Systematic Review of Diabetes Self-Management: Focusing on the Middle-Aged Population of Pakistan and Saudi Arabia

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The aim is to synthesize the most contemporary qualitative research on the self-management of type 2 diabetes with specific interest in the population of Pakistan and Saudi Arabia. The electronic databases searched include the Cochrane library, MEDLINE, PubMed, EMBASE and PsycINFO, between the year 1993 and 2013. The inclusion criteria was the middle-aged population aged 40 – 60 years. Studies must report qualitative research on diabetes self-management, diabetic complications, quality of life, and patient-doctor relationship or interaction. Out of the 36 identified studies, 30 studies from the literature search representing self-management in context suggest that the multiple contextual factors identified are the fertile ground for further research, and the context which is useful for health care professionals suggests that coping with diagnosis and living with diabetes are affected by a complex constellation of factors, including life circumstances, social support, gender roles and economy. Three conceptual themes were identified from the analysis. The review has revealed that there is a lack of studies in literature on self-management of type 2 diabetes in both the countries.

Cite this paper

Ansari, R. , Dixon, J. and Browning, C. (2015) Systematic Review of Diabetes Self-Management: Focusing on the Middle-Aged Population of Pakistan and Saudi Arabia. Open Journal of Preventive Medicine, 5, 47-60. doi: 10.4236/ojpm.2015.52006.

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The Effect of Soy Nuts on Glycemic Control, Lipid Profile and Insulin-Resistance in Type 2 Diabetic Patients

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ABSTRACT

Type 2 diabetes has a high prevalence and a growing trend. The use of a proper diet treatment is one of the therapeutic approaches of patients. The use of the soy has shown the effective results in glycemic control of patients with type 2 diabetes; however, data are paradoxical. The present study aimed to examine the effectiveness of soy nuts on glycemic control, blood pressure and lipid profile and insulin-resistance of the diabetic patients<span “=””>.<span “=””> Methods: In this case-control study 69 type 2 diabetic patients were randomly divided into two groups: intervention (n = 35) and control (n = 34). The patients in the intervention group substituted 60 grams of soy nuts as a part of the daily protein requirement for eight weeks. In contrast, the patients in the control group received usual diet of diabetes (no soy)<span “=””>.<span “=””> The drugs received by patients had not been changed during the intervention period. Before and at the end of the intervention, Hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), serum insulin levels, insulin-resistance, systolic and diastolic blood pressure, low density lipoprotein-cholesterol (LDL-c), high density lipoprotein-cholesterol (HDL-c) and total cholesterol, and triglycerides (TG) were measured in the patients. Insulin-resistance was calculated by Homeostatic model assessment-IR formula (HOMA-IR)<span “=””>.<span “=””> <span “=””>Results: Soy consumption significantly lowered FPG (P = 0.03), HbA1c (P < 0.01), plasma insulin levels (P = 0.01), insulin-resistance (P = 0.01), total cholesterol (P < 0.01) and LDL-c (P = 0.01), but did not have any significant effect on systolic blood pressure (P = 0.4), diastolic blood pressure (P = 0.2), HDL-c (P = 0.4) and TG (P = 0.2)<span “=””>.<span “=””> Conclusion: Consumption of soy nuts in type 2 diabetic patients can cause an improvement in the glycemic control and insulin-resistance, and the lipid profile does not have any significant effect on blood pressure.

Cite this paper

Sedaghat, A. , Shahbazian, H. , Haidari, F. , Payami, S. , Jahanshahi, A. and Latifi, S. (2015) The Effect of Soy Nuts on Glycemic Control, Lipid Profile and Insulin-Resistance in Type 2 Diabetic Patients. Open Journal of Endocrine and Metabolic Diseases, 5, 1-7. doi: 10.4236/ojemd.2015.51001.

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Progressive β Cell Failure in Type 2 Diabetes Mellitus: Microvascular Pancreatic Isletopathy?

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53118#.VLXOUsnQrzE

ABSTRACT

Background: UKPDS suggested relentless deterioration of β cell function as a part of natural course of type 2 diabetes mellitus. However, the course was apparently not universal since many patients maintained glycemic goal (HbA1c < 7.0%) at 9 years while receiving conventional life style programs consisting of diet and exercise or/and oral agents. Moreover, β cell failure occurred around the same time as the time of onset of microvascular complications. Finally, the exact mechanism of progressive β cell failure remains to be defined. It is plausible that β cell failure may be due to fibrosis of pancreatic islets secondary to microangiopathy since no organ or tissue is exempt from this complication. Objective: To assess epidemiologic correlation between presence of b cell failure and microvascular complications by determining the prevalence of β cell failure in subjects with type 2 diabetes with increasing number of known microvascular complications. Methods: 650 Subjects with ages 40-75 years and duration of DM 4-23 years were divided into 4 groups according to number of microvascular complications, e.g. retinopathy, nephropathy, and neuropathy. β cell failure (β – ve ) is defined as HbA1c > 7.0% with any therapy or HbA1c < 7.0% with insulin, either monotherapy or in combination with oral agents. β cell function is deemed “preserved” (β + ve) with HbA1c < 7.0% with treatment consisting of life style program or/and oral drugs. Results: Prevalence of b cell failure progressively rose with increasing number of microvascular complications from 0 to 2 with no further significant rise with 3 complications whereas subjects with preserved β cell function declined with increasing number of microvascular complications (p < 0.01 for both groups). Significant relationships were also noted between the age and the duration of diabetes and prevalence of β cell failure (p < 0.01). The relative risks rose progressively for β cell failure/β cell preserved with increasing number of microvascular complications as well as the greater duration of Diabetes. However, a significantly (p < 0.01) higher relative risk for β cell failure persisted for rising number of microvascular complications even after eliminating the influence of age and duration of diabetes. Conclusion: β cell failure may be a manifestation of microvascular pancreatic isletopathy similar to other microvascular complications.

Cite this paper

Kabadi, U. , Kabadi, M. , Weber, S. , Bubolz, A. and Finnerty, E. (2015) Progressive β Cell Failure in Type 2 Diabetes Mellitus: Microvascular Pancreatic Isletopathy?. Journal of Diabetes Mellitus, 5, 21-27. doi: 10.4236/jdm.2015.51003.

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Biphasic Insulin Aspart 30 Therapy in Insulin-Naïve and Insulin-Experienced Patients with Type 2 Diabetes: Results from the Jordanian Subgroup of the A1chieve Study

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51841#.VHfJaWfHRK0

ABSTRACT

Objective: To analyse the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in a Jordanian subgroup of the 24-week, non-interventional A1chieve study. Methods: A total of 509 Jordanian patients with type 2 diabetes (392 insulin-naive and 117 insulin-experienced) starting BIAsp30, alone or in combination with oral glucose-lowering drugs, were included. Safety and effectiveness outcomes were analysed over 24 weeks. Results: Patients had a mean age of 55.8 years, body mass index of 28.8 kg/m2 and diabetes duration of 9.4 years at baseline. Two serious adverse drug reactions of hypoglycaemia were reported. The proportion of patients who reported major hypoglycaemic events decreased (2.4% at baseline vs. 0.2% at Week 24, p = 0.0039). The proportion of patients reporting overall hypoglycaemia increased marginally (6.3% at baseline vs. 9.9% at Week 24, p = 0.0378), primarily attributed to a rise in minor and nocturnal hypoglycaemia reported in insulin-naive patients. From baseline to Week 24, the mean ± SD glycated haemoglobin A1c level decreased from 9.8% ± 1.4% to 7.4% ± 0.9% (p < 0.001). Significant reductions after 24 weeks were also noted in the mean fasting plasma glucose, postprandial plasma glucose, lipids, systolic blood pressure and quality of life (all p < 0.001), while the mean body weight increased by 1.8 ± 6.5 kg (p < 0.001). Conclusion: Overall, BIAsp 30 therapy was well-tolerated and resulted in improved glycaemic control in this Jordanian subgroup over 24 weeks.

Cite this paper

Haddad, J. , Haddad, F. , Nasser, R. , Al-Shudifat, A. , Annabi, F. , Sandalci, L. and Al-Kilani, M. (2014) Biphasic Insulin Aspart 30 Therapy in Insulin-Naïve and Insulin-Experienced Patients with Type 2 Diabetes: Results from the Jordanian Subgroup of the A1chieve Study. Journal of Diabetes Mellitus, 4, 379-387. doi: 10.4236/jdm.2014.44051.

References

[1] Rawal, L.B., Tapp, R.J., Williams, E.D., Chan, C., Yasin, S. and Oldenburg, B. (2012) Prevention of Type 2 Diabetes and Its Complications in Developing Countries: A Review. International Journal of Behavioral Medicine, 19, 121-133. http://dx.doi.org/10.1007/s12529-011-9162-9
[2] International Diabetes Federation (2011) International Diabetes Federation (IDF) Diabetes Atlas. 5th Edition, IDF, Brussels.
[3] Zindah, M., Belbeisi, A., Walke, H. and Mokdad, A.H. (2008) Obesity and Diabetes in Jordan: Findings from the Behavioral Risk Factors Surveillance System, 2004. Preventing Chronic Disease, 5, A17.
[4] Khattab, M., Khader, Y.S., Al-Khawaldeh, A. and Ajlouni, K. (2010) Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes. Journal of Diabetes and Its Complications, 24, 84-89. http://dx.doi.org/10.1016/j.jdiacomp.2008.12.008
[5] Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., et al. (2012) Management of Hyperglycaemia in Type 2 Diabetes: A Patient-Centered Approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia, 55, 1577-1596. http://dx.doi.org/10.1007/s00125-012-2534-0
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http://dx.doi.org/10.1016/j.pec.2008.05.005                                                                        eww141128lx

Biphasic Insulin Aspart 30 Therapy in Insulin-Naïve and Insulin-Experienced Patients with Type 2 Diabetes: Results from the Jordanian Subgroup of the A1chieve Study

Read  full  paper  at:

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51841#.VHfGuWfHRK0

ABSTRACT

Objective: To analyse the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in a Jordanian subgroup of the 24-week, non-interventional A1chieve study. Methods: A total of 509 Jordanian patients with type 2 diabetes (392 insulin-naive and 117 insulin-experienced) starting BIAsp30, alone or in combination with oral glucose-lowering drugs, were included. Safety and effectiveness outcomes were analysed over 24 weeks. Results: Patients had a mean age of 55.8 years, body mass index of 28.8 kg/m2 and diabetes duration of 9.4 years at baseline. Two serious adverse drug reactions of hypoglycaemia were reported. The proportion of patients who reported major hypoglycaemic events decreased (2.4% at baseline vs. 0.2% at Week 24, p = 0.0039). The proportion of patients reporting overall hypoglycaemia increased marginally (6.3% at baseline vs. 9.9% at Week 24, p = 0.0378), primarily attributed to a rise in minor and nocturnal hypoglycaemia reported in insulin-naive patients. From baseline to Week 24, the mean ± SD glycated haemoglobin A1c level decreased from 9.8% ± 1.4% to 7.4% ± 0.9% (p < 0.001). Significant reductions after 24 weeks were also noted in the mean fasting plasma glucose, postprandial plasma glucose, lipids, systolic blood pressure and quality of life (all p < 0.001), while the mean body weight increased by 1.8 ± 6.5 kg (p < 0.001). Conclusion: Overall, BIAsp 30 therapy was well-tolerated and resulted in improved glycaemic control in this Jordanian subgroup over 24 weeks.

Cite this paper

Haddad, J. , Haddad, F. , Nasser, R. , Al-Shudifat, A. , Annabi, F. , Sandalci, L. and Al-Kilani, M. (2014) Biphasic Insulin Aspart 30 Therapy in Insulin-Naïve and Insulin-Experienced Patients with Type 2 Diabetes: Results from the Jordanian Subgroup of the A1chieve Study. Journal of Diabetes Mellitus, 4, 379-387. doi: 10.4236/jdm.2014.44051.

References

[1] Rawal, L.B., Tapp, R.J., Williams, E.D., Chan, C., Yasin, S. and Oldenburg, B. (2012) Prevention of Type 2 Diabetes and Its Complications in Developing Countries: A Review. International Journal of Behavioral Medicine, 19, 121-133. http://dx.doi.org/10.1007/s12529-011-9162-9
[2] International Diabetes Federation (2011) International Diabetes Federation (IDF) Diabetes Atlas. 5th Edition, IDF, Brussels.
[3] Zindah, M., Belbeisi, A., Walke, H. and Mokdad, A.H. (2008) Obesity and Diabetes in Jordan: Findings from the Behavioral Risk Factors Surveillance System, 2004. Preventing Chronic Disease, 5, A17.
[4] Khattab, M., Khader, Y.S., Al-Khawaldeh, A. and Ajlouni, K. (2010) Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes. Journal of Diabetes and Its Complications, 24, 84-89. http://dx.doi.org/10.1016/j.jdiacomp.2008.12.008
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http://dx.doi.org/10.1016/j.pec.2008.05.005                                                                          eww141128lx

Women Who Develop Diabetes Later in Life Have Diabetes-Associated Complications during Preceding Pregnancies

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51305#.VGLAVGfHRK0

ABSTRACT

Aims: The aim of this study was to explore the outcome of previous pregnancies in women who later developed diabetes. Method: A Swedish population based cohort of 23,524 women from 1990 aged 45 – 85 yr in 2000 when they self reported health status in a questionnaire. To identify which women who delivered we matched it towards the Swedish Medical Birth Register (SMBR). We identified 14,856 women who appeared in both registers and a total of 30,559 new birth registrations. Among these women 216 had developed diabetes after their pregnancy (ies) and additional twelve women were reported to have gestational diabetes in SMBR. These 228 women and their 455 pregnancies were compared with women without diabetes. Results: Women who developed diabetes later in life were already heavier before the pregnancy (ies) (69.2 ± 13.9 vs. 63.2 ± 10.3 kg; p < 0.001) but had less weight gain during pregnancy (13.3 ± 5.4 vs. 14.1 ± 4.6 kg; p = 0.03) compared to women without diabetes. Newborns to women with diabetes diagnosed any time after pregnancy had higher birth weight (3602 vs. 3507 g; p < 0.001), were more often large for gestational age (10.5% vs. 3.1%; p < 0.001), were more often delivered by caesarean section (4.8% vs. 2.7%; p = 0.005) and had lower Apgar scores. Conclusion: Women who developed diabetes after pregnancy had hyperglycaemia-associated complications during their pregnancy (ies). We therefore postulated that women with Type 2 diabetes are mainly recruited from women with earlier GDM. A general screening for GDM should identify these women and enable life style intervention that may prevent or at least delay diabetes.

Cite this paper

Moll, U. , Olsson, H. and Landin-Olsson, M. (2014) Women Who Develop Diabetes Later in Life Have Diabetes-Associated Complications during Preceding Pregnancies. Journal of Diabetes Mellitus, 4, 341-349. doi: 10.4236/jdm.2014.44047.

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http://dx.doi.org/10.2174/157339911794940738                                                                          eww141112lx
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The Short and Long-Term Effect of Liraglutide on the Beta Cell Function in Type 2 Diabetic Patients

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51304#.VGK99GfHRK0

ABSTRACT

Glucagon-like peptide 1 (GLP-1) is a hormone, inducing glucose-dependent stimulation of insulin secretion from beta cells. Liraglutide acts as a GLP-1 receptor agonist. To assess the effect of liraglutide on the beta cell function, we performed oral glucose tolerance tests in 7 subjects with type 2 diabetes before and after treatment of liraglutide. Moreover, we performed same study again in 4 subjects at 6 months after induction. Liraglutide significantly increased area under the Curve (AUC) of plasma insulin level after glucose loading and significantly decreased AUC of plasma glucose level, compared with before induction. HOMA-beta was significantly increased, whereas insulinogenic index was not changed. HOMA-R was not affected but Matsuda index was significantly decreased after induction of liraglutide. Disposition index was not altered significantly, but tendency of improvement was observed. Glucose tolerance tests revealed that those effects of liraglutide were continued for 6 months after induction. These results showed that treatment of liraglutide could improve insulin secretion but early phase of insulin secretion was not improved. The results suggest that liraglutide is likely to improve beta-cell function, but this effect is still inadequate by six-month treatment.

Cite this paper

Suzuki, T. , Hirai, K. , Chen, Y. and Hashimoto, K. (2014) The Short and Long-Term Effect of Liraglutide on the Beta Cell Function in Type 2 Diabetic Patients. Journal of Diabetes Mellitus, 4, 334-340. doi: 10.4236/jdm.2014.44046.

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http://dx.doi.org/10.1210/en.2002-220897                                                                              eww141112lx