Make Your Diabetic Patients Walk: Long-term impact of different amounts of physical activity on type 2 diabetes

Aim To evaluate the effects of sodium-glucose co-transporter 2 (SGLT2) inhibition on renal function and albuminuria in patients with type 2 diabetes. Methods We conducted systematic searches of PubMed, Embase and Cochrane Central Register of Controlled Trials up to June 2016 and included randomized controlled trials of SGLT2 inhibitors in adult type 2 diabetic patients reporting estimated glomerular filtration rate (eGFR) and/or urine albumin/creatinine ratio (ACR) changes. Data were synthesized using the random-effects model. Results Forty-seven studies with 22,843 participants were included. SGLT2 inhibition was not associated with a significant change in eGFR in general (weighted mean difference (WMD), −0.33 ml/min per 1.73 m2, 95% CI [−0.90 to 0.23]) or in patients with chronic kidney disease (CKD) (WMD −0.78 ml/min per 1.73 m2, 95% CI [−2.52 to 0.97]). SGLT2 inhibition was associated with eGFR reduction in short-term trials (WMD −0.98 ml/min per 1.73 m2, 95% CI [−1.42 to −0.54]), and with eGFR preservation in long-term trials (WMD 2.01 ml/min per 1.73 m2, 95% CI [0.86 to 3.16]). Urine ACR reduction after SGLT2 inhibition was not statistically significant in type 2 diabetic patients in general (WMD −7.24 mg/g, 95% CI [−15.54 to 1.06]), but was significant in patients with CKD (WMD −107.35 mg/g, 95% CI [−192.53 to −22.18]). Conclusions SGLT2 inhibition was not associated with significant changes in eGFR in patients with type 2 diabetes, likely resulting from a mixture of an initial reduction of eGFR and long-term renal function preservation. SGLT2 inhibition was associated with statistically significant albuminuria reduction in type 2 diabetic patients with CKD.

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Evaluation of the Long-Term Impact of Improving Care for People with Type 2 Diabetes in China

Value in Health Regional Issues ◽

10.1016/j.vhri.2018.03.005 ◽

2018 ◽

Vol 15 ◽

pp. 169-174

Author(s):

Limin Wang ◽

Qing Ye ◽

Ole Kjerkegaard Nielsen ◽

Anne Gadegaard ◽

William J. Valentine ◽

...

Keyword(s):

Type 2 Diabetes ◽

Long Term Impact

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Chapter-27 Bariatric Surgery: Long-term Impact on Type 2 Diabetes

A Complete Textbook for GNM Internship ◽

10.5005/jp/books/12602_28 ◽

2015 ◽

pp. 179-180

Author(s):

Shashank Shah ◽

Poonam Shah

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Long Term Impact

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Evaluating the Long-Term Impact of Improving Care for Patients with Type 2 Diabetes in China

Value in Health ◽

10.1016/j.jval.2017.08.503 ◽

2017 ◽

Vol 20 (9) ◽

pp. A487

Author(s):

LM Wang ◽

Q Ye ◽

O Kjerkegaard Nielsen ◽

A Gadegaard ◽

WJ Valentine ◽

...

Keyword(s):

Type 2 Diabetes ◽

Long Term Impact

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Long-Term Impact of Chronic Hemodialysis on Glycemic Control and Serum Lipids in Insulin-Treated Type 2-Diabetic Patients

Renal Failure ◽

10.1081/jdi-200056608 ◽

2005 ◽

Vol 27 (3) ◽

pp. 305-308 ◽

Cited By ~ 3

Author(s):

Johann Loipl ◽

Bernhard Schmekal ◽

Georg Biesenbach

Keyword(s):

Glycemic Control ◽

Serum Lipids ◽

Chronic Hemodialysis ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Long Term Impact ◽

Type 2 Diabetic

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Novel Digital Architecture of a “Low Carb Program” for Initiating and Maintaining Long-Term Sustainable Health-Promoting Behavior Change in Patients with Type 2 Diabetes

JMIR Diabetes ◽

10.2196/15030 ◽

2020 ◽

Vol 5 (1) ◽

pp. e15030 ◽

Cited By ~ 3

Author(s):

Charlotte Summers ◽

Kristina Curtis

Keyword(s):

Type 2 Diabetes ◽

Behavior Change ◽

Digital Health ◽

Health Care Systems ◽

Noncommunicable Diseases ◽

Digital Architecture ◽

Care Systems ◽

Long Term Impact

Globally, the burden of noncommunicable diseases such as type 2 diabetes is crippling health care systems. Type 2 diabetes, a disease linked with obesity, affects 1 in every 30 people today and is expected to affect 1 in 10 people by 2030. Current provisions are struggling to manage the trajectory of type 2 diabetes prevalence. Offline, face-to-face education for patients with type 2 diabetes has shown to lack long-term impact or the capacity for widespread democratized adoption. Digitally delivered interventions have been developed for patients with type 2 diabetes, and the evidence shows that some interventions provide the capacity to support hyperpersonalization and real-time continuous support to patients, which can result in significant engagement and health outcomes. However, digital health app engagement is notoriously difficult to achieve. This paper reviews the digital behavior change architecture of the Low Carb Program and the application of health behavioral theory underpinning its development and use in scaling novel methods of engaging the population with type 2 diabetes and supporting long-term behavior change.

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Effect of insulin treatment on pulsatility ratio and resistance index of the retinal artery in patients with type 2 diabetes

PLoS ONE ◽

10.1371/journal.pone.0254980 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254980

Author(s):

Tsuneaki Omae ◽

Youngseok Song ◽

Takafumi Yoshioka ◽

Tomofumi Tani ◽

Akitoshi Yoshida

Keyword(s):

Type 2 Diabetes ◽

Blood Flow ◽

Insulin Treatment ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Significant Difference ◽

Retinal Artery ◽

Type 2 Diabetic

This study aimed to evaluate whether long-term insulin treatment is associated with abnormalities in retinal circulation in type 2 diabetic patients. We evaluated 19 eyes of nondiabetic individuals and 68 eyes of type 2 diabetic patients. The eyes of diabetic patients were classified into two groups according to the presence or absence of long-term insulin therapy. We used a Doppler optical coherence tomography flowmeter to measure diameter, velocity, and blood flow in the major temporal retinal artery. The pulsatility ratio (PR) and resistance index (RI), indices of vascular rigidity, were calculated from the blood velocity profile. PR and RI were significantly elevated in type 2 diabetic patients compared with nondiabetic subjects (P < 0.05). In type 2 diabetes patients, PR and RI were significantly higher in patients receiving long-term insulin treatment than in those without (P < 0.01). There was a significant difference in velocity (P < 0.05), but not diameter and blood flow, between nondiabetic subjects and type 2 diabetes patients. No significant difference in diameter, velocity, or blood flow was observed between the groups with and without long-term insulin treatment. Long-term insulin treatment can affect PR and RI, which might be associated with vascular rigidity of the retinal artery in patients with type 2 diabetes.

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Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges

Nutrients ◽

10.3390/nu13082748 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2748

Author(s):

Maria Letizia Petroni ◽

Lucia Brodosi ◽

Francesca Marchignoli ◽

Anna Simona Sasdelli ◽

Paolo Caraceni ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Metabolic Control ◽

Best Practice ◽

Patient Adherence ◽

Vitamin D Supplementation ◽

Modest Improvement ◽

Obesity Epidemic

Unhealthy behaviours, including diet and physical activity, coupled with genetic predisposition, drive type 2 diabetes (T2D) occurrence and severity; the present review aims to summarise the most recent nutritional approaches in T2D, outlining unmet needs. Guidelines consistently suggest reducing energy intake to counteract the obesity epidemic, frequently resulting in sarcopenic obesity, a condition associated with poorer metabolic control and cardiovascular disease. Various dietary approaches have been proposed with largely similar results, with a preference for the Mediterranean diet and the best practice being the diet that patients feel confident of maintaining in the long term based on individual preferences. Patient adherence is indeed the pivotal factor for weight loss and long-term maintenance, requiring intensive lifestyle intervention. The consumption of nutritional supplements continues to increase even if international societies do not support their systematic use. Inositols and vitamin D supplementation, as well as micronutrients (zinc, chromium, magnesium) and pre/probiotics, result in modest improvement in insulin sensitivity, but their use is not systematically suggested. To reach the desired goals, patients should be actively involved in the collaborative development of a personalised meal plan associated with habitual physical activity, aiming at normal body weight and metabolic control.

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