A Self-Report Measure of Diabetes Self-Management for Type 1 and Type 2 Diabetes: The Diabetes Self-Management Questionnaire-Revised (DSMQ-R) – Clinimetric Evidence From Five Studies

AimsMeasurement tools to evaluate self-management behavior are useful for diabetes research and clinical practice. The Diabetes Self-Management Questionnaire (DSMQ) was introduced in 2013 and has become a widely used tool. This article presents a revised and updated version, DSMQ-R, and evaluates its properties in assessing self-management practices in type 1 diabetes (T1D) and type 2 diabetes (T2D).MethodsThe DSMQ-R is a multidimensional questionnaire with 27 items regarding essential self-management practices for T1D and T2D (including diabetes-adjusted eating, glucose testing/monitoring, medication taking, physical activity and cooperation with the diabetes team). For the revised form, the original items were partially amended and the wording was updated; eleven items were newly added. The tool was applied as part of health-related surveys in five clinical studies (two cross-sectional, three prospective) including a total of 1,447 people with T1D and T2D. Using this data base, clinimetric properties were rigorously tested.ResultsThe analyses showed high internal and retest reliability coefficients for the total scale and moderate to high coefficients for the subscales. Reliability coefficients for scales including the new items were consistently higher. Correlations with convergent criteria and related variables supported validity. Responsiveness was supported by significant short to medium term changes in prospective studies. Significant associations with glycemic outcomes were observed for DSMQ-R-assessed medication taking, glucose monitoring and eating behaviors.ConclusionsThe results support good clinimetric properties of the DSMQ-R. The tool can be useful for research and clinical practice and may facilitate the identification of improvable self-management practices in individuals.

Stem Cell-Derived β Cells: A Versatile Research Platform to Interrogate the Genetic Basis of β Cell Dysfunction

Pancreatic β cell dysfunction is a central component of diabetes progression. During the last decades, the genetic basis of several monogenic forms of diabetes has been recognized. Genome-wide association studies (GWAS) have also facilitated the identification of common genetic variants associated with an increased risk of diabetes. These studies highlight the importance of impaired β cell function in all forms of diabetes. However, how most of these risk variants confer disease risk, remains unanswered. Understanding the specific contribution of genetic variants and the precise role of their molecular effectors is the next step toward developing treatments that target β cell dysfunction in the era of personalized medicine. Protocols that allow derivation of β cells from pluripotent stem cells, represent a powerful research tool that allows modeling of human development and versatile experimental designs that can be used to shed some light on diabetes pathophysiology. This article reviews different models to study the genetic basis of β cell dysfunction, focusing on the recent advances made possible by stem cell applications in the field of diabetes research.

Role of Polyherbal Formulations of Medicinal Plants From Himalayan Regions in the Management of Diabetes

Current research on phytochemicals is mainly focused on novel phenolic and polyphenolic compounds expressing their potential as therapeutic agents in various diseases like cancer, autoimmune diseases, cardiovascular disorders, diabetes, oxidative stress-related diseases, as well as their properties to inhibit the growth and proliferation of infectious agents. Among the human physiological disorders, one of the most severe endocrine metabolic diseases is Diabetes mellitus which is a clinical disease distinguished by a deficit in the production of insulin or resistance to the action of insulin. Globally, diabetes is an increasing health concern which is now emerging as an epidemic. About 700-800 plants are exhibiting anti-diabetic activity that has been studied. As far as nanotechnology in diabetes research is concerned, it has made possible the buildout of novel glucose measurement as well as insulin delivery modalities that possess the potential to excellently enhance the quality of life of the diabetic patient.

Endogenous Levels of Gamma Amino-Butyric Acid Are Correlated to Glutamic-Acid Decarboxylase Antibody Levels in Type 1 Diabetes

Gamma-aminobutyric acid (GABA) is an important inhibitory neurotransmitter in the central nervous system (CNS) and outside of the CNS, found in the highest concentrations in immune cells and pancreatic beta-cells. GABA is gaining increasing interest in diabetes research due to its immune-modulatory and beta-cell stimulatory effects and is a highly interesting drug candidate for the treatment of type 1 diabetes (T1D). GABA is synthesized from glutamate by glutamic acid decarboxylase (GAD), one of the targets for autoantibodies linked to T1D. Using mass spectrometry, we have quantified the endogenous circulating levels of GABA in patients with new-onset and long-standing T1D and found that the levels are unaltered when compared to healthy controls, i.e., T1D patients do not have a deficit of systemic GABA levels. In T1D, GABA levels were negatively correlated with IL-1 beta, IL-12, and IL-15 15 and positively correlated to levels of IL-36 beta and IL-37. Interestingly, GABA levels were also correlated to the levels of GAD-autoantibodies. The unaltered levels of GABA in T1D patients suggest that the GABA secretion from beta-cells only has a minor impact on the circulating systemic levels. However, the local levels of GABA could be altered within pancreatic islets in the presence of GAD-autoantibodies.

Comparison Of Retinopathy And Hearing Impairment In Poorly Controlled Diabetics In Population Of Muzaffarabad AJK

Aim: Prevalence and comparison of retinopathy and sensorineural hearing loss in poorly managed diabetics Methodology: A cross sectional study was designed with the approval of the Ethical Review Board Committee. The study enrolled 50 people who met the inclusion criteria. Anthropometric data were collected using standardized procedures. All laboratory assays were performed on the initial visit to the diabetes research center's laboratory. Tuning fork and PTA examinations of the ears were performed. The scores of Rinne and Weber were recorded and synchronised. Fundoscopy was used in ophthalmic investigations. Results: The Rinne test was found to be normal in 50(100%) cases of population while Weber’s test was centralized in 43(86%) of patients, 1(2%) case was lateralized to right, 5(10%)cases were lateralized to left, 1(2%) case had moderate disease. PTA scores revealed mild disease in 1(2%), moderate 14(28%), severe 1(2%) and 34(68%) patients showed normal results. Fundoscopy demonstrated normal results in 11(22%), Grade 1 retinopathy in 15(30%), grade 2 RP in 17(34%) and grade 3 RP in 7(14%). Conclusion: Retinopathy is more prevalent with poorly managed diabetic individuals in contrast to hearing impairment. Key words: Retinopathy, Fundoscopy, Diabetes mellitus

The Current State of Beta-Cell-Mass PET Imaging for Diabetes Research and Therapies

Diabetes is a chronic metabolic disease affecting over 400 million people worldwide and one of the leading causes of death, especially in developing nations. The disease is characterized by chronic hyperglycemia, caused by defects in the insulin secretion or action pathway. Current diagnostic methods measure metabolic byproducts of the disease such as glucose level, glycated hemoglobin (HbA1c), insulin or C-peptide levels, which are indicators of the beta-cell function. However, they inaccurately reflect the disease progression and provide poor longitudinal information. Beta-cell mass has been suggested as an alternative approach to study disease progression in correlation to beta-cell function, as it behaves differently in the diabetes physiopathology. Study of the beta-cell mass, however, requires highly invasive and potentially harmful procedures such as pancreatic biopsies, making diagnosis and monitoring of the disease tedious. Nuclear medical imaging techniques using radiation emitting tracers have been suggested as strong non-invasive tools for beta-cell mass. A highly sensitive and high-resolution technique, such as positron emission tomography, provides an ideal solution for the visualization of beta-cell mass, which is particularly essential for better characterization of a disease such as diabetes, and for estimating treatment effects towards regeneration of the beta-cell mass. Development of novel, validated biomarkers that are aimed at beta-cell mass imaging are thus highly necessary and would contribute to invaluable breakthroughs in the field of diabetes research and therapies. This review aims to describe the various biomarkers and radioactive probes currently available for positron emission tomography imaging of beta-cell mass, as well as highlight the need for precise quantification and visualization of the beta-cell mass for designing new therapy strategies and monitoring changes in the beta-cell mass during the progression of diabetes.

Risk Assessment for Diabetes Mellitus by Using Indian Diabetes Risk Score among Office Workers of Health Institutions of South India

Background: Diabetes mellitus (DM) is one of the non-communicable diseases plaguing the world and contributes a major part to the total disease burden. Diabetes has been prevalent in all countries throughout the years, with the majority of diabetics living in low- and middle-income countries. Madras Diabetes Research Foundation developed the Indian Diabetes Risk Score (IDRS), a simple and cost-effective method to assess the chances of developing diabetes. Objectives: To assess the diabetes risk profile of office workers using IDRS and to determine the proportion of individual risk factors of diabetes among the participants. Methods: This cross sectional study included 94 non-diabetic office workers working in two health care institutions situated in coastal South India. Data was collected by a study questionnaire consisting of three sections. Section A included details related to participant characteristics, Section B included anthropometric measurements, and Section C consisted of the Indian Diabetes Risk Score. The collected data were coded and entered into Statistical Package for Social Sciences. Results: The mean age of the study participants was 40.88 (±9.761) years, and the mean BMI was 23.8 (±3.6) kg/m2. Majority (n=65, 67%) of the study participants did not have a family history of diabetes. One-third of the study participants had IDRS ≥ 60, which allocated them in the high risk category for type 2 diabetes (n=34, 35.1%). Conclusion: It has been conclusively shown from the study that most of the office workers have moderate to high risk of developing diabetes and are also overweight or obese.