The Patient-Doctor Relationship and Metabolic Control in Patients with Type 1 (Insulin-Dependent) Diabetes Mellitus

1993 ◽  
Vol 23 (3) ◽  
pp. 265-274 ◽  
Author(s):  
Heimo Viinamäki ◽  
Leo Niskanen ◽  
Timo Korhonen ◽  
Veikko Tähkä
Keyword(s):  
Metabolic Control ◽  
Self Esteem ◽  
Physician Satisfaction ◽  
Dependent Diabetes Mellitus ◽  
Diabetic Patients ◽  
Direct Estimate ◽  
Cross Sectional ◽  
Control Of Diabetes ◽  
The Impact

Objective: Our hypothesis was that patient-doctor relationship experienced positively by the patient is associated with adequate compliance behavior and thus to the long-term metabolic control of diabetes. Method: Cross-sectional study of 100 consecutive adult patients with Type 1 diabetes treated in a diabetes out-patient department. From a questionnaire, four scores (direct estimate of physician, satisfaction with the place of treatment, self-esteem score, security with the patient-doctor relationship) determining the patient-doctor relationship were formed. In score 3 (self-esteem score) the impact of the patient-doctor relationship to the patients' self-esteem was indirectly estimated. The anonymous data taken from diabetes register including information about treatment of diabetes, metabolic control and end-organ complications were returned together with the questionnaire. On the basis of GHbA1c diabetic patients were divided into two groups: with adequate metabolic control (GHbA1c ⩽ 8.0%) or with poor/moderate control (GHbA1c > 8.0%). Results: In univariate analyses the score 3 associated with metabolic control ( p < 0.001). In logistic regression analyses the nephropathy ( t = 2.80, p < 0.05) and score 3 ( t = 3.98, p < 0.001) were associated with metabolic control. Conclusion: Patient's positively-experienced patient-doctor relationship was associated with good metabolic control of diabetes.

scholarly journals Changes from 1986 to 2018 in the Prevalence of Obesity and Overweight, Metabolic Control and Treatment in Children with Type 1 Diabetes Mellitus

2021 ◽  
Author(s):  
María Teresa Pastor-Fajardo ◽  
María Teresa Fajardo-Giménez ◽  
Vicente Bosch-Giménez ◽  
José Pastor-Rosado
Keyword(s):  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Metabolic Control ◽  
Overweight And Obesity ◽  
World Health ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Diabetic Children ◽  
Health Organization

Abstract Background: In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes.Methods: This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged <16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations.Results: The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1-38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p=0.002) and from 1986 to 2018 (11.9% to 34.8%, p=0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p=0.492). The age at diagnosis was lower in the group with excess body mass (p=0.037). No significant differences were observed in age (p=0.690), duration of diabetes (p=0.163), distribution according to sex (p=0.452), metabolic control (HbA1c, p=0.909), or insulin units kg/day (p=0.566), in diabetic patients with overweight or obesity. From 2007 to 2018, the use of insulin analogs (p=0.009) and a higher number of insulin doses (p=0.007) increased significantly, with no increase in the prevalence of overweight and obesity.Conclusions: The evolution of the prevalence of overweight and obesity in diabetic children and adolescents during the study period is a reflection of the epidemic of childhood obesity in a global obesogenic environment.

What is the impact of sleeve gastrectomy and gastric bypass on metabolic control of diabetes? A clinic-based cohort of Mediterranean diabetic patients

2015 ◽  
Vol 11 (5) ◽  
pp. 1014-1019 ◽  
Author(s):  
Graziella Bruno ◽  
Gabriella Gruden ◽  
Federica Barutta ◽  
Paolo Cavallo Perin ◽  
Mario Morino ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Metabolic Control ◽  
Diabetic Patients ◽  
Control Of Diabetes ◽  
The Impact

scholarly journals A study to assess the efficacy of metabolic control of diabetes in the development of neuropathy

2017 ◽  
Vol 4 (4) ◽  
pp. 1059
Author(s):  
MD. Mubasheer Ali ◽  
E. Ashok Kumar
Keyword(s):  
Diabetic Neuropathy ◽  
Metabolic Control ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Poor Glycaemic Control ◽  
Medical College ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Control Of Diabetes

Background: The metabolic syndrome is a deadly combination of hypertension, diabetes, heart disease, and dyslipidemia due to abdominal obesity. The causes this is both bad genes and bad environment. The objective of this study was to assess the efficacy of metabolic control of diabetes in the development of neuropathy.Methods: The present hospital based cross sectional study was conducted at MNR Medical College and Hospital, Sangareddy. The study was undertaken between October 2012 to May 2014 both in inpatient and outpatient department. Diabetic patients seeking consultation for the symptoms suggestive of neuropathy were screened and labeled as suffering from diabetic neuropathy based on the inclusion and exclusion criteria.Results: Diabetic neuropathy was common in the age group of 56 to 65 years in both male and female (33.3%). Average duration of diabetes was 8.7 years. Overall the rate of irregularity was much more (78%). Maximum (78%) patients reported presence of sensory symptoms. Diminision or loss of both ankle jerks was present in all 60 cases while 28 patients showed sluggish or absent knee jerks in total 60 patients. Maximum patients (60%) had distal symmetrical neuropathy.Conclusions: Longstanding diabetes and poor glycaemic control are particularly associated with an increased risk of neuropathy in diabetes mellitus.

Periphere arterielle Verschlusskrankheit bei Diabetes mellitus Typ 1 und Typ 2: Unterscheiden sich die Risikofaktoren?

VASA ◽  
2002 ◽  
Vol 31 (4) ◽  
pp. 249-254 ◽  
Author(s):  
Zander ◽  
Heinke ◽  
Reindel ◽  
Kohnert ◽  
Kairies ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Multivariate Logistic Regression Analysis ◽  
Diabetes Duration ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
The Impact

Background : Diabetic patients have increased prevalence of peripheral arterial disease (PAD). It is not clearly shown whether the prognostic factors are identical in relation to the type of diabetes. This study was done to compare the associations of PAD with risk factors and with micro-and macrovascular complications of inpatients with type 1 and type 2 diabetes. Methods: In a retrospective cross-sectional study 1087 patients with type 1 diabetes and 1060 patients with type 2 diabetes were examined. PAD was diagnosed when ankle-brachial-pressure-index (ABI) was < 1.0. In cases with incompressible arteries (mediasclerosis) pulse wave formes were analyzed. Multivariate logistic regression analysis was applied to evaluate the impact of different variables on PAD risk , after adjusting for different variables separately. Results: In both types of diabetes (type 1 vs. type 2) PAD risk (odds ratio; OR) was increased in the presence of coronary heart disease (OR 9.3 vs. 3.5), diabetic nephropathy (OR 3.0 vs.2.8), neuropathy (OR 7.9 vs. 1.8), foot ulceration (OR 8.9 vs. 5.5), increased daily insulin requirement > 0.6 m/kg b.w. (OR 5.2 vs. 2.9), diabetes duration of 20–29 years (OR 28.9) and > 30 years (OR 51.1) in type 1 diabetes, and diabetes duration of 10–19 years (OR 3.8) and > 20 years (OR 4.3) in type 2 diabetes. In type 2 diabetes, PAD risk was associated with microalbuminuria (OR 2.1), macroalbuminuria (OR 3.3), background retinopathy (OR 1.9), proliferative retinopathy (OR 2.8), increased triglycerides (TG) (OR 1.7) and decreased HDL-cholesterol (HDL-C > 0.90 mmol/l: OR 0.49). Conclusions: PAD risk factors and micro- and macrovascular comorbidity are very similar in type 1 and type 2 diabetes.

The impact of real-time continuous glucose monitoring on metabolic control in children with type 1 diabetes

2020 ◽  
Author(s):  
Ruxandra Calapod Ioana ◽  
Irina Bojoga ◽  
Duta Simona Gabriela ◽  
Ana-Maria Stancu ◽  
Amalia Arhire ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Metabolic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
The Impact

Perception of Therapeutic Education in Diabetic Patients at Tit Melil Health Center

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mory Sanoh
Keyword(s):  
Well Being ◽  
Cross Sectional Study ◽  
Basic Element ◽  
Therapeutic Education ◽  
Diabetic Patients ◽  
Oral Antidiabetics ◽  
Educational Training ◽  
Cross Sectional ◽  
Type 2 Diabetics

Introduction : A chronic condition like diabetes interferes with an individual's well-being, and if some of their needs are not met because of the disease, their quality of life is reduced. In this context, therapeutic education constitutes a basic element in the management of diabetes.Materials and Methods : A cross-sectional study by self-administered questionnaire and interviews which were carried out with all type 1 and type 2 diabetics, consultants at the level of the Tit Mélil Primary Health Care establishment, in 2019 and who benefited from or not therapeutic education, with or without complications.Result : The study included 50 diabetic patients, surveys show us that type 1 diabetic patients were 13 (26%). And type 2.37 (74%). Regarding the organization of care, 74% of patients say they are under treatment with oral antidiabetics, 10% oral antidiabetics and insulins, 6% insulin therapy and others under diet. Speaking of Food, 76.5% of diabetics know the importance and know what foods to avoid.Conclusion : TVE is possible, it will result in a change in the structure of programs and new educational training for caregivers.

The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

2021 ◽  
pp. 112067212199057
Author(s):  
Tomás de Oliveira Loureiro ◽  
João Nobre Cardoso ◽  
Carlos Diogo Pinheiro Lima Lopes ◽  
Ana Rita Carreira ◽  
Sandra Rodrigues-Barros ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Metabolic Control ◽  
Insulin Pump Therapy ◽  
Vascular Density ◽  
Diabetic Patients ◽  
Retinal Vasculature ◽  
Increased Risk ◽  
The Mean ◽  
Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

scholarly journals Prevalence of dental caries in children and adolescents with type 1 diabetes: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Wang ◽  
Lin Xing ◽  
Hui Yu ◽  
LiJuan Zhao
Keyword(s):  
Type 1 Diabetes ◽  
Dental Caries ◽  
Children And Adolescents ◽  
Metabolic Control ◽  
Meta Analysis ◽  
Preventive Treatment ◽  
Diabetic Patients ◽  
China National Knowledge Infrastructure ◽  
Pooled Prevalence

Abstract Background Dental caries and type 1 diabetes are responsible for a large burden of global disease; however, the exact prevalence of dental caries among children and adolescents with type 1 diabetes remains controversial, and no quantitative meta-analysis exists. Thus, we performed a meta-analysis to evaluate the prevalence of dental caries among children and adolescents with type 1 diabetes. Methods We performed a systematic search strategy using PubMed, EMBASE and China National Knowledge Infrastructure for relevant studies investigating the prevalence of dental caries in children and adolescents with type 1 diabetes from July 1971 until December 2018. The pooled prevalence with 95% confidence intervals (95%CIs) and subgroup analyses were calculated using a random effects model. Results After screening 358 non-duplicated articles, a total of 10 articles involving 538 individuals were included. The overall prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI: 0.56–0.77%; I2 = 83%). The prevalence was highest in South America (84%) and lowest in diabetic patients with good metabolic control (47%). Conclusions The prevalence of dental caries was high among children and adolescents with type 1 diabetes. Screening and preventive treatment should be included in dental clinical routines for diabetic children and adolescents, especially in those with poor metabolic control.

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

scholarly journals Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefana Catalina Bilha ◽  
Letitia Leustean ◽  
Cristina Preda ◽  
Dumitru D. Branisteanu ◽  
Laura Mihalache ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Mineral Density ◽  
Cross Sectional ◽  
The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

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