scholarly journals Ayurveda Body–Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions

2021 ◽  
pp. 097275312110000
Author(s):  
Madhava Sai Sivapuram ◽  
Vinod Srivastava ◽  
Navneet Kaur ◽  
Akshay Anand ◽  
Raghuram Nagarathna ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Lipid Profiles ◽  
Control Groups ◽  
Yoga Intervention ◽  
Positive Effects ◽  
Study Results ◽  
Significant Difference ◽  
And Control

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

scholarly journals Telomere length and vascular wall in patients with Type 2 Diabetes Mellitus

2014 ◽  
Vol 17 (3) ◽  
pp. 31-38 ◽  
Author(s):  
Ekaterina Nailyevna Dudinskaya ◽  
Olga Nikolaevna Tkacheva ◽  
Marina Vladimirovna Shestakova ◽  
Natalya Vasilyevna Brailova ◽  
Irina Dmitrievna Strazhesko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Carbohydrate Metabolism ◽  
Telomere Length ◽  
Vascular Wall ◽  
Vascular Changes ◽  
Control Groups ◽  
And Control

Aim. To study the relationship between changes in the artery structure and function and peripheral lymphocyte telomere length in patients with type 2 diabetes mellitus (DM2). Materials and methods. A total of 50 patients with T2DM and without clinical manifestations of cardiovascular disease (CVD) were included in the study; the control group consisted of 49 people. The following tests were conducted for all study participants: carbohydrate metabolism evaluation, carotid artery duplex scan to measure intima?media complex thickness (IMT) and to determine the presence of atherosclerotic plaques, carotid?femoral pulse wave velocity (PWV) measurement and lymphocyte telomere length measurement. Results. The vascular changes were more pronounced in patients with T2DM than in controls. The telomeres were shorter in patients with T2DM than in those without diabetes (9.53?0.1 vs 9.86?0.1, p=0.033). The participants were divided according to the telomere length. Among patients with T2DM, there were significant differences in the condition of the vascular wall [PWV: 10.58?0.1 m/s in patients with ?long? telomeres and 15.08?1.3 m/s in patients with ?short? telomeres; IMT: 0.80?0.09 mm in patients with ?long? telomeres and 0.87?0.05 mm in patients with ?short? telomeres (p=0.024)]. There were no significant differences in the arterial structure between the patient and control groups with ?long? telomeres [PWV: 10.58?0.1 m/s vs 10.5?0.5 m/s (p=0.913); IMT: 0.080?0.09 mm vs 0.73?0.03 mm (p=0.12). However, there were significant differences in the vascular wall condition between the patient and control groups with ?short? telomeres [PWV: 15.08?1.3 m/s vs, 10.7?0.5 m/s (p=0.015); IMT: 0.87?0.1 vs 0.78?0.1 (p=0.03)]. Conclusions. The signs of vascular ageing were more pronounced in patients with T2DM than in controls. However, despite diabetes, vascular changes were minimal in patients with ?long? lymphocyte telomeres, comparable with the state of the vascular walls in healthy individuals. Thus, enhanced lymphocyte telomere length may have a protective effect on the vascular wall and may prevent damage from carbohydrate metabolism disorders.

scholarly journals Correlation between Microalbuminuria and Glucose/ Leptin ratio in a sample of Iraqi patients with type 2 diabetes mellitus

2012 ◽  
Vol 6 (2) ◽  
pp. 42-49
Author(s):  
Rayah Sulaiman Baban ◽  
Zeina Ismael Ibrahem ◽  
Isam Noori Al-Karawi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Glucose ◽  
Fasting Serum ◽  
Control Groups ◽  
Normal Range ◽  
Serum Leptin ◽  
And Control

o study the association of serum leptin and glucose/leptin ratio with microalbuminuria in patients with type 2 diabetes mellitus at different durations, and to predict their effect on their renal function. A case control study was conducted in the International Diabetic Center at Al-Mustansiryia University in Baghdad-Iraq from 1st September 2008 to the 30th of July 2010. One hundred and eight male patients with type 2 diabetes mellitus (DM) were introduced in this study. Fifty three healthy subjects were used as a control. Fasting serum glucose, insulin, leptin, urea, creatinine and body mass index were estimated in both patient and control groups. Fifty three 49.07% out of 108 were diabetic for ≤2 years, while 55 patient 50.93% were diabetic >2 years. All patients were obese while healthy control subjects were not. Fasting serum glucose, insulin and leptin levels were found elevated in patients group while in control group their levels were found within normal range. Both urea and creatinine were also within the normal range for patients and control groups. Level of albumin in urine of patients with diabetes mellitus for ≤ 2years was found normal while in those with 3 to 6 or more than 6 years of DM, level of urinary albumin was found within the micro rang. A positive correlation with highly significant p value (<0.01) was found between patients (≤ 2 years and >2 years) serum leptin, glucose/leptin ratio and microalbuminuria. Conclusions: a strong association was found between serum leptin and glucose/leptin ratio with microalbuminuria in type 2 diabetic patients which can be used to predict the efficiency of their renal function at different durations and can be used as additional marker for the diagnosis of early stage of nephropathy.

scholarly journals A STUDY OF LIPID PROFILE IN DIABETES MELLITUS TYPE-2 PATIENTS

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Vipin Kumar ◽  
Maya Pensiya ◽  
V B Singh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Sugar Levels ◽  
And Control

Background: To study the lipid profile in diabetes mellitus in type 2 Diabetes mellitus patients. Methods: This is a cross sectional case control study. 100 patients of type 2 diabetes mellitus and 100 age and sex matched healthy controls were taken. Lipid profile were done in cases and controls using appropriate tests. Results: The fasting blood sugar levels in all the diabetics were significantly higher as compare to control. There was significant difference in mean HDL, Triglycerides level in diabetic and control patients. There was no significant difference in LDL, Cholesterol level in Diabetic and control patients. Conclusion: We concluded that there is a high prevalence of elevated lipid levels among the diabetic patients. Keywords: Diabetes Mellitus -2, Cholesterol, Lipid Profile

scholarly journals Bioinformatic Analysis of Evolutional Conservatism and Functional Significance of Microsatellite Alleles of Human 14Q13.2 Region Associated with Type 2 Diabetes Mellitus

2008 ◽  
Vol 62 (3) ◽  
pp. 91-102 ◽  
Author(s):  
Tatjana Sjakste ◽  
Ilva Poudžiunas ◽  
Valdis Pīrāgs ◽  
Māris Lazdiñš ◽  
Nikolajs Sjakste
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Functional Significance ◽  
Bioinformatic Analysis ◽  
Control Group ◽  
Case Group ◽  
Control Groups ◽  
And Control ◽  
Microsatellite Alleles

Bioinformatic Analysis of Evolutional Conservatism and Functional Significance of Microsatellite Alleles of Human 14Q13.2 Region Associated with Type 2 Diabetes Mellitus The paper deals with bioinformatic and statistical analysis of the possible functional significance of the previously shown association of several microsatellite alleles in intron 6 of the human proteasome core particle PSMA6 gene (HSMS006) and four other microsatellites localised upstream in human chromosome 14q13.2 (HSMS801, HSMS702, HSMS701, HSMS602) with type 2 diabetes mellitus in Latvia and Botnia, Finland. Genotype analysis revealed that (CAA)8/(CAA)8 homozygotes of the HSMS602 marker were never found in Type 2 diabetes patients, although 6.56% of the individuals from the control groups were the (CAA)8/(CAA)8 homozygotes. For the HSMS801 marker the (AC)21/(AC)23 genotype was never found in the case group and in the control group it was detected with a frequency 4.40%; these differences were statistically significant (P < 0.05). In contrast to the Latvian population, the distribution of genotype frequencies in cases and controls taken from the Botnian dataset was almost similar. Haplotype analysis showed that in the Latvian population besides haplotypes including alleles differently represented in case and control groups, a combination of some alleles almost equally represented in both groups formed combinations that were more characteristic of either the case group or the control group. This indicates probable independent functional significance of these haplotypes that warrants further investigation. In the Botnian population, more allele combinations were observed, and the distribution of haplotypes in case and control groups differed from that observed in Latvia. The observed haplotype distributions might reflect differences between the studied populations: a homogenous and isolated Botnian vis-à-vis a mixed Latvian population. Linkage disequilibrium (LD) analysis of data on the Latvian population revealed nine of ten two-allele combinations manifesting a high LD. HSMS006 and HSMS602 combination had a low LD; among the analysed markers these were situated at the largest distance from one another. Data on the Botnian population showed that haplotypes in eight of ten combinations had a high LD, including the HSMS006 and HSMS602 combinations. It appears that the two populations differ also in linkage disequilibrium of two-loci haplotypes. Theoretical analysis of a potential functional role of the polymorphisms indicated the significance of the microsatellite length of HSMS602 and HSMS006 for the formation of DNA hairpins. The whole genomic region appears to be conservative in mammals.

scholarly journals Association of Genetic Variants of KCNJ11 and KCNQ1 Genes with Risk of Type 2 Diabetes Mellitus (T2DM) in the Indian Population: A Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Vasiuddin Khan ◽  
Amit Kumar Verma ◽  
Deepti Bhatt ◽  
Shahbaz Khan ◽  
Rameez Hasan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Genetic Variants ◽  
Indian Population ◽  
Clinicopathological Characteristics ◽  
Variant Allele ◽  
Significant Difference ◽  
And Control

Type 2 diabetes mellitus (T2DM) is a polygenic metabolic disease described by hyperglycemia, which is caused by insulin resistance or reduced insulin secretion. The interaction between various genetic variants and environmental factors triggers T2DM. The aim of this study was to find risk associated with genetic variants rs5210 and rs2237895 of KCNJ11 and KCNQ1 genes, respectively, in the development of T2DM in the Indian population. A total number of 300 cases of T2DM and 100 control samples were studied to find the polymorphism in KCNJ11 and KCNQ1 through PCR-RFLP. The genotype and allele frequencies in T2DM cases were significantly different compared to the control population. KCNJ11 rs5210 and KCNQ1 rs2237895 variants were found to be significantly associated with risk of T2DM in dominant (KCNJ11: OR, 2.07; 95% CI, 1.30–3.27; p−0.001; KCNQ1: OR, 2.33; 95% CI, 1.46–3.70; p−0.0003) and codominant models (KCNJ11: OR, 1.76; 95% CI, 1.09–2.84; p−0.020; KCNQ1: OR, 1.85; 95% CI, 1.16–2.95; p−0.009). We also compared clinicopathological characteristics between cases and control and observed a significant difference in all the parameters except HDL, gender, and family history. In this study, clinicopathological data with a carrier of a variant allele of both KCNJ11 and KCNQ1 genes were also analysed, and a significant association was found between the carrier of a variant allele with gender and PPG in KCNJ11 and with triglyceride in KCNQ1. We confirm the significant association of KCNJ11 (rs5210) and KCNQ1 (rs2237895) gene polymorphism with T2DM, indicating the role of these variants in developing risk for T2DM in Indian population.

scholarly journals Drift of the Subgingival Periodontal Microbiome during Chronic Periodontitis in Type 2 Diabetes Mellitus Patients

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 504
Author(s):  
Irina P. Balmasova ◽  
Evgenii I. Olekhnovich ◽  
Ksenia M. Klimina ◽  
Anna A. Korenkova ◽  
Maria T. Vakhitova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Relative Abundance ◽  
Chronic Periodontitis ◽  
Control Group ◽  
Control Groups ◽  
And Control ◽  
Pooled Samples

Since periodontitis and type 2 diabetes mellitus are complex diseases, a thorough understanding of their pathogenesis requires knowing the relationship of these pathologies with other disorders and environmental factors. In this study, the representability of the subgingival periodontal microbiome of 46 subjects was studied by 16S rRNA gene sequencing and shotgun sequencing of pooled samples. We examined 15 patients with chronic periodontitis (CP), 15 patients with chronic periodontitis associated with type 2 diabetes mellitus (CPT2DM), and 16 healthy subjects (Control). The severity of generalized chronic periodontitis in both periodontitis groups of patients (CP and CPT2DM) was moderate (stage II). The male to female ratios were approximately equal in each group (22 males and 24 females); the average age of the subjects was 53.9 ± 7.3 and 54.3 ± 7.2 years, respectively. The presence of overweight patients (Body Mass Index (BMI) 30–34.9 kg/m2) and patients with class 1–2 obesity (BMI 35–45.9 kg/m2) was significantly higher in the CPT2DM group than in patients having only chronic periodontitis or in the Control group. However, there was no statistically significant difference in all clinical indices between the CP and CPT2DM groups. An analysis of the metagenomic data revealed that the alpha diversity in the CPT2DM group was increased compared to that in the CP and Control groups. The microbiome biomarkers associated with experimental groups were evaluated. In both groups of patients with periodontitis, the relative abundance of Porphyromonadaceae was increased compared to that in the Control group. The CPT2DM group was characterized by a lower relative abundance of Streptococcaceae/Pasteurellaceae and a higher abundance of Leptotrichiaceae compared to those in the CP and Control groups. Furthermore, the CP and CPT2DM groups differed in terms of the relative abundance of Veillonellaceae (which was decreased in the CPT2DM group compared to CP) and Neisseriaceae (which was increased in the CPT2DM group compared to CP). In addition, differences in bacterial content were identified by a combination of shotgun sequencing of pooled samples and genome-resolved metagenomics. The results indicate that there are subgingival microbiome-specific features in patients with chronic periodontitis associated with type 2 diabetes mellitus.

scholarly journals Evaluation of the T-SPOT.TB test, oxidation-related factors, and antimicrobial peptide LL-37 in the diagnosis of pulmonary tuberculosis with type 2 diabetes

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110644
Author(s):  
Liangliang Ma ◽  
Xuelin Chen ◽  
Shengfeng Weng ◽  
Xinting Yang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Pulmonary Tuberculosis ◽  
Antimicrobial Peptide ◽  
Diagnostic Value ◽  
Control Groups ◽  
Related Factors ◽  
Total Antioxidant ◽  
And Control

Objective To investigate the diagnostic value of the T cell spot (T-SPOT.TB) test, oxidation-related factors (ORF), and antimicrobial peptide LL-37 in patients with pulmonary tuberculosis (PTB) with type 2 diabetes. Methods A total of 560 patients with PTB admitted to our hospital from January 2019 to April 2021 were retrospectively included in this study. Of these, 232 patients with PTB and type 2 diabetes were assigned to the combined group, and 328 patients without complications were assigned to the PTB group. Results Areas under the curve (AUCs) for the number of spot-forming cells in CFP10 and ESAT-6 test panels detecting PTB with type 2 diabetes were 0.892 (95% confidence interval [CI] 0.831–0.921) and 0.893 (95% CI 0.841–0.935), respectively. CFP10 combined with ESAT-6 had the highest diagnostic value, with sensitivity and specificity levels and an AUC of 87.73%, 88.93%, and 0.942 (95% CI 0.907–0.967), respectively. The levels of total antioxidant capacity, superoxide dismutase, and catalase in the combined group were lower than in PTB and control groups. Conclusion The combination of T-SPOT.TB, ORF, and LL-37 in the diagnosis of pulmonary tuberculosis with type 2 diabetes mellitus has a high diagnostic value and clinical application value.

scholarly journals The effect of vitamin D therapy on glycemic control and biochemical indices in type 2 diabetic patients: a randomized, clinical trial study

2021 ◽  
Vol 25 (2) ◽  
pp. 125-133
Author(s):  
Majid Mozaffari ◽  
◽  
Hamed Hajmoradi ◽  
Alireza Moravveji ◽  
Fatemeh Sadat Asgarian ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Vitamin D ◽  
Glycemic Control ◽  
Control Groups ◽  
Significant Difference ◽  
The Mean ◽  
Biochemical Indices ◽  
And Control

Introduction: The aim of the present study was to evaluate the effect of vitamin D on glycemic control and biochemical indices in type 2 diabetes. Methods: This randomized double blind placebo-controlled clinical trial was conducted on 80 patients with type 2 diabetes mellitus (T2DM) referred to Shahid Beheshti hospital. These patients were randomly classified into case and control groups. Case group consumed 50,000 IU of vitamin D once a week for 12 weeks and control group placebo. Biochemical and lipid parameters and vitamin D3 were measured in two groups. Glycosylated hemoglobin (HbA1c) was assessed by latex enhance immunoturbidimetric assay. Results: There was no significant difference between case and control groups in terms of age, sex, body mass index and used medications. The mean vitamin D level in case and control groups before intervention was 15.06 ±3.307 and 15.83± 2.509 ng/ml and after intervention was 49.77 ±15.73 and 14.91±3.13 ng/ml respectively. The mean fast blood sugar in case and control groups after intervention was 156.565±32.23 and 147.75±35.06 mg/dl, respectively. The mean HbA1c in case and control groups before intervention was 7.59± 0.39 % and 7.66± 0.38 % and after intervention was 7.26 ± 0.60 and 7.60 ± 0.38, respectively. Moreover, significant difference was seen between case (20.2± 5.74 IU/L) and control groups (23.35± 7.80 IU/L) in terms of alanine aminotransferase, after intervention. Conclusion: According to these findings, vitamin D supplementation possibly through decreasing HbA1C and hepatic alanine aminotransferase could improve diabetes complications.

Abstract 111: Paradoxical Exacerbation of Arrhythmias by the Cardioprotective Mitochondrial K-ATP Channel Agonist Diazoxide in Type 2 Diabetes Mellitus

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Chaoqin Xie ◽  
Basil S Karam ◽  
Fadi G Akar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Anion Channel ◽  
Sprague Dawley ◽  
Control Groups ◽  
And Control

Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular complications including ischemia reperfusion injury (IR). Activation of mitochondrial KATP channels by Diazoxide (DZX) promotes beta cell rest and suppresses glucose production in patients. We hypothesized that DZX prevents IR arrhythmias in T2DM owing to its dual cardioprotective & antidiabetic property. Methods: Obese Zucker Diabetic Fatty (ZDF) rats (n=17) with established T2DM were studied. Control groups consisted of lean ZDF (n=6) and normal Sprague Dawley (n=10) rats. High resolution optical action potential (AP) mapping was performed in hearts before and after challenge with no flow ischemia for 12min followed by reperfusion. Results: Basal properties including rate dependence of conduction velocity (CV) and AP duration (APD) were not significantly (p=NS) altered in T2DM. Remarkably, ischemia uncovered major differences between groups as APD in T2DM failed to adapt to the ischemic challenge. Unlike APD, CV was reduced in all groups. DZX paradoxically promoted arrhythmias as all DZX (30uM) treated T2DM hearts exhibited ischemia related VT. In contrast, untreated T2DM (0/5) and control (0/9) hearts did not exhibit VT during ischemia. Underlying arrhythmic vulnerability of DZX treated T2DM hearts was a pronounced reduction (by 75% p<0.01) of the cardiac wavelength (WL) caused by accelerated APD shortening in response to ischemia. Upon reperfusion, T2DM and control groups exhibited a high (60% T2DM vs 44% control, p=NS) rate of VT, although the VT cycle length in T2DM was significantly longer (72 vs 44ms, p<0.01) suggesting a more adverse substrate modification by IR injury. Blocking the inner membrane anion channel (IMAC) fully abrogated reperfusion VT in T2DM. Conclusion: Ischemia uncovers a paradoxical resistance of T2DM hearts to APD adaptation. DZX reverses this property resulting in accelerated APD & WL shortening. This promotes reentrant VT during ischemia. Therefore, the anti-diabetic agent DZX should be avoided in T2DM patients at risk of ischemic events. Instead IMAC is an effective antiarrhythmic target for these patients.

scholarly journals A daily physical activity and diet intervention for individuals with type 2 diabetes mellitus: a randomized controlled trial

2010 ◽  
Vol 66 (2) ◽  
Author(s):  
Agatha J. Van Rooijen ◽  
Christa M. Viviers ◽  
Piet J. Becker
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Control Groups ◽  
Randomized Controlled ◽  
One Year ◽  
And Control

Urbanisation,  a  sedentary  lifestyle  and  increasing  obesity  due  to westernization and changed eating habits have been identified as independent risk factors for diabetes in the South African population. To establish the effectiveness of a daily walk and diet education intervention program. A randomized controlled trial was performed. The study population consisted of men and women of all races, ages 40 to 65 with Type 2 Diabetes Mellitus (DM) of duration at least one year attending the Steve Biko Diabetes Outpatient clinic. Patients of all weights were considered. Patients who had an HbA1c > 8 – 9.5% were included in the sample group.Four  weekly  group  classes  consisted  of  education  considered  essential  for  ongoing  nutrition  self-management  and physical activity. Yamax pedometers and walk prescriptions based on the average number of steps walked in three days were used. The participants had a follow-up assessment at 16 weeks and one year. The intervention and control groups were compared with respect to changes from baseline, using analysis of covariance (ANCOVA) with baseline values as covariates.The  difference  between  the  intervention  and  control  groups  in  the  change  in  HbA1c  from  the  baseline  was significant at the 16-week follow-up assessment (p=0.041) and in the total cholesterol and LDL-cholesterol at the  one-year follow-up assessment (p =0.047; p =0.014). These results suggest that HbA1c can be improved over a period of four months. More frequent contact with the patients is necessary.

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