scholarly journals Financial incentives to improve glycemic control in African American adults with type 2 diabetes: a pilot randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonard E. Egede ◽  
Jennifer A. Campbell ◽  
Rebekah J. Walker ◽  
Aprill Z. Dawson ◽  
Joni S. Williams
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Financial Incentives ◽  
Financial Incentive ◽  
Incentive Group ◽  
Home Testing ◽  
Incentive Structures ◽  
Group 3 ◽  
Group 2

Abstract Background Financial incentives is emerging as a viable strategy for improving clinical outcomes for adults with type 2 diabetes. However, there is limited data on optimal structure for financial incentives and whether financial incentives are effective in African Americans with type 2 diabetes. This pilot study evaluated impact of three financial incentive structures on glycemic control in this population. Methods Sixty adults with type 2 diabetes were randomized to one of three financial incentive structures: 1) single incentive (Group 1) at 3 months for Hemoglobin A1c (HbA1c) reduction, 2) two-part equal incentive (Group 2) for home testing of glucose and HbA1c reduction at 3 months, and 3) three-part equal incentive (Group 3) for home testing, attendance of weekly telephone education classes and HbA1c reduction at 3 months. The primary outcome was HbA1c reduction within each group at 3 months post-randomization. Paired t-tests were used to test differences between baseline and 3-month HbA1c within each group. Results The mean age for the sample was 57.9 years and 71.9% were women. Each incentive structure led to significant reductions in HbA1c at 3 months with the greatest reduction from baseline in the group with incentives for multiple components: Group 1 mean reduction = 1.25, Group 2 mean reduction = 1.73, Group 3 mean reduction = 1.74. Conclusion Financial incentives led to significant reductions in HbA1c from baseline within each group. Incentives for multiple components led to the greatest reductions from baseline. Structured financial incentives that reward home monitoring, attendance of telephone education sessions, and lifestyle modification to lower HbA1c are viable options for glycemic control in African Americans with type 2 diabetes. Trial registration Trial registration: NCT02722499. Registered 23 March 2016, url.

scholarly journals Supplementation disrupts the circannual rhythm of vitamin D: A retrospective analysis

2020 ◽  
Vol 11 (3) ◽  
pp. 108-115
Author(s):  
Özgür Aydın
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Therapy Group ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: MPV and PDW are vascular complications markers and improved glycemic control levels are correlated those indicators in patients with type 2 Diabetes Mellitus. The aim of in this study, MPV and PDW levels were compared type 2 diabetic patients treated with oral antihyperglycemic agent and insulin. Methods: This study was performed retrospectively on type 2 DM patients who were admitted to Ankara Atatürk Training and Research Hospital. 118 randomly selected patients were divided into 3 groups that were non-diabetic (Group 1), who received OAD therapy (Group 2), and those who received insulin therapy (Group 3). HbA1c, MPV, PDW levels were collected, analyzed and compared with each other. Results: MPV and PDW values were increased in type 2 DM patients compared to the control group (Group 2; p <0.001 and Group 3 p <0.001, respectively). There was no statistically significant difference between MPV and PDW values in patients treated OAD and insulin therapy (p=0.736 ve p=0.360 respectively). A statistically significant positive correlation was found between HbA1c values and MPV (p <0.001) and PDW (p <0.001) values. Conclusions: In our study, no significant difference was found bet-ween MPV and PDW values of patients using insulin and oad. Early initiation of conventional insulin therapy in patients with type 2 diabetes provides good glycemic control. Rational drug use in accordance with the guidelines; gains importance in treatment success. Skipping this factor may reduce the efficiency of other efforts in relation to rational treatment.

scholarly journals Evaluation of MPV and PDW levels by using antihyperglycemic drugs in type 2 DM patients

2020 ◽  
Vol 11 (3) ◽  
pp. 102-107
Author(s):  
Hacer Dinçoğlu ◽  
İrep Eray
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Therapy Group ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: MPV and PDW are vascular complications markers and improved glycemic control levels are correlated those indicators in patients with type 2 Diabetes Mellitus. The aim of in this study, MPV and PDW levels were compared type 2 diabetic patients treated with oral antihyperglycemic agent and insulin. Methods: This study was performed retrospectively on type 2 DM patients who were admitted to Ankara Atatürk Training and Research Hospital. 118 randomly selected patients were divided into 3 groups that were non-diabetic (Group 1), who received OAD therapy (Group 2), and those who received insulin therapy (Group 3). HbA1c, MPV, PDW levels were collected, analyzed and compared with each other. Results: MPV and PDW values were increased in type 2 DM patients compared to the control group (Group 2; p <0.001 and Group 3 p <0.001, respectively). There was no statistically significant difference between MPV and PDW values in patients treated OAD and insulin therapy (p=0.736 ve p=0.360 respectively). A statistically significant positive correlation was found between HbA1c values and MPV (p <0.001) and PDW (p <0.001) values. Conclusions: In our study, no significant difference was found between MPV and PDW values of patients using insulin and oad. Early initiation of conventional insulin therapy in patients with type 2 diabetes provides good glycemic control. Rational drug use in accordance with the guidelines; gains importance in treatment success. Skipping this factor may reduce the efficiency of other efforts in relation to rational treatment.

scholarly journals Study of neutrophil lymphocyte ratio in patients with type 2 diabetes mellitus and its correlation with glycemic control

2019 ◽  
Vol 6 (5) ◽  
pp. 1637
Author(s):  
Devamsh G. N. ◽  
Parvathi M. ◽  
Madhumathi R. ◽  
Leela Raghavan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Neutrophil lymphocyte ratio (NLR) is an indicator of subclinical inflammation. Subclinical inflammation may be associated with increased cardiovascular risk. Raised NLR is associated with metabolic syndrome and is found to be a predictor of cardiovascular disorders. There are only few studies assessing the correlation between NLR and glycemic control. The aim of the present study is to investigate the relationship between NLR and glycemic control in type 2 diabetes patients.Methods: This observational study was conducted in Department of Medicine, Bangalore medical college. 100 patients diagnosed to have type 2 diabetes mellitus were assessed. They were divided into three groups based upon HbA1c levels: Group 1, HbA1c ≤7%; group 2, HbA1c 7-9%, and group 3, HbA1c>9%. Complete blood count and other relevant investigations were performed. SPSS software was used for statistical analysis. T test was used for continuous variables and chi square test for categorical variables. ANOVA test was used to compare three groups. A p value of <0.05 was considered statistically significant.Results: Out of 100 patients, the white blood cell count (WBC count) was higher in group 3 as compared to group 1 and group 2(p 0.008). Similarly, the absolute neutrophil count was higher in group 3 as compared to group 1 and group 2(p.017). The neutrophil lymphocyte ratio (NLR) was significantly higher in group 3 as compared with group 1 and group 2(p.009). NLR had a positive correlation with HbA1c and was found to be an independent predictor of poor glycemic control in patients with type 2 diabetes mellitusConclusions: Our study found a significant positive correlation between NLR and glycemic control. Increased NLR is associated with elevated HbA1c and poor glycemic control. Type 2 diabetes mellitus patients with raised NLR should be evaluated for cardiovascular, renal and ocular complications of diabetes.

Intercellular adhesion molecule-1 is a surrogate biomarker for subclinical atherosclerosis in Type 2 diabetes mellitus

2021 ◽  
Vol 15 (2) ◽  
pp. 121-132
Author(s):  
Thallapaneni Sasikala ◽  
Suchitra M Manohar ◽  
Aparna RR Bitla ◽  
S Sarala ◽  
Suresh Vaikkakara
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Intercellular Adhesion Molecule ◽  
Intercellular Adhesion Molecule 1 ◽  
Group 3 ◽  
Group 2

Aim: We aimed to investigate biomarkers of inflammation, oxidative stress as surrogate markers of subclinical atherosclerosis in patients with Type 2 diabetes mellitus (T2DM). Materials & methods: Subjects were grouped based on carotid intima media thickness (CIMT). Group 1: healthy controls (CIMT <0.57 mm); Group 2: T2DM without subclinical atherosclerosis (CIMT <0.57 mm); Group 3: T2DM with subclinical atherosclerosis (CIMT ≥0.57 mm). Results: Significantly higher MDA, Hs-CRP, Ox-LDL, PTX-3, IL-6, ICAM-1 and lower FRAP, IL-10 levels in T2DM groups compared with controls (p = 0.001). Changes were more significant in Group 3 compared with Group 2. ICAM-1 had the highest sensitivity and specificity at a cut-off value of >40.34 ng/ml compared with Ox-LDL and PTX-3 (p < 0.001). Conclusion: ICAM can be considered as an alternate surrogate biomarker of CIMT.

scholarly journals Expression Profiling of Genes Related to Endothelial Cells Biology in Patients with Type 2 Diabetes and Patients with Prediabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Sara Moradipoor ◽  
Patimah Ismail ◽  
Ali Etemad ◽  
Wan Aliaa Wan Sulaiman ◽  
Salma Ahmadloo
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cells ◽  
Endothelial Dysfunction ◽  
Cell Biology ◽  
Control Group ◽  
Expression Levels ◽  
New Genes ◽  
Group 3 ◽  
Group 2

Endothelial dysfunction appears to be an early sign indicating vascular damage and predicts the progression of atherosclerosis and cardiovascular disorders. Extensive clinical and experimental evidence suggests that endothelial dysfunction occurs in Type 2 Diabetes Mellitus (T2DM) and prediabetes patients. This study was carried out with an aim to appraise the expression levels in the peripheral blood of 84 genes related to endothelial cells biology in patients with diagnosed T2DM or prediabetes, trying to identify new genes whose expression might be changed under these pathological conditions. The study covered a total of 45 participants. The participants were divided into three groups: group 1, patients with T2DM; group 2, patients with prediabetes; group 3, control group. The gene expression analysis was performed using the Endothelial Cell Biology RT2Profiler PCR Array. In the case of T2DM, 59 genes were found to be upregulated, and four genes were observed to be downregulated. In prediabetes patients, increased expression was observed for 49 genes, with two downregulated genes observed. Our results indicate that diabetic and prediabetic conditions change the expression levels of genes related to endothelial cells biology and, consequently, may increase the risk for occurrence of endothelial dysfunction.

scholarly journals Comparing the effect of ladies’ finger water with fenugreek seeds water on the blood glucose level among subjects with type 2 diabetes mellitus-a randomized controlled trial

2021 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Radhika R. ◽  
Navaneetha M. ◽  
Ravichandran K. ◽  
Hemavathi P.
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fenugreek Seeds ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<p><strong>Background: </strong>The primary aim of managing diabetes is to maintain blood glucose level to prevent diabetes induced complications. Studies showed that ladies finger and fenugreek seeds are blood sugar stabilizer. The objective of this randomized active controlled trial was to assess the effect of ladies finger water versus fenugreek seeds water on the blood glucose level among subject with type 2 diabetes.</p><p><strong>Methods: </strong>Total of 180 study participants were selected and equally assigned to three groups by computer generated randomization. Group 1-received ladies finger water and oral antidiabetic drug (OAD); group 2-received fenugreek seeds water and OAD; group 3-received only OAD for 15 days. Pre and post intervention fasting blood sugar (FBS) was assessed by accu-chek Performa glucometer. Wilcoxon signed rank test; one-way analysis of covariance followed by post hoc test with Bon-ferroni correction was done.</p><p><strong>Results: </strong>Analysis was done based on 168 subjects. There was a significant reduction in FBS level with the mean difference of group 1-21.0 mg/dl (p&lt;0.001), group 2-20.3 mg/dl (p&lt;0.001) and group 3-4.7 mg/dl (p=0.068). No significant difference found between group 1 and group 2 (p=1.00), but significant difference found between group 1 and group 3 (p=0.032); group 2 and group 3 (p=0.012). Both ladies finger water and fenugreek seeds water were superior in reduction of FBS than OAD.</p><p><strong>Conclusions: </strong>Ladies finger water or fenugreek seeds water can be used as adjunct along with OAD to control type 2 diabetes mellitus.</p><p><strong> </strong></p>

scholarly journals TYPE 2 DIABETES MELLITUS

2015 ◽  
Vol 22 (01) ◽  
pp. 143-148
Author(s):  
Rehan Khawaja ◽  
Tahir Munir ◽  
Uzma Hassan ◽  
Syed Shoaib Shah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin E ◽  
Vitamin C ◽  
Group 4 ◽  
Anti Oxidant ◽  
Group 3 ◽  
Group 2 ◽  
Dm Type 2

Objectives: To access the Antioxidant Status in Patient with Variation in Durationof Type 2 Diabetes Mellitus. Data source: 90 selected patients suffering from Type 2 DiabetesMellitus (DM) and 30 subjects as control group. Design of study: Case Control Study. Setting:Rawal Institute of Health Sciences, Islamabad. Period: July 2013 – March 2014. Materials& methods: Out of 120 selected subjects, 90 were of DM type 2and 30 were assigned ascontrol group (group 1). Based on duration, patients of DM type 2 were divided into; group2, 3 and 4; group 2 – patients with DM (type 2) duration less than 5 years, group 3 - with DMduration between 5-10 years and group 4 - with duration of DM more than 10 years. Smokers,renal failure, coronary artery disease, thyroid disease and previous antioxidant treatmentpatients were excluded from the study. Diabetes mellitus type 2 was diagnosed according tothe standards set by American Diabetes Association. The fasting plasma glucose levels weremeasured by glucose oxidase method; HbA1c by automated kit on Cobas Integra of Roche.The TAC was measured by calorimetric TAC Assay Kit (BioVision) while Vitamin C and E weremeasured by using ELISA Kit (HUMAN). Cut off values for HbA1c was taken as ≤6%; FBS≤110 mg/dl; TAC ≥1.16 mmol/L; Vitamin C ≥2 mg/dl; Vitamin E ≥ 9.5nmol/ml. Results: Asthe duration of type 2 diabetes increases, it was seen that vitamin C levels and TAC levels inall groups except between groups 1 & 2 decreased significantly; however, anti-oxidant vitaminE, was found to be significantly decreased in all the groups as the duration increases. Asignificantly increased level of HbA1c were noticed in groups 2, 3 and 4 as compared to group1 as the duration of diabetes increases; however, the levels were found to be non-significantwhen group 4 was compared with that of group 2 and group 3. When fasting blood sugarwas compared between the diabetic groups a significant increased levels were noticed in allthe groups with the exception between group 3 and 4. A significant differences between eachgroup and within the groups was observed when Hb1Ac, vitamin E, vitamin C, &TAC werecompared using ANOVA. A statistical significant correlation was observed when HbA1c wascorrelated with FBS; however, it shows an inverse relationship with TAC, vitamin C and vitaminE. A significant inverse correlation of FBS was noticed with TAC, vitamin C, and vitamin E. Asignificant positive correlation was seen when TAC was correlated with vitamin C and vitamin E.A similar trend of significant positive correlation was seen when vitamin C was correlated withvitamin E. Conclusions: The levels of total anti-oxidant capacity, vitamin C, and vitamin Egradually decrease with duration of diabetes and are associated with oxidative stress. Theseantioxidant vitamins (vitamin C and vitamin E) should be supplemented in diabetics to increasetheir quality of life. TAC status may be taken as early marker to detect complications in diabetictype 2 patients especially of longer duration.

scholarly journals Lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. 21-27
Author(s):  
S.O. Rykov ◽  
K.V. Korobov ◽  
S.Yu. Mogilevskyy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Vascular Anomalies ◽  
Vascular Changes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. One of the early microvascular complications of type 2 diabetes mellitus (T2DM) is diabetic retino­pathy (DR). Its main cause is prolonged hyperglycemia, which triggers the development of microangiopathy. In this regard, the issue of damage to paired eyes and the spread of DR in the initial stages has not been fully clarified. The purpose: to study the peculiarities of lesions of paired eyes at the initial stages of non-proliferative diabetic retinopathy in patients with type 2 dia­betes mellitus. Materials and methods. We examined 91 patients with T2DM (182 eyes), who did not have retinopathy according to the International Diabetic Retinopathy Severity Scale of the American Academy of Ophthalmology (2002). Paired eyes were divided into three groups: group 1 included 132 paired eyes (66 patients) with 10 points according to the Early Treatment Diabetic Retinopathy Group Study (ETDRS); group 2 consisted of 25 eyes with 10 points on ETDRS, and group 3 — 25 paired eyes with retinal vascular anomalies (14–15 points on ETDRS). The patients were examined again after 1 year. According to the ETDRS, Airlie House classification, microaneurysms, microhemorrhages, intraretinal microvascular abnormalities, retinal vascular abnormalities, and retinal nonperfusion were detec­ted. Results. The majority (58.3 %) of paired eyes without initial changes (group 1) had no progression of DR within 1 year, 12.9 % had vascular anomalies (14–15 points on ETDRS), 13.6 % deve­loped mild, and 15.2 % — moderate non-proliferative DR. The highest progression of DR (88.0 % of eyes) was observed in eyes without diabetic vascular changes, which were paired to eyes with such changes (group 2) that was 2.1 times (p < 0.001) higher than the indicator of paired eyes without diabetic changes (group 1; 41.7 %). Most eyes that had mild vascular changes (group 3) progressed to moderate non-proliferative DR after 1 year, which was four times more often than in eyes that had no initial changes (60.0 versus 15.2 %; p < 0.001). DR in the eyes of group 3 with progression accounted for 43–47 points on EDTRS; the visual acuity of these eyes, both before and after 1 year, was significantly lower than in other groups, and the level of glycated hemoglobin in the blood of patients with such eyes was significantly higher. Conclusions. This study established the features of the progression of early stages of DR in patients with T2DM, and the significance of primary retinal vascular anomalies in the presence of which the progression of DR was faster.

Phenylthiocarbamide Taste Perception among Patients with Type 2 Diabetes Mellitus

2019 ◽  
pp. 1-5
Author(s):  
C. Igbeneghu ◽  
J. M. Olisekodiaka ◽  
J. A. Onuegbu ◽  
O. H. Oyeyode
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Taste Perception ◽  
Taste Sensitivity ◽  
Type 2 Dm ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim: To determine whether Phenylthiocarbamide (PTC) taste blindness is associated with type 2 Diabetes Mellitus (DM) and possible relationship between intake of treatment medications and PTC taste sensitivity. Methodology: The study participants consisted of 100 type 2 DM patients on treatment (group 1) and 100 newly diagnosed type 2 DM patients not on drugs treatment (group 2). Apparently healthy individuals (100) served as controls (group 3). Informed consent was obtained from each participant at the commencement of the study. Tasters and non-tasters were determined using phenylthiocarbamide (PTC) taste strips (0.0143 mg/strip). Results: In group 1, 66% were non-tasters; in group 2, 60% were non-tasters while 37% in group 3 were non-tasters. Phenylthiocarbamide taste perception varied significantly among the 3 groups studied (p < 0.001). Non-tasters of PTC in groups 1 and 2 were not significantly different (p = 0.38). Non-tasters of PTC in groups 1 and 2 (p < 0.001; OR 3.30 and p = 0.001; OR 2.55 respectively) were significantly higher than non-tasters in the control (group 3). Conclusion: This study shows that inability to taste PTC is associated with type 2 DM. However, intake of DM treatment medications does not appear to have any significant influence on PTC taste sensitivity.

Combined Ayurveda and Yoga Practices for Newly Diagnosed Type 2 Diabetes Mellitus: A Controlled Trial

2017 ◽  
Vol 25 (1) ◽  
pp. 16-23
Author(s):  
Purnima Datey ◽  
Alex Hankey ◽  
H.R. Nagendra
Keyword(s):  
Type 2 Diabetes ◽  
Blood Sugar ◽  
Controlled Trial ◽  
Newly Diagnosed ◽  
Post Intervention ◽  
Group 3 ◽  
Group 2 ◽  
Male Prisoners ◽  
Group 1

Background: The increasing prevalence of type 2 diabetes in India is a cause for national concern, particularly the spiraling cost burden to the country. As one approach to stop its increase, Yoga medicine has been widely implemented, finding popularity with all social strata. Here, we report a study suggesting that treatment with fresh herbal juices and Yoga can improve the levels of blood glucose and hemoglobin A1c (HbA1c) in people with pre-diabetes. Methods: Study design: 3-arm controlled trial 3 months in duration. Participants: 157 male prisoners with newly diagnosed, high fasting blood sugar (FBS) and postprandial blood sugar (PPBS) levels. Group interventions: (1) Rasahara and Yoga, (2) Yoga, (3) no intervention. Assessments: FBS and PPBS levels were measured every 2 weeks; HbA1c and blood lipids were determined pre- and post-intervention. Results: Significant decreases occurred in the FBS (-21.13 ± 21.16 mg/dl) and PPBS levels (-15.02 ± 14.89 mg/dl) in group 1 (both p < 0.0001) and in the FBS level (20.62 ± 32.68 mg/dl) in group 2 (p = 0.0005), while the increases in group 3 attained significance only for the PPBS level (9.62 ± 21.83 mg/dl) (p = 0.0022). Observed changes in HbA1c were: group 1, -0.044 ± 0.059 mg/dl; group 2, +0.024 ± 0.456 mg/dl (not significant); and group 3, +0.365 ± 0.369 mg/dl (p < 0.0001). Conclusions: This study of Yoga for the treatment of diabetes shows that all male prisoners could benefit from the Yoga prison programs. Addition of Yoga programs to state and federal activities at all levels is now national policy in India. Follow-up studies should be carried out to obtain more robust results.

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