scholarly journals Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Hyder Osman Mirghani
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Plasma Glucose ◽  
Meta Analysis ◽  
Postprandial Plasma Glucose ◽  
Creative Commons ◽  
Patients With Diabetes ◽  
Glycemic Indices ◽  
Open Access Article

Background & Objective: Dates fruit is known for its great nutritional value and two to three servings of dates fruit/day are beneficial for patients with diabetes. However, some may advice against this cheap and widely available fruit consumption. Besides, 12% of the population Worldwide are either suffering or are at risk of developing diabetes, but no previous meta-analysis has assessed this important issue. Thus, the study aimed to investigate the effects of date’s fruit on glycemia among patients with diabetes. Methods: A systematic literature search was conducted in PubMed, Medline, EBSCO, Cochrane, and Google Scholar databases for trials published in English from the first published article up to December 2020. The following keywords were used: “dates fruit and glycemic control”, “dates fruit and blood glucose”, “dates fruit and HbA1c” without limitations regarding the date of publication. Results: Out of the 942 references identified, only 10 cohorts from five full texts were included, a reduction of Fasting plasma glucose (FPG), odd ratio, -24.79, 95% CI=-34.75, -14.83 P =0.002. I2 for heterogeneity=79%, P <0.00001 and postprandial plasma glucose (PPPG), odd ratio -28.19, 95% CI=-60.66-4.29, P =<0.0001. I2 for heterogeneity=92%, P=0.09) was observed. While the effect on HbA1c was neutral, odd ratio, -.20, 95% CI=-.46 -.06, P=0.13. I2 for heterogeneity=0. %, P=0.55. Conclusion: Dates fruit was beneficial regarding glycemic control among patients with diabetes, physician may not need to restrict its use among patients with diabetes. The small number of the included studies and the heterogeneity observed in PPPG and FPG sub-analysis limited the current results. Further trials assessing the glycemic indices of various types of dates fruit are needed. doi: https://doi.org/10.12669/pjms.37.4.4112 How to cite this:Mirghani HO. Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4112 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Glycemic impact of intensified self monitoring of blood glucose in insulin treated subjects with type 2 diabetes mellitus

2018 ◽  
Vol 06 (01) ◽  
pp. 027-033
Author(s):  
Ejiofor Ugwu ◽  
Ibrahim Gezawa ◽  
Olufunmilayo Adeleye
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Hba1c Level ◽  
Insulin Dosage ◽  
Self Monitoring ◽  
Glycemic Indices

Objective:The aim of this study was to evaluate if intensified self-monitoring of blood glucose (SMBG) improves glycemic control in insulin-treated subjects with type 2 diabetes mellitus (T2DM). Methods:Ninety-six adults with stable but poorly controlled [glycated hemoglobin (HbA1c) level >7.5%] T2DM receiving twice-daily biphasic insulin were randomly assigned to either of the two groups: intensive monitors (IM) that performed SMBG at least twice daily or conventional monitors (CM) that performed SMBG at their discretionary frequency for 12 weeks. Demographic, clinical, and glycemic indices, including fasting blood glucose (FBG), postprandial glucose (PPG), and HbA1c, were compared at baseline and week 12. Results:A total of 71 subjects (25 IM and 46 CM) completed the study. Both groups had similar HbA1c at baseline. From baseline to week 12, the IM group had higher mean daily test strip usage (P <0.001), engaged in more frequent insulin dose adjustments (P <0.001), and attained greater daily insulin dosage (P = 0.002). All glycemic indices including FBG, PPG, and HbA1c improved significantly from baseline to week 12 in the IM but not in the CM group. HbA1c level declined by −1.2 ±0.4% in the IM group (P = 0.002). There was no difference in the frequency of hypoglycemia in both groups. The monthly cost of intensified SMBG was nearly four times that of conventional monitoring (P <0.001). Conclusion:Both short- and long-term glycemic control significantly improved by intensified SMBG in stable but poorly controlled insulin-treated adults with T2DM. Intensified SMBG enabled better self-titration of insulin and probably other self-care practices. This benefit, however, occurred at the expense of costs that may be difficult to sustain in resource-poor countries.

scholarly journals Hyperglycemic memory in diabetic cardiomyopathy

2021 ◽  
Author(s):  
Jiabing Zhan ◽  
Chen Chen ◽  
Dao Wen Wang ◽  
Huaping Li
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Glycemic Control ◽  
Diabetic Cardiomyopathy ◽  
Cardiovascular Complication ◽  
Diabetes Therapy ◽  
Patients With Diabetes ◽  
Underlying Mechanisms

AbstractCardiovascular diseases account for approximately 80% of deaths among individuals with diabetes mellitus, with diabetic cardiomyopathy as the major diabetic cardiovascular complication. Hyperglycemia is a symptom that abnormally activates multiple downstream pathways and contributes to cardiac hypertrophy, fibrosis, apoptosis, and other pathophysiological changes. Although glycemic control has long been at the center of diabetes therapy, multicenter randomized clinical studies have revealed that intensive glycemic control fails to reduce heart failure-associated hospitalization and mortality in patients with diabetes. This finding indicates that hyperglycemic stress persists in the cardiovascular system of patients with diabetes even if blood glucose level is tightly controlled to the normal level. This process is now referred to as hyperglycemic memory (HGM) phenomenon. We briefly reviewed herein the current advances that have been achieved in research on the underlying mechanisms of HGM in diabetic cardiomyopathy.

scholarly journals Relevance of self-control of blood glucose in the aspect of prevention of cardiovascular complications in patients with diabetes mellitus

2021 ◽  
pp. 104-109
Author(s):  
D. I. Trukhan
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Glycemic Control ◽  
Complications Of Diabetes ◽  
Glucose Levels ◽  
Risk Of Death ◽  
Increased Risk ◽  
Patients With Diabetes

There is a clear link between diabetes and cardiovascular disease. It is known that cardiovascular diseases in patients with diabetes mellitus occur 2–5 times more often than in people without diabetes. It is cardiovascular outcomes that are the main cause of death in patients with diabetes mellitus in both men and women. Diabetes mellitus has a high risk of coronary heart disease, myocardial infarction, arterial hypertension and acute cerebrovascular accident, and patients with diabetes mellitus may experience painless acute myocardial infarction associated with the presence of autonomic cardiac neuropathy. Various rhythm disturbances are much more common in diabetes mellitus, including paroxysmal forms of atrial fibrillation, which increase the risk of death by 1.8–2 times. The leading factor in the development of vascular complications of diabetes mellitus is hyperglycemia. In addition, early glycemic disorders - impaired glucose tolerance or impaired fasting glycemia - make a significant contribution to the increased risk of macrovascular complications. Improving glycemic control leads to a significant reduction in the risk of late macro- and microvascular complications of diabetes mellitus. Glycated hemoglobin is the gold standard for monitoring glycemic control, but it does not provide complete information on daily and intraday changes in glucose levels. Regular self-monitoring of glucose levels is important in the prevention of cardiovascular diseases in patients with diabetes mellitus. In addition, during the COVID-19 pandemic, all consensus documents and recommendations for the management of patients with diabetes indicate the need for regular monitoring of glucose levels. An important aspect of the technical impact on patients’ adherence to selfcontrol and diabetes therapy is the presence of a convenient communicative connection between the patient and the doctor, in particular, the possibility of contact remotely via a computer and a mobile phone. In conclusion, the possibilities of the new model of the line of blood glucose meters are considered.

Evaluating Perioperative Glycemic Control of Non-cardiac Surgical Patients with Diabetes

2020 ◽  
Author(s):  
L Alan Todd ◽  
Robert A Vigersky
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Surgery ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Perioperative Period ◽  
Poor Glycemic Control ◽  
Surgical Patients ◽  
Patients With Diabetes

ABSTRACT Introduction Hyperglycemia during the perioperative period has generally been accepted as a contributor of poor outcomes in patients with diabetes mellitus undergoing surgery. Although an optimal glycemic range has not been clearly established in the literature, a consensus among national medical organizations generally recommends serum glucose levels to be maintained less than 180 mg/dL during the perioperative period. Materials and Methods The primary purpose of this evidence-based project was to identify the range of blood glucose values obtained from adult patients with diabetes mellitus undergoing non-cardiac surgery at a large military medical facility. The secondary purpose of this project was to assess the need for change in future practice. A retrospective review of the electronic medical record was conducted to identify adult surgical patients with diabetes scheduled for non-cardiac surgery. Preoperative and postoperative blood glucose values were obtained from the electronic medical record. The frequency of blood glucose values maintained within the recommended range of 140-180 mg/dL was recorded. Additional demographic data were collected to include age, height, weight, body mass index, length of surgery, and insulin/oral glycemic medications. Results Of the 9,449 surgeries performed between January 1, 2013, and December 31, 2013, there were 762 (8%) adult non-cardiac surgical patients identified with either a diagnosis of diabetes or a blood glucose value reported during the perioperative period. The recommended blood glucose range of 140-180 mg/dL was achieved in 31.3% (179 of 572) of patients before surgery and 28.6% (71 of 248) after surgery. A blood glucose value was not recorded before or after surgery in 24.9% (190 of 762) of patients identified as having pre-diabetes or diabetes. Conclusion Diabetes is a frequent finding in surgical patients. Monitoring blood glucose values during the perioperative period may allow for early treatment and prevent complications related to poor glycemic control. The results of this project revealed 2 potential areas of improvement in the care of non-cardiac surgical patients with diabetes: (1) improving compliance with obtaining blood glucose values before and after surgery and (2) reducing the incidence of postoperative hyperglycemia (&gt;180 mg/dL) which potentially could prevent avoidable complications related to poor glycemic control.

scholarly journals Diabetic ketoacidosis in patients with SARS-CoV-2: a systematic review and meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Saad Alhumaid ◽  
Abbas Al Mutair ◽  
Zainab Al Alawi ◽  
Ali A. Rabaan ◽  
Mohammed A. Alomari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Biochemical Parameters ◽  
Diabetes Mellitus Type 2 ◽  
Meta Analysis ◽  
Male Gender ◽  
Patients With Diabetes

Abstract Background One possible reason for increased mortality due to SARS-CoV-2 in patients with diabetes is from the complication of diabetic ketoacidosis (DKA). Objectives To re-evaluate the association of SARS-CoV-2 and development of DKA and analyse the demographic and biochemical parameters and the clinical outcomes in COVID-19 patients with DKA. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature) were searched from 1 December 2019 to 30 June 2021 in the English language using the following keywords alone or in combination: COVID-19 OR SARS-CoV-2 AND diabetic ketoacidosis OR DKA OR ketosis OR ketonemia OR hyperglycaemic emergency OR hyperglycaemic crisis. We included studies in adults and children of all ages in all healthcare settings. Binary logistic regression model was used to explore the effect of various demographic and biochemical parameters variables on patient’s final treatment outcome (survival or death). Results Of the 484 papers that were identified, 68 articles were included in the systematic review and meta-analysis (54 case report, 10 case series, and 4 cohort studies). Studies involving 639 DKA patients with confirmed SARS-CoV-2 [46 (7.2%) were children and 334 (52.3%) were adults] were analyzed. The median or mean patient age ranged from < 1 years to 66 years across studies. Most of the patients (n = 309, 48.3%) had pre-existing type 2 diabetes mellitus. The majority of the patients were male (n = 373, 58.4%) and belonged to Hispanic (n = 156, 24.4%) and black (n = 98, 15.3%) ethnicity. The median random blood glucose level, HbA1c, pH, bicarbonate, and anion gap in all included patients at presentation were 507 mg/dl [IQR 399–638 mg/dl], 11.4% [IQR 9.9–13.5%], 7.16 [IQR 7.00–7.22], 10 mmol/l [IQR 6.9–13 mmol/l], and 24.5 mEq/l [18–29.2 mEq/l]; respectively. Mortality rate was [63/243, 25.9%], with a majority of death in patients of Hispanic ethnicity (n = 17, 27%; p = 0.001). The odd ratios of death were significantly high in patients with pre-existing diabetes mellitus type 2 [OR 5.24, 95% CI 2.07–15.19; p = 0.001], old age (≥ 60 years) [OR 3.29, 95% CI 1.38–7.91; p = 0.007], and male gender [OR 2.61, 95% CI 1.37–5.17; p = 0.004] compared to those who survived. Conclusion DKA is not uncommon in SARS-CoV-2 patients with diabetes mellitus and results in a mortality rate of 25.9%. Mortality key determinants in DKA patients with SARS-CoV-2 infection are individuals with pre-existing diabetes mellitus type 2, older age [≥ 60 years old], male gender, BMI ≥ 30, blood glucose level > 1000 mg/dl, and anion gap ≥ 30 mEq/l.

scholarly journals Lipid profile and blood glucose in patients with Diabetes Mellitus treated with Cinnamon - Systematic Review and Meta-analysis with randomized clinical research

2021 ◽  
Vol 10 (9) ◽  
pp. e45910918203
Author(s):  
Antônio Guilherme Sousa Silva ◽  
Lucas Cândido Gonçalves ◽  
Paulo Alex Neves da Silva ◽  
Lilian Carla Carneiro ◽  
José Arthur Silva e Sousa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Placebo Group ◽  
Blood Glucose ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Hdl Cholesterol ◽  
Lipid Profiles ◽  
High Dose ◽  
Patients With Diabetes ◽  
The Difference

This study aimed to measure the efficiency of cinnamon in patients with Type 2 Diabetes Mellitus (DM2), comparing fasting plasma glucose averages and lipid profiles with a placebo group through a meta-analysis. Four databases were the source of the research to find the articles used, including: Medline / PubMed, LILACS and NCBI. 11 randomized clinical trials that evaluated cinnamon on glycemic and lipid parameters were included in this study. Meta-analysis was performed with the aid of the STATA® 16.0 software, which determined the difference in glucose means and lipid profiles compared to a placebo group. Cinnamon at concentrations of 250 mg twice a day decreased blood glucose with MD = -0.25 (95%CI = - 0.36 to -0.14; p<0.00001) and in the intervention with 2 g 3 times a day with MD = -5.60 (95%CI = -6.98 to -4.22; p<0.00001). Total cholesterol was significant with 2 g 3 times a day with MD = 0.98 (95%CI = -1.27 to -0.69), followed by LDL-cholesterol MD = 0.64 (95%CI = 0.88 to 0.40; p<0.00001), and HDL-cholesterol with 500 mg 3 times daily with MD = 0.12 (95%CI = 0.05 to 0.19). High-dose supplementation of cinnamon can reduce glucose and lipid profiles in patients with DM2. This supporting treatment can be useful when added to the diet plan of patients with DM2.

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