Co-creation of Massive Open Online Courses to improve Digital Health Literacy in Diabetes: A Process Description (Preprint)

2021 ◽  
Author(s):  
Yolanda Alvarez-Perez ◽  
Lilisbeth Perestelo-Perez ◽  
Amado Rivero-Santana ◽  
Ana Wägner ◽  
Alezandra Torres-Castaño ◽  
...  
Keyword(s):  
Health Literacy ◽  
Online Courses ◽  
Digital Health ◽  
Massive Open Online Courses ◽  
Massive Open Online ◽  
Creation Process ◽  
Type 2 Dm ◽  
Type 1 Dm

BACKGROUND Self-management education is a fundamental aspect in the health care of people with Diabetes Mellitus (DM) to develop the necessary skills for the improvement of health outcomes. Patients are required to have the competencies to manage electronic information resources, that is, an appropriate level of digital health literacy (DHL). The European project IC-Health aimed to improve DHL among people with DM, through the co-creation of a Massive Open Online Courses (MOOCs). OBJECTIVE We report the preliminary results obtained in three participating countries in IC-Health (Italy, Spain and Sweden) regarding: 1) the experience of the participants during the co-creation process of MOOCs; 2) perceived changes in their DHL level before and after using MOOCs; and 3) a preliminary assessment of the acceptability of MOOCs. METHODS The co-creation of the MOOCs included: 1) focus groups and group interviews with adults and adolescents with DM; and 2) the creation of independent Communities of Practice (CoPs) for Type 1 DM and Type 2 DM participants aimed to co-design the MOOCs. Quantitative measures of MOOCs’ acceptability, experience in the co-creation process and increase of DHL (dimensions of Finding, Understanding and Appraisal) were assessed. RESULTS Twenty eight participants with DM participated in focus groups and groups interviews. Participants with Type 2 DM were older and less empowered, had lower DHL and were less informed about their disease than participants with Type 1 DM. 149 participants made up the DM CoPs. A total of nine MOOCs were developed. The acceptability of the MOOCs and the co-creation experience were positively valued. There was a significant improvement in DHL both in adults and adolescents after using MOOCs (P-values < 0.001). CONCLUSIONS Although the results presented on self-perceived DHL are preliminary and exploratory, they suggest that IC-Health MOOCs represent a promising tool for the medical care of DM, being able to help reduce the limitations associated with low DHL and other communication barriers in DM population

scholarly journals Co-creation of Massive Open Online Courses to improve Digital Health Literacy in Diabetes: A Process Description (Preprint)

JMIR Diabetes ◽  
10.2196/30603 ◽  
2021 ◽  
Author(s):  
Yolanda Alvarez-Perez ◽  
Lilisbeth Perestelo-Perez ◽  
Amado Rivero-Santana ◽  
Ana Wägner ◽  
Alezandra Torres-Castaño ◽  
...  
Keyword(s):  
Health Literacy ◽  
Online Courses ◽  
Digital Health ◽  
Massive Open Online Courses ◽  
Massive Open Online

scholarly journals Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women

2022 ◽  
Vol 19 (2) ◽  
pp. 913
Author(s):  
Yolanda Álvarez-Pérez ◽  
Lilisbeth Perestelo-Pérez ◽  
Amado Rivero-Santanta ◽  
Alezandra Torres-Castaño ◽  
Ana Toledo-Chávarri ◽  
...  
Keyword(s):  
Health Literacy ◽  
Communities Of Practice ◽  
Focus Groups ◽  
Online Courses ◽  
Digital Health ◽  
Massive Open Online Courses ◽  
P Value ◽  
Health Issues ◽  
Massive Open Online ◽  
Lactating Women

Background: Digital health literacy (DHL) increases the self-efficacy and empowerment of pregnant and lactating women (PLW) in using the Internet for health issues. The European project IC-Health aimed to improve DHL among PLW, through the co-creation of Massive Open Online Courses (MOOCs). Methods: The co-creation of the MOOCs included focus groups and the creation of communities of practice (CoPs) with PLW and healthcare professionals aimed to co-design the MOOCs. The quantitative measures of MOOCs’ acceptability, experience in the co-creation process and increase in DHL (dimensions of finding, understanding and appraisal) were assessed. Results: 17 PLW participated in focus groups, 113 participants were included in CoPs and 68 participants evaluated the acceptability of MOOCs. A total of 6 MOOCs aimed at improving PLW’s DHL were co-designed. There was a significant improvement in self-perceived DHL after using MOOCs (p-value < 0.001). The acceptability of MOOCs and co-creation experience were positively valued. Conclusions: The preliminary results of the quantitative assessment showed a higher self-perceived DHL after the IC-Health MOOCs. These results suggest that IC-Health MOOCs and the co-creation methodology appear to be a viable process to carry out an intervention aimed to improve DHL levels in European PLW.

Associations between Diabetes Mellitus and Nontuberculous Mycobacterium-Caused Diseases in Taiwan: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Jui-Yang Wang ◽  
Hsin-Chung Lin ◽  
Hsin-An Lin ◽  
Chi-Hsiang Chung ◽  
Lih-Chyang Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Cox Regression ◽  
Nontuberculous Mycobacterium ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Type 2 Dm ◽  
Type 1 Dm

Patients with diabetes mellitus (DM) are at greater risk of developing active tuberculosis and other intracellular bacterial infections, although the risk of acquiring infections from nontuberculous Mycobacterium (NTM) remains undefined. This study evaluated associations between DM and incidence of NTM infection-caused pulmonary and cutaneous diseases. Data for DM patients were extracted from the National Health Insurance Research Database of Taiwan. The DM cohort included 136,736 patients, and cases were matched randomly by age, gender, and index year with non-DM patients. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios of incident NTM-caused diseases in the DM cohort compared with non-DM control subjects. The frequency of incident NTM-caused diseases was significantly greater in DM patients (0.12%) than in non-DM patients (0.08%) (P < 0.05), including patients with type 1 DM (0.12%) and type 2 DM (0.12%) (all P < 0.05). Adjusted multivariate Cox regression analysis revealed that the incidence of NTM-caused diseases in DM patients was 1.43-fold greater than that in non-DM patients overall (P < 0.05), particularly in pulmonary (1.13-fold), other specific (excluding pulmonary, cutaneous, and disseminated diseases; 3.88-fold), and unspecific (atypical NTM infection; 1.54-fold) diseases (all P < 0.05). In conclusion, both type 1 DM and type 2 DM patients have high risk of NTM-caused diseases, suggesting that physicians need to pay more attention to this issue concerning the high risk of NTM-caused infection in DM patients.

scholarly journals Activation of CD4+ and CD8+ T-lymphocytes by insulin and GAD in patients with type 1 or 2 diabetes mellitus

2017 ◽  
Vol 6 (8) ◽  
pp. 758-765 ◽  
Author(s):  
Borros Arneth
Keyword(s):  
Diabetes Mellitus ◽  
T Lymphocytes ◽  
Whole Blood ◽  
Blood Samples ◽  
Cd8 T Lymphocytes ◽  
Type 2 Dm ◽  
Whole Blood Samples ◽  
Type 1 Dm

Background The origin of autoimmune disease type 1 diabetes is still unknown. Aim This study assessed the activation of CD4+ and CD8+ T-lymphocytes by human insulin and human glutamate decarboxylase (GAD) in patients with type 1 or type 2 diabetes mellitus (DM) and healthy volunteers. Materials and methods The expression of CD69, a marker of T-lymphocyte activity, was determined in whole blood samples by flow cytometry after 12 h of incubation with or without insulin or GAD. The analysis included samples from 12 type 1 DM patients, 14 type 2 DM patients and 12 healthy volunteers. Results Significant increases in the number of activated CD4+ and CD8+ T-lymphocytes following pre-incubation of whole blood samples with human insulin or GAD were observed in samples from patients with type 1 DM, whereas no activation of these cells was detected in samples from either type 2 DM patients or healthy subjects. Discussion These results indicated that latent pre-activation of CD4+ and CD8+ T-lymphocytes in response to insulin or GAD epitopes occurred in type 1 DM patients. Conclusion These findings suggest that pre-immunization against insulin and/or GAD might be associated with the development of type 1 DM. Alternatively, these results might reflect a non-specific, bystander autoimmune response.

scholarly journals Treatment with Mammalian Ste-20-like Kinase 1/2 (MST1/2) Inhibitor XMU-MP-1 Improves Glucose Tolerance in Streptozotocin-Induced Diabetes Mice

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4381
Author(s):  
Zakiyatul Faizah ◽  
Bella Amanda ◽  
Faisal Yusuf Ashari ◽  
Efta Triastuti ◽  
Rebecca Oxtoby ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Tolerance ◽  
Diabetic Mice ◽  
Β Cells ◽  
Pancreatic Β Cells ◽  
In Vivo Models ◽  
Type 2 Dm ◽  
Type 1 Dm

Diabetes mellitus (DM) is one of the major causes of death in the world. There are two types of DM—type 1 DM and type 2 DM. Type 1 DM can only be treated by insulin injection whereas type 2 DM is commonly treated using anti-hyperglycemic agents. Despite its effectiveness in controlling blood glucose level, this therapeutic approach is not able to reduce the decline in the number of functional pancreatic β cells. MST1 is a strong pro-apoptotic kinase that is expressed in pancreatic β cells. It induces β cell death and impairs insulin secretion. Recently, a potent and specific inhibitor for MST1, called XMU-MP-1, was identified and characterized. We hypothesized that treatment with XMU-MP-1 would produce beneficial effects by improving the survival and function of the pancreatic β cells. We used INS-1 cells and STZ-induced diabetic mice as in vitro and in vivo models to test the effect of XMU-MP-1 treatment. We found that XMU-MP-1 inhibited MST1/2 activity in INS-1 cells. Moreover, treatment with XMU-MP-1 produced a beneficial effect in improving glucose tolerance in the STZ-induced diabetic mouse model. Histological analysis indicated that XMU-MP-1 increased the number of pancreatic β cells and enhanced Langerhans islet area in the severe diabetic mice. Overall, this study showed that MST1 could become a promising therapeutic target for diabetes mellitus.

scholarly journals Individuals with Peripheral Artery Disease (PAD) and Type 1 Diabetes Are More Likely to Undergo Limb Amputation than Those with PAD and Type 2 Diabetes

2020 ◽  
Vol 9 (9) ◽  
pp. 2809
Author(s):  
Nidhi Jain ◽  
Manyoo A. Agarwal ◽  
Diana Jalal ◽  
Ayotunde O. Dokun
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Peripheral Artery Disease ◽  
Limb Amputation ◽  
Peripheral Artery ◽  
Type 2 Dm ◽  
Artery Disease ◽  
Type 1 Dm

Background: Limited data exist comparing how type 1 diabetes mellitus (DM) and type 2 DM may have differential effects on peripheral artery disease (PAD) severity. We aimed to study the association of type of DM with the procedure utilized in hospitalizations with a diagnosis of PAD. Methods: We used the national inpatient sample databases from 2003 to 2014 to identify hospitalizations with a diagnosis of PAD and type 1 or type 2 DM. Logistic regression was utilized to evaluate the association between type of DM and procedure utilized (amputation-overall, major, endovascular revascularization, surgical revascularization). Results: We identified 14,012,860 hospitalizations with PAD diagnosis and DM, 5.6% (n = 784,720) had type 1 DM. The patients with type 1 DM were more likely to present with chronic limb-threatening ischemia (CLTI) (45.2% vs. 32.0%), ulcer (25.9% vs. 17.7%), or complicated ulcer (16.6% vs. 10.5%) (all p < 0.001) when compared to those with type 2 DM. Type 1 DM was independently and significantly associated with more amputation procedures (adjusted odds ratio = 1.12, 95% confidence interval [CI] I 1.08 to 1.16, p < 0.001). Overall, in-hospital mortality did not differ between the individuals with type 1 and type 2 DM. The overall mean (95% CI) length of stay (in days) was 6.6 (6.5 to 6.6) and was significantly higher for type 1 DM (7.8 [7.7 to 8.0]) when compared to those with type 2 DM (6.5 [6.4 to 6.6]). Conclusion: We observed that individuals with PAD and type 1 DM were more likely to present with CLTI and ulcer and undergo amputation when compared to those with PAD and type 2 diabetes. Further studies are needed to better understand the underlying mechanisms behind these findings and to identify novel interventions to reduce the risk of amputation in patients with type 1 DM.

scholarly journals An Altered Pattern of Myocardial Histopathological and Molecular Changes Underlies the Different Characteristics of Type-1 and Type-2 Diabetic Cardiac Dysfunction

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Tamás Radovits ◽  
Sevil Korkmaz ◽  
Csaba Mátyás ◽  
Attila Oláh ◽  
Balázs Tamás Németh ◽  
...  
Keyword(s):  
Diabetic Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiomyocyte Hypertrophy ◽  
Pathological Features ◽  
Rat Models ◽  
Type 2 Dm ◽  
Type 1 Dm ◽  
Type 2 Diabetic

Increasing evidence suggests that both types of diabetes mellitus (DM) lead to cardiac structural and functional changes. In this study we investigated and compared functional characteristics and underlying subcellular pathological features in rat models of type-1 and type-2 diabetic cardiomyopathy. Type-1 DM was induced by streptozotocin. For type-2 DM, Zucker Diabetic Fatty (ZDF) rats were used. Left ventricular pressure-volume analysis was performed to assess cardiac function. Myocardial nitrotyrosine immunohistochemistry, TUNEL assay, hematoxylin-eosin, and Masson’s trichrome staining were performed. mRNA and protein expression were quantified by qRT-PCR and Western blot. Marked systolic dysfunction in type-1 DM was associated with severe nitrooxidative stress, apoptosis, and fibrosis. These pathological features were less pronounced or absent, while cardiomyocyte hypertrophy was comparable in type-2 DM, which was associated with unaltered systolic function and increased diastolic stiffness. mRNA-expression of hypertrophy markers c-fos, c-jun, andβ-MHC, as well as pro-apoptotic caspase-12, was elevated in type-1, while it remained unaltered or only slightly increased in type-2 DM. Expression of the profibrotic TGF-β1was upregulated in type-1 and showed a decrease in type-2 DM. We compared type-1 and type-2 diabetic cardiomyopathy in standard rat models and described an altered pattern of key pathophysiological features in the diabetic heart and corresponding functional consequences.

scholarly journals Helicobacter pyloriInfection Is Associated with Type 2 Diabetes, Not Type 1 Diabetes: An Updated Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-15 ◽  
Author(s):  
Jun-Zhen Li ◽  
Jie-Yao Li ◽  
Ting-Feng Wu ◽  
Ji-Hao Xu ◽  
Can-Ze Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Knowledge Database ◽  
Type 2 Dm ◽  
The Difference ◽  
H Pylori ◽  
Type 1 Dm

Background. Extragastric manifestations ofHelicobacter pylori(H. pylori) infection have been reported in many diseases. However, there are still controversies about whetherH. pyloriinfection is associated with diabetes mellitus (DM). This study was aimed at answering the question.Methods. A systematic search of the literature from January 1996 to January 2016 was conducted in PubMed, Embase databases, Cochrane Library, Google Scholar, Wanfang Data, China national knowledge database, and SinoMed. Published studies reportingH. pyloriinfection in both DM and non-DM individuals were recruited.Results. 79 studies with 57,397 individuals were included in this meta-analysis. The prevalence ofH. pyloriinfection in DM group (54.9%) was significantly higher than that (47.5%) in non-DM group (OR = 1.69,P<0.001). The difference was significant in comparison between type 2 DM group and non-DM group (OR = 2.05), but not in that between type 1 DM group and non-DM group (OR = 1.23, 95% CI: 0.77–1.96,P=0.38).Conclusion. Our meta-analysis suggested that there is significantly higher prevalence ofH. pyloriinfection in DM patients as compared to non-DM individuals. And the difference is associated with type 2 DM but not type 1 DM.

scholarly journals Study of cutaneous manifestations of type 2 diabetes mellitus

2018 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Yoganand J. Phulari ◽  
Vidisha Kaushik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Age Group ◽  
Cutaneous Manifestations ◽  
Skin Manifestations ◽  
Type 2 Dm ◽  
Type 1 Dm

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Poorly controlled Type 2 diabetes mellitus (DM) is associated with several disorders and microvascular, macrovascular and neuropathic complications. Multiple factors play a role in the manifestations of cutaneous signs of DM. The prevalence of a cutaneous disorder appears to be similar between Type 1 DM and Type 2 DM patients, but Type 2 DM patients develop more frequent cutaneous infections, and Type 1 DM patients manifest more autoimmune-type  cutaneous lesions. The objective of the study was to assess the various cutaneous manifestations of Type 2 DM and the relation of cutaneous manifestations with the duration of Type 2 DM.</span></p><p class="abstract"><strong>Methods:</strong> All patients of Type 2 DM, of age group 20 and above, of both sexes, attending   OPD or IPD at Dr. D. Y. Patil  Hospital, Kolhapur  willing to give written informed consent, were included for the study between August 2014 – July 2016. Complete history and examination of all the patients with regards to onset of cutaneous manifestations was taken.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority (49%) of respondents were in the age group of 41 to 60 years, and majority (66%) were males. 57.5% were new cases and 42.5% were known cases. Duration of illness- majority 50.58% were &lt;5 years, 27.05% in 6 to 10 years. In present study there were 61% who had infectious skin manifestations and 39% who had non-infectious skin manifestations. Out of infectious manifestations 39.5% had fungal infection<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Therefore on the basis of present study, we conclude that the skin is involved in DM quite often. The manifestations are numerous and varied and many a times they can serve as diagnostic marker for underlying DM. Whenever patients present with multiple skin manifestations, their diabetic status should be checked. The recognition of these skin findings is the key to treatment and prevention<span lang="EN-IN">.</span></p>

scholarly journals Relationship between TP53 and interleukin-6 gene variants and the risk of types 1 and 2 diabetes mellitus development in the Kermanshah province

2021 ◽  
Vol 14 (1) ◽  
pp. 37-44
Author(s):  
Lida Haghnazari ◽  
◽  
Ramin Sabzi ◽  
◽  
Keyword(s):  
Diabetes Mellitus ◽  
Tp53 Gene ◽  
Control Group ◽  
Control Groups ◽  
Codon 72 ◽  
Type 2 Dm ◽  
And Control ◽  
Type 1 Dm

Diabetes mellitus (DM) is a metabolic disorder that results from insufficient secretion or insulin resistance, or both. Insulin secretion deficiency leads to chronic hyperglycemia along with impaired metabolism of proteins, lipids, and carbohydrates. This study aimed to investigate the TP53 gene SNP (single nucleotide polymorphism) rs1042522 genotype and the interleukin-6 (IL-6) gene SNP rs1800795 genotype in DM and control groups. This study was performed on 70 patients with type 1 DM, 100 patients with type 2 DM without related complications, 66 control subjects for type 1 DM, and 95 control subjects for type 2 DM. The control groups were matched regarding age and gender and did not have a familial relationship with the patient groups. All the subjects were residents of Kermanshah, located in the western part of Iran. Polymorphisms of TP53 and IL-6 genes were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Lipid profile, fasting blood glucose, and HbA1c were measured using the ELISA and immunoturbidometric methods. The frequency of genotypes (CC, CG, GG) of the TP53 gene codon 72 in type 1 DM and its control group were significantly different (P= 0.013). Likewise, the frequency of genotypes (CC, CG, GG) of the TP53 gene codon 72 was significantly different between type 2 DM and control groups (P <0.001). The frequency of genotypes (GG, GC, CC) of G174C polymorphisms in the IL-6 gene was different between type 1 DM and control group as well as between type 2 DM and its control group, but it was not statistically significant. SNP rs1042522 genotypes in the dominant form (CG + GG vs. CC) (OR= 3.880; P < 0.001) and alleles G vs. C alleles (OR= 0.384; P < 0.001) increased the risk of type 2 DM significantly. There was no significant difference between type 1 and type 2 DM groups and respected control groups regarding the frequency of the IL-6 gene SNP rs1800795 alleles. The G allele of SNP rs1042522 encoding the TP53 gene increases the risk of developing DM in the population of the Kermanshah province, Iran.

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