Dapagliflozin or saxagliptin in pediatric type 2 diabetes: a plain language summary

Background: Diabetes mellitus (DM) causes high morbidity and mortality and loss of quality of life significantly. It is an important public health concern. In epidemiologic studies, people with poor sleep quality are more prone to develop diabetes or metabolism disorder of glucose. Sleep has an important role for metabolic function and specifically homeostasis of glucose metabolism. Many studies have shown a correlation between increased diabetes risk and poor sleep quality or sleep deprivation. DM creates a negative effect impact on quality of sleep on patients. Prevalence of obesity and diabetes becomes greater among aged people, it is of vital importance to fix on sleep for overall medical management. This is aimed to determine hyperglycaemia with sleep quality among the patient. Methods: This was a cross sectional study carried out at Ibrahim General Hospital, National Health Care Network (NHN), Mirpur-10, Dhaka during the period of January 2014 to December 2014. Total 129 respondents were selected purposively for this study. Semi-structured questionnaire was pretested first and then it was used for data collection. Pittsburgh Sleep Quality Index score (PSQI) was used to assess sleep quality. Statistical Package for Social Sciences (SPSS) version 22.0. was used for analysis of the collected data. Results: Among 129 respondents, 98(76%) were male and 31(24%) were female. 93.8% respondents were married and rest 6.2% of them were unmarried. Mean(±SD) age was found 53.64(±9.26) years and range 35 to 70 years. 79.1% of the respondents had co-morbidity of DM, 70(54.3%) had diabetes more than 10 years duration. Mean(±SD) of overall sleep quality score was 9.04(±3.965) and range 1 to 18. Among the respondents of age group >64, 95.70% had poor sleep quality, 76.14% respondents sleep less than 6 hours in a day. So association between sleep quality and glycemic status of type 2 DM was significant(p<0.05). Conclusion: The prevalence of high blood sugar level in Type 2 DM patients have poor sleep quality. Type 2 DM patients with high blood sugar level have to overcompensate kidneys to visit washroom more frequent and lead to disturbance in sleep. Type 2 DM patients with controlled blood sugar level have good sleep quality. It is evident from the study that Type 2 DM patients with high sugar level (Hyperglycaemia) frequently experience sleep difficulties. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 21-27

Indonesia is ranked seventh out of countries that contributed to the highest number of DM in the world in 2019 and estimate that in 2045 it could reach 16.6 million cases. West Nusa Tenggara Province is one of the provinces with a fairly high DM rate reaching 21,308 with various complications due to uncontrolled blood sugar levels. High blood sugar levels in DM patients are caused by several uncontrolled factors in DM patients. This study aims to determine the factors associated with uncontrolled blood sugar levels in type 2 DM patients at the NTB Provincial Hospital. This research is a observational with a cross sectional study. The sample selection using the consecutive sampling obtained from the medical records of type 2 DM patients who were treated at the Internal Medicine Polyclinic of the NTB Provincial Hospital. The study sample size were 100 people with univariate and bivariate data analysis using the Chi-square test. The subjects in this study were dominated by patient age > 45 years (75.6%), female (51.2%), using non-insulin therapy (52.4%), and duration of type 2 diabetes < 10 years. (67.07%) with uncontrolled blood sugar status (52.4%). Bivariate analysis using the Chi-square showed that there were a statistically significant relationship between controlled blood sugar levels and patient age (p=0.021), controlled blood sugar levels with gender (p=0.008), controlled blood sugar levels and the type of therapy (p=0.008). = 0.004), and controlled blood sugar levels with duration of diabetes (0.023).

Diabetes mellitus was a disease with macro and micro risk of angiopathy, which includes the impact of causing cataracts. Diabetic patients with high sugar levels have a greater chance of developing cataracts at a younger age and certain tendencies towards cataract type. The aim of the study was to analyze the correlation between diabetes blood sugar levels and cataract type. The research design was correlation analysis with Cross-Sectional approach. Samples in the study were some cataract patients who had a history of diabetes mellitus in Surabaya Undaan Eye Hospital as many as 125 people, it was taken using consecutive sampling technique, and fulfilling the criteria of the study (age range 45 - 65 years, have complete medical records related to the continuity of sugar examination results in blood, the incidence of cataracts is not caused by congenital cataracts, juveniles, due to trauma, chemical exposure to UV radiation). Independent variable was the blood sugar level of Diabetes mellitus and the Dependent variable was cataract type. The instruments used were laboratory tests related to blood sugar levels, and medical diagnosis related to cataract type. Data were analyzed by Spearman rho, with a significant value <0.05. The results showed a close association between diabetes and cataracts, where as many as 47.2% with high blood sugar levels, 40% with nuclear cataract type and from 59 respondents with high blood sugar levels 26 people experienced nuclear cataract type, with rho value = 0.001. The mechanism of glucose toxicity in Diabetes Mellitus which causes cataracts can go through three paths: increased activity of the aldose reductase enzyme which causes the formation of sugar alcohol, sorbitol and galactitol in crystalline lenses; through the non-enzymatic replication process; and at high blood glucose levels a glucose oxidation process will occur which causes oxidative stress conditions. Maintenance of managing blood sugar levels must be a concern for diabetics.
 
 Keywords: Blood Sugar Level, Diabetes Mellitus, Type of Cataract 

Diabetes mellitus was a disease with macro and micro risk of angiopathy, which includes the impact of causing cataracts. Diabetic patients with high sugar levels have a greater chance of developing cataracts at a younger age and certain tendencies towards cataract type. The aim of the study was to analyze the correlation between diabetes blood sugar levels and cataract type. The research design was correlation analysis with Cross-Sectional approach. Samples in the study were some cataract patients who had a history of diabetes mellitus in Surabaya Undaan Eye Hospital as many as 125 people, it was taken using consecutive sampling technique, and fulfilling the criteria of the study (age range 45 - 65 years, have complete medical records related to the continuity of sugar examination results in blood, the incidence of cataracts is not caused by congenital cataracts, juveniles, due to trauma, chemical exposure to UV radiation). Independent variable was the blood sugar level of Diabetes mellitus and the Dependent variable was cataract type. The instruments used were laboratory tests related to blood sugar levels, and medical diagnosis related to cataract type. Data were analyzed by Spearman rho, with a significant value <0.05. The results showed a close association between diabetes and cataracts, where as many as 47.2% with high blood sugar levels, 40% with nuclear cataract type and from 59 respondents with high blood sugar levels 26 people experienced nuclear cataract type, with rho value = 0.001. The mechanism of glucose toxicity in Diabetes Mellitus which causes cataracts can go through three paths: increased activity of the aldose reductase enzyme which causes the formation of sugar alcohol, sorbitol and galactitol in crystalline lenses; through the non-enzymatic replication process; and at high blood glucose levels a glucose oxidation process will occur which causes oxidative stress conditions. Maintenance of managing blood sugar levels must be a concern for diabetics.
 
 Keywords: Blood Sugar Level, Diabetes Mellitus, Type of Cataract 

Plain Language Summary What is this summary about? This meta-analysis looked at the safety of empagliflozin, by looking at the number of side effects in a broad range of participants who were taking empagliflozin for type 2 diabetes, heart failure, or chronic (long-term) kidney disease across 4 large studies (20,933 participants in total). Researchers looked at the number of side effects in participants who took empagliflozin compared to those who took a placebo (a pill that looked like empagliflozin but contained no medicine). For the main results of the 4 individual trials, please see the “Where can readers find out more information about these studies?” section at the end of this article to find out more. What are the key takeaways? The number of side effects reported was similar in participants who took the placebo and in participants who took empagliflozin. The number of participants with a serious (life-threatening, requiring hospitalization, or caused people to die) urinary tract infection, including serious kidney infections, was similar in participants who took the placebo or empagliflozin. However, the number of serious urinary tract infections was higher in women taking empagliflozin compared with women taking the placebo. The number of serious urinary tract infections was similar in people with or without diabetes, or who had or did not have chronic kidney disease. The numbers of participants with a serious infection of the outer reproductive organs (genital infection) was similar in participants who took the placebo or empagliflozin. Ketoacidosis was a very rare side effect but was slightly more frequent in participants taking empagliflozin. The number of participants with a serious reduction in blood volume was slightly higher in participants taking empagliflozin. The number of participants with serious kidney injury was lower in participants taking empagliflozin. The numbers of participants with severe low blood sugar (hypoglycemia), break or crack in the bone (bone fractures), or amputation of the leg or part of the leg were similar in participants who took the empagliflozin or placebo. What are the main conclusions reported by the researchers? This study reported similar side effects of empagliflozin as reported in previous studies in a broad range of participants with type 2 diabetes, heart failure, or chronic kidney disease. How to say (download PDF and double click sound icon to play sound)… Cardiovascular disease: car-dee-yoh-VAH-skyoo-luhr dih-ZEEZ Diabetes: dye-uh-BEE-teez Empagliflozin: EM-pah-glih-FLOW-zin Hypoglycemia: HY-poh-gly-SEE-mee-uh Ketoacidosis: KEE-tow-ah-sih-DOW-sus Pyelonephritis: pai-uh-low-nuh-FRAI-tus Urosepsis: YUH-row-sehp-sus Ventricle: ven-TRI-kul Ketoacidosis: Acidic blood when there are high levels of substances called ketones in the blood. Ketones are made by the body when fat is degraded. Ketones can be used as an energy source by the body. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here

Diabetes mellitus is a chronic metabolic disease or disorder with multietiologi characterized by high blood sugar levels (hyperglycemia). Diabetes mellitus can not be cured but can be controlled by regulating blood sugar levels. One of important factor in controlling blood sugar levels is the family role. The purpose of this study was to determine relation between family role with blood sugar levels in diabetes mellitus patients at the working area of Pauh Health Center Padang 2013. The study was a descriptive analytic with cross sectional approach. were taken with simple random sampling technique. Data were analyzed using univariate descriptive statistical form frequency distributions and bivariate analysis performed by chi-square test with a significance level of α 0.05. The results showed 53.3% of respondents had an unfavorable role of the family in patients with diabetes mellitus, 57.8% with abnormal blood sugar levels. The results of the bivariate analyzes indicate that there is a significant relationship between the role of family ties with the blood sugar levels in patients with diabetes mellitus (p <0.05). Based on the results, the role of the family has a role in controlling blood sugar levels. Therefore expected to increase family participation in care and to motivate patients with diabetes mellitus in controlling blood sugar levels so that blood sugar levels under controlled conditions.

Controlling blood sugar levels is the main goal of nursing interventions that will be carried out in Diabetes Mellitus patients. Patients with diabetes mellitus are advised to always have a healthy lifestyle every day. Control blood sugar in DM patients by regulating diet such as: regulating the amount of food, type of food and frequency of eating hours and doing activities (sports). Non-Communicable Diseases (PTM), including Diabetes Mellitus, has now become a serious threat to global health. Quoted from WHO 2016 data, 70% of the world's total deaths and more than half of the disease burden. 90-95% of diabetes cases. Type 2 diabetes, which is largely preventable because it is caused by an unhealthy lifestyle. (Ministry of Health, 2018). Solok City has cases of Diabetes mellitus sufferers in four Puskesmas where there are 284 KTK Puskesmas working areas, while the number of visits to Type II Diabetes mellitus sufferers in the KTK Puskesmas work area is 50 people. Based on the results of research that has been carried out in the Working Area of the KTK Kota Solok Health Center, it was found that more than part (66%) of the respondents 'blood sugar levels were abnormal (high), more than part (64%) of the respondents' diet was not appropriate and more than some (60 %) respondents do not do physical activity regularly. There is a relationship between a diet that is not in accordance with abnormal blood sugar levels and there is a relationship that does not do physical activity with abnormal (high) blood sugar levels in the Working Area of the KTK Kota Solok Health Center. It is hoped that health workers will remind people with Type II Diabetes Mellitus, about the importance of dietary regulation in controlling blood sugar levels and carrying out regular physical activity (exercise) so that it can help in controlling blood sugar levels so that blood sugar levels can be controlled.

Background: People with diabetes mellitus are increasing in number. Controlling blood sugar levels is an action that must be taken to get normal and stable blood sugar levels. Self-control takes precedence over treatment. Compliance with diet is one of the important things in controlling blood sugar levels. Raflesia Room as one of the internal medicine inpatients in dr. SoedomoTrenggalek, received inpatient care for the majority of diabetes mellitus patients.
 Purpose : The purpose of this study was to analyze the relationship between diet adherence and blood sugar levels in people with diabetes mellitus.
 Methods : The research design used descriptive analytic with cross sectional approach. The population in this study were patients with diabetes mellitus in the Raflesia room of Dr. SoedomoTrenggalek Hospital in January 2017 with 30 patients. With a simple random sampling technique so that 29 samples were obtained.
 Result : The results showed that almost all respondents, namely 25 (86%) respondents, had abnormal blood sugar levels. Almost all respondents, 23 (79%) did not comply with the diet. Chi square test results obtained 0.004 which means there is a relationship between dietary compliance with blood sugar levels of diabetes mellitus patients in Raflesia room Dr. Soedomo Hospital Trenggalek in 2017.
 Conclusion : Old age is an age that is susceptible to a decrease in body function, especially hormonal causes of decreased pancreatic function resulting in a decrease in insulin sensitivity which causes high blood sugar levels. The level of education has an important role in diet compliance where patients are required to understand 3J "Types, Amounts and Schedules" so that the lower level of education causes lower diet compliance. Disobedience to diets causes sufferers to consume irregular foods which cause a pile of glucose and blood so that hyperglycemia occurs.

Diabetes mellitus (DM) is a chronic disease, and specific treatments are needed in order to control blood glucose. In addition to pharmacological therapy, non-pharmacology therapy also takes an important role to control blood glucose levels and should be done regularly. Brisk walking is one example of physical activity which included in non-pharmacology therapy and can improve body expenditure. This activity can help DM patient to control their blood glucose level within the normal range. The physical activity of Brisk Walking, which is one type of exercise that can maintain blood sugar levels within the normal range, especially in people with Diabetes Mellitus. This study aimed to determine the effect of Brisk Walking on the blood glucose level of DM patients at Tamalenrea Health Center Makassar City. This study adopted a quasy experiment and a one-group pre-post test design. A total of 16 respondents were selected purposively based on the determined criteria. Data analysis of the difference of blood sugar level between the treatment and control was carried out by using the Spearman correlation test with SPSS version of 21. The difference was significant with the value of p < 0.05. The results showed that the physical activity of Brisk Walking could control blood sugar levels. Statistical analysis showed that the average blood sugar content was significantly lower in patients practicing Brisk Walking (blood sugar level <200 mg/dl)(176.06%) than the control (blood sugar level > 200 mg/dl) (218.81%). So it can be concluded that by doing physical activity Brisk Walking can control blood glucose levels.

To compare the effect of erythromycin and metoclopramide on feeding intolerance of critically ill patients in intensive care unit (ICU). One hundred and fifty-two critically ill patients in ICU who needed early enteral nutrition exceeding 7 days between January 2007 and January 2009 were included in the study. The patients were randomly divided into three groups: erythromycin group (200 mg intravenous drip, once every 12 hours), metoclopramide group (10 mg intravenous injection, once every 8 hours), and combination therapy group. The whole experiment was carried out for 7 days. Residual gastric volume was aspirated and measured every day at 03:00, 09:00, 15:00 and 21:00. The daily mean gastric residual volume was compared. At the same time, the daily effectiveness of erythromycin and metoclopramide on the success of feeding was also compared. The factors associated with a poor response to prokinetic therapy were looked for. The daily gastric residual volume in the combination therapy group was smallest, the maximum was (40+/-8) ml; the maximum of gastric residual volume in erythromycin group was (42+/-7) ml; the maximum of gastric residual volume in metoclopramide group was (59+/-8) ml (P<0.05 or P<0.01). The successful rate of feeding was highest in the combination therapy group, and it was as high as 97.4%, the erythromycin group ranked the second (90.0%), and that of the metoclopramide group was lowest (89.5%, P<0.05 or P<0.01). Factors that were associated with a poor response to prokinetic therapy was high pretreatment 24-hour gastric residual volume (r=-0.584, P=0.000), high blood sugar level (r=-0.345, P=0.029), a high acute physiology and chronic health evaluation II (APACHEII) score (r=-0.437, P=0.005), and requirement for inotropic drug support (r=-0.389, P=0.041). Low dose of erythromycin could improve the successful rate of feeding in critically ill patients in ICU. The combined administration of erythromycin and metoclopramide was more effective. Its side effect was minimal.

High blood sugar levels in the morning in juvenile type 1 diabetics may be caused by a Somogyi phenomenon (counter-regulation after nocturnal hypoglycaemia) or insulin resistance in the morning hours (dawn phenomenon). To enable differentiation between the two, 1,562 blood sugar profiles (24 h, 3 h, 6 h) were determined in 161 children and juveniles (74 boys, 87 girls; mean age 10.8 [1.0-19.7] years) with type 1 diabetes mellitus. In accordance with the mechanism of the dawn phenomenon there was a close positive correlation between the blood sugar levels in the night and morning (r = +0.696; P less than 0.0001); the mean fasting blood sugar level was about 60 mg/dl above the 3 h value. Low nocturnal blood sugar levels as a possible cause of a high morning blood sugar (greater than 250 mg/dl) was demonstrated in fewer than 1% of profiles. On the other hand, the probability of nocturnal hypoglycaemia rose exponentially in the presence of low morning fasting blood sugar levels. Thus, if the morning level was below 80 mg/dl, the blood sugar levels at 3 h was below 50 mg/dl in 41.2%. This indicates that high morning blood sugar levels result from the dawn phenomenon and require a higher evening dose of slow-release insulin. But if the morning blood sugar values are clearly below 100 mg/dl, the cause may be nocturnal low blood sugar levels and the evening insulin dose should, therefore, be reduced.

Plain Language Summary What is this plain language summary about? For this study, a Delphi panel of 10 experts discussed and agreed upon recommendations for doctors and other healthcare providers about considerations to make when providing care for people who are very sleepy during the day (that is, the patients have excessive daytime sleepiness) and have sleep apnea. How to say (download PDF and double click sound icon to play sound)… Apnea: AP-nee-uh Consensus: kuhn-SEN-suhs Delphi: DEL-fie What are the key takeaways? The panel reached consensus on 32 statements. The Delphi panel agreed that excessive daytime sleepiness is when a patient says they have trouble staying alert while they are awake. Healthcare providers should use appropriate tests to check for this symptom when a patient is first tested for sleep apnea, from 6 weeks to 3 months after starting a new treatment for sleep apnea, and otherwise at least once per year along with regular follow-up visits after the patient has started treatment for sleep apnea. The panel also agreed that even after ensuring patients use their treatment for sleep apnea as prescribed for 3 to 6 months, some patients still feel sleepy during the day. In these cases, healthcare providers should think about other potential causes of the sleepiness and consider other diagnostic tests or using medicine to help these patients stay alert during the day. These recommendations may improve the care of patients by assisting healthcare providers in diagnosing patients, making decisions about treatments, and explaining the benefits of treatment to patients. Delphi panel: A group of experts on a certain topic with the goal of reaching a consensus on answers to questions related to the topic. Consensus: A majority agreement between the experts. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here

Background: Diabetes Mellitus (DM) is a chronic disease of metabolic disorder characterized by blood sugar levels that increase from normal limits. It is necessary to prevent diabetes with control by monitoring metabolic status. The method that can be used in controlling blood sugar in patients with diabetes mellitus by measuring Hemoglobin-glycation (HbA1c). HbA1c measurement is the most accurate way to determine high blood sugar levels over the past 2 - 3 months. HbA1c is an examination to assess the risk of tissue damage caused by high sugar levels. The aimed of this study is to analyze the correlation between HbA1c levels ​​and blood sugar levels in patients with diabetes mellitus.&#x0D; Method: This study used descriptive methods with an analytical descriptive study with a cross-sectional among of 100 samples, based on the criteria of respondents who checked HbA1c and fasting blood sugar. Data analysis used the Speartam correlation test which was previously carried out by the Kolmogorov-Smirnov normality test.&#x0D; Result: The results of this study showed that the average HbA1c level was 3.9% while the average fasting blood sugar level was 82 mg/dl. There is a significant correlation between HbA1c concentration and fasting blood sugar with p (0.000) &lt; (0.05). According to the test results, the value r = 0.666 means the correlation is very strong (0.51-0.75).&#x0D; Conclusion: In conclusion, there is a strong correlation between HbA1c levels and fasting blood sugar level, the correlation happens to be positive, meaning there is a one-way relationship if HbA1c levels increases (High), fasting blood sugar levels will also increase (High). If the HbA1c levels is reduced (low), then the fasting blood sugar level is also reduced (low), and if the HbA1c level is normal, the blood sugar level is also normal.

Compliance control is an important aspect for success in controlling blood sugar levels.Difficulties in knowing health developments, causing the risk of complications will arise in patients with diabetes mellitus who do not routinely control blood sugar.The purpose of the study was to determine the relationship between control compliance with fasting blood sugar levels in patients with diabetes mellitus at the Ngraho Public Health Center. The research design uses quantitative methods with a Cross Sectional approach.The independent variable in this study is control compliance and the dependent variable is blood sugar levels.The population in this study were all 32 DM patients who took control in January-December 2020 using total sampling. The results showed that 16 respondents who complied with control had an average fasting blood sugar of 211.45 while 16 respondents who did not comply with control had an average fasting blood sugar of 189.20.Based on the Mann-Whitney test, the p-value was 0.142 with a significance value of &lt;0.05, which means there is no relationship between Control Compliance and Blood Sugar Levels in Diabetes Mellitus Patients at the Ngraho Public Health Center. Increased fasting blood sugar levels occur not solely because of the regularity of the control schedule, but there are other factors such as age, irregular insulin use, foods with high glucose levels, excessive stress levels, and lack of activity. affect the body in controlling blood sugar levels.

It is of practical importance in the treatment of diabetic patients to know if there is a difference in the rate of disappearance of glucose under the action of insulin at different blood-sugar levels. Our interest in this problem was aroused during routine observations on diabetic patients. We observed a patient on insulin with the blood sugar in the normal range who did not excrete the extra glucose ingested when placed on a high carbohydrate diet with the same insulin dose. The latter regime was associated with a high blood-sugar level and the result was similar to that which has been reported by others (1, 2, 3). This paper summarises the results of a study of the disposal of glucose at normal and high blood-sugar levels under the action of the same amount of insulin. The study was made on depancreatized animals as well as diabetic patients.