The aim of this study was to examine the effect of telephone follow-up on glycemic control, lipid profiles. and treatment method in diabetic patients with depressive symptoms over one year follow-up period. Twenty-two diabetic patients attended the structured diabetes education program between March 2004 and February 2005 and completed a questionnaire using the Beck Depression Inventory(BDI) to measure depressive symptoms. The patients showed depressive symptoms with the criterion being a BDI score at least 16. The intervention was applied to the telephone follow-up for one year. Data were analyzed using Wilcoxon signed rank test and McNemar test. The patients decreased their mean glycosylated hemoglobin(HbAlc) levels by 1.9%(p=0.001). There was a significant mean change in the fasting blood sugar(FBS) level, with a mean change of -61mg/$d{\ell}$(p=0.008). These findings indicated that the telephone follow-up may be effective in the HbAlc and FBS control.
Purpose: The purpose of this study was to evaluate whether the effect of Intenet diabetes education varied by gender. Method: An experimental group assessed pre- and post intervention was used to assess the effectiveness of diabetes education by nurses. Forty patients separated into two groups by gender partook in the study. The goal of the intervention was to keep blood glucose concentrations close to normal range. The intervention was applied weekly for 3 months. Participants were requested to input their blood glucose level, diet, and exercise diary everyday at http://www.biodang.com by cellular phone or wire Internet. The researcher sent optimal recommendations to each patient using the short message service of cellular phones and wire Internet. All medication adjustments were communicated to the subjects' doctors. The plasma glucose levels, serum lipids, and care satisfaction were measured before and after the intervention. Result: Glycosylated hemoglobin (HbA1c) decreased 1.6% and 0.8% in male and female patients respectively after 3 months of education. Total cholesterol decreased 37.2mg/dl in male patients but increased 80.5mg/dl in female patients. Conclusion: These findings indicated that Internet diabetes education could improve HbA1c and total cholesterol in male patients.
Thirteen healthy control, 13 pre-eclamptic, 7 diabetic(DM) and 12 gestational diabetic(GDM) pregnant women participated in a study ofthe interrelationships between the levels of protein, calcium, magnesium, phosphorus, zinc and copper in urine. Urinary protein, magnesium and copper levels were significantly higher (p<0.0005, p<0.0003, p<0.005 respectively) in pre-eclamptic women than those of control, DM and GDM women. Urinary zinc excretion in pre-eclamptic women (1.61 mg/g creatinine) was higher than that of DM women (0.81mg/g creatinine); urinary zinc losses of control and GDM women were wre between the other two rups. The GDM women excreted significantly ore phosphorus in their urine in comparison to control and preeclamptic women (p<0.02), but this was not seen in DM women. Among the DM women, urinary protein excretion was positively correlated with glycosylated hemoglobin(r=0.940) and fasting blood glucose concentration (r=0.889). Urinary zinc excretion also was correlated with glycosylated hemoglobin (r=0.853) and fasting blood glucose (r=0.956). In the GDM and pre-eclamptic women there were also significant correlations between urinar calcium and magnesium (r=0.857, r=0.749 respectively) and between urinary protein and copper(r=0.638, r=0.778 respectively).
BACKGROUND/OBJECTIVES: Type 2 Diabetes mellitus (T2DM) is a hereditary disease that is also strongly dependent on environmental factors, lifestyles, and dietary habits. This study explored the relationship between lifestyle habits and glycosylated hemoglobin management in T2DM patients to provide empirical outcomes to improve T2DM management and patient health literacy. SUBJECTS/METHODS: This study enrolled 349 diabetic patients with more than 5 care visits to a Diabetes Mellitus care network under the Health Management Plan led by Taiwan Department of Health (DOH). Based on relevant literature, an Outpatient Record Form of Diabetes Mellitus Care was designed and lipid profile tests were conducted for data collection and analysis. RESULTS: When modeling the data, the results showed that the odds for HbA1c > 7.5% in T2DM patients duration over 10 years was 3.785 (P = 0.002) times that in patients with disease duration of fewer than 3 years. The odds of HbA1c > 7.5% in illiterate patients was 3.128 (P = 0.039) times that in patients with senior high school education or above. The odds of HbA1c > 7.5% in patients with other chronic illness was 2.207 (P = 0.019) times that in participants without chronic illness. Among 5 beneficial lifestyle habits, the odds of HbA1c > 7.5% in patients with 2 or 3 good habits were 3.243 (P = 0.003) and 3.424 (P = 0.001) times that in patients with more than 3 good habits, respectively. CONCLUSION: This empirical outcome shows that maintaining a good lifestyle improves T2DM management and patients' knowledge, motivation, and ability to use health information. Patients with longer disease duration, education, or good lifestyle habits had optimal HbA1c management than those in patients who did not. Thus, effective selfmanagement and precaution in daily life and improved health literacy of diabetic patients are necessary to increase the quality of T2DM care.
Background: We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates. Methods: This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) <7% and HbA1c ${\geq}7%$. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model. Results: During the 1-year follow-up period, 46.6% of the patients achieved HbA1c <7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels <7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ${\geq}65$ years than those aged ${\leq}44$ years (cost ratio, 1.45; 95% CI, 1.25-1.70). Conclusion: More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.
E. japonica is a well-known medicinal plant in Japan. The leaves of E. japonica were reported to have a hypoglycemic action. However, seeds of E. japonica are discarded and not used. To elucidate for anti-diabetic effects of E. japonica, Type 2 diabetic mice were allocated to control group, E. japonica leaf, and seed extract group. Animals were fed a 2018S Teklad global 18% protein rodent diet. Animals were received daily oral injections of E. japonica leaf or seed extract at a dose of 200 mg/kg body weight for 6 weeks. Body weight, food intake and water intake, and total adipose tissue weight of animals were significantly reduced by feeding of E. japonica leaf extract. All E. japonica extract groups significantly decreased fasting blood glucose, glycosylated hemoglobin levels, size of adipocytes and serum adiponectins. However, they did not have a beneficial effect on the serum triglyceride and cholesterol in the diabetic animals. These results suggest that E. japonica seed and leaf extracts have a antidiabetic effect by controlling of blood glucose and decrease of size of adipocytes in db/db mice and seed extract is more effective in hypoglycemic action than leaf extract.
Abnormal regulation of glucose and impaired lipid metabolism that result from a defective or deficient insulin are the key etiological factor in type 2 diabetes mellitus (T2DM). The our study evaluated the beneficial effect of diet supplementation with Lentinus edodes on hyperglycemia and lipid metabolism in normal and type 2 diabetic rats. The animals were divided into 4 groups: group I(control) rats were fed standard diet (12% of calories as fat); group II (T2DM) rats were fed HFD (40% of calories as fat) for 2 weeks and then injected with STZ (50 mg/kg); group III and group IV rats were continually fed a diet containing 1% and 10% Lentinus edodes for 4 weeks after T2DM induction, respectively. After 4 weeks we determined biochemical parameters such as glucose, insulin concentration, serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and glycosylated hemoglobin (HbA1c) concentration were also measured. There was a significant reduction in serum TC and TG in the Lentinus edodes supplement groups. The Lentinus edodes diet supplementation were found to have a potent lipid metabolism improvement as well as LDL concentration decreased and HDL concentration was increased. Concentrations of blood glucose and HbA1c in the experimental groups II were significantly decreased after 4 weeks compared with the control group. The Lentinus edodes diet supplementation is useful in regulating the glucose level, improves the insulin, HbA1c, serum lipid metabolism in experimental diabetic rats. We suggest that Lentinus edodes supplementation may have the control effects of diabetes mellitus by improving blood glucose control and lipid metabolism.
Purpose: The purpose of this study was to identify relationships between HbA1c (Glycosylated Hemoglobin), WHR (Waist hip ratio), WTR (Waist thigh ratio) and compliance in elderly diabetes mellitus patients aged 65 years or over. Method: We conducted a survey and measured HbA1c, WHR, WTR in a total of 180 elderly patients with diabetes from 5 May 2014 to 30 May 2014. The data were analyzed by t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS program. Results: There were no significant differences in diabetes-related characteristics for HbA1c, WHR and WTR. However, patients with a family history had low compliance scores (p=.004). Furthermore, patients who visited the hospital regularly had higher compliance scores than patients who visited hospital when they were sick (p<.001). Patients with diabetic complications had low treatment compliance scores (p=.001). In addition, WHR and WTR (r=0.47, p<.001). and WHR and compliance (r=0.15, p=.045) showed positive correlation. Conclusion: For elderly diabetes mellitus patients, diabetes-related characteristics and compliance were highly related, so it is necessary to improve compliance for managing diabetes mellitus.
Objectives: This study examined the effects of nutrition education and exercise therapies on the hematological status and diabetes knowledge of diabetic patients. For this purpose, a 12-week intensive management program was provided to diabetic patients participating in an exercise program in S health subcenter in Kwangju city and the effects were analyzed. Methods: The subjects were 26 diabetic patients, who provided written informed consent. As a preliminary survey, this study examined the general characteristics, physical status, obesity, blood pressure, hematological status, daily activity level, diabetes knowledge, diet performance, and barriers to diet therapy. After the 12-week intensive management program was completed, a post-test was conducted in the same way as the preliminary test. The data were analyzed with using SPSS 18.0. The data from this study are presented as the mean${\pm}$standard deviation. A paired t-test was conducted to compare differences in the means before and after the program. Statistical significance was set to p<0.05. Results: The results of the program are presented as follows. The HDL-cholesterol levels changed from $39.8{\pm}10.5mg/dL$ to $48.3{\pm}13.1mg/dL$, showing a significant increase (p<0.001). The blood sugar 2 hours after a meal changed from $175.2{\pm}67.1mg/dL$ to $140.5{\pm}42.5mg/dL$, showing a significant decrease (p=0.014). The glycosylated hemoglobin levels decreased significantly from $6.7{\pm}1.1%$ to $6.3{\pm}1.0%$ (p=0.010). The total scores of the daily activity levels increased significantly from $3.8{\pm}2.4$ to $4.8{\pm}2.5$ (p=0.040). The scores of knowledge on diabetes increased from $11.5{\pm}3.6$ to $14.0{\pm}3.8$ (p=0.001). The scores of knowledge on diet therapy changed from $6.7{\pm}2.2$ to $7.9{\pm}1.7$, showing a significant increase (p=0.027). Conclusions: The 12-week intensive management program intervened by nutrition education and exercise therapies induced positive changes to the HDL-cholesterol, blood sugar 2 hours after a meal, glycosylated hemoglobin, daily activity levels, and knowledge on diabetes.
Carnosine is a dipeptide $(\beta-alanyl-L-histidine)$ found in mammalian brain, eye, olfactory bulb and skeletal muscle at high concentrations. Its biological functions include antioxidant and anti-glycation activities. The objectives of this study were to investigate anti-diabetic effects of carnosine as determined by blood glucose levels, glucose tolerance test (GTT), glycosylated hemoglobin, and serum biochemical and lipid levels in streptozotocin-induced diabetic mice. There were five experimental groups including normal (ICR mice), control (saline), and three groups of carnosine at doses of 6, 30, and 150 mg/kg b.w.. Carnosine was orally administered to the diabetic mice everyday for 12 weeks. There was no significant difference in body weight changes in carnosine-treated groups compared to the control. The treatments of carnosine at the dose of 6 mg/kg significantly decreased the blood glucose level compared with the control at 2 and 4 weeks. The treatments of carnosine at the doses of 6 and 30 mg/kg significantly decreased the blood glucose levels in GTT and glycosylated hemoglobin compared with the control. Carnosine significantly increased total proteins compared with the control. Carnosine at the dose of 6 mg/kg significantly decreased total cholesterol and triglyceride in the serum compared to the control. These results suggest that carnosine at a low level has a hypoglycermic effect resulting from reduction of blood glucose and that a carnosine-containing diet or drug may give a benefit for controlling diabetes mellitus in humans.
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