Evaluation of the effects of the national diabetes control and prevention program on a sample of iranian people with type 2 diabetes

2021 ◽  
pp. 1-13
Author(s):  
Simin Haghravan ◽  
Fatemeh Mohammadi-Nasrabadi ◽  
Maryam Rafraf ◽  
Mohammad Asghari Jafarabadi
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Prevention Program ◽  
Time Effect ◽  
Anthropometric Indices ◽  
Hba1 C ◽  
Significant Difference ◽  
Before And After ◽  
Control And Prevention

Diabetes prevention programs have been developed in the different countries and it is therefore necessary to gain a better understanding of factors affecting the effectiveness of these programs for each society. Accordingly, the purpose of this study was to evaluate the effect of the National Diabetes Control and Prevention Program (NDCPP) on the biochemical and anthropometric indices among a sample of Iranian patients with type 2 diabetes mellitus (T2DM). A total of 384 patients with T2DM from the primary health care system of Tehran and Tabriz cities during January to June 2020, were included in the study. A two-part questionnaire consisting of items related to socio-economic and demographic characteristics was used and biochemical and anthropometric indices were measured at the beginning and the end of the 3-month intervention period. There was a significant difference in fasting blood sugar (FBS), hemoglobin glycosides (HbA1 C), systolic blood pressure (SBP) and weight before and after the NDCPP (P <  0.001). Also, there was significant improvement in carbohydrate (P = 0.015) and protein intake (P = 0.027) after the NDCPP compared to before the study. No significant difference was observed in waist circumference (WC) (P = 0.689), body mass index (P = 0.784), diastolic blood pressure (P = 0.647), and other dietary nutrient intake before and after the NDCPP. Repeated measure ANOVA revealed a significant decrease in FBS (Time effect P = 0.019) and weight (Time effect P = 0.006) after the NDCPP. Also, residing in different cities had a significant effect on FBS (time×city effect P <  0.001), HbA1 C (time×city effect P <  0.001), and SBP (time×city effect P = 0.037) after the NDCPP. The NDCPP resulted in weight loss, improved HbA1 C, and FBS. These findings suggested that NDCPP had a positive effect on controlling T2DM among Iranian population and can be considered as a way to prevent complications of T2DM.

scholarly journals Home Blood Pressure Measurement in the Morning Related to Cancer in Patients with Type 2 Diabetes Mellitus: 10 Years-Term Results of a Longitudinal Study and Cancer

2015 ◽  
Vol 7 (1) ◽  
pp. 1-6
Author(s):  
Kyuzi Kamoi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Factor ◽  
Cause Of Death ◽  
Japanese Patients ◽  
Pressure Measurements ◽  
Significant Difference

Previous longitudinal studies have demonstrated that blood pressure measurements at home (HBP) in the wakening- up display stronger predictive power for death, and vascular complications in patients with type 2 diabetes mellitus (T2DM) than clinic blood pressure measurements (CBP). The leading cause of death was cancer. Patients with T2DM have associated with cancer, and high CBP is a risk factor for cancer. Therefore, this study investigated whether HBP or CBP is related to cancer event in patients with T2DM for 10 years. At baseline, 400 Japanese patients with T2DM were classified as hypertensive (HT) or normotensive (NT) based on HBP and CBP. Mean (± SD) duration was 95 ± 35 months. Primary and secondary endpoints were death and cancer, respectively. Differences in outcome between HT and NT were analyzed using survival curves from Kaplan-Meier analysis and log-rank testing. Associated risk factors were assessed using Cox proportional hazards. On basis of HBP, death and event of cancer were significantly higher in HT than in NT. The leading cause of death was cancer. On basis of CBP, there was no significant difference in the incidence of death and event of cancer between patients with HT and NT at baseline. Associated risk factor for cancer was T2DM. Home morning HT may be reflected more keenly state of cancer than clinic HT, which may be superior to clinic NT. When we meet with such patients, it is important that cancer may be one of many causes for morning HT in Japanese patients with T2DM.

scholarly journals Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Nocturnal Blood Pressure ◽  
Type 2 Dm ◽  
Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

scholarly journals Efficacy of single-dose cholecalciferol in the blood pressure of patients with type 2 diabetes, hypertension and hypovitaminoses D

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tatiana P. de Paula ◽  
Juliano S. R. Moreira ◽  
Luiza F. Sperb ◽  
Maria Elisa P. Muller ◽  
Thais Steemburgo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Single Dose ◽  
Blood Pressure Monitoring ◽  
Hypovitaminosis D ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Before And After

AbstractObservational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension. We investigated the effect of a single dose of 100,000 IU of cholecalciferol, in office blood pressure (BP), and 24-h ambulatory blood pressure monitoring (ABPM) in patients with type 2 diabetes mellitus (DM), hypertension, and hypovitaminosis D. Forty-three patients were randomized to a placebo or cholecalciferol group. BP was assessed by office measurements and 24-h ABPM, before and after intervention. At week 8, a greater decrease in median ABPM values was observed in cholecalciferol supplementation than in the placebo group for systolic 24-h (− 7.5 vs. − 1; P = 0.02), systolic daytime (− 7 vs. − 1; P = 0.007), systolic nighttime (− 7.0 vs. 3; P = 0.009), diastolic 24-h (− 3.5 vs. − 1; P = 0.037), and daytime DBP (− 5 vs. 0; P = 0.01). Office DBP was also reduced after vitamin D supplementation. A single dose of vitamin D3 improves BP in patients with type 2 diabetes, hypertension, and vitamin D insufficiency, regardless of vitamin D normalization. Vitamin D supplementation could be a valuable tool to treat patients with type 2 DM, hypertension, and hypovitaminosis D.Trial registration: Clinicaltrials.gov NCT 02204527.

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 Anthropometric indices as predictors of 10-year cardiovascular risk among Sub-Sahara Africans with type 2 diabetes

2021 ◽  
Vol 8 (4) ◽  
pp. 072-078
Author(s):  
TA Azeez
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Anthropometric Indices

Background: Body mass index, waist circumference, waist-hip ratio and waist-height ratio are simple clinical tools for determining obesity. Type 2 diabetes mellitus is often associated with multiple cardiovascular risk factors and increased cardiovascular death. The study was aimed at determining the relationship between these anthropometric indices and 10-year cardiovascular risk among sub-saharan Africans with type 2 diabetes mellitus. Methods: It was a cross-sectional study involving 67 adults (with 50.7% females) managed for type 2 diabetes mellitus in a referral hospital in Nigeria. Ethical approval was obtained at the institution review board and the participants also gave written consent. Anthropometric indices were determined using standard protocols. Fasting lipid profile, fasting plasma glucose, glycated haemoglobin and plasma creatinine were assayed using standard laboratory techniques. Atherogenic index of plasma, estimated glomerular filtration rate and the WHO-ISH cardiovascular risk score were also determined. Data was analyzed with SPSS version 22. Pearson correlation coefficient, Students’ t test, Chi square test, ROC curve analysis were performed as appropriate. Results: The mean age was 54.12±9.03 years. Obesity was found in 37.3%, 66.5%, 70.1% and 95.5% of the participants using BMI, WHR, WC and WHtR respectively. Intermediate/high cardiovascular risk was found in 38.2% and 24.2% of the males and females respectively. BMI and WC significantly correlated with blood pressure. There was no significant correlation between anthropometric indices and other cardiovascular risk factors studied. Using ROC curve analysis, BMI and WHtR had the highest AUC of 0.613 and 0.577 respectively. Conclusion: Among sub-sahara Africans with type 2 diabetes mellitus, there is a significant association between WC and BMI with the blood pressure. BMI and WHtR have the highest 10-year cardiovascular risk predictability among the anthropometric indices in this cohort of individuals. Larger and prospective studies are needed to validate these findings.

scholarly journals Renal Effects of Sulodexide in Type 2 Diabetic Patients without Nephrotic Range Proteinuria

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Kachonsak Yongwatana ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Control Group ◽  
Diabetic Patients ◽  
Long Term Effects ◽  
Renal Disease Progression ◽  
Significant Difference

Background. Glycosaminoglycan plays an important role in the maintenance of glomerular charge selectivity of diabetic nephropathy. Sulodexide, a mixture of naturally occurring glycosaminoglycan polysaccharide components, has shown a nephroprotective effect in an experimental model of diabetic nephropathy. Although sulodexide reduced albuminuria in patients with type 1 and type 2 diabetes, long-term effects in patients with type 2 diabetes with significant proteinuria have not been established. Objectives. The study was aimed at investigating the effects of sulodexide on proteinuria and renal function in patients with type 2 diabetes and nephropathy. Methods. Fifty-two patients with proteinuria between 500 and 3000 mg/day received sulodexide 200 mg/day for 12 months, while 56 matched patients with type 2 diabetes constituted the control group. All patients received standard metabolic and blood pressure controls. Primary outcome was evaluated as percentage of reduced proteinuria compared with the control group. Renal function was assessed using estimated glomerular filtration rate (GFR). Results. Proteinuria significantly increased in the control group [0.9 (IQR 0.3 to 1.78) to 1.16 (IQR 0.44 to 2.23) g/gCr, P=0.001], whereas it remained stable in the sulodexide group [0.66 (IQR 0.23 to 0.67) to 0.67 (IQR 0.17 to 1.51) g/gCr, P=0.108]. At 12 months, proteinuria was higher by 19.4% (IQR 10.3 to 37.6) in the control group while proteinuria was lower by -17.7% (IQR -53.1 to 3.2) in the sulodexide group with a significant difference between groups (P=0.001). Renal function was noted as a change of estimated GFR, and serum creatinine decreased significantly during the study in both groups but did not significantly differ between groups. No significant changes in the blood pressure, fasting plasma glucose, and hemoglobin A1C were reported. Conclusion. In addition to standard treatment, sulodexide is efficient in maintaining proteinuria in patients with type 2 diabetes with nonnephrotic range proteinuria, but it did not provide an additional benefit concerning renal disease progression.

scholarly journals The product of waist and neck circumference outperforms traditional anthropometric indices in identifying metabolic syndrome in Chinese adults with type 2 diabetes: a cross-sectional study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Yunhong Huang ◽  
Liping Gu ◽  
Na Li ◽  
Fang Fang ◽  
Xiaoying Ding ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Logistic Regression ◽  
Roc Curves ◽  
Chinese Adults ◽  
Anthropometric Parameters ◽  
Anthropometric Indices ◽  
Men And Women

Abstract Background Traditional anthropometric indices are used in diagnosing metabolic syndrome (MetS). This study aimed to propose a novel index, a product of waist and neck circumferences (PWNC), and compared its value with traditional anthropometric parameters in identifying the presence of MetS in Chinese adults with type 2 diabetes mellitus (T2DM). Methods From September 2017 to June 2019, a total of 2017 Chinese adults with T2DM from the National Metabolic Management Center were included and categorized into a MetS group (1575 cases) and a non-MetS group (442 cases). Demographic and metabolic characteristics were compared between the two groups, and logistic regression analysis was performed for MetS. Body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), neck circumference (NC) and PWNC were assessed by constructing receiver operating characteristic (ROC) curves, and the area under the ROC curves was compared by DeLong’s test. Results Compared with the non-MetS group, men and women with MetS had higher blood pressure; higher levels of fasting plasma glucose, fasting insulin, and triglycerides (TGs); lower levels of high-density lipoprotein cholesterol (HDL-C); elevated homeostasis model assessment of insulin resistance (HOMA-IR); and higher BMI, WHR, WC, NC and PWNC (all P < 0.01). Logistic regression showed that PWNC, HDL-C, TGs, HOMA-IR, systolic blood pressure, hypertension and hypotensors were independent risk factors for MetS (all P < 0.01). PWNC, WC, NC, WHR and BMI displayed significant values in the ROC for MetS (all P < 0.01), while the area under the curve for PWNC was larger than that for traditional anthropometric parameters (WC, WHR and BMI) in both men and women (all P < 0.01). Conclusion PWNC outperformed traditional anthropometric parameters in identifying the presence of MetS in Chinese adults with T2DM.

scholarly journals The Effect of Self-Management Education on Distress of Type 2 Diabetes Mellitus Patients in Ulin General Hospital Banjarmasin, South Kalimantan, Indonesia

2018 ◽  
Vol 14 (1) ◽  
pp. 9
Author(s):  
Noor Diani ◽  
Maulidya Septiany ◽  
Lola Illona Elfani Kausar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
General Hospital ◽  
Diabetes Management ◽  
Management Education ◽  
Interpersonal Relationship ◽  
Self Management ◽  
Significant Difference ◽  
Before And After

Abstract: The purpose of this study was to analyze the effect of diabetes self management education (DSME) on distress of type 2 diabetes melitus patients which is hospitalized in Ulin General Hospital. This Study used Pre-Experiment with One Group Pretest-Posttest Design. The sample size was 32 patients. The results showed that the average of emotional burden before and after DSME was decrease, with difference number 0.325. The result of Distress among healthcare services before and after DSME was increase (0.211). The result of distress due to diabetes management before and after DSME was decrease (0.119). The result of distress interpersonal relationship before and after DSME was up (0,021). The analysis used Wilcox on Sign Rank test with p= 0,135 (p> 0,05) for emotional distress, p = 0,443 (p> 0,05) for Distress healthcare worker, p = 0.656 (p> 0.05) for distress due to diabetes management. P=0,527 (p>0,05) for Distress interpersonal relationship. The conclusion was there is no significant difference of distress level before and after DSME. It is shown that there is no effect of DSME on distress among patients with diabetes mellitus. Keywords: Diabetes Mellitus, Distress, Diabetes Self-Management Education (DSME)

scholarly journals The Impact of Frailty on the Effectiveness and Safety of Intensive Glucose Control and Blood Pressure-Lowering Therapy for People With Type 2 Diabetes: Results From the ADVANCE Trial

2021 ◽  
Author(s):  
Tu N Nguyen ◽  
Katie Harris ◽  
Mark Woodward ◽  
John Chalmers ◽  
Mark Cooper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Glucose Control ◽  
Severe Hypoglycaemia ◽  
Intensive Glucose Control ◽  
Vascular Events ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
The Impact

<b>Objective. </b>To develop a frailty index (FI) and explore the relationship of frailty to subsequent adverse outcomes on the effectiveness and safety of more intensive control of both blood glucose and blood pressure (BP), amongst participants with type-2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. <p><b>Research Design and Methods. </b>Cox proportional-hazard models were used to estimate the effectiveness and safety of intensive glucose control and BP intervention according to frailty (defined as FI>0.21) status. The primary outcomes were macrovascular events and microvascular events. The secondary outcomes were all-cause mortality, cardiovascular mortality, severe hypoglycaemia, and discontinuation of BP treatment due to hypotension/dizziness.</p> <p><b>Results.</b> There were 11140 participants (mean age 65.8, 42.5% female, 25.7% frail). Frailty was an independent predictor of all primary outcomes and secondary outcomes. The effect of intensive glucose treatment on primary outcomes showed some evidence of attenuation in the frail: HRs for combined major macro- and micro-vascular events 1.03, 95%CI 0.90-1.19 in the frail vs 0.84, 95%CI 0.74-0.94 non-frail (p=0.02). A similar trend was observed with BP intervention. <a>Severe hypoglycaemia rates (per 1000 person-years) were higher in the frail: 8.39 (6.15–10.63) vs. 4.80 (3.84–5.76) in non-frail</a> (p<0.001). There was no significant difference in discontinuation of BP treatment between frailty groups.</p> <p><b>Conclusions. </b>It was possible to retrospectively estimate frailty in a trial population, and this FI identified those at higher risk of poor outcomes. Participants with frailty had some attenuation of benefit from intensive glucose lowering and BP lowering treatments. </p>

scholarly journals Effect of Fenugreek Use on Fasting Blood Glucose, Glycosylated Hemoglobin, Body Mass Index, Waist Circumference, Blood Pressure and Quality of Life in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trials

2019 ◽  
Vol 8 ◽  
pp. e1432
Author(s):  
Seyyedeh Seddigheh Hassani ◽  
Faramarz Fallahi Arezodar ◽  
Seyyed Saeid Esmaeili ◽  
Mohammad Gholami-Fesharaki
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Significant Difference ◽  
Double Blinded

Background: Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system.The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: This randomized, double-blinded clinical trial study was conducted on patients with T2DMin Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder,and the placebo group received 5 g of wheat flour twice daily for two months before meals. Results: This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P<0.001), HgA1C (P<0.001), BMI (P<0.001), waist circumference (P<0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups.  Conclusion: Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients. [GMJ.2019;8:e1432]  

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