scholarly journals Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054629
Author(s):  
Sabine Singh ◽  
Ole Kirk ◽  
Shabbar Jaffar ◽  
Catherine Karakezi ◽  
Kaushik Ramaiya ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Integrated Care ◽  
Patient Perspectives ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
People Living With Hiv ◽  
Integration Of Care ◽  
Diverse Range ◽  
Scoping Reviews

IntroductionAntiretroviral therapy has reduced mortality and led to longer life expectancy in people living with HIV. These patients are now at an increased risk of non-communicable diseases (NCDs). Integration of care for HIV and NCDs has become a focus of research and policy. In this article, we aim to review patient perspectives on integration of healthcare for HIV, type 2 diabetes and hypertension.MethodsThe framework for scoping reviews developed by Arksey and O'Malley and updated by Peter et al was applied for this review. The databases PubMed, Web of Science and Cochrane library were searched. Broad search terms for HIV, NCDs (specifically type 2 diabetes and hypertension) and healthcare integration were used. As the review aimed to identify definitions of patient perspectives, they were not included as an independent term in the search strategy. References of included publications were searched for relevant articles. Titles and abstracts for these papers were screened by two independent reviewers. The full texts for all the publications appearing to meet the inclusion criteria were then read to make the final literature selection.ResultsOf 5502 studies initially identified, 13 articles were included in this review, of which 11 had a geographical origin in sub-Saharan Africa. Nine articles were primarily focused on HIV/diabetes healthcare integration while four articles were focused on HIV/hypertension integration. Patient’s experiences with integrated care were reduced HIV-related stigma, reduced travel and treatment costs and a more holistic person-centred care. Prominent concerns were long waiting times at clinics and a lack of continuity of care in some clinics due to a lack of healthcare workers. Non-integrated care was perceived as time-consuming and more expensive.ConclusionPatient perspectives and experiences on integrated care for HIV, diabetes and hypertension were mostly positive. Integrated services can save resources and allow for a more personalised approach to healthcare. There is a paucity of evidence and further longitudinal and interventional evidence from a more diverse range of healthcare systems are needed.

Patient Perspectives on the Burden of Type 2 Diabetes Mellitus Treatment

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 726-P
Author(s):  
KRISTINA YU-ISENBERG ◽  
GEOF D. GRAY ◽  
CATHERINE FOLEY ◽  
JONATHAN T. STOKES ◽  
ALAN SHIELDS ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Patient Perspectives ◽  
Diabetes Mellitus Treatment

scholarly journals Potential Therapeutic Effects of Curcumin on Glycemic and Lipid Profile in Uncomplicated Type 2 Diabetes—A Meta-Analysis of Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 404
Author(s):  
Emma Altobelli ◽  
Paolo Matteo Angeletti ◽  
Ciro Marziliano ◽  
Marianna Mastrodomenico ◽  
Anna Rita Giuliani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Effect Size ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Model Assessment

Diabetes mellitus is an important issue for public health, and it is growing in the world. In recent years, there has been a growing research interest on efficacy evidence of the curcumin use in the regulation of glycemia and lipidaemia. The molecular structure of curcumins allows to intercept reactive oxygen species (ROI) that are particularly harmful in chronic inflammation and tumorigenesis models. The aim of our study performed a systematic review and meta-analysis to evaluate the effect of curcumin on glycemic and lipid profile in subjects with uncomplicated type 2 diabetes. The papers included in the meta-analysis were sought in the MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library databases as of October 2020. The sizes were pooled across studies in order to obtain an overall effect size. A random effects model was used to account for different sources of variation among studies. Cohen’s d, with 95% confidence interval (CI) was used as a measure of the effect size. Heterogeneity was assessed while using Q statistics. The ANOVA-Q test was used to value the differences among groups. Publication bias was analyzed and represented by a funnel plot. Curcumin treatment does not show a statistically significant reduction between treated and untreated patients. On the other hand, glycosylated hemoglobin, homeostasis model assessment (HOMA), and low-density lipoprotein (LDL) showed a statistically significant reduction in subjects that were treated with curcumin, respectively (p = 0.008, p < 0.001, p = 0.021). When considering HBA1c, the meta-regressions only showed statistical significance for gender (p = 0.034). Our meta-analysis seems to confirm the benefits on glucose metabolism, with results that appear to be more solid than those of lipid metabolism. However, further studies are needed in order to test the efficacy and safety of curcumin in uncomplicated type 2 diabetes.

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.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials

2015 ◽  
Vol 172 (3) ◽  
pp. R93-R101 ◽  
Author(s):  
Zhenru Huang ◽  
Hong Tao ◽  
Qingdong Meng ◽  
Long Jing
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Randomized Controlled Trials ◽  
Sample Size ◽  
Plasma Glucose ◽  
Small Sample ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

ObjectiveTo review the published literature on the effects of telecare intervention in patients with type 2 diabetes and inadequate glycemic control.Design and methodsA review of randomized controlled trials on telecare intervention in patients with type 2 diabetes, and a search of electronic databases such as The Cochrane Library, PubMed, EBSCO, CINAHL, Science Direct, Journal of Telemedicine and Telecare, and China National Knowledge Infrastructure (CNKI), were conducted from December 8 to 16, 2013. Two evaluators independently selected and reviewed the eligible studies. Changes in HbA1c, fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), BMI, and body weight were analyzed.ResultsAn analysis of 18 studies with 3798 subjects revealed that telecare significantly improved the management of diabetes. Mean HbA1c values were reduced by −0.54 (95% CI, −0.75 to −0.34; P<0.05), mean FPG levels by −9.00 mg/dl (95% CI, −17.36 to −0.64; P=0.03), and mean PPG levels reduced by −52.86 mg/dl (95% CI, −77.13 to −28.58; P<0.05) when compared with the group receiving standard care. Meta-regression and subgroup analyses indicated that study location, sample size, and treatment-monitoring techniques were the sources of heterogeneity.ConclusionsPatients monitored by telecare showed significant improvement in glycemic control in type 2 diabetes when compared with those monitored by routine follow-up. Significant reduction in HbA1c levels was associated with Asian populations, small sample size, and telecare, and with those patients with baseline HbA1c greater than 8.0%.

scholarly journals Significance of African Diets in Biotherapeutic Modulation of the Gut Microbiome

2021 ◽  
Vol 15 ◽  
pp. 117793222110126
Author(s):  
PO Isibor ◽  
PA Akinduti ◽  
OS Aworunse ◽  
JO Oyewale ◽  
O Oshamika ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Immune Cell ◽  
Inflammatory Responses ◽  
Brown Rice ◽  
Well Being ◽  
Population Characteristics ◽  
Sub Saharan Africa ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Diet plays an essential role in human development and growth, contributing to health and well-being. The socio-economic values, cultural perspectives, and dietary formulation in sub-Saharan Africa can influence gut health and disease prevention. The vast microbial ecosystems in the human gut frequently interrelate to maintain a healthy, well-coordinated cellular and humoral immune signalling to prevent metabolic dysfunction, pathogen dominance, and induction of systemic diseases. The diverse indigenous diets could differentially act as biotherapeutics to modulate microbial abundance and population characteristics. Such modulation could prevent stunted growth, malnutrition, induction of bowel diseases, attenuated immune responses, and mortality, particularly among infants. Understanding the associations between specific indigenous African diets and the predictability of the dynamics of gut bacteria genera promises potential biotherapeutics towards improving the prevention, control, and treatment of microbiome-associated diseases such as cancer, inflammatory bowel disease, obesity, type 2 diabetes, and cardiovascular disease. The dietary influence of many African diets (especially grain-base such as millet, maize, brown rice, sorghum, soya, and tapioca) promotes gut lining integrity, immune tolerance towards the microbiota, and its associated immune and inflammatory responses. A fibre-rich diet is a promising biotherapeutic candidate that could effectively modulate inflammatory mediators’ expression associated with immune cell migration, lymphoid tissue maturation, and signalling pathways. It could also modulate the stimulation of cytokines and chemokines involved in ensuring balance for long-term microbiome programming. The interplay between host and gut microbial digestion is complex; microbes using and competing for dietary and endogenous proteins are often attributable to variances in the comparative abundances of Enterobacteriaceae taxa. Many auto-inducers could initiate the process of quorum sensing and mammalian epinephrine host cell signalling system. It could also downregulate inflammatory signals with microbiota tumour taxa that could trigger colorectal cancer initiation, metabolic type 2 diabetes, and inflammatory bowel diseases. The exploitation of essential biotherapeutic molecules derived from fibre-rich indigenous diet promises food substances for the downregulation of inflammatory signalling that could be harmful to gut microbiota ecological balance and improved immune response modulation.

scholarly journals Combination Therapy with an SGLT2 Inhibitor as Initial Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 45 ◽  
Author(s):  
Tamara Y. Milder ◽  
Sophie L. Stocker ◽  
Christina Abdel Shaheed ◽  
Lucy McGrath-Cadell ◽  
Dorit Samocha-Bonet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Combination Therapy ◽  
Low Dose ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Cochrane Library ◽  
High Dose ◽  
Dose Combination ◽  
Inhibitor Combination

Background: Guidelines differ with regard to indications for initial combination pharmacotherapy for type 2 diabetes. Aims: To compare the efficacy and safety of (i) sodium-glucose cotransporter 2 (SGLT2) inhibitor combination therapy in treatment-naïve type 2 diabetes adults; (ii) initial high and low dose SGLT2 inhibitor combination therapy. Methods: PubMed, Embase and Cochrane Library were searched for randomised controlled trials (RCTs) of initial SGLT2 combination therapy. Mean difference (MD) for changes from baseline (HbA1c, weight, blood pressure) after 24–26 weeks of treatment and relative risks (RR, safety) were calculated using a random-effects model. Risk of bias and quality of evidence was assessed. Results: In 4 RCTs (n = 3749) there was moderate quality evidence that SGLT2 inhibitor/metformin combination therapy resulted in a greater reduction in HbA1c (MD (95% CI); −0.55% (−0.67, −0.43)) and weight (−2.00 kg (−2.34, −1.66)) compared with metformin monotherapy, and a greater reduction in HbA1c (−0.59% (−0.72, −0.46)) and weight (−0.57 kg (−0.89, −0.25)) compared with SGLT2 inhibitor monotherapy. The high dose SGLT2 inhibitor/metformin combination resulted in a similar HbA1c but greater weight reduction; −0.47 kg (−0.88, −0.06) than the low dose combination therapy. The RR of genital infection with combination therapy was 2.22 (95% CI 1.33, 3.72) and 0.69 (95% CI 0.50, 0.96) compared with metformin and SGLT2 inhibitor monotherapy, respectively. The RR of diarrhoea was 2.23 (95% CI 1.46, 3.40) with combination therapy compared with SGLT2 inhibitor monotherapy. Conclusions: Initial SGLT2 inhibitor/metformin combination therapy has glycaemic and weight benefits compared with either agent alone and appears relatively safe. High dose SGLT2 inhibitor/metformin combination therapy appears to have modest weight, but no glycaemic benefits compared with the low dose combination therapy.

scholarly journals The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e020062 ◽  
Author(s):  
Xiaosu Bai ◽  
Zhiming Liu ◽  
Zhisen Li ◽  
Dewen Yan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Increased Risk

ObjectivesSeveral patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.DesignA meta-analysis.MethodsWe conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.ResultsTwenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.ConclusionsOur meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

scholarly journals Efektivitas Kurma (Phoenix dactylifera) dalam menurunkan kadar HbA1c pada pasien diabetes mellitus tipe 2: Laporan Kasus Berbasis Bukti

2020 ◽  
Vol 3 (1) ◽  
pp. 31-45
Author(s):  
Muhammad Sobri Maulana ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Phoenix Dactylifera ◽  
Herbal Remedies ◽  
Cochrane Library ◽  
Time Treatment ◽  
Type 2 Dm

Type 2 Diabetes Mellitus or Type 2 DM is a metabolic disease that can cause severe complications so that adequate management which one of the targets is lowering HbA1c level is needed. Up to this time, treatment for Type 2 DM including antihiperglycemic and injection. Herbal remedies as well as dates (Phoenix datcylifera) has been limited even though it has well-known antihyperglycemic effect. To investigate the effectivity of Dates (Phoenix dactylifera) in lowering HbA1c level among Type 2 Diabetes Mellitus patients. Literature searching was conducted on four online databases which are PubMed, Scopus, EBSCO, and Cochrane Library based on inclusion and exclusion criterias. Based on the results of critical studies, seven studies have shown that there is effectiveness in the administration of Dates (Phoenix dactylifera) in patients with type 2 diabetes mellitus on Lowering HbA1c levels and restricition of date diet needed for type 2 diabetes mellitus patients in 3 dates per day that are statistically significant for lowering HbA1c level with value of NNT is 1. Administration of Dates (Phoenix dactylifera) can be used as an adjuvant therapy on Type 2 Diabetes mellitus patients

A Review: Comparison of Efficacy of Liraglutide Versus Sitagliptin add-on-to Metformin in Type 2 Diabetes Mellitus patients

2021 ◽  
pp. 2291-2295
Author(s):  
A. Kavyasree ◽  
P. Geetha ◽  
P. Shanmugasundaram
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Randomized Controlled Trials ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Duration Of Treatment ◽  
Randomized Controlled ◽  
Gastrointestinal Problems

Background: The aim of this review is to compare the efficacy of liraglutide versus sitagliptin add-on-to metformin in patients with Type 2 Diabetes Mellitus and inadequate glycemic control for rational use of drugs. Methods: We searched for randomized controlled trials (RCT) in MEDLINE, Web of science, PubMed, Cochrane library, CNKI, and Wanfang database and extracted data from all randomized controlled trials (RCTs) up to July 11, 2019 of liraglutide versus sitagliptin given in combination with metformin. RCTs were selected only if they were RCTs comparing DPP-4 inhibitor (sitagliptin) monotherapy to metformin monotherapy with the GLP-1 Receptor Agonists (liraglutide), duration of treatment was ≥26 weeks and reported data on hemoglobin A1c (HbA1c) change, fasting plasma glucose (FPG) change, Odds ratio (OR), mean difference (MD), 95% confidence interval are used to analyze the outcomes. Results: A total of 2,257 patients from 6 RCTs were included in the study. When compared with sitagliptin (100mg) in combination with metformin group, the group of patients treated with liraglutide1.2mg and 1.8mg and metformin, produced greater reduction in HbA1c, FBG. (95% CI). The group of patients with 1.8mg liraglutide had significant weight loss. The incidence of nausea, hypoglycemic episodes, gastrointestinal problems was higher than the sitagliptin with metformin groups. Conclusions: The results of this study indicated that the liraglutide – metformin combination therapy could significantly lower the HbA1c level and increased reduction of body weight. ADRs such as gastrointestinal problems, hypoglycemic episodes were common in liraglutide treatment group.

Sign in / Sign up

Export Citation Format

Share Document