Blood Sugar Control in Type 2 Diabetes

This case focuses on how to treat patients with intensive and conservative blood sugar levels due to type 2 diabetes by asking the question: Should doctors target a “normal” blood glucose level in patients with type 2 diabetes? In the ACCORD trial, physicians could use any available diabetes medications to achieve the blood glucose targets. A target hemoglobin HbA1c (HbA1c) level of 6% or less was associated with increased mortality compared with a target of 7%–7.9%. Targeting an HbA1c ≤6% was associated with reduced early-stage microvascular disease, however. The optimal HbA1c target in patients with diabetes remains an area of active investigation.

2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Agung B S Satyarsa

Diabetes mellitus is a degenerative disease that commonly found and related to an unhealthy lifestyle and genetic factors. Current management of diabetes mellitus includes control of blood sugar levels and prevention of complications. Recent studies found that many phytochemicals have the potential to control blood sugar levels in patients with diabetes. Alkaloid substances from leaves of Tapak Dara have an effect on decreasing blood glucose. This review article aims to describe the potential effects of the Alkaloid vindolicine from Tapak Dara leaves (Catharanthus Roseus L.) in reducing blood glucose levels in patients with type 2 diabetes mellitus. The activity of vindolicine alkaloid against ? cells in previous studies has shown to improve ? cells activity and induce insulin secretion thus preventing further hyperglycemia. In addition, the vindolicine alkaloid also has a role in activating pancreatic ?-TC6 cells and carrying out an immediate reaction in blood vessels. As conclusion, further research is needed to prove the maximum effect of the utilization of tread leaf extract as well as the toxicity test to determine the toxic effects of the alkaloid substances in the tread leaf. Keywords: Type 2 Diabetes Mellitus, Vindolicine Alkaloid, Tapak Dara, blood glucoselevels


2021 ◽  
Vol 1 ◽  
pp. 1088-1096
Author(s):  
Regina Merdekari Rizki Ananda ◽  
Dafid Arifiyanto

AbstractDiabetes Mellitus is a group of metaboloc disoreders with sysptoms of increased blood sugar levels(hyperglycaemia) which results in damages to insulin secretion, insulin secretion,insulin activity, or both wrong behaviour ina diabetic diet will make blood sugar levels unstable and will have an impact in patients health problems. This study aimed to describe compliance in patients with type 2 diabetes mellitus through a literature review. The method used in the literature review wa to search for articles from 2011-2021 through NCBI searchles and the Garuda Portal. The searching results were obtained in the from of full text and pdf,rhen reviewed by using the strobe instrument,extracted then discussed, and concluded. The results of a literature review of 5 articles showed that there was an effect of dietary compliancr in patients with diabetes mellitus with results. Dietary adherence of diabetes patients was 324 respondents (58%) non-adherence and 235 respondents (42%) obedient in dientary compliance in type 2 diabetes mellitus patients. It can be concluded thet non-adherence diabetic patients can experience unstable blood sugar levels. Nurses should be able to increase the understanding of the importance of dietary compliance for patients with diabetes mellitus.Keywords: Compliance, Diet, Diabetes Mellitus. AbstrakDiabetes melitus merupakan sekumpulan hambatan metabolik dengan gejala peningkatan kadar gula darah (hiperglikemia) yang berdampak kerusakan sekresi insulin,aktivitas insulin, atau keduanya. Perilaku yang salah dalam diet diabetes akan menjadikan kadar gula darah tidak stabil dan akan berdampak pada gangguan kesehatan pada pasien. Penelitian ini bertujuan untuk mengetahui pengaruh kepatuhan diet pada penderita diabetes melitus tipe 2 melalui literatur review. Metode yang digunakan dalam literature review adalah mencari artikel tahun 2011-2021 melalui penelusuran Ncbi dan Portal Garuda. Hasil pencarian yang didapatkan berupa fulltext dan pdf, kemudian direview dengan menggunakan Intrumen strobe, diekstraksi kemudian dibahas dan disimpulkan. Hasil penelitian literature review dari 5 artikel menunjukkan bahwa adanya pengaruh terhadap kepatuhan diet pada pasien diabetes mellitus dengan hasil Kepatuhan diet pasien diabetes 324 responden (58%) tidak patuh dan 235 responden (42%) patuh dalam Kepatuhan Diet Pada Penderita Diabetes Mellitus Tipe 2. Pada penelitian ini didapatkan hasil penderita diabetes tidak patuh menjalani diet sehingga kadar gula darah dalam tubuh tidak stabil. Bagi perawat hendaknya dapat meningkatkan pemahaman tentang kepatuhan guna dapat memperbaiki diet bagi pasien Diabetes mellitus.Kata kunci: Kepatuhan , Diet, dan Diabetes Mellitus.


2021 ◽  
pp. 193229682110156
Author(s):  
Thibault Gautier ◽  
Rupesh Silwal ◽  
Aramesh Saremi ◽  
Anders Boss ◽  
Marc D. Breton

Background: As type 2 diabetes (T2D) progresses, intensification to combination therapies, such as iGlarLixi (a fixed-ratio GLP-1 RA and basal insulin combination), may be required. Here a simulation study was used to assess the effect of iGlarLixi administration timing (am vs pm) on blood sugar profiles. Methods: Models of lixisenatide were built with a selection procedure, optimizing measurement fits and model complexity, and were included in a pre-existing T2D simulation platform containing glargine models. With the resulting tool, a simulated trial was conducted with 100 in-silico participants with T2D. Individuals were given iGLarLixi either before breakfast or before an evening meal for 2 weeks and daily glycemic profiles were analyzed. In the model, breakfast was considered the largest meal of the day. Results: A similar percentage of time within 24 hours was spent with blood sugar levels between 70 to 180 mg/dL when iGlarLixi was administered pre-breakfast or pre-evening meal (73% vs 71%, respectively). Overall percent of time with blood glucose levels above 180 mg/dL within a 24-hour period was similar when iGlarLixi was administered pre-breakfast or pre-evening meal (26% vs 28%, respectively). Rates of hypoglycemia were low in both regimens, with a blood glucose concentration of below 70 mg/dL only observed for 1% of the 24-hour time period for either timing of administration. Conclusions: Good efficacy was observed when iGlarlixi was administered pre-breakfast; however, administration of iGlarlixi pre-evening meal was also deemed to be effective, even though in the model the size of the evening meal was smaller than that of the breakfast.


2021 ◽  
Vol 9 (1) ◽  
pp. e002032
Author(s):  
Marcela Martinez ◽  
Jimena Santamarina ◽  
Adrian Pavesi ◽  
Carla Musso ◽  
Guillermo E Umpierrez

Glycated hemoglobin is currently the gold standard for assessment of long-term glycemic control and response to medical treatment in patients with diabetes. Glycated hemoglobin, however, does not address fluctuations in blood glucose. Glycemic variability (GV) refers to fluctuations in blood glucose levels. Recent clinical data indicate that GV is associated with increased risk of hypoglycemia, microvascular and macrovascular complications, and mortality in patients with diabetes, independently of glycated hemoglobin level. The use of continuous glucose monitoring devices has markedly improved the assessment of GV in clinical practice and facilitated the assessment of GV as well as hypoglycemia and hyperglycemia events in patients with diabetes. We review current concepts on the definition and assessment of GV and its association with cardiovascular complications in patients with type 2 diabetes.


Author(s):  
Nur Rasdianah ◽  
Suwaldi Martodiharjo ◽  
Tri Murti Andayani ◽  
Lukman Hakim

The increasing prevalence of diabetes mellitus (DM) in Indonesia requires participation of all parties including pharmacists. This study aims to determine the impact of the implementation of home pharmacy service guidelines for patients with type 2 diabetes mellitus on the level of knowledge, medication adherence, therapeurical satisfaction and glycemic control. This study used a quasi-experimental design with one group pre-test and post-test design involving 37 patients with type 2 diabetes mellitus who met the requirements of inclusion and exclusion criterias. The Diabetes Knowledge Questionnaire (DKQ-24) and the Diabetes Medication Satisfaction Tool (DMSAT) were used for collecting the data. Patient adherence was measured using a pillcount method and fasting blood sugar levels (FSB) data were obtained from the laboratory results. The study was conducted in two community health centers and patient’s home in the Yogyakarta Municipality area. The data were analysed using Wilcoxon and Spearman test. The results showed the change of the level of knowledge, medication adherence, therapeutic satisfaction and glycemic control before and after intervention of pharmacy services at home. The average decreasing of fasting blood sugar levels 17.09 mg/dL ± 1.43


2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Akbar Riyanto ◽  
Fajar Susanti ◽  
Erlin Ifadah ◽  
Sugeng Hadisaputra

AbstractIncreasing prevalence of type 2 Diabetes Mellitus in developed and developing countries is a health problem. Therefore, type 2 Diabetes Mellitus can be prevented by regular exercise, healthy and regular life. The purpose of this study was to determine the effectiveness of foot exercise on changes in blood sugar levels in elderly people with type 2 diabetes mellitus at the Ciracas District Health Center. This type of research is experimental with one group pre-post test design. The population in this study were 36 elderly people with type 2 Diabetes Mellitus in the Ciracas District Health Center. The sample in this study were 18 elderly with type 2 diabetes mellitus in Ciracas District Health Center. The sampling technique used was convenience sampling. Methods of data collection using an observation sheet before and after being given foot exercises. The statistical test used in this study is the paired T test. The results showed that there was no change in blood sugar levels before and after doing foot exercises, the statistical test results obtained a p value of 0.870, which means 0.870> 0.05, it can be concluded that there is no significant effect between foot exercise and changes in blood sugar levels in elderly patients. Type II diabetes mellitus at the Ciracas Subdistrict Health Center. The absence of any effect of foot exercises on changes in blood sugar levels in the elderly could be due to incomplete exercise, therefore foot exercise training to change blood sugar levels must be done in the elderly. Keywords : Foot exercise, Blood Sugar Levels, DM type 2


2021 ◽  
Vol 1 ◽  
pp. 309-316
Author(s):  
Nurul Febrian Bintari Putri ◽  
Trina Kurniawati

AbstractDiabetes mellitus is a chronic disease that cannot be cured, but can be prevented by using the 5 pillars of diabetes mellitus management, one of which is controlling blood sugar levels. Patients with diabetes mellitus need support from the family because the family can influence a person's behavior and lifestyle so that it has an impact on the quality of life of patients with type 2 diabetes mellitus. To determine the relationship between family support and blood sugar levels in patients with type 2 diabetes mellitus through a literature review. The data collection technique uses a literature review method of 5 articles sourced from an online database with electronic searches on Google Scholar, Garba Garuda, and ProQuest published in 2017-2021. The critical analysis instrument used is using a strobe. The results of a literature review on the family support variable were 2 articles with supporting categories as many as 128 respondents, 2 articles with less categories as many as 63 respondents, and 1 article with good categories as many as 22 respondents. Variable blood sugar levels 2 articles in the controlled category as many as 98 respondents, 1 article in the poor category as many as 45 respondents, 1 article in the controlled category as many as 17 respondents, and 1 article in the diabetes category as many as 29 respondents. There is a relationship between family support and blood sugar levels in patients with type 2 diabetes mellitus.Keywords: Type 2 diabetes mellitus; family support; blood glucose levels; blood sugar levels AbstrakDiabetes mellitus merupakan penyakit kronik yang tidak dapat disembuhkan, namun dapat dicegah dengan menggunakan 5 pilarpengelolaan diabetes mellitus, salah satunya pengendalian kadar gula darah. Pasien diabetes mellitus perlu adanya dukungan dari keluarga karena keluarga dapat mempengaruhi perilaku dan gaya hidup seseorang sehingga berdampak pada kualitas hidup pasien diabetes mellitus tipe 2. Untuk mengetahui hubungan dukungan keluarga dengan kadar gula darah pada pasien diabetes mellitus tipe 2 melalui literature review. Teknik pengumpulan data menggunakan metode literature review 5 artikel yang bersumber database online dengan penelusuran elektronik pada Google Scholar, Garba Garuda, dan ProQuest yang dipublish pada tahun 2017-2021. Instrumen telaah kritis yang digunakan yaitu menggunakan Strobe. Hasil literature review pada variable dukungan keluarga 2 artikel dengan kategori mendukung sebanyak 128 responden, 2 artikel dengan kategori kurang sebanyak 63 responden, dan 1 artikel dengan kategori baik sebanyak 22 responden. Variable kadar gula darah 2 artikel dengan kategori terkendali sebanyak 98 responden, 1 artikel dengan kategori buruk sebanyak 45 responden, 1 artikel dengan kategori terkontrol sebanyak 17 responden, dan 1 artikel dengan kategori diabetes sebanyak 29 responden. Terdapat hubungan antara dukungan keluarga dengan kadar gula darah pada pasien diabetes mellitus tipe 2.Kata kunci: Diabetes mellitus tipe 2;dukungan keluarga;kadar glukosa darah;kadar gula darah


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