Glycemic Control In Diabetic Patients Research Articles

Laboratory diagnosis of mucormycosis: Present perspective

ABSTRACTUpsurge in mucormycosis cases in the second wave of SARS CoV2 infection in India has been reported. Uncontrolled diabetes is the major predisposing risk factor for these cases. The early diagnosis and surgical intervention with medical treatment may result in good clinical outcomes. The glycaemic control in diabetic patients also favours better treatment outcome in patients suffering from mucormycosis.

POSC265 The Use of Glycated Albumin for Glycaemic Control in Diabetic Patients with Chronic Kidney Disease: Preliminary Results from an Italian HTA

To investigate the implications of the introduction, in the Italian clinical practice, of glycated albumin (GA), as an innovative glycemic marker for monitoring type-2 diabetes mellitus (DM) in patients affected by chronic kidney disease (CKD) – level 4 and 5 –, in comparison to the gold standard glycated hemoglobin (HbA1c).

Uric acid level and its correlation with glycemic control in diabetics with normal renal function

Introduction: Limited studies have evaluated the relationship between uric acid and diabetes mellitus (DM), with different studies reporting varying findings. We aimed to investigate the association between levels of uric acid and glycemic control in type 2 DM (T2DM) in our patient cohort. Materials and Methods: We analyzed 200 consecutive patients in the age group of 30–70 years suffering from T2DM with normal renal functions (glomerular filtration rate >60 ml/min/1.73 m2), after excluding patients taking medications for lowering uric acid levels or diuretics. Fasting blood glucose (FBG), random blood glucose (RBG), glycated hemoglobin (HbA1c), and serum uric acid levels were measured in all the patients. Results: The mean age of the study population was 55.25 ± 12.05 years. There was no statistically significant difference in mean age, FBG, RBG, serum uric acid, and HbA1c levels or between males and females in our study cohort. There was a statistically significant negative correlation (P < 0.05) between uric acid levels and HbA1c (r = −0.189) and FBG (r = −0.114). Conclusion: We report an inverse correlation between uric acid levels and glycemic control in diabetic patients with normal renal function, irrespective of gender.

A study of musculoskeletal manifestations of diabetes mellitus and their association with HbA1C among diabetic patients

Background: The prevalence of diabetes mellitus (DM) is increasing significantly throughout the world. While the vascular complications of diabetes are well recognized and account for the principle mortality and morbidity from the condition, the musculoskeletal manifestations of diabetes are common and not life-threatening, which are an important cause for morbidity, pain, and disability. The most common reported forms of various musculoskeletal manifestations of DM include adhesive capsulitis, hand syndromes such as limited joint mobility syndrome (LJMS), Dupuytren’s contracture (DC), and carpal tunnel syndrome (CTS), flexor tenosynovitis, reflex sympathetic dystrophy, diffuse idiopathic skeletal hyperostosis (DISH), Charcot’s joints, diabetic amyotrophy (DA), and osteoarthritis. Materials and Methods: The study was conducted on a total of 150 patients with type 2 DM for a duration of at least 5 years in Bangalore during the study period from January 2020 to June 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Detailed history was taken and general physical examination was done to determine the musculoskeletal manifestations of DM. The Disability of Arm Shoulder and Hand (DASH) questionnaire was also completed as per the patient’s responses. Laboratory reports were collected, data compiled, and the data were analyzed. Results: Of the 150 cases enrolled, the maximum number of cases belonged to the age group of 36–50 years. About 64% of the diabetic cases were suffering from musculoskeletal disorders (MSDs) (LMJS, CTS, shoulder capsulitis, DC, trigger finger, DISH, DA). Among the MSDs, the highest prevalence was by LJMS (28%). There was a positive correlation among the duration of diabetes, HbA1C, and the DASH score among patients with MSDs in this study and this is statistically significant (P < 0.05). We also see that MSDs are present in 72.7% of the females and 57.1% of the males in the study and this was statistically significant (P = 0.048). Conclusion: MSDs have a high prevalence in diabetic patients. With advancing age and uncontrolled HbA1C levels, the number of MSDs was more as well as the severity as indicated by the DASH score. Early and better glycemic control in diabetic patients can reduce the morbidity associated with MSDs as evidenced by the reduced intensity of DASH score in well-controlled patients.

Role of Whole Grain Consumption in Glycaemic Control of Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Observational studies have indicated beneficial effects of whole grain consumption on human health. However, no evidence based on randomized controlled trials has been established. Our objective was to perform a systematic review and meta-analysis of randomized controlled trials to assess the effects of whole grain consumption in glycaemic control of diabetic patients. Methods: A comprehensive search in four databases (Web of Science, Pubmed, Scopus and Cochrane library) was conducted to collect potential articles which measured the roles of whole grain consumption on glycaemic control up to October 2021. Results: A total of 16 eligible trials involving 1068 subjects were identified to evaluate the pooled effect. The overall results indicated that compared with the control group, whole grain intake presented a significantly reduced concentration in fast plasma glucose (WMD = −0.51 mmol/L, 95% CI: −0.73, −0.28; = 88.6%, p < 0.001), a homeostasis model assessment of insulin resistance (WMD = −0.39 μU × mol/L2, 95% CI: −0.73, −0.04; = 58.4%, p = 0.014), and glycosylated haemoglobin (WMD = −0.56%, 95% CI: −0.88, −0.25, = 88.5%, p < 0.001), while no significant difference was observed in fast plasma insulin level between groups (SMD = −0.05, 95% CI: −0.25, 0.14; = 40.7%, p = 0.120). In terms of incremental area under the curve (iAUC), data suggested that whole grain effected a significant decrease in Glucose-iAUC (WMD = −233.09 min × mmol/L, 95% CI: −451.62, −14.57; = 96.1%, p < 0.001) and Insulin-iAUC (SMD = −4.80, 95% CI: −8.36, −1.23; = 89.9%, p = 0.002), although only in a small number of studies. Of note, there is evidence for modest unexplained heterogeneity in the present meta-analysis. Conclusion: Whole grain consumption confers a beneficial effect on glucose metabolism in patients with diabetes. Regrettably, since relevant studies were scarce, we failed to provide confident evidence of whole grain consumption on acute effects including Glucose-iAUC and Insulin-iAUC, which should be addressed in further trials.

Karakteristik Sosiodemografi Penderita Diabetes Melitus Yang Mengalami Kelainan Periodontal: A Scoping Review

Background: Diabetes mellitus and periodontal disease are a multifactorial diseases which have a bidirectional relationship. Diabetes mellitus can increase the risk of periodontal diseases while periodontal disease can interfere the glycemic control in diabetic patients by increasing insulin resistance. The epidemiology of both diseases are known to be related by the individuals characteristics of sociodemographic such as gender, age, educational level, socioeconomic and lifestyle. Objective: The aim of this study was to see the sociodemographic characteristics of diabetes mellitus patients with periodontal disease based on gender, age, educational level, socioeconomy, and lifestyle. Method: This type of research is a scoping review using Pubmed and Google Scholar as an electronic databases. Journals with observational study design, such as cross-sectional, case-control, and cohort in English and being published since 2019 were included in the inclusion criteria. Results: 6 journals were obtained according to the inclusion criteria. The increased risk of periodontal disease have a variation in gender, age, and socioeconomic variables. Meanwhile, the variables of educational level and smoking lifestyle showed that there was no variation in the increased risk of periodontal disease. Conclusion: Characteristic of sociodemographic in diabetes mellitus patients suffering periodontal disease have a variations in each variables.

J-curve relationship between long term glycemic control and mortality in diabetic patients with acute myocardial infarction undergoing percutaneous coronary intervention

BackgroundIntensive glycemic control is generally recommended for diabetic patients to reduce complications. However, the role of glycemic control in the mortality in diabetic patients with acute myocardial infarction (AMI) remained unclear.MethodsWe selected diabetic patients who measured HbA1c more than 3 times after AMI among 10,719 patients enrolled in the multicenter AMI registry. Patients (n = 1384) were categorized into five groups: according to mean HbA1c level: ≤ 6.5%, > 6.5 to ≤ 7.0%, > 7.0 to ≤ 7.5%, > 7.5 to ≤ 8.0% and > 8.0%. The primary endpoint was all-cause mortality.ResultsDuring a median follow-up of 6.2 years, the patients with a mean HbA1c of 6.5 to 7.0% had the lowest all-cause mortality. Compared to patients with mean HbA1c of 6.5 to 7.0%, the risk of all-cause mortality increased in subjects with mean HbA1c ≤ 6.5% (adjusted hazard ratio [HR] 2.00, 95% confidence interval [CI] 1.02–3.95) and in those with mean HbA1c > 8.0% (adjusted HR 3.35, 95% CI 1.78–6.29). In the subgroup analysis by age, the J-curve relationship between mean HbA1c and all-cause mortality was accentuated in elderly patients (age ≥ 65 years), while there was no difference in all-cause mortality across the HbA1c groups in younger patients (age < 65 years).ConclusionsThe less strict glycemic control in diabetic patients with AMI would be optimal for preventing mortality, especially in elderly patients.

AACE2021-A-1046: Frequency of Dyslipidemia and Associated Factors Among Patients with Type 2 Diabetes Mellitus in Peshawar

Atherogenic dyslipidemia in type 2 diabetes mellitus is a significant modifiable factor for cardiovascular disease (CVD), contributing to a high risk of morbidity and mortality. Poor glycemic control in diabetic patients is considered a secondary cause of dyslipidemia, with data from earlier studies indicating that it is a predictor of dyslipidemia, with higher total cholesterol (TC), trigerylcerides (TG), low density lipoprotein (LDL), and decreased high density lipoprotein (HDL). Dyslipidemia is a modifiable risk factor for CVD, thus understanding its impact is critical.

The Efficacy of Follow-up Phone Calls for Capillary Blood Glucose Lowering in Diabetic Patients in Primary Care Unit

Objective: To study the effect of telephone call intervention on glycemic control in diabetic patients for 2 monthsMaterials and Methods: The quasi-experimental research included 130 Patients from January 2020 to March 2020 in primary care. The 115 patients were divided into 2 groups through a simple randomization process, 61 in experimental group and 54 in control group after exclusion. 115 Patients will be tested for Capillary blood glucose (CBG) level at a period of 0-month, 1-month and 2-months. CBG level were presented in mean ± SD, mean difference ± SD and analyzed by Independent t-test and Paired t-test.Results: The phone call intervention can lower CBG level compared to the control group. Mean difference of CBG between 0 month and 2 months follow-up in phone calls group vs control group (-6.80 ± 4.86 vs -2.96 ± 4.82 mg/dL) and mean difference CBG level between 1 month and 2 months follow-up in phone calls group vs control group (-5.77 ± 4.09 vs -4.22 ± 5.10 mg/dL) but had no significant difference (p &gt;0.05)Conclusion: The follow-up phone calls can lower CBG level in the experimental group more than the control group, but there is no significant difference.

The effect of intraoperative glycemic control on surgical site infections among diabetic patients undergoing coronary artery bypass graft (CABG) surgery

ObjectivePerioperative poor glycemic control in diabetic patients undergoing Coronary Artery Bypass Graft (CABG) surgery has been associated with infectious complications, particularly surgical site infections that are linked with adverse health surgical outcomes. The purpose of this study was to investigate the effect of two different intraoperative glycemic control protocol, tight and conventional, on thirty-day postoperative surgical site infection (SSI) rates among diabetic patients undergoing CABG surgery. DesignA randomized controlled trial (RCT) design was employed in the study, with a convenience sample of 144 adult patients who were scheduled to undergo coronary artery bypass grafting surgery. SettingA main referral heart institute in Amman, Jordan. ParticipantsSubjects were randomly assigned to either the tight glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 110–149 mg/dl via continuous intravenous insulin infusion, or the conventional glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 150–180 mg/dl via continuous intravenous insulin infusion. The postoperative SSIs among both groups were evaluated and compared by independent blinded physicians. ResultsThe primary findings of this study indicated no statistically significant difference between the two treatment groups in terms of SSI rates and their potential adverse surgical outcomes (p = 0.512). ConclusionNurses should consider the glycemic stability and glycemic control approach to minimize adverse surgical outcomes post CABG surgery. Healthcare providers should also carefully consider diabetic patients who have undergone CABG surgery and are at risk of developing postoperative SSIs. Clinicaltrials.gov identifierNCT04451655 was retrospectively registered in 30/06/2020.

SGLT2i and GLP-1RA in Cardiometabolic and Renal Diseases: From Glycemic Control to Adipose Tissue Inflammation and Senescence.

Background. Over the last few years, the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) has increased substantially in medical practice due to their documented benefits in cardiorenal and metabolic health. In this sense, and in addition to being used for glycemic control in diabetic patients, these drugs also have other favorable effects such as weight loss and lowering blood pressure, and more recently, they have been shown to have cardio and renoprotective effects with anti-inflammatory properties. Concerning the latter, the individual or associated use of these antihyperglycemic agents has been linked with a decrease in proinflammatory cytokines and with an improvement in the inflammatory profile in chronic endocrine-metabolic diseases. Hence, these drugs have been positioned as first-line therapy in the management of diabetes and its multiple comorbidities, such as obesity, which has been associated with persistent inflammatory states that induce dysfunction of the adipose tissue. Moreover, other frequent comorbidities in long-standing diabetic patients are chronic complications such as diabetic kidney disease, whose progression can be slowed by SGLT2i and/or GLP-1RA. The neuroendocrine and immunometabolism mechanisms underlying adipose tissue inflammation in individuals with diabetes and cardiometabolic and renal diseases are complex and not fully understood. Summary. This review intends to expose the probable molecular mechanisms and compile evidence of the synergistic or additive anti-inflammatory effects of SGLT2i and GLP-1RA and their potential impact on the management of patients with obesity and cardiorenal compromise.

Poor glycemic control in diabetic patients increases the risk of recurrent atrial arrhythmia and cardiovascular hospitalizations among morbidly obese patients undergoing atrial fibrillation ablation

Abstract Background/Introduction Obesity and atrial fibrillation (AF) coexist and share multiple cardiovascular risk factors. Lifestyle modifications can reduce AF burden in obese patients. However, the time invested in pursing lifestyle changes may delay AF ablation, which could negate the procedural benefit. Purpose To examine the effects of lifestyle modifications and the timing of catheter ablation on morbidly obese patients with AF. Methods This retrospective study included 217 consecutive AF patients with a body mass index (BMI) ≥35 kg/m2 undergoing AF ablation at a tertiary care center from 2012 to 2019. Modifiable risks were examined, including the time from AF diagnosis to ablation, fluctuation of BMI &amp;gt;5% or an increase in BMI &amp;gt;3% prior to ablation, mean systolic blood pressure &amp;gt;130 mmHg or diastolic blood pressure &amp;gt;80 mmHg, obstructive sleep apnea with CPAP noncompliance, hyperlipidemia without statin therapy, tobacco use, excessive alcohol use, and diabetes mellitus with hemoglobin A1c (HbA1c) ≥6.5%. The primary outcome was a composite of recurrent atrial arrhythmias and cardiovascular (CV) hospitalizations following AF ablation. A multivariate analysis adjusting for age, gender and modifiable risks was performed. Results The mean age was 61±9 years old, 58% were female and 45% had persistent AF. A substantial portion of the study patients had modifiable risk factors, ranging from 2.7% with excessive alcohol use to 67.3% experiencing delayed AF ablation, Figure 1. The median time from diagnosed AF to ablation was 1.3 years. During a mean follow-up of 2.9 years after AF ablation, 136 (62.7%) patients met the primary outcome. Only HbA1c ≥6.5% was an independent risk factor with adjusted hazard ratio of 1.57, 95% confidence interval 1.02–2.36, P=0.0412, Figure 2A. Delayed AF ablation did not alter the outcome, Figure 2B. There was no interaction between time of ablation and HbA1c ≥6.5% (P=0.67). Conclusion Substantial portions of morbidly obese patients undergoing AF ablation have potentially modifiable risk factors. Poor glycemic control with HbA1c ≥6.5% predicts an increased risk of recurrent atrial arrhythmias and CV hospitalizations, while delayed AF ablation does not. This finding underscores an importance of optimizing HbA1c in morbidly obese patients with AF to reduce adverse outcomes after ablation. Funding Acknowledgement Type of funding sources: None.

S1250 The Role of Treatment of Hepatitis C with Direct-Acting Antiviral Agents on Glycemic Control in Diabetic Patients: A Systematic Review and Meta-Analysis

S1250 The Role of Treatment of Hepatitis C with Direct-Acting Antiviral Agents on Glycemic Control in Diabetic Patients: A Systematic Review and Meta-Analysis

Effect of diabetes self-management education program on glycemic control in diabetic patients attending the family medicine outpatient clinic, Suez Canal University Hospital, Ismailia, Egypt

BackgroundDiabetes mellitus (DM) is a chronic disease with debilitating complications. Patients with diabetes are recommended to take various self-management decisions and carry out complex care activities. Diabetes self-management education (DSME) and support help people with diabetes to take these decisions and activities to improve health outcomes. DSME may serve as the basis to minimize and avoid catastrophic diabetes-related complications and the resulting financial and personal costs associated with this disorder. We aimed to assess the effect of diabetes self-management education program on glycemic control on patients with diabetes. A quasi-experimental pre-post study was conducted at the family medicine clinic in Suez Canal University hospital, Ismailia, Egypt. A total of 116 patients with uncontrolled DM were recruited by a simple random technique after applying the inclusion and exclusion criteria. Participants were subjected to a 12-week health education program (1 session/week). The sessions focused on areas of diabetes self-management based on the American Diabetes Association (ADA) guidelines. The glycosylated hemoglobin (HbA1c) was assessed at baseline and again at the end of the program. Also, self-care activities were evaluated pre-post intervention using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument which measured the activities related to diet, exercise, blood sugar testing, foot care, and medications.ResultsThe mean age of participants was 47 years (± 11.54), male patients represented 54%. About two-thirds (67%) were from urban areas and came from a middle socioeconomic level. About half of the participants (51.7%) were diagnosed as diabetics for 5–10 years duration. More than half (52.7%) were on combination therapy of insulin and oral antidiabetic drugs. After the intervention program, there was a statistically significant decrease in HbA1c level (p value < 0.001), and 21% of the participants reached the ADA treatment goal for HbA1c below 7.ConclusionAppropriate DSME programs are practical and have a benefit to patients with diabetes.

GLP-1 Analogs Are Superior in Mediating Weight Loss But Not Glycemic Control in Diabetic Patients on Antidepressant Medications: A Retrospective Cohort Study.

Objective: Both antipsychotic and antidepressant medications have been associated with weight gain and hyperglycemia. Our previously published retrospective cohort study suggests that GLP-1 (glucagon-like peptide-1) analogs may be superior to alternative regimens for both glycemic and weight control in patients on antipsychotic plus/minus antidepressant medications. In the current study, we asked whether GLP-1 analogs or SGLT-2 (sodium-glucose-transporter-2) inhibitors would be similarly beneficial in patients on antidepressant medications alone.Methods: In this retrospective cohort study, we included all patients with type 2 diabetes on antidepressant medications referred to our endocrine clinics between January 1, 2016, and January 1, 2017. Overall, 61 patients were started on a GLP-1 analog, 9 patients were started on an SGLT-2 inhibitor, and 134 were on alternative regimens (controls).Results: The groups did not differ in age, sex, ethnicity, and glycosylated hemoglobin (HbA1c) levels, although body mass index levels were higher in patients started on a GLP-1 analog (P < .0001). After 12 months, patients on GLP-1 analogs lost 4 kg, patients on SGLT-2 inhibitors lost 2.4 kg, and controls gained 0.8 kg (P < .001 for controls versus GLP-1 analog group). Subanalyses revealed that GLP-1 analog-related weight loss was most notable in women and patients on selective serotonin reuptake inhibitors. On the other hand, all serotonin-norepinephrine reuptake inhibitor users lost weight over time, independent of the antidiabetic regimen applied. In contrast to the above noted differences in weight control, HbA1c reductions were comparable and somewhat diminished in all patients on antidepressant medications (-0.3% to 0.6%).Conclusions: In this retrospective cohort study, we confirm superiority of GLP-1 analogs in mediating weight loss in patients on psychotropic and, more specifically, antidepressant medications. We also note overall blunted glycemic improvements in patients on antidepressant medications, a finding that was independent of the treatment strategy used. It could be a result of mental distress or suboptimal self-care and clearly requires further attention by future, prospective studies.

Assessment of knowledge, attitude and practice of insulin injection among subjects with diabetes mellitus

Background: Diabetes mellitus (DM) is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycemic drugs and insulin along with the dietary and lifestyle modifications. Insulin is administered most subcutaneously. As the insulin injection sites are relatively painless, patients tend to inject in the same area repeatedly rather than moving to a newer site and increase risk for development of injection site reactions like lipodystrophy and impairment of glycemic control. Hence, it is utmost important for every diabetic patient and their relatives who would inject the insulin injection to be aware of appropriate manner of insulin injection. This helps in maintaining adequate glycemic control in diabetic patients. The main objective of this study was to assess the knowledge, attitude and practice of insulin injection technique among the diabetic patients.Methods: A cross-sectional study was conducted in the department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. A validated questionnaire was administered to patients to answer in order to assess their knowledge, attitude and practice about technique of insulin injection.Results: In this study, it was found that 90% of the patients were aware of rotating the injection site, whereas only 40% of the patients were aware of appropriate time duration (5-10 sec for syringes/counting 1-15 for releasing the pen) required for resting the syringe/pen needle inside the skin. Only 48% of the patients used to remove the air bubble prior to injection, 57% pinched the injection site before injecting, 20% rubbed the injection site after injection and 30% used to wash hands prior to injection. Hypoglycemia was the most common adverse effect noted in 54% of patients.Conclusions: It can be concluded from the present study that every patient and his/her attendant needs to be educated and trained appropriately regarding technique of injecting insulin injection for betterment of their health.

The Mediterranean diet and health: a comprehensive overview

The Mediterranean diet (MedDiet), one of the most studied and well-known dietary patterns worldwide, has been associated with a wide range of benefits for health. In the present narrative review, we aimed to provide a comprehensive overview of the current knowledge on the relation of the MedDiet to important health outcomes, considering both observational and intervention studies with both risk factors and clinical diseases as outcomes. In addition, we considered the clinical and public health impacts of the MedDiet on both human and planetary health. Earlier research confirmed by recent studies has provided strong evidence for the benefits of the MedDiet on cardiovascular health, including reduction in the incidence of cardiovascular outcomes as well as risk factors including obesity, hypertension, metabolic syndrome, and dyslipidaemia. There is also evidence that MedDiet is associated with lower rates of incident diabetes, and better glycaemic control in diabetic patients compared to control diets. In prospective studies, adherence to the MedDiet reduced mortality, especially cardiovascular mortality, hence increased longevity. In addition, it has been associated with less age-related cognitive dysfunction and lower incidence of neurodegenerative disorders, particularly Alzheimer's disease. Furthermore, the relatively low environmental impacts (water, nitrogen and carbon footprint) of the MedDiet is an additional positive aspect of the Mediterranean dietary model. It is likely that the combination of a healthy diet with social behaviours and the way of life of Mediterranean regions makes the MedDiet a sustainable lifestyle model that could likely be followed in other regions with country-specific and culturally appropriate variations.

"Peer Support" intervention to improve glycemic control in type 2 diabetes mellitus: A literature review

Hyperglycemia is one of the complications of Type 2 Diabetes Mellitus (T2DM). Continuation of this situation in T2DM will lead to more serious complications such as morbidity and death. There are improvements and advances in the management of T2DM at present, but they are accompanied by an increase in medical costs. To solve these problems, an organized approach is needed to control hyperglycemia through peer support interventions which are considered to be able to reduce treatment costs. Peer support may take advantage of the ability of diabetes patients to support each other in managing their daily lives, which is very useful as a step to promote the type of daily behavioral efforts needed to prevent disease progression. This study aimed to identify the effect of peer support intervention in improving glycemic control in patients with T2DM. This study was a literature review using seven databases including PubMed, ScienceDirect, ProQuest, Clinical Key, Cochrane, Ebsco, and DOAJ. Inclusion criteria were: articles published in the last 10 years, in full text and in English version. Five studies were reviewed that met the inclusion criteria. The results of this review showed the effectiveness of peer support in improving glycemic control in diabetes patients. Peer support significantly lowered HbA1c and also led to a significant reduction in fasting blood sugar. Peer support may reduce glycosylated blood hemoglobin levels, increase knowledge regarding insulin use and increase diabetes self-management skills, especially in patients who do not have literacy skills. In conclusion, peer support can be used as a non-pharmacological therapy to improve glycemic control in patients with T2DM.

The Relationship Between Magnesium Supplementation and Glycemic Control in Diabetic Patients: A Review

Background: Diabetes mellitus is a chronic disease with increasing worldwide prevalence. There are many studies to observe the role of minerals on the glycemic state in diabetic patients. One of the in the human se minerals is magnesium. Magnesium is the fourth most abundant mineral in the human body. It has a role in the action of more than 300 enzymes most of them is ATP-dependent reactions. Finally, magnesium has an effect on glucose metabolism, lipid metabolism, nucleic acid synthesis, and energy production. The relationship between magnesium and DM is complex and multifactorial. There is an association between hypomagnesemia and insulin resistance by affecting phosphorylation of insulin receptors, insulin signaling and insulin action. Another consequence of hypomagnesemia is oxidative stress which is also present in the pathogenesis of DM. Objective: This work is trying to emphasize the important role of magnesium in the control of the glycemic state in diabetic patients through highlighting the studies conducted to correlate between magnesium level in the body, dietary magnesium intake, or magnesium supplementation with risk of diabetes mellitus occurrence, insulin sensitivity or glycemic control in diabetic patients. This article suggested that magnesium therapy may be beneficial in improving the clinical parameters of diabetic patients including HbA1c%, fasting serum glucose, and fasting insulin level.

Therapeutic Exercise Platform for Type-2 Diabetic Mellitus

Exercise enables continuous glycemic control for diabetic patients, and it is effective in preventing diabetic complications and maintaining emotional stability. However, it is difficult for diabetic patients to know the appropriate intensity and duration of exercise. Excessive exercise causes sudden hypoglycemia, and patients avoid therapeutic exercise or perform it conservatively owing to the repeated hypoglycemia symptoms. In this paper, we propose a new therapeutic exercise platform that supports type 2 diabetes patients to exercise regularly according to the exercise prescription received from the hospital. The proposed platform includes the following three significant contributions. First, we develop a hardware platform that automatically tracks and records all aerobic exercise performed by a patient indoors or outdoors using a wearable band and aerobic exercise equipment. Second, we devise a patient-specific exercise stress test to know whether the patient is exercising according to his or her usual exercise regimen. Finally, we develop a mobile application that informs patients in real-time whether they are exercising appropriately for their exercise regimen each time they exercise. For platform evaluation and future improvement, we received satisfaction ratings and functional improvements through a questionnaire survey on 10 type 2 diabetes patients and 10 persons without a diabetes diagnosis who had used the proposed platform for more than 3 months. Most users were (1) satisfied with automatic exercise recording, and (2) exercise time increased. Diabetics reported that their fasting blood glucose was dropped, and they were more motivated to exercise. These results prove that exercise must be combined with medication for blood glucose management in chronic diabetic patients. The proposed platform can be helpful for patients to continue their daily exercise according to their exercise prescription.