scholarly journals The Effect of a Customized Nutrient-Profiling Approach on the Glycated Hemoglobin Levels of Patients With Type 2 Diabetes: Quasi-Experimental Study

10.2196/15497 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e15497
Author(s):  
Mayda Alrige ◽  
Riad Alharbey ◽  
Samir Chatterjee
Keyword(s):  
Type 2 Diabetes ◽  
Nutritional Value ◽  
Dietary Habits ◽  
Glycated Hemoglobin ◽  
Intervention Group ◽  
Dietary Management ◽  
Nutrient Profiling ◽  
Quasi Experimental ◽  
Hba1c Levels

Background Presently, dietary management approaches are mostly oriented toward using calorie-counting and diet-tracking tools that draw our attention away from the nutritional value of our food. To improve individuals’ dietary behavior, primarily that of people with type 2 diabetes, a simple technique is needed to increase their understanding of the nutritional content of their food. Objective This study aimed to design, develop, and evaluate a customized nutrient-profiling tool called EasyNutrition. EasyNutrition was built to introduce the new concept of nutrient profiling by applying the Intelligent Nutrition Engine, an algorithm that we developed for ranking different food recipes based on their nutritional value. This study also aimed to investigate the efficacy of EasyNutrition in lowering glycated hemoglobin (HbA1c) levels and improving dietary habits among people with type 2 diabetes. Methods We evaluated the utility of EasyNutrition using design science research in three sequential stages. This paper has elaborated on the third stage to investigate the efficacy of EasyNutrition in managing type 2 diabetes. A quasi-experimental study was conducted in a diabetes treatment center (n=28). The intervention group utilized EasyNutrition over 3 months, whereas participants in the control group utilized the standard of care provided by the center. Dietary habits and HbA1c levels were measured to capture any change before and after experimenting with EasyNutrition. Results The intervention group (n=9) exhibited a statistically significant change between the pre- and postexposure results of their HbA1c (t9=2.427; P=.04). Their HbA1c dropped from 8.13 to 6.72. This provided preliminary evidence of the efficacy of using a customized nutrient-profiling app in reducing HbA1c for people with type 2 diabetes. Conclusions This study adds to the evidence base that a nutrient-profiling strategy may be a modern adjunct to diabetes dietary management. In conjunction with reliable dietary education provided by a registered dietician, EasyNutrition may have some beneficial effects to improve the dietary habits of people with type 2 diabetes.

scholarly journals The Effect of a Customized Nutrient-Profiling Approach on the Glycated Hemoglobin Levels of Patients With Type 2 Diabetes: Quasi-Experimental Study (Preprint)

2019 ◽  
Author(s):  
Mayda Alrige ◽  
Riad Alharbey ◽  
Samir Chatterjee
Keyword(s):  
Type 2 Diabetes ◽  
Experimental Study ◽  
Nutritional Value ◽  
Dietary Habits ◽  
Glycated Hemoglobin ◽  
Intervention Group ◽  
Dietary Management ◽  
Nutrient Profiling ◽  
Quasi Experimental

BACKGROUND Presently, dietary management approaches are mostly oriented toward using calorie-counting and diet-tracking tools that draw our attention away from the nutritional value of our food. To improve individuals’ dietary behavior, primarily that of people with type 2 diabetes, a simple technique is needed to increase their understanding of the nutritional content of their food. OBJECTIVE This study aimed to design, develop, and evaluate a customized nutrient-profiling tool called <i>EasyNutrition</i>. <i>EasyNutrition</i> was built to introduce the new concept of nutrient profiling by applying the Intelligent Nutrition Engine, an algorithm that we developed for ranking different food recipes based on their nutritional value. This study also aimed to investigate the efficacy of <i>EasyNutrition</i> in lowering glycated hemoglobin (HbA<sub>1c</sub>) levels and improving dietary habits among people with type 2 diabetes. METHODS We evaluated the utility of <i>EasyNutrition</i> using design science research in three sequential stages. This paper has elaborated on the third stage to investigate the efficacy of <i>EasyNutrition</i> in managing type 2 diabetes. A quasi-experimental study was conducted in a diabetes treatment center (n=28). The intervention group utilized <i>EasyNutrition</i> over 3 months, whereas participants in the control group utilized the standard of care provided by the center. Dietary habits and HbA<sub>1c</sub> levels were measured to capture any change before and after experimenting with <i>EasyNutrition</i>. RESULTS The intervention group (n=9) exhibited a statistically significant change between the pre- and postexposure results of their HbA<sub>1c</sub> (<i>t</i><sub>9</sub>=2.427; <i>P</i>=.04). Their HbA<sub>1c</sub> dropped from 8.13 to 6.72. This provided preliminary evidence of the efficacy of using a customized nutrient-profiling app in reducing HbA<sub>1c</sub> for people with type 2 diabetes. CONCLUSIONS This study adds to the evidence base that a nutrient-profiling strategy may be a modern adjunct to diabetes dietary management. In conjunction with reliable dietary education provided by a registered dietician, <i>EasyNutrition</i> may have some beneficial effects to improve the dietary habits of people with type 2 diabetes.

scholarly journals Nursing-Intense Health Education Intervention for Persons with Type 2 Diabetes: A Quasi-Experimental Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 832
Author(s):  
María Begoña Martos-Cabrera ◽  
José Luis Gómez-Urquiza ◽  
Guillermo Cañadas-González ◽  
José Luis Romero-Bejar ◽  
Nora Suleiman-Martos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Experimental Study ◽  
Health Education ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
High Blood Glucose ◽  
Quasi Experimental ◽  
Hba1c Levels

Type 2 diabetes mellitus (DM2) is a highly prevalent disease, the progression of which depends on high blood glucose levels, which are reflected in the level of glycosylated haemoglobin (HbA1c). Appropriate health education equips patients with the knowledge and skills to control their glucose and HbA1c levels to avoid long-term complications. This study was set up to compare the results of an intensive (360 min) educational intervention to improve HbA1c parameters in patients with DM2 with those of a usual 90 min intervention. For this purpose, healthcare personnel led a quasi-experimental study of 249 diabetics: 171 in the control group, and 78 in the intervention group. In the control group, the mean HbA1c value decreased from 6.97 to 6.75, while in intervention group it fell from 8.97 to 8.06. The before and after mean difference between both groups was compared with a Wilcoxon test, and the results statistically significant (W = 4530; p < 0.001), indicating a higher reduction of HbA1c in the intervention group. We concluded that the intensive health education provided by nurses during the consultation helped improve HBA1c levels in persons with DM2.

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 Effectiveness of diabetes self-management education and support via a smartphone application in insulin-treated patients with type 2 diabetes: results of a randomized controlled trial (TRIGGER study)

2019 ◽  
Vol 7 (1) ◽  
pp. e000981 ◽  
Author(s):  
Anne Meike Boels ◽  
Rimke C Vos ◽  
Lioe-Ting Dijkhorst-Oei ◽  
Guy E H M Rutten
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Habits ◽  
Management Education ◽  
Intervention Group ◽  
Self Management ◽  
Smartphone App ◽  
Control Group ◽  
Hypoglycemic Event ◽  
Randomized Controlled

ObjectiveTo investigate the effect of diabetes self-management education and support via a smartphone app in individuals with type 2 diabetes on insulin therapy.Research design and methodsOpen two-arm multicenter parallel randomized controlled superiority trial. The intervention group (n=115) received theory and evidence-based self-management education and support via a smartphone app (optionally two or six times per week, once daily at different times). The control group (n=115) received care as usual. Primary outcome: HbA1c at 6 months. Other outcomes included HbA1c ≤53 mmol/mol (≤7%) without any hypoglycemic event, body mass index, glycemic variability, dietary habits and quality of life. We performed multiple imputation and regression models adjusted for baseline value, age, sex, diabetes duration and insulin dose.ResultsSixty-six general practices and five hospital outpatient clinics recruited 230 participants. Baseline HbA1c was comparable between groups (8.1% and 8.3%, respectively). At 6 months, the HbA1c was 63.8 mmol/mol (8.0%) in the intervention vs 66.2 mmol/mol (8.2%) in the control group; adjusted difference −0.93 mmol/mol (−0.08%), 95% CI −4.02 to 2.17 mmol/mol (−0.37% to 0.20%), p=0.557. The odds for achieving an HbA1c level ≤7% without any hypoglycemic event was lower in the intervention group: OR 0.87, 95% CI 0.33 to 2.35. There was no effect on secondary outcomes. No adverse events were reported.ConclusionsThis smartphone app providing diabetes self-management education and support had small and clinically not relevant effects. Apps should be more personalized and target individuals who think the app will be useful for them.Trial registration numberNTR5515.

scholarly journals Use Of The GLYCEMIZER® Tool By General Practitioners To Meet Individual Glycated Hemoglobin Goals In Patients With Type 2 Diabetes Mellitus

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Nicolas Byron Hatziisaak ◽  
Telemachos Hatziisaak ◽  
Urs Keller
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Practitioners ◽  
Glycated Hemoglobin ◽  
Cross Sectional Survey ◽  
Significant Difference ◽  
The Individual ◽  
Hba1c Levels

Background — For general practitioners (GPs), it is often not easy to determine the individual glycated hemoglobin (HbA1c)-goal of patients with type 2 diabetes mellitus (T2DM) in order to offer them a tailored treatment and minimize side effects. Usually, they simply rely on their gut feeling. Objective — We assessed the usefulness of an easy-to-use algorithm (GLYCEMIZER®) to calculate individual HbA1c-goals and compared them with targeted (‘gut feeling’ of the GP’s) and achieved levels. Material and Methods — In this cross-sectional survey, general practitioners were asked to report anonymized data of at least 30 consecutive patients with T2DM presenting in their offices from May 1st to August 15th 2016 after obtaining informed consent. Demographic, clinical and biochemical data were used for the GLYCEMIZER® tool to calculate the individual HbA1c-goals. A statistical analysis was conducted in order to compare the calculated HbA1c-goals with targeted and achieved HbA1c-levels. Results — A total of 184 patients (mean age: 69y) were enrolled by 6 participating general practitioners from the Werdenberg-Sarganserland region in eastern Switzerland. Four patients did not meet the inclusion criteria. The overall median calculated HbA1c-goal did not differ from the targeted and achieved levels (7.1% vs. 7.0% vs. 7.1%, p=0.894). There was a significant difference between achieved and calculated HbA1c-levels in patients aged <50 (n=13, median 7.2% vs. 6.5%, p=0.014), goals not achieved) and patients aged >71 (n=85, median 6.9% vs. 7.5%, p=0.005), lower levels achieved in relation to calculated HbA1c-goals). Both in patients treated with insulin (n=44) and in patients without insulin (n=136) the achieved HbA1c-levels met the calculated goals (no insulin: 6.9% vs. 7.0%, ns; with insulin: 7.8% vs. 7.7%, ns). In regard to CKD-stages 3 and 4 the achieved HbA1c-levels were significantly lower than calculated (n= 41, median 6.9% vs. 7.6%, p=0.001). Conclusion — Calculating HbA1c-goals using the GLYCEMIZER tool is more accurate than relying on gut feeling alone, and is specifically useful in the treatment of patients with T2DM of less than 50, as well as more than 70 years of age. Furthermore, it is helpful to meet individual HbA1c-goals in patients with CKD-stages 3+.

scholarly journals Motivational Interviewing to Improve Self-efficacy in Type 2 Diabetes Management

2020 ◽  
Author(s):  
Masumeh Hemmati Maslakpak ◽  
Naser Parizad ◽  
Amir Ghahremani ◽  
Vahid Alinejad
Keyword(s):  
Type 2 Diabetes ◽  
Motivational Interviewing ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Intervention Group ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental ◽  
The Mean

Abstract Background Self-efficacy predicts adherence to treatment in patients with diabetes. Motivational interviewing could be a promising intervention to increase the patients’ motivation to follow therapeutic recommendations. The present study aimed to assess the effects of motivational interviewing on self-efficacy in type 2 diabetes management. Methods This quasi-experimental study with a pretest-posttest design was conducted on 60 patients with type 2 diabetes, who were members of the Bukan Diabetes Association in Iran. The patients were selected using a random number table and were randomly allocated into intervention (n = 30) and control (n = 30) groups. Five motivational interviewing sessions (30–45 minutes) were held for the intervention group (two sessions per week). Data were collected using a demographic questionnaire and the diabetes management self-efficacy scale (DMSES). Data were analyzed with SPSS software version 14.0 using descriptive and inferential statistics. Results Sixty patients entered the analysis. A significant difference was observed in the mean score of diabetes management self-efficacy between the two groups before and after the intervention (P = 0.014). The mean score of self-efficacy in diabetes management was increased significantly in the intervention group after MI (P = 0.001). Conclusions Motivational interviewing improved self-efficacy in diabetes management. Thus, this approach is recommended to be used in patients with type 2 diabetes in order to increase their self-efficacy.

scholarly journals Comparison of 3 Medicine Groups Used to Control Glycemic and Glycated Hemoglobin Levels in Newly Diagnosed Type 2 Diabetes Patients

2021 ◽  
Vol 9 (B) ◽  
pp. 101-106
Author(s):  
Ngoc Chau Nguyen ◽  
Hoai Thuong Pham ◽  
Diep Thao Pham ◽  
Thi Minh Hoang ◽  
Thi Phuong Lan Dam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Level ◽  
Glucose Control ◽  
Glycated Hemoglobin ◽  
Control Level ◽  
Newly Diagnosed ◽  
P Values ◽  
Metformin Group ◽  
Hba1c Levels

AIM: This research aims to compare the effectiveness of three medicines groups in controlling glycemic and glycated hemoglobin (HbA1c) levels in the newly diagnosed diabetes mellitus type 2. METHODS: One hundred fifty newly diagnosed patients with type 2 diabetes were treated by mono therapy and divided into three groups. Each group of 50 patients was treated by one medicine: Group 1 using Diamicron MR 30 mg (Sulfonylurea) – three capsules per day, Group 2 using metformin 500 mg – 1–3 capsules per day, and Group 3 using Januvia (sitagliptin, dipeptidyl peptidase-4 inhibitor) 100 mg – 1 capsule per day. The evaluation of glucose control was based on fasting plasma glucose and HbA1c concentration and divided into three levels: Excellent, good, and poor. The assessment was carried out after every 3 months of treatment, at 3rd month, 6th month, and 12th month (WHO, 2002). RESULTS: After treatment 3, 6, and 12 months, glucose level was decreased when compared to before treatment in all three groups (pall < 0.001). At the month 6th, the groups treated by sulfonylurea and sitagliptin had lower glucose level than metformin (with p values were 0.04 and 0.01, respectively), and maintained the low glucose level from the month 6th to month 12th (with p values were 0.71 and 0.77, respectively) while glucose level of the metformin group increased (p = 0.005). HbA1c has decreased dramatically in all three groups after treatment (p values of sulfonylurea group at the month 3rd, 6th, and 12th vs. before treatment were 0.006, 0.021, and 0.001, respectively; all p values of metformin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001; all p values of sitagliptin group at the month 3rd, 6th, and 12th vs. before treatment were below 0.001). The group treated by sitagliptin got the highest ratio of excellent HbA1c control (82% after 12 months of treatment). CONCLUSION: Significant improvement of glucose and HbA1c levels was observed in all three groups. Glucose control level of group treated with sulfonylurea was markedly improved and the group treated with sitagliptin achieved optimal control of HbA1c.

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.

scholarly journals Acute and chronic glycemic effects of aerobic training in patients with type 2 diabetes

2019 ◽  
Vol 23 ◽  
pp. 1-8
Author(s):  
Rodrigo Sudatti Delevatti ◽  
Nathalie Netto ◽  
Isabel Heberle ◽  
Cláudia Gomes Bracht ◽  
Éder Santiago ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Aerobic Training ◽  
Glycated Hemoglobin ◽  
Training Session ◽  
Chronic Effect ◽  
Before And After ◽  
Capillary Glucose ◽  
Hba1c Levels ◽  
First Session

The aim of the present study was to analyze acute glycemic effects in different moments of an aerobic training, as well as to analyze the chronic effect of training, in patients with type 2 diabetes mellitus (T2D). The participants performed 16 weeks of interval aerobic training with three weekly sessions. The main part of each session consisted of nine blocks of five minutes, in which four minutes consisted of stimulus between 85% and 95% of the anaerobic threshold heart rate (ATHR) and one minute consisted of recovery below 85% of the ATHR, totalizing 45 minutes. Capillary glucose was assessed before, immediately after and 30 minutes after the first and the last training sessions. Glycated hemoglobin (HbA1c) was assessed before and after the intervention. Paired t-test and Generalized Estimating Equations were performed for the analyses; α = 5%. The participants were seven individuals (four women) aged 59.60±6.69 years. In the first session, glucose values immediately after and 30 minutes after exercise were lower than pre-exercise values. On the other hand, in the last training session, only the glucose values immediately after exercise were lower than pre-exercise values. Analyzing the glycemic reductions, the first session presented a greater reduction immediately after (p = 0.042) and 30 minutes after exercise (p = 0.010). Regarding chronic glycemic effects, an increase (p = 0.010) in HbA1c levels was observed after training. It is concluded that, after 16 weeks of training without progression of duration and intensity, the exercise loses its acute glycemic effect, and may be even insufficient to reduce HbA1c levels.

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