Some aspects of preparing diabetic patients for self-care

BackgroundDiabetes is a lifestyle disease which can cause many complications and organ-related disorders. The aim of the study was to analyze selected aspects of preparing patients with diabetes for self-care.MethodsThe study group consisted of 190 people diagnosed with type 1 and type 2 diabetes, including 101 women and 89 men. The mean age of the respondents was 42.2 ± 13.4 years. The study was conducted using an anonymous self-designed questionnaire containing 50 questions.ResultsAmong the respondents, 23.2% did not control their glucose levels at home. The respondents most often measured glucose once a day (33.6%) or three times a day (26.7%). 64.7% of the respondents declared that they kept a self-monitoring diary. The knowledge of the symptoms of hypoglycemia and the ability to properly manage it was declared by 64.8% of the respondents. 52.1% of the patients did not undertake any activity lasting more than 30 minutes at least 3 times a week. 75.2% described their condition as very good and good. Independent participation in therapy, i.e. taking hypoglycemic drugs or insulin, was declared by 63.7% of the respondents.ConclusionsDespite undergoing therapeutic education, the study population diagnosed with diabetes still show deficiencies in terms of awareness of proper health behaviors. Objective results showed that the patients had insufficient knowledge and skills in terms of self-care and self-observation, blood glucose and blood pressure measurements, physical activity, diet therapy and adherence to pharmacotherapy recommendations. Despite the good general preparation for self-care as declared by the respondents, these patients require further systematic, individual educational activities.Study implicationsThe results of the present study have implications for nursing practice, patient therapeutic education, and the functioning of the public health and healthcare systems. The number of diabetic patients is constantly increasing. Patients require coordinated care and individualized therapeutic education in order to be prepared for self-care and self-management, thus reducing the risk of complications. Delaying the occurrence of potential complications provides patients with a chance to live an active private and professional life, and protects the health care system from carrying the cost burden of expensive highly specialized services.

What Is the Role of Gut Microbiota in Obesity Prevalence? A Few Words about Gut Microbiota and Its Association with Obesity and Related Diseases

Obesity is becoming the most dangerous lifestyle disease of our time, and its effects are already being observed in both developed and developing countries. The aim of this study was to investigate the impact of gut microbiota on the prevalence of obesity and associated morbidities, taking into consideration underlying molecular mechanisms. In addition to exploring the relationship between obesity and fecal microorganisms with their metabolites, the study also focused on the factors that would be able to stimulate growth and remodeling of microbiota. Assessed articles were carefully classified according to a predetermined criterion and were critically appraised and used as a basis for conclusions. The considered articles and reviews acknowledge that intestinal microbiota forms a multifunctional system that might significantly affect human homeostasis. It has been proved that alterations in the gut microbiota are found in obese and metabolically diseased patients. The imbalance of microbiome composition, such as changes in Bacteroidetes/Firmicutes ratio and presence of different species of genus Lactobacillus, might promote obesity and comorbidities (type 2 diabetes mellitus, hypertension, dyslipidemia, depression, obstructive sleep apnea). However, there are also studies that contradict this theory. Therefore, further well-designed studies are needed to improve the knowledge about the influence of microbiota, its metabolites, and probiotics on obesity.

Molecular Mechanisms and Epigenetic Regulation in Diabetic Cardiomyopathy

Diabetes mellitus (DM) is an important lifestyle disease. Type 2 diabetes is one of the prime contributors to cardiovascular diseases (CVD) and diabetic cardiomyopathy (DbCM) and leads to increased morbidity and mortality in patients with DM. DbCM is a typical cardiac disease, characterized by cardiac remodeling in the presence of DM and in the absence of other comorbidities such as hypertension, valvular diseases, and coronary artery disease. DbCM is associated with defective cardiac metabolism, altered mitochondrial structure and function, and other physiological and pathophysiological signaling mechanisms such as oxidative stress, inflammation, myocardial apoptosis, and autophagy. Epigenetic modifiers are crucial players in the pathogenesis of DbCM. Thus, it is important to explore the role of epigenetic modifiers or modifications in regulating molecular pathways associated with DbCM. In this review, we have discussed the role of various epigenetic mechanisms such as histone modifications (acetylation and methylation), DNA methylation and non-coding RNAs in modulating molecular pathways involved in the pathophysiology of the DbCM.

Association between Laughter and Lifestyle Diseases after the Great East Japan Earthquake: The Fukushima Health Management Survey

We investigated the association between the frequency of laughter and lifestyle diseases after the Great East Japan Earthquake. We included 41,432 participants aged 30–89 years in the Fukushima Health Management Survey in fiscal year 2012 and 2013. Gender-specific, age-adjusted and multivariable odds ratios of lifestyle diseases were calculated using logistic regressions stratified by evacuation status. Those who laugh every day had significantly lower multivariable odds ratios for hypertension (HT), diabetes mellitus (DM) and heart disease (HD) for men, and HT and dyslipidemia (DL) for women compared to those who do not, especially in male evacuees. The multivariable odds ratios (95% confidence intervals) of HT, DM and HD (non-evacuees vs. evacuees) for men were 1.00 (0.89–1.11) vs. 0.85 (0.74–0.96), 0.90 (0.77–1.05) vs. 0.77 (0.64–0.91) and 0.92 (0.76–1.11) vs. 0.79 (0.63–0.99), and HT and DL for women were 0.90 (0.81–1.00) vs. 0.88 (0.78–0.99) and 0.80 (0.70–0.92) vs. 0.72 (0.62–0.83), respectively. The daily frequency of laughter was associated with a lower prevalence of lifestyle disease, especially in evacuees.

Synbiotic (Lactiplantibacillus pentosus GSSK2 and isomalto-oligosaccharides) supplementation modulates pathophysiology and gut dysbiosis in experimental metabolic syndrome

Metabolic syndrome a lifestyle disease, where diet and gut microbiota play a prodigious role in its initiation and progression. Prophylactic bio-interventions employing probiotics and prebiotics offer an alternate nutritional approach towards attenuating its progression. The present study aimed to evaluate the protective efficacy of a novel synbiotic (Lactiplantibacillus pentosus GSSK2 + isomalto-oligosaccharides) in comparison to orlistat in an experimental model of metabolic syndrome. It was observed that supplementation of synbiotic for 12 weeks to Sprague Dawley rats fed with high fat diet (HFD), ameliorated the morphometric parameters i.e. weight gain, abdominal circumference, Lee’s index, BMI and visceral fat deposition along with significantly increased fecal Bacteroidetes to Firmicutes ratio, elevated population of Lactobacillus spp., Akkermansia spp., Faecalibacterium spp., Roseburia spp. and decreased Enterobacteriaceae compared with HFD animals. Additionally, synbiotic administration to HFD animals exhibited improved glucose clearance, lipid biomarkers, alleviated oxidative stress, prevented leaky gut phenotype, reduced serum lipopolysaccharides and modulated the inflammatory, lipid and glucose metabolism genes along with restored histomorphology of adipose tissue, colon and liver compared with HFD animals. Taken together, the study highlights the protective potential of synbiotic in comparison with its individual components in ameliorating HFD-induced metabolic complications.

ROLE OF AN ETHNOMEDICINE- MUSTADI MODAKA IN THE MANAGEMENT OF 2ND DEGREE HAEMORRHOIDS (ARSHAS) – A CASE REPORT

In the present era of 21st century, haemorrhoids have become the most common and distressing anorectal disease. It is a lifestyle disease due to excessive intake of spicy food non-vegetarian food, and lack of exercise. Inadequate consumption of water and the habit of taking alcohol are some of the main reasons for the manifestation of the disease. Perianal trauma due to the long journey and excessive two-wheeler riding particularly on uneven roads and terrenes are also main reasons. Constipation is also a common cause of this disease. Haemorrhoids are dealt with rationally under the concept of Arshas. Use of medicine, surgery, cauterization with kshara and Agni are the treatment principles recommended for Arshas by Acharya Susruta. Except medicine, the rest of the procedures are invasive. The basic principles for the treatment of Arshas are deepana and anulomana (digestive, carminative, and laxative). A medicine with the above properties which is used traditionally by tribes is selected for the study. It has been found using among the tribes for a long time with no side effects. The contents of this medicine are safe and are used in routine ayurvedic practice. In this case study, an effort was made to evaluate the role of Mustadimodaka and ethnomedicine in the management of Arshas. Keywords: 2nd-degree haemorrhoids, Arshas, Mustadimodaka, Ethnomedicine

PREVENTIVE AND THERAPEUTIC EFFECT OF YOGĀSANA AND PRĀNĀYAM IN THE PATIENTS OF DIABETES MELLITUS: AN OVERVIEW

Objective: The present review was carried out with the objectives of identifying the role of Yogāsana (yogic practices) and Prānāyam (breathing practices) as a modality to prevent and treat diabetes. Data Source: The fea- sible beneficial effects of Yogāsana (yogic practices) and Prānāyam (breathing practices) on diabetes were as- sessed, which is based on relevant classical texts along with textbooks of contemporary medical sciences. Be- sides, recent research articles related to clinical studies conducted in various institutions as available on the inter- net and published in authentic databases (Pub-Med, Google Scholar, Web of Science etc.) were also referred through the ancestry approach. Review Methods: The possible correlation has been made between collected in- formation and has been presented systematically. The quality of the studies was assessed by the author and logi- cally presented in this context. Result and Discussion: Yoga offers a non-invasive way to manage various clini- cal conditions up to some extent. It can be prescribed with other systems of medicines as an adjuvant for health promotion. Recent evidence suggests that Yoga and controlled lifestyle measures reduce blood sugar load in peo- ple with diabetes. Keywords: Yoga, Yogāsana, Prānāyam, Diabetes mellitus, Insulin resistance, lifestyle disease.

Chronobiology of hypertension and its chronotherapeutical management - A review

Hypertension / High blood pressure is a very common disease and is a major risk factor for total organ failure, cardiovascular diseases (CVD) and premature death around worldwide. Prevalence of hypertension varies across regions and country and is dramatically variable in presentation. Sometimes it act as a silent killer i.e. the patients are unaware that they have the condition. According to estimation 46.5% of adults are unaware about their hypertensive condition, 36.9% are diagnosed and treated and the remaining 13.8% with hypertension have it under control. The investigation regarding the chronobiology, chronotherapy and chronopharmacology in treatment of hypertension began a long back ago. Hypertension is a lifestyle disease largely exhibit circadian variation. Also the condition is more evident to surge during early morning hours. Hence this requires chronotherapy. The chronobiology of hypertension along with its treatment in relation to the circadian variation is reviewed in this article.

UNDERSTANDING OF LIFESTYLE DISEASES IN THE LIGHT OF AYURVEDA

Ayurveda is one of the most ancient medical sciences in the world. It is more life and health-oriented and empha- sizes prevention rather than cure. In Ayurvedic texts “CHARYA” word has been used to denote lifestyle or day to day activities being performed by individuals. Charya means “Aahara” and “Vihara”, which is to be consumed or followed, to maintain Swasthaya (Health) of an individual. A Comprehensive schedule of a health regimen for promotion and preservation of health as a code of conduct which can be attained through Dincharya (Daily regi- men), Ratricharya (night regimen), Ritucharya (seasonal regimen), Vyaayaam (exercise), along with AaharaVidhi Vidhana (rules of diet) has been described in Ayurvedic texts. Lifestyle is the way in which a person lives. Life- style includes behaviours such as dietary habits, sleeping and resting habits, physical activity (include exercising), weight control, smoking and alcohol consumption. The diseases which are not transmitted by any vector, envi- ronment and not transmitted from person to person is called Non-Communicable Disease or chronic disease or Lifestyle disease. In Ayurvedic texts, there is no such type of disease mentioned but in Ayurveda, this kind of dis- ease and its causative factors have been mentioned in abundance during the description of Nidana. So, an attempt has been made to understand the Lifestyle diseases and their Nidanain the light of Ayurveda, through this paper. Keywords: Charya, Vihara, Lifestyle.

FOLK ANTIDIABETIC PLANTS OF ASSAM: A SURVEY ON THEIR REPORTED ACTIVITY AND FUTURE POTENTIAL

Assam is a state in Indias north-eastern region, known for its lush floral and cultural diversity. We combed through the literature and discovered that about 117 Assamese plant species had been shown to have antidiabetic potential in preclinical studies. Diabetes, in its many forms, has been a long-standing problem for doctors for decades. Many aspects of diabetes must be investigated, including the physiological actions of insulin and the different clinical features of the condition, such as tissue complications. Since diabetes is a lifestyle disease, careful care with regard to diet and anti-diabetic agents is essential. Herbal diabetes therapy is not a novel concept. Plants and plant extracts have been used to treat diabetes since 1550 B.C., with as many as 400 prescribed before the development of effective diabetes drugs earlier this century.