scholarly journals Population segmentation of type 2 diabetes mellitus patients and its clinical applications - a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jun Jie Benjamin Seng ◽  
Amelia Yuting Monteiro ◽  
Yu Heng Kwan ◽  
Sueziani Binte Zainudin ◽  
Chuen Seng Tan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Scoping Review ◽  
Clinical Applications ◽  
Data Driven ◽  
Population Segmentation ◽  
Wide Range ◽  
Segmentation Approach

Abstract Background Population segmentation permits the division of a heterogeneous population into relatively homogenous subgroups. This scoping review aims to summarize the clinical applications of data driven and expert driven population segmentation among Type 2 diabetes mellitus (T2DM) patients. Methods The literature search was conducted in Medline®, Embase®, Scopus® and PsycInfo®. Articles which utilized expert-based or data-driven population segmentation methodologies for evaluation of outcomes among T2DM patients were included. Population segmentation variables were grouped into five domains (socio-demographic, diabetes related, non-diabetes medical related, psychiatric / psychological and health system related variables). A framework for PopulAtion Segmentation Study design for T2DM patients (PASS-T2DM) was proposed. Results Of 155,124 articles screened, 148 articles were included. Expert driven population segmentation approach was most commonly used, of which judgemental splitting was the main strategy employed (n = 111, 75.0%). Cluster based analyses (n = 37, 25.0%) was the main data driven population segmentation strategies utilized. Socio-demographic (n = 66, 44.6%), diabetes related (n = 54, 36.5%) and non-diabetes medical related (n = 18, 12.2%) were the most used domains. Specifically, patients’ race, age, Hba1c related parameters and depression / anxiety related variables were most frequently used. Health grouping/profiling (n = 71, 48%), assessment of diabetes related complications (n = 57, 38.5%) and non-diabetes metabolic derangements (n = 42, 28.4%) were the most frequent population segmentation objectives of the studies. Conclusions Population segmentation has a wide range of clinical applications for evaluating clinical outcomes among T2DM patients. More studies are required to identify the optimal set of population segmentation framework for T2DM patients.

scholarly journals Strategies to Overcome Therapeutic Inertia in Type 2 Diabetes Mellitus: A Scoping Review

2020 ◽  
Author(s):  
Paulina K. Wrzal ◽  
Andrean Bunko ◽  
Varun Myageri ◽  
Atif Kukaswadia ◽  
Calum S. Neish ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Scoping Review ◽  
Therapeutic Inertia

scholarly journals Investigation on the Enzymatic Profile of Mulberry Alkaloids by Enzymatic Study and Molecular Docking

Molecules ◽  
2019 ◽  
Vol 24 (9) ◽  
pp. 1776 ◽  
Author(s):  
Zhihua Liu ◽  
Ying Yang ◽  
Wujun Dong ◽  
Quan Liu ◽  
Renyun Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Molecular Docking ◽  
Side Effects ◽  
Inhibitory Effect ◽  
Active Ingredients ◽  
Wide Range ◽  
Consensus Score

α-glucosidase inhibitors (AGIs) have been an important category of oral antidiabetic drugs being widely exploited for the effective management of type 2 diabetes mellitus. However, the marketed AGIs not only inhibited the disaccharidases, but also exhibited an excessive inhibitory effect on α-amylase, resulting in undesirable gastrointestinal side effects. Compared to these agents, Ramulus Mori alkaloids (SZ-A), was a group of effective alkaloids from natural Morus alba L., and showed excellent hypoglycemic effect and fewer side effects in the Phase II/III clinical trials. Thus, this paper aims to investigate the selective inhibitory effect and mechanism of SZ-A and its major active ingredients (1-DNJ, FA and DAB) on different α-glucosidases (α-amylase and disaccharidases) by using a combination of kinetic analysis and molecular docking approaches. From the results, SZ-A displayed a strong inhibitory effect on maltase and sucrase with an IC50 of 0.06 μg/mL and 0.03 μg/mL, respectively, which was similar to the positive control of acarbose with an IC50 of 0.07 μg/mL and 0.68 μg/mL. With regard to α-amylase, SZ-A exhibited no inhibitory activity at 100 μg/mL, while acarbose showed an obvious inhibitory effect with an IC50 of 1.74 μg/mL. The above analysis demonstrated that SZ-A could selectively inhibit disaccharidase to reduce hyperglycemia with a reversible competitive inhibition, which was primarily attributed to the three major active ingredients of SZ-A, especially 1-DNJ molecule. In the light of these findings, molecular docking study was utilized to analyze their inhibition mechanisms at molecular level. It pointed out that acarbose with a four-ring structure could perform desirable interactions with various α-glucosidases, while the three active ingredients of SZ-A, belonging to monocyclic compounds, had a high affinity to the active site of disaccharidases through forming a wide range of hydrogen bonds, whose affinity and consensus score with α-amylase was significantly lower than that of acarbose. Our study illustrates the selective inhibition mechanism of SZ-A on α-glucosidase for the first time, which is of great importance for the treatment of type 2 diabetes mellitus.

scholarly journals Type 2 Diabetes Mellitus Associated with Obesity (Diabesity). The Central Role of Gut Microbiota and Its Translational Applications

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2749 ◽  
Author(s):  
Miguel A. Ortega ◽  
Oscar Fraile-Martínez ◽  
Irene Naya ◽  
Natalio García-Honduvilla ◽  
Melchor Álvarez-Mon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gut Microbiota ◽  
Metabolic Disorders ◽  
Health Concern ◽  
Public Health Concern ◽  
Wide Range

Obesity is a condition of rising prevalence worldwide, with important socioeconomic implications, being considered as a growing public health concern. Frequently, obesity brings other complications in addition to itself—like Type 2 Diabetes Mellitus (T2DM)—sharing origin, risk factors and pathophysiological mechanisms. In this context, some authors have decided to include both conditions as a unique entity known as “diabesity”. In fact, understanding diabesity as a single disease is possible to maximise the benefits from therapies received in these patients. Gut microbiota plays a key role in individual’s health, and their alterations, either in its composition or derived products are related to a wide range of metabolic disorders like T2DM and obesity. The present work aims to collect the different changes reported in gut microbiota in patients with T2DM associated with obesity and their possible role in the onset, development, and establishment of the disease. Moreover, current research lines to modulate gut microbiota and the potential clinical translation derived from the knowledge of this system will also be reviewed, which may provide support for a better clinical management of such a complex condition.

scholarly journals Barriers and Facilitators for Physical Activity in Adults with Type 2 Diabetes Mellitus: A Scoping Review

2021 ◽  
Vol 18 (10) ◽  
pp. 5359
Author(s):  
Mireia Vilafranca Cartagena ◽  
Glòria Tort-Nasarre ◽  
Esther Rubinat Arnaldo
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Social Support ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Physical Exercise ◽  
Scoping Review ◽  
Sociodemographic Characteristics ◽  
Personal Motivation

The treatment of Type 2 Diabetes Mellitus (DM2) comprises physical activity (PA), diet, and medication. PA provides important benefits for people with diabetes. However, the majority of patients with DM2 do not attain the recommended levels of PA. Despite the evidence of the benefits to health of engaging in PA, the recommendations have not been fully translated into clinical improvements. Using a scoping review, this study aimed to identify the factors that influence levels of physical activity in adults with DM2. Eighteen studies published from 2009–2020 were identified by a search of relevant systematic databases between March 2019 and December 2020. The scoping review was carried out in accordance with the model defined by Arksey and O’Malley. The synthesis revelated sociodemographic characteristics, and six components—personal, motivation, social, mental, clinical, and self-efficacy—were identified as factors. Those that were most frequently identified were motivation and social support. In conclusion, these results should be considered to implement strategies to encourage people with DM2 to engage in physical exercise and thus improve the management of their condition.

scholarly journals Is it possible to achieve sustained remission or cure of type 2 diabetes mellitus in the 21st century?

2017 ◽  
Vol 89 (10) ◽  
pp. 4-11 ◽  
Author(s):  
M V Shestakova ◽  
I A Sklyanik ◽  
I I Dedov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Sustained Remission ◽  
Normal Range ◽  
Wide Range ◽  
Drug Treatments

A practitioner has a wide range of the hypoglycemic drugs for type 2 diabetes mellitus (T2DM) treatment, which can be used within a normal or near-normal range for long-term glycemic control. However, the question remains whether there are ways to achieve not only satisfactory glycemic control, but also T2DM remission (or even complete cure). The review presents an update on the concept of T2DM remission and describes the ways of its possible achievement with non-drug and drug treatments and surgery. The mechanisms of T2DM remission are given.

scholarly journals Community-based models of care for management of type 2 diabetes mellitus among non-pregnant adults in sub-Saharan Africa: a scoping review protocol

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 535
Author(s):  
Emmanuel Firima ◽  
Lucia Gonzalez ◽  
Jacqueline Huber ◽  
Jennifer M. Belus ◽  
Fabian Raeber ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Scoping Review ◽  
Health Care Facilities ◽  
Engagement In Care ◽  
Community Based ◽  
Care Facilities

Background: The burden of type 2 diabetes mellitus (T2DM) is increasing in low- and middle-income countries, including sub-Sahara Africa (SSA). However, awareness of and access to T2DM diagnosis and care remain low in SSA, leading to delayed treatment, early morbidity, and mortality. Particularly in rural settings with long distances to health care facilities, community-based care models may contribute to increased timely diagnosis and care. This scoping review aims to summarize and categorize existing models of community-based care for T2DM among non-pregnant adults in SSA, and to synthesize the evidence on acceptance, clinical outcomes, and engagement in care. Method and analysis: This review will follow the framework suggested by Arskey and O’Malley, which has been further refined by Levac et al. and the Joanna Briggs Institute. Electronic searches will be performed in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus, supplemented with backward and forward citation searches. We will include cohort studies, randomized trials and case-control studies that report cases of non-pregnant individuals diagnosed with T2DM in SSA who receive a substantial part of care in the community. Our outcomes of interest will be model acceptability, blood sugar control, end organ damage, and patient engagement in care. A narrative analysis will be conducted, and comparisons made between community-based and facility-based models, where within-study comparison is reported. Conclusion: Care for T2DM has become a global health priority. Community-based care may be an important add-on approach especially in populations with poor access to health care facilities. This review will inform policy makers and program implementers on different community-based models for care of T2DM in SSA, and critically appraise their acceptability and clinical outcomes. It will further identify evidence gaps and future research priorities in community-based T2DM care.

scholarly journals Meal replacement in dietary management of type-2 diabetes mellitus: a scoping review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Lew Leong Chen ◽  
Arimi Fitri Mat Ludin ◽  
Suzana Shahar ◽  
Zahara Abdul Manaf ◽  
Noorlaili Mohd Tohit
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Scoping Review ◽  
Early Stage ◽  
Meal Replacement ◽  
Diet Modification ◽  
Cochrane Reviews ◽  
Review Protocol

Abstract Background The prevalence of type-2 diabetes mellitus (T2DM) has been increasing globally. Without proper management, T2DM can develop into serious complications and even death. Diet modification is one of the most effective tools in managing T2DM at the early stage, but it requires knowledge and compliance from the patients. Thus, meal replacement (MR) has gained its popularity as a tool for diet modification to improve glycemic control and also reducing weight in T2DM patients. There are several existing meal replacement studies but not much is known on the general scope and effect of these existing MRs. Hence, this review is aimed to provide an overview of the existing evidences regarding the application of meal replacement on T2DM patients and identify the gaps or limitations in the studies. Methodology The scoping review will be carried out in six stages: (1) identifying the research question, (2) identifying relevant studies through electronic databases (i.e., PubMed, Scopus, Cochrane Reviews, Google Scholar, EBSCOHOST, Science Direct) and also gray literature, and (3) selection of studies to be included based on inclusion criteria. Search and initial screening of studies to be included will be conducted by two independent reviewers. Discrepancies will then be solved through discussion with other reviewers; (4) charting and categorizing extracted data in a pretested data extraction form; (5) collating, summarizing, and reporting the results; and lastly, (6) conducting consultation with stakeholders and experts in diabetes. Discussion This scoping review protocol is aimed to provide a framework enabling us to map and summarize the findings from existing studies involving meal replacement. It will help researchers to identify the research gap and provide recommendations for future meal replacement studies. The results from this scoping review will be useful to various stakeholders in healthcare. It is also part of a research project in which the information obtained will be utilized in a clinical trial of a developed meal replacement plan. Dissemination of knowledge will also be done through presentations at related scientific conferences.

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