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Background: Little is known about the mechanisms underlying the association of the serum phospholipid lipophilic index (LI) with atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes (T2D). Therefore, we investigated whether the LI is associated with glucometabolic control, meta-inflammation, thrombin generation, fibrin clot properties, endothelial function and platelet activation in T2D patients with angiographically documented ASCVD. Methods: We studied 74 T2D patients with ASCVD, aged 65.6 ± 6.8 years, with a median diabetes duration of 10 years and median HbA1c of 7.0%. Serum phospholipid fatty acids (FAs) were measured by gas chromatography. The serum phospholipid LI was calculated as the sum of the products of the proportion (% of total FAs) with the melting points (°C) of each individual FA, divided by the sum of the proportions of all FAs. Levels of HbA1c, insulin, leptin, adiponectin, lipid profiles, inflammatory markers (hsCRP, interleukin-6, TNF-α), Lp-PLA2 (a biomarker of vascular inflammation), endothelial function (sICAM-1, sVCAM-1, FMD, NMD), thrombin generation, fibrin clot properties and platelet activation, measured by light transmission aggregometry with arachidonic acid [AA] and adenosine diphosphate [ADP], were assessed. Results: Patients with LI > 16.9 °C (median) had higher HbA1c concentrations by 5.9% compared to the remaining subjects (p = 0.035). In this group, HbA1c levels ≥ 7.0% were found more often than in individuals with LI ≤ 16.9 °C (62.2 vs. 35.1%; p = 0.020). Subjects with LI > 16.9 °C had higher levels of TCh by 17.1% (p = 0.012), LDL-Ch by 29.4% (p = 0.003), interleukin-6 by 22.2% (p = 0.031) and Lp-PLA2 by 32.4% (p = 0.040), compared to the remaining patients. Moreover, they had increased maximal platelet aggregation induced by AA (p = 0.045), but not by ADP. Serum phospholipid LI correlated with HbA1c (r = 0.24; p = 0.037), TCh (r = 0.36; p = 0.002), LDL-Ch (r = 0.38; p < 0.001), interleukin-6 (r = 0.27; p = 0.020) and Lp-PLA2 (r = 0.26; p = 0.026). There were no intergroup differences in endothelial function, thrombin generation and fibrin clot properties. Regression analysis showed that HbA1c ≥ 7.0% and serum levels of LDL-Ch, interleukin-6 and Lp-PLA2 were predictors of LI > 16.9 °C in adjusted models. Conclusions: In well-controlled T2D patients with ASCVD, the higher serum phospholipid LI is associated with worse glucometabolic control, enhanced vascular inflammation and higher platelet reactivity during aspirin treatment at cyclooxygenase-1-selective doses. [ABSTRACT FROM AUTHOR]

Aim: To synthesize the evidence on the effects of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in adolescents with overweight or obesity. Materials and Methods: For this systematic review and network meta‐analysis, we searched five databases and registries until 2 March 2024 for eligible randomized controlled trials (RCTs). The primary outcome was weight change. We did a pairwise meta‐analysis to compare GLP‐1RAs and placebo, followed by a drug‐wise network meta‐analysis (NMA) to compare GLP‐1RAs against each other. Results: We screened 770 records to include 12 RCTs with 883 participants. The evidence suggests that GLP‐1RAs reduced weight (mean difference −4.21 kg, 95% confidence interval [CI] −7.08 to −1.35) and body mass index (BMI; mean difference −2.11 kg/m2, 95% CI −3.60 to −0.62). The evidence on waist circumference, body fat percentage and adverse events (AEs) was very uncertain. The results remained consistent with subgroup analyses for coexisting type 2 diabetes. Longer therapy duration led to a greater reduction in weight and BMI. In the NMA, semaglutide led to the greatest weight reduction, followed by exenatide, liraglutide and lixisenatide. Conclusions: The evidence suggests that GLP‐1RAs reduce most weight‐related outcomes in adolescents, with semaglutide being the most efficacious. There is uncertain evidence on body fat and serious AEs, probably due to fewer studies and low incidence, respectively. Larger RCTs with head‐to‐head comparisons, pragmatic design, adiposity‐related outcomes, and economic evaluation can further guide the use and choice of GLP‐1RAs. [ABSTRACT FROM AUTHOR]

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Background: Social jetlag is a chronic disruption of sleep timing that is characterized by different sleep timing during workdays and free days. Social jetlag has been associated with disturbed glucose metabolism, insulin resistance, and increased risk of metabolic syndrome and type 2 diabetes. In this study, we aim to investigate whether a combination of bright light therapy in the morning, bright light reduction in the evening and sleep advance instructions for 3 weeks reduces social jetlag and if this results in improvement of glycemic and metabolic control, sleep, mood and quality of life after 3 and 12 weeks in people with prediabetes and type 2 diabetes and to assess possible mediators, compared to regular sleep habits. Methods: In this randomized controlled trial, 60 people with prediabetes or type 2 diabetes with > 1 h social jetlag will be recruited. The intervention consists of bright light therapy (5000 lx) emitted by Vitamine-L (Lumie, UK) for 30 min each morning, combined with the advice to follow sleep advance instructions and to wear bright light-dimming goggles every evening for a period of 3 weeks. The control group adheres to their regular sleep habits and conditions. The primary outcome is glycated hemoglobin (HbA1c) after 12 weeks comparing the intervention and control in an intention-to-treat analysis. Secondary outcomes at 3 and 12 weeks are (1) social jetlag; (2) insulin sensitivity, fasting blood glucose, glucose-lowering medication use, and frequency of perceived hypoglycemia; (3) metabolic outcomes, including body mass index (BMI), waist circumference, body fat percentage, and blood pressure; (4) mood, including depression, fatigue and anxiety (measured with questionnaires); and (5) quality of life measured using EQ5D questionnaire. To assess other factors that might play a role as possible mediators, we will measure (para)sympathetic nervous system activity assessed with ECGs and electrochemical skin conductance tests, sleep quality and sleep phase distribution assessed with a sleep measuring headband (ZMax), the Dim Light Melatonin Onset in saliva samples (in a subgroup) at 3 and 12 weeks, the feeling of satiety and satiation with a 10-cm visual analog scale (VAS), diet using a food frequency questionnaire, and physical activity using an accelerometer (ActiGraph). Discussion: Social jetlag can contribute to poorer glycemic control and metabolic control in those with type 2 diabetes. With this intervention, we aim to reduce social jetlag and thereby improve glycemic and metabolic control. This could offer a way to improve overall population health and to reduce the disease burden of type 2 diabetes. Trial registration: ISRCTN registry ISRCTN11967109. Registered on 9 May 2024. [ABSTRACT FROM AUTHOR]

Introduction: Efficacy and safety of the fixed ratio combination of insulin degludec and liraglutide (IDegLira) has been largely documented. However, long-term data are limited. This study aimed at describing persistence in therapy and the effectiveness at 48 months of IDegLira. Methods: We conducted an observational study based on retrospective chart review. All patients treated with IDegLira during 2018–2022 were included. Data on treatment approaches and clinical outcomes were collected at the first prescription of IDegLira (T0) and after 6, 12, 24, 36, and 48 months. Results: Overall, 156 patients (mean age 68 years, 64.1% men) started IDegLira, of whom 88 (56.4%) were previously treated with basal-oral therapy (BOT) and 68 (43.6%) with basal-bolus schemes (BB). Before starting IDegLira, 23.8% were treated with ≥ 2 oral antihyperglycemic agents in association with insulin; at T0, the proportion decreased to 3.2%. Short-acting insulin was discontinued after the first week. After 48 months, levels of HbA1c were significantly reduced by 1.34% in the BOT group and 1.07% in the BB group (p < 0.0001 in both groups). In the BOT group, FBG levels decreased by about 50 mg/dl and body weight was unchanged. In the BB group, FBG levels decreased by about 40 mg/dl and body weight was significantly reduced by an average of 7.7 kg. Five patients (3.2%) interrupted therapy with IDegLira during 48 months, and no severe hypoglycemia occurred. Conclusions: Our study emphasizes the important role of IDegLira in maintaining a good metabolic control while minimizing the risk of major hypoglycemia and weight gain in the long term. The substantial simplification of treatment schemes can increase adherence. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the relationship between metabolic control factors, socio-demographic characteristics, personality traits, and self-perceived health status in diabetes. Methods: This cross-sectional study included 318 patients with type 1 and 2 diabetes (DM). Participants completed a questionnaire-based survey, which included the NEO Personality Inventory-Revised to measure five personality dimensions and the SF-12 survey to assess self-perceived health status. Binary logistic regression was performed to analyze the data, with socio-demographic characteristics, clinical data, and nutrition status as independent variables, and self-perceived health status (categorized as poor or good condition) as the dependent variable. Unadjusted and adjusted binary logistic regression analyses were used to examine the association between personality traits (high vs. low) and metabolic control factors (good control vs. bad control) with health status scores. Results: 60.7% of the participants with diabetes in the study described their health as "good." The results indicated that female gender (OR: 0.314, 95%CI: 0.105–0.938, P = 0.038), age > 60 years (OR: 0.263, 95%CI: 0.117–0.592, P = 0.001), comorbidities (OR: 0.314, 95%CI: 0.178–0.556, P = 0.001), DM complications (OR: 0.531, 95%CI: 0.337–0.838, P = 0.007), diabetic neuropathy (OR: 0.562, 95%CI: 0.356–0.886, P = 0.013), and diabetic ulcer (OR: 0.130, 95%CI: 0.023–0.747, P = 0.022) were independent variables associated with a "poor" health status. However, regular physical activity (OR: 3.144, 95%CI: 1.209–8.175, P = 0.019) and a healthy nutritional diet (OR: 2.456, 95%CI: 1.421–4.245, P < 0.001) were associated with a higher likelihood of a "good" self-perceived health status. Conclusion: Preventive programs and interventions aimed at improving self-perceived health among patients with diabetes should focus on increasing regular physical activity and promoting a healthy nutritional status. These actions should be particularly targeted towards female and older patients with higher neuroticism traits. [ABSTRACT FROM AUTHOR]

Abstract Background The SARS-CoV-2 pandemic brought a radical shift in the healthcare system and suboptimal care for vulnerable patients, such as those with Type 2 Diabetes Mellitus (T2D). Therefore, we compared metabolic control and macro/microvascular complications of patients with T2D before and throughout the three-year SARS-CoV-2 pandemic. Research design and methods A retrospective observational cohort of subjects with T2D studied from 2018 to 2022 in Northern Mexico was treated by a dynamic multidisciplinary team. Levels of Glycated hemoglobin (HbA1c), fasting serum glucose (FG), LDL-Cholesterol (LDL-C), blood pressure (BP), albuminuria, triglycerides, Body Mass Index (BMI), and FIB-4 score, micro and macrovascular complications were evaluated. Results A total of 999 patients were studied, 51.7% males with a mean (SD) age of 60.1 (12.7) years. Adequate glycemic control based on HbA1c increased by 15.2% and 42.3% in FSG (p

Background: The SARS-CoV-2 pandemic brought a radical shift in the healthcare system and suboptimal care for vulnerable patients, such as those with Type 2 Diabetes Mellitus (T2D). Therefore, we compared metabolic control and macro/microvascular complications of patients with T2D before and throughout the three-year SARS-CoV-2 pandemic. Research design and methods: A retrospective observational cohort of subjects with T2D studied from 2018 to 2022 in Northern Mexico was treated by a dynamic multidisciplinary team. Levels of Glycated hemoglobin (HbA1c), fasting serum glucose (FG), LDL-Cholesterol (LDL-C), blood pressure (BP), albuminuria, triglycerides, Body Mass Index (BMI), and FIB-4 score, micro and macrovascular complications were evaluated. Results: A total of 999 patients were studied, 51.7% males with a mean (SD) age of 60.1 (12.7) years. Adequate glycemic control based on HbA1c increased by 15.2% and 42.3% in FSG (p < 0.001) between the beginning 2018 and the end of 2022. LDL-C control decreased by 5.1% between 2018 and 2022 (p < 0.001). Systolic BP control decreased by 2.6% (p < 0.001), whereas diastolic BP control increased by 1.8% (p = 0.01) between 2018 and 2022. Albuminuria control increased by 8.5% (p = 0.002). When comparing the Area Under the Curve (AUC) of metabolic parameters between patients who developed SARS-CoV-2 vs. those who did not, AUC was statistically higher in those who developed SARS-CoV-2 (p < 0.05). Diabetic neuropathy was the most prevalent microvascular complication (n = 35; 3.6%); ischemic heart disease was the most frequent macrovascular complication (n = 11;1.1%). Conclusions: A multidisciplinary dynamic team that adapts to the pandemic SARS-CoV-2 maintains and increases metabolic control in subjects with type 2 diabetes in Mexico. This represents a low percentage of chronic complications. The AUC of metabolic parameters of subjects with SARS-CoV-2 infection is higher, reflecting more variability in metabolic control. [ABSTRACT FROM AUTHOR]

Context: The condition when a person's gender identity does not match the sex assigned at birth is called gender incongruence (GI). Numbers of GI people seeking medical care increased tremendously over the last decade. Diabetes mellitus is a severe and lifelong disease. GI combined with diabetes may potentiate into a burdensome package for affected people. Objective: The study aimed to characterize people with GI and diabetes from an extensive standardized registry, the Prospective Diabetes Follow-up Registry (DPV), and to identify potential metabolic and psychological burdens. Methods: We compared demographic and clinical registry data of persons with type 1 or type 2 diabetes and GI to those without GI and used propensity score matching (1:4) with age, diabetes duration and treatment year as covariates. Results: 75 persons with GI, 49 with type 1 and 26 with type 2 diabetes were identified. HbA1c values were similar in matched persons with type 1 or 2 diabetes and GI compared to those without GI. Lipid profiles showed no difference, neither in type 1 nor in type 2 diabetes. Diastolic blood pressure was higher in the type 1 and GI group than in those without, whereas systolic blood pressure showed comparable results in all groups. Depression and anxiety were significantly higher in GI people (type 1 and 2). Non-suicidal self-injurious behaviour was more common in type 1 and GI, as was suicidality in type 2 with GI. Conclusion: Mental health issues are frequent in people with diabetes and GI and need to be specially addressed in this population. [ABSTRACT FROM AUTHOR]

aime-Casas,3 Aida Jiménez-Corona,2,4 David Rivera-De La Parra,1,2 Enrique Octavio Graue-Hernández,2 Sergio Hernández-Jiménez1 On behalf of the Group of Study CAIPaDi1Centro de Atención Integral del Paciente con Diabetes (CAIPaDi) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 2Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico; 3Escuela de Medicina, Universidad Panamericana, Mexico City, Mexico; 4Dirección General de Epidemiología, Secretaría de Salud, Mexico City, MexicoCorrespondence: Liliana Pérez-Peralta, Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15. Colonia Sección XVI, Tlalpan, Mexico City, 14080, Mexico, Tel +52 55 54870900 (5045), Email [email protected] Purpose: To evaluate the risk factors associated with diabetic macular edema (DME) in patients with a recent type 2 diabetes mellitus (T2DM) diagnosis.Patients and Methods: We conducted a case-control study at a third-level hospital in Mexico City. We enrolled patients ≥ 18 years old, with T2DM less than five years of diagnosis, without disabling complications, and non-smokers. The control group was patients with diabetic retinopathy and without macular edema (DR-DME). Cases were patients with DR+DME. We measured fasting glucose, creatinine, lipid profile, urinary albumin/creatinine ratio (ACR), and HbA1c. An ophthalmological examination consisted of visual acuity measurement, digital three-field fundus photography with an automatic non-mydriatic camera, slit lamp, and Optical coherence tomography (OCT) examination.Results: 183 and 61 patients with DR-DME and DR+DME, respectively, were included in the analysis. The prevalence of mild DR was higher in the DR-DME group, but the frequencies of moderate and severe retinopathy were higher in the DR+DME group. Patients in the DR-DME group had better vision than those in the DR+DME group. Logistic regression analysis revealed that age (OR, 1.07), HbA1c (OR, 1.19), and Albumin-to-Creatinine Ratio (ACR) > 30 mg/g (OR, 3.37) were associated with an increased possibility of DME compared to DR-DME.Conclusion: Our study provides insights into the association between risk factors and DME. We found a statistically strong association between HbA1c levels, age, and ACR. Patients with poor metabolic control should undergo an extensive medical examination to screen for DME, which may be related to the chronicity of DM and renal damage. [ABSTRACT FROM AUTHOR]

Background: Low-density lipoprotein receptor-related protein 1 (LRP1) negatively modulates circulating atrial natriuretic peptide (ANP) levels. Both molecules are involved in the regulation of cardiometabolism. Objectives: To evaluate soluble LRP1 (sLRP1) and ANP levels in people with newly diagnosed type 2 diabetes mellitus (T2DM) and determine the effects of metabolic optimization. Methods: This single-center longitudinal observational study recruited patients with newly diagnosed T2DM (n = 29, HbA1c > 8.5%), and 12 healthy control, age- and sex-matched volunteers. sLRP1 and ANP levels were measured by immunoassays at T2DM onset and at one year after optimization of glycemic control (HbA1c ≤ 6.5%). Results: T2DM had higher sLRP1 levels than the control group (p = 0.014) and lower ANP levels (p =0.002). At 12 months, 23 T2DM patients reached the target of HbA1c ≤ 6.5%. These patients significantly reduced sLRP1 and increased ANP levels. Patients who did not achieve HbA1c < 6.5% failed to normalize sLRP1 and ANP levels. There was an inverse correlation in the changes in sLRP1 and ANP (p = 0.031). The extent of sLRP1 changes over 12 months of metabolic control positively correlated with those of total cholesterol, LDL cholesterol, TG, TG/HDLc, and apolipoprotein B. Conclusions: Newly diagnosed T2DM patients have an increased sLRP1/ANP ratio, and increased sLRP1 and decreased ANP levels are normalized in the T2DM patients that reached an strict glycemic and metabolic control. sLRP1/ANP ratio could be a reliable marker of cardiometabolic function. [ABSTRACT FROM AUTHOR]

Background and Objectives: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease affecting an estimated 537 million individuals worldwide. 'Superfoods' can be integrated into the diet of T2DM patients due to their health benefits. Study Objectives: (i) To carry out a narrative review of 'superfoods' with the potential to reduce glycaemic levels in T2DM patients (2019 to 2022), (ii) to identify 'superfoods' with the potential to reduce HbA1c and (iii) to propose new guidance on the use of 'superfoods'. Materials and Methods: A narrative review was carried out using the databases PubMed, SciELO, DOAJ and Google Scholar. The keywords were ["type 2 diabetes" and ("food" or "diet" or "nutrition") and ("glycaemia" or "glycemia")]. Only review studies were included. Results: Thirty reviews were selected. The 'superfoods' identified as having a potential impact on glycaemic control were foods with polyphenols (e.g., berries), fermented dairy products, whole cereals/grains, nuts and proteins, among others. The possibility of an extensive reduction in Hb1Ac was reported for fermented dairy products, especially yoghurts enriched with vitamin D or probiotics (HbA1c reduction of around 1%) or by increasing the fibre intake by 15 g (or up to 35 g) (HbA1c reduction of around 2%). Conclusion: It is recommended that the identified 'superfoods' are included in the diet of T2DM patients, although this should not substitute an appropriate diet and exercise plan. In particular, yoghurts and an increased fibre intake (by 15 g or up to 35 g) can be used as nutraceuticals. New recommendations on the introduction of 'superfoods' in the diet of T2DM patients have been proposed. [ABSTRACT FROM AUTHOR]

Background: Patients with type 2 diabetes mellitus (T2DM) have risk of cardiovascular complications if blood glucose, blood lipids, and blood pressure (BP) are not optimally controlled. National Metabolic Management Center (MMC) has established a new management model to improve metabolic control. Purpose: This study aimed to assess the level of metabolic control in T2DM patients under MMC and explore the relationship between clinical follow-up frequency and target-reaching rate of HbA1c, LDL-C, and BP. Method: This was a retrospective study. Baseline measurements and follow-up data were collected from September 2017 to November 2019. The subjects were grouped according to the follow-up frequency as <4 times/year, =4 times/year, and >4 times/year. Results: The positive changes in HbA1c and LDL-C were associated with follow-up frequency. After adjusting for confounders, the target-reaching rate of HbA1c for patients with follow-up ≥4 times/year was higher than those with <4 times/year, with odds ratios of 1.518 (=4 times/year) and 1.508 (>4 times/year). Compared to patients with follow-up <4 times/year, the target-reaching rate of LDL-C for patients with follow-up ≥4 times/year was higher, with odds ratios of 1.998 (=4 times/year) and 2.517 (>4 times/year). After 1 year of management, 48.91%, 47.43%, and 56.72% of patients achieved the target goals, respectively. 12.88% patients met all three targets. Conclusion: MMC improves the target-reaching rate of HbA1c, BP, and LDL-C for T2DM patients in China. Compared with follow-up <4 times/year, follow-up 4 times/year has the maximum benefit of metabolic control in patients while >4 times/year was found no additional benefits than 4 times/year. [ABSTRACT FROM AUTHOR]

The study aim was to evaluate the effects of public lockdown during the covid-19 pandemic on glucose and metabolic parameters as well as body weight control in type 2 diabetic patients. This study was conducted in two outpatient Diabetes Clinics and analyzed data available in database of Diabetes Clinic. Data related to a year before covid-19 pandemic and a year during covid-19 pandemic was collected from the database and analyzed. Patients with type 2 diabetes included in the analysis if they had referred to Diabetes Clinics both before and during covid-19 pandemic. Demographic information and data about metabolic status were collected from the records of previous outpatient Clinic visits and compared Finally 9440 patients with mean age of 61.08 ± 11.62 referred to Diabetes Clinics in both the year before and the year of the corona pandemic. Mean FBS and HbA1c in diabetes patients reduced significantly from 155.37 ± 62.93 and 7.97 ± 1.74 before pandemic, respectively to 138.77 ± 45.39 and 7.54 ± 1.34, respectively during covid-19 outbreak. During covid-19 pandemic, all metabolic parameters including glycemic and lipid profile (except for triglyceride) and BMI (body mass index) reduced significantly statistically, but, these changes were not clinically significant. However, triglyceride level increased statistically significantly but again it was not significant clinically. During COVID-19 lockdown, glycemic and metabolic control of diabetes patients have improved significantly except for triglycerides. • During covid-19 lockdown, glycemic control of diabetes patients improved significantly. • During lockdown lipid profile except for triglyceride improved significantly. • During lockdown BMI reduced significantly. • All metabolic improvement were statistically significant but not clinically. • This metabolic improvement indicates improved self-care. [ABSTRACT FROM AUTHOR]

Background: Noncommunicable diseases such as diabetes mellitus (DM) have gained attention worldwide. Latin America experienced a rise in rates of DM. During the COVID-19 pandemic, a telemedicine program was implemented in a quaternary care academic complex in Latin America to continue the follow-up of patients with diabetes. Objective: The aim of this study is to describe the clinical experience of DM patient management through telemedicine and the HbA1c behavior of patients followed-up through this modality. Materials and methods: We conducted a retrospective cohort study including all patients with type 1 or 2 diabetes who were treated via telemedicine from March to December 2020. A Wilcoxon statistical test was used to compare the changes in glycosylated hemoglobin between the first teleconsultation and after 6 months of telemedicine follow-up. Results: A total of 663 patients were included, 17.65% (117) of whom had type 1 diabetes and 82.35% (546) of whom had type 2 diabetes. Patients with both types of diabetes, presented with stable HbA1c values regardless of the length of follow-up. Conclusion: The use of telemedicine can be a helpful tool for both patients and health care providers to support the continuity of care to maintain acceptable control levels within glycemic control goals. [ABSTRACT FROM AUTHOR]

Aims: This study was carried out to investigate fear levels, treatment compliance, and metabolic control of type II Diabetes Mellitus patients during the COVID-19 pandemic.Methods: The study employed a single-center, observational design and was conducted between January and April 2021. The study consisted of 303 patients who attended the internal medicine outpatient clinic of a university hospital in Turkey. For data collection, the Patient Identification Form, COVID-19 Fear Scale, and the Type II Diabetes Treatment Compliance Scale were used. The study complied with the Helsinki Declaration criteria. IBM SPSS v25.0 statistics package program was used for data analysis.Results: The mean age of the patients was 45.8 ± 7.5 years, the mean duration of illness was 8.2 ± 3.6 years. Moreover, 40.6% of patients presented with poor levels of treatment compliance. In addition, the mean FCV-19S score of the patients was 29.1 ± 3.05. It was noticeable that those with high mean scores of FCV-19S had poor compliance with treatment and metabolic control during the pandemic (p < 0.05).Practice Implications: Fear of COVID-19 negatively affects treatment compliance and metabolic control of type II diabetes patients. The patients avoided attending their regular follow-ups at the hospital due to fear of contracting COVID-19. In order to reduce the fear of COVID-19 it is paramount to maintain optimum metabolic control and treatment compliance. [ABSTRACT FROM AUTHOR]

Aims: Diabetes mellitus (DM) is a common chronic disease with serious individual and socioeconomic consequences. Low health literacy (HL) has been associated with higher morbimortality. Health knowledge about DM (HK-DM) may also influence individual health. We aimed to assess HL and HK-DM in patients with type 2 DM and their associations with metabolic control. Methods: Our sample comprised 194 diabetic patients from a primary care health centre. We collected clinical and demographic data and applied two validated questionnaires, the Newest Vital Sign (NST) and Diabetes Knowledge Test (DKT), to assess HL and HK-DM, respectively. Metabolic control was defined as HbA1c < 7.0%. Participants were classified according to the NST as having "high likelihood of limited HL" (HLL-HL), "possibility of limited HL" (PL-HL), or "adequate HL" (A-HL) and by the DKT as having "low", "average" and "good" HK. Statistical analysis included logistic regression models, using p < 0.05 as a cut-off for statistical significance. Results: Overall, 72.7 and 34.7% of participants had HLL-HL and low HK-DM, respectively. A-HL (OR = 6.02; 95% CI: 1.691–21.450) and PL-HL (OR = 4.78; 95% CI: 1.350–16.899) were significantly associated with better metabolic control than HLL-HL. We did not find a significant association between HK-DM and metabolic control. Conclusions: HL seems to be associated with better metabolic control. We also found a high prevalence of illiteracy and scarce knowledge about DM. Primary care physicians should promote HL to help patients achieve better metabolic control. [ABSTRACT FROM AUTHOR]

Abstract Background Health beliefs are relevant to consider in patients with type 2 diabetes since disease control depends mainly on the patient’s behaviour. The aim of this study was to assess the association between health beliefs and glycated hemoglobin levels in Mexican patients with type 2 diabetes. Methods An analytical cross-sectional study was conducted, and 336 patients were included. Fasting blood levels of glycated hemoglobin, glucose, cholesterol; triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Body fat percentage, weight, height; waist circumference, and systolic and diastolic blood pressures were also obtained. A previously validated self-administered questionnaire was used to assess the health beliefs with regards to non-pharmacological treatment. Health beliefs were classified as positive, neutral, and negative. Results The average age of patients was 54.7 ± 8.5 years, with a higher proportion of females (69%). The questionnaire had a good internal consistency with a Cronbach’s alpha score of 0.83. More than 90% of patients attributed a health benefit to diet and exercise, 30 to 40% experienced barriers, and more than 80% had a perception of complications associated to uncontrolled diabetes. Patients with positive health beliefs had lower HbA1c levels (8.2 ± 1.7%) compared to those with neutral (9.0 ± 2.3%), or negative (8.8 ± 1.8%; p = 0.042). The LDL-c levels were lower (p = 0.03), and HDL-c levels were higher (0.002) in patients with positive heath beliefs. Conclusions Positive health beliefs are associated with better metabolic control indicators in patients with type 2 diabetes.

Objectives To achieve normoglycaemia and maintain correct parameters of disease compensation, as well as analysis of the impact of social support on the values of metabolic control parameters of type 2 diabetes. Material and methods The study involved 79 patients with type 2 diabetes staying in a diabetology clinic. To collect the research material, the Social Support Scale (S4-MAD) and the results of patient measurements and tests were used, such as blood pressure, weight, height, and laboratory test results: glycated haemoglobin, full lipidogram (triglycerides, total cholesterol, LDL and HDL). Results Patients received the most support in the field of nutrition (S = 46.9/100 points), the least in the field of foot care (S = 25.3/100 points). With the increase in social support in 4 sub-scales of the MAD-4 scale, a decrease in diastolic blood pressure was demonstrated. Greater support in the area of self-control resulted in lowering the total cholesterol value, in the area of cigarette smoking, in lowering systolic and diastolic pressure. Conclusions Patients who receiving higher social support have better metabolic control results. Due to the low level of social support for patients with diabetes, healthcare professionals should include family members in education and care whenever possible to provide more support to patients and pay more attention to non-clinical factors in addressing diabetes-related problems. They should also remember that interventions based on psychosocial approaches may not necessarily improve the metabolic control assessed by the values of clinical indicators, but they can affect the quality of life of patients.

Introduction: Objective: the aim of this study was to identify dietary patterns in a sample of patients with type-2 diabetes, and to evaluate their association with markers of metabolic control. Methods: a cross-sectional study in 395 patients with type-2 diabetes in primary care was conducted. Fasting blood levels of glycated hemoglobin (A1c), glucose, total cholesterol, low- (LDL-c) and high-density lipoprotein cholesterol (HDL-c), and triglycerides were measured. Waist circumference, body mass index (BMI), and blood pressure were evaluated. Dietary intake was assessed by a food frequency questionnaire, and dietary patterns were derived by cluster analysis. Three dietary patterns were identified: 'fruits and vegetables', 'dairy and sweetened beverages', and 'diverse with alcohol'. Results: an association between the 'dairy and sweetened beverages' dietary pattern and A1c levels was identified (ß = 0.61; 95 % CI: 0.09, 1.12, p = 0.021), considering the 'fruits and vegetables' dietary pattern as the reference group. We also observed a trend towards an adjusted increased risk of A1c ≥ 7 % (odds ratio [OR]: 1.56; 95 % CI: 0.92, 2.64; p = 0.099) and an increased risk of BMI ≥ 25 kg/m2 (OR: 2.62, 95 % CI: 1.20, 5.71, p = 0.015) among patients in the 'dairy and sweetened beverages' dietary pattern as compared to the reference group. Conclusions: a dietary pattern characterized by a high intake of full-fat dairy and sweetened beverages was associated with higher A1c levels and increased risk of high glucose and BMI when compared to a dietary pattern with a higher consumption of fruits and vegetables. [ABSTRACT FROM AUTHOR]

Introduction: the more frequent diabetes's micro vascular complications involve mainly to the retina and the kidney. A narrow relationship has been recognized between diabetic retinopathy and micro albuminuria. Objective: to determine the behavior of the micro albuminuria in patient with diabetes type 2 and diabetic retinopathy. Methods: an observational, descriptive, cross-sectional study in patients with diabetes type 2 and diabetic retinopathy at the Arnaldo Milián Castro Hospital in the period between 2018 and 2019. Results: the women bigger than 60 years old were more affected with diabetic retinopathy (43, 2%). The proliferative retinopathy diabetic predominated (47, 7%) in patients with more than 10 years of evolution. The 38, 6% of patients had high micro albuminuria. The 32, 4% of patients with high micro albuminuria had a proliferative diabetic retinopathy and bad metabolic control. The number of patient with proliferative diabetic retinopathy, arterial hypertension associate and high micro albuminuria was smaller than we hoped to find. Conclusions: a little more than a 1/3 of the patients with diabetes and some grade of severity of diabetic retinopathy present high micro albuminuria. More than half of the patients with high micro albuminuria have a bad metabolic control, of these the majority with proliferative diabetic retinopathy. The number of patient with proliferative diabetic retinopathy, arterial hypertension associate and high micro albuminuria was smaller than we hoped to find in this series. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic led to an international health crisis and restrictions. While the phenotype associated with COVID-19 severity in people with diabetes has rapidly been explored, the impact of restrictive measures, including lockdown, and tertiary care disruption on metabolic control and access to healthcare remained unknown. The aim of our study was to provide a comprehensive assessment on the overall management of diabetes during lockdown, including glucose control, weight changes, health care consumption and use of alternative forms of care such as telemedicine services, in a large sample of patients with type 1 (T1DM) or type 2 diabetes mellitus (T2DM). Methods: A prioritization of a care self-administered questionnaire was sent at the end of the first COVID-19 lockdown to all patients with diabetes routinely followed by diabetologists from the University Hospital of Nancy (France). This observational cross-sectional single-center study focused on data from patients with diabetes who returned the questionnaire along with medical records. The primary outcome was the change in HbA1c levels between the 6 months preceding and the 6 weeks following the lockdown. Data are expressed as numbers (%) or medians (quartiles). This study is registered with ClinicalTrials.gov (NCT04485351). Results: We analyzed data from 870 patients with diabetes: 549 T2DM (63.1%), 520 males (59.8%), age 65.0 (57.0, 72.0), body mass index 28.6 (25.1, 32.9) and diabetes duration 20.0 (10.0, 30.0) years. HbA1c levels pre- and post-lockdown were respectively 7.7% (7.1, 8.4) and 7.4% (6.8, 8.2), translating into a significant reduction of − 0.1% (− 0.6, 0.15) (p < 0.0001). Stratified analyses suggested a consistent significant reduction of HbA1c independently of diabetes type. HbA1c reduction was significantly different according to weight changes: − 0.3% (− 0.8, 0.0), − 0.1% (− 0.5, 0.1) and − 0.1% (− 0.5, 0.3) for patients who lost, had stable or gained weight, respectively (p = 0.0029). Respectively, 423 (49.4%) and 790 (92.3%) patients did not consult their general practitioner and diabetologist. Blood tests were undergone by 379 (44.8%) patients, 673 (78.3%) did refill their prescriptions, and 269 (32.1%) used teleconsultation services. Conclusions: Despite the implementation of a lockdown and disruption in healthcare, no deterioration, rather an improvement, in metabolic control was observed in a large sample of patients with T1DM and T2DM. [ABSTRACT FROM AUTHOR]

Aims Self-compassion is a modifiable characteristic, linked with psychological well being and intrinsic motivation to engage in positive health behaviours. We aimed to explore levels of self-compassion in individuals with type 2 diabetes (T2DM) and their association with levels of depression, diabetes-related distress and glycaemic control. Methods A cross-sectional study in 176 patients with T2DM in Leicester, UK, using three self-report questionnaires: the Self Compassion Scale (SCS); Patient Health Questionnaire (PHQ-9), and Diabetes Distress Scale (DDS-17). Demographic data, medical history and blood samples were collected. Results Majority of participants were male (n=120, 68.2%), with median [IQR] age and HbA1c of 66 [60, 71] years and 7.3 [6.7, 8.0] %, respectively. Multivariable analysis adjusting for age, gender, ethnicity and diabetes duration revealed significant association of all three scores with HbA1c : per one standard deviation increase of each score, a -0.16% reduction in HbA1c for SCS (p=0.027), 0.21% increase for PHQ-9 (p=0.012) and 0.33% increase for DDS-17 (p<0.001). Conclusions Higher levels of self-compassion and lower levels of depressive symptoms were associated with significantly better long-term diabetes control. These results reinforce the importance of emphasis on psychological parameters, including self-compassion, in the multi-disciplinary management of T2DM. We identify this as a potential area for intervention in UK practice. [ABSTRACT FROM AUTHOR]

Aim: This study used a randomized controlled trial design and was carried out to examine the effect of education on diabetes self-management and self-efficacy in patients with type 2 diabetes.Methods: The study was carried out between July 2016-March 2017. Data were collected using information form, Diabetes Self-Management Questionnaire (DSMQ), self-efficacy scale for patients with type 2 diabetes (DSS).The individuals in the experimental group were given education. Both groups were reminded about the control time of their metabolic values on the phone in the 3rd and 6th months.Results: The average age of the individuals was 59.91 ± 8.93 (n = 78), 62.8% (n = 49) were female, 92.3% (n = 72), were married, 42.3% (n = 33) were high school graduates and their diabetes duration was 7.05 ± 3.9. There was a statistically significant difference in the 6th month metabolic values in the experimental group compared to the control group. When diabetes self-management and self-efficacy were examined, a statistically significant difference was found in the experimental group compared to the control group at 3rd and 6th months (p < 0.05, p < 0.01).Conclusion: In this study, a significant increase in diabetes self-management and self-efficacy and a significant decrease in metabolic values were observed as a result of education and phone reminders given to individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aims/hypothesis: The strict rules applied in Italy during the recent COVID-19 pandemic, with the prohibition to attend any regular outdoor activity, are likely to influence the degree of metabolic control in patients with type 2 diabetes. We explored such putative effect immediately after the resolution of lockdown rules, in the absence of any variation of pharmacologic treatment. Methods: One-hundred and fourteen patients with adequate metabolic control took part in this single-centre, prospective, observational study. The metabolic profile tested 1 week after the end of the lockdown was compared with the last value and the mean of the last three determinations performed before the pandemic emergency (from 6 months to 2 years before). Results: After 8 weeks of lockdown, an increase of HbA1c > 0.3% (mean +0.7%) was observed in 26% of the participants; these were also characterized by a persistent elevation in serum triglycerides able to predict the worsening of glucose control. Conclusions: Lockdown determined a relevant short-term metabolic worsening in approximately one-fourth of previously well-controlled type 2 diabetic individuals; pre-lockdown triglycerides were the only parameter able to predict such derangement of glucose control. [ABSTRACT FROM AUTHOR]

This study aims to determine the effects of transtheoretical model-based walking exercise training and follow-up on improving exercise behavior and metabolic control in patients with type 2 diabetes. This randomized controlled trial was conducted as a pre-test and post-test experimental model with 76 intervention and 76 control individuals. The intervention group received the transtheoretical model-based exercise training. Data were collected using patient identification form, transtheoretical model scales, pedometer and metabolic outcomes. Data were analyzed by Chi square, two-way ANOVA, Mauchly's, Greenhouse-Geisser, Friedman, and McNamer test. The overall score means for the exercise change processes, decision-making balance and self-efficacy scales increased compared to the pre-test (p <.001). The mean HDL increased from 41.39 ± 10.35 to 49.18 ± 11.58, and average number of steps per day increased from 3264.31 ± 1933.03 to 5639.37 ± 2317.01. Consequently, this difference between the groups was significant (p <.05). [ABSTRACT FROM AUTHOR]

Background and Objective: Educating patients plays an important role in improving their quality of life. The collaborative care model is a new method of self-care training. This study was conducted to evaluate the effect of collaborative care model on the quality of life and metabolic control indexes in patients with type 2 diabetes. Materials and Methods: In this semi-experimental study, 60 patients with type 2 diabetes visiting diabetes clinic of Jiroft Hospital were studied. The participants were selected based on the convenience sampling method. To implement the collaborative model that included four stages of motivation, preparation, engagement, and evaluation, the patients were divided into four groups, and the model was executed for three months for each group. Data collection tools included a researcher-made questionnaire including demographic characteristics, metabolic indexes and vital signs and the quality of life questionnaire for patients with diabetes. The collected data were analyzed using Wilcoxon, Mac-Nemar and paired t-test in SPSS, version 20. Results: After performing the collaborative care model, the total mean quality of life increased from 50.7±5.7 to 68.3 ±5.2. The results of Wilcoxon test showed a significant difference in care and metabolic indexes (P

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Introduction. Diet compliance is an essential part of the treatment and control of diabetes. The present study aimed to determine the effectiveness of education and face to face diet counseling on metabolic control parameters of patients with type 2 diabetes in primary health care centers. Material and methods. This quasi-experimental study was conducted on 90 T2DM patients who referred to Andimeshk community health centers in 2018. Patients were randomly divided into two intervention (n = 45) and control (n = 45) groups. Data were analyzed by independent t-test, paired t-test and Chi-square using SPSS-18 software. Results. Sixteen weeks after the implementation of the nutrition education and counseling program, there was a significant decrease in the clinical, anthropometric, and biochemical parameters of the intervention group (P < 0.001). However, none of the parameters were significantly decreased in the control group (P > 0.05). Conclusion. The research findings show that the implementation of group education program, along with individual nutrition counseling, is very effective and can lead to weight loss, improved blood pressure and better control of blood glucose and lipids in T2DM patients. Therefore, the combination of education and counseling as two complementary methods in the treatment and control of diseases such as diabetes seems essential and effective. [ABSTRACT FROM AUTHOR]

Background: The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients.Methods: The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson's linear correlation coefficient (r, parametric method), was used for hypothesis verification.Results: Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control.Conclusions: Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Summary: Resistance training (RT) is a powerful first‐line intervention for the management of type 2 diabetes mellitus (T2DM). Nonetheless, the effects of the most frequent RT (hypertrophy training [HT] and muscular endurance training [MERT]) employed for the management of T2DM, and which type of RT might exert superior effects, remain elusive. Thus, this review aims to assess the effects of HT and MERT on glycaemic control, physical fitness, body composition, lipid profile, blood pressure, C‐reactive protein, and quality of life in patients with T2DM; to analyse which particular RT is more effective; to assess the effects of general RT; and to identify RT components, characteristics of patients, and medications that could mediate the effects of RT. Randomized controlled trials (RCT) and non‐RCT (RT≥ 4 weeks) in adults with T2DM were selected. Both HT and MERT improved HbA1c, insulin levels and sensitivity, muscle strength, body mass index, waist circumference, and fat mass. Additionally, HT improved glucose, cardiorespiratory fitness, fat percentage, lean body mass, lipid profile, systolic blood pressure, and C‐reactive protein, and MERT improved weight. Overall, HT and MERT exert beneficial effects well comparable with aerobic training. Both types of RT can be used as potent therapeutic interventions for the management of T2DM depending on patients' limitations/preferences. [ABSTRACT FROM AUTHOR]

Background: Health beliefs are relevant to consider in patients with type 2 diabetes since disease control depends mainly on the patient's behaviour. The aim of this study was to assess the association between health beliefs and glycated hemoglobin levels in Mexican patients with type 2 diabetes.Methods: An analytical cross-sectional study was conducted, and 336 patients were included. Fasting blood levels of glycated hemoglobin, glucose, cholesterol; triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Body fat percentage, weight, height; waist circumference, and systolic and diastolic blood pressures were also obtained. A previously validated self-administered questionnaire was used to assess the health beliefs with regards to non-pharmacological treatment. Health beliefs were classified as positive, neutral, and negative.Results: The average age of patients was 54.7 ± 8.5 years, with a higher proportion of females (69%). The questionnaire had a good internal consistency with a Cronbach's alpha score of 0.83. More than 90% of patients attributed a health benefit to diet and exercise, 30 to 40% experienced barriers, and more than 80% had a perception of complications associated to uncontrolled diabetes. Patients with positive health beliefs had lower HbA1c levels (8.2 ± 1.7%) compared to those with neutral (9.0 ± 2.3%), or negative (8.8 ± 1.8%; p = 0.042). The LDL-c levels were lower (p = 0.03), and HDL-c levels were higher (0.002) in patients with positive heath beliefs.Conclusions: Positive health beliefs are associated with better metabolic control indicators in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry. Methods Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4. Results Patients with diabetes and acromegaly (n=52) or Cushing's disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes). Conclusion Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed. [ABSTRACT FROM AUTHOR]

Introduction: Changes in lifestyle can significantly affect the management of good glycemic control and target values of blood pressure and lipids. Objective: To determine the achievement of target values of glycated hemoglobin (HbA1c), blood pressure and lipids, in participants with type 2 diabetes, who used a proper diet and controlled physical activity. Method: The study was a prospective study, conducted on participants with type 2 diabetes, from 01 October 2012 until 31 October 2013, at the Primary Health Center Banja Luka, by 60 family medicine teams. At the beginning of the study, all participants had individual counseling on lifestyle changes, eating habits, and regulation of body weight. Results: The study included 591 participants with the type 2 diabetes. At the beginning of the study, 49.92% of participants adhered to the proper diet, and at the end 76.65% of them (p

Abstract Aims Intensification of type 2 diabetes (T2DM) treatment with GLP‐1 receptor agonists (GLP‐1RAs) promotes weight loss. We aimed to determine the synergistic effect of behavioural programmes on body weight on top of GLP‐1RA treatment. Materials and methods We retrospectively analysed the time course of 328 individuals with T2DM starting GLP‐1RA treatment because of insufficient metabolic control. In 29, a structured programme of elementary nutritional counselling was also implemented (elementary nutritional education [ENE]‐5 group sessions), whereas 53 entered a programme of cognitive‐behavioural treatment (CBT‐12 group sessions). Both programmes were completed within 6 months of switching to GLP‐1RAs. Data of body weight and metabolic control were followed up to 2 years as part of regular follow‐up. Weight loss targets (≥10% and ≥5%) and metabolic target (HbA1c

Objective The aim of this observational study was to analyse snacking pattern and satisfaction with snacking, and to associate snacking patterns with metabolic control and quality of life in people with diabetes type 1 and 2 on insulin therapy. Methods In 2017, 390 people with diabetes were interviewed in a university outpatient department: 132 diabetes type 1 (56.1y, diabetes duration 24.2y, HbA1c 7.0%), 89 diabetes type 2/biphasic insulin (72.8y, diabetes duration 22.0y, HbA1c 7.1%) and 169 diabetes type 2/prandial insulin (66.7y, diabetes duration 20.5y, HbA1c 7.0%). Standardised questionnaires were used to assess eating patterns, satisfaction with snacking, treatment satisfaction and quality of life. Results The far majority snacked regardless of diabetes type and type of insulin therapy (70.5% type 1, 80.9% type 2/biphasic insulin, 74.6% type 2/prandial insulin) and liked to do so or did not mind (type 1 diabetes 79.5%, type 2 diabetes/biphasic insulin 84.8%, type 2 diabetes/prandial insulin 83.5%). Snacking because of recommendations of healthcare professionals was rare (10.8% type 1 diabetes, 8.2% type 2 diabetes/biphasic insulin, 9.4% type 2 diabetes/prandial insulin). Snacking and not snacking participants did not differ in respect to HbA1c, quality of life or treatment satisfaction. Conclusions Snacking seems to be a common habit in individuals with diabetes and most of them like to snack. Snacking is not associated with better or worse metabolic control or quality of life. The decision to snack or not to snack can be left to the individual and integrated into the therapy without danger for the glycaemic control. [ABSTRACT FROM AUTHOR]

The results of two large multicentric, observational and cross-sectional studies (the DIAINFORM study and BALI study) reflecting routine clinical practice for insulin treatment in type 2 diabetes mellitus in the Czech Republic were published recently. In this commentary, we analyze these results and compare them with the findings of similar studies conducted in other countries within the last decade. The analysis focuses on achievement of glycated hemoglobin goals, insulin dosage and frequency of hypoglycemia. [ABSTRACT FROM AUTHOR]

Objective: To identify the epidemiological characteristics in patients of the diabetes club of the Hospital Básico de Paute, Ecuador. Materials and methods: This was a descriptive and crosssectional study in patients with diabetes mellitus type 2 of the Hospital Básico de Paute diabetes club, during the period January to August 2018, a questionnaire validated by 2 experts in diabetes mellitus was used, the following data was recorded: age, sex, ethnicity, educational status, occupation, used drugs and anthropometric data. Results: Out of the 80 patients evaluated, 73.8% (n=59) were female, with a predominance of subjects >70 years (41.3%, n=33), with only primary education (62.5%; n=50), and housewives (67.5%; n=54), the majority were obese (56.3%; n=45) with a predominance of weight disorders in women (overweight: 35.6% and obesity: 32.5%). 50% of the patients received combined pharmacological therapy, being metformin the most used antidiabetic drug (92.5%), followed by sulfonylureas (35%); while ACE inhibitors were the most antihypertensive used with 33.8%. Conclusion: Patients from the Hospital Básico de Paute diabetes club are predominantly women, older adults, with a low educational level and whose prevalence of obesity and overweight is very high; most of them receive antidiabetic pharmacotherapy, with metformin as the main drug used. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic control is a collection of tests and studies related to diabetes performed on a daily basis for 2 to 3 months. Self-efficacy means the belief of an individual in him/herself to successfully perform a particular behavior and expect the associated results. The present study aimed to investigate the relationship between metabolic control and selfefficacy in diabetic patients in Qom, Iran. Materials and Methods: This cross-sectional study was conducted on a total 325 patients with type II diabetes who referred to Diabetic Community in Qom through simple random sampling. Demographic information and standard self-efficacy in diabetic management questionnaires were used in this study. Fasting blood sugar (FBS) and hemoglobin A1c (HbA1c) data sheet was used based on the last 3-month test results. Finally, the data were analyzed by SPSS software (version 20) using descriptive indices and analytical tests. Results: The obtained results of this study showed that there was a significant reverse correlation between the mean score of self-efficacy with the mean scores of FBS and HbA1c. There was also a significant difference in self-efficacy scores in terms of gender (P<0.05). According to the results, self-efficacy showed predictive power of FBS and HbA1C reported as 22% and 18%, respectively. Conclusion: The obtained results of this study showed that self-efficacy was at a moderate level among the patients. The levels of FBS and HbA1c did not indicate the optimal control of diabetes. It should be noted that there was a significant reverse correlation between self-efficacy with FBS and HbA1c, indicating that FBS and HbA1c levels decrease with the increase of self-efficacy score. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of a comprehensive care program to achieve and maintain goals in patients with type 2 diabetes.Methods: The CAIPaDi program includes 9 interventions delivered in 7 h. It seeks to achieve metabolic goals, identify and resolve barriers that would make implementation difficult, and provide self-efficacy and empowerment to patients by identifying personal profiles to establish individualized strategies. The program consists of a 4 intervention visits (1, 2, 3, and 4 months) and two follow up visits (12 and 24 months). Outcomes are compared between every visit. Main outcome was the attainment of the USA National Committee for Quality Assurance treatment goals.Results: 1104 patients completed the first 4 visits, 545 the 12 month evaluation, and 218 the 24 month evaluation. After the conclusion of the four monthly sessions, 80.6% had HbA1c <7%, 72.1% had BP <130/80 mmHg and 71.6% had LDL- cholesterol <100 mg/dl. After twelve months, the percentage of goals achieved were 65.9%, 67.7% and 43.3% respectively (p < 0.001). For the 2-year evaluation the percentages were 61.0%, 70.6%, and 40.8% respectively (p < 0.001). All patients had renal, eye, foot and dental evaluations. Empowerment and quality of life showed significant changes; anxiety and depression scores remained low at annual follow-ups.Conclusions: The CAIPaDI program results in sustained improvement and maintenance of treatment goals. [ABSTRACT FROM AUTHOR]

Background: Our hypothesis was that a modified diet would improve blood glucose control with beneficial impact on weight management and overall health in established diabetes. Objective: This prospective interventional study investigated the clinical effect of an Okinawan-based Nordic diet on anthropometry, metabolic control, and health-related quality of life (HRQoL) in Scandinavian type 2 diabetes patients. Design: Food was prepared and delivered to 30 type 2 diabetes patients. Clinical information along with data on HRQoL, blood samples, and urine samples were collected during 12 weeks of diet interventions, with follow-up 16 weeks after diet completion. Results: After 12 weeks of dietary intervention, a reduction in body weight (7%) (p

Aim: To compare metabolic control and complications in people with type 2 diabetes in Nauru and the Solomon Islands before and after a project intervention. Methods: This follow-up study compared metabolic control and complications in a cohort of 216 people with diabetes (81 from Nauru and 135 from the Solomon Islands) at baseline and 15 months following a project intervention (upgrading and equipping the existing diabetes centres, and providing training and clinical support systems) aimed at improving the quality of clinical diabetes care. Subjects were screened using a standardised protocol which gathered information on demographics, treatment, physical and biochemical parameters and their outcomes. Results: At follow-up, glycaemic control had improved and mean HbA1c had decreased in study participants in both Nauru (mean difference (MD) = −0.9 ± 2.3%) and the Solomon Islands (MD = −0.6 ± 1.4%), P

Background and objective: The incidence of diabetes co-morbidities could probably be better assessed by studying its associations with major corpulence parameters and glycaemic control indicators. We assessed the utility of body mass index (BMI), waist circumference (WC), and glycosylated haemoglobin (HbA1c) levels in metabolic control for type 2 diabetic patients. Methods: Fasting and postprandial blood samples were collected from 238 type 2 diabetic patients aged 57.4±11.9 years. The sera were analysed for glucose, HbA1c, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and apolipoproteins (apoA-I and apoB). Ratios of lipids and apolipoproteins were calculated and their associations with BMI, WC, and HbA1c levels were analysed. Results: Our investigation showed increases in most fasting and postprandial lipid parameters according to BMI and WC. In men, postprandial HDL-c and TG levels were significantly higher (p

Background: Hypomagnesemia could worsen glycemic control by impairing insulin release and promoting insulin resistance. On the contrary, type 2 diabetes mellitus (T2DM) may induce and/or exacerbate low serum magnesium levels, and this could, in turn, worsen glycemic control of diabetes.Objective: The aim of this study was to investigate the relationship between serum magnesium level, dietary magnesium intake, and metabolic control parameters in patients with T2DM.Methods: The study included 119 patients with T2DM (26 male, 93 female; mean age 54.7 ± 8.4 years). Serum magnesium level was measured by spectrophotometric method. Magnesium intake was assessed by food frequency questionnaire. Anthropometric measurements were taken. The General Linear Model procedure was applied to determine the relationship of serum magnesium with quantitative variables.Results: Of the 119 patients, 23.5% of the patients had inadequate magnesium intake (lower than 67% of the recommended daily allowance), and 18.5% had hypomagnesemia. In patients with hypomagnesemia (< 0.75 mmol/l), serum levels of fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and serum glycosylated hemoglobin (HbA1c) were higher compared to patients with normomagnesemia. FPG levels were significantly higher in patients with hypomagnesemia in Model 1 (179.0 ± 64.9 vs. 148.7 ± 52.0 mg/dl, p = 0.009) but the significance disappeared in other models. PPG levels were significantly higher in patients with hypomagnesemia in all models (287.9 ± 108.4 vs. 226.8 ± 89.4 mg/dl, p = 0.006 for Model 1, p = 0.027 for Model 2, p = 0.016 for Model 3). Serum HbA1c levels were significantly higher in patients with hypomagnesemia, and this significance proceeded (8.0 ± 1.9% vs. 6.5 ± 1.2%, p = 0.000 for all models). Body fat mass was significantly higher in patients with hypomagnesemia as compared to patients with normomagnesemia in model 3 (35.4 ± 9.4 kg, 34.6 ± 10.2 kg; p = 0.034). Dietary magnesium intake was not significantly associated with either metabolic parameters or anthropometric measurements.Conclusion: Hypomagnesemia in T2DM is directly associated with poor metabolic control. Clinical assessment should, therefore, focus on augmentation of magnesium status and adequate magnesium intake in patients with T2DM. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to determine the level of metabolic control in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients in the Czech and Slovak Republics.Methods: A non-interventional prospective (observational) study was conducted from January 2015 until April 2016 in routine clinical practice settings at 141 centers in the Czech and Slovak Republics. Data were analyzed from a total of 425 patients with T1DM and 1034 patients with T2DM, proportionally corresponding to the number of patients in both countries. The primary objective of the study was to determine the percentage of patients with HbA1c < 7% (53 mmol/mol).Results: Patients with T1DM: In this group of patients (55.8% males, mean age 45.9 ± 14.83 years, BMI 25.8 ± 4.21 kg/m², diabetes duration 12.1 ± 9.44 years), 29.9% reached HbA1c levels < 53 mmol/mol. Patients with T2DM: In this group of patients (50.3% male, mean age 63.9 ± 9.65 years, BMI 31.0 ± 5.19 kg/m², diabetes duration 12.4 ± 7.47 years, duration of insulin therapy 5.8 ± 4.71 years), 33.4% reached HbA1c levels < 53 mmol/mol.Conclusion: The overall percentage of patients with HbA1c < 53 mmol/mol in the T1DM group was 29.9% and in the T2DM group was 33.4%. Despite an increasing number of treatment options, most patients still fail to reach the recommended HbA1c targets.Funding: Sanofi, Czech Republic. [ABSTRACT FROM AUTHOR]

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Aims: To compare type 2 diabetes (T2D) patients included in a Diabetes Integrated Management (DIM) program with those followed in Diabetes Specialized Care (DSC), investigating differences in general characteristics, changes in clinical outcomes, and factors related with the inclusion in the DIM program.Methods: T2D patients living in the ASLTO3 district and included into the DIM program, a shared disease management between general practitioners and diabetes specialists, from 2008 to 2014 were compared with T2D patients living in the same district and in charge of the local DSC. Demographic, anthropometric and clinical data for both groups of patients were obtained from the electronic records of DSC.Results: 1326 DIM patients were compared with 3494 DSC patients. A higher proportion of females was observed among DIM patients than among DSC patients. DIM patients were older, more frequently in therapy with diet only or with oral hypoglycemic, and had HbA1c and creatinine lower than DSC patients. The analyses of changes in clinical parameters during the study period showed a good and statistically significant improvement of most parameters, independently of the inclusion in DIM or DSC, with the exception of creatinine level.Conclusions: Integrated Management is an efficient and effective way to achieve good long-term clinical outcomes for patients with diabetes. [ABSTRACT FROM AUTHOR]

Background: An Okinawa-based Nordic diet with moderately low carbohydrate content and high fat and protein content has been shown to improve anthropometry and metabolism in type 2 diabetes. Objective: The objectives of this study were to measure plasma or serum levels of hormones regulating energy metabolism and metabolic control, that is, cholecystokinin (CCK), Cortisol, C-peptide, ghrelin, glucagon, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), insulin, leptin, plasminogen activator inhibitor-1 (PAI-1), polypeptide YY (PYY), resistin, and visfatin after this diet intervention, and to determine partial correlations between hormonal levels and anthropometric and metabolic responses. Design: A total of 30 patients (17 women) with type 2 diabetes, mean age 57.5 ± 8.2 years, and body mass index (BMI) 29.9 ± 4.1 kg/m2 were served the diet for 12 weeks. Fasting hormones were measured by Luminex and enzyme--linked immunosorbent assay (ELISA) before study start and after 12 and 28 weeks, along with anthropometric and metabolic parameters. Result: The levels of CCK (P = 0.005), cortisol (P = 0.015), C-peptide (P = 0.022), glucagon (P = 0.003), GLP-1 (P = 0.013), GIP (P < 0.001), insulin (P = 0.004), leptin (P < 0.001), and PYY (P < 0.001) were lowered after dietary intervention. These reduced levels only remained for PYY at week 28 (P = 0.002), when also ghrelin (P = 0.012) and visfatin (P = 0.021) levels were reduced. Changes of glucose values correlated with changed levels of C-peptide and PYY (P < 0.001), insulin (P = 0.002), and PAI-1 (P = 0.009); changes of triglyceride values with changed levels of C-peptide, insulin, and PYY (P < 0.001) and PAI-1 (P = 0.005); changes of insulin resistance with changes of leptin levels (P = 0.003); and changes of BMI values with changed levels of C-peptide, insulin, and leptin (P < 0.001). Conclusions: Okinawa-based Nordic diet in type 2 diabetes has significant impact on the endocrine profile, which correlates with anthropometric and metabolic improvements. [ABSTRACT FROM AUTHOR]

Objective: The study has been conducted to determine the relation between anger level, manners of expressing anger and the metabolic control variables in type 2 diabetes. Methods: This descriptive and cross-sectional study was conducted in 177 patients with type 2 diabetes presenting at the endocrinology and metabolic diseases clinic of of Cumhuriyet University Health Services Application and Research Hospital in Turkey between February and June 2017. Data is acquired through Patient Identification Form and Constant Anger and Manner of Expressing Anger Scale. Results: The mean duration of disease among individuals was 12.41 ± 10.56 years and 57.1% had another chronic disease. 46.4% of the individuals developed diabetic complications; average rate of total cholesterol is above the limit, fasting glucose level, HbA1C, triglyceride and LDL cholesterol levels are above the target value. The constant anger and anger control of the individuals are at medium level while intrinsic anger and extrinsic anger levels are below the average. It is determined that there is a significant low degree positive relation between individuals' constant anger and intrinsic anger score averages, and the disease period, HbA1C, LDL cholesterol and HDL cholesterol levels (p<0.05). Conclusion: In this study, it was determined that type 2 diabetic individuals obtain a medium-level anger; the more the anger levels rise, the more HbA1C and LDL cholesterol rates increase. Therefore health professionals can support individuals risky in sense of constant anger and anger control. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of a multimedia education program and nutrition therapy on metabolic control in patients with type 2 diabetes. Research question: What is the effect of a multimedia education program and nutritional therapy on metabolic control in type 2 diabetes? Patients and methods: A randomized clinical trial was conducted in 351 patients randomly assigned to either an experimental group receiving a multimedia diabetes education program (MDE) and nutrition therapy (NT) (NT + MDE: n = 173), or to a control group who received nutrition therapy only (NT: n = 178). At baseline, 7, 14, and 21 months, the glycated hemoglobin (HbA1c), glucose, cholesterol, triglycerides, LDL-cholesterol, and HDL-cholesterol were measured. Weight, body mass index (BMI), waist circumference (WC), fat percentage, fat and lean mass, systolic blood pressure (SBP), and diastolic (DBP) were also recorded. Results: Glycated hemoglobin decreased in both groups, although the group with NT + MDE had a greater reduction, with a difference of −0.76% (95%CI −1.33 to −0.19) at 7 months and −0.73% (95%CI −1.37 to −0.09) at 21 months. Only in the NT + MDE did the glucose decrease at 7 (−41.2 mg/dL; 95%CI −52.0 to −30.5), 14 (−27.8 mg/dL; 95%CI −32.6 to −23.1), and 21 months (−36.6 mg/dL; 95%CI −46.6 to −26.6). Triglycerides and the atherogenic index decreased in both groups at 7 and 14 months; while only in the NT + MDE group did it decrease at 21 months. ( p < 0.05). Weight decreased at 21 months in the NT + MDE group (−1.23, −2.29 at −0.16; p < 0.05). Conclusion: Nutrition therapy and a multimedia diabetes education program have a favorable impact on achieving metabolic control goals in type 2 diabetes. [ABSTRACT FROM AUTHOR]