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Conclusions There is an association between depression and poor glycemic control among type 2 diabetes patients. Salivary function and glycemic control in older persons with diabetes.

There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study’s purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population.

Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated age range, years. Diabetic status was determined by a glycosylated hemoglobin HbA 1c test and a 2-hour glucose tolerance test. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire.

There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.

Managing type 2 diabetes: going beyond glycemic control. Although rarely associated with hypoglycemia, TZDs may cause total body weight gain that is most commonly caused by volume expansion, which may manifest as new or worsened heart failure in susceptible individuals. Pioglitazone and rosiglitazone, the 2 TZDs available in the United States, contain black box label warnings about their potential to cause or exacerbate congestive heart failure; additional data have suggested a link to ischemic cardiac events.

Recent data also suggest that TZDs may reduce bone density. Conversely, pioglitazone may have some vasculoprotective effect related to elevation of high-density lipoprotein and lessened progression of carotid intima-media thickness; however, any effect on macrovascular clinical outcomes is unknown.

Other drug options are available for the treatment of type 2 diabetes, such as incretin-based therapies. Yet despite their favorable effects on glycemia, they have not been included to date in the ADA treatment algorithm. Proper glycemic control and attainment of other nonglycemic management targets e. Therefore, patients with diabetes should be followed closely to ensure that they achieve and maintain both glycemic and nonglycemic treatment goals. Most patients will not sustain an adequate level of control using nondrug or single-drug therapeutic approaches.

When choosing among treatment options, consideration should be given to the nonglycemic as well as glycemic effects of various glucose-lowering agents.

Glycemic control and type 1 diabetes: the differential impact of model of care and income. To examine the effect of model of care specialist care vs. A total of children and young people with type 1 diabetes, aged yr, and their families, were recruited independent of their source of care as part of a longitudinal, cross-sectional exploratory study. At enrollment, participants completed a series of questionnaires and underwent a structured interview to gather data regarding the type of specialist and healthcare services attended, as well as demographic, healthcare, and self-care information.

Capillary sample was taken for HbA1c determination. The mean HbA1c for the group as a whole was 8. There was no effect for model of care on glycemic control. Although no differences were found with respect to the short-term impact of specialist vs. Further research is also indicated to determine the relationship between glycemic control and socioeconomic status.

Indicators of glycemic control in patients with gestational diabetes mellitus and pregnant women with diabetes mellitus. Recently, it has become clear that mild abnormal glucose tolerance increases the incidence of perinatal maternal-infant complications, and so the definition and diagnostic criteria of gestational diabetes mellitus GDM have been changed.

Therefore, in patients with GDM and pregnant women with diabetes mellitus, even stricter glycemic control than before is required to reduce the incidence of perinatal maternal-infant complications. Strict glycemic control cannot be attained without an indicator of glycemic control ; this review proposes a reliable indicator.

The gold standard indicator of glycemic control in patients with diabetes mellitus is hemoglobin A1c HbA1c ; however, we have demonstrated that HbA1c does not reflect glycemic control accurately during pregnancy because of iron deficiency.

It has also become clear that glycated albumin, another indicator of glycemic control , is not influenced by iron deficiency and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus.

However, large-population epidemiological studies are necessary in order to confirm our proposal. Here, we outline the most recent findings about the indicators of glycemic control during pregnancy including fructosamine and 1,5-anhydroglucitol. Impact of improving postprandial glycemic control with intensifying insulin therapy in type 2 diabetes.

Worldwide, many people with type 2 diabetes are not at recommended glycemic targets and remain at increased risk of microvascular and macrovascular complications. Reaching recommended glycemic targets requires normalizing both fasting and postprandial glucose PPG. For some patients, this will require addition of a prandial insulin delivered by injection to control PPG excursions. Evidence from epidemiological studies suggests an association between postprandial hyperglycemia and cardiovascular disease, and thus, expert guidelines recommend that treatment for elevated PPG not be delayed.

Indeed, studies have demonstrated that PPG makes the greatest contribution to HbA 1c in patients who are approaching, but have not yet reached HbA 1c glycemic control. Continuous subcutaneous insulin infusion CSII represents another option for intensifying therapy and improving postprandial control in some patients, and studies have shown that the benefits are sustainable long-term.

However, it is currently unclear which patients stand to benefit the most from the extra expense and complexity of a CSII regimen, and further studies are needed. Objective Although active diabetes self-management is required to achieve glycemic control , adherence is poor among ethnic minorities, especially Latinos.

Research shows that individuals who report greater social-environmental support resources for disease management manage their diabetes more effectively than those with fewer support resources. Methods Path analysis was conducted to investigate the value of a multiple-mediator model in explaining how support resources for disease management influence hemoglobin A1c HbA1c levels in a sample of Latinos with type 2 diabetes recruited from low-income serving community clinics in San Diego County.

Conclusions These findings demonstrate the important connection that support resources for disease management can have with diabetes self-management, emotional well-being, and glycemic control among Latinos. Thus, programs targeting diabetes self-management and glycemic control in this population should consider culturally-relevant, multi-level influences on health outcomes. Type 2 diabetes is a progressive disease associated with high levels of morbidity and mortality and for which there is both a large and growing prevalence worldwide.

Lifestyle advice plus metformin is commonly recommended initially to manage hyperglycemia and to minimize the risk of vascular complications. However, additional agents are required when glycemic targets cannot be achieved or maintained due to the progressive nature of the disease. This FDC is a rational second-line therapy given the complementary mechanisms of action of the components. Repaglinide is a rapidly absorbed, short-acting insulin secretagogue targeting postprandial glucose excursions; metformin is an insulin sensitizer with a longer duration of action that principally regulates basal glucose levels.

To highlight recent findings from studies of sleep in type 1 diabetes T1D , with a focus on the role of sleep in self-management, the cognitive and psychosocial outcomes related to sleep disturbances, and factors associated with sleep disturbances specific to T1D. People with T1D experience higher rates of sleep disturbances than people without diabetes, and these disturbances have negative implications for glycemic control and diabetes management, as well as psychosocial and cognitive outcomes.

Inconsistent sleep timing bedtime and wake time has emerged as a potential target for interventions, as variability in sleep timing has been linked with poorer glycemic control and adherence to treatment.

Sleep-promoting interventions and new diabetes technology have the potential to improve sleep in people with T1D. Sleep is increasingly considered a critical factor in diabetes management, but more multi-method and longitudinal research is needed. We emphasize the importance of sufficient and consistent sleep for people with T1D, and the need for providers to routinely assess sleep among patients with T1D.

Validation of theoretical pathway between discrimination, diabetes self-care and glycemic control. This study examined the mechanisms through which discrimination influences diabetes self-care and glycemic control in patients with diabetes by using structured equation modeling.

Measures were based on a theoretical model and included perceived discrimination, social support, social cohesion, and perceived stress. Structured equation modeling examined the relationship with diabetes self-care and glycemic control.

Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications. Background Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus T2DM patients with renal complications.

To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established. Purpose This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease CKD. Patients and methods This retrospective, cross-sectional study involved T2DM inpatients and outpatients with renal complications from January to March and was conducted in a tertiary teaching hospital in Malaysia.

Results Majority of the patients presented with CKD stage 4 Approximately Insulin Of all antidiabetic regimens, sulfonylureas monotherapy P glycemic control. Conclusion Identification of factors that are associated with glycemic control is important to help in optimization of glucose control in T2DM patients with renal complication. ASHP therapeutic position statement on strict glycemic control in patients with diabetes.

The deleterious effects of hyperglycemia have been documented from the biochemical to the pathophysiologic level. Given the research findings and the guidelines for glycemic control established by ADA and ACE, ASHP supports and encourages strict glycemic control in all appropriate patients with diabetes mellitus to reduce the progression of chronic complications. Identifying barriers to glycemic control in patients with type 2 diabetes after completion of an accredited education program.

The objective of this study was to identify patient-perceived barriers to achieving A1C targets after receiving instruction in an accredited diabetes education program.

Qualitative research using semistructured interviews and thematic analyses. One pharmacist-run diabetes center located within an independent community pharmacy in a suburban region of southern Indiana. A total of 17 participants between the ages of were interviewed in March and April Not applicable. Patient-perceived barriers to attaining glycemic control after completion of a pharmacist-taught diabetes self-management education DSME program accredited by the American Association of Diabetes Educators.

Participants reported a variety of perceived barriers to glycemic control subsequent to the receipt of structured education. Seven major themes emerged: 1 health care provider factors; 2 self-identified indiscretions; 3 psychological barriers and poor social support; 4 knowledge deficits; 5 personal injury or adverse drug events; 6 time constraints and competing life demands; and 7 financial constraints. Incorporation of solutions and coping mechanisms to these barriers into diabetes education programs may help patients attain glycemic control.

Other factors may require individualized attention outside of DSME in follow-up episodes of diabetes care. Association between glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with cardiovascular complications. To date, glycemic control profiles of antidiabetic drugs in cardiovascular CV complications have not been clearly elucidated. Therefore, this study was conducted retrospectively to assess the association of antidiabetic drugs and glycemic control with CV profiles in T2DM patients.

The association of concurrent medications and comorbidities with glycemic control was also investigated. Methods A total of T2DM patients from the University of Malaya Medical Centre, Malaysia, who had at least one CV complication and who had been taking at least one antidiabetic drug for at least 3 months, were included.

The associations of antidiabetics, cardiovascular diseases, laboratory parameters, concurrent medications, comorbidities, demographics, and clinical characteristics with glycemic control were investigated. Cushing’s syndrome in type 2 diabetes patients with poor glycemic control. Cushing’s syndrome may be more frequent in some specific patient groups such as type 2 diabetes and obesity.

The aim of this study was to investigate the prevalence of Cushing’s syndrome in outpatients with type 2 diabetes with poor glycemic control despite at least 3-months insulin therapy. Patients with classic features of Cushing’s syndrome were excluded.

Overnight 1 mg dexamethasone suppression test DST was performed as a screening test. Two of the patients with type 2 diabetes were diagnosed with Cushing’s syndrome 0. Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes: Systematic review.

To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. PubMed and Scopus were searched for relevant studies published since using the following key words: diabetes type 1, glycemic control , family stress, family conflict, and family function.

In total, papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement.

In most studies family stress was negatively correlated with patients’ glycemic control. Family function was strongly related to patients’ glycemic control , while family conflict was adversely associated with glycemic control.

Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control. Utility of different glycemic control metrics for optimizing management of diabetes.

The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin HbA1c. Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment.

On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control.

In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications.

Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management.

This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize. Retrospective review of postoperative glycemic control in patients after distal pancreatectomy. Distal pancreatectomy DP is carried out for resection of lesions in the body and tail of the pancreas. DP may lead to both insulin and glucagon deficiency, which may worsen diabetes mellitus and render patients more vulnerable to severe hypoglycemia.

Maintaining glycemic control can be challenging after DP, and no guidelines have been established for clinicians. The objective of this study was to investigate postoperative glycemic control and insulin dose among patients after DP. The medical records from 82 eligible adult patients after DP between and were reviewed retrospectively.

Twenty-one The average length of stay was 5. Of blood glucose BG values, only 0. Postoperatively, insulin was the most common agent prescribed for glycemic control. Among those who received insulin, On postoperative day 1 through 6 and on the day before hospital discharge, glycemic control. At discharge, Only 2 patients without pre-existing diabetes required medications. Postoperative BG levels were relatively well controlled.

The majority of BG levels were in the optimal range, and the incidence of hypoglycemia or clinically significant hypoglycemia was minimal with our current regimen. Postoperative patients required small TDD of insulin for glycemic control. Our data suggested that 0. Our findings provide guidance for. To investigate the effect on glycemic control of improving diabetic gastroparesis, we evaluated symptoms scored , gastric motor functions solid and liquid gastric emptying studies and electrogastrography , and glycemic control in 11 patients with diabetic gastroparesis 5 men, 6 women, None of the patients had organic abnormalities on gastrointestinal endoscopy.

The dysmotility symptom score maximum: 18 on cisapride significantly improved from There were no significant changes in glycemic control after treatment with cisapride. We conclude that long-term administration of cisapride reduced dysmotility symptoms and improved solid and liquid gastric emptying without adversely affecting glycemic control.

OBJECTIVE To determine whether food insecurity—the inability to reliably afford safe and nutritious food—is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes.

We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control. Food-insecure participants were more likely to report difficulty affording a diabetic diet 64 vs. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management.

Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting. Food insecurity and glycemic control among low-income patients with type 2 diabetes. To determine whether food insecurity–the inability to reliably afford safe and nutritious food–is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes.

We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of patients with diabetes in safety net health clinics. Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. Pathways from emotional adjustment to glycemic control in youths with diabetes in Hong Kong.

To examine factors that influence emotional adjustment, adherence to diabetic care, and glycemic control in Hong Kong youths with insulin-dependent diabetes mellitus IDDM. Seventy youths, their mothers, and matched controls provided information on health beliefs, authoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen.

Glycosylated hemoglobin levels were obtained to measure glycemic control. The data supported a pathway from emotional adjustment to self-efficacy to adherence behaviors to glycemic control.

In contrast to Western culture and consistent with prediction, parenting style did not associate with negative outcomes, and even relatively low levels of parent-child conflict correlated negatively with emotional adjustment in this culture. Management of conflict and self-efficacy enhancing interactions are suggested interventions to enhance adherence to diabetic care in Hong Kong youths with IDDM. Similarly, natural Ad36 infection is cross-sectionally associated with greater adiposity and better glycemic control in humans.

This study compared longitudinal observations in indices of adiposity BMI and body fat percentage and glycemic control fasting glucose and insulin in Adinfected versus uninfected adults. In addition to age and sex, indices of glycemic control were adjusted for baseline BMI and were analyzed only for nondiabetic subjects. Longitudinally, seropositive subjects showed greater adiposity indices but lower fasting insulin levels.

Statistically, the differences between seropositive and seronegative individuals were modest in light of the multiple tests performed. Panoptically, the study raises the possibility that certain infections may modulate obesity or diabetes risk. A comprehensive understanding of these under-recognized factors is needed to effectively combat such metabolic disorders. The use of an autocorrecting blood glucose monitoring system for intensive insulin therapy may improve glycemic control in severely burned children.

Patient perception of understanding health education and instructions has moderating effect on glycemic control.

Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial.

We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus DM in the outpatient clinic of the metabolism department were recruited into this pilot study.

The clinical background information was collected through electronic medical records. A questionnaire derived from part of the Mandarin Health Literacy Scale was used to measure numeracy and functional health literacy of people with diabetes. Health literacy levels were categorized into inadequate, marginal and adequate. Patient self-ratings of their perceived understanding of the health education information and instructions provided by their case manager in the past were categorized into two subgroups: better and poor.

Multivariate logistic regression was used to find associated factors of health literacy and understanding of health education and instructions. Results Higher educational attainment and higher household income odds ratios were 2. Higher educational attainment and patients with a family history of DM odds ratios were 4.

Adequate health literacy is not the only factor associated with good glycemic control. The effect of adequate health literacy in achieving good glycemic control might be masked by patients with better understanding.

Treatment of early diabetes mellitus, the most common cause of chronic kidney disease CKD , may prevent or slow the progression of diabetic nephropathy and lower mortality and the incidence of cardiovascular disease in the general diabetic population and in patients with early stages of CKD.

It is unclear whether glycemic control in patients with advanced CKD, including those with end-stage renal disease ESRD who undergo maintenance dialysis treatment is beneficial. Further difficulties in ESRD are posed by the complicated pharmacokinetics of antidiabetic medications and the serious flaws in our available diagnostic tools used for monitoring long-term glycemic control.

We review the physiology and pathophysiology of glucose homeostasis in advanced CKD and ESRD, the available antidiabetic medications and their specifics related to kidney function, and the diagnostic tools used to monitor the severity of hyperglycemia and the therapeutic effects of available treatments, along with their deficiencies in ESRD. We also review the concept of burnt-out diabetes and summarize the findings of studies that examined outcomes related to glycemic control in diabetic ESRD patients, and emphasize areas in need of further research.

Interaction of sleep quality and sleep duration on glycemic control in patients with type 2 diabetes mellitus. Copious evidence from epidemiological and laboratory studies has revealed that sleep status is associated with glucose intolerance, insulin resistance, thus increasing the risk of developing type 2 diabetes. The aim of this study was to reveal the interaction of sleep quality and sleep quantity on glycemic control in patients with type 2 diabetes mellitus.

From May to May , a total of type 2 diabetes patients in Tianjin Metabolic Diseases Hospital were enrolled. Blood samples were taken to measure glycosylated hemoglobin HbA1c , and all the patients completed the Chinese version of the Pittsburgh Sleep Quality Index PSQI questionnaire to evaluate their sleep status.

The sleep duration’s OR was 0. One-way analysis of variance showed that the poor sleep quality group had the highest homeostasis model assessment-insulin resistance P glycemic control in type 2 diabetes.

Poor sleep might bring much more serious insulin resistance and could be the reason for bad glycemic control. A good night’s sleep should be seen as a critical. Taking a low glycemic index multi-nutrient supplement as breakfast improves glycemic control in patients with type 2 diabetes mellitus: a randomized controlled trial. Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index GI multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus T2DM.

A total of 71 participants were randomized at a ratio into either a breakfast replacement group or a normal breakfast group for a week interventional study. The primary outcome measure was change in hemoglobin A1c HbA1c. Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a The baseline Mini Nutritional Assessment score for both groups was These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.

The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes. Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients.

We collected sleep timing and h dietary recall from non-shift-working type 2 diabetes patients who were being followed in outpatient clinics. Mid-sleep time on free days MSF was used as an indicator of chronotype.

Hierarchical linear regression analyses controlling for demographic, sleep, and dietary variables were computed to determine whether breakfast skipping was associated with HbA1C.

Additional regression analyses were performed to test if this association was mediated by chronotype. There were 22 participants The relationship between breakfast skipping and HbA1C was partially mediated by chronotype. In summary, breakfast skipping is associated with a later chronotype.

Later chronotype and breakfast skipping both contribute to poorer glycemic control , as indicated by higher HbA1C levels. Future studies are needed to confirm these findings and determine whether behavioral interventions targeting breakfast eating or sleep timing may improve glycemic control in patients with type 2 diabetes. Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study.

The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. A total of type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity.

Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Subjects were on average The mean hemoglobin A1c of the subjects was 7. Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Materials and Methods: A total of type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Results: Subjects were on average Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

To identify the association of socioeconomic, demographic, nutritional and of physical activity factors in the glycemic control of adolescents with T1DM. Sectional study of 71 adolescents with type 1 diabetes.

Socioeconomic, demographic and anthropometric data were obtained. The glycemic control was classified by the index of glycated hemoglobin A1C.

Four hours recalls of food consumption and physical activity were applied. The A1C was inadequate for the majority of the adolescents. The low educational level of the caregivers influenced the inadequate glycemic control. Patients with lower insulin dose presented better glycemic control.

The food consumption was high of fat and poor of carbohydrate. Most of the patients were sedentary. Factors related to education, insulin and food consumption influenced the glycemic control. Association of good glycemic control and cost of diabetes care: Experience from a tertiary care hospital in Bangladesh. The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus T2DM.

Glycated hemoglobin A1c level glycemic control. All treatment-related records from the last year were collected from patients’ guide books and all cost components were calculated.

Good glycemic control can lead to substantial cost saving through prevention and control of complications. Characteristics associated with glycemic control among family medicine patients with type 2 diabetes. As new payment models are developed for chronic diseases such as diabetes, there is a need to understand which patient characteristics impact glycemic control.

This study examines the relationship between patient variables and glycemic control , defined as a hemoglobin A1c A1c level of glycemic control.

Other variables, such as annual income, education level, and receipt of diabetes education, that were expected to impact glycemic control were not significantly associated with an A1c level of glycemic control. Further evaluation is needed to identify determinants that lead to achievement of optimal glycemic control among individuals with type 2 diabetes. How is the weather? Forecasting inpatient glycemic control. Aim: Apply methods of damped trend analysis to forecast inpatient glycemic control.

Method: Observed and calculated point-of-care blood glucose data trends were determined over 62 weeks. Mean absolute percent error was used to calculate differences between observed and forecasted values. Comparisons were drawn between model results and linear regression forecasting. Results: The forecasted mean glucose trends observed during the first 24 and 48 weeks of projections compared favorably to the results provided by linear regression forecasting.

However, in some scenarios, the damped trend method changed inferences compared with linear regression. Conclusion: Results indicate that forecasting methods historically applied within demand industries can project future inpatient glycemic control. Additional study is needed to determine if forecasting is useful in the analyses of other glucometric parameters and, if so, how to apply the techniques to quality improvement.

Physical inactivity, excess energy consumption, and obesity are associated with elevated systemic oxidative stress and the sustained activation of redox-sensitive stress-activated protein kinase SAPK and mitogen-activated protein kinase signaling pathways. Sustained SAPK activation leads to aberrant insulin signaling, impaired glycemic control , and the development and progression of cardiometabolic disease.

Paradoxically, acute exercise transiently increases oxidative stress and SAPK signaling, yet postexercise glycemic control and skeletal muscle function are enhanced. Furthermore, regular exercise leads to the upregulation of antioxidant defense, which likely assists in the mitigation of chronic oxidative stress-associated disease. In this review, we explore the complex spatiotemporal interplay between exercise, oxidative stress, and glycemic control , and highlight exercise-induced reactive oxygen species and redox-sensitive protein signaling as important regulators of glucose homeostasis.

Prevalence of poor glycemic and blood pressure control and pattern of drug use among primary health-care outpatients in Al Ahsa Saudi Arabia. Objectives: To assess drug use pattern and the effect on glycemic and blood pressure BP control in type 2 diabetes mellitus T2DM and hypertensive patients.

Furthermore, to evaluate the duration of drug use and antecedence in diagnosis. During the interview, their fasting blood glucose, weight, and height were measured, along with their BP.

Time and duration of drug use were recorded. The history, sociodemographic data and the presence of any other disease conditions were also documented. Results: The highest number of uncontrolled BP and poor glycemic control was among the age group of 45 and 49 years.

Significant number of the patients The prevalence of developing hypertension before T2DM among participants was Drug use pattern revealed single or combinations according to clinical guidelines initially but did not follow through in meeting targets. Majority received angiotensin converting enzyme inhibitors, amlodipine or atenolol for BP control and metformin for T2DM.

Patients diagnosed between 1 and 5 years displayed significant poor glycemic and BP control. Significantly, most patients appeared to have been on same prescriptions for a longer time without review. Conclusion: Poor glycemic and BP controls observed in this study could be due to deficient treatment strategy among others.

Patients were, however, not adequately managed in line with prescribed clinical guidelines. Harris, Lynne T. We hypothesized that messaging use would be associated with better glycemic control and a higher rate of adherence to HbA1c testing recommendations. Our analysis included adults with diabetes who had registered for access to a shared electronic medical record SMR between and Multiple imputation and inverse probability weights were used to account for missing data.

Frequent use of messaging during the previous calendar quarter was associated with a higher rate of good glycemic control HbA1c glycemic control and a higher rate of HbA1c testing adherence. These results suggest that secure messaging may facilitate important processes of care and help some patients to achieve or maintain adequate glycemic control.

Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy. To evaluate the impact of glycemic control and nutritional status after total pancreatectomy TP on complications, tumor recurrence and overall survival.

Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from to A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined.

Risk factors for postoperative glycemic control and nutritional status were identified. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

Subjects with type 2 diabetes mellitus DM2 require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases.

Effect of Fructose on Glycemic Control in Diabetes. Cozma, Adrian I. We conducted a systematic review and meta-analysis of controlled feeding trials to clarify the effect of fructose on glycemic control in individuals with diabetes.

Heterogeneity was assessed by the Cochran Q statistic and quantified by the I2 statistic. Trial quality was assessed by the Heyland methodological quality score MQS. Fructose consumption did not significantly affect fasting glucose or insulin. A priori subgroup analyses showed no evidence of effect modification on any end point.

Generalizability may be limited because most of the trials were glycemic benefit and adverse metabolic effects are required.

Purpose The purpose of this study is to examine the effectiveness of a culturally specific pilot clinic for Asian Americans AA in reaching glycemic target and to characterize factors affecting the attainment of glycemic control in comparison with white counterparts. Factors associated with the lack of success in reaching target in AA but not in whites included older age, lower educational attainment, less likelihood of having health insurance, and a need for more educational visits.

Conclusion While a culturally specific diabetes program in a specialty setting achieved a similar glycemic outcome for AA compared with whites, reasons for not reaching glycemic target differed. The findings suggest that the elimination of diabetes disparities requires not only culturally and linguistically specific programs, but must also identify and address the socio-environmental differences unique to each population.

Depression is associated with type 2 diabetes mellitus DM2 , physically affecting the general condition of the patient. It also has repercussions with a poor glycemic control , as found when nutrition is not adequate and there is little adherence to the therapeutic plan. Our objective was to identify the association between depression disorders DD in patients with DM2 and their glycemic control.

A case and control study was carried out in patients with DM2, aged 30 to 60 years, selected by simple random sampling. The glycemic control was documented. There were 54 males and females. Fifty three Fifty one There were 45 patients The presence of DD is associated with an uncontrolled glycemia in the DM2 patients. However, traditional vegan diets low-fat diets that proscribe animal product consumption are also effective at improving glycemic control , and dietary portfolios vegan diets that contain prescribed amounts of plant sterols, viscous fibers, soy protein, and nuts are also effective at improving blood lipids.

The purpose of this review was to compare the effects of traditional vegan diets and dietary portfolios with ADA and NCEP diets on body weight, blood lipids, blood pressure, and glycemic control.

The main findings are that traditional vegan diets appear to improve glycemic control better than ADA diets in individuals with type 2 diabetes mellitus T2DM , while dietary portfolios have been consistently shown to improve blood lipids better than NCEP diets in hypercholesterolemic individuals.

The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people.

Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control.

Better glycemic control was significantly associated with meeting with friends one to four times per month odds ratio [OR] 0. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Meeting with friends occasionally is associated with better glycemic control among older people. Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control : An evidence linking oxidative stress, inflammation and glycemic control.

Diabetes is undoubtedly one of the most challenging health problems in 21st century. Understanding the pathogenesis and preventing long term complications have been major goals of research in diabetes mellitus DM. Research in the past few years has linked oxidative stress and inflammation to beta cell dysfunction.

Aim of this study is to evaluate serum gamma-glutamyl transferase GGT activity marker of oxidative stress and high sensitivity C reactive protein hsCRP level an inflammatory marker in type 2 DM subjects with good and poor glycemic control. Mean serum GGT and hsCRP concentration were statistically significantly higher in group III patients compared to group I and group II subjects as well as increased in group II compared to group I p glycemic control and further pathogenesis of diabetes and its complications.

All our finding suggesting a link between oxidative stress, inflammation and glycemic control in patient with type 2 diabetes mellitus. Glycemic control : a combination of lifestyle management and the use of drugs. There is still no final conclusive evidence of cardiovascular benefit by good glycemic control in type 2 diabetes, although studies like the United Kingdom Prospective Diabetes Study UKPDS and the Prospective Pioglitazone Clinical Trial in Macrovascular Events, and meta-analyses based on these and other randomized controlled trials of blood glucose-lowering therapies have been encouraging.

On the other hand, microvascular disease is clearly reduced by good glycemic control. Structured education has remained a mandatory prerequisite of any successful treatment. Not only is appropriate weight management by diet and exercise able to revert new onset diabetes to normal, but it is also the foundation of any successful pharmacotherapy of diabetes.

Aiming at normal fasting plasma glucose concentrations of 5. Individualized target glycosylated hemoglobin levels as near to normal as safely possible i. Hypoglycemia seems to emerge as a real concern in cardiology patients. Based on the findings of UKPDS, including the “legacy” study, metformin is the most widely recommended first-line drug therapy in type 2 diabetes, also in terms of preventing cardiovascular complications. An alternate first-line option in some parts of the world, especially Asian countries, is the class of alpha-glucosidase inhibitors.

In most patients, combination therapies with two or three classes of drugs are warranted. Early combination are the golden strategy as type 2 diabetes is a multi-causal disease; the various classes of drugs have distinct and synergistic modes of action, and the blood glucose-lowering efficacy of these.

Some aspects of socioeconomic status have not been assessed in these studies. We conducted a cross-sectional prevalence study in consecutive diabetic patients age Glycemic control , lipid levels, blood pressure, retinopathy, neuropathy, and nephropathy were assessed.

The medical and economic burden of deprived patients is high. Assessment of glycemic control in type 2 diabetes in the Eastern Sudan. A cross-sectional study was conducted in Gadarif, eastern Sudan to assess glycaemic control among adult patients with type 2 diabetes in eastern Sudan.

Questionnaire was used to gathered sociodemographic and clinical characteristics. A total of patients The mean age of the participants was A round one-fifth The rate of poor glycemic control was In logistic regression analyses, duration of diabetes, medications used, and the triglycerides were not associated with poor glycemic control. In summary the rate of uncontrolled type 2 diabetes mellitus was considerably high especially among being unmarried patients and patients who were adding sugar to the drinks.

Body image mediates negative family climate and deteriorating glycemic control for single adolescents with type 1 diabetes. Glycemic control declines during adolescence, as youth with diabetes struggle with pubertal changes and a changing social world. The present study tests whether body image mediates longitudinal links between family climate and changes in adolescent glycemic control.

Mediation was hypothesized for nondating adolescents but not for dating adolescents, because the former are thought to remain more family oriented than the latter. Participants reported body image and family climate.

For nondating adolescents, body image mediated associations between family climate and longitudinal changes in glycemic control. Poorer family climate was associated with poorer body image, which predicted deteriorating glycemic control. For dating adolescents, family climate was unassociated with changes in glycemic control.

Nondating adolescents may look to parents for feedback on body image, which affects how they manage the challenges of diabetes. Parents and practitioners alike should be alert to the fact that family climate continues to be an important determinant of adolescent adjustment, particularly for those who have not moved into romantic relationships.

We know that body image matters to adolescents, but for some youth, body image may be the difference between health and serious physical problems. Reutrakul, Sirimon; Hood, Megan M. OBJECTIVE To examine whether chronotype and daily caloric distribution are associated with glycemic control in patients with type 2 diabetes independently of sleep disturbances. Shift workers were excluded. A recently validated construct derived from mid-sleep time on weekends was used as an indicator of chronotype.

One-day food recall was used to compute the temporal distribution of caloric intake. Hierarchical linear regression analyses controlling for demographic and sleep variables were computed to determine whether chronotype was associated with HbA1c values and whether this association was mediated by a higher proportion of caloric intake at dinner. This association was partially mediated by a greater percentage of total daily calories consumed at dinner.

These results suggest that chronotype may be predictive of disease outcomes and lend further support to the role of the circadian system in metabolic regulation. Youth with Type 1 diabetes T1D from single-parent families have poorer glycemic control ; a finding confounded with socioeconomic status SES. To learn more, view our Privacy Policy. To browse Academia. Sara L. Jennifer Boittin. The organisation had branches in North Africa, and thus feminists in Algeria, Morocco and Tunisia are compared to those in France.

Where these women lived shaped their understanding of French women’s roles in the colonies, along with their opinions regarding the rights to which colonised women could lay claim.

These sources indicate that while all these French women positioned themselves as mediators of colonialism and women’s rights, their precise interpretations of that mediation were consistently influenced by local concerns. Manuela Deiana. Deeply modifying the Personal Status Code dating back to , the Moroccan family code Moudawana was introduced in after a long and sometimes dramatic process promoted by Moroccan women against retrograde Islamists and male domination.

In a society at half way between the construction of a secular identity and the Islamist revival, this innovative code is considered a fundamental achievement in the framework of an incomplete transition toward democratisation. Rita Stephan.

Sherifa Zuhur. From Review: This resource is helpful for sexuality rights advocates, those seeking to gain a deeper understanding of the status of women under Islamic law, and women’s rights advocates working in Islamic countries, or countries with deeply traditional cultural contexts that differ significantly from Western and modern articulations of human rights.


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Quinn, Michael J. Merinville, Eve; and Elkaim, Judith Cl. Transportation time to food stores, home cooking, and social support were not associated with glycemic control or pregnancy outcomes. Method and system for controlling mercury emissions from coal-fired thermal processes Cl. Lee, Changhoon; and Son, Kuyoung Cl. Low-power mobile telephony alert system Cl. Glycemic targets and medication use for T2DM should be individualized in older adults. Roh, Junghyun Cl.❿

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Lifestyle advice plus metformin is commonly recommended initially to manage hyperglycemia and to minimize the risk of vascular complications. Diabetes is undoubtedly one of the most challenging health problems in 21st century. KG Predictive measurement for non-terrestrial communication Cl. These patients should be carefully monitored to determine whether depression treatment should be initiated or intensified. There was a significant positive relationship between control and improvement in depression, but….