Management Of Type 2 Diabetes Mellitus Research Articles

Impact of telerehabilitation on the physical, physiological, and psychological parameters in individuals with diabetes

Abstract The primary objective of this critical review is to evaluate the effectiveness of telerehabilitation (TR) in managing physical, physiological, and psychological parameters in patients with type 2 diabetes mellitus (T2DM). T2DM has become a major global health concern, with complications that significantly impact the well-being and quality of life of affected individuals. The introduction of this review aims to elucidate the complexities of T2DM by discussing its prevalence, cardiovascular implications, and the crucial role of physical activity in its management. The study’s goal is clearly stated, focusing on a comprehensive assessment of electronically provided rehabilitation models to address the multifaceted aspects of T2DM. The methodology section details a systematic review covering reputable databases such as PubMed, Medline, and EMBASE, establishing a solid foundation for this review. Furthermore, recent empirical findings from a specific study provide valuable insights by demonstrating the positive effects of a 6-week TR program on individuals with T2DM. Including various modes of exercise supervision and their noticeable impact on HbA1c levels enhances the analytical depth of this review. In conclusion, this scholarly review acknowledges the evolving role of technology-based rehabilitation in healthcare and recognizes the promising findings from current studies. However, it emphasizes the need for further research, particularly larger, multi-centered randomized controlled trials, to refine the effectiveness, cost-effectiveness, and long-term interpretability of TR in the complex landscape of T2DM management. The primary aim of this review is to contribute to the academic discussion surrounding the integration of telehealth applications, particularly TR, as an essential component in the holistic care of individuals with T2DM.

Survival of type 1 diabetes mellitus patients on disease control programme

Survival among children diagnosed with T1DM in SSA has been estimated to be very poor with average duration of survival at 1 year. With care and increasing availability of insulin through philanthropic projects like the Changing Diabetes in Children (CDiC), there is improved survival of children and adolescents with T1DM in the low and medium income countries (LMICS). We aimed to investigate the survival rates of patients with type 1 diabetes mellitus (T1DM) on a national programme at specialized T1DM clinics. Furthermore, the study sought to determine the associated factors for patients with T1DM to stay on the programme. The median duration for registered patients with T1DM on the programme was 99 (μ≔ 600, Min—Max ≔ 1—16864) days. Findings show that the hemoglobin A1C (HbA1c) poor control, body mass index (BMI), hypertension, hospital and residence were significantly associated with time in days to dropout from the programme. Of these predictors, being underweight and the centre of registration (Nsambya Hospital) had poor T1DM prognostics, while residing in the central region and being at least 15 years were associated with better T1DM control and management, hence a greater likelihood to stay on the T1DM programme.

Relationship between thyroid hormone levels and metabolic dysfunction associated steatotic liver disease in patients with type 2 diabetes: A clinical study.

This study investigates the correlation between thyroid hormone levels and metabolic dysfunction in patients with type 2 diabetes mellitus (T2DM) who exhibit normal thyroid function and metabolic dysfunction associated with steatotic liver disease (MASLD). The objective is to identify a scientific basis for the management of T2DM complicated by MASLD, aiming to refine clinical strategies and enhance patient well-being. Statistical analysis was conducted using SPSS 26.0, employing independent sample t-tests for normally distributed data and logarithmic transformations for non-normal data to meet analysis prerequisites. Multifactorial logistic regression analysis elucidated the impact of various factors on the risk of MASLD in T2DM patients. Elevated levels of FT3 may be associated with an increased risk of nonalcoholic fatty liver disease. Additionally, the FT3/FT4 ratio has been validated as an effective serological marker for predicting the risk of MASLD. In patients with DM2 and normal thyroid function, changes in thyroid hormone levels are closely related to the occurrence of MASLD. Elevated levels of FT3, total triiodothyronine (TT3), and thyroid-stimulating hormone are associated with an increased risk of MASLD. FT3, TT3, and thyroid-stimulating hormone have important clinical value in the diagnosis of patients with T2DM complicated with MASLD.

Gut Microbiota as Therapeutic Targets in Diabetes Management: Opportunities and Challenges

This article delves into the complex interplay between Type 2 Diabetes Mellitus (T2DM), gut microbiota, and dietary strategies for effective diabetes management. T2DM, characterized by insulin resistance and β-cell dysfunction, is influenced by genetic and environmental factors. The gut-brain axis and alterations in incretin functioning contribute to gastrointestinal permeability in T2DM. Plant-based diets offer substantial benefits for managing T2DM by improving emotional well-being, HbA1c levels, weight, and cholesterol. High-fiber diets positively impact gut microbiota, serum metabolism, and emotional health in T2DM individuals. Probiotics, prebiotics, synbiotics, and postbiotics (PPSP) are emerging as pivotal interventions. Probiotics improve serum fructosamine, HbA1c, and cholesterol levels, while prebiotics like oligofructose-enriched inulin and synbiotics enhance glycemic control and lipid profiles. Insights from microbiome studies in diverse dietary populations provide personalized approaches for diabetes management. Integrating plant-based nutrition, PPSP interventions, and microbiome-focused strategies may offer a comprehensive and effective approach to T2DM management, addressing physiological aspects and empowering individuals in their health journey.

Understanding Gut Health: Probiotics, Dysbiosis, and their Connection to Type 2 Diabetes - A Review

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. The pathophysiology of T2DM involves a multifaceted interplay of genetic, behavioural, and environmental factors. Beta cells play a central role in regulating blood glucose levels through intricate mechanisms involving insulin secretion triggered by elevated glucose concentrations and other factors. Dysfunction of beta cells in T2DM encompasses various molecular pathways influenced by factors such as hyperglycaemia, hyperlipidaemia, chronic inflammation, and genetic susceptibility, leading to impaired insulin secretion and insulin resistance. Recent research has highlighted the role of gut dysbiosis in the pathogenesis of T2DM, with alterations in gut microbiome composition impacting glucose metabolism. Dysbiosis-induced intestinal permeability can lead to systemic inflammation, contributing to insulin resistance and diabetes progression. Conversely, a diverse and rich gut microbiome has been associated with protection against obesity, diabetes, and metabolic syndrome. Probiotics, defined as live bacteria conferring health benefits when administered in adequate amounts, hold promise in mitigating T2DM-related metabolic derangements through various mechanisms, including modulation of gut microbiota, regulation of the gut-brain axis, and reduction of chronic low-grade inflammation. This provides a comprehensive overview of the mechanisms through which probiotics may positively impact glucose metabolism and discusses current evidence on the efficacy of probiotic supplementation in improving glycemic parameters and highlights the need for further research to elucidate strain-specific effects, optimal dosages, and long-term outcomes. Additionally, the translation of research findings into clinical practice and the potential of microbiome-targeted therapies for precision management of T2DM are explored, underscoring the importance of evidence-based guidelines for healthcare practitioners.

Novel Therapeutics for Type 2 Diabetes Mellitus-A Look at the Past Decade and a Glimpse into the Future.

Cardiovascular disease (CVD) and kidney disease are the main causes of morbidity and mortality in type 2 diabetes mellitus (T2DM). Globally, the incidence of T2DM continues to rise. A substantial increase in the burden of CVD and renal disease, alongside the socioeconomic implications, would be anticipated. Adopting a purely glucose-centric approach focusing only on glycemic targets is no longer adequate to mitigate the cardiovascular risks in T2DM. In the past decade, significant advancement has been achieved in expanding the pharmaceutical options for T2DM, with novel agents such as the sodium-glucose cotransporter type 2 (SGLT2) inhibitors and glucagon-like peptide receptor agonists (GLP-1 RAs) demonstrating robust evidence in cardiorenal protection. Combinatorial approaches comprising multiple pharmacotherapies combined in a single agent are an emerging and promising way to not only enhance patient adherence and improve glycemic control but also to achieve the potential synergistic effects for greater cardiorenal protection. In this review, we provide an update on the novel antidiabetic agents in the past decade, with an appraisal of the mechanisms contributing to cardiorenal protection. Additionally, we offer a glimpse into the landscape of T2DM management in the near future by providing a comprehensive summary of upcoming agents in early-phase trials.

Evaluating usability of and satisfaction with mHealth app in rural and remote areas-Germany GIZ collaboration in Bosnia-Herzegovina to optimize type 1 diabetes care.

Type 1 diabetes mellitus (T1DM) management in children and adolescents requires intensive supervision and monitoring to prevent acute and late diabetes complications and to improve quality of life. Digital health interventions, in particular diabetes mobile health apps (mHealth apps) can facilitate specialized T1DM care in this population. This study evaluated the initial usability of and satisfaction with the m-Health intervention Diabetes: M app, and the ease of use of various app features in supporting T1DM care in rural and remote areas of Bosnia-Herzegovina with limited access to specialized diabetes care. This cross-sectional study, performed in February-March 2023, evaluated T1DM pediatric patients who used the Diabetes: M app in a 3-month mHealth-based T1DM management program, along with their parents and healthcare providers (HCPs). All participants completed self-administered online questionnaires at the end of the 3-month period. Data were analyzed by descriptive statistics. The study population included 50 T1DM patients (children/parents and adolescents) and nine HCPs. The mean ± SD age of the T1DM patients was 14 ± 4.54 years, with 26 (52%) being female. The mean ± SD age of the HCPs was 43.4 ± 7.76 years; all (100%) were women, with a mean ± SD professional experience of 17.8 ± 8.81 years. The app was reported usable in the domains of ease-of-use and satisfaction by the T1DM children/parents (5.82/7.0), T1DM adolescents/young adults (5.68/7.0), and HCPs (5.22/7.0). Various app features, as well as the overall app experience, were rated positively by the participants. The results strongly support the usability of mHealth-based interventions in T1DM care, especially in overcoming care shortage and improving diabetes management and communications between HCPs and patients. Further studies are needed to compare the effectiveness of apps used to support T1DM management with routine care.

The mediating role of psychological well-being in the relationship between the light triad of personality and sense of concordance with treatment adherence in patients with type 2 diabetes: A network analysis and structural equation modeling study

BackgroundThis study aimed to investigate the intricate relationship among treatment adherence, the light triad of personality, self-coherence, and psychological well-being in individuals diagnosed with Type 2 Diabetes Mellitus (T2DM). Structural equation modeling (SEM) was employed to elucidate the direct and mediated pathways linking these variables, while network analysis sought to identify and characterize the underlying factors of the light triad of personality within the context of T2DM management. MethodA path analysis-network analysis study using convenience sampling was conducted, recruiting 412 T2DM patients from ten private practices and general hospitals in Gilan province, Iran. Data collection utilized Antonovsky's Self of Coherence scale (SOC), The Light Triad Rating Scale, and The Reef's Psychological Well-being Questionnaire. Structural equation modeling assessed model fitness and determined direct and indirect links between variables. Analysis was conducted using R-Studio software (Version 4.2.1), SPSS (V.26), and AMOS software (V.24). ResultsConfirmatory factor analysis and network analysis confirmed the three-factor structure of the Light Triad of Personality scale. Direct impacts of Light Triad of Personality (β = 0.34, p < .001) and self-coherence (β = 0.32, p < .001) on treatment adherence were observed. Psychological well-being played an indirect role in this relationship, with significant effects from Light Triad of Personality (β = 0.25, p < .001) and self-coherence (β = 0.08, p < .001) on treatment adherence. Bootstrapped exploratory graph analysis revealed an average of 3 dimensions within the network, indicating community structures. ConclusionSEM analysis demonstrated good model fit, suggesting the importance of designing interventional programs incorporating self-coherence and psychological well-being frameworks to enhance treatment adherence in T2DM patients.

Obesity management for the treatment of type 2 diabetes: emerging evidence and therapeutic approaches.

Excess adiposity can contribute to metabolic complications, such as type 2 diabetes mellitus (T2DM), which poses a significant global health burden. Traditionally viewed as a chronic and irreversible condition, T2DM management has evolved and new approaches emphasizing reversal and remission are emerging. Bariatric surgery demonstrates significant improvements in body weight and glucose homeostasis. However, its complexity limits widespread implementation as a population-wide intervention. The identification of glucagon-like peptide 1 (GLP-1) and the development of GLP-1 receptor agonists (GLP-1RAs) have improved T2DM management and offer promising outcomes in terms of weight loss. Innovative treatment approaches combining GLP-1RA with other gut and pancreatic-derived hormone receptor agonists, such as glucose-dependant insulinotropic peptide (GIP) and glucagon (GCG) receptor agonists, or coadministered with amylin analogues, are demonstrating enhanced efficacy in both weight loss and glycemic control. This review aims to explore the benefits of bariatric surgery and emerging pharmacological therapies such as GLP-1RAs, and dual and triple agonists in managing obesity and T2DM while highlighting the caveats and evolving landscape of treatment options.

Potential Role of Phytochemicals as Glucagon-like Peptide 1 Receptor (GLP-1R) Agonists in the Treatment of Diabetes Mellitus.

Currently, there is no known cure for diabetes. Different pharmaceutical therapies have been approved for the management of type 2 diabetes mellitus (T2DM), some are in clinical trials and they have been classified according to their route or mechanism of action. Insulin types, sulfonylureas, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, meglitinides, sodium-glucose cotransporter type 2 inhibitors, and incretin-dependent therapies (glucagon-like peptide-1 receptor agonists: GLP-1R, and dipeptidyl peptidase 4 inhibitors: DPP-4). Although some of the currently available drugs are effective in the management of T2DM, the side effects resulting from prolonged use of these drugs remain a serious challenge. GLP-1R agonists are currently the preferred medications to include when oral metformin alone is insufficient to manage T2DM. Medicinal plants now play prominent roles in the management of various diseases globally because they are readily available and affordable as well as having limited and transient side effects. Recently, studies have reported the ability of phytochemicals to activate glucagon-like peptide-1 receptor (GLP-1R), acting as an agonist just like the GLP-1R agonist with beneficial effects in the management of T2DM. Consequently, we propose that careful exploration of phytochemicals for the development of novel therapeutic candidates as GLP-1R agonists will be a welcome breakthrough in the management of T2DM and the co-morbidities associated with T2DM.

Optimizing Blood Pressure Management in Type 2 Diabetes: A Comparative Investigation of One-Time Versus Periodic Lifestyle Modification Counseling.

Background Type 2 diabetes mellitus (T2DM) often coexists with hypertension, significantly increasing cardiovascular risks. Lifestyle modification counseling has shown promise in managing T2DM and its comorbidities. However, the optimal frequency and structure of counseling for blood pressure control remain uncertain. Our study examines the best approach for managing blood pressure in T2DM patients by comparing the outcomes of two counseling strategies: a single session and periodic counseling over time. Methodology A total of 110 diabetic patients were enrolled, with 52 patients in each group after loss to follow-up.A randomized controlled trial compared one-time counseling (control) to six months of periodic counseling (intervention) on lifestyle modification. A weighing machine, stadiometer, 24-hour dietary recall, food frequency questionnaire, biochemical blood sugar level analysis, and telephonic follow-up were the essential tools used. The data were analyzed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA), employing descriptive statistics, including frequencies, percentages, graphs, mean, and standard deviation. Statistical significance at the 5% level was tested using probability (p) calculations. The Kolmogorov-Smirnov test confirmed normal distribution (p > 0.05). Parametric tests, specifically independent t-tests, were used for between-group comparisons of continuous variables, while categorical variables were analyzed using the chi-square test or Fisher's exact test. Intragroup comparisons over time employed repeated-measures analysis of variance for continuous variables. Changes within groups after six months were assessed using paired t-tests. All statistical analyses adhered to a significance level of p < 0.05. Results The gender distribution at baseline was similar between the control (55.8% male, 44.2% female) and intervention (46.2% male, 53.8% female) groups, with no significant differences (p = 0.327).The mean weight was 66.67 ± 11.51 kg in the control group and 67.14 ± 11.19 kg in the intervention group (p = 0.835), and the body mass index was 25.61 ± 4.09 kg/m² and 26.29 ± 6.01 kg/m², respectively (p = 0.503).Clinical parameters such as fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin, and blood pressure showed no significant differences between the control and intervention groups at baseline (p > 0.05).After six months, the intervention group exhibited a trend toward lower blood pressure compared to the control group, but the differences were not statistically significant. The mean systolic blood pressure was 132.15 ± 14.867 mmHg in the control group and 129.15 ± 9.123 mmHg in the intervention group (p = 0.218). Changes in blood pressure over the six-month period showed significant decreases within the intervention group, while changes in the control group did not reach statistical significance. The mean difference in systolic blood pressure in the intervention group was 5.54 ± 9.77 mmHg (p = 0.0001), indicating a notable reduction, while the control group had a smaller and statistically insignificant increase of 2.308 ± 9.388 mmHg (p = 0.082). Conclusions This study addresses a significant gap in the literature by comparing the efficacy of one-time vs. periodic counseling in T2DM management. While periodic counseling shows promise in improving diastolic blood pressure, further research is needed to understand its nuanced effects and optimize lifestyle interventions for T2DM patients.

Expert Consensus on Dipeptidyl Peptidase-4 Inhibitor-Based Therapies in the Modern Era of Type 2 Diabetes Mellitus Management in India.

India has a high prevalence of type 2 diabetes mellitus (T2DM) with unique clinical characteristics compared to other populations. Despite advancements in diabetes therapy, a significant number of patients in India still experience poor glycemic control and complications. Dipeptidyl peptidase-4 (DPP-4) inhibitors continue to be an important component of T2DM treatment due to their favorable efficacy and tolerability profile. Given the current scenario, there is a need to revisit the role of DPP-4 inhibitors in T2DM management in Indian patients. This consensus paper aims to provide guidance on the utilization of DPP-4 inhibitors in T2DM management from an Indian perspective. A consensus group of 100 experts developed recommendations based on an extensive literature review and discussions. The expert group emphasized the importance of timely glycemic control, combination therapy, and targeting the underlying pathophysiology of T2DM. The combinations of DPP-4 inhibitors with metformin and/or sodium-glucose transport protein-2 inhibitors are rationalized in this paper, considering their complementary mechanisms of action. This paper provides valuable insights for clinicians in optimizing the management of T2DM in the Indian population with the use of DPP-4 inhibitors and proposes an algorithm for selecting DPP-4 inhibitor-based therapies.

Potential Therapeutic Targets for the Management of Diabetes Mellitus Type 2.

Diabetes is one of the lifelong chronic metabolic diseases which is prevalent globally. There is a continuous rise in the number of people suffering from this disease with time. It is characterized by hyperglycemia, which leads to severe damage to the body's system, such as blood vessels and nerves. Diabetes occurs due to the dysfunction of pancreatic β -cell which leads to the reduction in the production of insulin or body cells unable to use insulin produce efficiently. As per the data shared International diabetes federation (IDF), there are around 415 million affected by this disease worldwide. There are a number of hit targets available that can be focused on treating diabetes. There are many drugs available and still under development for the treatment of type 2 diabetes. Inhibition of gluconeogenesis, lipolysis, fatty acid oxidation, and glucokinase activator is emerging targets for type 2 diabetes treatment. Diabetes management can be supplemented with drug intervention for obesity. The antidiabetic drug sale is the second-largest in the world, trailing only that of cancer. The future of managing diabetes will be guided by research on various novel targets and the development of various therapeutic leads, such as GLP-1 agonists, DPP-IV inhibitors, and SGLT2 inhibitors that have recently completed their different phases of clinical trials. Among these therapeutic targets associated with type 2 diabetes, this review focused on some common therapeutic targets for developing novel drug candidates of the newer generation with better safety and efficacy.

Assessing satisfaction, quality of life, and HbA1c changes in type 1 diabetes patients who are using freestyle libre glucose monitoring

ABSTRACT Introduction: Type 1 diabetes mellitus (T1DM) is a chronic auto-immune disease in which loss of pancreatic islet β-cells leads to the deficiency of insulin in the body thus resulting in enhanced blood sugar levels. Effective blood glucose monitoring is crucial in T1DM management to prevent complications, particularly hypoglycemia. Method: The study adopted a cross-sectional survey to assess satisfaction and quality of life among T1DM patients using the freestyle libre continuous glucose monitoring (FSL-CGM), and a retrospective cohort study design to evaluate changes in HbA1c over a year. Result: The study involved 98 Saudi subjects, with 46.9% (n = 46) being male. The results indicated a high level of user satisfaction, with more than 85% of the participants responding positively, yielding a total satisfaction score of 30.86. User satisfaction with FSL-CGM was found to be significantly associated with the level of education. The use of FSL-CGM was also found to significantly improve the patients’ quality of life. However, the levels of HbA1c had an impact on both satisfaction and quality of life. Before using the FSL-CGM system, the mean HbA1c was 9.83%, which significantly decreased to 8.63% after using the system (P-value &lt;0.001). Conclusion: The study’s findings align with previous literature on satisfaction and quality of life, but there are conflicting results regarding the reduction of HbA1c levels using FSL-CGM. Given the limited sample size, future research could explore the topic more comprehensively, potentially utilizing a longitudinal study design to better measure changes in HbA1c level.

Type 2 Diabetes Mellitus Patients' Knowledge About Disease Complications and Management Targets for Glucose, Lipids, Blood Pressure, and Body Weight.

Background As a result of the chronic nature of type 2 diabetes mellitus (T2DM), its complications, and treatment complexity, patients should have a comprehensive knowledge of various aspects of T2DM management and follow-up. The study aimed to assess T2DM patients' knowledge of disease complications and their screening strategies and the management targets for glucose, lipids, blood pressure, and body weight. Methods This was a cross-sectional and questionnaire-based study including 205 adult patients with T2DM from November 2023 to March 2024. The patients were randomly selected at one tertiary endocrine center and the outpatient clinics of three teaching hospitals in Basrah, southern Iraq. Social and disease-related data were collected. Another 18 T2DM-related questions were designed to assess the patients' knowledge about the aim of treatment; T2DM complications and their screening; the recommended targets for glycemic, lipid, and blood pressure control; and the recommended exercise and weight loss. We gave one point for each correct answer and considered a final score of 10/18 as adequate. Results Of a total of 205 patients, 109 (53.2) were women. The mean age for patients was 48.7 ± 13.1 years. Based on the patients' responses, 107 (52.2%) had adequate knowledge about T2DM. Questions about the target fasting and post-prandial capillary blood glucose, HbA1c target and frequency, and naming the current treatment were the most correctly answered questions (80.9%, 73.1%, 68.7%, and 72.6%, respectively). Questions about the lipid target, definition of hypoglycemia, and ideal lifestyle for T2DM (exercise and bodyweight loss) were least correctly answered. Patients younger than 40 years old, being a man, with a higher educational level, and T2DM duration of more than five years had significantly higher T2DM knowledge. Conclusions Only half of the patients had adequate T2DM knowledge. Better degree of knowledge was particularly observed in patients with younger age, male gender, higher educational level, and longer T2DM duration.There is a need to promote diabetes education strategies for people with T2DM.

TYPE 2 DIABETES MELLITUS MANAGEMENT KNOWLEDGE AMONG PHC PHYSICIANS IN BURAIDAH CITY, 2020

Introduction: Type 2 diabetes mellitus (T2DM) is highly prevalent in Saudi Arabia. primary health care (PHC) doctors provide most of T2DM medical care Objectives: To estimate PHC physicians and family medicine residents level of T2DM management knowledge as per Saudi national reference of clinical guidelines for care of diabetic patients. Methods: We conducted a cross-sectional study using a structured questionnaire. Beside general participant characteristics, we prepared 17 questions on four aspects of T2DM management. These were diagnosis, non-pharmacological and oral hypoglycemic agent, insulin and follow up. Each aspect was given a score of 4-6 points and the total score was 20 points. Result: Out of 258 physicians, 178 were actually available at the time of the survey and 106 completed the study questionnaire. The overall response rate was 41.1%. The mean age of participants was 34.1 years and around two thirds of them were males. In-training family medicine residents formed the largest segment, 45 (42.5%). Mean duration of practice was 7.8 years. The reported daily workload showed that more than one-third of physicians (36.5%) manage ≥ 20 patients per day and almost all of them manage T2DM. Out of the total 20 points, only one quarter of participants had scored more than 15 points, while another quarter could not achieve more than 40%. Only physician qualification had impacted physician performance. Conclusion: PHC doctors knowledge about T2DM management is sub-optimal. Properly selected educational activities targeted diabetes management are needed.

Analytical Method Development and Optimization on High Performance Liquid Chromatography for Related Substances Test of Gliclazide Drug as Active Pharmaceutical Ingredient

Diabetes mellitus, particularly Type 2 Diabetes Mellitus (T2DM), presents a significant global health challenge, necessitating continuous advancements in therapeutic strategies. Gliclazide, an oral selective inhibitor of sodium glucose co-transporter-2 (SGLT2), has emerged as a promising agent for managing T2DM by facilitating urinary glucose excretion and reducing plasma glucose levels. However, ensuring the quality and efficacy of pharmaceutical formulations remains crucial for regulatory approval and clinical effectiveness. In this study, we present the development of an improved stability-indicating Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) method for the precise quantification of Gliclazide. The novel analytical method employs 0.1% Potassium Phosphate in water 0.1% Potassium Phosphate in methanol (MeOH) as the mobile phase, demonstrating enhanced sensitivity, cost-effectiveness, and reduced reliance on organic chemicals. Through rigorous validation following International Conference on Harmonisation (ICH) guidelines, the developed method exhibited superior performance in terms of retention times compared to existing methodologies. The proposed analytical approach holds promise for routine analysis of Gliclazide in both bulk and tablet formulations, offering a valuable tool for pharmaceutical quality control and clinical research in the management of T2DM.

Supernatural Beliefs-Based Intervention to Improve Type-2 Diabetes Self-Management: A Pilot Randomized Controlled Trial from China.

China has over 100 million people living with type 2 diabetes mellitus (T2DM). Interventions framed around pre-existing personal beliefs in the supernatural may improve T2DM self-management, but such interventions are lacking in China. This pilot randomized controlled trial (RCT) assessed the feasibility of a full-scale RCT to evaluate the efficacy of a supernatural beliefs-based intervention on T2DM management self-efficacy in China. In 2019, 62 T2DM patients were enrolled at two hospitals in Suzhou, China. Participants were randomly assigned to view a 30-s control or intervention video at baseline. The control video showed general diabetes self-management information. The intervention video showed identical information, but also indicated that some diabetics with supernatural beliefs (chao ziran xinnian) have lower glycemic levels, because their beliefs enhance their confidence in diabetes self-management. Development of the intervention was guided by the theory of planned behavior and literature on spiritual framing health interventions. Baseline and follow-up measures after two weeks were assessed by interviewer administered surveys in-person and by telephone, respectively. Diabetes management self-efficacy was assessed with the diabetes management self-efficacy scale. Randomization of intervention allocation appeared to be successful. However, follow-up retention was low, especially for the intervention group (3% vs. 31%). A full-size efficacy RCT using the current study design is unlikely to succeed. T2DM patients shown the supernatural beliefs-based intervention had significantly higher loss to follow-up that was insurmountable. T2DM patients in Suzhou, China may not be receptive to brief, non-tailored supernatural beliefs-based interventions delivered to a general population in clinical settings.

Exploring the therapeutic potential of barley grain in type 2 diabetes management: a review

SummaryA healthy lifestyle with a high intake of whole grains is preferred for the effective type 2 diabetes mellitus (T2DM) prevention. Plenty of studies have shown the health benefits of barley on metabolic diseases, but there is a dearth of review articles specifically focused on antidiabetic effects. Hence, it is urgent to consolidate the up‐to‐date findings and provide guidance for future research endeavours in a timely review. This review aims to provide an overview on barley consumption for T2DM prevention and management, focusing on certain key aspects such as glycaemic control, insulin sensitivity and lipid profile. Extensive research has highlighted the potential benefits of barley grains in T2DM prevention, attributed to their high dietary fibre content, a diverse array of phytochemicals, and bioactive peptides. The dietary fibre (e.g., β‐glucan and arabinoxylan), characterised by their viscous and water‐soluble nature, is involved in modulating gastrointestinal physiology, thereby exerting regulatory effects on blood glucose and insulin levels. Phenolic compounds in barley have the potential to inhibit α‐amylase and α‐glucosidase enzymes, offering further support for glucose homeostasis. In addition, outer layers of barley are found to have high levels of fibres and bioactive compounds. The levels of these bioactive compounds can be improved through food processing techniques. Future investigation is necessary to establish the relationships between barley bioactive components and their specific antidiabetic capacity to improve study consistency and innovative strategies to incorporate barley into daily diet.

Modern-Day Therapeutics and Ongoing Clinical Trials against Type 2 Diabetes Mellitus: A Narrative Review.

Diabetes Mellitus (DM) is a global health concern that affects millions of people globally. The present review aims to narrate the clinical guidelines and therapeutic interventions for Type 2 Diabetes Mellitus (T2DM) patients. Furthermore, the present work summarizes the ongoing phase 1/2/3 and clinical trials against T2DM. A meticulous and comprehensive literature review was performed using various databases, such as PubMed, MEDLINE, Clinical trials database (https://clinicaltrials.gov/), and Google Scholar, to include various clinical trials and therapeutic interventions against T2DM. Based on our findings, we concluded that most T2DM-associated clinical trials are interventional. Anti-diabetic therapeutics, including insulin, metformin, Dipeptidyl Peptidase-4 (DPP-4) inhibitors, Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs), and Sodium- Glucose cotransporter-2 (SGLT-2) inhibitors are frontline therapeutics being clinically investigated. Currently, the therapeutics in phase IV clinical trials are mostly SGLT-2 inhibitors, implicating their critical contribution to the clinical management of T2DM. Despite the success of T2DM treatments, a surge in innovative treatment options to reduce diabetic consequences and improve glycemic control is currently ongoing. More emphasis needs to be on exploring novel targeted drug candidates that can offer more sustained glycemic control.