Blood Glucose Levels In People Research Articles

A zero-knowledge proof federated learning on DLT for healthcare data

With the increasingly widespread adoption of Healthcare 4.0 practices, new challenges have arisen for the utilization of collected sensitive data. On the one hand, these data have immense potential to unlock valuable insights for personalized medicine, early disease detection, and predictive analysis thanks to the use of Artificial Intelligence. On the other hand, ensuring the protection of patient privacy is of paramount importance to maintain trust and uphold ethical practices within the healthcare system. Classical centralized learning approaches do not fit well with the privacy and security requirements imposed by the law and the sensitivity of treated data, which is why decentralized learning approaches are gaining ground. Among these, Federated Learning (FL) stands out as a viable alternative, providing greater security and performance comparable to classic centralized learning approaches. However, there are still various attacks targeting the local parameters or gradients updated by the participants. Therefore, we present our architecture based on the conjunction of Zero-Knowledge Proof, FL, and blockchain that implements also the decentralized identifier standard. The adoption of this architecture can grant the execution, management, supervision, and updating of the FL process, guaranteeing the resilience of the system and the reliability and traceability of exchanged data. In order to test the performance, robustness, and implementation costs of the proposed architecture, we develop a case study on the prediction of blood glucose levels in people with Type-1-diabetes. The results of our analysis show an improved system in terms of balance between performance privacy and security, guaranteeing high levels of verifiability, therefore proving the proposed architecture suitable for most of the FL processes needed in the healthcare field.

Effectiveness of aerobic exercise intervention and butterfly pea flower tea on reducing blood glucose levels in type II diabetes mellitus patients

The aim of this research is to analyze the effectiveness of the combination of aerobic exercise and butterfly pea flower tea as a therapy for type 2 diabetes mellitus. This research uses experimental research methods with pre and post design. This research uses only one group as a sign of the existence of a comparison group. A total of 36 adult women suffering from Type II Diabetes Mellitus participated in this study. The inclusion criteria in this study were women suffering from type II diabetes mellitus. The exclusion criteria in this study were elderly women. The initial procedure in this research is preparing research administration. Next, screen respondents who are research subjects based on inclusion and exclusion criteria and fill out Informed Consent. Subjects took pre‑test data to measure blood glucose levels. Next, the intervention was carried out within 4 weeks and aerobic exercise treatment was carried out 8 times (2x/week) and butterfly pea flower tea intervention for Type II Diabetes Mellitus sufferers. Telang flower tea is packaged in the form of tea bags which already have BPOM. Subjects collected post‑test data to measure blood glucose levels. Blood glucose levels are measured using a Point Of Care Testing (POCT) device. The first statistical analysis in this research is a descriptive test to obtain the mean, standard deviation and standard error. Next, the normality test was carried out using the Shapiro‑Wilk method, if the data was normally distributed, a difference test was carried out using the paired t test, but if the data was not normally distributed then a difference test was carried out using the Wilcoxon signed rank test. The results of this study report that providing aerobic exercise and butterfly pea flower tea intervention for 4 weeks was able to significantly reduce blood glucose levels in DM sufferers. In this case, aerobic exercise and butterfly pea flower tea are categorized as effective in reducing blood glucose levels in people with type II diabetes mellitus. We hope that future research will examine the effects of exercise with varying intensity and giving butterfly pea flower tea.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes.

Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes. A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model. Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01). This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

Penerapan Progressive Muscle Relaxation Terhadap Penurunan Kadar Glukosa Darah Pada Penderita Diabetes Melitus Tipe 2 di RSUD Dr Moewardi Surakarta

Background: Type 2 diabetes mellitus is a type of metabolic disorder characterized by hyperglycemia which leads to serious complications. One physical activity that can be applied is progressive muscle relaxation, which focuses on sequentially tightening and relaxing muscle groups resulting in controlled blood glucose levels so that holistic treatment is needed. Objective: To determine the results of the application of Progressive Muscle Relaxation (PMR) to reduce blood glucose levels in people with type 2 diabetes mellitus at RSUD Dr. Moewardi Surakarta. Method: This research is a type of qualitative descriptive research with a case study approach (Case Study). The design for this application was a control group design which was applied to 1 respondent with Diabetes Mellitus Type 2. Results: Based on the results of this application, it was found that blood glucose levels decreased after Progressive Muscle Relaxation was carried out, which was indicated by the number of high glucose levels decreasing. Comparison before and after applying Progressive Muscle Relaxation, before being given the application of PMR high blood sugar levels were 415 mg/dl and after being given the application of PMR 2 times a day (morning and evening) for 3 consecutive days normal blood sugar levels were 173 mg/dl etc. Conclusion: Blood sugar levels before the application were given were high and after the application was given the patient's blood sugar levels were normal.

Validation and Application of Screen-Printed Microchip for Potentiometric Determination of Metformin Hydrochloride in Tablet Dosage Form.

Metformin is an oral biguanides hypoglycaemic agent, which used to lower the blood glucose levels in people with type 2 diabetes mellitus. Many analytical techniques have been used to quantify the drug in different pharmaceutical dosage forms; however, most of these methods have limited throughput in the quality control application. A disposable potentiometric microsensor responsive to metformin has recently been reported. For the first time, herein, this method of analysis has been validated according to IUPAC recommendations and successfully applied in the determination of metformin drug in some dosage form. Different drug formulations of metformin hydrochloride have been collected from the local pharmaceutical stores in Saudi Arabia and analysed using the validated microchip-based method of analysis. Subsequently, the results of this study showed that the validated method was linear, specific, precise, and accurate. The linear range was 1 × 10-1-1 × 10-5 mol L-1 and the correlation coefficient was 0.999. The limit of detection was 2.89 × 10-6 mol L-1, and the limit of quantification was 8.77 × 10-6 mol L-1. This method demonstrated high precision, with an RSD% of less than 2.22%. The accuracy of this method was obtained by comparing the recovery percentage with percentage values less than 5%. The results obtained showed that there was no significant difference between the references, label, and recovery of less than 5%.

Pengaruh Pemberian Air Kelapa Muda (Cocos Nucifera L.) Terhadap Kadar Glukosa Darah Penderita Diabetes Melitus Tipe 2 pada Masyarakat Pesisir

To date the prevalence of diabetes sufferers is increasing both globally and nationally. Providing Tender Coconut Water (TCW) to reduce blood glucose levels in diabetes sufferers is a form of therapy that is practical, economical, easy to reach and easy to obtain. Moreover, coconut trees are widely spread, especially in coastal areas, so they are always available whenever you want them. Several animal studies have shown that young coconut water can be beneficial for diabetes sufferers, including its complications. However, studies in humans are currently still lacking. Therefore, this study aims to see the effect of giving young coconut water on reducing blood glucose levels in people with type 2 diabetes mellitus, especially in coastal communities. This research is a quantitative research with Quasi Experimental design with pre-test post-test with control group design. The research was conducted in the coastal area of the Nambo Community Health Center with a sample of 20 people consisting of 2 groups (10 people in the intervention group and 10 people in the control group). Statistical analysis uses independent t-test. The mean pre-test blood glucose level in the intervention group was 281.3 mg/dL while the post-test was 172.8 mg/dL. Whereas, in the control group, between pre and post, there was an increase in the average blood glucose level from 299.9 mg/dL to 326.6 mg/dL. Statistical analysis showed the p value &lt;0.001 (p&lt;0.05), meaning that there was a difference in average blood glucose levels between the intervention group and the control group. There is an effect of giving young coconut water or Tender Coconut Water (TCW) on blood glucose levels in people with type 2 diabetes mellitus.

Pengaruh Senam Apiyu Terhadap Kadar Glukosa Darah Pasien Diabetes Mellitus (DM) Tipe II Di Puskesmas Rejosari Kota Pekanbaru

Diabetes Mellitus (DM) is a disease caused by the body not being able to adequately release or use insulin so that blood glucose levels in the blood are high. The purpose of this study was to determine the effect of APIYU exercise on blood glucose levels of Diabetes Mellitus (DM) Type II patients. Method: Quantitative Research Design Quasy Experiment. The study sample was 34 respondents, Purposive sampling technique which was divided into 2 groups, namely 17 experimental respondents given APIYU exercise intervention and 17 control group respondents were not given APIYU exercise intervention. Both groups continued to take the drugs Glibenclamide and Metformin. The measuring instruments used are observation sheets and glucometers with pre-test and post test for 3 consecutive days after doing APIYU exercise. The statistical tests used are the Paired Samples T Test and the Mann Whitney test. Result:. There was a significant difference in the mean blood glucose levels of the pre-test and post-test in the experimental group with a p value of 0.000. APIYU exercise affects blood glucose levels in Type II Diabetes Mellitus (DM) patients with a ? value of 0.000 (&lt;0.05) Conclusion: APIYU exercise affects the blood glucose level of people with Type II Diabetes Mellitus (DM). These results are expected to be an alternative treatment in controlling blood glucose levels of people with Type II Diabetes Mellitus (DM). Keywords: , ,

Estimation and Prediction of Glucose Appearance Rate for Use in a Fully Closed-Loop Dual-Hormone Intraperitoneal Artificial Pancreas.

A fully automated artificial pancreas requires a meal estimator and predictions of blood glucose levels (BGL) to handle disturbances during meal times, all without relying on manual meal announcements and user interventions. This study introduces a technique for estimating the glucose appearance rate (GAR) and predicting BGL in people with type 1 diabetes and insulin and glucagon administration. It is demonstrated for intraperitoneal insulin and glucagon delivery but may be adapted to other delivery sites. The estimator is designed based on the moving horizon estimation (MHE) approach, where the underlying cost function incorporates prior statistical information on the GAR in subjects over the course of a day. The proposed prediction scheme is developed to predict GAR using estimated states and an intestinal model, which is then used to predict BGL with the help of an animal glucose metabolic model. The intraperitoneal dual-hormone estimator was evaluated on three anesthetized animals, achieving a 21.8% mean absolute percentage error (MAPE) for GAR estimation and a 10.0% MAPE for BGL prediction when the future GAR is known. For a 120-minute prediction horizon, the proposed predictor achieved an 18.0% MAPE for GAR and a 28.4% MAPE for BGL. The findings demonstrate the effectiveness and reliability of the proposed estimator and its potential for use in a fully automated artificial pancreas and reducing user interventions. This study represents advancements toward the development of a fully automated artificial pancreas, ultimately enhancing the quality of life for people with type 1 diabetes.

Glycemic control and associated factors among type 2 diabetes mellitus patients: a cross-sectional study of Azar cohort population

BackgroundDespite the growing prevalence of diabetes and its complications, there is a dearth of data regarding factors associated with glycemic control. Therefore, in this cross-sectional study, we aimed to identify factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM) in the Iranian population.MethodsThis cross-sectional study was conducted among the Azar cohort population and the glycemic control status of patients with T2DM was investigated. Possible risk factors including age, sex, marital status, educational level, smoking status, sleep duration, family history of diabetes and hypertension, socioeconomic status, physical activity level, and co-existence of other chronic diseases and their relationship with glycemic control status were also assessed. Multivariate logistic regression analysis was used to identify determinants of glycemic control.ResultsAmong 1,710 T2DM patients (60.2% female), the overall prevalence of poor glycemic control was 56.8%. In the unadjusted logistic regression analysis model, a low wealth score index significantly increased the risk of poor glycemic control (OR: 1.49;1.10–2.02). Variables significantly associated with poor glycemic control even after adjusting for confounding factors were first-degree family history of diabetes (OR: 1.34; 1.08–1.65), and sleep duration (OR: 1.29 ;1.02–1.62 for 6.6-8 h/d; OR:1.42;1.10–1.88 for > 8 h/d). Interestingly, we found that the co-existence of ≥ 3 chronic diseases with diabetes decreased the risk of poor glycemic control.ConclusionsIn the current study, most of the patients with T2DM had uncontrolled glycemic control. Due to the individual and social costs of diabetes complications, it is necessary to suggest tailored and effective interventions for controlling blood glucose levels in people with diabetes.

Clopidogrel-induced non-diabetic hypoglycemia reported from Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a case report

BackgroundRecurrent episodes of hypoglycemia may be caused by several factors, including drugs, critical illnesses, hormonal deficiency, non-islet cell tumor endogenous hyperinsulinism, and accidental, surreptitious, or malicious hypoglycemia. Multiple drugs have been previously reported as causes of hypoglycemia, with moderate and low-quality evidence. However, Clopidogrel as a cause of non-diabetic hypoglycemia is rarely reported. Here we describe a single non-diabetic patient who experienced recurrent episodes of hypoglycemia after initiation of clopidogrel for clinical suspicion of acute coronary syndrome.Case presentationThe patient, a 33-year-old Ethiopian male with documented hypertension on antihypertensive medication, has started receiving treatment for acute coronary syndrome after experiencing angina symptoms. He experienced hypoglycemia following the start of Clopidogrel, but it subsided once it was stopped. Currently, he has a follow-up at the cardiac clinic with a normal measurement of his serum blood glucose level.ConclusionNon-diabetic hypoglycemia is a rare illness characterized by low blood glucose levels in people who do not have diabetes. Patients with severe hypoglycemia may become unconscious or have seizures as a result of low blood sugar. Severe hypoglycemia is fatal and must be treated as soon as possible. Therefore, if non-diabetic hypoglycemia occurs, a thorough evaluation of the causes is essential, particularly any potential drug as a cause of hypoglycemia should be evaluated.

Pancreas Histology of Hyperglycemia of Mice (Mus musculus L.) After Treatment Basil (Ocimum x africanum Lour.) Leaf Extract and Papaya (Carica papaya L.)

Hyperglycemia is a condition in which the level of glucose in the blood is abnormally high. Hyperglycemia is caused by disturbances in the metabolic system in secreting insulin. Hyperglycemia if left unchecked can cause a disease which is usually called diabetes. Basil (Ocimum x africanum Lour.) and papaya (Carica papaya L.) leaf extracts can reduce blood glucose levels in people with diabetes mellitus because they contain active compounds of flavonoids, alkaloids and tannins which function as anti-diabetics. The aim of this study was to examine the effectiveness of the effects of basil and papaya leaf in affecting the level of islet damage, and repairing pancreatic histological damage in hyperglycemic mice. This study used a completely randomized design with 5 treatment groups and 5 replications. Group K(N) as normal control, group K(+) as positive control, group K (-) as negative control, group P 1 (alloxan induced and treated with ethanol extract of basil leaves 24.5 mg/35g BW mice) 14 days oral) , P 2 group (induced by alloxan and treated with papaya leaf ethanol extract 24.5 mg/35 g BW mice (14 days oral). Data on the level of histological damage to the pancreas of hyperglycemic mice were analyzed using the Kruskal-Wallis method and the Wilcoxon-MannWhitney test at a significant level of 5%. Data histological appearance of the Langerhans were analyzed descriptively.The results showed basil leaf extract and papaya had an effect on the level of damage to the pancreas of mice, basil leaf extract was effective compared to papaya in histological repair of the mice pancreas

Faktor-Faktor yang Berhubungan dengan Kejadian Diabetes Melitus (DM) di Desa Kubah Sentang Kecamatan Pantai Labu

Analyze the risk factors associated with the incidence of Diabetes Mellitus in the village of Kubah Sentang, Pantai Labu subdistrict. This type of research is quantitative descriptive with a cross sectional research design. The sample in this study were all respondents who were diagnosed with Diabetes Mellitus. Consists of a case sample of 30 people. The factors associated with the incidence of diabetes mellitus are gender, education and hypertension with the incidence of Diabetes Mellitus in residents in the village of Kubah Sentang, Pantai Labu District. The factors that are not related to the incidence of diabetes mellitus are smoking and obesity which have no association with the incidence of DM in the village of Dome Sentang. Occupational status and physical relationships are factors that can affect the risk of diabetes mellitus in Kubah Sentang Village, Pantai Labu District. Physical activity such as exercise is an important part of health in terms of disease prevention. Exercise habits do not greatly affect the decrease in blood sugar but can increase glucose oxidation which can reduce insulin in people with diabetes mellitus. Good exercise will be useful in regulating blood glucose levels in people with diabetes mellitus which will affect the control of blood sugar levels.

An Evaluation of Healthy Eating Scale for Patients with Pre-Diabetes Using Rasch Analysis

Consumption of a healthy diet is required to manage blood glucose level in people with diabetes or pre-diabetes. The aim of this study was to test the internal validity of healthy eating habits assessed using a self-reported scale, the Rapid Eating Assessment for Participants (REAP) scale, in participants with pre-diabetes. The scale had 15 items with 4 categories: “Never”, “Rarely”, “Some days” and “Usually/most days”. Those items were administered to 119 participants from 2006 to 2008 in Victoria, Australia. Rasch analysis was applied using RUMM2030 software. Overall fit was adequate in the unaltered model (χ2 = 29.29, p = 0.500, person separation index (PSI) = 0.500), however, seven items had disordered thresholds which were remedied by collapsing “Rarely” with “Some days” (χ2 = 37.36, p = 0.166, psi = 0.550). Item 1 (“Eat 3 main meals”) remained disordered after collapsing. Two persons were removed due to their fit residuals being outside ±2.5, however, these deletions did not improve the fit, so it was decided to retain these persons in the scale. Overall, there was no significant differential item functioning (DIF) or local dependency. However, there was evidence of multidimensionality and a ceiling effect toward healthy eating in the person item threshold. The results from Rasch analysis showed that the current scale needs some improvement, such as addressing disordered thresholds, for measuring eating habits for people with pre-diabetes. A modified version with middle categories collapsed would provide a psychometrically more robust measure. Further study is needed to validate the scale as a screening tool for measuring healthy eating among people with pre-diabetes.

The Effect of Schleichera oleosa L. on HbA1c Levels in Alloxan-Induced Rats

Diabetes mellitus is a chronic disease that occurs due to the failure of the pancreas to produce sufficient insulin, or the body cannot use the insulin it makes effectively. The HbA1c (glycated hemoglobin) levels show an alteration in blood glucose levels in people with diabetes. As a traditional medicine, the kesambi plant (Schleichera oleosa L.) can improve diabetic people's health due to its secondary compounds, such as alkaloids, flavonoids, tannins, steroids, and phenolic compounds, besides several empirically proven as antiulcer, anticancer, and antimicrobial effects. The study aimed to determine the effect of the ethanol extract of Kesambi leaves on HbA1c levels in alloxan-induced rats. This research used a posttest-only design method, using 18 rats divided into six groups of mice and induced by alloxan 150 mg/kg in intraperitoneal with the division of groups: group I without treatment; group II alloxan + Na CMC; group III alloxan + glibenclamide; groups IV, V, and VI, given alloxan + kesambi leaf extract 200, 400, and 600 mg/kg BW, respectively. All treatments were given orally for 23 days. HbA1c values were measured on day 24 using the Afinion HbA1c. The data obtained were analyzed using the method of comparing the measurement results of each group against the control group. The results showed that the 200, 400, and 600 mg extracts affected HbA1c levels with successive values of 5.47%, 5.37%, and 5.47% compared to the control group, namely 5.10%. This study concluded that giving kesambi leaf ethanol extract can affect HbA1c levels.

THE EFFECT OF FOOT EXERCISE ON LOWER EXTREMITY SENSORY NEUROPATHY STATUS AND BLOOD GLUCOSE LEVELS PATIENTS TYPE 2 DIABETES MELLITUS

Introduction. The increasing prevalence of type 2 diabetes mellitus in developed and developing countries has become a global health problem or disease in society. Therefore, Type 2 Diabetes Mellitus can be prevented with regular exercise, healthy and regular life. The purpose of this study was to determine the effect of foot exercise on the status of lower extremity sensory neuropathy and changes in blood glucose levels in patients with type 2 diabetes mellitus at Tanjunganom Public Health Center, Nganjuk Regency. Method. The design in this study was pre-experimental with a one group pre-posttest design approach, this study sought the effect of foot exercise on the status of lower extremity sensory neuropathy and changes in blood glucose levels in patients with type 2 diabetes mellitus at Tanjunganom Public Health Center, Nganjuk Regency, in this study involved 30 respondents with purposive sampling technique. This research was conducted on October 14-21, 2022. Result&amp;Analysis. From the results of the Wilcoxon test, it was found that after doing foot exercises, the sensory neuropathy status of the lower extremities in the right extremity was obtained value = 0.000&lt;0.05, besides that after doing leg exercises, changes in blood glucose levels were obtained value = 0.000&lt;0.05 this indicates that there was an effect of foot exercise on the sensory neuropathy status of the lower extremities and changes in blood glucose levels in people with diabetes mellitus 2. Discussion. Patients with type 2 Diabetes Mellitus can applicate foot exercises to change lower extremity sensory status and blood glucose level.

Analysis Psychosocial Factors Affecting Behaviour of Self-Monitoring Blood Glucose in People with Type 2 Diabetes Mellitus

Introduction: Compliance with monitoring blood glucose levels is crucial to diabetes management. Self-monitoring behaviour of blood glucose levels can be influenced by psychosocial factors in people with T2DM, such as knowledge, coping, diabetes distress, family support, and nurse support. Objective: The study aimed to analyze psychosocial factors that influence the behaviour of self-monitoring of blood glucose levels in people with T2DM. Methods: The study was a descriptive-analytic study with a cross-sectional design. The sample was T2DM patients in the Jember Regency with a sample size of 138 respondents, taken using multistage random sampling. Data were collected using a questionnaire (SKILLDS, Coping Scale, DDS, HDFSS, Nurse's role perception, and the SMBG questionnaire) and analyzed using a multiple linear regression test. Results The modelling results show that psychosocial factors (knowledge, coping, diabetes distress, family support, and nurse support) have a simultaneous and significant influence on the behaviour of monitoring blood glucose levels (F = 9.292; p = 0.001 &lt; α = 0.05) with adjusted R2 = 0.232. It showed that psychosocial factors could explain the variance of behaviour monitoring blood glucose levels by 23.2%. Partially, there are three influential variables, namely coping, perception of family support, and perception of nurse support (p= 0.039; p= 0.016; and p= 0.020 &lt; α =0.05). Better coping, family support, and nurse support could improve blood glucose monitoring. Conclusion: Psychosocial factors can affect monitoring blood glucose levels in people with T2DM. The nurse can make efforts to improve the behaviour by monitoring blood glucose levels by considering the psychosocial aspects of people with T2DM through preventive promotion efforts to improve coping, family support, and nurse support to improve self-management and quality of life of people with T2DM.

Impact of SGLT2 inhibitors treatment on the chronic kidney disease in people with type 2 diabetes

Diabetes is the most common cause of CKD (chronic kidney disease). CKD is also one of the most important diabetic complication. SGLT2 (sodium glucose co‐transporter‐2) inhibitors are new class of medication used to lower high blood glucose level in people with type 2 diabetes. In new researches SGLT2 inhibitors demonstrated a significant and clinically relevant reduction in the risks of albuminuria and progression of nephropathy, doubling of serum creatinine levels, and initiation of renal replacement therapy. This review focuses on the therapeutic effectiveness of using SGLT2 inhibitors for the treatment of CKD in type 2 diabetes.

Blood glucose levels and the relationship of body mass index and circumference with blood glucose in China

Objective: To describe and compare blood glucose levels in adults aged 18 years old and above in China and explore the relationship between BMI and waist circumference with blood glucose. Methods: China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method selected permanent residents aged 18 years and above. Information on demographics, behavior-related risk factors, BMI, waist circumference, and blood glucose were collected through a face-to-face questionnaire, physical measurement, and laboratory examination. After complex weighting of data, they described the blood glucose levels of people with different characteristics and explored the relationship of BMI and waist circumference with blood glucose by multiple linear regression model analysis. Results: A total of 177 816 adults were included in the study. The average fasting blood glucose and average glycosylated hemoglobin were (5.73±1.46) mmol/L and (5.37±0.83) %, with people aged 60 years old and above group highest than that of other, with males higher than females (P<0.001); and urban was higher slightly than rural for the average of average glycosylated hemoglobin (P<0.001). The average fasting blood glucose and average glycosylated hemoglobin increased with increased BMI and waist circumference (P<0.001). Results from multiple linear regression model analysis showed that: 1) for each increase in BMI unit and waist circumference, the fasting glucose levels increased by 0.019 mmol/L and 0.008 mmol/L (all P<0.001) in those not diagnosed with diabetes, 2) by 0.021 mmol/L (P=0.163) and 0.014 mmol/L (P=0.004) in those newly detected as diabetes, and 3) by 0.028 mmol/L (P=0.088) and 0.023 mmol/L (P<0.001) in those self-reported as having been diagnosed as diabetes, respectively. However, glycosylated hemoglobin levels increased: 1) by 0.015% and 0.006% in those not diagnosed as diabetes (all P<0.001), 2) by 0.050% and 0.019% in those newly detected as diabetes (all P<0.001), and 3) by 0.033% and 0.019% in those self-reported as having been diagnosed as diabetes (all P<0.001), respectively. These associations with waist circumference were more robust than with BMI. Conclusions: Adults not diagnosed with diabetes with abnormal BMI or waist circumference are the key population for prevention and control. Measures improving the awareness rate of waist circumference should be taken to maintain average blood glucose in various groups.

Implementation of Transtheoretical Model Nutrition Education and Chromium Picolinate Supplementation on Improved Dietary Adherence Behavior, Chromium Consumption Pattern and Blood Glucose Level Diabetes Mellitus Patients

Bali is one of the provinces in Indonesia that has a Diabetes Mellitus rate above the national prevalence. According to the results of the 2020 study, 56.9% of DM patients did not understand diet education and did not comply with the diet by 56.9% with abnormal blood glucose levels of 63.9%. The results confirmed that repeated exposure with the right method, especially with The theoretical model is very effective in increasing knowledge and adherence to diet and chromium consumption patterns in DM patients. Chromium is effective in improving blood glucose levels in people with Diabetes Mellitus (Types 1 and 2). Chromium improves glucose metabolism in patients with prediabetic glucose intolerance and all women with gestational diabetes. The purpose of this study was to determine the role of nutrition education using a transtheoretical model and the effect of chromium picolinate supplementation on dietary adherence behavior, chromium consumption patterns, and blood glucose levels in patients with diabetes mellitus. This type of research is quasi-experimental. The research design used was one group pretest-posttest. This design does not use a comparison group (control) but uses the first observation (pretest) which allows testing the changes that occur after the experiment or program (Notoatmodjo, 2010). The study was conducted at the Denpasar Health Center. The results showed that there were differences in the level of knowledge and consumption of chromium and blood glucose levels in DM patients. However, there was no difference in the attitude and level of dietary compliance of DM patients.

Challenges of diabetes care in India: Results from a Family Cohort Study.

Diabetes is a significant public health concern in India, with Kerala being labeled as the diabetes capital of the country. The study aims to evaluate the prevalence, treatment, and management of diabetes to examine the unmet need for care to propose cost-effective strategies. A cross-sectional study was conducted on a geographically defined cohort population in Ernakulam. This paper presents diabetes data of adults ≥30 years enrolled from the community cohort. The interviews were conducted with 997 participants at their residence. Random blood glucose was assessed for each participant using a finger prick test. The overall prevalence of diabetes was 30.1%, of which 4.1% of participants had undiagnosed diabetes. Among those with diabetes, 86.3% were aware of their diagnosis; among those aware, 86.5% were on treatment. Among those on treatment for diabetes, 54% achieved controlled blood sugar. The challenge in diabetes management is controlling the blood glucose levels of people who adhere to treatment. Younger employed females from lower-income quartiles have the highest risk. The study also raises questions about quality and strategies for medication compliance. The findings inspire future research on care needs, policies, and program responses to reduce the diabetes disease burden.