• Title/Summary/Keyword: diabetic management

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Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

Investigating Non-Laboratory Variables to Predict Diabetic and Prediabetic Patients from Electronic Medical Records Using Machine Learning

  • Mukhtar, Hamid;Al Azwari, Sana
    • International Journal of Computer Science & Network Security
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    • v.21 no.9
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    • pp.19-30
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    • 2021
  • Diabetes Mellitus (DM) is one of common chronic diseases leading to severe health complications that may cause death. The disease influences individuals, community, and the government due to the continuous monitoring, lifelong commitment, and the cost of treatment. The World Health Organization (WHO) considers Saudi Arabia as one of the top 10 countries in diabetes prevalence across the world. Since most of the medical services are provided by the government, the cost of the treatment in terms of hospitals and clinical visits and lab tests represents a real burden due to the large scale of the disease. The ability to predict the diabetic status of a patient without the laboratory tests by performing screening based on some personal features can lessen the health and economic burden caused by diabetes alone. The goal of this paper is to investigate the prediction of diabetic and prediabetic patients by considering factors other than the laboratory tests, as required by physicians in general. With the data obtained from local hospitals, medical records were processed to obtain a dataset that classified patients into three classes: diabetic, prediabetic, and non-diabetic. After applying three machine learning algorithms, we established good performance for accuracy, precision, and recall of the models on the dataset. Further analysis was performed on the data to identify important non-laboratory variables related to the patients for diabetes classification. The importance of five variables (gender, physical activity level, hypertension, BMI, and age) from the person's basic health data were investigated to find their contribution to the state of a patient being diabetic, prediabetic or normal. Our analysis presented great agreement with the risk factors of diabetes and prediabetes stated by the American Diabetes Association (ADA) and other health institutions worldwide. We conclude that by performing class-specific analysis of the disease, important factors specific to Saudi population can be identified, whose management can result in controlling the disease. We also provide some recommendations learnt from this research.

Factors Related to Diabetic Patients' Quality of Life: The 8th Korean National Health and Nutrition Examination (1st Year, 2019) (당뇨 환자의 삶의 질 관련 요인: 제 8기 1차년도(2019년) 국민건강영양조사)

  • Woo, Sang Jun;Kim, Eun A
    • The Journal of Korean Society for School & Community Health Education
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    • v.23 no.2
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    • pp.51-64
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    • 2022
  • Objectives: This study aims to examine diabetic patients' quality of life by using the data of the 8th Korea National Health and Nutrition Examination Survey (1st year, 2019), identify the factors related to this, and utilize the results as basic data for intervention that can improve diabetic patients' quality of life. Methods: For the research subjects, this study extracted 624 patients who were diagnosed with Diabetes by a doctor from the total sample of 8,110 participants of the 8th Korea National Health and Nutrition Examination Survey. The SPSS(version25.0) program was used for the analysis of the collected data. Then, this study used a backward elimination multiple regression analysis method that applied complex sample, to examine the factors related with the finally estimated quality of life. Results: The results of this study revealed that diabetic patients' quality of life was related with gender, age, occupation, restriction of activity, subjected health status. The final model explained 35.7% of the variance (Wald F=28.210, p<.001). Conclusions: In order to improve the quality of life of diabetic patients, it would be desirable to provide differentiated management by developing a customized intervention strategy that takes into account gender, age, and occupation. When managing diabetic patients, the state, local governments, and hospitals should include content that prevents and copes with restrictions on activities that may occur due to disease. In addition, it is required to prepare a strategy to induce positive perception of the subject's own health status.

Effect of Nutrition Education on Diabetic Management in Diabetic Patients (영양교육이 당뇨병환자의 식사요법에 대한 지식과 실천 및 인지도, 혈당관리에 미치는 영향)

  • 임현숙;천종희;김용성;남문석
    • Journal of Nutrition and Health
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    • v.34 no.1
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    • pp.69-78
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    • 2001
  • The purpose of this study was to investigate the effect of nutritional education on the knowledge and the practice & Perception of diet therapy, and on the level of FBG and HBAlc. The subjects were selected among the patients treated in the Inha University Hospital from June of 1996 until April of 1998. Educated group consisted of 20 patients who visited the diet-counseling department as a part of diabetic treatment. Non-educated group consisted of 20 patients who visited the diet-counseling department ignoring doctors prescription purpose. The knowledge and the practice & perception of diet therapy drinking & smoking habits, regular exercise, and general characteristics including family history were analyzed by questionnaires. FBG and HbAlc were measured before and 4 months after the treatment. The results were as follows : Both groups were composed of 12(60%) male and 8(40%) female respectively. The mean age of subjects was 51.4 years in educated group and 51.9 tears in non-educated group. The duration and %IBW were 5.9 years and 109.8 % in educated group and 5.5 years and 111% non-educated group respectively. There were no significant differences in drinking & smoking habits and regular exercise between groups. The diet therapy knowledge score was significantly higher in educated group(p<0.001, 5.8$\pm$2.3/10.0 vs 3.4$\pm$2.0/10.0). The diet therapy practice & perception score was also significantly higher in educated group(p<0.001, 5.6$\pm$2.3/10.0 vs 2.8$\pm$2.2/10.0). Levels of FBG and HbAlc in both group were reduced at 4 month after the treatment(-74.2 mg/dl and -1.4% in educated group vs -58.7 mg/dl and -2.0% in non-educated group). However, the reduced amounts of them were not significantly different. Therefore, nutritional education seems to be very important in improving the knowledge and the practice & perception of the diet therapy. However, it appears no direct influence in reducing FBG and HbAlc levels. Further studies on diabetic management by using more efficient, consecutive and intensive nutritional education methods are needed. (Korean J Nutrition 34(1):69-78, 2001)

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A Study on Perceived Self-efficacy in Non-insulin Dependent Diabetes Mellitus (제 2형 당뇨병환자의 자기효능에 관한 연구)

  • Choi, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.304-313
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    • 1997
  • This study was designed to identify the degree of perceived self-efficacy and self-esteem in non - insulin dependent diabetes mellitus. The 278 Diabetic patients participating in this study were selected from a diabetic clinic. The period of data collection was September 2 to September 10, 1996. Collected data were analyzed by means of Frequency, Mean, SD, t - test, Pearson correlation, ANOVA using SPSS/PC+. The result are summarized as follows: 1. The mean score of perceived self-efficacy were 3.52 in total, 3.91 for medication, 3.40 for exercise, 3.60 for diet control, 3.18 for glucose test, 3.53 for general management. And the mean score of self-esteem were 3.51 2. Perceived self-efficacy and self-esteem had statistically significant positive correlations (r=.3125, p=.001). 3. The results of testing for the degree of perceived self -efficacy, according to the subject's demographic variables, showed that there were significant differences in sex (t=4.14, p<0.001), the level of education(t=6.24, p<0.01) and diabetic education(t=3.25, p<0.05). These results suggest that perceived self-efficacy and self-esteem is an important variable in the compliance of diabetic patients.

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A Study on the Related Factors and the Change after Foot-reflexo-massage Education Program for Diabetic Patients (당뇨병 환자의 발반사요법 교육프로그램 후 발관리지식, 자가간호행위, 생리적지표의 변화 및 관련요인분석)

  • Lee, Young-Hee
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.222-232
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    • 2004
  • Purpose: The purpose of this study was to identify the change in foot care knowledge, self care behavior, and physiologic indexes after foot reflexomassage education program, and the related factors. Method: Data were collected from 20 patients who were visited out patients clinic. The change and difference were analyzed with non-parametric statistics. Result: There were significant differences in foot care knowledge(P=.001), self care behavior(P=.000), dosalis pedis blood flow volume (P=.011), skin temperature of foot(P=.001), dorsalis pedis pulse(P=.000), capillary filling time of foot (P=.000) between pre and post. The level of changes of foot care knowledge was significant differences according to admission experience (P=.049), and negative related to systolic blood pressure(P=.028). The level of changes of self care behavior was related to age(P=.049), that of dosalis pedis blood flow was significant difference according to smoking(P=.042), that of skin temperatureof foot(P=.002) and dosalis pedis pulse(P=.038) were significant difference according to weight. The level of changes of capillary filling time of foot was related to diagnosis period(P=.014). Conclusion: Foot-Reflexo-Massage education program is an effective nursing intervention to promote foot care in diabetic patients. And the related factors can be recommended for the management of diabetic patients.

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Effect of Severe Limb Purpura Following the Administration of COVID-19 Vaccination on a Diabetic Foot Requiring Amputation: A Case Report (COVID-19 백신 투여 이후 발생한 심한 사지 자반증이 절단을 요하는 당뇨발에 미치는 영향: 증례 보고)

  • Kim, Byung Ho;Suh, Jin Soo;Chang, Sun Hee;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.48-53
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    • 2022
  • The current SARS-CoV-2 coronavirus disease 2019 (COVID-19) pandemic has been a particular challenge for diabetes patients. Since these patients are at a higher risk of COVID-19, they have been prioritized for vaccination. In this report, we describe the case of a patient scheduled for diabetic foot amputation who received the first dose of ChAdOx1 nCov-19 vaccine and subsequently developed severe purpura in his genitalia and both of his hands and feet, accompanied by acute renal failure. The operation had to be postponed as severe limb purpura appeared just before the operation. With adequate management for acute renal failure and topical steroid application for the severe purpura lesions, a successful outcome could be obtained after the delayed first ray amputation. We recommend that COVID-19 vaccination should be carefully administered in patients with a diabetic foot requiring amputation.

Diabetes Management and Hyperglycemia in Safety Sensitive Jobs

  • Lee, See-Muah;Koh, David;Fun, Sharon Nne;Sum, Chee-Fang
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.380-384
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    • 2011
  • The chronic and acute effects of hyperglycemia affecting cognition and work are as important as those of hypoglycemia. Its impact, considering that majority of diabetic patients fail to reach therapeutic targets, would be potentially significant. Self monitoring of blood glucose, recognition of body cues and management interventions should be geared not only towards avoidance of disabling hypoglycemia, but also towards unwanted hyperglycemia. Over the long term, chronic hyperglycemia is a risk for cognitive decline. Acute episodes of hyperglycemia, above 15 mmol/L have also been shown to affect cognitive motor tasks. Maintaining blood sugar to avoid hyperglycemia in diabetic workers will help promote safety at work.

The study on Nutritional Management Status of Diabetic Patients in the Health Center (일부지역 보건소 당뇨병 환자의 영양상태와 당뇨병 관리실태)

  • 조경옥
    • Journal of the East Asian Society of Dietary Life
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    • v.5 no.1
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    • pp.7-19
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    • 1995
  • This study was conducted to evaluate the nutritional status and diabetes management of diabetic patients in the Health Center. General characteristics, food habits, food intakes and the knowledge about diet therapy were investigated from ninety one diabetes subjects. Anthropometric assessment such as weight, hight, triceps skinfold thickness, and biochemical measurement of fasting blood glucose(FBG), post prandial 2 hours blood glucose(PP2), and hemoglobin A1c(HbA1c) were obtained form the subjects. The results were summarized as following : 1. The average of age was 60.9 years old and 83.5% of subjects was illiterate and primary school graduated. 2. Relative Body Weight(RBW) and % body muscle were 96.18${\pm}$13.6 and 33.56${\pm}$7.01%, respectively. Obese subjects whose body weight exceeded 120% of the ideal values were 3.3%. 3. The 86.8% of subjects were managed by oral hyperglycemic agents. 4. The mean of FBG, PP2, HbA1c were 140.75${\pm}$44.43mg/㎗, 7.60${\pm}$1.88%, respectively. 5. The mean daily intake of calorie was 1407㎉, and 73.6% of subjects lower caloric intake than prescribed calorie. when the degree of dietary compliance was expressed as Tunbridge score, 18.7% of total subjects was grouped as satisfactory, where as 20.9% and 60.4% could be considered as tolerable and hopeless, respectively. The nutrients intake were lower than RDA except for Vitamin A and Vitamin C and the ratio of carbohydrate : protein : fat was 72 : 14 : 14. 6. The mean score of knowledge test about diet therapy was 3.52${\pm}$2.19 out of possible 14.00 points. The above results suggested that the most of diabetic patient showed the poor nutritional status and they faced the lack of knowledge about diabetes management.

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Changes in the glucose and insulin responses according to high-protein snacks for diabetic patients

  • Yang, Junyoung;Park, Hae Jin;Hwang, Wonsun;Kim, Tae Ho;Kim, Hyeonmok;Oh, Jieun;Cho, Mi Sook
    • Nutrition Research and Practice
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    • v.15 no.1
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    • pp.54-65
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    • 2021
  • BACKGROUND/OBJECTIVES: This study aimed to develop healthy, appetizing high-protein snacks with enhanced isolated soy protein for diabetic patients and determine the blood glucose and insulin response after being consumed by these patients. MATERIALS/METHODS: Thirty adult patients aged between 30 and 75 years, with a ≤ 10-year history of type 2 diabetes and hemoglobin A1c of < 7.5%, were enrolled in this study. They made 3 clinical visits at one-week intervals. The control group consumed 50 g carbohydrates (white bread), whereas the test groups consumed high-protein grain (HP_G) or high-protein chocolate (HP_C) after an 8-hrs fast. Blood (2 ㎤) was drawn at 15, 30, 45, 60, 90, and 120 min before and after consumption to analyze the blood glucose and insulin concentrations. RESULTS: Compared to the commercial snacks, the developed high-protein snacks had below-average calorie, carbohydrate, and fat content and a 2.5-fold higher protein content. In diabetic patients who consumed these snacks, the postprandial blood glucose increased between 15 min and 2 h after consumption, which was significantly slower than the time taken for the blood glucose to increase in the patients who consumed the control food product (P < 0.001). Insulin secretion was significantly lower at 45 min after consumption (P < 0.05), showing that the high-protein snacks did not increase the blood glucose levels rapidly. The incremental area under the curve (iAUC), which indicated the degree of blood sugar and insulin elevation after food intake, was higher in the control group than the groups given the 2 developed snacks (P < 0.001), and there was no significant difference in insulin secretion. CONCLUSIONS: The results of the postprandial blood glucose and insulin response suggest that high-protein snacks are potential convenient sources of high-quality protein and serve as a healthier alternative for patients with type 2 diabetes, who may have limited snack product choices. Such snacks may also provide balanced nutrition to pre-diabetic and obese individuals.