Rakesh Parikh, Banshi Saboo, Abdul Basit, Bishwajit Bhowmik, Asher Fawwad, Viswanathan Mohan, Akthar Hussain, Azad Khan, Mesbah Kamel, Peter Schwarz, Nadima Shegem, Shashank Joshi, Shabeen Naz Masood, Amit Gupta
Introduction The latest International Diabetes Federation atlas estimates 537 million adults living with diabetes, with Asia alone accounting for 60% of the diabetic population of the world. The prevalence is projected to rise by 68% in South East Asia by 2045.[1] The recent ICMR—INDIAB study showed that there are 101 million people with diabetes (PWD) and 136 million people with prediabetes in India.[2] Lifestyle modification with restriction of simple sugars is the cornerstone of managing diabetes. PWD have been routinely using various nonsugar sweeteners (NSS) as a substitute for sugar. These NSS undergo toxicological assessments by various regulatory bodies to establish their acceptable daily intake (ADI). The US Food and Drug Administration (FDA) has approved many NSS for consumption by the general public, including PWD.[3] The recently released World Health Organization (WHO) guidelines on the use of NSS received a lot of media coverage, raising concerns among PWDs regarding the safety of their long-term use. This white paper is intended to alleviate their concerns and provide clarity regarding the use of NSS. WHO Guidelines on the Use of NSS The WHO guidelines on the use of NSS[4] are intended to complement other WHO guidance on healthy diet, particularly the WHO guidelines on sugar intake. Under the section on objective, scope, and methods, it has been clarified that “guidance on the management of diabetes in individuals with pre-existing diabetes is beyond the scope of this guideline.” It has been further clarified that “the guidance in the guideline may not be relevant for individuals with existing diabetes.” The WHO guidelines are based on a systematic review and meta-analysis in which studies specifically assessing effects on individuals with pre-existing diabetes or including only such individuals were not included.[5] Although the WHO guidelines raise concerns regarding the long-term use of NSS by individuals without diabetes, the strength of evidence is graded as low to very low. The guidelines further emphasize that individual NSSs are different chemical compounds and may have different effects. It has also been clarified that reverse causation might have a potential role in the adverse outcomes observed in prospective studies because individuals who prefer consuming NSS are more likely to have a high risk of cardiovascular events at baseline. Safety of NSS Extensive research and rigorous regulatory evaluations have been conducted to assess the safety of NSS. These evaluations involve comprehensive studies, including preclinical and clinical trials, toxicological assessments, and epidemiological investigations. Regulatory bodies such as the US FDA, the European Food Safety Authority (EFSA), and other global regulatory authorities carefully review the scientific data and evidence surrounding each NSS before approving their use in food and beverages. These evaluations consider factors such as ADI, no observed adverse effect level, p
{"title":"A position statement by diabetes in Asia study group on WHO guidelines regarding the use of nonsugar sweeteners","authors":"Rakesh Parikh, Banshi Saboo, Abdul Basit, Bishwajit Bhowmik, Asher Fawwad, Viswanathan Mohan, Akthar Hussain, Azad Khan, Mesbah Kamel, Peter Schwarz, Nadima Shegem, Shashank Joshi, Shabeen Naz Masood, Amit Gupta","doi":"10.4103/jod.jod_85_23","DOIUrl":"https://doi.org/10.4103/jod.jod_85_23","url":null,"abstract":"Introduction The latest International Diabetes Federation atlas estimates 537 million adults living with diabetes, with Asia alone accounting for 60% of the diabetic population of the world. The prevalence is projected to rise by 68% in South East Asia by 2045.[1] The recent ICMR—INDIAB study showed that there are 101 million people with diabetes (PWD) and 136 million people with prediabetes in India.[2] Lifestyle modification with restriction of simple sugars is the cornerstone of managing diabetes. PWD have been routinely using various nonsugar sweeteners (NSS) as a substitute for sugar. These NSS undergo toxicological assessments by various regulatory bodies to establish their acceptable daily intake (ADI). The US Food and Drug Administration (FDA) has approved many NSS for consumption by the general public, including PWD.[3] The recently released World Health Organization (WHO) guidelines on the use of NSS received a lot of media coverage, raising concerns among PWDs regarding the safety of their long-term use. This white paper is intended to alleviate their concerns and provide clarity regarding the use of NSS. WHO Guidelines on the Use of NSS The WHO guidelines on the use of NSS[4] are intended to complement other WHO guidance on healthy diet, particularly the WHO guidelines on sugar intake. Under the section on objective, scope, and methods, it has been clarified that “guidance on the management of diabetes in individuals with pre-existing diabetes is beyond the scope of this guideline.” It has been further clarified that “the guidance in the guideline may not be relevant for individuals with existing diabetes.” The WHO guidelines are based on a systematic review and meta-analysis in which studies specifically assessing effects on individuals with pre-existing diabetes or including only such individuals were not included.[5] Although the WHO guidelines raise concerns regarding the long-term use of NSS by individuals without diabetes, the strength of evidence is graded as low to very low. The guidelines further emphasize that individual NSSs are different chemical compounds and may have different effects. It has also been clarified that reverse causation might have a potential role in the adverse outcomes observed in prospective studies because individuals who prefer consuming NSS are more likely to have a high risk of cardiovascular events at baseline. Safety of NSS Extensive research and rigorous regulatory evaluations have been conducted to assess the safety of NSS. These evaluations involve comprehensive studies, including preclinical and clinical trials, toxicological assessments, and epidemiological investigations. Regulatory bodies such as the US FDA, the European Food Safety Authority (EFSA), and other global regulatory authorities carefully review the scientific data and evidence surrounding each NSS before approving their use in food and beverages. These evaluations consider factors such as ADI, no observed adverse effect level, p","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135705041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saurabh Srivastava, Amit Gupta, Deepak Sharma, Anuj Maheshwari, Nadima Shaikeh, Rakesh Sahay, Noel C Barengo
Abstract Glucagon is a hormone released from the alpha cells of the pancreas. It has a major role in carbohydrate metabolism. It has a major role in increasing blood glucose levels and is helpful in glycogenolysis, gluconeogenesis, and amino acid catabolism. Its role in lipid metabolism is in the form of lipolysis and beta-oxidation of fatty acids. It also has major implications in the pathogenesis of metabolic dysfunction-associated steatotic liver diseases or non-alcoholic fatty liver disease.
{"title":"Effect of glucagon on lipid metabolism","authors":"Saurabh Srivastava, Amit Gupta, Deepak Sharma, Anuj Maheshwari, Nadima Shaikeh, Rakesh Sahay, Noel C Barengo","doi":"10.4103/jod.jod_99_23","DOIUrl":"https://doi.org/10.4103/jod.jod_99_23","url":null,"abstract":"Abstract Glucagon is a hormone released from the alpha cells of the pancreas. It has a major role in carbohydrate metabolism. It has a major role in increasing blood glucose levels and is helpful in glycogenolysis, gluconeogenesis, and amino acid catabolism. Its role in lipid metabolism is in the form of lipolysis and beta-oxidation of fatty acids. It also has major implications in the pathogenesis of metabolic dysfunction-associated steatotic liver diseases or non-alcoholic fatty liver disease.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135704071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ujjawal Rawat, Ambika Choudhary, P. Mittal, A. Verma
A large number of people are suffering with one or the other type of diabetes around the globe. Insulin has proven to be beneficial for the treatment of both types of diabetes. Due to the drawbacks (injection pain, needle phobia, lipodystrophy, noncompliance peripheral hyperinsulinemia, failure to deliver physiological pattern of insulin, and daily metabolic variability in glycemic control) associated with a conventional delivery system that is, the subcutaneous injection, a need to develop new insulin delivery system was felt strongly. A few noninvasive methods which are under process to deliver insulin include per-oral (enteric gastrointestinal route), intrapulmonary, buccal, intranasal, oropharyngeal, rectal, intrauterine, ocular, transdermal, oral, and vaginal. Intranasal insulin is fetching tons of importance as it provides multiple reasons to choose this method of delivery over other delivery systems. Certain factors are responsible for limiting the use of intranasal insulin for which various methods have been studied to overcome it. Many clinical trials are going on for launching intranasal insulin into the market.
{"title":"The hidden obstacles to intranasal insulin delivery: A narrative review","authors":"Ujjawal Rawat, Ambika Choudhary, P. Mittal, A. Verma","doi":"10.4103/jod.jod_108_22","DOIUrl":"https://doi.org/10.4103/jod.jod_108_22","url":null,"abstract":"A large number of people are suffering with one or the other type of diabetes around the globe. Insulin has proven to be beneficial for the treatment of both types of diabetes. Due to the drawbacks (injection pain, needle phobia, lipodystrophy, noncompliance peripheral hyperinsulinemia, failure to deliver physiological pattern of insulin, and daily metabolic variability in glycemic control) associated with a conventional delivery system that is, the subcutaneous injection, a need to develop new insulin delivery system was felt strongly. A few noninvasive methods which are under process to deliver insulin include per-oral (enteric gastrointestinal route), intrapulmonary, buccal, intranasal, oropharyngeal, rectal, intrauterine, ocular, transdermal, oral, and vaginal. Intranasal insulin is fetching tons of importance as it provides multiple reasons to choose this method of delivery over other delivery systems. Certain factors are responsible for limiting the use of intranasal insulin for which various methods have been studied to overcome it. Many clinical trials are going on for launching intranasal insulin into the market.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"38 1","pages":"14 - 19"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75751951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Agrawal, Shoorvir Singh, Akhilesh K Singh, N. Pursnani, Chandan K Keshari, A. Gautam, Harendra Kumar
{"title":"Platelet indices as a predictor of microvascular complications of type 2 diabetes mellitus","authors":"P. Agrawal, Shoorvir Singh, Akhilesh K Singh, N. Pursnani, Chandan K Keshari, A. Gautam, Harendra Kumar","doi":"10.4103/jod.jod_129_22","DOIUrl":"https://doi.org/10.4103/jod.jod_129_22","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82854958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Glucagon has been an important hormone for nearly a century, as it was first discovered in 1923. Over the years, research on glucagon has provided valuable insights into its function and its role in glucose homeostasis. Glucagon receptors have indeed been identified in cardiac tissue as well. This discovery indicates that glucagon might exert direct effects on the heart, extending beyond its primary role in regulating glucose levels in the liver. The cardiovascular implications of modulating glucagon’s effects remain inadequately comprehended even in 2023. Researchers have continued to study its precise mechanisms of action and its potential therapeutic applications, especially in the context of addressing resistant cardiac failure, managing myocardial infarction, mitigating post-cardiac operation hypotension, countering intoxication from beta-blockers or calcium channel blockers, and addressing heart block. This article provides an overview of the current status of cardiac considerations in relation to the therapeutic potential of glucagon in 2023 and its future prospects.
{"title":"Glucagon and cardiovascular disease","authors":"Nagendra Kumar Singh, Banshi Saboo, Sanjeev Phatak, Samuel Seidu, Viral Shah, Wasim Hanif, Asher Fawwad","doi":"10.4103/jod.jod_94_23","DOIUrl":"https://doi.org/10.4103/jod.jod_94_23","url":null,"abstract":"Abstract Glucagon has been an important hormone for nearly a century, as it was first discovered in 1923. Over the years, research on glucagon has provided valuable insights into its function and its role in glucose homeostasis. Glucagon receptors have indeed been identified in cardiac tissue as well. This discovery indicates that glucagon might exert direct effects on the heart, extending beyond its primary role in regulating glucose levels in the liver. The cardiovascular implications of modulating glucagon’s effects remain inadequately comprehended even in 2023. Researchers have continued to study its precise mechanisms of action and its potential therapeutic applications, especially in the context of addressing resistant cardiac failure, managing myocardial infarction, mitigating post-cardiac operation hypotension, countering intoxication from beta-blockers or calcium channel blockers, and addressing heart block. This article provides an overview of the current status of cardiac considerations in relation to the therapeutic potential of glucagon in 2023 and its future prospects.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135704354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Binayak Sinha, Samit Ghosal, Satinath Mukhopadhyay, Akhtar Hussain, Anjana Ranjit Mohan, Peter Schwarz, Francesc Xavier Cos Xavier
Abstract Traditionally, treatment for type 2 diabetes (T2D) centered on the failure of insulin secretion from the beta cells of the pancreas and insulin resistance. Though effective in certain respects, these treatments are marred by multiple undesirable side effects. The discovery of the incretin defect and the role of glucagon in T2D shifted the focus to therapies that addressed not only the beta cell defect but also the alpha cell defect in the pancreas. Therapies addressing these defects, simultaneously, have switched the entire focus of T2D therapy by not only improving glycemic control but also reducing the risk of hypoglycemia and weight gain and improving outcomes. These newer modalities of treatment started off with dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP1-RAs), and now further treatments in the form of twincretins (GLP1/GIP dual agonists) and triple agonists (GLP1/GIP/glucagon agonists) are unraveling. This article provides a summary of the evidence available with these newer antidiabetics, which address the glucagon defect in T2D.
{"title":"Glucagon-related advancements in diabetes therapy","authors":"Binayak Sinha, Samit Ghosal, Satinath Mukhopadhyay, Akhtar Hussain, Anjana Ranjit Mohan, Peter Schwarz, Francesc Xavier Cos Xavier","doi":"10.4103/jod.jod_96_23","DOIUrl":"https://doi.org/10.4103/jod.jod_96_23","url":null,"abstract":"Abstract Traditionally, treatment for type 2 diabetes (T2D) centered on the failure of insulin secretion from the beta cells of the pancreas and insulin resistance. Though effective in certain respects, these treatments are marred by multiple undesirable side effects. The discovery of the incretin defect and the role of glucagon in T2D shifted the focus to therapies that addressed not only the beta cell defect but also the alpha cell defect in the pancreas. Therapies addressing these defects, simultaneously, have switched the entire focus of T2D therapy by not only improving glycemic control but also reducing the risk of hypoglycemia and weight gain and improving outcomes. These newer modalities of treatment started off with dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists (GLP1-RAs), and now further treatments in the form of twincretins (GLP1/GIP dual agonists) and triple agonists (GLP1/GIP/glucagon agonists) are unraveling. This article provides a summary of the evidence available with these newer antidiabetics, which address the glucagon defect in T2D.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135704670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aarthi Raveendiran, R. Pradeepa, Venkatesan Ulagamathesan, J. Chambers, V. Mohan, P. Venkatasubramanian, A. Mohan
Background: A large number of epidemiologic studies across the world indicate a growing link between obesity and diabetes. The metropolitan city of Chennai in South India is experiencing an alarming increase in diabetes and obesity. Aim: The aim of this study was to determine the prevalence of and risk factors for diabetes and obesity together termed as “diabesity” among adults in urban Chennai. Materials and Methods: This was a community-based cross-sectional door-to-door study done as part of a large National Institute of Health and Care Research (NIHR)––a funded project aimed to understand patterns and determinants of health in South Asia. Of the 200 wards in Chennai, 34 wards were surveyed in the main project and two wards were selected randomly for this substudy. Five community enumeration blocks were selected using a systematic sampling technique. Participants aged ≥18 years were selected using a consecutive sampling method. Results: Of the 1138 participants studied, the prevalence of diabesity was found to be 34.3%(n = 390). Of the study participants, 74.8% had obesity (61.9%––generalized obesity; 68.5%––abdominal obesity) and 43.0% had diabetes. As age increased, the diabesity risk also increased gradually from 30 to 39 years (odds ratio [OR]: 3.6[95%, confidence interval [CI]: 1.4–8.9]) to 50–59 years (OR: 5.4[95%, CI: 2.2–13.2]), whereas there was a slight decrease in risk after 60 years (OR: 5.1[95%, CI: 2.1–12.3]). Females had nearly twice the risk of diabesity compared to men (OR: 1.8, P < 0.001), and physically inactive individuals had 1.7 times increased risk (P < 0.001). Conclusion: We report in this study that the prevalence of the dual metabolic defect (diabesity) is alarmingly high in urban Chennai. This study was an attempt to understand the epidemiology of diabesity.
{"title":"Prevalence of and risk factors for diabesity in urban Chennai","authors":"Aarthi Raveendiran, R. Pradeepa, Venkatesan Ulagamathesan, J. Chambers, V. Mohan, P. Venkatasubramanian, A. Mohan","doi":"10.4103/jod.jod_121_22","DOIUrl":"https://doi.org/10.4103/jod.jod_121_22","url":null,"abstract":"Background: A large number of epidemiologic studies across the world indicate a growing link between obesity and diabetes. The metropolitan city of Chennai in South India is experiencing an alarming increase in diabetes and obesity. Aim: The aim of this study was to determine the prevalence of and risk factors for diabetes and obesity together termed as “diabesity” among adults in urban Chennai. Materials and Methods: This was a community-based cross-sectional door-to-door study done as part of a large National Institute of Health and Care Research (NIHR)––a funded project aimed to understand patterns and determinants of health in South Asia. Of the 200 wards in Chennai, 34 wards were surveyed in the main project and two wards were selected randomly for this substudy. Five community enumeration blocks were selected using a systematic sampling technique. Participants aged ≥18 years were selected using a consecutive sampling method. Results: Of the 1138 participants studied, the prevalence of diabesity was found to be 34.3%(n = 390). Of the study participants, 74.8% had obesity (61.9%––generalized obesity; 68.5%––abdominal obesity) and 43.0% had diabetes. As age increased, the diabesity risk also increased gradually from 30 to 39 years (odds ratio [OR]: 3.6[95%, confidence interval [CI]: 1.4–8.9]) to 50–59 years (OR: 5.4[95%, CI: 2.2–13.2]), whereas there was a slight decrease in risk after 60 years (OR: 5.1[95%, CI: 2.1–12.3]). Females had nearly twice the risk of diabesity compared to men (OR: 1.8, P < 0.001), and physically inactive individuals had 1.7 times increased risk (P < 0.001). Conclusion: We report in this study that the prevalence of the dual metabolic defect (diabesity) is alarmingly high in urban Chennai. This study was an attempt to understand the epidemiology of diabesity.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"188 1","pages":"34 - 40"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74421191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vallari Jadav, Hetal K Rathod, Sudhir Jadhav, Anil D. Mahajan, Deepu Palal, N. Borah, Prerna Verma, Sheri DeBoe Johnson, Gracia Sohkhlet, Sandeep Nallapu
{"title":"Development and validation of treatment adherence scale for type 2 diabetes mellitus","authors":"Vallari Jadav, Hetal K Rathod, Sudhir Jadhav, Anil D. Mahajan, Deepu Palal, N. Borah, Prerna Verma, Sheri DeBoe Johnson, Gracia Sohkhlet, Sandeep Nallapu","doi":"10.4103/jod.jod_126_22","DOIUrl":"https://doi.org/10.4103/jod.jod_126_22","url":null,"abstract":"","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79308555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Aim: The purpose of this study is to determine the effects of the self-management education provided to patients with type 2 diabetes under the leadership of a nurse on the perceptions of self-management and clinical findings of patients. Materials and Methods: The sampling of the research comprises 281 patients who received a diagnosis of type 2 diabetes and whose treatment is being conducted. The self-management perceptions, body mass index, preprandial blood glucoses, and glycolyzed hemoglobin levels of the patients were measured before and after the intervention and 3 months later. Results: It was determined as a result of the comparison of the scores before and after the nursing education provided to the patients that the patients’ self-management perception scale scores increased significantly and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels reduced significantly ( P < 0.01). Conclusions: It is determined in research that the self-management education provided to patients with type 2 diabetes under the leadership of a nurse had a meaningful impact on the diabetes self-management skills and clinical findings of the patients. Practice Implications: It was determined that the average diabetes self-management education scores increased significantly when comparing before and after the self-management provided to patients and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels decreased at a statistically meaningful level.
{"title":"Management of type 2 diabetes: Self-management education and clinical findings","authors":"Aysun Türe, Nilufer Demirsoy, Deniz Gökalp","doi":"10.4103/jod.jod_20_23","DOIUrl":"https://doi.org/10.4103/jod.jod_20_23","url":null,"abstract":"Abstract Aim: The purpose of this study is to determine the effects of the self-management education provided to patients with type 2 diabetes under the leadership of a nurse on the perceptions of self-management and clinical findings of patients. Materials and Methods: The sampling of the research comprises 281 patients who received a diagnosis of type 2 diabetes and whose treatment is being conducted. The self-management perceptions, body mass index, preprandial blood glucoses, and glycolyzed hemoglobin levels of the patients were measured before and after the intervention and 3 months later. Results: It was determined as a result of the comparison of the scores before and after the nursing education provided to the patients that the patients’ self-management perception scale scores increased significantly and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels reduced significantly ( P < 0.01). Conclusions: It is determined in research that the self-management education provided to patients with type 2 diabetes under the leadership of a nurse had a meaningful impact on the diabetes self-management skills and clinical findings of the patients. Practice Implications: It was determined that the average diabetes self-management education scores increased significantly when comparing before and after the self-management provided to patients and that the body mass index, preprandial blood glucose, and glycolyzed hemoglobin levels decreased at a statistically meaningful level.","PeriodicalId":15627,"journal":{"name":"Journal of Diabetology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136116406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity and cardiovascular complications are the two pandemic which plays a crucial role in the pathophysiology of type 2 diabetes mellitus. Loss of weight and increased cardiovascular risk are becoming the hurdles for the diabetic population. The tremendous hike in the rate of obesity is one of the main reasons for the increased cases of diabetes mellitus and hence, obesity becomes a high-risk factor for diabetes. Glucagon-like peptide-1 (GLP-1) agonists were initially developed for the treatment of diabetes mellitus but was found to be effective not only for the glycemic control but also for the weight loss. Hence this review article aims to assess the clinical efficacy of GLP-1 agonists in the management of weight loss, and also discusses the detailed insights of FDA approved drugs used in weight management, and discuss the mechanisms by which GLP-1 agonist, used in weight loss therapy. It also discusses the role of dual co-agonist in the treatment of obesity. This literature survey has been done by searching term “GLP-1 agonist, diabetes, obesity, novel drug targets” in the PubMed, Scopus, Embase, and web of science databases. Then, the search is further narrowed by including the articles having recent updates only and then further it is narrowed by excluding the animal studies and including only the clinical studies. This article is purely based on the published clinical data obtained from various clinical trials. Based on the previous studies and clinical trials, it has been observed that GLP-1 agonists such as liraglutide and semaglutide are more efficacious drug than other approved drugs in weight management therapy and have advantage of improving the blood glucose profile and reduces the cardiovascular risk also. It is also found that dual gastric inhibitory polypeptide (GIP)/GLP-1 agonists is regarded as the more effective in treating obesity than the GLP-1 agonist alone.
肥胖和心血管并发症在2型糖尿病的病理生理中起着至关重要的作用。体重减轻和心血管疾病风险增加正在成为糖尿病人群的障碍。肥胖率的急剧上升是糖尿病患者增加的主要原因之一，因此肥胖成为糖尿病的高危因素。胰高血糖素样肽-1 (GLP-1)激动剂最初是为治疗糖尿病而开发的，但人们发现它不仅对血糖控制有效，而且对减肥也有效。因此，本文旨在评估GLP-1激动剂在减肥治疗中的临床疗效，并讨论FDA批准的用于减肥治疗的药物的详细见解，并讨论GLP-1激动剂用于减肥治疗的机制。本文还讨论了双重协同激动剂在肥胖治疗中的作用。通过在PubMed, Scopus, Embase和web of science数据库中搜索“GLP-1激动剂，糖尿病，肥胖，新型药物靶点”进行文献调查。然后，搜索范围进一步缩小，只包括最近更新的文章，然后进一步缩小，排除动物研究，只包括临床研究。这篇文章纯粹是基于从各种临床试验中获得的已发表的临床数据。根据以往的研究和临床试验，GLP-1激动剂如利拉鲁肽和西马鲁肽在体重管理治疗中比其他已批准的药物更有效，并且具有改善血糖水平和降低心血管风险的优势。研究还发现，胃抑制多肽(GIP)/GLP-1双激动剂被认为比单独GLP-1激动剂更有效地治疗肥胖。
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