"Taming the Monster aka Uncontrolled Diabetes: A Viewpoint" (Preprint)

2020 ◽  
Author(s):  
Swati Anand ◽  
Amardeep Kalsi ◽  
Jonathan Figueroa ◽  
Parag Mehta
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Positive Impact ◽  
The United States ◽  
Phone Call ◽  
Diabetic Patients ◽  
Dietary Compliance ◽  
Glucose Levels ◽  
Uncontrolled Diabetes ◽  
Number Of Patients

BACKGROUND HbA1c between 6% and 6.9% is associated with the lowest incidence of all‐cause and CVD mortality, with a stepwise increase in all‐cause and cardiovascular mortality in those with an HbA1c >7%. • There are 30 million individuals in the United States (9.4% of the population) currently living with Diabetes Mellitus. OBJECTIVE Improving HbA1C levels in patients with uncontrolled Diabetes with a focused and collaborative effort. METHODS Our baseline data for Diabetic patients attending the outpatient department from July 2018 to July 2019 in a University-affiliated hospital showed a total of 217 patients for one physician. • Of 217 patients, 17 had HbA1C 9 and above. We contacted these patients and discussed the need for tight control of their blood glucose levels. We intended to ensure them that we care and encourage them to participate in our efforts to improve their outcome. • We referred 13 patients that agreed to participate to the Diabetic educator who would schedule an appointment with the patients, discuss their diet, exercise, how to take medications, self-monitoring, and psychosocial factors. • If needed, she would refer them to the Nutritionist based on patients’ dietary compliance. • The patients were followed up in the next two weeks via telemedicine or a phone call by the PCP to confirm and reinforce the education provided by the diabetes educator. RESULTS Number of patients that showed an improvement in HbA1C values: 11 Cumulative decrease in HbA1C values for 13 patients: 25.3 The average reduction in HbA1C: 1.94 CONCLUSIONS Our initiative to exclusively target the blood glucose level with our multidisciplinary approach has made a positive impact, which is reflected in the outcome. • It leads to an improvement in patient compliance and facilitates diabetes management to reduce the risk for complications CLINICALTRIAL NA

scholarly journals Prediction and prevention of hypoglycaemic events in type-1 diabetic patients using machine learning

2019 ◽  
Vol 26 (1) ◽  
pp. 703-718 ◽  
Author(s):  
Josep Vehí ◽  
Iván Contreras ◽  
Silvia Oviedo ◽  
Lyvia Biagi ◽  
Arthur Bertachi
Keyword(s):  
Machine Learning ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Diabetes Management ◽  
Machine Learning Algorithms ◽  
Support Vector ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Prediction And Prevention

Tight blood glucose control reduces the risk of microvascular and macrovascular complications in patients with type 1 diabetes. However, this is very difficult due to the large intra-individual variability and other factors that affect glycaemic control. The main limiting factor to achieve strict control of glucose levels in patients on intensive insulin therapy is the risk of severe hypoglycaemia. Therefore, hypoglycaemia is the main safety problem in the treatment of type 1 diabetes, negatively affecting the quality of life of patients suffering from this disease. Decision support tools based on machine learning methods have become a viable way to enhance patient safety by anticipating adverse glycaemic events. This study proposes the application of four machine learning algorithms to tackle the problem of safety in diabetes management: (1) grammatical evolution for the mid-term continuous prediction of blood glucose levels, (2) support vector machines to predict hypoglycaemic events during postprandial periods, (3) artificial neural networks to predict hypoglycaemic episodes overnight, and (4) data mining to profile diabetes management scenarios. The proposal consists of the combination of prediction and classification capabilities of the implemented approaches. The resulting system significantly reduces the number of episodes of hypoglycaemia, improving safety and providing patients with greater confidence in decision-making.

scholarly journals Compliance of checking HbA1c in a tertiary care hospital of Pakistan

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Aziz ◽  
Syed Ahsan Ali
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Creative Commons ◽  
Glucose Levels ◽  
Uncontrolled Diabetes

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world. Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c. Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%. Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c. doi: https://doi.org/10.12669/pjms.37.1.2814 How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145.  doi: https://doi.org/10.12669/pjms.37.1.2814 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.

Nutritional Interventions and Considerations for the Development of Low Calorie or Sugar Free Foods

2020 ◽  
Vol 16 (4) ◽  
pp. 301-312 ◽  
Author(s):  
Jyoti Singh ◽  
Prasad Rasane ◽  
Sawinder Kaur ◽  
Vikas Kumar ◽  
Kajal Dhawan ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Blood Glucose ◽  
Human Population ◽  
Artificial Sweeteners ◽  
Diabetic Patients ◽  
Nutritional Interventions ◽  
Low Calorie ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Diet Plan

Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.

Two Exercise Programs for People with Diabetes and Visual Impairment

1993 ◽  
Vol 87 (9) ◽  
pp. 365-367
Author(s):  
J. Dods
Keyword(s):  
United States ◽  
Blood Glucose ◽  
Visual Impairment ◽  
The United States ◽  
Exercise Programs ◽  
Daily Lives ◽  
Glucose Levels ◽  
Basic Model ◽  
Blood Glucose Levels ◽  
Exercise Regimen

This article describes two programs—one in Australia and one in the United States—that teach people with diabetes and visual impairment to incorporate proper diets and exercise into their daily lives and hence to gain better control of their blood glucose levels. It also presents a basic model of an exercise regimen that clients can perform at home.

scholarly journals Self-Care IoT Platform for Diabetic Mellitus

2021 ◽  
Vol 11 (5) ◽  
pp. 2006
Author(s):  
Jai-Chang Park ◽  
Seongbeom Kim ◽  
Je-Hoon Lee
Keyword(s):  
Blood Glucose ◽  
Self Care ◽  
Target Range ◽  
Process Data ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Iot Platform ◽  
Number Of Patients ◽  
Glucose Management ◽  
The Relationship

Diabetes mellitus is a severe chronic disease, and the number of patients has increased. To manage blood glucose levels, patients should frequently measure their blood glucose and analyze which lifestyle habits affect blood glucose levels. However, it is hard to record and analyze the relationship between their blood glucose levels and lifestyle. The internet of things (IoT) is useful to interconnect, monitor, obtain, and process data between various devices used in everyday life to fulfill a common objective. This paper proposes an intelligent self-care platform using IoT technology that helps patients with chronic diabetes manage their blood glucose levels in their target range. In particular, we developed various devices called the self-care IoT pack. It consists of five different types of devices to obtain blood glucose levels, physical activities, food intake, medication, sleeping, and so on. They can collect blood glucose levels with lifestyles that automatically impact the patient’s blood glucose level. We also devised a self-care application to display and analyze the data obtained from the IoT pack. Consequently, the proposed self-care IoT platform collects the blood glucose levels and the lifestyles without any burden of record. By reviewing the accumulated information, the patients can find bad habits in blood glucose management and improve their lifestyle.

Indole as a new tentative marker in exhaled breath for non-invasive blood glucose monitoring of diabetic subjects

2021 ◽  
Author(s):  
Herbert Fink ◽  
Tim Maihöfer ◽  
Jeffrey Bender ◽  
Jochen Schulat
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Glucose Measurement ◽  
Diabetic Patients ◽  
Exhaled Breath ◽  
Invasive Approach ◽  
Test Strips ◽  
Non Invasive

Abstract Blood glucose monitoring (BGM) is the most important part of diabetes management. In classical BGM, glucose measurement by test strips involves invasive finger pricking. We present results of a clinical study that focused on a non-invasive approach based on volatile organic compounds (VOCs) in exhaled breath. Main objective was the discovery of markers for prediction of blood glucose levels (BGL) in diabetic patients. Exhaled breath was measured repeatedly in 60 diabetic patients (30 type 1, 30 type 2) in fasting state and after a standardized meal. Proton Transfer Reaction Time of Flight Mass Spectrometry (PTR-ToF-MS) was used to sample breath every 15 minutes for a total of six hours. BGLs were tested in parallel via BGM test strips. VOC signals were plotted against glucose trends for each subject to identify correlations. Exhaled indole (a bacterial metabolite of tryptophan) showed significant mean correlation to BGL (with negative trend) and significant individual correlation in 36 patients. The type of diabetes did not affect this result. Additional experiments of one healthy male subject by ingestion of lactulose and 13C-labeled glucose (n=3) revealed that exhaled indole does not directly originate from food digestion by intestinal microbiota. As indole has been linked to human glucose metabolism, it might be a tentative marker in breath for non-invasive BGM. Clinical studies with greater diversity are required for confirmation of such results and further investigation of metabolic pathways.

Effect of Corticosteroid Injections on Blood Glucose Levels in Diabetic Patients

2018 ◽  
pp. 1
Author(s):  
Sylvain Mathieu ◽  
Marion Couderc ◽  
Sandrine Malochet-Guinamand ◽  
Jean-Jacques Dubost ◽  
Anne Tournadre ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Corticosteroid Injections
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