scholarly journals Time in range, as measured by continuous glucose monitor, as a predictor of microvascular complications in type 2 diabetes: a systematic review

2022 ◽  
Vol 10 (1) ◽  
pp. e002573
Author(s):  
Rishi Raj ◽  
Rahul Mishra ◽  
Nivedita Jha ◽  
Vivek Joshi ◽  
Ricardo Correa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Microvascular Complications ◽  
Cardiac Autonomic Neuropathy ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
Time In Range ◽  
The Relationship

Continuous glucose monitoring (CGM)-derived time in range (TIR) correlates with hemoglobin A1c (A1c) among patients with type 2 diabetes mellitus (T2DM); however, there is a paucity of data evaluating its association with microvascular complications. We conducted this systematic review to examine the association between TIR and microvascular complications of diabetic retinopathy (DR), diabetic nephropathy (DN), and diabetic peripheral neuropathy (DPN). We conducted a comprehensive literature search on PubMed, Scopus, and Web of Science online databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Full-text original articles that evaluated the association between CGM-derived TIR and risk of microvascular complications and were published between 2010 and June 2021 were included in our systematic review. The quality of the included studies was evaluated using the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data were analyzed using qualitative synthesis. Eleven studies on a total of 13 987 patients were included in the systematic review. The median sample size, baseline A1c, and diabetes duration were 466 patients (range: 105–5901), 8.2% (SD 0.5%), and 11.3 years (1.0), respectively. Majority of the studies were conducted in Asia (10 out of 11). Four studies evaluated the relationship between CGM-derived TIR and DR and CGM-derived TIR and DN, while seven studies evaluated the relationship between CGM-derived TIR and DPN. A 10% increase in TIR was associated with a reduction in albuminuria, severity of DR, and prevalence of DPN and cardiac autonomic neuropathy. In addition, an association was observed between urinary albumin to creatinine ratio but not with estimated glomerular filtration rate. This review summarizes recent evidence supporting an association between CGM-derived TIR and microvascular complications among patients with T2DM. A larger-scale multicenter investigation that includes more diverse participants is warranted to further validate the utility of TIR as a predictor of diabetic microvascular complications.

scholarly journals Time In Range as measured by continuous glucose monitor as a predictor of microvascular complications in type 2 diabetes: A systemic review

2021 ◽  
Author(s):  
Rishi Raj ◽  
Rahul Mishra ◽  
Nivedita Jha ◽  
Vivek Joshi ◽  
Ricardo Correa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Assessment Tool ◽  
Microvascular Complications ◽  
Systemic Review ◽  
Cardiac Autonomic Neuropathy ◽  
Qualitative Synthesis ◽  
The Relationship

Aim: Continuous glucose monitoring (CGM) derived times in range (TIR) correlates with hemoglobin A1c (A1c) among patients with type 2 diabetes mellitus (T2DM); however, there is a paucity of data evaluating its association with microvascular complications. We conducted this systematic review to examine the association between TIR and microvascular complications of diabetic retinopathy (DR), diabetic nephropathy (DN) and peripheral diabetic neuropathy (DPN). Method: We conducted a comprehensive literature search on online database of PubMed, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Full texts original articles that evaluated association between CGM-derived TIR and risk of microvascular complications which were published between 2010 and June 2021, were included in our systematic review. The quality of included studies were evaluated using National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data were analyzed using qualitative synthesis. Result: Eleven studies were included in the systematic review. The mean sample size, baseline A1c, and diabetes duration were 1271 (105-5901), 8.2 % (SD 0.5 %) and 11.3 years, respectively. Majority of studies were conducted in Asia (10 out 11). Four studies evaluated the relationship between CGM-derived TIR and DR and CGM-derived TIR and DN, while seven studies evaluated the relationship between CGM-derived TIR and DPN. A 10 % increase in TIR was associated with a reduction in albuminuria, severity of diabetic retinopathy, and prevalence of diabetic peripheral nephropathy and cardiac autonomic neuropathy. In addition, an association was observed between urinary albumin-to-creatinine ratio but not with estimated glomerular filtration rate. Conclusion: This review summarizes recent evidence supporting an association between CGM-derived TIR and microvascular complications among patients with T2DM. A larger‐scale multi-center investigation that includes more diverse participants is warranted to further validate the utility of TIR as a predictor for diabetic microvascular complications.

Relationship between medication adherence and psychosocial adjustment in patients with type 2 diabetes: A cross-sectional study

2020 ◽  
Vol 40 (3) ◽  
pp. 116-122
Author(s):  
Duygu Kes ◽  
Feray Gökdoğan
Keyword(s):  
Type 2 Diabetes ◽  
Psychosocial Adjustment ◽  
Large City ◽  
Psychosocial Care ◽  
Self Report ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Adherence To Medication ◽  
The Relationship

Adherence to drug treatment is a multidimensional concept. It is affected by many factors, such as physiological, psychological, family, environmental and social conditions. However, relatively little is known about the relationship between adherence to medication and psychosocial adjustment. The aim was to explore the relationship between adherence to antidiabetic drugs and the psychosocial adjustment of patients with type 2 diabetes mellitus. This cross-sectional descriptive correlational study was conducted between March and June 2018. A convenience sample of participants was recruited from seven internal disease outpatient clinics at a public tertiary hospital, located in a large city that serves as a gateway to nearby rural and urban areas in the north-west region of Turkey. Data were collected using the Adherence to Refills and Medications Scale (ARMS-7), and the Psychosocial Adjustment to Illness Scale–Self Report (PAIS–SR). This study is reported in accordance with STROBE. Pearson’s correlation analysis found a significant weak positive correlation between all domains of the PAIS–SR and the total scores on the ARMS‐7. The participants’ scores on medication refill were found to be significantly and positively correlated with all of the PAIS–SR domain scores except the sexual relationships domain. Psychosocial care could play a crucial role in improving drug regimen adherence among patients with diabetes. Therefore, nurses should integrate psychosocial care into daily practice.

scholarly journals Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Cross Sectional ◽  
The Relationship ◽  
At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

scholarly journals Auditory and Vestibular Functioning in Individuals with Type-2 Diabetes Mellitus: A Systematic Review

2021 ◽  
Author(s):  
Prawin Kumar ◽  
Niraj Kumar Singh ◽  
Kumari Apeksha ◽  
Vipin Ghosh ◽  
Raveendran Rajesh Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Auditory System ◽  
Microvascular Complications ◽  
Data Synthesis ◽  
Vestibular Tests ◽  
Peripheral Auditory System

Abstract Introduction Diabetes mellitus is a metabolic disease associated with a rise in the level of blood glucose. Individuals with diabetes mellitus are more likely to develop hearing loss, tinnitus, and dizziness due to macro- and microvascular complications. The extent to which auditory and vestibular functions are impaired in individuals with type-2 diabetes mellitus is still under debate. Objective To systematically review studies focusing on auditory and vestibular functions in individuals with type-2 diabetes mellitus. Data Synthesis A search was conducted in the PubMed, MedlinePlus, Ingenta Connect and Google Scholar databases for articles published until June 2019. A total of 15,980 articles were primarily retrieved, 33 of which were shortlisted based on the inclusion criteria set by the investigators for the systematic review. Out of 33 full-length articles, 26 evaluated the functioning of the auditory system, while 7 evaluated the functioning of the vestibular system. Most studies related to auditory functioning reported a significant effect of type-2 diabetes mellitus on the peripheral auditory system, whereas studies on vestibular functioning reported no significant effect of diabetes mellitus on the functioning of the peripheral vestibular end-organ. Conclusion Overall, the results of various audiological and peripheral vestibular tests reveal distinctive peripheral and/or central auditory and vestibular end-organ impairments in individuals with type-2 diabetes mellitus.

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

Association of Pro-inflammatory Diet With Risk of Type 2 Diabetes and Hypertension; Results From RaNCD Cohort Study

2021 ◽  
Author(s):  
Samira Arbabi Jam ◽  
Shahab Rezaeian ◽  
Farid Najafi ◽  
Behroz Hamze ◽  
Ebrahim Shakiba ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Assessment Tool ◽  
Communicable Diseases ◽  
Dietary Factors ◽  
Base Line ◽  
Cross Sectional ◽  
Non Communicable Diseases

Abstract Background: Dietary factors and inflammation are associated with most non-communicable diseases (NCDs). The Dietary Inflammatory Index (DII) is a developed validated assessment tool. This study was conducted to assessed association of DII with the hypertension and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional analysis was performed on 9,811 participants of 35 to 65 years of the base-line phase data of Ravansar Non-Communicable Diseases (RaNCD) cohort study. The DII was calculated using 31 parameters food of food frequency questionnaire (FFQ). The estimates were performed using univariable and multivariable logistic regression.Results: The mean DII scores in healthy participants was -2.32± 1.60, in participant with T2DM, hypertension and both were -2.23± 1.59, -2.45± 1.60 and -2.25± 1.60, respectively (P= 0.011). Pre-inflammatory diet was significantly higher in male compared to female (P<0.001). In the most pro-inflammatory diet was significantly higher BMI (body mass index), triglyceride, energy intake, smokers; and was significantly lower socio-economic status (SES), physical activity and HDL-C compared to the most anti-inflammatory diet. Participants with T2DM, hypertension and comorbidity had a significantly higher mean of anthropometry indices (P<0.001) and lipid profile compared to healthy subjects (P<0.001). After adjustment for age, sex and physical activity, the odds of T2DM in the fourth quartile of DII was 1.48 (95% CI: 1.19, 1.85) times higher compared to the first quartile of DII. Conclusions: Pro-inflammatory diet was weak associations with hypertension. Pro-inflammatory diet was significant associations with increasing T2DM and its related risk factors. Modification of diet and lifestyle is suggested to reduce inflammation.

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