Effect the Pharmaceutical Care and Health Education on Knowledge and Disease Control for Type 2 Diabetes Mellitus Patients: A sample of Iraqi Patients

2020 ◽  
pp. 40-54
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Education ◽  
Pharmaceutical Care ◽  
P Value ◽  
Diabetes Knowledge

Objective: To study the effect of Pharmaceutical Care (PC) program and health education delivered by pharmacist on Type 2 Diabetes Mellitus (T2DM) patient’s knowledge about diabetes, glycemic control, blood pressure and Body Mass Index (BMI). Patients and methods: A prospective interventional study including T2DM patients with poor glycemic control, i.e. glycated hemoglobin (HbA1c) more than 7%. Patients receiving PC and education about T2DM and cardiovascular disease by the researcher pharmacist. Patients were followed for 26 weeks. The study parameters included HbA1c, Fasting Blood Sugar (FBS), Systolic Blood pressure (SBP), Diastolic Blood Pressure (DBP), BMI and Diabetes Knowledge Questionnaire (DKQ-24). Results: Thirty-eight T2DM patients were included in the study. Thirty-two completed the program. A significant decrease in the HbA1c and FBS at the end line measurements (from 9.1% to 7.4%, P-value = 0.001) and (from 187.4 to 135.3, P-value = 0.001) respectively. A significant decrease occurred in both SBP and DBP (from 129.8 to 125.2, P-value = 0.009) and (from 82.0 to 77.9, P-value =0.001) respectively. Diabetes knowledge score also showed a significant increase at the end of study (from 52.6 to 63.7, P-value =0.001) Conclusion: Pharmaceutical care and health education with continuous follow up delivered by the pharmacist even for a relatively short period of time in collaboration with specialist physician, resulted in improved T2DM Knowledge plus better glycemic and blood pressure control.

scholarly journals The influence of baseline diastolic blood pressure on the effects of intensive blood pressure lowering on cardiovascular outcomes and all-cause mortality in type 2 diabetes mellitus

2020 ◽  
Author(s):  
Olesya L. Ilkun ◽  
Tom Greene ◽  
Alfred K. Cheung ◽  
Paul K. Whelton ◽  
Guo Wei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Diastolic Blood Pressure ◽  
Controlled Trial ◽  
Cardiovascular Outcomes ◽  
P Value

<b><i>Objective:</i></b> To examine whether low baseline diastolic blood pressure (DBP) modifies the effects of intensive systolic blood pressure (SBP) lowering on cardiovascular outcomes in type 2 diabetes mellitus (T2DM). <p><b><i>Research Design and Methods:</i></b> The Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial (ACCORD BP),a 2X2 factorial randomized controlled trial, examined effects of SBP (<120 vs. <140 mmHg) and glycemic (HbA1C < 6% vs. 7.0–7.9% (<42 vs 53-63 mmol/mol)) control on cardiovascular events in T2DM (N=4731). We examined whether effects of SBP control on cardiovascular composite was modified by baseline DBP and glycemic control. </p> <p><b><i>Results: </i></b>Intensive SBP lowering decreased the risk of the cardiovascular composite (HR 0.76, 95% CI 0.59 to 0.98) in the standard glycemic arm but not in the intensive glycemic arm (HR=1.06, 95% CI 0.81 to 1.40). Spline regression models relating the effects of the intervention on the cardiovascular composite across the range of baseline DBP did not show evidence of effect modification by low baseline DBP for the cardiovascular composite in the standard or intensive glycemic arms. The relation between the effect of the intensive SBP intervention and baseline DBP was similar between glycemic arms for the cardiovascular composite (3-way interaction p-value = 0.83).</p> <p><b><i>Conclusions: </i></b>in persons with T2DM, intensive SBP lowering decreased the risk of cardiovascular composite endpoint irrespective of baseline DBP in the setting of standard glycemic control. Hence, low baseline DBP should not be an impediment to intensive SBP lowering in T2DM patients treated with guidelines recommended standard glycemic control. </p>

scholarly journals The influence of baseline diastolic blood pressure on the effects of intensive blood pressure lowering on cardiovascular outcomes and all-cause mortality in type 2 diabetes mellitus

2020 ◽  
Author(s):  
Olesya L. Ilkun ◽  
Tom Greene ◽  
Alfred K. Cheung ◽  
Paul K. Whelton ◽  
Guo Wei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Diastolic Blood Pressure ◽  
Controlled Trial ◽  
Cardiovascular Outcomes ◽  
P Value

<b><i>Objective:</i></b> To examine whether low baseline diastolic blood pressure (DBP) modifies the effects of intensive systolic blood pressure (SBP) lowering on cardiovascular outcomes in type 2 diabetes mellitus (T2DM). <p><b><i>Research Design and Methods:</i></b> The Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial (ACCORD BP),a 2X2 factorial randomized controlled trial, examined effects of SBP (<120 vs. <140 mmHg) and glycemic (HbA1C < 6% vs. 7.0–7.9% (<42 vs 53-63 mmol/mol)) control on cardiovascular events in T2DM (N=4731). We examined whether effects of SBP control on cardiovascular composite was modified by baseline DBP and glycemic control. </p> <p><b><i>Results: </i></b>Intensive SBP lowering decreased the risk of the cardiovascular composite (HR 0.76, 95% CI 0.59 to 0.98) in the standard glycemic arm but not in the intensive glycemic arm (HR=1.06, 95% CI 0.81 to 1.40). Spline regression models relating the effects of the intervention on the cardiovascular composite across the range of baseline DBP did not show evidence of effect modification by low baseline DBP for the cardiovascular composite in the standard or intensive glycemic arms. The relation between the effect of the intensive SBP intervention and baseline DBP was similar between glycemic arms for the cardiovascular composite (3-way interaction p-value = 0.83).</p> <p><b><i>Conclusions: </i></b>in persons with T2DM, intensive SBP lowering decreased the risk of cardiovascular composite endpoint irrespective of baseline DBP in the setting of standard glycemic control. Hence, low baseline DBP should not be an impediment to intensive SBP lowering in T2DM patients treated with guidelines recommended standard glycemic control. </p>

scholarly journals Efficacy and Safety of Ertugliflozin in Patients With Type 2 Diabetes Mellitus and Established Cardiovascular Disease Treated With Metformin and Sulfonylurea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A331-A331
Author(s):  
Matthew J Budoff ◽  
Timothy M E Davis ◽  
Alexandra G Palmer ◽  
Robert Frederich ◽  
David E Lawrence ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Glycemic Control ◽  
Sglt2 Inhibitor ◽  
Efficacy And Safety

Abstract Introduction: Ertugliflozin (ERTU), a sodium-glucose cotransporter 2 (SGLT2) inhibitor, is approved as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus (T2DM). Aim: As a pre-specified sub-study of the Phase 3 VERTIS CV trial (NCT01986881), the efficacy and safety of ERTU were assessed in patients with T2DM and established atherosclerotic cardiovascular disease (ASCVD) inadequately controlled with metformin and sulfonylurea (SU). Methods: Patients with T2DM, established ASCVD, and HbA1c 7.0–10.5% on stable metformin (≥1500 mg/day) and SU doses as defined per protocol were randomized to once-daily ERTU (5 mg or 15 mg) or placebo. The primary sub-study objectives were to assess the effect of ERTU on HbA1c compared with placebo and to evaluate safety and tolerability during 18-week follow-up. Key secondary endpoints included proportion of patients achieving HbA1c &lt;7%, fasting plasma glucose (FPG), body weight, and systolic blood pressure. Changes from baseline at Week 18 for continuous efficacy endpoints were assessed using a constrained longitudinal data analysis model. Results: Of the 8246 patients enrolled in the VERTIS CV trial, 330 patients were eligible for this sub-study (ERTU 5 mg, n=100; ERTU 15 mg, n=113; placebo, n=117). Patients had a mean (SD) age of 63.2 (8.4) years, T2DM duration 11.4 (7.4) years, estimated glomerular filtration rate 83.5 (17.8) mL/min/1.73 m2, and HbA1c 8.3% (1.0) (67.4 [10.6] mmol/mol). At Week 18, ERTU 5 mg and 15 mg were each associated with a significantly greater least squares mean (95% CI) HbA1c reduction from baseline versus placebo; the placebo-adjusted differences for ERTU 5 mg and 15 mg were –0.7% (–0.9, –0.4) and –0.8% (–1.0, –0.5), respectively (P&lt;0.001). A higher proportion of patients in each ERTU group achieved HbA1c &lt;7% relative to placebo (P&lt;0.001). ERTU significantly reduced FPG and body weight (P&lt;0.001, for each dose versus placebo), but not systolic blood pressure. Adverse events were reported in 48.0%, 54.9%, and 47.0% of patients in the ERTU 5 mg, 15 mg, and placebo groups, respectively. Genital mycotic infections were experienced by significantly higher proportions of male patients who received ERTU 5 mg and 15 mg (4.2% and 4.8%, respectively) versus placebo (0.0%; P≤0.05) and by a numerically, but not significantly, higher proportion of female patients who received ERTU 15 mg (10.3%) compared with placebo (3.8%) (P=0.36). The incidences of symptomatic hypoglycemia were 11.0% (5 mg), 12.4% (15 mg), and 7.7% (placebo), and of severe hypoglycemia 2.0% (5 mg), 1.8% (15 mg), and 0.9% (placebo). Conclusion: Among patients with T2DM and ASCVD, ERTU (5 mg and 15 mg) added to metformin and SU for 18 weeks improved glycemic control (HbA1c and FPG) and reduced body weight, and was generally well tolerated with a safety profile consistent with the SGLT2 inhibitor class.

scholarly journals The Effect of Health Education on Control Glycemic at Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Education ◽  
Diabetic Patients ◽  
The Mean ◽  
Educational Course

AIM: The aim of this study was to evaluate the effect of short-term education on glycemic control (glycated hemoglobin [HbA1c] and fasting blood sugar [FBS]) among type 2 diabetes mellitus patients attending to primary health care (PHC) in Medan Johor of North Sumatera, Indonesia. METHODS: The study was performed on type 2 diabetes mellitus patients in Johor PHC, Medan of North Sumatera, on 40 patients with type 2 diabetes mellitus. We took the samples of all the patients of type 2 diabetes mellitus who attend PHC in Medan Johor. The patients received for 3 months intervention by education. An educational course of diabetes together with exercise training and nutritional education was designed for the study population in order to increase the patients’ knowledge and attitude toward diabetes and to increase their participation in the self-monitoring of glycemic control. Samples of FBS and HbA1c were recorded for each patient at the time of the baseline survey, then health education was conducted to the diabetic patients of both sexes attending PHC. The patients received standard advice on diet management and variation about activity. We put HbA1c <6.5% as cut limit for the control of diabetes mellitus. RESULTS: All 40 type 2 diabetes patients completed the educational course. The mean of age of the samples is 62.53 years old, the mean of body mass index was 24.81 kg/m, and the mean of waist size was 92.15 cm. Before the education, the mean of FBS level was 238.83 mg/dl and the mean of Hba1c value is 8.90%. After education, the FBS was 216.88 mg/dl, the mean of HbA1c value was 8.74%. CONCLUSION: The effect of health education in Johor Public Health Care Medan city reduced glycemic control (FBS) in type 2 diabetes mellitus patients, North Sumatera, Indonesia.

scholarly journals Impact of health education on knowledge, attitude, practices and glycemic control in type 2 diabetes mellitus

2019 ◽  
Vol 8 (1) ◽  
pp. 261 ◽  
Author(s):  
Ravinder Garg ◽  
SumitPal Singh Chawla ◽  
Sarabjot Kaur ◽  
Aman Bharti ◽  
Manjeet Kaur ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Education

scholarly journals Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Miguel A Salinero-Fort ◽  
Enrique Carrillo-de Santa Pau ◽  
Francisco J Arrieta-Blanco ◽  
Juan C Abanades-Herranz ◽  
Carmen Martín-Madrazo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Health Education ◽  
Body Mass

scholarly journals Association of Serum Adipokines Levels with Glycemic Control and Metabolic Dyslipidemia in Sudanese Patients with Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Halima Babiikir Eltahir ◽  
Elmahadi Mohamed Ali ◽  
Abdelrahim Osman Mohamed
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Glycemic Control ◽  
Total Cholesterol ◽  
Pearson Correlation ◽  
P Value

Abstract Background:The pathogenesis of type 2 diabetes mellitus is due to two major abnormalities including insulin resistance and dysfunction, which lead to the inability to regulate blood glucose level. Adiponectin is a hormone secreted by the adipose tissue and it takes part in glucose metabolism with insulin-sensitising properties. Low levels of adiponectin leads to reduction of fatty acid oxidation decreased glucose uptake in skeletal muscle cells and increased level of free fatty acids leading to insulin resistance. Leptin is another adipokine produced by adipose tissue involved in the control of food intake via its action on the hypothalamus, suppressing appetite and stimulating energy expenditure. Leptin plays a critical role in pathophysiology of type 2 diabetes mellitus.The aim of the study was to investigate the association of serum adipokines levels with glycemic control and metabolic dyslipidemia in Sudanese patients with type 2 diabetes mellitus.Methods: This was a case control study. 202 patients with type 2 diabetes and 102 non-diabetic controls participated after signing written consent. Weight (kg) and height (m) were measured thenthe body mass index (kg/m2) was determined. Blood samples were collected after an overnight fasting. FBG, HbA1c and lipid profiles were measured using enzymatic methods. Adiponectin and leptin were measured using sandwich ELISA.Results: Adiponectin concentrations was significantly lower in patients with type 2 diabetes compared with the controls (p<0.001) and it was inversely correlated with HbA1c (Pearson Correlation -.160, P value = 0.005), total cholesterol and LDL levels (P = 0.05) and direct correlated HDL levels (P = 0.05). Leptin concentrations was significantly higher in patients with type 2 diabetes compared with the controls (p<0.002) and it was positively correlated with HbA1c (Pearson Correlation .155, P value = 0.02), total cholesterol and LDL levels (P = 0.05), there were no correlation with HDL and TG levels. Patients had significantly higher fasting blood glucose, HbA1c levels, total cholesterol and LDL levels compared with the controls. Conclusion: Patients with type 2 diabetes mellitus had decreased levels of serum adiponectin, high levels of serum leptin. There were significant correlations found between adiponectin and leptin levels with glycemic control and metabolic dyslipidemia

scholarly journals Predictors of Glycemic Control Among Patients With Type 2 Diabetes in North West Ethiopia: a Longitudinal Study

2021 ◽  
Author(s):  
Nigusie Gashaye Shita ◽  
Ashagrie Sharew Iyasu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Good Glycemic Control ◽  
Diabetes Patients

Abstract Background: Type 2 diabetes mellitus patients with hyperglycemia for a long period are significant causes of mortality and morbidity worldwide. Studying the predictors of glycemic control helps to minimize deaths and the development of acute and chronic diabetes complication. Hence, this study aims to assess predictors of glycemic control among patients with Type 2 diabetes in Ethiopia.Methods: A retrospective cohort study was conducted among type 2 Diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Debre Markos and Felege Hiwot Referral Hospital. A total of 191 T2DM patients were included in the study meets the eligibility criteria. A generalized linear mixed model was employed. Results: The prevalence of good glycemic control among type 2 diabetes patients was 58.4% whereas 23.25% of the variation was explained in the fitted model due to adding the random effects. The significance predictors of glycemic control among patients with Type 2 diabetes at 95% confidence level were reside in rural(0.454, 0.614)), patients age 38-50, 51-59 and 60-66 years(1.267,1.776), (1.057,1.476) and (1.004, 1.403), respectively, Proteinuria Positive (1.211, 1.546), diastolic blood pressure ≥90 (1.101, 1.522), systolic blood pressure ≥140 (1.352, 1.895), creatinine (0.415, 0.660), duration per visit (0.913, 0.987), duration since diagnosis (0.985, 0.998), weight 78-88(0.603, 0.881).Conclusion: The level of glycemic control among type 2 diabetes patients was poor. Type 2 diabetes mellitus patients having higher age of the patient, higher weight, reside in rural, longer duration of T2DM since diagnosis, longer duration of type 2DM per visit, increase creatinine, positive protein urea, diastolic blood pressure≥90, and systolic blood pressure≥140 were significant predictors of poor glycemic control among type 2 DM patients. During diabetic patients follow up, clinicians should give appropriate attention to these significant variables for good glycemic control since it is the main goal of diabetes management.

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