scholarly journals The effects of education with printed material on glycemic control in patients with diabetes type 2 treated with different therapeutic regimens

2011 ◽  
Vol 68 (8) ◽  
pp. 676-683 ◽  
Author(s):  
Anujka Selea ◽  
Mirjana Sumarac-Dumanovic ◽  
Milica Pesic ◽  
Dusica Suluburic ◽  
Danica Stamenkovic-Pejkovic ◽  
...  

Background/Aim. Diabetes mellitus (DM) is considered to be an epidemic, chronic and progressive disease. The treatment of DM reqiures substantial effort from both the diabetes treatment team and a patient. Patient education is one of the treatment elements. The most efficacious form and content of education has not yet been established. However, every DM education must include introduction to a substantial number of facts about diabetes. The aim of our study was to estimate the levels of DM knowledge and glycemic control in Serbian patients with DM type 2 as well as to estimate the effects of education using printed material on the levels of glycemic control and knowledge about DM. Also, the effects of education on glycemic control and the level of knowledge in differently treated patients were estimated. Methods. The patients with DM type 2 (n = 364), aged 40 to 65 years, from three regional health centers, were randomized for the study. After informed consent, patients filled out the questionnaire, and were checked for HbA1c and fasting blood glucose. Finally, booklet ?Healthy lifestyle with diabetes mellitus type 2? was given to them. The same procedure was repeated after 3, 6 and 18 months. Results. There was a significant improvement in HbA1c levels after 3 months (8.00 ? 1.66% vs 9.06 ? 2.23%, p < 0.01) and after 6 months (7.67 ? 1.75% vs 9.06 ? 2.23%, p < 0.01). There was no further improvement in HbA1c levels after 18 months (7.88 ? 1.46% vs 7.67 ? 1.75%, p > 0.05). There was a significant improvement in the average test score (percent of correct answers per test sheet) after three monts (64.6% vs 55.6%, p < 0.01). There were no further statistically significant changes in the general level of DM knowledge after 6 months (65.0 ? 32.5% vs 64.5 ? 33.7%, p > 0.05 ) and after 18 months ( 64.8 ? 32.7 vs 64.5 ? 33.7%, p > 0.05). There was a significant difference in educational intervention response in DM type 2 patients on different therapeutic regimens. Conclusion. Education with printed material led to improvement in glycemic control and level of DM knowledge in our patients. Education with printed material may be a useful adjunct to DM treatment and should be structured according to the treatment modality.

Author(s):  
Heriansyah T ◽  
Hanifa H ◽  
Andarini S ◽  
Wihastuti Titin Andri

Objective: Hyperglycemia and hyperlipidemia in diabetes mellitus (DM) can lead an atherosclerosis. The increase of low-density lipoprotein level in DM and atherosclerosis is correlated with lipoprotein-associated phospholipase A2 (Lp-PLA2). Lp-PLA2 is an enzyme that produces lysophosphatidylcholine (LysoPC) and oxidized nonesterified fatty acids. LysoPC regulated inflammation mediators, include cytokines, adhesion molecules (such as vascular cell adhesion molecule-1 [VCAM-1] and intercellular adhesion molecules-1 [ICAM-1]), and monocyte chemoattractant protein-1 (MCP-1) chemotactic. Darapladib is known as a Lp-PLA2 specific inhibitor. It is also considered to be an atherosclerosis treatment. The aim of this study is to know darapladib effect on VCAM-1 and ICAM-1 aorta expression in early stages of atherosclerosis using Sprague-Dawley Type 2 DM (T2DM) model.Methods: About 30 Spraque-Dawley rats are divided into three main groups: Normal, T2DM, and T2DM with darapladib administration group. Each group consists of 2 serials treatment time: 8 and 16 weeks treatment group. Fasting blood glucose, resistance insulin, and lipid profile were measured and analyzed to ensure T2DM model. VCAM-1 and ICAM-1 expression were measured using double staining immunofluorescence. Each data were analyzed using one-way ANOVA.Results: There is a significant difference in VCAM-1 expression in T2DM group (8 and 16 weeks), with p=0.011 and 0.034 (p<0.05), respectively. Mean while, a significant difference for ICAM-1 only showed in 8 weeks T2DM group with p=0.03 (p<0.05). Moreover, there is a decreasing trend in 16 weeks T2DM group.Conclusion: Our results showed that darapladib can decrease VCAM-1 and ICAM-1 aorta expression in early stages of atherosclerosis using Sprague- Dawley T2DM model. This showed another evidence of darapladib as atherosclerosis treatment.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.


2021 ◽  
Vol 71 (1) ◽  
pp. 24-29
Author(s):  
Rachma Putri Nariswari ◽  
Gwenny Ichsan Prabowo ◽  
Hermina Novida ◽  
Nurina Hasanatuludhhiyah

Introduction: Type 2 diabetes mellitus is caused by decreased tissue sensitivity to insulin. The prevalence of diabetes in the world has almost doubled since 1980, from 4.7% to 8.5% in adult population. Early diagnosis and treatment aimed at normalizing glycemic control are very important. The objective of this study was to evaluate and compare glycemic control of metformin and glimepiride in monotherapy of type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya. Method: This was a retrospective observational study using secondary data (medical record), include glycemic control (RPG) before and two months after receiving therapy of outpatients’ type 2 diabetes mellitus with metformin or glimepiride therapy in 2018. 96 samples were found that fit the inclusion criteria. The data were analyzed by Mann-Whitney test. Result: Most patients were female, aged 50-69 years old, and dosage of metformin therapy 1500 mg/day or glimepiride therapy 2 mg/day. There was no significant difference (p>0.05) of glycemic control (RPG) of metformin compared to glimepiride therapies in type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya in 2018. Conclusion: Metformin and glimepiride were not significantly different in glycemic control (RPG). There were patients with RPG >200 mg/dl after two months of metformin or glimepiride therapy.  


2020 ◽  
Vol 8 (2) ◽  
pp. 66-72
Author(s):  
Angiesta Pinakesty ◽  
Restu Noor Azizah

Introduction: Diabetes mellitus (DM) is a non-communicable disease that has increased from year to year. Type 2 diabetes mellitus is not caused by lack of insulin secretion, but is caused by the failure of the body's cells to respond to the hormone insulin (insulin resistance). Insulin resistance was found to be a major contributor to atherogenic dyslipidemia. Dyslipidemia in DM risks 2 to 4 times higher than non-DM. Although dyslipidemia has a great risk for people with type 2 diabetes mellitus, this conventional risk factor only explains a portion (25%) of excess cardiovascular risk in type 2 DM. Discussion: In uncontrolled type 2 DM patients, LDL oxidation occurs faster which results from an increase in chronic blood glucose levels. Glycemic control as a determinant of DM progressivity is determined through HbA1c examination. HbA1c levels are associated with blood triglyceride levels. Meanwhile, triglyceride levels are associated with total cholesterol and HDL cholesterol levels. HbA1c levels are also associated with LDL cholesterol levels. Conclusion: There is a relationship between lipid profile and the progression of type 2 diabetes mellitus.   Keywords: type 2 diabetes mellitus, dyslipidemia, HbA1c, glycemic control, lipid profile


2013 ◽  
Vol 59 (5) ◽  
pp. 25-31
Author(s):  
I V Glinkina

The present study included patients presenting with type 2 diabetes mellitus (DM2) of less than 10 years in duration having the HbA1c levels between 7.0% and 10.0%. They were treated with insulin detemir (once or twice daily) in combination with oral hypoglycemic agents (OHGA) and transferred thereafter to therapy with insulin glargine (Lantus, SoloSTAR) administered once daily. The patients were advised to adjust the dose of insulin glargine in order to achieve the desired fasting blood glucose level (FBGL) below 5.6 mmol/l. The HbA1c levels and FBGL, insulin doses, body weight, frequency of hypoglycemic episodes and adverse reactions were measured within 3 and 6 months after inclusion in the study; simultaneously, the patients and doctors' satisfaction with the treatment was estimated. A total of 915 patients were available for the examination (mean age 57.9±9.2 years, mean duration of DM2 5.9±2.3 years, average BMI 31.0±5.1 kg/m2). The number of the patients presenting with the HbA1c levels below 7% within 6 months after the onset of therapy amounted to 46.5% of the total. During the same period, percentage of the patients experiencing nocturnal and daytime glycemic episodes decreased. No cases of severe hypoglycemia were documented. Moreover, the body weight of the patients somewhat decreased (by 0.9±2.9 kg; p<0.001) by the 6 month. The majority of the patients and their doctors reported the effects of described therapy as "good" or "very good". It is concluded that the substitution of the treatment with insulin detemir in combination with OHGA by therapy with insulin glargine in the patients with DM2 and suboptimal glycemic control under conditions of the routine clinical practice may improve the quality of glycemic control without a substantial body weight gain and with the low frequency of hypoglycemic episodes.


2020 ◽  
Vol 10 (4) ◽  
pp. e34-e34
Author(s):  
Mahsa Mohammadi ◽  
Mohsen Rajabnia ◽  
Mohammad Saad Forghani ◽  
Khaled Rahmani ◽  
Mohammad Bahadoram

Introduction: Diabetic nephropathy (diabetic kidney disease) is one of the microvascular complications of diabetes mellitus. The human leukocyte antigen (HLA) is a group of genes that is related to autoimmune diseases, infections and inflammation. Studies regarding the association of type 2diabetes and HLA-II are negligible. Objectives: The aim of this study is to determinate association between diabetic nephropathy and HLA II-DQ1 in diabetes type 2 patients. Patients and Methods: In this study, 120 diabetes type 2 patients were divided into two groups of diabetic nephropathy (case group) and without diabetic nephropathy (control group). Blood samples were taken and DNA was isolated. Asymmetric polymerase chain reaction (PCR) was used to amplify the HLA II-DQ1 exon 2 and exon 3. PCR products were hybridized and labeled with probes on the chip. Determination of HLAII-DQ1 gene typing was conducted by scanning hybrid products and analyzed with PerkinElmer ScanArray software. Results: The results of chi-square test showed no significant difference between expression levels of HLA in the two groups (P<0.05). Conclusion: There was no significant difference between expression levels of HLA in two groups of patients. Various factors such as demographic characteristics, lifestyle, geographic region, and race are the factors influencing the relationship between diabetic nephropathy and DQ1-HLA II. Since this study is conducted in one region and one race and with limited population, it is suggested that future studies should be considered and the association between the mentioned variables with HLA should be considered.


Author(s):  
Mukadas O Akindele ◽  
Phillip Kodzo ◽  
Mustapha Naimat

Background: The use of aerobic exercise as a form of glycemic control in type 2 diabetes mellitus has been well documented in the literatures. High blood pressure has been shown to be one of the sequelae of type 2 diabetes mellitus. Determination of mode of exercises for glycemic control that will not adversely affect the cardiovascular indices of type 2 diabetes mellitus subjects is highly indicated. Objective: The purpose of this study was to determine the acute cardiovascular responses of type 2 diabetes mellitus subjects to continuous and intermittent modes of exercises. Results: There was statistical significant difference in heart rate of both groups. Continuous mode of exercise elicited no statistical difference in SBP and DBP but there was statistical significant difference in SBP in intermittent exercise group with no statistical significant in their DBP. Cross comparison of pre and post cardiovascular indices showed that there were statistical significant differences in SBP (F=0.710, P>0.05) and DBP (F=1.397, P>0.05). Conclusion: Cardiovascular responses of type 2 diabetes mellitus subjects were higher in intermittent exercise group compared with the continuous exercise group. KEYWORDS: Type 2 diabetes mellitus, Aerobic exercise, cardiovascular response.


2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Nicolas Byron Hatziisaak ◽  
Telemachos Hatziisaak ◽  
Urs Keller

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+.


2021 ◽  
Vol 17 (3) ◽  
pp. 413-423
Author(s):  
Sambit Das ◽  

It is of interest to evaluate the clinical effectiveness and safety of vildagliptin as monotherapy and combination therapy of vildagliptin and metformin for the management of type 2 diabetes mellitus (T2DM) patients in Indian settings. The study included patients with T2DM (aged >18 years) receiving vildagliptin monotherapy and vildagliptin in combination with metformin therapy of various strengths. Data related to demographics, risk factors, medical history, glycated hemoglobin (HbA1c) levels, and medical therapies were retrieved from medical records. Out of 9678 patients (median age, 52.0 years), 59.1% were men. A combination of vildagliptin and metformin (50/500 mg) was the most commonly used therapy (54.8%), and the median duration of therapy was 24.0 months. The predominant reason for selecting vildagliptin therapy was to improve HbA1c levels (87.8%). A total of 87.5% of patients required dosage up-titration. Vildagliptin therapy was used in patients with T2DM and associated complications (peripheral neuropathy, CAD, nephropathy, retinopathy, autonomous neuropathy, stroke/TIA, and peripheral artery disease). Among 5175 patients who experienced body weight changes, a majority of patients had lost weight (68.6%). The target glycemic control was achieved in 95.3% of patients. The mean HbA1c levels were significantly decreased post-treatment (mean change: 1.34%; p<0.001). Adverse events were reported in 0.4% of patients. Physicians rated the majority of patients as good to excellent on the global evaluation of efficacy and tolerability scale (98.9%, each). Vildagliptin with or without metformin was an effective therapy in reducing HbA1c helps in achieving target glycemic control, and was well-tolerated in Indian patients with T2DM continuum.


2021 ◽  
Vol 16 (3) ◽  
pp. 267
Author(s):  
Devi Novia ◽  
Sugiarto Sugiarto ◽  
Yulia Lanti Dewi

Nowadays the epidemiological burden of diabetes increases with long life-threatening symptoms and the effects      of antidiabetic drugs. Lack of insulin activity is one of the signs of a drop in diabetes mellitus. The mechanisms in antidiabetic include stimulating β-Langerhans cells which secrete insulin and inhibit enzyme activity. The purpose of this study was to analyze the effect of giving tamarind leaf extract on levels of homa-β in type 2 diabetes mellitus rats. This study used 30 male Wistar rats aged 8-12 weeks with a bodyweight of 150-200 grams and separated into 5 groups. The first group is KN group (DMT2 mice + standard diet), group 2 is KP (DMT2 + Acarbose mice), group 3 is P1 (DMT2 mice + tamarind leaf extract 28 mg / 200gr / day), group 4 is P2 (rat DMT2 + tamarind leaf extract 56 mg/200gr/day), and group 5 is P3 (DMT2 rat + tamarind leaf extract 112 mg / 200gr / day). The measurement method for Homa-β is to use a standardized formula and use the results of blood tests for fasting blood glucose and insulin levels. The results of the inter-variable study using one-way Anova found a significant difference between the levels of homa-β and the administration of tamarind leaves extract in rats with type 2 diabetes mellitus model (p <0.05). There were significant differences in the 5 treatment groups. On the 7th day, there was an increase in homa-β levels in the KP, P1, P2, and P3 groups while in the KN group decreased in homa-β levels. The P3 group was seen to have the highest increase in homa-β levels in the 14th day, but on the 14th day there was no significant difference between the acarbose drug group (99.57 ± 6.41) and the P3 group (15.09 ± 1, 71). The conclusion was the administration of tamarind extract at a dose of 28.56, and 112 mg/kgBW/day significantly increased levels of HOMA-β for 7 and 14 days in rats with type 2 diabetes mellitus.


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