association between PA and depressive symptoms. Among studies classified as high quality or reliability, the figure was 81.8%. Conclusion A majority of the sample found an association between depressive symptoms and PA, which is fairly consistent across study characteristics. The findings provide the evidence for the health benefits of PA on reducing depressive symptoms in persons with T2DM, suggesting active engagement in PA for effective diabetes management. However, guidelines for objective measurements and well-designed prospective studies are needed to strengthen the evidence base and rigor for the association and its directionality.

scholarly journals Variables associated with HbA1c and weight reductions when adding liraglutide to multiple daily insulin injections in persons with type 2 diabetes (MDI Liraglutide trial 3)

2018 ◽  
Vol 6 (1) ◽  
pp. e000464 ◽  
Author(s):  
Sofia Dahlqvist ◽  
Elsa Ahlén ◽  
Karin Filipsson ◽  
Thomas Gustafsson ◽  
Irl B Hirsch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Reduction ◽  
Hba1c Level ◽  
Insulin Dose ◽  
Double Blind ◽  
Daily Insulin ◽  
Daily Insulin Dose ◽  
The Mean ◽  
Multiple Daily Insulin Injections

ObjectiveTo evaluate variables associated with hemoglobin A1c (HbA1c) and weight reduction when adding liraglutide to persons with type 2 diabetes treated with multiple daily insulin injections (MDI).Research design and methodsThis was a reanalysis of a previous trial where 124 patients were enrolled in a double-blind, placebo-controlled, multicenter randomized trial carried out over 24 weeks. Predictors for effect on change in HbA1c and weight were analyzed within the treatment group and with concurrent interaction analyses. Correlation analyses for change in HbA1c and weight from baseline to week 24 were made.ResultsThe mean age at baseline was 63.7 years, 64.8% were men, the mean number of insulin injections was 4.4 per day, the mean daily insulin dose was 105 units and the mean HbA1c was 74.5 mmol/mol (9.0%). The mean HbA1c and weight reductions were 12.3 mmol/mol (1.13%; P<0.001) and 3.8 kg (P<0.001) greater in liraglutide than placebo-treated persons. There was no significant predictor for greater effect on HbA1c that existed in all analyses (univariate, multivariate and interaction analyses against controls). For a greater weight reduction when adding liraglutide, a lower HbA1c level at baseline was a predictor (liraglutide group P=0.002, P=0.020 for liraglutide group vs placebo). During follow-up in the liraglutide group, no significant correlation was found between change in weight and change in HbA1c (r=0.09, P=0.46), whereas a correlation existed between weight and insulin dose reduction (r=0.44, P<0.001).ConclusionWeight reduction becomes greater when adding liraglutide in patients with type 2 diabetes treated with MDI who had a lower HbA1c level compared with those with a higher HbA1c level. There was no correlation between reductions in HbA1c and weight when liraglutide was added, that is, different patient groups responded with HbA1c and weight reductions.Trial registration numberEudraCT nr: 2012-001941-42.

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