Diabetic Diet Research Articles

Lived Experiences of Parents of Children Having Type-I Diabetes Aged 6 to 12 Years

Type I diabetes is chronic illness which change the life styles of parents, children as well as the entire family. Parents faced many challenges such as care, management (insulin administration, diabetic diet, blood glucose monitoring) and treatment cost. Objective of the study is to explore lived experience of parents of children having type I diabetes. A qualitative phenomenological study design was adopted, and total eleven parents (8 mothers and 3 fathers) were selected as participants by using non probability purposive sampling procedure. Data was gathered by using in-depth interview. The huge information was reduced to smaller statements by grouping similar responses to get actual meaning which were coded, categorized and organized to sub themes and themes. Findings revealed that parents had experienced so many ups and downs emotional feelings during the journey of treatment. They experienced nature of type I diabetes like treatment need for the whole of life, hardship during diagnosis process, facing the diabetes complications, financial crisis and need for treatment in emergency situation. The study also revealed that parents felt permanent impact from their child’s previous health condition and disruption of family unit but they were hopeful about their children’s future consequences. They struggled for supporting and caring their children’s lives at all times in the best possible ways. They learnt to live with children having Type-I diabetes. Parents suggested to launch awareness programs to educate school teachers, staffs and health worker for early diagnosis.

Essential role of germ cell glycerol-3-phosphate phosphatase for sperm health, oxidative stress control and male fertility in mice.

Obesity, diabetes and high-calorie diets are associated with defective sperm function and lowered male fertility. Mature spermatozoa primarily use fructose and glucose, and glucose and glycerol metabolism are important for sperm function. We recently discovered a novel mammalian enzyme, glycerol-3-phosphate (Gro3P) phosphatase (G3PP), and showed that it operates the glycerol shunt by hydrolyzing Gro3P to glycerol, and regulates glucose, lipid and energy metabolism in pancreatic β-cells and liver. We now observed that G3PP expression is the highest in the testis and spermatozoa, and investigated its role in male fertility. We examined G3PP expression during spermatogenesis in mouse and assessed male fertility and spermatozoon function in conditional germ cell specific G3PP-KO (cG3PP-KO) mice and tamoxifen-inducible conditional germ cell G3PP-KO (icG3PP-KO) mice. We also determined the structural and metabolic parameters and oxidative stress in the spermatozoa from icG3PP-KO and control mice. G3PP expression in mouse spermatocytes and spermatids markedly increases during spermatogenesis. Male cG3PP-KO mice, in which germ cell G3PP is deleted from embryonic stage, are infertile due to dysfunctional sperm with reduced motility and capacitation, and elevated spontaneous acrosomal reaction and oxidative stress. However, in icG3PP-KO male mice do not have altered fertility, due to the presence of ∼10% normal spermatozoa. icG3PP-KO spermatozoa display significantly reduced functionality and morphological and ultrastructural alterations. The icG3PP-KO spermatozoa show reduced glycerol production, elevated levels of Gro3P and reactive oxygen species (ROS), and oxidative stress that is associated with increased mitochondrial membrane potential. Germ cell G3PP deletion leads to the generation of spermatozoa that are functionally and structurally abnormal, likely due to the build-up of Gro3P that increases mitochondrial membrane potential, ROS, and oxidative stress and alters spermatozoa function. Overall, the results indicate that G3PP and the glycerol shunt are essential for normal spermatozoa function and male fertility.

The effect of the keto diet on lipid profile with type two diabetic patients

Introduction. In the developed world, among the main causes of disease and death is type 2 diabetes. It is a significant public health issue with rising prevalence, with more than 380 million patients estimated to be affected by 2025.Aim. To evaluate the effect of ketogenic diets on glycemic control in patients with type II DM in Kirkuk and Mosul provinces.Materials and methods. Patients with T2DM in both Mosul and Kirkuk cities were enrolled in this study to evaluate the effect of keto diet on HbA1c level and Lipid profile variations between 1/9/2022 to 1/4/2023.Results and discussion. This study shows that the distributions of patients according to age and gender there was about 43.3 % female and 56.7 % male and the age variations, female with age above 56 years old was 30 % while male 60.7 %. A significant p value was shown in HbA1C variations before and after keto diet (0.0001), also in lipid profile of a significant p value before and after keto diet (0.001) regarding total Glyceride a significant p value highly was (0.002). Due to the large particle size of LDL-C, it has been hypothesized that this elevation in LDL-C would not likely cause cardiovascular problems. For individuals with type 2 diabetes, the low-calorie-ketogenic VLCK diet (<50 g of carbohydrates per day) is a safe, well-tolerated, and recognized medical nutritional therapy option when used in conjunction with an interventional weight loss program that offers support for lifestyle and behavioral modification over a 4-month period.Conclusion. Diabetic and ketogenic diet there is a good clear relationship regarding the HbA1c and lipid profile. Further studies are required for larger numbers of patients and longer duration follow up.

Dietary practices and associated factors among adult diabetic patients at academic tertiary-level hospitals in central Ethiopia: convergent mixed study

BackgroundDiabetes mellitus (DM) is one of the most prevalent chronic diseases worldwide. Despite the existence of national strategies to prevent potential complications, DM-related morbidities and mortality continue to rise in Ethiopia. Although studies have been conducted regarding dietary practices among DM patients in the country, there is a lack of in-depth understanding of the situation.ObjectiveTo assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia in 2024.MethodsA concurrent mixed-methods study was conducted from January 01 to 30, 2024, involving 420 adult DM patients. Participants were selected using a simple random sampling technique for the quantitative study. A purposive sampling technique was used to select sixteen participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and in-depth interviews were conducted for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data.ResultOf 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (42.4%). Being female, residing in urban areas, having a family history of DM, and having good dietary knowledge were significantly associated with better dietary practices. From the qualitative analysis, two themes emerged "Living as before and not adhering to diabetic dietary recommendations" and "Barriers to adherence to effective eating practices."Conclusions and recommendationsLess than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended.

Management of a Dual Low Sodium and Diabetic Diet by Patient-Caregiver Dyads: A Qualitative Descriptive Study.

The purpose of the study was to explore factors surrounding management of simultaneous dietary recommendations for heart failure and type 2 diabetes among patient-caregiver dyads. Qualitative description was used to explore dyad experiences managing a dual diet. Semi-structured interviews were conducted with patients with a concurrent diagnosis of type 2 diabetes and heart failure and their family caregiver. Each 60-minute interview was conducted virtually. Interviews were audio recorded and transcribed verbatim. Thematic analysis was conducted with coding used for themes at dyadic-and individual levels. Twelve patient-caregiver dyads (N = 24) were interviewed. The mean age was 57 years (±15 years). Most participants were white (75%); patients were predominantly male, and caregivers were predominantly female (83.3% for both). Dyadic-level themes that emerged included factors that influence simultaneous management of dual diet recommendations. Themes included shared barriers, facilitators, motivators, and strategies for dual diet management. Individual-level themes discussed by patients were barriers and motivators to dual diet management, and caregivers discussed barriers to supporting dual diet management. Findings from the study highlight that patients and caregivers often work together and share similar barriers, facilitators, motivators, and strategies for adhering to a dual diet. The results provide insight into chronic disease management at the family level and can guide health care providers' efforts to promote family involvement with dietary recommendations for patients with multiple comorbidities.

Benefit of Probiotics on Cardiovascular Health- A Narrative Review

Coronary artery disease (CAD) is a leading cause of death globally and a prevalent cardiovascular disease (CVD) in which plaque buildup in artery walls results in inadequate blood flow. Risk factors for CAD include hypertension, inflammation, diabetes, and poor diet. In the past few decades, research has emerged on the employment of probiotics in cardiovascular health, particularly focused on methods for using probiotics as preventative measures for the risk factors of CAD. Probiotics can reduce hypertension and inflammation, improve insulin sensitivity, and possibly reduce salt levels in individuals with high-sodium diets. Still, more research needs to be done on the safety and considerations of administering probiotics and their underlying mechanisms since the evidence is predominantly experimental. Probiotics have proven to be a valuable research point given the urgency and incidence rates of coronary artery disease.

Investigation of amino acid and fatty acid profiles of Japanese diets using the food exchange lists for diabetes diet

Investigation of amino acid and fatty acid profiles of Japanese diets using the food exchange lists for diabetes diet

Effects of a Paleolithic diet compared to a diabetes diet on leptin binding inhibition in secondary analysis of a randomised cross-over study

BackgroundBeneficial effects from practising a Paleolithic diet as compared to a diabetes diet on weight, waist circumference, satiety, leptin, HbA1c and glucose control in randomised controlled trial participants with type 2 diabetes could be due to lower leptin resistance. Support for this hypothesis comes from an in vitro experiment that showed that digested wheat gluten, which is excluded from a Paleolithic diet, inhibits leptin from binding to its receptor, thus indicating a possible dietary cause of leptin resistance. However, the clinical relevance of the latter finding is unclear since removal of enzyme activity from the gluten digest by heat treatment also abolished leptin binding inhibition. Assessment of leptin binding inhibition in vivo is possible by comparison of total leptin levels with those of ‘biologically active’ leptin bound to its receptor (bioLep).ObjectivesTo assess the effects of a Paleolithic diet compared to a diabetes diet on leptin binding inhibition and to replicate our in vitro study.MethodsBioLep and total leptin levels were measured in secondary analysis of fasting plasma samples from our open label random order three plus three-month long cross-over trial performed in 2005–2007, that compared a Paleolithic diet with a diabetes diet in participants with type 2 diabetes without insulin treatment (per protocol). BioLep was also measured in vitro for known recombinant leptin concentrations incubated with a series of concentrations of 10 kDa spin-filtered digested wheat gluten, with or without prior heat treatment, at 100ºC for 30 min and centrifugation.ResultsThere was no difference between diets when comparing differences between bioLep and total leptin levels and their ratio in the 13 participants, three women and 10 men, aged 52–74 years with a mean BMI of 30 kg/m2 and a mean diabetes duration of eight years. We found no carry-over or period effect for bioLep and total leptin. In vitro, wheat gluten digest inhibited leptin binding in a dose-dependent manner but not after heat treatment.ConclusionsWe found no leptin binding inhibition after the Paleolithic or diabetes diet, possibly due to its abolishment from cooking-related heat treatment of wheat gluten.Trial registrationRegistered on 14/02/2007 at ClinicalTrials.gov Identifier: NCT00435240.

Negative Self-Care Behaviours Among Diabetic Patients Bukittinggi, Indonesia

Diabetes mellitus is a chronic multifactorial endocrine disorder that affects approximately 5-10% of adults worldwide. In Indonesia, approximately 10.8 million people, which accounts for 10% of the population, suffer from diabetes. The current treatment considered suitable for diabetes management involves self-care management. Self-management plays a crucial role in achieving blood sugar control, reducing complications, improving quality of life, and lowering hospitalization rates. Negative self-care behaviors frequently observed among diabetes patients include consuming high-fat foods, sugary snacks, non-adherence to diabetes diet protocols. These unhealthy habits make it more difficult to regulate one's own health, which increases the risk of morbidity and death, uncontrolled blood sugar levels, and a decline in quality of life. The purpose of this study is to identify poor self-care practices among type 2 diabetes patients in the Bukittinggi health facilities' service region. Using a deliberate sample technique, a qualitative descriptive study was carried out in seven operational regions of the community health clinics in Bukittinggi, Indonesia. Participants were interviewed in semi-structured interviews, and a chollezi was used to analyze the data. There were 15 people in all, ages 30 to 69, who participated in this study. The participants had been diagnosed with diabetes for a duration of 2 to 21 years. The study identified four themes: unhealthy dietary behaviors, poor medication adherence, preference of unstandardized based herbal medicine, and surrender to Diabetic. Future research should focus on developing appropriate interventions and health promotion strategies

Effect of the Theory-driven Educational Intervention on Self-Care Behavior and Glycosylated Hemoglobin Level in Patients with Type 2 Diabetes.

The diabetics' lack of knowledge about self-care and incorrect beliefs in this care are the reasons for their admission to hospitals. The present study aimed to examine the impact of education based on the theory of planned behavior (TPB) on intention, self-care behavior, and glycosylated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes. The present study was conducted on 60 diabetic patients who were randomly classified into intervention and control groups. In the intervention group, self-care education based on TPB was held, but the control group only received routine care. The data were collected using a fourpart questionnaire including characteristics, items of patients' knowledge, items of TPB constructs, and items of diabetes self-care. Data were analyzed in SPSS software. In intervention group, mean score of self-care behavior and its domains significantly changed from (total: 52.26±14.75, diabetic diet: 22.20±6.05, exercise: 5.17±4.04, blood sugar testing: 5.03 ± 4.15, medication: 5.40±2.28, foot care: 13.47±8.42) into 76.66±8.87, 29.43±5.48, 7.60±2.60, 8.73±2.31, 6.48±1.09, 23.53±3.09, respectively three months after intervention (p<0.01). In this case, these changes were not seen in the control group. The mean level of HbA1c in the intervention group (6.38±0.16) was significantly lower than before the intervention (7.56±1.08) and the control group (8.02±0.25) three months after intervention (p<0.01). Education based on the TPB was effective in improving the patients' self-care behavior and HbA1c index. Therefore, we suggest all medical centers to use the TPB as an effective and low-cost educational approach to improve diabetics' self-care behavior and health.

Enhancing Diabetic Elderly Health Diet Education Through Mobile Application: An Interdisciplinary Conceptual Framework

The increasing incidence of diabetes among the elderly has heightened the demand for effective healthcare solutions, with mobile applications emerging as promising options for managing healthy diet education. However, age-related declines in cognitive, physical, and sensory functions may reduce elderly's willingness to learn new technologies. This study aims to examine the dietary needs of diabetic elderly, identify factors influencing their learning habits, and explore key elements in designing and accepting mobile applications. Using a four-step approach—identifying target users, reviewing literature, pinpointing key variables, and developing a conceptual framework—the study found that exercise, BMI, and a healthy diet attitude significantly shape dietary habits. It also identified appearance, functionality, and interface design as critical factors for mobile applications. Additionally, perceived ease of use, usefulness, safety, and enjoyment were found to be important for acceptance. These elements should guide future research in designing mobile applications for diabetic elderly healthy diet education.

Engaging Students in a Bilingual Service-Learning Health Promotion Project.

Introduction: This service-learning, health promotion project used Leininger's Culture Care Theory to engage Baccalaureate Nursing students in a health promotion initiative specific to Hispanic community members. Methods: Thirty-seven students examined population health data, surveyed Hispanic community members to identify health priorities, and developed a population-specific intervention on diet and risk factors for diabetes. Students created a 5-min script focused on healthy eating plans with recognition of traditional foods associated with the Hispanic culture. Students delivered the script to community members attending an annual Hispanic Heritage Festival. Results: Seventy-six percent of the 488 community participants reported increased knowledge about diabetes risk factors and healthy eating habits. Each student completed a self-reflection on how the project impacted their transcultural skills and reported increased confidence related to engagement and communication with the Hispanic community. Discussion/Significance: Incorporating community-based service-learning into the undergraduate curricula is a powerful educational approach that can enhance students' ability to provide culturally congruent nursing care.

Effects of a carbohydrate-reduced high-protein diet delivered with meal kits to Danish people with type 2 diabetes: protocol for a 12-month randomised controlled trial

IntroductionThe cornerstone in the management of type 2 diabetes (T2D) is lifestyle modification including a healthy diet, typically one in which carbohydrate provides 45%–60% of total energy intake (E%). Nevertheless,...

Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes

Hispanic adults with type 2 diabetes (T2D) are more likely to develop complications and die from the disease than the US general population. Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research approach to surface the authentic voices of participants overcoming obstacles to health-promoting behaviors that perpetuate health inequities; research on the effect of digital storytelling on T2D outcomes among Hispanic adults is lacking. To assess the impact of a digital storytelling intervention on glycemic control and its acceptability among Hispanic patients with poorly controlled T2D. This was a multicenter, randomized clinical trial conducted within 2 primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c level ≥8%). Enrollment and follow-up were conducted between February 14, 2019, and November 1, 2023. The intervention group viewed a 12-minute digital storytelling video. The video included 4 Spanish-language stories that reinforced 4 diabetes self-management behavioral goals (healthful diet for diabetes, physical activity, medication adherence, and glucose self-monitoring). The control group received printed, culturally tailored T2D education materials. The primary outcome was the mean change from baseline to 3 months for hemoglobin A1c levels, adjusting for baseline hemoglobin A1c, age, gender, education, and income. Acceptability and narrative quality of the intervention were assessed through questionnaires. There were 451 study participants, with 227 (mean [SD] age, 54.3 [9.3] years; 158 [69.3%] women) randomized to the intervention group and 224 (mean [SD] age, 54.5 [9.1] years; 156 [69.3%] women) to the control group. Of these, 390 completed 3-month follow-up of the primary outcome (86% retention). There was a small improvement in the mean (SD) hemoglobin A1c level in the intervention group compared with the control group in the adjusted model (9.1% [1.7] to 8.4% [1.6] vs 9.4% [1.8] to 8.8% [2.0]; P = .04] but not in the unadjusted model. Acceptability and narrative quality of the intervention were high. In this randomized clinical trial, a digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control. This was a highly scalable intervention that may be integrated into clinical practice as part of a longitudinal diabetes self-management program for Hispanic adults. ClinicalTrials.gov Identifier: NCT03766438.

Prevalence of overweight/obesity, and associated factors among adolescents aged 12 ∼ 15 in Shandong Province, China: A cross-sectional study

Overweight/obesity among adolescents in Shandong Province, China, has been rising, posing significant public health challenge. Comprehensive investigation is needed to develop effective interventions. Following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, a stratified random cluster sampling approach was used from September to October 2023 across 17 cities in Shandong Province. The study included 165 middle schools, surveying 99,638 students aged 12 ∼ 15. After applying exclusion criteria, 97,356 students (97.71% effective rate) completed anthropometric measurements and questionnaires. Overweight/obesity were assessed based on national and international standards. Univariable chi-square test and multivariable logistic regression were used to analyze factors influencing overweight/obesity. In 2023, the overweight/obesity rate among 12 ∼ 15-year-olds in Shandong was 19.75%. Significant factors included sex, age, residence, family income, parental weight status and activity, mother’s gestational diabetes history, birth weight, physical activity, sleep, screen time, homework, and diet. Girls, older adolescents, and those with physically active parents or who themselves engaged in over 1.5 hours of daily physical activity had lower odds of being overweight/obese. Adequate sleep and frequent consumption of vegetable and fruit were also protective. Higher odds were associated with urban residence, high family income, overweight/obese parents, maternal gestational diabetes, high birth weight, excessive screen time, extensive homework, and frequent fast food consumption. Overweight/obesity in Shandong adolescents is influenced by multiple determinants. Holistic interventions addressing genetic, behavioral, and environmental factors are essential for promoting healthier lifestyles and reducing the prevalence in this demographic.

Healthcare workers' views on type 2 diabetes mellitus management at selected clinics in Mthatha.

Diabetes is a non-communicable disease of global public health importance. Healthcare workers play a vital role in the management of this disease. This study aimed to explore healthcare workers' views on managing patients with type 2 diabetes at primary health care facilities. The study was conducted at two primary health care facilities in Mthatha, South Africa. This exploratory descriptive qualitative study included 28 primary health care workers. Data were collected through individual interviews and focus group discussions and analysed using a thematic analysis approach. Study participants' views of poor control of type 2 diabetes mellitus were categorised under patient- and healthcare system-related factors. The patient-related factors included poor adherence to an ideal diabetic diet, poor medication adherence, a lack of personal glucometers, and dearth of support systems. The healthcare system-related factors identified were inadequate patient education, long waiting times at the health facilities, high patient volumes, limited resources, and delayed service provision. Proposed solutions to address poor control of diabetes included improving patient health education, providing diabetic patients with glucometers, multi-stakeholder management of diabetes, allocating designated areas for patients with chronic illnesses, improved resource allocation, and regular staff training. Study participants perceived an improved level of control of diabetes among patients managed at the Community Health Centres. When designing interventions for the management of diabetes, both patient and healthcare system-related factors and the proposed solutions should be considered.Contribution:This study's findings could promote better management of diabetes at the primary health care level.

Effects of Plant-Based Diets on Markers of Insulin Sensitivity: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

The aim of this systematic review and meta-analysis was to examine the effects of plant-based diets on markers of insulin sensitivity in people with overweight/obesity, prediabetes, or type 2 diabetes (T2D). A systematic literature search in MEDLINE, Embase, CINAHL, and CENTRAL was conducted, and randomised controlled trials (RCTs) investigating the effect of plant-based diets (vegan, ovo-vegetarian, lacto-vegetarian, and lacto-ovo-vegetarian) for ≥14 d on markers of insulin sensitivity in adults (≥18 years) with BMI ≥ 25 kg/m2, prediabetes, or T2D were eligible. We identified eight RCTs, including 716 participants. In comparison with control diets, plant-based diets improved Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (-0.97, 95% confidence interval (CI) (-1.67, -0.27), p = 0.007) and fasting insulin (-4.13 µU/mL, 95% CI (-7.22, -1.04), p = 0.009) in people with overweight/obesity. In people with prediabetes, one study compared vegan and vegetarian diets and found no difference in HOMA-IR, or fasting insulin. One study of people with T2D reported no difference in immunoreactive insulin and metabolic glucose clearance compared with a conventional diabetes diet. In conclusion, adhering to plant-based diets for ≥14 d improved HOMA-IR and fasting insulin in people with overweight/obesity. Long-term RCTs are needed to determine whether plant-based diets can result in prolonged improvements in insulin sensitivity in people at risk of or with T2D.

Diabetes Self-Efficacy on Glycemic Control and Well-Being of Patients With Type 2 Diabetes Mellitus: An Analytical Cross-Sectional Study.

Diabetes mellitus is a major, chronic, and progressive lifestyle disease. It adversely affects patients' quality of life, effectiveness, and well-being. Self-care practices are universally recognized as imperative to keep the illness under control and prevent complications. Self-efficacy is one of the factors involved in the successful self-care of diabetic patients. The primary objective of the study was to estimate the proportion of diabetes self-efficacy and to assess the correlation ofdiabetes self-efficacy with glycemic control, and the well-being of patients with type 2 diabetes mellitus (T2DM). The secondary objective was to assess the factors associated with diabetes self-efficacy. An analytical cross-sectional study was conducted among T2DM patients attending the non-communicable disease clinic in the outreach centers of Government Medical College, Thiruvananthapuram, Kerala, India. Four hundred patients with T2DM were included in the study.Diabetes self-efficacy was assessed by the Stanford Diabetes Self-Efficacy Scaleand the WHO-5 index scale was used to assess wellbeing. Glycemic control was determinedby HbA1C estimation, with ≤7% as good control. Among 400 patients with T2DM, 51.25 % (95% CI: 46.2-56.2) had high diabetes self-efficacy. A significantly negative correlation was found between HbA1C and self-efficacy (r =- 0.208, p = 0.01), and a positive correlation was shown between well-being and self-efficacy (r = 0.418, p = 0.01). Logistic regression analysis found that factors associated with diabetes self-efficacy were upper socioeconomic status (OR = 8.53, 95% CI: 3.06-13.82), family support (OR = 1.97, 95% CI: 1.10-3.54), participation in diabetes education classes (OR = 1.95, 95% CI: 1.10-3.54), diet compliance (OR = 4.74, 95% CI: 2.80-8.01), glycemic control (OR = 1.69, 95% CI: 1.01-2.84), and overall wellbeing (OR = 6.7, 95% CI: 3.84-11.64). The proportion of high diabetes self-efficacy was 51.25% (95% CI: 46.2-56.2). The factors associated with diabetes self-efficacy were family support, participation in diabetes education classes, high socioeconomic status, absence of complications, good glycemic control, and well-being. The study findings depicted that high self-efficacy was significantly correlated with good glycemic control and well-being of patients with T2DM.

Comparison between Ketogenic and Diabetic Conventional Diet on Wound Closure in Diabetic Rat Model

Background: Managing diabetic ulcers should be multimodal; nutrition is one of the modalities to improve wound healing. This study therefore aimed to compare ketogenic diet and conventional diabetic diet in closing the wounds of diabetic rat models.Methods: Diabetes mellitus was induced in 30 rats which were divided equally into three groups. Group I was given a ketogenic diet (60% fat, 24% carbohydrate, and 16% protein). Group II was given a conventional diabetic diet (43% carbohydrate, 15% fat, and 42% protein). Group III was the control group with a normal diet (13% water, 18.5%–20.5% protein, fat ≥4%, fiber ≤6%, ash ≤8%, 0.9% calcium, and 0.7% phosphor). A 1 cm-diameter wound was made with the Mason-Walker model as a guideline. The rate of wound closure was measured on days 1, 7, 14, and 21 to represent each wound healing phase.Results: On day 7, comparison between wound areas in the ketogenic diet, conventional diet, and normal diet yielded significant differences (mean, 0.664, 0.717, 0.747; P=0.051). There was also a significant difference on day 14 (mean, 0.564, 0.817, 0.647; P&lt;0.001) and day 21 (mean, 0.164, 0.517, 0.447; P&lt;0.001).Conclusion: Compared to a conventional diabetic diet, a ketogenic diet significantly enhanced the wound closure rate in the diabetic rat model. Further studies are needed to confirm this finding.

Factors Associated with Antidiabetic Medications and Dietary Recommendation Adherence Among Patients with Type 2 Diabetes

ABSTRACT Introduction Diabetes mellitus is a global noncommunicable disease epidemic of public concern. Adherence poses a challenge to patients due to the long-term management of type 2 diabetes. This study assessed the factors associated with antidiabetic medications and dietary recommendation adherence among patients with type 2 diabetes in Ghana. Methods A hospital-based, cross-sectional study design was used to assess self-reported factors associated with antidiabetic medications and dietary recommendation adherence among 165 recruited type 2 diabetes patients who visited diabetic clinics of two selected municipal hospitals in the Volta region of Ghana. A structured questionnaire consisting of closed-ended questions was used. Phone calls were used to collect responses from participants using the structured questionnaire, which included the United Kingdom Diabetes Diet Questionnaire and Morisky Adherence Scale. Data collected were entered into a Microsoft Excel sheet and exported to STATA software (version 15) to analyze variables. Binary logistic regression was run to determine the association between the level of adherence (outcome variable) and the independent variables. A CI of 95% with a p-value of &amp;lt; 0.05 was statistically significant. Results Self-reported factors were as follows: forgetfulness (p = 0.0001), taking medication (p = 0.006), difficulty remembering to take medication (p = 0.001), worry about long-term intake of drugs (p = 0.0001), choice of high-fiber diet (p = 0.037), intake of processed or refined carbohydrate (p = 0.049) alcohol intake (p = 0.033), age (p = 0.015), occupation (p = 0.009), and patient waiting time (p = 0.020) were found to have contributed to medication/dietary nonadherence among the participants. Conclusion Patient adherence was low. Health authorities in the two selected hospitals should develop strategies to reduce the problem of poor adherence.