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Effectiveness of Theory-Based Intervention on Knowledge Level, Psychological Constructs, Metabolic Index and Physical Activity Status in Patients with Type 2 Diabetes: Application of the Health Action Process Approach (HAPA) Model 健康行动过程方法(HAPA)模型对2型糖尿病患者知识水平、心理结构、代谢指数和身体活动状况的理论干预效果
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.5603/cd.96203
Fatemeh Zanjanchi Neko, Isa Mohammadi Zeidi, Hadi Morshedi, Banafsheh Mohammadi Zeidi, Mohammad Reza Maleki, Amir Pakpoor Hajia
Objective: The aim of the study was to determine the effect of the educational intervention based on the health action process approach (HAPA) model on the level of knowledge, metabolic indicators, psychological constructs and physical activity status in type 2 diabetes (T2D) patients in 2022–2023. Material and methods: The present study was a randomized controlled trial and 100 T2D patients were equally assigned to experimental and control groups using multistage random sampling. The educational program included six online sessions, targeted pamphlets, educational audio files and reminder messages. Data were collected before and 3 months after intervention with demographic items, awareness scale, constructs of HAPA model, IPAQ-s, HbA1c and fasting blood glucose (FBG). Data were entered to SPSS 25.0 and analyzed with chi-square, ANOVA and ANCOVA. Results: After controlling the effect of the pre-test variable, the mean of the HAPA model constructs and mean of physical activity improved significantly in posttest. In addition, educational intervention explained 30.2%, 57.8%, 33.2%, 64.4%, 76.3%, 25.3%, 24.6%, 36.1% and 36.9% of the variance of health awareness, risk perception, outcome expectancy, action self-efficacy, maintenance self-efficacy, action plan, coping plan, behavioral intention and physical activity, respectively. In addition, the mean of FBG and HbA1c in the experimental group improved significantly after the intervention by controlling the pre-test effect (p < 0.001). Conclusions: Providing theory-based educational interventions through the web and mobile can increasingly promote the effectiveness of cognitive behavioral interventions and facilitate the process of behavior change in T2D.
目的:研究基于健康行动过程方法(HAPA)模型的教育干预对2022-2023年2型糖尿病(T2D)患者知识水平、代谢指标、心理构建和身体活动状况的影响。材料与方法:本研究为随机对照试验,采用多阶段随机抽样将100例T2D患者平均分为实验组和对照组。该教育项目包括六个在线课程、有针对性的小册子、教育音频文件和提醒信息。收集干预前和干预后3个月的人口统计项目、认知量表、HAPA模型构建、IPAQ-s、HbA1c和空腹血糖(FBG)数据。数据输入SPSS 25.0,采用卡方、方差分析和方差分析进行分析。结果:在控制了前测变量的影响后,HAPA模型建构的均值和体力活动的均值在后测中有显著提高。此外,教育干预对健康意识、风险感知、结果预期、行动自我效能感、维持自我效能感、行动计划、应对计划、行为意向和身体活动的方差解释分别为30.2%、57.8%、33.2%、64.4%、76.3%、25.3%、24.6%、36.1%和36.9%。另外,实验组通过控制测前效应,干预后FBG和HbA1c均值均有明显改善(p <0.001)。结论:通过网络和移动提供基于理论的教育干预,可以日益提高认知行为干预的有效性,促进T2D行为改变的过程。
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引用次数: 0
Prevalence and Severity of Chronic Obstructive Pulmonary Disease in People with Type 2 Diabetes: A Cross-Sectional Study 2型糖尿病患者慢性阻塞性肺疾病的患病率和严重程度:一项横断面研究
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.5603/cd.95828
Mridul Bera, Amit Gupta, Rishad Ahmed, Arjun Baidya, Mrinal Kanti Guha
Objective: The aim of the study was to determine and evaluate the prevalence of chronic obstructive pulmonary disease (COPD) in patients with type 2 diabetes and the impact of diabetes on lung function and the severity of the COPD. Materials and methods: This was a retrospective observational study conducted in a private clinic setup among 1200 patients and was performed according to the Strengthening the Reporting of Observational Studies in Epidemiology Statement (STROBE). Chronic Obstructive Lung Disease (GOLD) criteria, 2023 were used to diagnose COPD and for diabetes mellitus (DM) were executed according to the American Diabetes Association (ADA) and International Diabetes Federation (IDF) consensus statement. Results: The prevalence of type 2 diabetes (T2D) was 27% among 1200 COPD patients. Among 335 patients with diabetes 37% had newly detected T2D. Prevalence in mild, moderate, severe, and very severe COPD among patients having documented T2D was 14.6%, 18.8%, 37%, and 29.5%, respectively. Furthermore, among diabetes patients 7.5% were having HbA1c < 7%, 63.9% were having HbA1c 7–10% and 28.6% were having HbA1c > 10%. As compared to people without diabetes (56.64 ± 3.55), in patients with diabetes (46.22 ± 4.19) there was a severe decline in lung function (mean FEV1) and it was statistically significant (p = 0.001). Comorbidities, as shown by multivariate Cox proportional hazards analysis, including hypertension (HR, 1.902; 95% CI, 1.261–2.403), dyslipidemia (HR, 1.391; 95% CI, 1.172–1.198), cerebrovascular disease (HR, 1.532; 95% CI, 1.132–2.008), coronary artery disease (HR, 1.427; 95% CI, 1.079–1.830), kidney disease (HR, 1.006, 95% CI, 0.833–1.397) and liver disease (HR, 1.083, 95% CI, 0.821–1.427) were independent clinical factors associated with T2D. Conclusions: Chronic obstructive pulmonary disease is one of the comorbidities found in patients with T2D. A significant number of cases of new-onset diabetes are observed among patients with pre-existing COPD. Therefore, the outcome of this research advocates that targeted surveillance and management of diabetes are important in clinical care of the COPD population.
目的:研究的目的是确定和评估慢性阻塞性肺疾病(COPD)在2型糖尿病患者中的患病率以及糖尿病对肺功能和COPD严重程度的影响。材料和方法:这是一项回顾性观察性研究,在一家私人诊所进行,共有1200名患者,并根据加强流行病学观察性研究报告声明(STROBE)进行。根据美国糖尿病协会(ADA)和国际糖尿病联合会(IDF)共识声明,慢性阻塞性肺疾病(GOLD)标准2023被用于诊断COPD和糖尿病(DM)。结果:1200例COPD患者中2型糖尿病(T2D)患病率为27%。335例糖尿病患者中,37%新检出T2D。在有T2D记录的患者中,轻度、中度、重度和极重度COPD的患病率分别为14.6%、18.8%、37%和29.5%。此外,在糖尿病患者中,7.5%的人有HbA1c和lt;7%, 63.9% HbA1c 7-10%, 28.6% HbA1c >10%. 与非糖尿病患者(56.64±3.55)相比,糖尿病患者(46.22±4.19)肺功能(平均FEV1)严重下降,差异有统计学意义(p = 0.001)。多因素Cox比例风险分析显示,合并症包括高血压(HR, 1.902;95% CI, 1.261-2.403),血脂异常(HR, 1.391;95% CI, 1.172-1.198),脑血管疾病(HR, 1.532;95% CI, 1.132-2.008),冠状动脉疾病(HR, 1.427;95% CI, 1.079-1.830)、肾脏疾病(HR, 1.006, 95% CI, 0.833-1.397)和肝脏疾病(HR, 1.083, 95% CI, 0.821-1.427)是与T2D相关的独立临床因素。结论:慢性阻塞性肺疾病是t2dm患者的合并症之一。在已有COPD的患者中观察到大量新发糖尿病病例。因此,本研究的结果提倡糖尿病的针对性监测和管理在COPD人群的临床护理中是重要的。
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引用次数: 0
The Effect of the COVID-19 Crisis on Metabolic Control of Patients with Type 2 Diabetes in Tunisia: A Cross-Section and Retrospective Cohort Study COVID-19危机对突尼斯2型糖尿病患者代谢控制的影响:一项横断面和回顾性队列研究
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.5603/cd.97313
Melika Chihaoui, Chayma Bel Hadj Sliman, Anis Grassa, Nadia Khessairi, Fatma Chaker, Meriem Yazidi, Bessam Hammami, Moncef Feki, Ibtissem Oueslati
Clinical Diabetology is a bimonthly, open access journal of scientific and educational profile, which was created by combining the scientific assumptions of Experimental and Clinical Diabetology (Diabetologia Doświadczalna i Kliniczna)
《临床糖尿病学》是一本双月刊,开放获取的科学和教育期刊,它是通过结合实验和临床糖尿病学的科学假设而创建的(Diabetologia Doświadczalna i Kliniczna)。
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引用次数: 0
Association between Random Glucose Level, HbA1c and COVID-19 Mortality: A Single Center, Cross-Sectional Study 随机血糖水平、糖化血红蛋白与COVID-19死亡率之间的关系:一项单中心横断面研究
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.5603/cd.96589
Faizal Awaluddin, Husaini Umar, Sudirman Katu, Syakib Bakri, Andi Makbul Aman, Harun Iskandar, Arifin Seweng
Clinical Diabetology is a bimonthly, open access journal of scientific and educational profile, which was created by combining the scientific assumptions of Experimental and Clinical Diabetology (Diabetologia Doświadczalna i Kliniczna)
《临床糖尿病学》是一本双月刊,开放获取的科学和教育期刊,它是通过结合实验和临床糖尿病学的科学假设而创建的(Diabetologia Doświadczalna i Kliniczna)。
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引用次数: 0
Beyond Diabetes Management: Unraveling Metformin’s Long-Term Effects on Vitamin B12 超越糖尿病管理:揭示二甲双胍对维生素B12的长期影响
Q4 Medicine Pub Date : 2023-10-22 DOI: 10.5603/cd.97473
Gurusha Bahl, Md Sadique Hussain, Nikita Saraswat, Mohit Agrawal
Clinical Diabetology is a bimonthly, open access journal of scientific and educational profile, which was created by combining the scientific assumptions of Experimental and Clinical Diabetology (Diabetologia Doświadczalna i Kliniczna)
《临床糖尿病学》是一本双月刊,开放获取的科学和教育期刊,它是通过结合实验和临床糖尿病学的科学假设而创建的(Diabetologia Doświadczalna i Kliniczna)。
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引用次数: 0
Stromal Vascular Fraction and Autologous Activated Platelet-Rich Plasma Combination in Treatment of Type 2 Diabetes: A Single Center Retrospective Study 基质血管组分和自体活化富血小板血浆联合治疗2型糖尿病:单中心回顾性研究
IF 0.7 Q4 Medicine Pub Date : 2023-08-26 DOI: 10.5603/dk.a2023.0027
K. Karina, Grady Krisandi, I. Rosadi, T. P. Sibuea, J. A. Biben, Krista Ekaputri, Azza Maryam, Sulaeha Ad, S. Sobariah, I. Afini, Tias Widyastuti, A. Zakiyah, D. Ernanda, N. Aini
Objective: A cutting edge potential treatment of type 2 diabetes (T2D) is the use of cellular therapy. One recent method is the use of combination of stromal vascular fraction (SVF) and autologous activated platelet-rich plasma (aaPRP). This study is aimed to evaluate the efficacy of SVF combined with aaPRP to treat T2D. Materials and methods: Patients with T2D who un - derwent SVF and aaPRP treatment were recruited in this study. The lipoaspirate was digested by H-Remedy enzyme and centrifuged to isolate SVF. Blood was drawn from the patients and the aaPRP was isolated. The combination of autologous SVF and aaPRP was administered intravenously to each patient. Patients’ 1-month and 3-month post-therapy HbA1c level were statistically analyzed to their baseline level. Results: A total of 39 patients, 28 male and 11 female, with T2D with mean age of 59±11 years and baseline HbA1c of 8.31 g/dL were included in this study. Com - bination of SVF and aaPRP treatment in T2D resulted in a statistically significant decrease in HbA1c level to 7.58 g/dL at 1 month and to 7.63 g/dL at 3 months post-therapy, while a decrease in HbA1c was still observed at 6 and 12 months after therapy. Conclusions: SVF combined with aaPRP may have potential to reduce HbA1c levels in patients with T2D. Further research is needed to confirm the findings of our research. (Clin Diabetol 2023; 12; 4: 247–252) Clinical trial registration number: NCT05925829
目的:细胞疗法是治疗2型糖尿病(T2D)的一种前沿疗法。最近的一种方法是结合基质血管分数(SVF)和自体活化富血小板血浆(aaPRP)。本研究旨在评价SVF联合aaPRP治疗T2D的疗效。材料和方法:本研究招募了接受SVF和aaPRP治疗的T2D患者。抽脂液经H-Remedy酶解后离心分离SVF。从患者身上抽血并分离aaPRP。每例患者均静脉给予自体SVF联合aaPRP。统计分析患者治疗后1个月和3个月的HbA1c水平至基线水平。结果:本研究共纳入39例T2D患者,男性28例,女性11例,平均年龄59±11岁,基线HbA1c为8.31 g/dL。SVF联合aaPRP治疗T2D患者,治疗后1个月HbA1c水平降至7.58 g/dL,治疗后3个月HbA1c水平降至7.63 g/dL,治疗后6个月和12个月HbA1c仍有下降。结论:SVF联合aaPRP可能具有降低T2D患者HbA1c水平的潜力。需要进一步的研究来证实我们的研究结果。《临床糖尿病杂志》2023;12;4: 247-252)临床试验注册号:NCT05925829
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引用次数: 0
The Microbiota–Gut–Brain Axis and Diabetic Cognitive Impairment: A Memorable Journey 微生物-肠-脑轴和糖尿病认知障碍:难忘的旅程
IF 0.7 Q4 Medicine Pub Date : 2023-08-26 DOI: 10.5603/dk.a2023.0025
Srinidhi Rai, S. Sreelatha, Nayana Devang, Priyadharshini Alva, A. V. Raveendran
Objective: Diabetes mellitus (DM) is associated with complications affecting the quality of life. Interest-ingly, the gut microbiota is closely related to glucose metabolism. This narrative review introduces the characteristics of the gut microbiota in DM, describes the modulation of host glycemic control by the gut microbiota, characteristics of intestinal permeability, mechanisms of diabetic cognitive impairment (DCI), and the role of brain–gut–microbiota axis in DM. Materials and methods: The literature search was performed in Medline, Scopus, WOS, and PubMed databases using the keywords gut microbiota, DM, intestinal permeability, and DCI. Results: Dysbiosis of gut microbiota causes intestinal barrier disruption resulting in the entry of intestinal bacteria and their metabolites into the circulatory system, which may disturb insulin sensitivity, glucose metabolism, and immune homeostasis. Gut microbiota plays a critical role in regulating systemic insulin sensitivity and energy metabolism. Intestinal barrier dysfunction induced by hyperglycemia is considered to be the underlying mechanism of systemic infection and inflammatory response in patients with diabetes. Both dysbacteriosis and cytokines will lead to the intestinal barrier and blood–brain barrier dysfunction, facilitating harmful substances (advanced glycated end products) to access neurons, and thus contribute to the development of DCI. The modulation of intestinal permeability through nutritional interventions may represent a potential prevention target for DM. Conclusions: The clinical evidence for the association between hyperglycemia and intestinal barrier dysfunction in humans is scarce. Further clinical studies are needed to provide more insight by studying the intestinal barrier integrity markers and glycemic status and their association with cognitive status. (Clin Diabetol 2023; 12; 4: 261–271)
目的:糖尿病(DM)与影响生活质量的并发症相关。有趣的是,肠道微生物群与葡萄糖代谢密切相关。本文综述了糖尿病肠道菌群的特点,阐述了肠道菌群对宿主血糖控制的调节,肠道通透性的特点,糖尿病认知功能障碍(DCI)的机制,以及脑-肠-微生物轴在糖尿病中的作用。材料和方法:在Medline、Scopus、WOS和PubMed数据库中检索相关文献,检索关键词为肠道菌群、糖尿病、肠道通透性和DCI。结果:肠道菌群失调会破坏肠道屏障,导致肠道细菌及其代谢物进入循环系统,扰乱胰岛素敏感性、葡萄糖代谢和免疫稳态。肠道菌群在调节全身胰岛素敏感性和能量代谢中起关键作用。高血糖引起的肠道屏障功能障碍被认为是糖尿病患者全身性感染和炎症反应的潜在机制。细菌失调和细胞因子都会导致肠屏障和血脑屏障功能障碍,促进有害物质(晚期糖基化终产物)进入神经元,从而促进DCI的发展。通过营养干预调节肠道通透性可能是糖尿病的潜在预防目标。结论:人类高血糖和肠屏障功能障碍之间的关联的临床证据很少。进一步的临床研究需要通过研究肠屏障完整性标志物和血糖状态及其与认知状态的关系来提供更多的见解。《临床糖尿病杂志》2023;12;4: 261 - 271)
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引用次数: 0
Investigation of the Mutation Spectrum in Pediatric Patients with Maturity-Onset Diabetes of Youth (MODY): Experience from a Diagnostic Center in Türkiye 青壮年型糖尿病(MODY)患儿突变谱的研究:来自<s:1>基耶诊断中心的经验
IF 0.7 Q4 Medicine Pub Date : 2023-08-26 DOI: 10.5603/dk.a2023.0030
Neslihan Duzkale, C. Emiroğlu
Objective: This study was aimed to determine the ge-netic background of pediatric patients with a clinical diagnosis of maturity-onset diabetes of youth (MODY). Materials and methods: In this study, MODY-related genes of 80 pediatric patients diagnosed with MODY in Türkiye between January 2016 and January 2022 were investigated using three different large gene panels and next-generation sequencing. Results: Causal variants were detected in the genes investigated in 16 (20%) of 80 patients included in the study. The GCK gene was responsible for the clinical findings in 13 (82%) of 16 patients with a molecular diagnosis, and the HNF1A , HNF1B , and ABCC8 genes in the remaining three patients. This study identified six of the detected genomic variants for the first time in the literature. Conclusions: MODY is a group of diseases that differ from each other in terms of clinical findings, treatment, progression, genetic etiopathogenesis and incidence. For this reason, genetic analyses using multigene panels will enable accurate identification of MODY subtypes, genetic counseling of patients, guidance to optimal treatment options, and screening of carrier relatives. (Clin Diabetol 2023; 12; 4: 232–238)
目的:本研究旨在确定临床诊断为青年成熟型糖尿病(MODY)的儿科患者的遗传背景。材料与方法:本研究对2016年1月至2022年1月期间在 rkiye诊断为MODY的80例儿科患者的MODY相关基因进行了三种不同的大基因面板和下一代测序。结果:在纳入研究的80例患者中,有16例(20%)在所调查的基因中检测到因果变异。16例分子诊断患者中有13例(82%)的临床表现与GCK基因有关,其余3例患者的临床表现与HNF1A、HNF1B和ABCC8基因有关。本研究在文献中首次鉴定了6个检测到的基因组变异。结论:MODY是一组在临床表现、治疗、进展、遗传病因、发病率等方面存在差异的疾病。因此,使用多基因面板进行遗传分析将能够准确识别MODY亚型,为患者提供遗传咨询,指导最佳治疗方案,并筛选携带者亲属。《临床糖尿病杂志》2023;12;4: 232 - 238)
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引用次数: 0
Association of Angiopoietin-Like Protein-8 Gene Variant (Rs2278426 (C/T)) in a Cohort of Egyptian Patients with Metabolic Syndrome: A Case-Control Study 血管生成素样蛋白-8基因变异(Rs2278426 (C/T))在埃及代谢综合征患者队列中的关联:一项病例对照研究
IF 0.7 Q4 Medicine Pub Date : 2023-08-26 DOI: 10.5603/dk.a2023.0023
T. Abdel-Aty, E. Moursi, E. Elsayed, Marwa Ahmed Salah, Sary Ibrahim Abdelsalam
Objective: This study was conducted to reveal the association of ANGPTL8 gene variant (Rs2278426 (C/T)) with metabolic syndrome in a cohort of Egyptian patients. Materials and methods: This study is a case control study that included 150 patients with metabolic syndrome and 150 healthy control subjects. All subjects were submitted to history taking and thorough physical examination and laboratory analysis. Genomic DNA was extracted and ANGPTL8 gene SNP (rs2278426) was detected by 5’ nuclease assay. The tested genotypes included homozygous genotypes for C allele (CC), homozygous genotypes for T allele (TT) and heterozygous genotypes (CT). Results: A total of 300 subjects were included in the study; group 1 included 150 patients with metabolic syndrome. 21.3% were males and 78.7% were females, and group 2 had 150 healthy subjects. 17.3% were males, and 82.7% were females. In the current study, the metabolic syndrome group showed dysregulation of lipids and fasting plasma glucose (FPG) with a statistically significant increase in body anthropometric measures. There was no statistically significant differ - ence in the distribution of the heterozygous genotype (C/T) relative to the wild-type genotype (C/C) in each of the two tested groups (p = 0.287 and 0.245 in the metabolic syndrome and control groups, respectively). Conclusions: There was no statistically significant dif - ference in the genotype distribution of ANGPTL8 gene variant (Rs2278426) genotypes between the metabolic syndrome and control groups. The homozygous recessive genotype for T allele (TT) was not detected in both tested groups. (Clin Diabetol 2023; 12; 4: 215–222)
目的:本研究旨在揭示埃及ANGPTL8基因变异Rs2278426 (C/T)与代谢综合征的相关性。材料与方法:本研究为病例对照研究,纳入150例代谢综合征患者和150例健康对照。所有受试者均进行病史记录、全面体格检查和实验室分析。提取基因组DNA,用5′核酸酶法检测ANGPTL8基因SNP (rs2278426)。检测的基因型包括C等位基因纯合型(CC)、T等位基因纯合型(TT)和杂合型(CT)。结果:本研究共纳入受试者300人;第一组包括150例代谢综合征患者。其中男性占21.3%,女性占78.7%,第2组健康者150人。男性占17.3%,女性占82.7%。在目前的研究中,代谢综合征组表现出血脂和空腹血糖(FPG)失调,人体测量值有统计学意义上的显著增加。杂合子基因型(C/T)与野生型基因型(C/C)在两组间的分布差异无统计学意义(代谢综合征组和对照组的p值分别为0.287和0.245)。结论:代谢综合征组与对照组ANGPTL8基因变异(Rs2278426)基因型分布差异无统计学意义。两组均未检测到T等位基因的纯合隐性基因型。《临床糖尿病杂志》2023;12;4: 215 - 222)
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引用次数: 0
Low-Dose Glimepiride and Metformin Fixed-Dose Combination in treating Maturity-Onset Diabetes of the Young Type (MODY): A Cross Sectional Survey 低剂量格列美脲和二甲双胍联合固定剂量治疗年轻型成熟型糖尿病(MODY)的横断面调查
IF 0.7 Q4 Medicine Pub Date : 2023-08-26 DOI: 10.5603/dk.a2023.0028
B. Sharma, Amit Dey, J. George, Lakshmi Nagendra, S. Mittal, Ajoy Tewari, Ashish Birla, Ashish Prasad, Aushili M
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引用次数: 0
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Clinical Diabetology
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