Gambaran Pengetahuan dan Upaya Pencegahan Diabetes Melitus: Literatur Review

Diabetes Mellitus ia a non-communicable disease characterized by high blood sugar levels due to impaired insulin function. Diabetes prevention encompassed modified and unmodifie factors. Age and heredity are the ummodified factors, whereas diet, pack of physical activity, drugs, stress, and pack of knowledge are the modified factors. Education and family support Van influence the level of knowledge that can affect a person both towards the environment and particular objects. To identify the level of knowledge, physical activity, and other prevention efforts to prevent diabetes. A Literature review was used on this study, The article was selected from the Pubmeed, Portal Garuda, and Scilit database. Five studies where selected based on inclusion criteria. This study showed that people with diabetes mellitus had good knowledge 377 respondents, 161 respondents gas suffcient knowledge, and 131 respondents lacked knowledge. While the prevention of diabetes mellitus had good prevention as many as 322 respondents, adequate prevention as 166 respondents, lack of prevention was 141 respondents. Physical activity gas a level of mild as many as 30 respondents, moderate as right respondents, high as two respondents. Many people had a lack of knowledge and prevention of diabetes mellitus, Nurse are expected to provide education or nursing care as well as phychological aspects. Keywords : Diabetes Melitus; Prevention; Knowledge. AbstrakDiabetes Melitus suatu penyakit tidak menular yakni gangguan metabolisme kronis yang disebabkan oleh banyak faktor dengan ditandai tingginya kadar gula darah sebagian dari akibat gangguan fungsi insulin, upaya pencegahan diabetes memiliki faktor risiko meliputi faktor yang tidak dapat diubah yakni umur dan keturunan dan faktor yang dapat diubah yakni makanan, aktifitas fisik yang kurang, obat- obatan,stress dan kurangnya pengetahuan. Tingkat pengetahuan dapat dipengaruhi oleh pendidikan dan dukungan keluarga yang dapat mempengaruhi seseorang baik terhadap lingkungan maupun objek tertentu. Mengetahui gambaran pengetahuan dan upaya pencegahan dan juga pencegahan dengan melakukan aktivitas fisik. Penelitian ini merupakan penelitian sekunder berjenis literatur review. Metode yang digunakan dalam pemilihan artikel yaitu dengan melakukan penelusuran literatur dari sumber database Pubmed, Portal Garuda, dan Scilit dan didapatkan 5 artikel yang sesuai dengan kriteria inklusi penelitian. Hasil analisis literatur review menunjukkan bahwa masyarakat dengan pengetahuan dan upaya pencegahan diabetes melitus memiliki pengetahuan baik dengan hasil sebanyak 377 responden, pengetahuan cukup sebanyak 161 responden, pengetahuan kurang sebanyak 131 responden. Sedangkan pencegahan diabetes melitus memiliki pencegahan baik sebanyak 322 responden, pencegahan cukup sebanyak 166 respondnen, pencegahan kurang baik sebanyak 141 responden. Dan pencegahan aktivitas fisik memiliki tingkat pencegahan ringan sebanyak 30 responden, pencegahan sedang sebanyak 8 responden, pencegahan tinggi sebanyak 2 responden. Masyarakat yang mengalami kurang pengetahuan dan pencegahan diabetes melitus paling banyak mengalami tingkat pengetahuan dan pencegahan baik. Diharapkan perawat dapat memberikan edukasi atau asuhan keperawatan dengan tetap memperhatikan aspek psikologi. Kata kunci : Diabetes Melitus; Pencegahan; Pengetahuan.

Curcumin and Its Analogs as Potential Epigenetic Modulators: Prevention of Diabetes and Its Complications

<b><i>Background:</i></b> The pathobiology of diabetes and associated complications has been widely researched in various countries, but effective prevention and treatment methods are still insufficient. Diabetes is a metabolic disorder of carbohydrates, fats, and proteins caused by an absence of insulin or insulin resistance, which mediates an increase of oxidative stress, release of inflammatory factors, and macro- or micro-circulation dysfunctions, ultimately developing into diverse complications. <b><i>Summary:</i></b> In the last decade through pathogenesis research, epigenetics has been found to affect metabolic diseases. Particularly, DNA methylation, histone acetylation, and miRNAs promote or inhibit diabetes and complications by regulating the expression of related factors. Curcumin has a wide range of beneficial pharmacological activities, including anti-inflammatory, anti-oxidation, anticancer, anti-diabetes, anti-rheumatism, and increased immunity. <b><i>Key Messages:</i></b> In this review, we discuss the effects of curcumin and analogs on diabetes and associated complications through epigenetics, and we summarize the preclinical and clinical researches for curcumin and its analogs in terms of management of diabetes and associated complications, which may provide an insight into the development of targeted therapy of endocrine diseases.

The Beneficial Effects of Astaxanthin on Glucose Metabolism and Modified Low-Density Lipoprotein in Healthy Volunteers and Subjects with Prediabetes

Astaxanthin (ASTX) is an antioxidant agent. Recently, its use has been focused on the prevention of diabetes and atherosclerosis. We examined the effects of astaxanthin supplementation for 12 weeks on glucose metabolism, glycemic control, insulin sensitivity, lipid profiles and anthropometric indices in healthy volunteers including subjects with prediabetes with a randomized, placebo-controlled trial. Methods: We enrolled 53 subjects who met our inclusion criteria and administered them with 12 mg astaxanthin or a placebo once daily for 12 weeks. Subsequently, their HbA1c levels, lipid profiles and biochemical parameters were determined. The participants also underwent a 75 g oral glucose tolerance test (OGTT), vascular endothelial function test and measurement of the visceral fat area. Results: After astaxanthin supplementation for 12 weeks, glucose levels after 120 min in a 75 g OGTT significantly decreased compared to those before supplementation. Furthermore, the levels of HbA1c (5.64 ± 0.33 vs. 5.57 ± 0.39%, p < 0.05), apo E (4.43 ± 1.29 vs. 4.13 ± 1.24 mg/dL, p < 0.05) and malondialdehyde-modified low-density lipoprotein (87.3 ± 28.6 vs. 76.3 ± 24.6 U/L, p < 0.05) were also reduced, whereas total cholesterol (TC), triglyceride (TG) and high-density lipoprotein-C (HDL-C) levels were unaltered. The Matuda index, which is one of the parameters of insulin resistance, was improved in the ASTX group compared to that before supplementation. Conclusions: our results suggest that ASTX may have preventive effects against diabetes and atherosclerosis and may be a novel complementary treatment option for the prevention of diabetes in healthy volunteers, including subjects with prediabetes, without adverse effects.

Simposio: el embarazo de Iris. Función de la célula β después del embarazo, prevención de diabetes mellitus tipo 2, intervención en estilo de vida y/o farmacológica

La diabetes mellitus gestacional (DG), definida como cualquier grado de intolerancia a la glucosa con inicio o primer reconocimiento durante el embarazo, se caracteriza por defectos maternos subyacentes en la respuesta de las células β a la insulina durante el embarazo. Las mujeres con antecedentes de DG tienen un riesgo siete veces mayor de desarrollar DM posparto en comparación con aquellas sin DG.Se han identificado varios factores de riesgo para la diabetes posparto, incluida la edad materna, los niveles de glucosa durante el embarazo, los antecedentes familiares de DM, el índice de masa corporal antes y después del parto, los patrones dietéticos, la actividad física y la lactancia. Estudios genéticos revelaron que la DG comparte variantes genéticas comunes con la DM2. Varios ensayos de intervención en el estilo de vida que tenían como objetivo mejorar los factores de riesgo modificables, incluida la dieta, el ejercicio y la lactancia materna, lograron reducir la incidencia de DM posparto, reducir el peso y otras morbilidades relacionadas con la obesidad.El Programa de Prevención de la Diabetes (DPP) es un ensayo representativo, intervencionista, aleatorizado, multicéntrico, que tenía como objetivo demostrar que las modificaciones intensivas del estilo de vida (IEV) o la metformina podrían prevenir el desarrollo de DM en hombres y mujeres de alto riesgo con intolerancia a la glucosa. Luego de 10 años de seguimiento, las mujeres con antecedentes de DG asignadas al placebo tenían un riesgo 48% mayor de desarrollar DM en comparación con aquellas sin antecedentes de DG. En mujeres con antecedentes de DG, la IEV y la metformina redujeron la progresión a DM en comparación con el placebo en un 35% y un 40% respectivamente. Entre las mujeres sin antecedentes de DG, la IEV redujo la progresión a DM en un 30% y la metformina no redujo la progresión a diabetes. La presión arterial sistólica y diastólica y los niveles de triglicéridos también fueron más bajos en sujetos que se sometieron a modificaciones en el estilo de vida. La lactancia materna proporciona beneficios tanto a la madre como a su descendencia. La lactancia de más de tres meses redujo la DM posparto en un 46% en un estudio alemán. Otros estudios de intervención como el Troglitazone in Prevention of Diabetes (TRIPOD) y el Pioglitazone in Prevention of Diabetes (PIPOD) demostraron una tasa de incidencia de diabetes del 4,6% por año, que fue considerablemente más baja que la tasa de DM para el grupo placebo.Aunque sabemos que la prevención de la DM es posible, en la práctica clínica, la pérdida en el seguimiento de las mujeres con DG después del parto es problemática. La mayoría de las mujeres con DG comprende la asociación entre DMG y DM posparto, aún así no perciben el mayor riesgo que tienen de desarrollarla. Las tasas de reclasificación posparto oscilan entre el 19 y 73%, que en general son bajas en comparación con las expectativas.

Plant Products in the Prevention of Diabetes Mellitus

: The beneficial effect of plants in treating diabetes is not only well-known in traditional medicine but also confirmed in numerous scientific studies. The basic platform for testing the potential antidiabetic activity of traditionally known plants and their bioactive compounds is a set of in vitro, in vivo experiments, clinical trials and molecular docking studies. Basic assays usually measure enzyme inhibitory activity (α-amylase and α-glucosidase) and other aspects related to diabetes mellitus disease. Recently, the use of plant-derived compounds has proven useful in treating diabetes and reducing complications resulting from high blood sugar levels. The main goal is to establish an action mechanism of plant extracts or active compounds to find new antidiabetic drugs with less toxicological properties. This work aims to collect data and discuss the newest results in the area of plant extracts, compounds and antidiabetic effects using in vitro, in vivo and in silico models. The data covered in this review include plant extracts, polyphenols, terpenoids, saponins, phytosterols, and other bioactive compounds, with some of the investigated plants being less known. Isolation of new compounds might be a plentiful source for treatment and prevention of diabetes mellitus. Clinical trials with adequate monitoring give the best results of plants' product efficacy and safety. Many studies give us the confirmation for importance of patent and use medicinal herbs in the treatment of diabetes.

Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

Effect of Nutritional Composition and Glycemic Index on Selected Varieties of Rice, Millets and Legumes

Diabetes mellitus is a disease that is increasing globally and is a group of metabolic disorder, characterized by polyuria, polyphagia and polydypsia. By maintaining glycemic index levels in individuals diet aids in prevention of diabetes. Rice, millets and legumes are considered to be one of the staple food and play a vital role in human diet. In our study the glycemic index of varieties of rice, millets and legumes were determined in-vitro. Consumption of foods with high glycemic index is hypothesized to contribute to insulin resistance, which is associated with increased risk of diabetes mellitus, obesity and cardiovascular disease. It was seen that the legumes possess low glycemic index with comparison to rice and millets. Hence, it can be concluded that legumes are particularly good for preventing and managing diabetes.