scholarly journals Are Patients with Type 2 Diabetes Mellitus at a University Hospital in Jeddah Achieving Treatment Goals?

2016 ◽  
Vol 6 (2) ◽  
pp. 35-41
Author(s):  
Suhaib A. Radi ◽  
Nada K. Bashnini ◽  
Hebah Y. Alahwal ◽  
Deemah A. Tashkandi ◽  
Maram J. Sibyani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Outpatient Clinics ◽  
Treatment Goals ◽  
Hba1c Levels

Background: Diabetes mellitus is one of the most prevalent chronic diseases worldwide and is very debilitating. Studies have shown that adherence to treatment recommendations are rewarded with a decrease in diabetes mellitus - related morbidity and mortality. The aim of this study is to assess adherence to the American Diabetes Association treatment goals in patients with type 2 diabetes mellitus. Methods: This was a retrospective chart review study, between February and April, 2013, of patients with type 2 diabetes mellitus who attended outpatient clinics at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. We included patients provided they were adults (≥ 18 years) with type 2 diabetes mellitus who were regularly followed up at the outpatient clinics, and they have had the disease for more than one year. Results: We included 201 patients between 27 – 96 years old. Most patients had their blood pressure and creatinine levels measured during each visit, and close to half had their HbA1c levels measured twice in the last year of follow up. Approximately 55.10% of the patients achieved an LDL level < 2.6 mmol/L. A relatively small proportion of the patients had blood pressure measurements and HbA1c levels within the recommended guidelines (29.03% and 24.53%, respectively). Conclusion: Diabetes mellitus is not very well controlled. This could be attributed to physicians’ factors and patients’ factors. Further studies to assess this issue are recommended.  

Pharmacists’ Impact on Improving Outcomes in Patients With Type 2 Diabetes Mellitus

2012 ◽  
Vol 38 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Matthew J. Pepper ◽  
Natohya Mallory ◽  
T. Nicole Coker ◽  
Amber Chaki ◽  
Karen R. Sando
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Management Team ◽  
Outpatient Clinics ◽  
End Points ◽  
Number Of Patients

Purpose The purpose of this study was to evaluate a diabetes education program that includes a pharmacist as a member of the diabetes management team by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in outpatient clinics. Methods This was a retrospective study in outpatient clinics at Shands Jacksonville Medical Center. The patients were assigned into either the pharmacist group or the nonpharmacist group, according to the presence or the absence of a pharmacist in the clinic. The primary end point was the absolute change in A1C versus baseline. Secondary end points included change in cholesterol and blood pressure and the number of patients to attain American Diabetes Association goals. End points were recorded to correlate within 3 months of the initial visit and final visit with a provider. Results Compared to the nonpharmacist group, patients in the pharmacist group had more advanced and uncontrolled diabetes at baseline. The pharmacist group showed a greater percent change in A1C and improvement between the initial and final clinic visits, after adjusting for baseline confounders. Despite the statistically significant improvement in A1C in the pharmacist group, there was no difference found between the 2 groups for the end points of cholesterol and blood pressure. Conclusion Including a pharmacist as a part of the diabetes management team may result in lower A1C in patients with more advanced and uncontrolled type 2 diabetes mellitus versus a health care team without a pharmacist.

scholarly journals Optimizing treatment goals for long-term health outcomes among patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e002396
Author(s):  
Qian Shi ◽  
Yilu Lin ◽  
Vivian A Fonseca ◽  
Lizheng Shi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Treatment Strategies ◽  
Optimal Treatment ◽  
Treatment Goals ◽  
Macrovascular Complication

IntroductionConsiderable confusions on treatment target have resulted from recent changes in guidelines. Evidence in medical guidelines came from clinical trials with highly selected patients, whereas treatment goals may differ in some subgroups. This study aimed to assess optimal treatment goals (A1C, blood pressure, low-density lipoprotein cholesterol (LDL-C)) for patients with type 2 diabetes mellitus (T2DM), which lead to optimal health outcomes by different treatment strategies.Research design and methodsA retrospective longitudinal study was conducted for veterans with T2DM by using US Veterans Affairs Administrative Database (2005−2015). Medical records were prepared for repeated evaluation performed at 6-month intervals and multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial and splines were applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications.ResultsA total of 124 651 patients with T2DM were selected, with mean of 6.72 follow-up years. In the general population, to achieve the lowest risk of microvascular and macrovascular complication, the optimal goals were A1C=6.81%, LDL-C=109.10 mg/dL; and A1C=6.76%, LDL-C=111.65 mg/dL, systolic blood pressure (SBP)=130.60 mmHg, respectively. The optimal goals differed between age and racial subgroups. Lower SBP for younger patients and lower LDL-C for black patients were associated with better health outcomes.ConclusionsOptimal treatment goals were identified and multi-faceted treatment strategies targeting hyperglycemia and hyperlipidemia and hypertension may improve health outcome in veterans with T2DM. In addition to guidelines’ recommended goals, health systems may examine their own large diverse patients with T2DM for better quality of care.

scholarly journals Influence of ferritin levels and inflammatory markers on HbA1c in the Type 2 Diabetes mellitus patients

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Nazan Erenoglu Son
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Serum Ferritin ◽  
Inflammatory Markers ◽  
Outpatient Clinics ◽  
Type 2 Dm ◽  
Hba1c Levels

Objective: Diabetes Mellitus (DM) is a significant public health issue worldwide due to the associated comorbidities. Recent studies have demonstrated a strong relationship between blood glucose levels and serum ferritin levels in patients with type 2 DM. The aim of the study was to investigate the association between Ferritin Levels and Inflammatory Markers on HbA1c in the Type 2 Diabetes Mellitus Patients. Methods: This single-center, cross-sectional, controlled study included patients who were admitted to the Endocrine and Metabolic Disorders outpatient clinics of the Private Kütahya Hospital in the province of Kutahya in the Western Turkey. The study included a total of 172 patients, 84 of whom had type 2 DM and 88 without diabetes and constituted the control group. A total of 190 patients with DM were admitted to the Adult Endocrine and Metabolic Diseases Outpatient Clinics of the hospital between July 1, 2018 and September 1, 2018, and among these, the study was conducted on 172 volunteer patients who met the study inclusion criteria and who did not have any missing data. The HbA1c levels, serum ferritin, hemoglobin (Hb), insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), C-Reactive Protein (CRP), lipid profiles, and uric acid levels were compared between the groups. Results: The serum ferritin levels of the patients with type 2 DM significantly increased with increasing HbA1c levels (p<0.01). A strong positive correlation was found between serum ferritin levels and HbA1c and fasting blood glucose (FBG) levels (p<0.01). Conclusions: Our study results show a significant relationship between HbA1c levels and serum ferritin and CRP levels, suggesting that serum ferritin and CRP levels can be used as a routine screening tool for the early diagnosis of DM. However, further large-scale, prospective studies are needed to confirm these findings. doi: https://doi.org/10.12669/pjms.35.4.1003 How to cite this:Son NE. Influence of ferritin levels and inflammatory markers on HbA1c in the Type 2 Diabetes mellitus patients. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1003 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.

scholarly journals Effect of Combination Therapy of Canagliflozin Added to Teneligliptin Monotherapy in Japanese Subjects with Type 2 Diabetes Mellitus: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yoshiro Fushimi ◽  
Atsushi Obata ◽  
Junpei Sanada ◽  
Yuichiro Iwamoto ◽  
Akiko Mashiko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Combination Therapy ◽  
Sglt2 Inhibitors ◽  
Japanese Subjects ◽  
Hba1c Levels

Recently, dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors have been very often used in subjects with type 2 diabetes mellitus (T2DM). In addition, combination drugs of both inhibitors have attracted much attention in aspects of its cost-effectiveness and improvement of patients’ adherence. However, it is still poorly understood which factors are related to the efficacy of SGLT2 inhibitors as add-on therapy to DPP-4 inhibitors. Therefore, we aimed to elucidate in which type of individuals and/or under which conditions canagliflozin as add-on therapy to teneligliptin could exert more beneficial effects on glycemic control and/or renal protection. We retrospectively analyzed 56 Japanese subjects with T2DM in the real-world clinical practice. Three months after starting the combination therapy, the change of HbA1c (ΔHbA1c) was strongly related to HbA1c levels at baseline. As expected, serum glucagon level was increased after starting the combination therapy. Interestingly, however, the change of glucagon levels (Δglucagon) was not related to HbA1c levels at baseline, ΔHbA1c, and other parameters, which indicated that the increase of glucagon did not clinically affect the effectiveness of combination therapy. In addition, the change of urinary albumin excretion (ΔUAE) was negatively correlated with systolic blood pressure and HbA1c levels at baseline and positively correlated with the change of systolic blood pressure (ΔsBP) in univariate analysis. Furthermore, in multivariate analysis, only ΔsBP was the independent factor associated with ΔUAE. Taken together, canagliflozin as add-on therapy to teneligliptin improves glycemic control in a Δglucagon-independent manner and reduces UAE in a ΔsBP-dependent manner in Japanese subjects with T2DM.

scholarly journals Relationship between HbA1c Levels with eGFR and Blood Pressure in Type 2 Diabetes Mellitus Patients in the Department of Internal Medicine Dr. Soetomo General Hospital Surabaya

2019 ◽  
Vol 2 (2) ◽  
pp. 117
Author(s):  
Alexander Tikara Sugondo ◽  
Deasy Ardiany ◽  
Djohar Nuswantoro ◽  
Pulus Budiono Notopuro
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
The World ◽  
Prevalence Of Diabetes Mellitus ◽  
Hba1c Levels

Introduction: Diabetes mellitus is a non-transmitted pandemic disease which had spreaded on a global scale. The prevalence of diabetes mellitus in the world according to the International Diabetes Federation (IDF) is 1.9% and diabetes mellitus is ranked seventh as the cause of death in the world, around 95% in the world is type 2 diabetes mellitus. According to Riset Kesehatan Dasar (Riskesdas) in 2013, the prevalence of diabetes mellitus in Indonesia is 6,9%. Type 2 diabetes mellitus that is not well controlled will increase the risk of chronic complications, both microangiopathies such as nephropathy, and macroangiopathy such as hypertension. The aim of the study was to determine correlation between HbA1c levels with eGFR (Estimated Glomerulus Filtration Rate) and blood pressure (systolic and diastolic).Methods: An analytic observational cross-sectional study, collecting the data from 94 patients with type 2 diabetes mellitus, Dr. Soetomo General Hospital, Surabaya, from January to May 2018. The variables were collected from patient’s medical records. Analysis using Spearman’s Rank Correlation test. To determine normality of the data, we use Kolmogorov-smirnov test.Results: The results showed that there are 134 (57,8%) patients with type 2 diabetes mellitus are female more than male. Patients with greater than or equal to 45 years old were 203 (87,5%) patients, more than under 45 years old. The correlation test showed that there was no significant correlation between HbA1c and systolic blood pressure (r=-0,127; p=0,054). Also there was no significant correlation between HbA1c and diastolic blood pressure (r=-0,111; p=0,093). Analysis on other factor showed a significant correlation between HbA1c and eGFR (r=0.341; p=0.000).Conclusion: There was no significant correlation between HbA1c and systolic blood pressure, also there was no significant correlation between HbA1c and diastolic blood pressure. But, there was a significant correlation between HbA1c and eGFR. This is because the data retrieval does not consider the drug consumption and therapy that has been done by the patient, as well as examination of HbA1c, serum creatinine eGFR, and blood pressure not at the same time.

Effects of epigallocatechin-3-gallate of Camellia sinensis leaves on blood pressure, lipid profile, atherogenic index of plasma and some inflammatory and antioxidant markers in type 2 diabetes mellitus patients: a clinical trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hadi Bazyar ◽  
Seyed Ahmad Hosseini ◽  
Sirous Saradar ◽  
Delsa Mombaini ◽  
Mohammad Allivand ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profile ◽  
Atherogenic Index ◽  
Control Group ◽  
Atherogenic Index Of Plasma ◽  
The Mean

Abstract Background In patients with type 2 diabetes mellitus (T2DM) the inflammatory and metabolic responses to epigallocatechin-3-gallate (EGCG) are unknown. Objectives Evaluate the impacts of EGCG on metabolic factors and some biomarkers of stress oxidative in patients with T2DM. Methods In this randomized, double-blind, placebo-controlled trial, 50 patients with T2DM consumed either 2 tablets (300 mg) EGCG (n=25) or wheat flour as placebo (n=25) for 2 months. The total antioxidant capacity (TAC), interleukin-6 (IL-6), lipid profile, mean arterial pressure (MAP), atherogenic index of plasma (AIP) were evaluated before and after the intervention. Results The finding of present study exhibited a significant increase in the serum levels of TAC after the EGCG supplementation (p=0.001). Also, in compare with control group, the mean changes of TAC were significantly higher in supplement group (p=0.01). In intervention group, a significant decrease was observed in the mean levels of triglyceride, total cholesterol, diastolic blood pressure (DBP), AIP, and MAP (p<0.05). Taking EGCG resulted in the mean changes of total cholesterol, MAP and DBP were significantly lower in compare with control group (p<0.05). Conclusions This study recommended that EGCG supplementation may be improved blood pressure, lipid profile, AIP, and oxidative status in patients with T2DM.

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