scholarly journals Can a sleep disorder intervention-embedded self-management programme contribute to improve management of diabetes? A pilot single-arm pretest and post-test study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045783
Author(s):  
Ritsuko Sakamoto ◽  
Kana Kazawa ◽  
Yasmin Jahan ◽  
Naoko Takeyama ◽  
Michiko Moriyama
Keyword(s):  
Sleep Disorders ◽  
Diabetes Management ◽  
Management Programme ◽  
Self Management ◽  
Physical Factors ◽  
Haemoglobin A1c ◽  
Test Study ◽  
Diabetes Status ◽  
Post Test ◽  
Sleep Condition

ObjectiveTo investigate the efficacy and feasibility of a self-management programme incorporating a sleep intervention for improving diabetes outcomes.DesignA single-arm pre-test and post-test study was conducted within a community setting in Hiroshima, Japan.ParticipantsParticipants were aged 52–74 years and diagnosed with type 2 diabetic nephropathy stages 1–3.InterventionsParticipants received self-management education from nurses for 6 months. First, the nurses assessed their sleep conditions using insomnia scales and a sleep metre. Then, the participants learnt self-management to increase their physical activity and improve their sleep condition. They also implemented diet therapy and medication adherence.Outcome measuresPhysiological indicators, subjective and objective indicators of sleep quality, self-management indicators, quality of life (QOL) and feasibility were evaluated. To confirm the efficacy of intervention, Freidman tests, analysis of variance, Wilcoxon signed-rank test and t-test were performed. Pearson’s correlations were analysed between activities and sleep condition.ResultsOf the 26 enrolled participants, 24 completed the programme and were analysed. Among them, 15 participants (62.5%) had sleep disorders caused by multiple factors, such as an inappropriate lifestyle and physical factors that interfere with good sleep. Although insomnia scales did not change for the sleep disorders, their subjective health status improved. Regarding indicators related to diabetes management, lifestyles improved significantly. Haemoglobin A1c, body mass index, systolic blood pressure, non-high-density lipoprotein-cholesterol and QOL also improved. All participants except one were satisfied with the programme. However, use of the sleep metre and nurses’ consultation about sleep disturbance were not well evaluated.ConclusionsThis programme was effective in improving diabetes status, lifestyle and behaviour changes. However, its effect on sleep condition was limited because of its complexity. A simple and novel approach is needed to strengthen the motivation for sleep behaviour change and to increase programme efficacy and feasibility.Trial registration numberUMIN000025906.

scholarly journals Digital Diabetes Management: A Literature Review of Smart Insulin Pens

2021 ◽  
pp. 193229682098386 ◽  
Author(s):  
Lutz Heinemann ◽  
Oliver Schnell ◽  
Bernhard Gehr ◽  
Nanette C. Schloot ◽  
Sven W. Görgens ◽  
...  
Keyword(s):  
Patient Preference ◽  
Diabetes Management ◽  
Electronic Device ◽  
Digital Health ◽  
Memory Function ◽  
Near Field ◽  
Self Management ◽  
Published Data ◽  
Technical Accuracy ◽  
Insulin Pens

Digital health management is increasingly pivotal in the care of patients with diabetes. The aim of this review was to evaluate the clinical benefits of using smart insulin pens with connectivity for diabetes management. The search was performed using PubMed and PubMed Central on May 15, 2019, to identify publications investigating the use of insulin pens. Studies evaluating insulin pens with connectivity via Bluetooth/Near Field Communication, with an associated electronic device enabling connectivity, or with a memory function were included in the review. Nine studies were identified in the search. Overall, these studies lacked data on smart insulin pens with a connectivity function, with eight of the available studies investigating only pens with a memory function. The studies focused primarily on assessing patient preference, usability, and technical accuracy. The number of studies assessing clinical outcomes was small ( n = 3). However, the majority of studies ( n = 8) reported that patients preferred smart insulin pens because they increased confidence with regard to diabetes self-management. These results suggest a lack of published data regarding smart insulin pens with connectivity for the management of diabetes. However, the available published data on usability and patient preference suggest that the use of smart insulin pens holds promise for improving and simplifying diabetes self-management.

scholarly journals Assessment of an Educational Intervention to Improve Healthy Life Habits in Children Living in Vulnerable Socioeconomic Conditions

2021 ◽  
Vol 18 (9) ◽  
pp. 4495
Author(s):  
María López ◽  
Irene Alcoceba ◽  
María-José Castro ◽  
María-José Cao ◽  
Sara García ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Eating Habits ◽  
Vegetable Consumption ◽  
Socioeconomic Conditions ◽  
Healthy Living ◽  
Mortality And Morbidity ◽  
Test Study ◽  
Post Test ◽  
Quasi Experimental ◽  
Life Habits

Nutritional condition impacts academic performance and cognitive development. In Peru, the prevalence of chronic undernutrition in children is 6.9%, increasing the risk of mortality and morbidity. This study aimed to develop an educational intervention to achieve an improvement in the healthy habits of children in a primary education school in Lima who live in vulnerable socioeconomic conditions. We conducted a prospective quasi-experimental pre-test and post-test study of an educational intervention. The information was collected through the adaptation of the WHO questionnaire “Global School-based Student Health Survey” (GSHS), with anthropometric variables, socioeconomic level, hygiene and eating habits. One hundred eight students from 5 to 13 years old from Arenitas del Mar School in Lima (Peru) participated. The educational intervention improved eating habits. Fruit and vegetable consumption 3 or more times/day (50.9%) increased after the educational intervention (49% vs. 62.9%,) p < 0.0001. There was an improvement in hygiene habits, such as the frequency of handwashing with soap (32.4% vs. 63.9%) and the frequency of weekly bathing 4–6 times/week (25% vs. 47.5%) p < 0.0001. The educational intervention promoted better healthy living behaviors, eating habits and hygiene. This kind of initiative is a crucial tool to establish healthy living habits.

scholarly journals Retinal microvascular parameters are not associated with diabetes in the Northern Ireland Cohort for the Longitudinal Study of Ageing

2021 ◽  
Author(s):  
Rachael Ann O’Neill ◽  
Alexander Peter Maxwell ◽  
Frank Kee ◽  
Ian Young ◽  
Bernadette McGuinness ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Northern Ireland ◽  
Glycated Haemoglobin ◽  
Haemoglobin A1c ◽  
Cross Sectional ◽  
Non Invasive ◽  
Retinal Microvasculature ◽  
Diabetes Status ◽  
Automated Software ◽  
Sectional Analysis

Abstract Background The retinal microvasculature offers unique non-invasive evaluation of systemic microvascular abnormalities. Previous studies reported associations between retinal microvascular parameters (RMPs) and diabetes. The aim of this study was to assess associations between RMPs and diabetes in a cross-sectional analysis of older persons from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). Methods RMPs (central retinal arteriolar/venular equivalents, arteriolar to venular ratio, fractal dimension, and tortuosity) were measured from optic disc-centred fundus images using semi-automated software. Associations were assessed between RMPs and diabetes status with adjustment for potential confounders. Results Data were included for 1762 participants with 209 classified as having diabetes. Participants had a mean age of 62.1 ± 8.5 years, and 54% were female. As expected, participants with diabetes had significantly higher mean glycated haemoglobin A1c compared to participants without diabetes (57.4 ± 17.6 mmol/mol versus 37.0 ± 4.2 mmol/mol, respectively). In unadjusted and minimally adjusted regression, arteriolar to venular ratio, arteriolar tortuosity and venular tortuosity were significantly associated with diabetes (minimally adjusted odds ratio [OR] = 0.85; 95% confidence intervals [CIs] 0.73, 0.99; P = 0.04, OR = 1.18; 95% CI 1.02, 1.37; P = 0.03 and OR = 1.20; 95% CI 1.04, 1.38; P = 0.01, respectively), although all failed to remain significant following adjustment for potential confounders. No additional associations between other RMPs and diabetes were detected. Conclusion Despite previously reported associations between diabetes and RMPs, our study failed to corroborate these associations in an older community-based cohort.

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