First Author: Merlinda Alu? Tokat
All Authors: Alu? Tokat M, Sanc? M, GirgeÃ§ S, Kulhan NG, Ã–zcan Ã‡Y
Journal Title: International journal of nursing practice
Abstract: Women with previous gestational diabetes mellitus (GDM) have at least sevenfold increased risk for developing type 2 diabetes compared with non-GDM mothers. The risk can be decreased by self-care measures.The aim of this study was to explore the postpartum education and lifestyle changes of Turkish women with previous GDM.This was a retrospective descriptive epidemiological study. A total of 111 women who had given birth within the previous 3-4?years were interviewed by telephone between December 2013 and April 2014.The 83.8% of the women with GDM had not received education related to exercise, while 40.5% received no education regarding the importance of diet. More importantly, while 68.5% had been informed about testing blood glucose levels postpartum, a large majority, 69.3%, did not know for how long they would have had to continue testing their glucose levels. However, 31.3% of those who monitored their glucose levels had glucose intolerance. In terms of lifestyle changes, less than half of the women, 48.6%, had made changes in their diet and the majority, 51.4%, were inactive.Women need access to sustained education and supportive counselling both to motivate and to minimize the risk of type 2 diabetes after GDM.
Evaluate the Effect of Education Interventions in the Prevention of Diabetic Foot Ulcers through Knowledge of the Disease and Self-Care Practices in Saudi Arabia
Authors: Kataoka H, Miyatake N, Kitayama N, Murao S, Kohi F, Tanaka S
Abstract: The aim of this study was to explore the relations between toe pinch force and other muscle strength parameters in male patients with type 2 diabetes mellitus.A total of 40 men with type 2 diabetes (age: 53.4 ± 13.1 years, duration of diabetes: 8.5 ± 8.1 years) who needed exercise training were enrolled in this cross-sectional study. We evaluated the clinical parameters and 4 muscle strength parameters, which were toe pinch force, handgrip strength, isometric knee extension force, and isometric ankle dorsiflexion force.The HbA1c, toe pinch force, handgrip strength, isometric knee extension force, and isometric ankle dorsiflexion force were 10.1 ± 2.4 %, 3.2 ± 1.2 kg, 37.3 ± 7.0 kg, 39.6 ± 11.4 kgf, and 17.0 ± 6.3 kgf, respectively. Toe pinch force was significantly correlated with handgrip strength (r = 0.365, p = 0.0206), isometric knee extension force (r = 0.668, p < 0.0001), and isometric ankle dorsiflexion force (r = 0.514, p = 0.0007). All muscle strength parameters were significantly lower in patients with diabetic polyneuropathy than in those without polyneuropathy.Although toe pinch force was significantly correlated with the other muscle strength parameters, the correlation was not so strong. However, evaluation of toe pinch force might be recommended for assessment of distal limb muscle strength in patients with type 2 diabetes.
Authors: Kuznetsov SV, Markina MS
Abstract: In out-patient dental care a history of somatic pathology is of vital importance. Unfortunately patients are not always compliant enough not understanding the impact of somatic pathology on dental treatment. The current paper presents a case of dental implant placement and splint bridge fixation in a patient with type II diabetes and asthma. The authors summarize the most useful recommendations for treatment and follow-up of such patients.
Authors: Chinenye S, Young EE
Abstract: The importance of diabetes education in the management of patients is very crucial. One-on-one education, didactic group lectures are traditional methods employed in Diabetes Education. In our environment, group interaction using the Diabetes Conversation Map tools may prove to be effective especially during regular meetings of the Diabetes Association.
Authors: Nakajima H, Nakamura Y, Inaba Y, Tsutsumi C, Unoda K, Hosokawa T, Kimura F, Hanafusa T, Date M, Kitaoka H
Abstract: To determine clinical features of neurologic disorders associated with anti-glutamic acid decarboxylase antibodies (anti-GAD-Ab), we examined titers and time-dependent changes of anti-GAD-Ab. Six patients, stiff person syndrome (2), cerebellar ataxia (1), limbic encephalitis (1), epilepsy (1), brainstem encephalitis (1), were compared with 87 type I diabetes mellitus (T1DM) patients without neurologic disorders. Anti-GAD-Ab titers and index were higher in neurologic disorders than in T1DM, suggesting intrathecal antibody synthesis. Anti-GAD-Ab titers in T1DM decreased over time, whereas they remained high in neurologic disorders. Immunotherapy improved neurological disorders and anti-GAD-Ab titers and index provide clinically meaningful information about their diagnostic accuracy.
Authors: Izar MC, Helfenstein T, Ihara SS, Relvas WG, Santos AO, Fischer SC, Pinto LE, Lopes IE, Pomaro DR, Fonseca MI, Bodanese LC, Moriguchi EH, Saraiva JF, Introcaso L, Souza AD, Scartezini M, Torres KP, Zagury L, Jardim PC, Costa EA, Tacito LH, Forti A, Magalhaes ME, Chacra AR, Bertolami MC, Loures-Vale AA, Barros MA, Xavier HT, Lyra R, Argamanijan D, Guimaraes A, Novazzi JP, Kasinski N, Afiune A, Martinez TL, Santos RD, Nicolau JC, Cesar LA, Povoa RM, Carvalho AC, Han SW, Fonseca FA,
Abstract: The association of polymorphisms affecting lipid metabolism with the risk of myocardial infarction (MI) in type 2 diabetes mellitus was investigated. The Genetics, Outcomes and Lipids in type 2 Diabetes (GOLD) Study is a prospective, multicenter study, conducted on 990 patients presenting diabetes and MI (n=386), or diabetes without previous manifestation of stroke, peripheral or coronary arterial disease (n=604), recruited from 27 institutions in Brazil. APO A1 (A/G -75 and C/T +83) and APO C3 (C/G 3'UTR) non-coding sequences, CETP (Taq 1B), LPL (D9N), APO E (epsilon2, epsilon3, epsilon4,), PON-1 (Q192R), and two LCAT variants Arg(147)-->Trp and Tyr(171)-->Stop were tested by PCR-RFLP. There was a higher prevalence of LPL DN genotype (19% vs.12%, p=0.03) and a higher frequency of the N allele (11% vs. 7%) among subjects with MI when compared to controls, with an odds ratio of MI for carriers of 9N allele of 2.46 (95% CI=1.79-3.39, p<0.0001). This association was present in men and women, in non-smokers and in hypertensive patients. A logistic regression model including gender, duration of diabetes, systolic blood pressure, HDL-C, left ventricle hypertrophy and D9N polymorphism showed that the latter still remained significantly associated with MI (OR=1.50, 95% CI=1.02-2.25, p=0.049). These findings suggest that D9N polymorphism can be a useful risk marker for myocardial infarction and that further potential candidate genes should be screened for exploratory analysis and for future therapeutic intervention in diabetes.
Authors: Hitsumoto T
Abstract: Type 2 diabetes mellitus is known to be closely associated with the risk of ischemic stroke. Recent clinical studies have reported that a high pulsatility index (PI) of the cerebral or carotid artery, which is estimated by ultrasonography, also reflects a risk of ischemic stroke. This cross-sectional study aimed to clarify the impact of hemorheology assessed by the microchannel method on the PI of the common carotid artery (CCA) in patients with type 2 diabetes mellitus in terms of the primary prevention of ischemic stroke.In total, 349 outpatients on treatment for type 2 diabetes mellitus (131 men and 218 women; mean age ± standard deviation: 65 ± 11 years) with no history of cardiovascular events, including ischemic stroke, were enrolled. The whole blood passage time (WBPT) as a marker of hemorheology and the PI of CCA were measured using commercial devices, and their relationships to various clinical parameters were examined.A significant positive correlation was observed between WBPT and the PI of CCA (r = 0.49, P < 0.001). Furthermore, multivariate analysis revealed that patients with high WBPT (?70 s) had significantly higher risk (odds ratio: 5.2; 95% confidence interval: 2.4 - 9.2; P < 0.001) of being detected with a high PI of CCA (? 2) than those with low WBPT (? 52.0 s).The results of this study indicated that WBPT was an important determination factor for the PI of CCA, suggesting that an increase in WBPT can potentially predict the incidence of ischemic stroke in patients with type 2 diabetes mellitus.
Authors: Fang F, Xiao H, Li C, Tian H, Li J, Li Z, Cheng X
Abstract: Nocturnal hypoglycemia was a common and serious problem among patients with type 2 diabetes (T2DM), especially in the elderly. This study investigated whether fasting glucose was an indicator of nocturnal hypoglycemia in elderly male patients with T2DM.A total of 291 elderly male type 2 diabetic patients who received continuous glucose monitoring (CGM) between January 2007 and January 2011 were enrolled in the study. The association of fasting glucose and nocturnal hypoglycemia based on CGM data was analyzed, comparing with bedtime glucose.Based on CGM data, patients with nocturnal hypoglycemia had significantly lower fasting glucose (5.88 ± 1.29 versus 6.92 ± 1.32 mmol/L) and bedtime glucose (7.33 ± 1.70 versus 8.01 ± 1.95 mmol/L) than patients without nocturnal hypoglycemia (both p < 0.01). Compared with the highest quartile, the lowest quartile of fasting glucose had a significantly increased risk of nocturnal hypoglycemia after the multiple adjustments (pfor trend < 0.001). However, this association did not appear in bedtime glucose. When the prediction of nocturnal hypoglycemia either by fasting glucose or bedtime glucose using the area under receiver operating characteristic (ROC) curve, fasting glucose but not bedtime glucose, was an indicator of nocturnal hypoglycemia, with an area under the ROC curve (AUC) of 0.714 (95% CI: 0.653 ? 0.774, p < 0.001). On the ROC curve, the Youden index was maximal when fasting glucose was 6.1 mmol/L.Fasting glucose may be a convenient and clinically useful indicator of nocturnal hypoglycemia in elderly male patients with T2DM. Risk of nocturnal hypoglycemia significantly increased when fasting glucose was less than 6.1 mmol/L.
Authors: Guo F, Garvey WT
Abstract: Metabolic syndrome traits are important risk factors for diabetes; however, each trait has different predictive power for future diabetes. Additionally, the impact of insulin resistance on metabolic profile can differ by gender and racial group, suggesting that gender-race specific prediction algorithms for diabetes may be warranted.To develop a quantitative scoring system based on weighting of risk components in the cardiometabolic disease staging (CMDS) system for the prediction of future diabetes.We derived the CMDS score in 2857 participants with valid follow-up information on incident diabetes from the Coronary Artery Risk Development in Young Adults study and validated it in 6425 older participants from the Atherosclerosis Risk in Communities study. We assigned a simple integer value for each CMDS risk factor component.Incident diabetes.Fasting glucose, 2-hour glucose, waist circumference, and blood pressure components contributed similarly for the prediction of future diabetes (CMDS scores, 23, 21, 26, and 20, respectively). The area under the receiver operating characteristic curve was 0.7158 for the CMDS scoring system, whereas it was 0.7053 for the Framingham diabetes score. The CMDS components performed differently for prediction of future diabetes in Black and White men and women. The components with the highest predictive power for diabetes were waist circumference in Black men, 2-hour glucose in Black women, and fasting glucose in both White men and White women.The weighted CMDS score has high model discrimination power for diabetes and can be used clinically to identify patients for weight loss therapy based on differential risk for future diabetes.
Authors: Idriss-Kanoun S, Kanoun F, Hsaïri H, Machgoul M, Bahri M, Ben Khalifa F
Abstract: The aim of this study was to evaluate the frequency of micro and macro vascular complications among a cohort of diabetic out-patients without proteinuria.It is a cross sectional study of 249 diabetic patients (126 mean and 123 women) 166 with type 2 diabetes and 83 with type 1 diabetes. Patients were recruited according to sex, age and diabetic duration stratification. Mean age was 45.2 +/- 6.6 years and mean duration of diabetic was 8.9 +/- 7 years. Diabetic complications were investigated through a questionnaire, physical examination, ECG eyes fundoscopy and microalbuminuria measured in overnight urine collection.Prevalence of diabetic micro angiopathy in our population was one of the most frequent in the world. Diabetic peripheral neuropathy and retinopathy were the most frequent complications found in our patients. It was 63.5% for peripheral neuropathy, 43.8% for retinopathy and 25.3% for microalbuminuria. Macro angiopathy, as defined by hypertension, coronary heart diseases (CHD), lower limb arteritis (LLA) or stroke, was found in 24.5% of patients. CHD rate was equal to 14.5% and LLA in 12.4%. Prevalence rates of vascular complications of diabetes were correlated with age, duration and type of diabetes.Prevention of diabetes complications needs early screening of glucose tolerance abnormalities, better glycemic control, reduction of associated vascular risk factors and identification of genetic factors predisposing to a higher cardiovascular risk.
Authors: Gonzalez C, Ménissier De Murcia J, Janiak P, Bidouard JP, Beauvais C, Karray S, Garchon HJ, Lévi-Strauss M
Abstract: Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear enzyme that consumes NAD in response to DNA strand breaks. Its excessive activation seems particularly deleterious to pancreatic beta-cells, as exemplified by the complete resistance of PARP-1-deficient mice to the toxic diabetes induced by streptozotocin. Because of the possible implication of this enzyme in type 1 diabetes, many human trials using nicotinamide, an inhibitor of PARP-1, have been conducted either in patients recently diagnosed or in subjects highly predisposed to this disease. To analyze the role of this enzyme in murine type 1 diabetes, we introgressed a disrupted PARP-1 allele onto the autoimmune diabetes-prone nonobese diabetic (NOD) mouse strain. We showed that these mice were protected neither from spontaneous nor from cyclophosphamide-accelerated diabetes. Surprisingly they were also highly sensitive to the diabetes induced by a single high dose of streptozotocin, standing in sharp contrast with C57BL/6 mice that bear the same inactivated PARP-1 allele. Our results suggest that NOD mice are characterized not only by their immune dysfunction but also by a peculiarity of their islets leading to a PARP-1-independent mechanism of streptozotocin-induced beta-cell death.