Short-Term Effect of Hypergastrinemia Following Esomeprazole Treatment On Well-Controlled Type 2 Diabetes Mellitus: A Prospective Study

2020 ◽  
Vol 20 (7) ◽  
pp. 1090-1096
Author(s):  
Yusuf Bozkuş ◽  
Umut Mousa ◽  
Özlem T. İyidir ◽  
Nazlı Kırnap ◽  
Canan Ç. Demir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Level ◽  
Intervention Group ◽  
Control Group ◽  
Metformin Monotherapy ◽  
The Mean ◽  
Hba1c Levels

Objective: Proton pump inhibitor (PPI) drugs reduce gastric acid secretion and lead to an increase in serum gastrin levels. Many preclinical and some clinical researches have established some positive effects of gastrin or PPI therapy on glucose regulation. The aim of this study was to prospectively investigate the short term effects of esomeprazole on glycaemic control in patients with type 2 diabetes mellitus. In addition, the presence of an association between this effect and gastrin levels was evaluated. Methods: Thirty-two subjects with type 2 diabetes mellitus were enrolled and grouped as intervention (n=16) and control (n=16). The participants in the intervention group were prescribed 40 mg of esomeprazole treatment for three months. At the beginning of the study and at the 3rd month, HbA1c level (%) and gastrin levels (pmol/L) of participants were assessed. Then, the groups were compared in terms of their baseline and 3rd month values. Results: In the intervention group, the mean gastrin level increased significantly from 34.3±14.4 pmol/L to 87.4±43.6 pmol/L (p<0.001). The mean HbA1c level was similar to the pre-treatment level (6.3±0.7% vs. 6.4±0.9%, p=0.441). There were no statistically significant differences in all parameters of the control group. The majority of individuals were on metformin monotherapy (65.6 %). The subgroup analysis of metformin monotherapy revealed that, in intervention group, there was a significant increase in gastrin levels (39.9±12.6 vs. 95.5±52.5, p=0.026), but the HbA1c levels did not change (6.0±0.4 % vs. 5.9±0.6 %, p=0.288); and in control group, gastrin levels did not change (37.5 ± 26.7 vs. 36.1 ±23.3, p=0.367), but there was an increase in HbA1c levels (6.1 ± 0.50 vs. 6.4 ± 0.60, p=0.01). Conclusion: Our study demonstrates that esomeprazole has no extra benefit for the controlled diabetic patient in three months. However, in only the metformin-treated subgroup, esomeprazole may prevent the rise in HbA1c level.

Effects of epigallocatechin-3-gallate of Camellia sinensis leaves on blood pressure, lipid profile, atherogenic index of plasma and some inflammatory and antioxidant markers in type 2 diabetes mellitus patients: a clinical trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Atherogenic Index ◽  
Control Group ◽  
Atherogenic Index Of Plasma ◽  
The Mean

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.

scholarly journals Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anja Wollny ◽  
Christin Löffler ◽  
Eva Drewelow ◽  
Attila Altiner ◽  
Christian Helbig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Decision Making ◽  
Type 2 Diabetes Mellitus ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Control Group ◽  
Shared Decision ◽  
Patient Centeredness

Abstract Background We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus? Methods We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline. Results Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups. Conclusions The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness. Trial registration The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.

scholarly journals Influence of physical activity on periodontal health in patients with type 2 diabetes mellitus. A blinded, randomized, controlled trial

2021 ◽  
Author(s):  
K. Wernicke ◽  
J. Grischke ◽  
M. Stiesch ◽  
S. Zeissler ◽  
K. Krüger ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Periodontal Health ◽  
Randomized Controlled ◽  
Hba1c Levels

Abstract Objectives The aim was to investigate the effect of physical activity on periodontal health and HbA1c levels in patients with type 2 diabetes mellitus (T2DM) over a period of 6 months. Materials and methods Thirty-seven patients with non-insulin-dependent T2DM were included in the study. The intervention group (n=20) performed physical activity over a period of 6 months. The control group (n=17) did not receive any intervention. Baseline and final examinations included dental parameters and concentrations of glycosylated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hsCRP). Results Physical activity showed a positive effect on periodontal health. Both the BOP (p= 0.005) and the severity of periodontitis (p= 0.001) were significantly reduced in the intervention group compared to the control group. Furthermore, HbA1c levels were reduced (p= 0.010) significantly in the intervention group while hsCRP levels significantly increased in the control group (p= 0.04). Conclusions Within the limitations of this randomized, controlled trial, physical activity over a period of 6 months is a health-promoting measure for patients with T2DM and improves both periodontal health and HbA1c concentrations.

scholarly journals The relation of anatomical distribution of symptomatic peripheral arterial disease (PAD) with HbA1c level in patients with type 2 diabetes mellitus

2021 ◽  
Vol 12 ◽  
pp. 204201882110005
Author(s):  
Nawaf J. Shatnawi ◽  
Nabil A. Al-Zoubi ◽  
Hassan M. Hawamdeh ◽  
Yousef S. Khader ◽  
Mowafeq Heis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Hba1c Level ◽  
Arterial Disease ◽  
Anatomical Distribution ◽  
The Mean ◽  
Peripheral Arterial

Aims: Increased level of glycated hemoglobin (HbA1c) is associated with an increased prevalence of peripheral arterial disease (PAD). This study aimed to assess the relationship between the anatomical distribution of symptomatic PAD lesions in patients with type 2 diabetes and HbA1c levels at the time of PAD diagnosis. Patients and methods: A retrospective study was conducted at King Abdullah University Hospital during the period August 2011 to December 2015. Consecutive patients with type 2 diabetes presented with symptomatic PAD confirmed by computed tomography-angiography (CTA) were included in this study. CTA images were reviewed. Relevant information including demographic data, PAD symptoms, comorbidities, HbA1c level, lipid profile, C-reactive protein and the mean platelets volume were retrieved from medical records. Results: A total of 332 patients with type 2 diabetes (255 males and 77 females) were included in this study. The mean HbA1c at the time of PAD diagnosis was 8.68% (±2.06%). The prevalence of hemodynamic relevant atherosclerotic lesions of the superficial femoral artery, popliteal artery, leg vessels, femoro-popliteal, and crural segments was significantly higher in patients with HbA1c >7.5% compared with patients with HbA1c ⩽7.5%. Conclusion: The anatomical distribution of symptomatic PAD in patients with type 2 diabetes mellitus differed significantly according to HbA1c level at the time of PAD diagnosis.

scholarly journals ADHERENCE LEVEL AND BLOOD SUGAR CONTROL OF TYPE 2 DIABETES MELLITUS PATIENTS WHO GETS COUNSELING AND SHORT MESSAGES SERVICE AS REMINDER AND MOTIVATION

2018 ◽  
Vol 11 (2) ◽  
pp. 219 ◽  
Author(s):  
Wirawan Adikusuma ◽  
Nurul Qiyaam
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Treatment Adherence ◽  
Data Retrieval ◽  
Control Group ◽  
Hba1c Levels ◽  
Short Messages

  Objective: Examines the effects of counseling and short messages service (SMS) as a reminder and motivation toward medication adherence improvement and controlled HbA1c levels of type 2 diabetes mellitus (T2DM) patients.Methods: This study used a quasi-experimental method with prospective data retrieval. The subjects of this study were 40 patients with outpatient T2DM in internal disease polyclinic in West Nusa Tenggara Hospital, Indonesia. Patients who fulfilled the inclusion criteria were divided into two groups: The control group (n=20) receiving only the drug care service and the treatment group (n=20) receiving counseling and SMS reminder and motivation from the pharmacist. Data collecting was conducted using the pill count method, and HbA1c levels were taken from the medical record.Results: The results showed that counseling and SMS as reminder and motivation by a pharmacist can improve treatment adherence significantly (p<0.05) by 11.33 ± 8.47 and can decrease HbA1c level significantly (p<0.05) of 1.32 ± 0.72 in the intervention group. There was a positive correlation between T2DM patient treatment adherence to HbA1c levels (r=0.254, p=0.023).Conclusion: The provision of counseling and SMS as a reminder and motivation by the pharmacist can have a positive effect toward medication adherence and control of HbA1c in T2DM patients. 

scholarly journals Walking prescription of 10 000 steps per day in patients with type 2 diabetes mellitus: a randomised trial in Nigerian general practice

2018 ◽  
Vol 68 (667) ◽  
pp. e139-e145 ◽  
Author(s):  
Ayorinde F Fayehun ◽  
Olufemi O Olowookere ◽  
Adetola M Ogunbode ◽  
Adedotun A Adetunji ◽  
Arinola Esan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Intervention Group ◽  
Step Count ◽  
Control Group ◽  
Baseline Hba1c ◽  
Steps Per Day

BackgroundIn clinical practice, translating the benefits of a sustained physically active lifestyle on glycaemic control in patients with type 2 diabetes mellitus (T2DM) is difficult. A walking prescription may be an effective alternative.AimTo examine the effect of a 10 000 steps per day prescription on glycaemic control of patients with T2DM.Design and settingForty-six adults with T2DM attending a general outpatient clinic were randomised into two equal groups. The intervention group was given goals to accumulate 10 000 steps per day for 10 weeks, whereas the control group maintained their normal activity habits.MethodDaily step count was measured with waist-mounted pedometer and baseline and endline average steps per day. Glycosylated haemoglobin (HbA1c), anthropometric, and cardiovascular measurements were also obtained. An intention-to-treat analysis was done.ResultsThe average baseline step count was 4505 steps per day for all participants, and the average step count in the intervention group for the last 4 weeks of the study period was higher by 2913 steps per day (95% confidence interval [CI] = 1274 to 4551, F (2, 37.7) = 18.90, P<0.001). Only 6.1% of the intervention group participants achieved the 10 000 steps per day goal. The mean baseline HbA1c was 6.6% (range = 5.3 to 9.0). Endline HbA1c was lower in the intervention group than in the control group (mean difference −0.74%, 95% CI = −1.32 to −0.02, F = 12.92, P = 0.015) after adjusting for baseline HbA1c. There was no change in anthropometric and cardiovascular indices.ConclusionAdherence to 10 000 steps per day prescription is low but may still be associated with improved glycaemic control in T2DM. Motivational strategies for better adherence would improve glycaemic control.

Effect of Precede–Proceed Model on Preventive Behaviors for Type 2 Diabetes Mellitus in High-Risk Individuals

2016 ◽  
Vol 26 (2) ◽  
pp. 241-253 ◽  
Author(s):  
Mahdi Moshki ◽  
Atefeh Dehnoalian ◽  
Ali Alami
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Risk ◽  
Intervention Group ◽  
Control Group ◽  
Preventive Behaviors ◽  
Type 2 Dm ◽  
Face To Face Instruction

This study sought to assess the effect of precede–proceed model on preventive behaviors for type 2 diabetes mellitus (DM) in high-risk individuals. In this semi-experimental study, 164 high-risk individuals for type 2 DM were selected and were randomly divided into two groups of intervention and control ( n = 85). Educational intervention was performed as a single session face-to-face instruction for 1.5 hr for the intervention group participants. Data were collected before (baseline) and immediately and 1 month after the intervention in the two groups. The mean score of predisposing (knowledge) factors ( p = .001), reinforcing factors ( p = .001), and enabling factors ( p = .02) were significantly different at baseline and 1 month after the intervention in the intervention group compared with the control group ( p < .05). A significant improvement occurred in the nutritional habits of high-risk participants in the intervention group at 1 month after the intervention compared with controls ( p = .001). The precede–proceed model can be effective for promoting the preventive behaviors for type 2 DM in high-risk individuals.

scholarly journals The Effect of Combined Herbal Capsule on Glycemic Indices and Lipid Profile in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Clinical Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Rezvan Ghafarzadegan ◽  
Javad Javaheri ◽  
Mina Asgari ◽  
Mohammad Golitaleb ◽  
Fatemeh Maraki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Glycemic Indices

Objectives: The present study aimed to investigate the potential effects of the combined herbal capsule (CHC), as a nutritional supplement, on glycemic indices (GIs) and lipid profile (LP) of patients with type 2 diabetes mellitus (T2DM). Methods: Following a randomized, single-blind, placebo-controlled clinical trial, the current study was conducted on 80 cases with T2DM who were randomly assigned into two groups of treatment (CHCs; n = 40) and control (placebo; n = 40). Both groups received the intervention (500 mg capsules) twice a day for three months, without changes in the previous dose of oral anti-hyperglycemic drugs. The GI and LP levels were measured before the intervention and three months later to investigate the potential efficacy of the interventions. Results: For those in the intervention group, the mean GI [i.e., fasting blood sugar, two hours postprandial (2hpp), and HbA1c] was significantly different after 3 months (P < 0.05). The GI- and LP-related outcomes (TG, LDL-C except for TC) were improved after 3-month of receiving the intervention compared to the control group; however, the observed improvement was no statistically significant (P > 0.05). The HDL-C level was also significantly improved in the intervention group compared to the control group (P < 0.05). Conclusions: This study demonstrated that receiving CHCs could improve GI and LP levels (TG, LDL-C, and HDL-C, except for TC), which indicates its potential to control T2DM. Moreover, no significant side effect was observed in the intervention group. It can be argued that the use of CHCs, as adjuvant therapy, in combination with conventional hypoglycemic and lipid-lowering drugs, as well as following a modified lifestyle, not only can significantly enhance glycemic control but also may prevent T2DM complications.

The effectiveness and safety of the supplementation of therapy with oral hypoglycemic agents by basal insulin in the patients with type 2 diabetes mellitus. Results of the SOLOS observational program

2013 ◽  
Vol 59 (4) ◽  
pp. 65-68
Author(s):  
M G Pavlova ◽  
I V Glinkina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Glargine ◽  
Hba1c Level ◽  
Combined Therapy ◽  
Fasting Blood Glucose ◽  
Hypoglycemic Agents ◽  
The Mean

The results of numerous clinical investigations carried out during the last years provide convincing evidence of the high effectiveness and safety of early initiation of insulin therapy. Of special interest are the studies conducted under conditions of real clinical practice. One of them is the Russian SOLOS observational program designed to evaluate the influence of intensification of the treatment of type 2 diabetes mellitus with oral hypoglycemic agents (OHA) supplemented by using insulin glargine in the patients who failed to be adequately compensated by OHA therapy alone. Another objective of this program was to find out the opinion of the patients and physicians about the SoloStar pen employed for injecting insulin glargine. The data concerning 1309 patients at the mean age of 59.5±8.8 years with type 2 diabetes mellitus and the mean duration of the disease 6.9±5.0 years were available for the analysis. The overwhelming majority of the patients presented with severe decompensation of carbohydrate metabolism, the mean fasting blood glucose level being 10.7±2.4 mmol/l and the HbA1c level varying from 7.2 to 18.2% (mean 9.6±1.5%). Supplementation of OHA therapy with insulin glargine caused the significant reduction of the HbA1c level to 8.1±1.0% (p<0.001) within 3 months after the onset of the combined treatment. The HbA1c level fell down to 7.2±0.9% (p<0.001) after 6 months 40.6% of the patients had HbA1c at the level below 7%. Fasting blood glucose levels decreased to 7.4±1.4 mmol/l and 6.3±1.0 mmol/l (p<0.001) at 3 and 6 months after the onset of insulin administration respectively. The number of daytime and nocturnal hypoglycemic episodes under effect of insulin glargine injections significantly decreased by the end of the study. Severe hypoglycemic episodes suffered initially by 8 (0.5%) patients totally disappeared 6 months after the initiation of the combined therapy. Most patients did not need hospitalization after supplementation of OHA treatment with insulin. The results of combined therapy with the use of disposable SoloStar pens were positively assessed by the overwhelming majority of both the patients and the physicians involved in the study.

scholarly journals Can non-responders be ‘rescued’ by increasing exercise intensity? A quasi-experimental trial of individual responses among humans living with pre-diabetes or type 2 diabetes mellitus in Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044478
Author(s):  
Travis J Hrubeniuk ◽  
Danielle R Bouchard ◽  
Brendon J Gurd ◽  
Martin Sénéchal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Aerobic Exercise ◽  
Intervention Group ◽  
Aerobic Exercise Training ◽  
Control Group ◽  
Metabolic Equivalents

IntroductionExercise is recommended to improve glycaemic control. Yet, individual changes in glycaemic control following exercise can vary greatly, meaning while some significantly improve others, coined ‘non-responders’, do not. Increasing the intensity of exercise may ‘rescue’ non-responders and help generate a response to training. This trial will identify non-responders to changes in glycated haemoglobin (HbA1c) across inactive individuals living with pre-diabetes or type 2 diabetes mellitus following an aerobic exercise programme and evaluate if increasing training intensity will elicit beneficial changes to ‘rescue’ previously categorised non-responders.Methods and analysisThis study will recruit 60 participants for a two-phase aerobic exercise training programme. Participants will be allocated to a control group or assigned to an intervention group. Control participants will maintain their current lifestyle habits. During phase 1, intervention participants will complete 16 weeks of aerobic exercise at an intensity of 4.5 metabolic equivalents (METs) for 150 min per week. Participants will then be categorised as responders or non-responders based on the change in HbA1c. For phase 2, participants will be blocked based on responder status and randomly allocated to a maintained intensity, or increased intensity group for 12 weeks. The maintained group will continue to train at 4.5 METs, while the increased intensity group will train at 6.0 METs for 150 min per week.Ethics and disseminationResults will be presented at scientific meetings and submitted to peer-reviewed journals. Publications and presentations related to the study will be authorised and reviewed by all investigators. Findings from this study will be used to provide support for future randomised control trials. All experimental procedures have been approved by the Research Ethics Board at the University of New Brunswick (REB: 2018–168).Trial registration numberNCT03787836.

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