Typ-2-Diabetes im Alter: Beispiel für eine Patienten-zentrierte medikamentöse Therapie

2018 ◽  
Vol 143 (04) ◽  
pp. 253-261
Author(s):  
Dirk Müller-Wieland
Keyword(s):  
Blood Glucose ◽  
Long Term Effects ◽  
Policy Makers ◽  
Glucose Levels ◽  
Typ 2 Diabetes ◽  
Blood Glucose Levels ◽  
High Prevalence ◽  
Aged Individual ◽  
Glucose Management

AbstractDiabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual. Therefore, long-term diabetes medication should avoid hypoglycemia and prevent acute hyperglycemia or short-term complications on morbidity and clinical course of geriatric syndromes associated with regular blood glucose levels above 200 mg/dl (11.1 mmol/l). The therapy should be safe, easy to handle for the patient and possibly affect co-morbidities positively. However, there are limited data available about efficacy, safety and pharmacokinetics of drugs in patients over 75 years of age or older. Since more than 5 % of the population in Germany is older than 80 years means that more than 1 million of these individuals suffer from diabetes. It is time to ask for data in these elderly subpopulations by policy makers in health care.

scholarly journals Self-Care IoT Platform for Diabetic Mellitus

2021 ◽  
Vol 11 (5) ◽  
pp. 2006
Author(s):  
Jai-Chang Park ◽  
Seongbeom Kim ◽  
Je-Hoon Lee
Keyword(s):  
Blood Glucose ◽  
Self Care ◽  
Target Range ◽  
Process Data ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Iot Platform ◽  
Number Of Patients ◽  
Glucose Management ◽  
The Relationship

Diabetes mellitus is a severe chronic disease, and the number of patients has increased. To manage blood glucose levels, patients should frequently measure their blood glucose and analyze which lifestyle habits affect blood glucose levels. However, it is hard to record and analyze the relationship between their blood glucose levels and lifestyle. The internet of things (IoT) is useful to interconnect, monitor, obtain, and process data between various devices used in everyday life to fulfill a common objective. This paper proposes an intelligent self-care platform using IoT technology that helps patients with chronic diabetes manage their blood glucose levels in their target range. In particular, we developed various devices called the self-care IoT pack. It consists of five different types of devices to obtain blood glucose levels, physical activities, food intake, medication, sleeping, and so on. They can collect blood glucose levels with lifestyles that automatically impact the patient’s blood glucose level. We also devised a self-care application to display and analyze the data obtained from the IoT pack. Consequently, the proposed self-care IoT platform collects the blood glucose levels and the lifestyles without any burden of record. By reviewing the accumulated information, the patients can find bad habits in blood glucose management and improve their lifestyle.

The metabolic implications of long term cannabis use in patients with psychosis

2008 ◽  
Vol 17 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Farrah Mushtaq ◽  
Valeria Mondelli ◽  
Carmine M. Pariante
Keyword(s):  
Body Weight ◽  
General Population ◽  
Endocannabinoid System ◽  
Cannabis Use ◽  
Long Term Effects ◽  
Glucose Levels ◽  
High Prevalence ◽  
Vulnerable Patient ◽  
Vulnerable Patient Group

SummaryAimsThe aim of this paper is to summarise the effects of cannabis use on appetite and energy balance, and to subsequently investigate the possible implications this may have in patients with psychosis, in whom a high prevalence of cannabis use has been reported.Methods– A narrative review based on the recent literature regarding cannabis use in the gen-eral population and patients with psychosis.Results– The short-term abilities of cannabis to increase appetite and body weight, through actions on the endogenous endocannabinoid system, have been well characterised throughout the literature. The long term effects of cannabis use are however unclear and only a minority of studies have been conducted in the general population with overall conflicting results. In terms of the effects of cannabis in patients with psychosis, there has only been one study to date that has investigated this and interestingly found cannabis use to be associated with increased body weight and blood glucose levels, thus providing evidence that cannabis use may be an important contributing factor to the reduced life expectancy, as is currently observed in this vulnerable patient group.Conclusions– It is clear from the literature that patients with psychosis are at a high risk of metabolic and cardiovascular disease in comparison to the general population. However the contribution of cannabis use to this risk is as of yet undetermined and further long term studies are need to confirm current findings and evaluate hypothesised mechanisms.Declaration of Interest: None.

scholarly journals PENGAPLIKASIAN ASUHAN KEPERAWATAN KELUARGA PADA PENDERITA DIABETES MELLITUS

2019 ◽  
Author(s):  
Rizky Asmaul Husnah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Chronic Disease ◽  
Glucose Levels ◽  
Normal Limits ◽  
Blood Glucose Levels ◽  
Family Behavior ◽  
Nursing Services ◽  
Patients With Diabetes

Diabetes mellitus is a chronic disease that lasts long term, where blood glucose levels pass within normal limits. Family is also one of the support systems that can be utilized in providing nursing services and management of patients with diabetes mellitus. Support and good family behavior can affect the compliance of patients with diabetes mellitus in treatment.

scholarly journals Effects of mycoprotein on glycaemic control and energy intake in humans: a systematic review

2020 ◽  
Vol 123 (12) ◽  
pp. 1321-1332 ◽  
Author(s):  
Anna Cherta-Murillo ◽  
Aaron M. Lett ◽  
James Frampton ◽  
Edward S. Chambers ◽  
Tim J. A. Finnigan ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Energy Intake ◽  
Long Term Effects ◽  
Hand Search ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Acute Ingestion ◽  
Short And Long Term ◽  
Randomised Controlled

AbstractMycoprotein is a food high in both dietary fibre and non-animal-derived protein. Global mycoprotein consumption is increasing, although its effect on human health has not yet been systematically reviewed. This study aims to systematically review the effects of mycoprotein on glycaemic control and energy intake in humans. A literature search of randomised controlled trials was performed in PubMed, Embase, Web of Science, Google Scholar and hand search. A total of twenty-one studies were identified of which only five studies, totalling 122 participants, met the inclusion criteria. All five studies were acute studies of which one reported outcomes on glycaemia and insulinaemia, two reported on energy intake and two reported on all of these outcomes. Data were extracted, and risk-of-bias assessment was then conducted. The results did not show a clear effect of acute mycoprotein on blood glucose levels, but it showed a decrease in insulin levels. Acute mycoprotein intake also showed to decrease energy intake at an ad libitum meal and post-24 h in healthy lean, overweight and obese humans. In conclusion, the acute ingestion of mycoprotein reduces energy intake and insulinaemia, whereas its impact on glycaemia is currently unclear. However, evidence comes from a very limited number of heterogeneous studies. Further well-controlled studies are needed to elucidate the short- and long-term effects of mycoprotein intake on glycaemic control and energy intake, as well as the mechanisms underpinning these effects.

The Effect of Intraoperative Blood Glucose Management on Postoperative Blood Glucose Levels in Noncardiac Surgery Patients

2016 ◽  
Vol 122 (3) ◽  
pp. 893-902 ◽  
Author(s):  
Bala G. Nair ◽  
Mayumi Horibe ◽  
Moni B. Neradilek ◽  
Shu-Fang Newman ◽  
Gene N. Peterson
Keyword(s):  
Blood Glucose ◽  
Noncardiac Surgery ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Glucose Management

scholarly journals Reduced autophagy in livers of fasted, fat-depleted, ghrelin-deficient mice: Reversal by growth hormone

2015 ◽  
Vol 112 (4) ◽  
pp. 1226-1231 ◽  
Author(s):  
Yuanyuan Zhang ◽  
Fei Fang ◽  
Joseph L. Goldstein ◽  
Michael S. Brown ◽  
Tong-Jin Zhao
Keyword(s):  
Growth Hormone ◽  
Blood Glucose ◽  
Calorie Restriction ◽  
Gene Encoding ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Increase Blood Glucose ◽  
Plasma Gh ◽  
Deficient Mice

Plasma growth hormone (GH) and hepatic autophagy each have been reported to protect against hypoglycemia in the fasted state, but previous data have not linked the two. Here we demonstrate a connection using a mouse model of fasting in a fat-depleted state. Mice were subjected to 1 wk of 60% calorie restriction, causing them to lose nearly all body fat. They were then fasted for 23 h. During fasting, WT mice developed massive increases in plasma GH and a concomitant increase in hepatic autophagy, allowing them to maintain viable levels of blood glucose. In contrast, lethal hypoglycemia occurred in mice deficient in the GH secretagogue ghrelin as a result of knockout of the gene encoding ghrelin O-acyltransferase (GOAT), which catalyzes a required acylation of the peptide. Fasting fat-depleted Goat−/− mice showed a blunted increase in GH and a marked decrease in hepatic autophagy. Restoration of GH by infusion during the week of calorie restriction maintained autophagy in the Goat−/− mice and prevented lethal hypoglycemia. Acute injections of GH after 7 d of calorie restriction also restored hepatic autophagy, but failed to increase blood glucose, perhaps owing to ATP deficiency in the liver. These data indicate that GH stimulation of autophagy is necessary over the long term, but not sufficient over the short term to maintain blood glucose levels in fasted, fat-depleted mice.

scholarly journals Diabetes status affects long-term changes in coronal caries - The SHIP Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Julia Schmolinsky ◽  
Thomas Kocher ◽  
Wolfgang Rathmann ◽  
Henry Völzke ◽  
Christiane Pink ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Population Based ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Term Change ◽  
Diabetes Status

Abstract We estimated effects of diabetes mellitus and metabolic control on long-term change in coronal caries and restorative status using 11-year-follow-up data from the population-based Study of Health in Pomerania. Data of 3731 participants with baseline and 5- and 11-year follow-up information were included. Diabetes was defined via self-reported physician´s diagnosis or intake of glucose-lowering drugs or hemoglobin A1c (HbA1c) ≥6.5% or fasting blood glucose levels ≥11.1 mmol/l. The diabetes status was defined as no diabetes (HbA1c < 6.5% or non-fasting blood glucose <11.1 mmol/l), subjects with known or undetected diabetes mellitus and HbA1c ≤ 7% (well-controlled diabetes), and subjects with known or undetected diabetes mellitus and HbA1c > 7% (poorly-controlled diabetes). The caries status was clinically assessed using the half-mouth method and the Decayed Missing Filled Surfaces (DMFS) index and its component scores were determined. Covariate-adjusted linear mixed models were evaluated. Rates in change in DMFS were significantly higher in subjects with poorly-controlled diabetes compared to subjects without diabetes. Subjects with poorly- and well-controlled diabetes had significantly higher rates in change in Missing Surfaces (MS) compared to subjects without diabetes. For the DFS, rates in change were significantly lower for subjects with well-controlled diabetes and higher for subjects with poorly-controlled diabetes as compared to subjects without diabetes. Concordantly, all rates in change increased proportional to HbA1c levels. Effects were even more pronounced in subjects with diabetes duration of ≥5 years. Subjects with poorly-controlled diabetes are at higher risk for caries progression compared to subjects without diabetes, especially in case of longer disease duration.

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