Control Of Glucose Levels Research Articles

IDF21-0212 Interactions between herbs and antidiabetic drugs and their effects on glycemia: A simple tool for a fast identification

Background: Many studies conducted in Algeria have found that approximately 39% (Boutebba M et al) to 43% (Sadoun et al) of diabetics use the plants concomitantly with their conventional drugs with 22% describing adverse reactions (hypoglycemia or hyperglycemia).This notion is not taken in consideration by many clinicians due to the lack of information and the absence of trainings in the field of phytotherapy, NHP and their potential interactions with drugs. Aim: Our aim is to help health professional identifying potential herbs-antidiabetic drugs interaction by creating a simple tool by reviewing the literature. Method: Databases (MEDLINE, Google scholar, science direct, NCBI) and books (as Medi-herb, WHO monographs on selected medicinal plants…) were consulted searching for the clinical studies, case reports and studies published in term of herb-antidiabetic drugs interaction. The most commonly used plants by the Algerian diabetics were selected using the previous ethnopharmacological surveys and the antidiabetic effect of these plants to deduct the potential pharmacodynamic interactions were searched. The interactions were classified into four groups each group corresponds to a level of evidence:1.Probable interactions with high chances to produce: include interactions supported by clinical evidence and case studies.2.Possible interactions with medium chances to produce: include interactions based on animal or in vitro data.3.Theoretical interactions: include theoretical interactions extrapolated from pharmacodynamic and pharmacokinetic data.4.No reported interactions or theoretical interactions identified from the literature. Results: Thirty-one plants and six antidiabetic drugs were retained to create the tool. More than 200 references were reviewed. A grid was established with color keys that were used to simplify the detection of the interaction and its level of evidence by the user. Discussion: The tool that we developed can help health professionals who take care of diabetics to determine the risk of hyperglycemia or hypoglycemia and avoiding them which contributes to a better control of glucose level and an improvement of the diabetes management.

Therapeutic comparison of flex seed and black seed supplementation for treatment of type II diabetic patients

Diabetes is one of the most prevailing global health issues. Genetic factors, obesity, environmental factors, poor dietary habits and sedentary life style are the main causes of its occurrence that leads to hyperglycemia and insulin resistance. In recent years therapeutic effects of dietary flaxseed and blackseed in management of diabetes has been studied. Both possess anti-oxidant, anti-hyperglycemic and anti-inflammatory properties. Secoisolariciresinol diglucoside (SDG) is a lignan present in flaxseed that lower the blood glucose level and fiber control insulin secretion and its mechanism of action. Thymoquinone (TQ) is a bioactive component present in flaxseed that control blood glucose level, insulin secretion and maintain glucose hemostasis. Both seeds are considered as highly acceptable with the great safety profile in management of type II diabetes. Therefore, this article highlights the therapeutic effects of flaxseed and blackseed supplementation in management of type II diabetes.

Correlations of Salivary and Blood Glucose Levels among Six Saliva Collection Methods.

Background: Saliva has been studied as a better indicator of disorders and diseases than blood. Specifically, the salivary glucose level is considered to be an indicator of diabetes mellitus (DM). However, saliva collection methods can affect the salivary glucose level, thereby affecting the correlation between salivary glucose and blood glucose. Therefore, this study aims to identify an ideal saliva collection method and to use this method to determine the population and individual correlations between salivary glucose and blood glucose levels in DM patients and healthy controls. Finally, an analysis of the stability of the individual correlations is conducted. Methods: This study included 40 age-matched DM patients and 40 healthy controls. In the fasting state, saliva was collected using six saliva collection methods, venous blood was collected simultaneously from each study participant, and both samples were analyzed at the same time using glucose oxidase peroxidase. A total of 20 DM patients and 20 healthy controls were arbitrarily selected from the above participants for one week of daily testing. The correlations between salivary glucose and blood glucose before and after breakfast were analyzed. Finally, 10 DM patients and 10 healthy controls were arbitrarily selected for one month of daily testing to analyze the stability of individual correlations. Results: Salivary glucose levels were higher in DM patients than healthy controls for the six saliva collection methods. Compared with unstimulated saliva, stimulated saliva had decreased glucose level and increased salivary flow. In addition, unstimulated parotid salivary glucose was most correlated with blood glucose level (R2 = 0.9153), and the ROC curve area was 0.9316, which could accurately distinguish DM patients. Finally, it was found that the correlations between salivary glucose and blood glucose in different DM patients were quite different. The average correlation before breakfast was 0.83, and the average correlation after breakfast was 0.77. The coefficient of variation of the correlation coefficient before breakfast within 1 month was less than 5%. Conclusion: Unstimulated parotid salivary glucose level is the highest and is most correlated with blood glucose level, which can be accurately used to distinguish DM patients. Meanwhile, the correlation between salivary glucose and blood glucose was found to be relatively high and stable before breakfast. In general, the unstimulated parotid salivary glucose before breakfast presents an ideal saliva collecting method with which to replace blood-glucose use to detect DM, which provides a reference for the prediction of DM.

Possible Role of rs7903146 Polymorphism of the Transcription Factor 7-Like 2 Gene in Genetic Predisposition to Type 2 Diabetes.

<b>Background and Objective:</b> The association of rs7903146 polymorphism of TCF7L2 gene with Type 2 diabetes mellitus found almost in all ethnic groups. Therefore, the current study focused on estimating this association in the Azerbaijan population for the 1st time. <b>Materials and Methods:</b> A study was conducted on 110 patients with Type 2 diabetes mellitus and 115 healthy controls. The biochemical parameters were analyzed and calculated with an independent t-test and Fisher exact test. DNA extracted from the blood samples run in PCR. PCR was used to detect the presence of TCF7L2 rs7903146 C/T polymorphism and the products of the PCR were visualized in a 1.5% gel electrophoresis. <b>Results:</b> According to the obtained data, T allele and TT genotype of rs7903146 polymorphism strongly correlated with the risk for Type 2 diabetes (odds ratio of 1.68 for T allele and p = 0.007, odds ratio of 3.9 for TT genotype, p = 0.0028). These results were adjusted by applying the recessive model (p = 0.003). Moreover, the biochemical parameters also show a significant difference in the fasting glucose level (p = 0.0001), fasting insulin (p = 0.0001), BMI (p = 0.0002) and age (p = 0.015) inpatient and control groups. <b>Conclusion:</b> Based on the results, the TCF7L2 rs7903146 (C>T) polymorphism is the genetic risk factor related to Type 2 diabetes in the Azerbaijan population.

Acetylated Trifluoromethyl Diboronic Acid Anthracene with a Large Stokes Shift and Long Excitation Wavelength as a Glucose-Selective Probe

Continuous control of blood glucose levels is important for the effective treatment of diabetes. The short-term use of enzymatic continuous monitoring systems involves expensive maintenance and is inconvenient, which limits their widespread use by diabetes patients. The fluorescent diboronic anthracene-embedded system has demonstrated in vivo continuous glucose monitoring for 12 times longer than enzymatic systems by protecting the dye from reactive oxygen species. However, its small Stokes shift and low excitation and emission wavelength should be heavily considered for easy fabrication. We successfully synthesized a derivative of bis-phenyl boronate with a large Stokes shift and long excitation wavelength by adding an acetyl moiety to the anthracene ring. This resulted in a ~90-nm Stokes shift and 15-nm and 80-nm redshifts of the excitation and emission wavelengths, respectively. The fluorescence of the synthesized probe increased proportionally with the glucose concentration because the formation of the boronic acid-glucose complex prevented photoinduced electron transfer. The association constant and quantum yield for acetyl-substituted diboronic anthracene with glucose was 20% and 13% higher than that of the analog, respectively. While keeping resistance to the oxidation by reactive oxygen species, the improved optical properties and glucose-detecting performances of the newly synthesized dye will allow better pairing of the source and detecting unit for in vivo continuous glucose monitoring, leading to easy fabrication and then contributing more to utilization by diabetes patients.

Fast Customization of Hollow Microneedle Patches for Insulin Delivery.

Hollow microneedle patches (HMNPs) have great promise for efficient and precise transdermal drug delivery in a painless manner. Currently, the clinical application of HMNPs is restricted by its complex manufacturing processes. Here, we use a new three-dimensional (3D) printing technology, static optical projection lithography (SOPL), for the fast fabrication of HMNPs. In this technology, a light beam is modulated into a customized pattern by a digital micromirror device (DMD) and projected to induce the spatial polymerization of monomer solutions which is controlled by the distribution of the light intensity in the monomer solutions. After an annulus picture is inputted into the DMD via the computer, the microneedles with hollow-cone structure can be precisely printed in seconds. By designing the printing pictures, the personalized HMNPs can be fast customized, which can afford the scale-up preparation of personalized HMNPs. Meanwhile, the obtained hollow microneedles (HMNs) have smooth surface without layer-by-layer structure in the commonly 3D-printed products. After being equipped with a micro-syringe, the HMNPs can efficiently deliver insulin into the skin by injection, resulting in effective control of the blood glucose level in diabetic mice. This work demonstrates a SOPL-based 3D printing technology for fast customization of HMNPs with promising medical applications.

Expanding arsenal against diabetes mellitus through nanoformulations loaded with glimepiride and simvastatin: A comparative study

Type 2 diabetes mellitus is one of the most common and life-threatening diseases found across the globe. It occurs due to insulin resistance (IR). Major causes of IR include obesity, sedentary life style and hyperlipidemia. Glimepiride (GLM) is one of the most common oral sulphonyl ureas that is being used to treat diabetes and Simvastatin (SIM) is one of the most common statins that is used to treat hyperlipidaemia. However, both the drugs suffer from dissolution rate limited oral bioavailability. Hence, the aim of present study was to develop two different nanoformulations viz. nanosuspension and self-nanoemulsifying drug delivery systems (SNEDDS) and evaluate their potential in treating type 2 diabetes mellitus on streptozotocin (STZ) induced rats. In the present study two such drugs, GLM and SIM were co-formulated into nanosuspension (NS) as well as self-nanoemulsifying drug delivery systems (L-SNEDDS). Both formulations were spray dried for solidification and evaluated for their antidiabetic potential against high fat diet and streptozotocin induced rat model. The study showed significant (p < 0.05) decrease in lipid/cholesterol and blood glucose levels and significant increase in antioxidant levels in the rats treated with NS and SNEDDS containing the drugs alone as well as their combination as compared to their unprocessed forms. However, the efficacy was more prominent in case of combination possibly due to dual benefits i.e., decrease in IR due to statin and control of blood glucose level. Among NS and SNEDDS, NS was found more efficacious than that of the SNEDDS possibly due to higher enhancement of oral bioavailability in case of NS.

Neutrophil extracellular traps (NETosis) as a factor contributing to the development and progression of diabetes mellitus and its microvascular complications

NETosis, a new form of cell death, has attracted close attention of researchers in recent years due to its dual eff ect on the pathological process. Being initially a defense reaction of the innate immune defenсe aimed at trapping and neutralizing pathogens (bacteria, viruses and fungi) that have invaded the body, NETosis, in case of excessive activation, has an opposite eff ect. It can contribute to the progression of the disease, causing autoimmunization, damage to surrounding tissue, or the occurrence of atherothrombotic events. This review presents data dealing with the formation of extracellular traps of neutrophils, called NETs. NETosis plays an important role in the pathogenesis of diabetes mellitus (DM) and its microvascular complications. For example, in type 1 DM, β-cell death promotes sequestration of neutrophils into the pancreas and is clearly correlated with increased NETosis. In patients with type 2 DM, the release is also signifi cantly increased. High levels of dsDNA, a marker of NETosis, are correlated with the development of cardiovascular disease and DM caused kidney disease, which is also consistent with the contributing role of NETosis in the pathogenesis of diabetic complications such as impaired wound healing and diabetic retinitis. The mechanisms linking NETosis with high glucose levels are not clearly understood, as NETosis is also increased in diabetic patients strictly controlling glucose levels. One can only assume that NETosis is not a consequence of impaired glycemic control. On the contrary, it causes hyperglycemia, which further increases the initially high level of NETosis in patients with DM.

Efficacy of the Extract from Fermentation of Soybean and Rice Bran on Hyperglycemia

In recent years, lifestyle-related diseases such as hypertension and diabetes have been on the rise. These conditions can cause serious conditions such as myocardial and cerebral infarctions. Therefore, proper control of blood pressure and blood glucose levels is important issues in preventive medicine. Traditional fermented foods have been shown to have various functions, and their effects on lifestyle-related diseases have attracted particular attention. In this study, we investigated the effects of fermented soybeans and rice bran (OE-1) and supplements containing OE-1 on blood glucose levels and weight changes. We identified an inhibitory effect on elevated blood glucose levels upon administration of OE-1, and this effect was thought to be due to digestive enzyme inhibition. These effects of foods containing OE-1 are expected to have a positive effect on the prevention and improvement of lifestyle-related diseases as health foods.

Effect of Crude Leaves Extract of Bersama abyssinica on Blood Glucose Level and Serum Lipid Level of Streptozotocin-Induced Diabetic Mice: Evidence for in vivo Antidiabetic Activity.

Diabetes mellitus is one of the major and common metabolic and chronic disorders in the world. Several medicinal plants have been used globally for the management of diabetes mellitus. The current study aimed to study the antihyperglycemic and antihyperlipidemic effects of Bersama abyssinica. Antidiabetic effect of 80% methanolic crude extract of Bersama abyssinica was studied in a repeated dose-treated STZ-induced diabetic mice model. The activities of Bersama abyssinica on serum lipid level and body weight were investigated on STZ-induced diabetic mice. Data were analyzed using one-way ANOVA and were significant when the p-value was less than 0.05. All doses of the crude 80% methanolic extract of Bersama abyssinica (100 mg/kg, 200 mg/kg, and 400 mg/kg) exhibited a noticeable BGL reduction when compared with baseline blood glucose level and diabetic control on the 7th and 14th days of administration. Moreover, higher dose of the extract (at 400 mg/kg) significantly (p < 0.001, 54.3%) decreased the BGL in STZ-induced diabetic mice. The maximum decrement in fasting BGL was achieved at the 14th days: 34.92%, 41.10%, 54.30%, and 59.66%, respectively for BAC 100 mg/kg, BAC 200 mg/kg, BAC 400 mg/kg, and GLC 5 mg/kg treated groups. Bersama abyssinica also displayed a significant (p < 0.05) improvement of serum lipid levels and body weight. Bersama abyssinica crude extract exhibited a significant antidiabetic effect and prevented body weight loss in streptozotocin-induced diabetic mice. The finding also confirmed the valuable biochemical activity of Bersama abyssinica by improving serum lipid levels.

Novel Glitazones Reverses Hyperglycemia In STZ Induced Hyperglycaemic Rat Model

Diabetes mellitus is the most common chronic metabolic disorder characterized by reduced secretion of insulin or sensitivity to the insulin. It is also a disease of inadequate control of glucose levels in the blood plasma. The present study was formulated to assess the novel glitazones for hypoglycaemic activity in STZ induced rat model. Before in-vivo studies, thirty-two virtual compounds of novel glitazones were subjected to the molecular docking study. The docking study showed that, the compounds C5 and C22 showed the better binding activity with the target protein 3CS8. The acute toxicity studies were done on female rats using OECD guideline 425. No mortality observed at 300 mg/kg per kg body weight and based on this result, the dose for in-vivo studies was chosen. The compounds C5 and C22 were evaluated for the hypoglycaemic activity at 10 and 20 mg/kg body weight in STZ induced hyperglycaemic rats. The compound C5 at both the dose (10 mg and 20 mg/kg) showed the better activity than C22, where as C22 exhibited better activity at higher dose when tested. The activity was assessed by behavioural and biochemical parameters, on 0th ,7 th, 14 th and 21st day. The study duration was three weeks, on 21st day, the animals were sacrificed and biochemical estimations were done. The compound C5 showed significant activity when compared with C22. The current findings gives a lead for further research to prove the hypoglycaemic activity of novel glitazones at molecular level by employing some more research models.

The Association of Hemoglobin A1c Levels and Depression Among Adults With Diabetes in the United States.

Aim: Diabetes mellitus is linked to a decreased health-related quality of life, including poor mental health. Glycated hemoglobin/hemoglobin A1c (HbA1c) is an important marker in the diagnosis and management of diabetes mellitus. The main objective of this study was to assess the association between HbA1c levels (adequate control of serum glucose levels) and depression status among people with diabetes mellitus in the United States.Methods: We performed a secondary analysis of data from participants of the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The main exposure was HbA1c levels dichotomized into ≤ 7 and > 7. The primary outcome was Patient Health Questionnaire (PHQ-9) scores, dichotomized into no depression (scored 0-4 points) and depression regardless of severity (scored 5-27). Logistic regression was used to assess independent associations.Results: Our sample included 429 adults with diabetes in the United States. About 41.5% had HbA1c > 7 and 26.8% presented some level of depression. The unadjusted analysis indicated that compared to adults with diabetes with HbA1c > 7, those with HbA1c ≤ 7 had 1.5 times greater odds of having some level of depression (OR = 1.5, 95% CI: 1.04-2.1, p-value = 0.033). However, in the analyses adjusted for sex, race/ethnicity, poverty, BMI, and sedentary lifestyle, the association between HbA1c levels and depression was no longer significant (OR = 1.2, 95% CI: 0.9-1.8, p-value = 0.256). Other factors increasing the odds of depression included lower income to poverty ratio ≤ 1.3 (OR 2.9, 95% CI: 1.0-8.5, p-value = 0.048) and sedentary lifestyle of 5-10 hours and >10 hours (OR = 2.7, 95% CI: 1.6-4.5, p-value = 0.001 and OR = 5.2, 95% CI: 1.7-15.4, p-value = 0.006, respectively).Conclusion: Our study found no evidence for an association between HbA1c levels and depression. Due to limitations in power and the potential selection and measurement bias, further prospective studies in this field are needed. Implementation of depression screenings in people with diabetes may allow for timely treatment to those affected, improving the mental health of this population.

The Case for Clinical Trials with Novel GABAergic Drugs in Diabetes Mellitus and Obesity.

Obesity and diabetes mellitus have become the surprising menaces of relative economic well-being worldwide. Gamma amino butyric acid (GABA) has a prominent role in the control of blood glucose, energy homeostasis as well as food intake at several levels of regulation. The effects of GABA in the body are exerted through ionotropic GABAA and metabotropic GABAB receptors. This treatise will focus on the pharmacologic targeting of GABAA receptors to reap beneficial therapeutic effects in diabetes mellitus and obesity. A new crop of drugs selectively targeting GABAA receptors has been under investigation for efficacy in stroke recovery and cognitive deficits associated with schizophrenia. Although these trials have produced mixed outcomes the compounds are safe to use in humans. Preclinical evidence is summarized here to support the rationale of testing some of these compounds in diabetic patients receiving insulin in order to achieve better control of blood glucose levels and to combat the decline of cognitive performance. Potential therapeutic benefits could be achieved (i) By resetting the hypoglycemic counter-regulatory response; (ii) Through trophic actions on pancreatic islets, (iii) By the mobilization of antioxidant defence mechanisms in the brain. Furthermore, preclinical proof-of-concept work, as well as clinical trials that apply the novel GABAA compounds in eating disorders, e.g., olanzapine-induced weight-gain, also appear warranted.

Old and Novel Therapeutic Approaches in the Management of Hyperglycemia, an Important Risk Factor for Atherosclerosis.

Hyperglycemia is considered one of the main risk factors for atherosclerosis, since high glucose levels trigger multiple pathological processes, such as oxidative stress and hyperproduction of pro-inflammatory mediators, leading to endothelial dysfunction. In this context, recently approved drugs, such as glucagon-like-peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), could be considered a powerful tool for to reduce glucose concentration and cardiovascular risk. Interestingly, many patients with type 2 diabetes mellitus (T2DM) and insulin resistance have been found to be deficient in vitamin D. Recent studies pointed out the unfavorable prognostic values of T2DM and vitamin D deficiency in patients with cardiac dysfunction, either when considered individually or together, which shed light on the role of vitamin D in general health status. New evidence suggests that SGLT2i could adversely affect the production of vitamin D, thereby increasing the risk of fractures, which are common in patients with T2DM. Therefore, given the biological effects of vitamin D as an anti-inflammatory mediator and a regulator of endothelial function and calcium equilibrium, these new findings should be taken into consideration as well. The aim of this review is to gather the latest advancements regarding the use of antidiabetic and antiplatelet drugs coupled with vitamin D supplementation to control glucose levels, therefore reducing the risk of coronary artery disease (CAD).

Detection of Non-Alcoholic Fatty Liver Disease in Patients with Type-2 Diabetes Mellitus

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is defined as excessive fat in the liver that is not caused by excessive alcohol consumption. Recent studies have shown that NAFLD can predict the onset of diabetes and vice versa, and that one ailment might act as a progression factor for the other. The paper aims to find out the various risk factors associated with developing Non-Alcoholic Fatty Liver Disease (NAFLD) in patients with type 2 Diabetes Mellitus to prevent both hepatic and systemic flares. Material and Method: A prospective cross-sectional observational study was conducted around 950 known patients of type 2 Diabetes Mellitus attending the outpatient Diabetes clinics during a period of May 2019 to May 2021 at NIMS Medical College &amp; Hospital. Among them, 150 patients, willing to participate were selected as per inclusion and exclusion criteria. Results: A statistically significant difference was observed between the study groups in relation to Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, serum proteins, Albumin, AST, ALT, Alkaline Phosphatase as the p-value calculated to be &lt;0.05. Conclusions: The study showed people with high glycemic index have a higher chance of developing the disease. Thus tighter control of blood glucose level is the key to prevention. Obesity, uncontrolled diabetes, deranged lipid profile and abnormal liver enzymes are some of the risk factors for developing NAFLD. Thus screening must include all this risk factors and management strategies should address them separately.

Understanding different causes of Blindness with focus on Diabetic Retinopathy patients: a cross-sectional study

Background: National program for control of blindness and visual impairment is a centrally sponsored programme with the goal of reducing the prevalence of blindness. The data regarding the beneficiaries can help in planning for preventable causes of blindness. Diabetic retinopathy caused by diabetes mellitus is one such important cause that can be prevented with proper control of blood glucose levels and regular screening for DR; possible with appropriate knowledge and awareness among patients about the relationship between DM and Retinopathy.Methods: A cross-sectional study was carried out comprising two components: desk review of patients (N=1072) including all the beneficiaries of NPCBVI during August-2019 and October-2019 and personal interviews of DR patients (N=62) enrolled during same duration using semi-structured interviews at Tertiary care hospital in Waghodia, Gujarat.Results: Out of 1072 beneficiaries of NPCBVI, 61.4% were diagnosed with ocular disorders/diseases; 8% had Blindness and 92% had Visual impairment. Highest visual impairment was found due to uncorrected refractive error (62.75%) and highest blindness due to cataract (27.3%). Among 62 DR patients, mean random blood sugar levels was 238 mg/dl (SD±87.80) and majority (85.5%) had HbA1c levels in diabetic range. Out of all DR patients, 77.4% were unaware about the relationship between diabetes mellitus and retinopathy.Conclusions: Highest visual impairment and blindness were found due to uncorrected refractive errors and cataract respectively. Majority of DR patients showed poor long term control of blood sugar levels noted by high HBA1c levels and presented a noteworthy lack of awareness regarding retinopathy caused by DM.

Molecular Aspects of Insulin Aggregation and Various Therapeutic Interventions.

Protein aggregation leading to the formation of amyloid fibrils has various adverse effects on human health ranging from fatigue and numbness to organ failure and death in extreme cases. Insulin, a peptide hormone commonly used to treat diabetes, undergoes aggregation at the site of repeated injections in diabetic patients as well as during its industrial production and transport. The reduced bioavailability of insulin due to aggregation hinders the proper control of glucose levels in diabetic patients. Thus, it is necessary to develop rational approaches for inhibiting insulin aggregation, which in turn requires a detailed understanding of the mechanism of fibrillation. Given the relative simplicity of insulin and ease of access, insulin has also served as a model system for studying amyloids. Approaches to inhibit insulin aggregation have included the use of natural molecules, synthetic peptides or small molecules, and bacterial chaperone machinery. This review focuses on insulin aggregation with an emphasis on its mechanism, the structural features of insulin fibrils, and the reported inhibitors that act at different stages in the aggregation pathway. We discuss molecules that can serve as leads for improved inhibitors for use in commercial insulin formulations. We also discuss the aggregation propensity of fast- and slow-acting insulin biosimilars, commonly administered to diabetic patients. The development of better insulin aggregation inhibitors and insights into their mechanism of action will not only aid diabetic therapies, but also enhance our knowledge of protein amyloidosis.

Analysis of the Effect of Holistic Nursing on Elderly Diabetic Patients and Its Influence on Blood Glucose Control Level

Analysis of the Effect of Holistic Nursing on Elderly Diabetic Patients and Its Influence on Blood Glucose Control Level

Sex-Specific Associations Between Diabetes Mellitus and Hearing Loss in the Middle-Aged and Elderly Individuals: A National Cohort Study of Chinese Adults

ObjectiveTo examine the association between diabetes and hearing loss and whether the association varied by sex. MethodsThis cohort study based on nationally representative data from the China Health and Retirement Longitudinal Study included 16 140 Chinese adults aged >45 years between 2011 and 2018. Diabetes was identified by blood glucose levels, HbA1c levels, and a self-reported diagnosis at baseline. The main outcome was self-reported incident hearing loss. Cox proportional hazards regression models were performed to estimate the risk of hearing loss. ResultsWe documented 2388 cases of hearing loss during a median 6.9 years of follow-up. The incidence rates were 29.64 (95% CI, 28.07-31.29) per 1000 person-years in women and 25.23 (95% CI, 23.77-26.78) per 1000 person-years in men. After adjustment, the hazard ratios of hearing loss associated with diabetes were 1.20 (95% CI, 1.01-1.42) for women and 0.97 (95% CI, 0.78-1.19) for men. Compared with poor control of the blood sugar levels, the odds ratio for hearing loss for women with good glycemic control was reduced from 5.08 (95% CI, 1.31-19.66) to 1.26 (95% CI, 0.69-2.28), and the corresponding odds ratio for men was 1.65 (95% CI, 0.61-4.44) to 0.50 (95% CI, 0.18-1.38). ConclusionIn conclusion, we identified a differential effect of sex on hearing loss risk with more pronounced effects for women. Our data suggest that good blood glucose level control is helpful to prevent hearing loss.

Illness perception, medication adherence and glycemic control among primary health-care patients with type 2 diabetes mellitus at Port Said City, Egypt.

Despite the availability of a wide selection of antidiabetic treatments, many patients with type 2 diabetes mellitus (T2DM) still do not have controlled glucose levels. This study aimed to assess illness perception, medication adherence, and glycemic control among primary care attendees with T2DM. A cross-sectional study was conducted between July 2019 and November 2020. A random sample of 265 Egyptian T2DM patients were enrolled from primary health-care settings in Port Said, Egypt. Data on socio-demographic characteristics, lifestyle habits, and diabetic medical history were collected using a semi-structured questionnaire. The Brief Illness Perception Questionnaire (B-IPQ) was used to assess diabetes perception, whereas the 8-item Morisky Medication Adherence Scale (MMAS-8) was used to investigate medication adherence. There was a significant difference in B-IPQ scores between different groups of the patients in terms of diabetic medications, complications, and glycemic control (p < 0.05). There was a significant difference in MMAS-8 score found between different groups of the patients in terms of disease duration, family history of T2DM, and glycemic control (p < 0.05). Further, there was a significant difference in HbA1c score found between different groups of patients in terms of disease duration, medications, complications, and family history of T2DM (p < 0.05). Higher BMI, a positive family history of T2DM, patients who take insulin, high illness perception, and poor medication adherence were the factors associated with higher HbA1c level. Higher HbA1c levels were linked to a higher BMI, a positive family history of T2DM, insulin users, high illness perception, and poor medication adherence.