Glycemic Control In Type Research Articles

A Case Study of Inositol and Soluble Fiber Supplementation on Glycemic Control in an Overweight Subject

Background Soluble fiber has been shown to improve glycemic control by slowing the absorptions of glucose. And inositol has been shown to improve glycemic control in type 2 diabetes (T2D) and gestational diabetes via recruiting glucose transporter type 4 (GLUT4) to cell surface. However, neither inositol supplementation nor combination of inositol and soluble fiber supplementation has been studied in overweight. Objective To investigate if supplementation of inositol improves biological markers of glycemic control overweight and obesity, and that supplementation of inositol in combination with soluble fiber have synergistic effects to further improve these markers. Design A single cohort, uncontrolled, test-retest design was planned to be implemented over 5-weeks in which the participants supplemented 2 grams of myo-inositol twice daily for 4-weeks and then 2 grams of myo-inositol plus 2 grams of soluble fiber each twice daily for 1-week in overweight and obese subjects. Only one overweight subject was able to complete both phases of supplementation due to coronavirus disease-2019 (COVID-19), therefore the study is reported as a case study. Results Supplementation of 4 grams of myo-inositol daily for 4-weeks resulted in improved glucose parameters and lipid parameters including fasting blood glucose, post-prandial blood glucose, total blood cholesterol level, blood high-density lipoprotein (HDL) cholesterol level, and blood triglyceride level. The combination of inositol and soluble fiber supplementation further improved the total blood cholesterol level. Conclusion These results indicate there is potential benefit of inositol supplementation for sub-clinical hyperglycemic, overweight subjects on glycemic control.

Effectiveness of Wearable Device-based Intervention on Glycemic Control in Patients with Type 2 Diabetes: A System Review and Meta-Analysis.

With the development of flexible electronics and chip technology, the application value of wearable devices in lifelong treatment of chronic diseases is increasing. In view of its rapid development and diversified forms, wearable device-based intervention seems to provide a promising option to solve the problems of long-term glycemic control in type 2 diabetes (T2D). However, to date, it is unclear whether the intervention based on wearable device is effective on glycemic control in patients with T2D. In order to explore whether this choice is effective in glycemic control in patients with T2D, after database search and study screening, 6 studies and 1001 patients were selected from 181studies for this meta-analysis. The results guided that the wearable device-based intervention may be more effective than usual care on glycemic control in patients with T2D. Subgroup analysis showed that when the duration of intervention was equal to or less than 12 weeks, the effect of wearable device-based intervention was significantly different from that of usual care, but when the intervention duration greater than 12 weeks, the effect was not significantly different. The intervention effect of wearable devices with goal-setting or encouragement functions was significantly better than that of usual care, and there was no significant difference between automatic drug delivery wearable devices and usual care. In conclusion, the wearable device-based intervention is effective on glycemic control in patients with T2D. In general, this choice of wearable devices for patients with T2D may be effective to some extent.

Effectiveness and acceptability of a pragmatic exercise intervention for patients with type 2 diabetes in specialized care

AimsPhysical activity improves glycaemic control in type 2 diabetes (T2D), but adherence is low, and diabetes complications are barriers towards adopting physical activity. We investigated adherence and effects of individualized supervised exercise. MethodsPatients with intermediate (level 2) to high (level 3) risk of complications to T2D (stratified by Danish risk stratification model) were offered 12 weeks of exercise. Primary outcomes were working capacity assessed with the Åstrand-Rhyming cycling test (Åstrand), functional capacity assessed with the 30-second chair-stand test(30 s-CST) and health-related quality of life assessed with EuroQoL-5D-5L (EQ-5D-5L). Associations between stratification levels (2vs3) and drop-out, changes in 30 s-CST and EQ-5D-5L were analysed using multiple regression. ResultsIn total 350 patients accepted participation and 254 (73%) completed with 26 patients experiencing an adverse event. Odds ratio (OR) for non-completion were 1.82 [1.02–3.23] (p = 0.043) for patients stratified level 3 vs 2.Improvements were seen in Åstrand 2.71 [1.59; 3.83] ml O2/kg/min (p < 0.001), in 30 s-CST2.34 [2.01; 2.67] repetitions (p < 0.001) andin EQ-5D-5L 0.01 (−0.05 to 0.11) (p = 0.002). There were no associations between changes and risk-stratification levels. ConclusionsClinically relevant changes were seen after exercising regardless of the stratification levels in patients with intermediate to high risk of complications to T2D.

Impact of Nurse-Led Titration Versus Physician Prescription of Hypoglycaemic Agents on HbA1c Level in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

A nurse-led diabetic clinic to manage type 2 diabetes, which emphasizes medication adherence, titration of hypoglycemic agents, behavior modification, and motivation for lifestyle changes, is widely recommended and practiced in western countries.This review aims to examine the impact of a nurse-led diabetic clinic versus a standard physician-led diabetic clinic on glycaemic control of type 2 diabetes patients.Studies were obtained using a comprehensive search in the electronic databases of PubMed, Embase, SCOPUS, Cochrane Library, and gray literature through March 2021. We calculated the pooled effect estimate with 95% confidence intervals (CIs) comparing subjects with and without nurse-led titration of hypoglycemic agents using standardized mean difference (SMD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes.Four trials comprising 470 participants (241 intervention group and 229 control group) met the inclusion criteria. Glycated hemoglobin (HbA1c levels and BMI were lower in participants with a nurse-led diabetic clinic (SMD = -0.54, 95% CI -0.89 to -0.20, I2 = 67%, p = 0.002) and (SMD = -0.26 (95% CI -0.45 to -0.07, I2 = 0%, p = .008), respectively, than in those attending a standard physician-led diabetic clinic. Similarly, the pooled result shown that patients attending the nurse-led diabetic clinic had a 31% higher satisfaction level (RR 0.69; 95% CI, 0.51 to 0.92, I2 = 0%, p= 0.01). On the other hand, there was no significant association of the nurse-led diabetic clinics on patients’ blood pressure and intensification of hypoglycemic agents. The certainty of the evidence assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was moderate for outcomes like HbA1c level, intensification of hypoglycemic agents, and patients' satisfaction and low for other secondary outcomes.Our meta-analysis allows for the conclusion that nurse-led titration of hypoglycemic agents is associated with better glycemic control and enhances patients' satisfaction. Therefore, it is recommended to establish and strengthen nurses-led diabetic clinics for better HbA1c control where physician-led diabetic services are limited. Further research is needed to enhance the quality of the evidence.

The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

Impact of COVID-19 lockdown on glycemic control in type 1 diabetes

AimThe COVID-19 pandemic has forced governments to impose lockdown policies, thus impacting patients with chronic diseases, such as type 1 diabetes. The aim of this study was to evaluate the impact of lockdown on glycemic control in type 1 diabetes patients. Patients and methodsWe retrospectively evaluated patients using a continuous subcutaneous insulin infusion device during the nationwide lockdown. Children and adolescents aged 2–18 years followed up at the Pediatric Endocrinology Unit of Hospitalar São João in Portugal were included in the study. We collected data on the age, weight, insulin doses, and glycemic control of the patients before and after the restrictions. ResultsThe study included 100 patients, 59 males, with a mean age of 12.5 years. Baseline data showed a suboptimal glycemic control with a median HbA1c of 7.9%. The lockdown was associated with an increase in the body mass index (BMI) of all patients (p = 0.009), particularly girls and older teenagers. Metabolic control deteriorated in the 10–13 age group (p = 0.03), with a 0.4% increase in HbA1c. ConclusionTo date, this is the largest study on the impact of lockdown on type 1 diabetes in patients using an insulin pump. The results highlight the importance of physical activity, parental supervision, and continuation of healthcare assistance through telemedicine in young individuals with type 1 diabetes.

Controlling Hyperglycaemia Diabetes Mellitus Type-II: Bromocriptine Alone or in Combination with Metformin

Background: Diabetes Mellitus is one of the leading cause of morbidity and mortality globally. According to WHO there is a steady increase in the number of diabetic patients annually. Maintenance of good glycaemic control in type 2 diabetic patients typically becomes progressively more difficult as the duration of disease lengthens due to decline in the capacity of the pancreatic beta cells for glucose stimulated insulin release, in the presence of insulin resistance. This study is conducted to observe the effect of metformin and bromocriptine individually and sub-therapeutic doses of these drugs when used as a combination therapy. Objective: The objective of this study is to primarily investigate and then compare the antihyperglycemic effects of bromocriptine with metformin, also to see the combined effect of sub therapeutic doses of both these drugs. Methodology: Random allotment of 24 albino male rats was done in four groups. Group 1 was kept as control. Alloxan monohydrate was given to group 2, 3 and 4 and diabetes was induced. Group 2 and 3 were treated with metformin (1.5mg/kg body weight) and bromocriptine (3 mg/kg body weight) respectively while group 4 was treated with sub therapeutic doses of metformin (1 mg/kg body weight) and bromocriptine (1.5 mg/kg body weight)both. Serum glucose levels were estimated at 1, 10, 20 and 30 days. Results: Results showed that metformin reduces blood glucose level significantly where as bromocriptine also showed reduction of blood glucose level but not as significantly as metformin. However, the combination of metformin and bromocriptine showed much reduction in blood glucose level than metformin and bromocriptine used alone. Conclusion: Bromocriptine and metformin when combined ameliorated blood guclose efficiently than given alone Keywords: Diabetes mellitus, bromocriptine, metformin

The use of flash glucose monitoring significantly improves glycemic control in type 2 diabetes managed with basal bolus insulin therapy compared to self-monitoring of blood glucose: A prospective observational cohort study

AimThis prospective, observational cohort study aimed to measure HbA1c change over 3–6 months in type 2 diabetes managed with basal-bolus insulin and FreeStyle Libre® Flash Glucose Monitoring System (FSL) use compared to self-monitored blood glucose (SMBG). MethodsSixteen Italian hospitals enrolled patients with type 2 diabetes (n = 322, [109 FSL, 213 SMBG users]) using basal-bolus insulin therapy for ≥ 1 year, HbA1c 8.0–12.0% (64–108 mmol/mol), new to FSL use (<3 months) or continuing with SMBG (controls). Eligible FSL and SMBG users were matched (1:2 ratio) for baseline HbA1c (within ± 0.5%, recorded ≤ 3 months previously), study site and baseline data collection date. ResultsOverall, baseline HbA1c was 8.9 ± 0.8% (74 ± 9 mmol/mol), age 67.2 ± 10.0 years, BMI 30.5 ± 6.5 kg/m2 and insulin use duration 8.6 ± 6.6 years (mean ± SD), 56.2% were males. After 3–6 months, 234 complete cases (83 FSL, 151 SMBG users) demonstrated significantly reduced HbA1c for FSL use compared to SMBG (0.3% ± 0.12 [3 mmol/mol ± 1.3, (mean ± SE)], p = 0.0112). The difference remained statistically significant after adjusting for confounders. ConclusionsHbA1c significantly improved in basal-bolus treated type 2 diabetes after flash glucose monitoring use for 3–6 months compared to SMBG.

Comparing the Efficacy and Safety of Low-Carbohydrate Diets with Low-Fat Diets for Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Introduction To compare the efficacy of low-carbohydrate diets (LCDs) with low-fat diets (LFDs) in body weight and glycemic control for type 2 diabetes mellitus (T2DM) patients, and their cardiovascular and renal safety. Methods We searched PubMed, Ovid, Embase databases, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov from inception to April, 2021. Randomized controlled trials (RCTs) which lasted more than 3 months were included. The primary outcomes are the mean change from baseline in glycated haemoglobin (HbA1c) and body weight loss. Secondary outcomes included mean difference in lipid parameters, blood pressures, and serum creatinine. Results Totally, 12 RCTs met inclusion criteria representing 761 patients. Compared with LFDs, treatment with LCDs achieved significant reduced HbA1c by 0.35% (95% CI: −0.45, −0.24; P < 0.00001). LCDs appeared to be more beneficial in decreasing body weight than LFDs (WMD = −2.99 kg; 95% CI: −4.36, −1.63; P < 0.0001), especially in the subgroup that used VLCDs (WMD = −9.49 kg; 95% CI: −12.88, −6.09, P < 0.00001). For cardiovascular risk factors, the LCD interventions significantly reduced TG concentration (WMD: −0.20 mmol/l; 95% CI: −0.31, −0.10; P = 0.0001) and increased HDL-C concentration (WMD: 0.09 mmol/l; 95% CI: 0.05,0.13; P < 0.00001). Subgroup analyses demonstrated that the difference in HbA1c, TG, and HDL-C between two dietary restrictions respectively lasted up to 1.5 and 2 years, whereas the beneficial effects of body weight loss diminished over time and disappeared after 2 years. LCDs were not associated with decreased level of TC or LDL-C, neither SBP nor DBP in comparison with LFDs. Moreover, no significant difference in serum creatinine could be found among such two diet interventions. Conclusions LCDs are superior to LFDs for T2DM patients in improving HbA1c and reducing body weight, with a rewarding effect of some cardiovascular risk factors in a longer-term diabetes management. However, available data are insufficient to evaluate the association between diet interventions and renal safety. Future larger longer-term follow-up clinical trials are needed to provide more evidence about the sustainable effects and safety of LCDs compared with LFDs.

Influence of non-surgical periodontal therapy on the glycemic control of type 2 diabetic patients: case reports

Periodontal disease and diabetes mellitus present a bidirectional relationship in which one condition may influence the other. It is assumed that non-surgical periodontal therapy (scaling and root planning) could decrease the pro-inflammatory mediators, restoring periodontal health and the balance of glycemic control. Objective: To report the glycemic control of two type-2 diabetes patients with periodontal disease, who received non-surgical periodontal therapy and supportive periodontal therapy. Case report: Both patients were initially evaluated, and the delineated treatment plan included prophylaxis, manual scaling and root planning sessions and oral hygiene instructions. The patients were evaluated at baseline and after 30- and 60-days post-treatment, for the clinical parameters (visible plaque index, gingival bleeding index, probing pocket depth, clinical attachment level, bleeding on probing and dental mobility) and 90-days post treatment for the glycated hemoglobin and fasting plasma glucose. Results: The results showed a significant improvement in periodontal clinical parameters in both patients, as well as a decrease in their glycemic indices. Conclusion: Non-surgical periodontal therapy promoted improvement of periodontal parameters and also systemic health of individuals.

Effectiveness of Phytomedicines for Glycaemic Control in Type 2 Diabetes: Overview of Meta-analyses

Effectiveness of Phytomedicines for Glycaemic Control in Type 2 Diabetes: Overview of Meta-analyses

Effectiveness of Medicinal Plants for Glycaemic Control in Type 2 Diabetes: An Overview of Meta-Analyses of Clinical Trials.

Aims: To rank the effectiveness of medicinal plants for glycaemic control in Type 2 Diabetes (T2DM). Methods: MEDLINE, EMBASE, CINAHL and Cochrane Central were searched in October 2020. We included meta-analyses of randomised controlled clinical trials measuring the effectiveness of medicinal plants on HbA1c and/or Fasting Plasma Glucose (FPG) in patients with T2DM. Results: Twenty five meta-analyses reported the effects of 18 plant-based remedies. Aloe vera leaf gel, Psyllium fibre and Fenugreek seeds had the largest effects on HbA1c: mean difference –0.99% [95% CI−1.75, −0.23], −0.97% [95% CI −1.94, −0.01] and −0.85% [95% CI −1.49, −0.22] respectively. Four other remedies reduced HbA1c by at least 0.5%: Nigella sativa, Astragalus membranaceus, and the traditional Chinese formulae Jinqi Jiangtang and Gegen Qinlian. No serious adverse effects were reported. Several other herbal medicines significantly reduced FPG. Tea and tea extracts (Camellia sinensis) were ineffective. However, in some trials duration of follow-up was insufficient to measure the full effect on HbA1c (<8 weeks). Many herbal remedies had not been evaluated in a meta-analysis. Conclusion: Several medicinal plants appear to be as effective as conventional antidiabetic treatments for reducing HbA1c. Rigorous trials with at least 3 months’ follow-up are needed to ascertain the effects of promising plant-based preparations on diabetes.

Prevalence and determinants of poor glycaemic control among adults with type 2 diabetes mellitus in a selected urban population of Mysuru district

Background: India is referred to as the “diabetic capital of the world” and is home to the second-largest number of adults with diabetes worldwide. Urbanization is a key reason for the Indian diabetes epidemic. Poor glycaemic control in type 2 diabetes patients is a serious public health issue and a key risk factor for both progression and complication of diabetes. This study, therefore, intends to assess glycaemic control status and factors influencing poor glycaemic control among T2DM patients.Methods: This was a community-based cross-sectional study done over a period of four months, among T2DM patients in urban Mysuru, using a pre-tested semi-structured questionnaire by interview method. A total of 372 T2DM patients who had the latest reports of fasting blood sugar value were included in the study. SPSS version 23 was used to analyse the collected data and to identify the determinants and risk factors leading to poor glycaemic control.Results: Among 372 study participants, 63.7% of patients had poor glycaemic control. The mean FBS value of the study population was 146.886±43.2700 and the mean age of the study participants was 55.50±12.238 years. Further, it was found that longer diseases durations, irregular check-ups, type of medication, non-adherence to both medication and diabetic diet were risk factors for poor glycaemic status.Conclusions: The prevalence of poor glycaemic control among diabetics in Mysuru was found to be high; therefore, proper health education, counselling of diabetics and organizing health awareness programmes are needed to control it and hence reduce the disease burden.

Association between hyperuricemia and glycated hemoglobin in type 2 diabetes at the District Hospital of Dschang.

Introductiongiven the difficulty to obtain glycemic control in type 2 diabetes, the exploration of others pathophysiological hypotheses could improve the understanding of this phenomenon. We conducted this study to search for an association between uric acid and uncontrolled diabetes.Methodsit was a cross-sectional study in a population of type 2 diabetes with normal postprandial and fast blood sugar for the last three months at the District Hospital of Dschang. Chi square test were used to analyzed categorical variables and Pearson correlation coefficient to evaluate the relationship between uric acid level and HbA1c. Means were compared using Kruskal-Walli’s or Student's test.Resultsour study of 80 patients found that, female sex and central obesity were risk factors for hyperuricemia. Prevalence of hyperuricemia and uncontrolled diabetes was respectively 27.5% and 33.8%. The proportion of women with hyperuricemia was significantly higher than that of men (59.1% versus 40.9%, p=0.021) and this inequality of proportion was more marked particularly after 45 years (40% versus 18.8%, p=0.022). Hyperuricemia was not significantly associated to uncontrolled diabetes (OR=2.01 IC (0.73-5.52), p=0.095). Serum uric acid was positively and significantly correlated to glycated hemoglobin (r=0.318, p=0.002) and hyperuricemia was significantly correlated to uncontrolled diabetes (r=0.712, p=0.035). The mean of glycated hemoglobin is abnormal (7.14%) when uric acid level is around 5.75 mg/dl without sex distinction.Conclusionthese results suggest that the rate of glycated hemoglobin is associated to serum uric acid variations during type 2 diabetes.

Efficiency of empagliflosin in combined nephroprotective therapy in patients with type 2 diabetes mellitus

INTRODUCTION. The data obtained in clinical studies of recent years of the possible inhibitors of sodium-glucose cotransporter type 2 (SGLT2) nephroprotective effect in type 2 diabetes mellitus necessitate the further study of these drug's effect on kidney injury risk factors.THE AIM: to study the effect of SGLT2 inhibitor empagliflozin as part of combination therapy on the main mechanisms of kidney damage in patients with type 2 diabetes.PATIENTS AND METHODS. We have completed a clinical randomized study in parallel groups in patients with type 2 diabetes of nephroprotective effects of SGLT2 inhibitor empagliflozin during 2 years. The study included 244 patients with type 2 diabetes with a preserved glomerular filtration rate (GFR) and moderate arterial hypertension (AH), who had previously taken perindopril and indapamide, but did not reach target blood pressure (BP) values. Patients were randomized into 2 groups: Group I (n = 120) took Perindopril 10 mg per day, Indapamide retard 1.5 mg per day, β-blocker Carvedilol 12.5-25 mg 2 times a day; Group II (n = 124) was additionally prescribed empagliflozin 25 mg per day. The study endpoints were GFR changes, albuminuria, and renal blood flow as measured by Doppler imaging. Also studied the dynamics of blood pressure and glycemic control.RESULTS. It was found that empagliflozin as part of complex therapy for type 2 diabetes is able to reduce albuminuria and prevent a decrease in GFR within a 2-year follow-up period. The use of empagliflozin promoted an increase in the rate of renal blood flow and a decrease in intrarenal vascular resistance and had a corrective effect on the daily dynamics of blood pressure and glycemic control.CONCLUSION. Empagliflozin improves intrarenal and systemic hemodynamics, prevents a decrease in GFR, reduces albuminuria, and improves glycemic control in type 2 diabetes.

Flash glucose monitoring and glycemic control in type 1 diabetes with subcutaneous insulin infusion.

To analyze the association between scan frequency and glycemic measures in continuous subcutaneous insulin infusion (CSII) treated type 1 diabetes (T1DM) adults. This retrospective study included 140 patients (> 18years) with T1DM who used flash glucose monitoring (FGM). For each patient, we analyzed the Ambulatory Glucose Profile data over a period of 90days. Data regarding glucose management indicator (GMI), time above, below and within range (TIR) and coefficient of variation (CV) were correlated with the number of daily scans. The effect of each additional test on glucose parameters was also evaluated. Users performed a mean of 8.6 ± 4.4 scans per day. There was an inverse correlation between scanning frequency and GMI (r = - 0.431, p < 0.001), CV (r = - 0.440, p < 0.001), time above and below range (r = - 0.446, p < 0.001 and r = - 0.200, p = 0.018, respectively). The number of daily scans correlated positively with TIR (r = 0.554, p < 0.001). For each additional scan per day, the mean GMI decreased 0.09% and TIR increased 1.60%. In patients with T1DM and CSII, higher rates of scanning correlated with improved glycemic markers, including reduced GMI and CV and increased TIR. For each test performed, there was a significant effect on the improvement of all glucose parameters.

Factors influencing the effectiveness of using flash glucose monitoring on glycemic control for type 1 diabetes in Saudi Arabia.

BACKGROUNDIn 2017, 35000 Saudi children and adolescents were living with a type 1 diabetes (T1D) diagnosis. Diabetic complications are minimized upon strengthened glycemic regulation. The annual cost of treating diabetic patients with complications was four-fold higher than for patients without complications. The use of flash glucose monitoring (FGM) enables better diabetes treatment and thereby improves glycemic control. Understanding the factors that affect effectiveness of FGM will help enhance the device’s use and management of hospital resources, resulting in improved outcomes.AIMTo investigate factors that affect effectiveness of the FGM system for glycated hemoglobin (HbA1c) levels/glycemic control among T1D patients.METHODSA retrospective empirical analysis of T1D patient records from King Abdul-Aziz University Hospital and Prince Sultan Military Medical City was performed. T1D patients who began FGM between 2017 and 2019 were included.RESULTSThe data included 195 T1D patients (70 males and 125 females) with a mean age of 23.6 ± 8.1 years. Among them, 152 patients used multiple daily injection and 43 used an insulin pump. The difference in HbA1c level from baseline and after using FGM was -0.60 ± 2.10, with a maximum of 4.70 and a minimum of -6.30. There was a statistically significant negative correlation between the independent variables (age, duration of diabetes, level of engagement) and HbA1c. The group with the highest HbA1c mean (9.85) was 18-years-old, while the group with the lowest HbA1c mean (7.87) was 45-years-old. Patients with a low level of engagement (less than six scans per day) had the highest HbA1c mean (9.84), whereas those with a high level of engagement (more than eight scans per day) had the lowest HbA1c mean (8.33).CONCLUSIONWith proper education, FGM can help people with uncontrolled T1D over the age of 18 years to control their glucose level.

Glycemic control in type 2 diabetic patients during the COVID-19 virus pandemic

Background: The Coronavirus disease 2019 (COVID-19) disease is a pandemic disease spread worldwide and results in lifestyle changes in areas affected by COVID-19. The ongoing social distancing and lockdowns may negatively impact access to medical care and management of type 2 diabetes mellitus (T2DM). Accordingly, we examined the impact of the COVID-19 virus pandemic in Thailand on the glycemic control of patients with T2DM. Method: This study focused on T2DM outpatients at Rajavithi Hospital. Three hundred and fifty participants were included. Baseline characteristics, data on exercise, outdoor activities, and access to foods and blood chemistries, including hemoglobin A1C (A1C) and fasting plasma glucose (FPG), were reviewed, and collected from electronic medical records before and after the COVID-19 pandemic. Results: There was a significant increase in mean A1C (g/L) ± SD (74.8 ± 13.7 vs. 76.0 ± 15.3, p-value &lt;0.016), the mean duration of outdoor activities (hours/day) ± SD during the COVID-19 virus pandemic was significantly decreased. (5.35 ± 4.48 vs. 4.03 ± 4.37, p-value &lt;0.001) Conclusion: The present study showed that mean A1C was significantly increased during the COVID-19 virus pandemic. Nevertheless, a statistical difference was not observed in FPG. The impact of quarantine, social distancing, and community containment during the epidemic on lifestyles may be the essential factor in increasing A1C.

Sleep Extension Improves Glycemic Control in Type 2 Diabetes with Obstructive Sleep Apnea

Background: The purpose of this study was to investigate whether sleep extension lowers blood glucose in patients with type 2 diabetes and chronic sleep restriction, and the moderating role of sleep apnea on the effect of sleep extension. Methods: This study enrolled 19 adults with type 2 diabetes and a sleep duration of less than 7 hours per night, of whom 16 (84.2 %) had obstructive sleep apnea. They were instructed to sleep at their usual time for 3 weeks as baseline, and then to increase their time in bed by 1 more hour per night for 3 weeks. Their sleep duration was recorded using actigraphy monitoring and sleep logs. Their fasting plasma glucose, glycated albumin, and glycated hemoglobin were measured before and after sleep extension. Results: Nine of the 19 (47.4 %) participants had a decrease in glycated albumin after sleep extension, and these participants had a significantly higher apnea-hypopnea index (AHI; p &lt; 0.001). The participants with an AHI ≥ 30 times per hour were older (p = 0.04), had a shorter baseline total sleep time measured by actigraphy (p = 0.04), and had a more significant decrease in glycated albumin after sleep extension (p = 0.01). The AHI level was significantly correlated with the extent of decrease in glycated albumin after sleep extension (r = 0.72, p = 0.001). Conclusion: The current study showed the potential of 3-week sleep extension in decreasing blood glucose in patients with diabetes comorbid with severe obstructive sleep apnea and sleep deprivation.

Glycemic control in type 2 diabetic patients during the COVID-19 virus pandemic

Glycemic control in type 2 diabetic patients during the COVID-19 virus pandemic