scholarly journals EMDIA Case Series—Effective Medication Therapy Management (MTM) for Diabetes Type 2 Patients—A Proof of Concept Study

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 137
Author(s):  
Maira Anna Deters ◽  
Emina Obarcanin ◽  
Holger Schwender ◽  
Stephanie Läer

Background: A 2016 meta-analysis of pharmaceutical care for patients with diabetes mellitus showed that the following four components were most effective: (a) individual goal setting, (b) sending feedback to the physician, (c) reviewing the medication, and (d) reviewing blood glucose measurements. Methods: To formulate a hypothesis regarding the effect of these four pharmaceutical care components on glycemic control in patients with diabetes mellitus and the feasibility of these components in practice. Ten patients with type 2 diabetes were included in the case series and received medication therapy management over four months. Results: The four care components were feasible in everyday practice and could be implemented within one patient visit. The average visits were 49 and 28 min at the beginning and end of the study, respectively. The glycated hemoglobin values did not change over the study period, though the fasting blood glucose decreased from 142 to 120 mg/dl, and the number of unsolved drug-related problems decreased from 6.9 to 1.9 per patient by the study end. Conclusions: This case series supports the hypothesis that community pharmacists can implement structured pharmaceutical care in everyday pharmacy practice for patients with type 2 diabetes mellitus.

2017 ◽  
Vol 1 (2) ◽  
pp. 85-91
Author(s):  
Fauna Herawati ◽  
Ni Nyoman Yuni Astrini ◽  
I Made Agus Gelgel Wirasuta

Kolaborasi antar tenaga kesehatan diperlukan untuk meningkatkan pelayanan kesehatankepada pasien. Kolaborasi antar tenaga kesehatan didefinisikan sebagai profesional tenaga kesehatandengan peran yang saling melengkapi dan kooperatif bekerja sama, berbagi tanggung jawab untukpemecahan masalah dan pengambilan keputusan untuk merumuskan dan melaksanakan rencanaperawatan pasien; demikian pula dalam kolaborasi dokter dan apoteker, diperlukan kesepahamantentang masalah terkait obat. Penelitian ini bertujuan untuk mengukur tingkat kesepahaman dokter-apoteker di klinik pada periode September-Oktober 2013. Penelitian ini menggunakan metodedeskriptif observasional dan dilakukan di salah satu apotek di Bali yang bekerja sama dengan dokterspesialis penyakit dalam. Sampel penelitian adalah resep dokter spesialis penyakit dalam untukpasien diabetes mellitus (DM) dan pengambilan resep dilakukan secara consecutive sampling. Jumlahsampel yang berhasil diperoleh berjumlah 102 lembar resep pasien diabetes melitus rawat jalanyang akan dianalisis melalui 3 tahap dengan menggunakan elemen medication therapy management(MTM), daftar periksa the Pharmaceutical Care Network Europe (PCNE) versi 6.2, dan kappa agreement.Hasil analisis menunjukkan tingkat kesepahaman (κ) sebesar 0,84. Kesepahaman antara dokterdan apoteker tentang masalah terkait obat sangat baik (95% sepaham); ketidaksepahaman terutamaterkait pertimbangan klinis penggunaan obat dan kepatuhan pasien, oleh karena itu apotekerperlu meningkatkan pengetahuan agar dapat berkontribusi dalam kolaborasi tersebut. Apotekerdalam kolaborasi interprofesional dapat berperan dalam pengaturan dosis, identifikasi efek samping,rekonsiliasi pengobatan, dan memberikan rekomendasi terapi berbasis bukti.


2021 ◽  
Vol 104 (10) ◽  
pp. 1610-1616

Background: Volten VR4® capsules contain extract of Kaempferia parviflora (KP), which has been claimed to reduce blood glucose in patients with diabetes. Objective: To evaluate the efficacy of Volten VR4® on healthy individuals and Type-2 Diabetes Mellitus volunteers. Materials and Methods: The extracts of 400 mg capsules of KP were consumed for five days. The fasting and blood glucose levels of 2-hour postprandial were measured at baseline and day 5. A group of 15 healthy young adults between the age of 20- and 30-years old were the control group of the present study, while 12 volunteers aged 35 to 75 years old diagnosed with Type-2 Diabetes Mellitus constituted the experimental group. Data were validated through the Willcoxon and Friedman test statistics and error distribution. Results: It had been shown that the specificity of KP reduced blood glucose levels and has associated with the flavonoids and polymethoxyflavones components. The results showed that consuming VR4® capsules significantly reduced blood glucose, either at the state of fasting or postprandially in diabetic individual. Conclusion: Volten VR4® Kaempferia parviflora extract is safe to be consumed at 400 mg at one time. The study also has shown that the participants are free from adverse reactions and hypoglycaemia. Keywords: Kaempferia parviflora; Blood glucose; Type-2 Diabetes Mellitus; Flavonoids; Polymethoxyflavones; Hypoglycemia and heavy metal elements


Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


2020 ◽  
Vol 16 (6) ◽  
pp. 598-607 ◽  
Author(s):  
Rebeca Barbosa da Rocha ◽  
Cristiano Sales Silva ◽  
Vinícius Saura Cardoso

Background: Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. Objective: We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. Results: The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. Conclusion: The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.


1970 ◽  
Vol 5 (1) ◽  
pp. 61-74 ◽  
Author(s):  
Alexandre de Souza E Silva ◽  
Maria Paula Gonçalves Mota

O trabalho tem como objetivo analisar os estudos que avaliaram os efeitos dos programas de treinamento aeróbio, força e combinado nos níveis de glicose sanguínea em indivíduos com diabetes do tipo 2. Foi utilizado o método de revisão sistemática, sendo utilizada a base de dados PubMed. As palavras chaves utilizadas para pesquisa foram training and diabetes. Foram identificados 484 artigos originais. Apenas 17 estudos respeitaram os critérios de inclusão. Os resultados evidenciam que os programas de treinamento aeróbio diminuíram os níveis de glicose. O programa de treinamento de força também foi favorável à diminuição dos níveis de glicose sanguínea. Já o programa de treinamento combinado não demonstrou efeitos favoráveis no controle da glicose sanguínea. Conclui-se que o programa de treinamento aeróbio e de força ajudam a controlar os níveis de glicose sanguínea em indivíduos com diabetes do tipo 2. Palavras-chave: diabetes mellitus, treinamento, glicose.ABSTRACTThe study aims to analyze the studies that evaluated the effects of aerobic, strength and combined programs training in blood glucose levels in people with type 2 diabetes. We used a systematic review method and is used to PubMed database. The key words used for searching were training and diabetes. We identified 484 original articles. Only 17 studies complied with the inclusion criteria. The results show that aerobic training programs decreased glucose levels. The strength training program was also favorable to decrease in blood glucose levels. But the combined training program has not shown favorable effects on blood glucose control. We conclude that the aerobic training and strength helps control blood glucose levels in individuals with type 2 diabetes. Keywords: diabetes mellitus, training, glucose.


Epigenomics ◽  
2021 ◽  
Author(s):  
Marwa Matboli ◽  
Doaa Ibrahim ◽  
Amany H Hasanin ◽  
Mohamed Kamel Hassan ◽  
Eman K Habib ◽  
...  

Aim: To assess isorhamnetin efficacy for diabetic kidney disease in a Type 2 diabetes mellitus rat model, through investigating its effect at the epigenetic, mRNA and protein levels. Materials & methods: Type 2 diabetes mellitus was induced in rats by streptozotocin and high-fat diet. Rats were treated with isorhamnetin (50 mg/kg/d) for 4 or 8 weeks. Fasting blood glucose, renal and lipid profiles were evaluated. Renal tissues were examined by light and electron microscopy. Autophagy genes ( FYCO1, ULK, TECPR1 and  WIPI2) and miR-15b, miR-34a and miR-633 were assessed by qRT-PCR, and LC3A/B by immunoblotting. Results: Isorhamnetin improved fasting blood glucose, renal and lipid profiles with increased autophagosomes in renal tissues. It suppressed miRNA regulation of autophagy genes Conclusion: We propose a molecular mechanism for the isorhamnetin renoprotective effect by modulation of autophagy epigenetic regulators.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.


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