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Authors:Trisha Sarkar; Debmalya Sanyal, Amalesh Samanta, Sujoy Ghosh Abstract: Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of oral antidiabetic agents that increase endogenous levels of incretin hormones and lead to an increased insulin level and a reduced glucagon level in a glucose-dependent way. Gemigliptin, is a potent, selective, competitive, and long-acting DPP-4 inhibitor. The objective of our study was to evaluate the realworld efficacy and safety of gemigliptin. Materials and methods: A real-world prospective, observational, single-center study conducted in the Endocrinology Department, of a tertiary care hospital. 60 patients were included with 22 (36.7%) female patients. The treatment options consisted of uncontrolled metformin monotherapy, dual combination therapy, triple oral anti-hyperglycemic agents, metformin, and basal insulin combination. Weight, body mass index (BMI), fasting plasma glucose (FPG), 2 hours post postprandial glucose (PPG), HbA1c% were documented at baseline and followed up at 3 months. Results: The baseline HbA1c, FPG and PPG were 9.50 ± 2.24 %, 176.71 ± 67.076 mg/dL, 243.37 ± 93.97 mg/dl respectively. After 3 months of additional gemigliptin therapy, HbA1c, FPG, and PPG were significantly reduced to 8.24 ± 1.83%, 144.32 ± 50.664, 184.93 ± 69.66 respectively. Conclusions: In real world settings, gemigliptin, a new DPP-4 inhibitor was found to be effective, safe and well tolerated as add-on therapy in adult type 2 diabetes mellitus (T2DM) subjects. PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Edward Mahoney; Stanislav Glezer, Leah Baccari, Jason Lebowitz, Wen Yue, David Klonoff Abstract: Background: Studies of mobile diabetes applications (apps) have demonstrated improvements in glycemia, and patient-reported outcomes (PROs). In addition, shift to shorter pen needles (PN) and guidance on proper injection techniques have shown the potential for reduced glycemic variability. The purpose is to determine the impact of using a diabetes mobile app plus a novel 4 mm PN on PROs and glycemic outcomes in type 2 diabetes mellitus (T2DM) for multiple daily injection (MDI) insulin users. Materials and methods: In this 8-week prospective, parallel- group, randomized controlled trial, subjects either received (1:1) intervention (BD Diabetes Care [DC] App + BD Nano TM 2nd Gen PN) or control therapy. Controls used their current PN and did not use diabetes apps. Results: Fifty-eight subjects were randomized. Fiftyseven completed the study (intervention n = 27, control n = 30). At study end, there were no significant differences in PROs between groups, except improved medication adherence (ARMS-D) in controls. From flash glucose monitoring (fGM) data, there were no significant differences in most glycemic measures between groups except for a trend for improved glycemic variability [mean amplitude of the glycemic excursions (MAGE)] in the Intervention (p = 0.06). Controls had significantly reduced time spent in hypoglycemia but had 2 to 3-fold higher incidence at baseline. In general, Intervention subjects reported satisfaction with both the app and PN. Conclusions: This is the first BD DC App study, in combination with BD Nano TM 2nd Gen PN, to assess glycemic outcomes. This combination intervention shows promising results for reduced glycemic variability and the potential to positively impact self-management. PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Abdel-Hameed Ibrahim Mohamed Ebid; Yasmine Magdy Fahim Genina, Abdul-Majeed Abdulfattah Al-Jendy, Amira Mohamed El-Sawy Abstract: Background: The purpose of this study was to compare the efficacy and safety of high-dose atorvastatin (40 mg) versus high-dose rosuvastatin (20 mg) in Egyptian patients with type 2 diabetes and previous acute coronary syndrome history. Materials and methods: This open-labeled prospective, randomized clinical trial compared once daily atorvastatin 40 mg (Ator®) versus once daily rosuvastatin 20 mg (Crestor®). The primary outcome was the 50% reduction in low-density lipoprotein cholesterol levels at 12 weeks. The secondary outcome was the achievement of low-density lipoprotein cholesterol level < 55 mg/dL. Results: A total number of 108 patients had a significant percentage of improvement in atorvastatin arm (n = 59) and rosuvastatin arm (n = 49) in low-density lipoprotein cholesterol, total cholesterol, triglycerides, and high-density lipoprotein-cholesterol achieved (p ≤ 0.05). In atorvastatin arm, 32.2% of patients achieved fifty percent reduction in low-density lipoprotein cholesterol while 34.7% of patients in rosuvastatin arm (p > 0.05). Twenty percent of patients achieved low-density lipoprotein cholesterol < 55 mg/dL in atorvastatin group compared to eighteen percent only in rosuvastatin group (p > 0.05). Regarding safety, the mean difference in liver transaminases was non-significant between the two groups (p > 0.05). Muscular symptoms were experienced by 1.7% patients receiving atorvastatin 40 mg and 10.2% of those receiving rosuvastatin 20 mg (p > 0.05). Conclusions: In Egyptian context, both high doses statin therapy were comparable regarding efficacy and safety in patients with type 2 diabetes and previous history of acute coronary syndrome. The Clinicaltrial.gov registration ID is: NCT05306990. PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Fateme Mohammadi; Banafsheh Tehranineshat, Mojtaba Farjam, Soheila Rahnavard, Mostafa Bijani Abstract: Background: The present study aims to investigate the correlation between resilience, self-efficacy, and illness perception in patients with type 2 diabetes mellitus in the south of Iran. Materials and methods: The present study is a crosssectional work conducted on 405 patients with type 2 diabetes mellitus who were selected via convenience sampling from clinics in the south of Iran, from December 2019 to July 2020. Data were collected using a questionnaire consisting of four sections: a demographics survey, the Connor-Davidson Resilience Scale (CD-RISC), Lev’s Self-efficacy Scale, and Broadbent’s Brief Illness Perception Questionnaire (BIPQ). Data analysis was performed in SPSS 22 software using descriptive statistics, Pearson correlation, ANOVA, and multiple regression analysis at a p < 0.05 significance level. Results: The results of the study showed that there were significant positive correlations between the participants’ resilience and self-efficacy (r = 0.78, p < 0.001), resilience and illness perception (r = 0.57, p < 0.001), and self-efficacy and illness perception (r = 0.76, p < 0.001). Conclusions: The findings of the present study show that there is a positive correlation between resilience and self-efficacy and illness perception in patients with type 2 diabetes mellitus. patients with diabetes who can successfully cope with the traumatic conditions caused by their illness and have confidence in their ability to perform self-care activities have a more positive view of the manageability of their condition. Therefore, healthcare policymakers and nurses can use interventions designed to enhance resilience and self-efficacy in order to improve diabetic patients’ illness perception and management. PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Verónica Vázquez-Velázquez; José J. Pizarro, Sofia Sánchez Román, Valeria Soto Fuentes, Denise Arcila-Martínez, Hector Velazquez-Jurado Abstract: Introduction: Obesity and type 2 diabetes mellitus are two chronic diseases most associated with hospitalizations and deaths from COVID-19. Background: This study compared psychological impact of COVID-19 lockdown in people with obesity, people with type 2 diabetes (T2D) and people without diseases, and determined the factors associated with well-being. Materials and methods: An online survey on negative affect, attitudes, social support and sharing, coping, well-being, and eating behavior was conducted in 157 people with obesity, 92 with type 2 diabetes and 288 without diseases. Results: People with obesity were the most worried of getting infected (70%) or dying (64%) and had the highest levels of emotional eating. People with T2D showed better coping strategies and higher well-being. Negative affect, worries about COVID-19 consequences and uncontrolled eating had negative impact, but social support, social sharing, and coping contributed positively (p < 0.001) to well-being. A 48.7% of people with obesity experienced more difficulties to adhere to treatment compared to only 11.1% of people with T2D. Conclusions: People with obesity had less well-being and more COVID-19 worries and emotional eating than people with T2D and without diseases. Well-being depends on negative affect, worries and eating behavior. Future research about the impact in long-term on weight and health status in patients with chronic diseases is needed. PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Fateme Abshenas; Gholamhosein Yaghoobi, Ali Moradi, Hassan Mehrad-Majd, Mohammad Ali Yaghoubi, Amirhossein Sahebkar PubDate: Thu, 30 Jun 2022 00:00:00 +020
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Authors:Omid Khosravizadeh; Bahman Ahadinezhad, Aisa Maleki, Ailar Hashtroodi, Ali Moqadam, Hamideh Kamali Abstract: Background: The medication belief and appropriate and on-time medication usage are crucial determinants of diabetes control. The present systematic review has been conducted to examine the status of the medication beliefs of patients with type 2 diabetes based on a meta-analysis. Materials and methods: This study is a systematic review based on a meta-analysis conducted in 2021. Keywords “Medication belief”, “BMQ (Belief in Medication Questionnaire)”, “patients with type 2 diabetes”, “diabetes mellitus” were searched in Google Scholar, PubMed, Scopus, Web of Science, Science direct, Magiran, SID, and Irandoc database from 2010 to 2021. The pooled score of medication belief and its dimensions were estimated through a random-effects meta-analysis using STATA 15. Also, heterogeneity across the articles was determined with the I2 statistic. Results: Out of 584 articles, 8 studies were selected and analyzed. Based on estimates obtained from the random effects method, the pooled score of medication belief was obtained at 2.877 (95% CI: 2.22–3.53). Also, the pooled scores of specific necessity, specific concern, general harm and general overuse were calculated at 3.60 (95% CI: 2.92–4.06), 3.02 (95% CI: 2.19–3.85), 2.26 (95% CI: 1.50–3.02) and 2.54 (95% CI: 1.96–3.12) respectively. Conclusions: Health policymakers and economists need to take steps to increase the health literacy of patients with type 2 diabetes and improve the medication belief dimensions to reduce the disease costs to provide a better quality of life for patients with type 2 diabetes. Various programs are underway in developed countries. Public education about the side effects of diabetes drugs, narcotics, and drug dependence reduces patients’ worries and anxieties, which in turn reduces their anxious thoughts and brings relief to patients. PubDate: Mon, 20 Jun 2022 11:56:51 +020
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Authors:Ivana Beatrice Paulus; Jourdan Wirasugianto, Ni Luh Putu Putri Sanjiwani, I Gede Putu Supadmanaba, I Made Siswadi Semadi, Ketut Suastika Abstract: Introduction: Hyperglycemic crisis caused by an increase of insulin requirement and one of the predisposing factors are cardiovascular disease; this condition can induce an increasing cytokine which also acts as a coronary heart disease marker. The latest study remains unclear about the association with cardiovascular outcomes. This study aimed to investigate the association between hyperglycemic crisis and major adverse cardiovascular events (MACEs). Materials and methods: This study is an analytical study with cohort retrospective design conducted at Sanglah General Hospital from February until April 2019. The data was taken using the total sampling method; 126 samples were collected from the medical record with 43 samples hyperglycemic crisis as a case group and non-hyperglycemic crisis as a control group with 83 samples according to inclusion and exclusion criteria — the analysis using univariate and bivariate survival analysis. The primary outcome was the risk ratio. Results: The median age in this study was 45.69 years old (SD 2.53) for the case group and control 55.73 ± 1.21 years old. The gender ratio between males and females in both groups is 1:1–2; the mean of HbA1c in the case group is higher than the control group, 12.06 ± 3.06 vs. 7.9 (5.1–14.8) %. Relative risk analysis between hyperglycemic crisis and MACE is obtained RR 5.576 with 95% CI: 2.87–10.8 and p-value = 0.000 with potential confounding variable are not associated. Conclusions: There is a significant association between hyperglycemic crisis and MACE statistically. PubDate: Tue, 31 May 2022 13:39:55 +020
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Authors:Sudhir Tripathi; Sushil Jindal, Manoj Chawla, Arvind Gupta, Sujeet Jha, Uday Phadke, Tejal Lathia Abstract: Introduction: In recent times, traditional self-monitoring of blood glucose (SMBG) using fingerstick capillary samples is moving to continuous glucose monitoring (CGM) due to inherent limitations of the traditional methods. CGM displays current glucose level, trends, rate of change, time-in-range (TIR), and glucose variability (GV) over a period of several days. It detects episodes of hyperglycemia and hypoglycemia, which allows immediate response to prevent these episodes. It also allows physicians to provide a personalized glycemic response to the patients. Materials and methods: Though CGM systems have been available for more than 20 years, their use is quite low. It is challenging for clinicians to invest time in learning and understanding the diverse reports of the various CGM devices. Moreover, there is a lack of consensus on the frequency of TIR measurement. Hence. a review of the literature was performed and existing guidelines from India and abroad were reviewed for a need for CGM and its frequency of measurements in DM patients. Results: TIR is inversely correlated to the risk of microvascular and macrovascular complications. CGM is recommended by expert clinician consensus and national and international medical organizations. For the patients use of CGMs involves cost. Besides, there is the discomfort and inconvenience of wearing the device. Hence, defining the implications of using CGM in practice is important. According to the 2020 recommendations by the Research Society for the Study of Diabetes in India (RSSDI) — Endocrine Society of India (ESI) and the 2019 recommendations by an expert group of endocrinologists and diabetologists, in the Indian context, CGM could be suggested for patients with Type 2 Diabetes who encounter severe hyperglycemia or hypoglycemia, repeated hypoglycemia, asymptomatic hypoglycemia, nocturnal hypoglycemia, refractory hyperglycemia, or large blood glucose excursions. Conclusions: The role of CGM to achieve better glycemic control and prevention of complications in T1D and T2D is well established. Significant education and awareness on CGM needs to be provided to physicians as well as patients with high GV and those on insulin therapy. PubDate: Mon, 30 May 2022 14:46:59 +020
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Authors:Khadijeh Moulaei; Farhad Fatehi, Kambiz Bahaadinbeigy Abstract: Diabetic foot is the most common side-effect and the most financially expensive complication of diabetes, which increases the fatality risk of diabetic patients by two to four times. Without proper medical attention, this condition can lead to a plethora of complications, including scarring, infection, gangrene, amputation, and even death. Therefore, this study was performed with the purpose of designing and presenting the Minimum Data Set (MDS) required to introduce effective indicators in the better management, control, and monitoring of diabetic foot. First, we conducted a comprehensive review of different databases to identify the MDS. The necessary managerial and clinical data were extracted from the studies and then formulated using a questionnaire. In the second stage, the questionnaire was distributed to 15 specialists of fields of endocrinology, physical medicine, infectious diseases, and surgery, and three general practitioners and medical informatician experts during two rounds of the Delphi technique. Out of 105 proposed data elements of managerial and clinical data in 14 groups, 90 data elements were ultimately confirmed with consensus and collective agreement according to the opinion of experts, while 12 data elements were mentioned in the open question section of the questionnaire. The aforementioned MDS can assist policymakers, software developers, and health data managers in recognizing the type of information that should be in the system when starting to design different systems and/or software programs for patients diagnosed with diabetes. This system should be able to meet the needs of these patients, enable the standardization of medical services in hospitals, clinics, and health centers, and provide grounds for data collection. PubDate: Thu, 30 Dec 2021 16:58:45 +010
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