Social isolation and loneliness are forms of social disconnection that have been linked to increased risk of many metabolic disorders, including Type 2 Diabetes Mellitus (T2DM). However, evidence to support this relation is lacking. This study aims to investigate the association between social isolation, loneliness, and the incidence risk of T2DM.
Methods
We searched various electronic databases including MEDLINE (via PubMed), Embase, the Cochrane Library, and Google scholar to retrieve qualitative studies comparing the incidence of T2DM in patients with social isolation or loneliness. We performed statistical analysis on RevMan 5.4 using the random effect model.
Results
Loneliness was associated with a significantly increased incidence of T2DM (OR: 1.44; 95 % CI: 1.19–1.73; P:0.0001), with high heterogeneity (I² = 95 %). Sensitivity analysis indicated potential variability due to differences in loneliness measurements. Social isolation also showed a significant association with T2DM (OR: 1.88; 95 % CI: 1.38–2.58; P:<0.0001) with high heterogeneity (I² = 98 %).
Conclusion
In conclusion, we found social isolation and loneliness are independently associated with a higher incidence of T2DM. These findings underscore the need to address psychosocial elements like social isolation and loneliness in the management of T2DM. However, further studies with larger sample sizes, longer follow-up durations, and uniform criteria is warranted to better understand the association between social isolation, loneliness and T2DM.
{"title":"Social isolation, loneliness, and incidence of type 2 diabetes mellitus: A systematic review and meta-analysis","authors":"Maheen Asif , Aliza Asif , Ummi Aiman Rahman , Hafsa Ajmal , Uzair Jafar , Oshaz Fatima","doi":"10.1016/j.pcd.2025.03.006","DOIUrl":"10.1016/j.pcd.2025.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>Social isolation and loneliness are forms of social disconnection that have been linked to increased risk of many metabolic disorders, including Type 2 Diabetes Mellitus (T2DM). However, evidence to support this relation is lacking. This study aims to investigate the association between social isolation, loneliness, and the incidence risk of T2DM.</div></div><div><h3>Methods</h3><div>We searched various electronic databases including MEDLINE (via PubMed), Embase, the Cochrane Library, and Google scholar to retrieve qualitative studies comparing the incidence of T2DM in patients with social isolation or loneliness. We performed statistical analysis on RevMan 5.4 using the random effect model.</div></div><div><h3>Results</h3><div>Loneliness was associated with a significantly increased incidence of T2DM (OR: 1.44; 95 % CI: 1.19–1.73; P:0.0001), with high heterogeneity (I² = 95 %). Sensitivity analysis indicated potential variability due to differences in loneliness measurements. Social isolation also showed a significant association with T2DM (OR: 1.88; 95 % CI: 1.38–2.58; P:<0.0001) with high heterogeneity (I² = 98 %).</div></div><div><h3>Conclusion</h3><div>In conclusion, we found social isolation and loneliness are independently associated with a higher incidence of T2DM. These findings underscore the need to address psychosocial elements like social isolation and loneliness in the management of T2DM. However, further studies with larger sample sizes, longer follow-up durations, and uniform criteria is warranted to better understand the association between social isolation, loneliness and T2DM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 221-228"},"PeriodicalIF":2.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-19DOI: 10.1016/j.pcd.2025.02.009
Jesús Iturralde-Iriso , Aitana Lertxundi-Manterola , Iosu Delgado-Naranjo , Alfonso Barquilla-García , Rafael Manuel Micó-Pérez , José Polo-García , Sonsoles M. Velilla-Zancada , Naiara Cubelos-Fernández , Antonio Segura-Fragoso , Leovigildo Ginel-Mendoza , Vicente Pallares-Carratala , Miguel A. Prieto-Díaz , Sergio Cinza-Sanjurjo , Vicente Martín-Sanchez
The burden of disease attributable to excess body fat (EBF) in type 2 diabetes mellitus (T2DM) may be underestimated due to problems correlating BMI with body fat. The aim of this study is to compare the population attributable fraction (PAF) of EBF in T2DM assessed with various parameters.
Material and methods
Prevalence study based on the baseline visit of the IBERICAN study. Mixed unconditional logistic regression models were used to estimate the risk of T2DM for the various categories of BMI, of the estimation of EBF according to the CUN-BAE (Clínica Universidad de Navarra-Body Adiposity Estimator) and of waist circumference (WC), stratifying by sex. The PAF was calculated for each of the EBF estimates.
Results
A total of 7752 patients from IBERICAN study were eligible, of them 1536 (19.8 %) achieved T2DM criterion, The prevalence of diabetes was higher in men, in those with a lower level of education, and in those who reported a low level of physical activity. Subjects with diabetes were older, had a higher BMI, a higher CUN-BAE-estimated body fat percentage (eBFP) and a higher waist circumference. One in three cases T2DM risk was attributed to elevated BMI, whereas in the CUN-BAE case it was attributed to 9 out of 10 men and 2 out of 3 women. One out of two cases of T2DM in women, and less in men, was attributed to an excess WC.
Conclusions
The burden of disease attributable to EBF in the case of T2DM may be underestimated. Therefore, EBF should be used, together with BMI, WC -especially in women-, and the CUN-BAE to better estimate the risk of T2DM and to adapt dietary or lifestyle recommendations in daily clinical practice.
{"title":"Estimation of the population atributable fraction due a to excess body fat in primary care patients: IBERICAN study","authors":"Jesús Iturralde-Iriso , Aitana Lertxundi-Manterola , Iosu Delgado-Naranjo , Alfonso Barquilla-García , Rafael Manuel Micó-Pérez , José Polo-García , Sonsoles M. Velilla-Zancada , Naiara Cubelos-Fernández , Antonio Segura-Fragoso , Leovigildo Ginel-Mendoza , Vicente Pallares-Carratala , Miguel A. Prieto-Díaz , Sergio Cinza-Sanjurjo , Vicente Martín-Sanchez","doi":"10.1016/j.pcd.2025.02.009","DOIUrl":"10.1016/j.pcd.2025.02.009","url":null,"abstract":"<div><div>The burden of disease attributable to excess body fat (EBF) in type 2 diabetes mellitus (T2DM) may be underestimated due to problems correlating BMI with body fat. The aim of this study is to compare the population attributable fraction (PAF) of EBF in T2DM assessed with various parameters.</div></div><div><h3>Material and methods</h3><div>Prevalence study based on the baseline visit of the IBERICAN study. Mixed unconditional logistic regression models were used to estimate the risk of T2DM for the various categories of BMI, of the estimation of EBF according to the CUN-BAE (Clínica Universidad de Navarra-Body Adiposity Estimator) and of waist circumference (WC), stratifying by sex. The PAF was calculated for each of the EBF estimates.</div></div><div><h3>Results</h3><div>A total of 7752 patients from IBERICAN study were eligible, of them 1536 (19.8 %) achieved T2DM criterion, The prevalence of diabetes was higher in men, in those with a lower level of education, and in those who reported a low level of physical activity. Subjects with diabetes were older, had a higher BMI, a higher CUN-BAE-estimated body fat percentage (eBFP) and a higher waist circumference. One in three cases T2DM risk was attributed to elevated BMI, whereas in the CUN-BAE case it was attributed to 9 out of 10 men and 2 out of 3 women. One out of two cases of T2DM in women, and less in men, was attributed to an excess WC.</div></div><div><h3>Conclusions</h3><div>The burden of disease attributable to EBF in the case of T2DM may be underestimated. Therefore, EBF should be used, together with BMI, WC -especially in women-, and the CUN-BAE to better estimate the risk of T2DM and to adapt dietary or lifestyle recommendations in daily clinical practice.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 302-311"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-18DOI: 10.1016/j.pcd.2025.03.005
Elizabeth Hickman , Clare Gillies , Kamlesh Khunti , Samuel Seidu
Objectives
To investigate the patterns and trends associated with deprescribing of preventive medications in the final 12 months of life in palliative patients living with multiple long-term conditions using the Clinical Practice Research Datalink.
Participants
All patients with a medcode/readcode for palliative care assigned to their profile with a medcode/readcode for a cardiometabolic condition. All patients were on therapeutic interventions for their condition/s.
Primary and secondary outcome measures
the trends of medication deprescribing of preventive medications in the final twelve months of life in those known to be end-of-life.
Results
Preventive medication deprescribing was only observed in a very small cohort of patients. The findings were consistent across all six medication groups tested. Deprescribing was observed in a range of 2–60 patients with the most deprescribing efforts being associated with antihypertensive medications (n = 177), and antiplatelet medications (n = 70), and antihyperglycaemic medications (n = 10).
Conclusions
Deprescribing practices are not commonplace in patients with a known end-of-life designation with low patient numbers (range 2–60) undergoing the intervention, thus potentially reducing the quality of life in these patients final twelve months of life.
CPRD ID
#22_002253, linkage request 2914
目的：利用临床实践研究数据链（Clinical Practice Research Datalink）调查患有多种长期疾病的姑息治疗患者生命最后12个月预防性药物处方的模式和趋势。参与者：所有患有姑息治疗的医疗编码/阅读编码的患者，分配给他们的医疗编码/阅读编码为心脏代谢疾病。所有患者均接受治疗干预。主要和次要结果测量：在已知生命结束的患者生命的最后12个月，预防性药物处方的趋势。结果：预防性药物处方解除仅在一小部分患者中观察到。这一发现在所有六个药物组的测试中都是一致的。在2-60例患者中，降压药物（n = 177）、抗血小板药物（n = 70）和抗高血糖药物（n = 10）的降压程度最高。结论：在接受干预的已知临终患者数量较少（范围2-60）的患者中，减处方做法并不常见，因此可能降低这些患者最后12个月的生活质量。CPRD ID: #22_002253，联动请求2914。
{"title":"Deprescribing of preventive medications in palliative care patients living with multiple long-term conditions in their final 12 months of life: A retrospective cohort Clinical Practice Research Datalink study","authors":"Elizabeth Hickman , Clare Gillies , Kamlesh Khunti , Samuel Seidu","doi":"10.1016/j.pcd.2025.03.005","DOIUrl":"10.1016/j.pcd.2025.03.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the patterns and trends associated with deprescribing of preventive medications in the final 12 months of life in palliative patients living with multiple long-term conditions using the Clinical Practice Research Datalink.</div></div><div><h3>Participants</h3><div>All patients with a medcode/readcode for palliative care assigned to their profile with a medcode/readcode for a cardiometabolic condition. All patients were on therapeutic interventions for their condition/s.</div></div><div><h3>Primary and secondary outcome measures</h3><div>the trends of medication deprescribing of preventive medications in the final twelve months of life in those known to be end-of-life.</div></div><div><h3>Results</h3><div>Preventive medication deprescribing was only observed in a very small cohort of patients. The findings were consistent across all six medication groups tested. Deprescribing was observed in a range of 2–60 patients with the most deprescribing efforts being associated with antihypertensive medications (n = 177), and antiplatelet medications (n = 70), and antihyperglycaemic medications (n = 10).</div></div><div><h3>Conclusions</h3><div>Deprescribing practices are not commonplace in patients with a known end-of-life designation with low patient numbers (range 2–60) undergoing the intervention, thus potentially reducing the quality of life in these patients final twelve months of life.</div></div><div><h3>CPRD ID</h3><div>#22_002253, linkage request 2914</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 288-295"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine the prevalence of depression and anxiety during pregnancy and its association with GDM.
Methods
A total of 2141 pregnant women were recruited before 16 weeks of gestation (mean gestational age: 10.5 ± 2.9 weeks) from the STRiDE study in south India. Early GDM (eGDM) was detected in the first trimester, and late GDM (lGDM) during 24–28 weeks, both diagnosed using IADPSG criteria. Depression and anxiety were assessed using the PHQ-9 (score≥10) and GAD-7 (score≥7) scales, respectively.
Results
Overall, 14.9 % had depression and 17.5 % had anxiety in early pregnancy. eGDM was diagnosed in 474 (20.4 %) and lGDM in 321 (19.3 %) women. Women with eGDM had higher prevalence of depression (20.9 %) than those with lGDM (15.6 %, p = 0.06) and those without GDM (13.3 %, p < 0.01). Anxiety was also higher in eGDM (21.1 %) compared to IGDM (15.3 %, p < 0.05) and women without GDM (16.6 %, p < 0.05). eGDM was significantly associated with depression (aOR=1.84, 95 % CI:1.37–2.47, p < 0.001) and anxiety (aOR=1.36, 95 % CI:1.03–1.79, p = 0.03) after adjusting for age, systolic blood pressure, BMI, socioeconomic status, and family history of diabetes.
Conclusion
Women with early GDM have a higher prevalence of depression and anxiety compared to those with late GDM and women without GDM. Early and universal screening for GDM should be done and its association with mental health wellbeing should be explored and supported.
{"title":"Prevalence of depression and anxiety among pregnant women with gestational diabetes mellitus in South Asia","authors":"Saite Hemavathy , Mohan Deepa , Ram Uma , Ramesh Gowri , Rajendra Pradeepa , Wesley Hannah , Chockalingam Shivashri , Radhakrishnan Subashini , Duraivel Mohaneswari , Yonas Ghebremichael-Weldeselassie , Ponnusamy Saravanan , Viswanathan Mohan , Ranjit Mohan Anjana","doi":"10.1016/j.pcd.2025.03.002","DOIUrl":"10.1016/j.pcd.2025.03.002","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the prevalence of depression and anxiety during pregnancy and its association with GDM.</div></div><div><h3>Methods</h3><div>A total of 2141 pregnant women were recruited before 16 weeks of gestation (mean gestational age: 10.5 ± 2.9 weeks) from the STRiDE study in south India. Early GDM (eGDM) was detected in the first trimester, and late GDM (lGDM) during 24–28 weeks, both diagnosed using IADPSG criteria. Depression and anxiety were assessed using the PHQ-9 (score≥10) and GAD-7 (score≥7) scales, respectively.</div></div><div><h3>Results</h3><div>Overall, 14.9 % had depression and 17.5 % had anxiety in early pregnancy. eGDM was diagnosed in 474 (20.4 %) and lGDM in 321 (19.3 %) women. Women with eGDM had higher prevalence of depression (20.9 %) than those with lGDM (15.6 %, p = 0.06) and those without GDM (13.3 %, p < 0.01). Anxiety was also higher in eGDM (21.1 %) compared to IGDM (15.3 %, p < 0.05) and women without GDM (16.6 %, p < 0.05). eGDM was significantly associated with depression (aOR=1.84, 95 % CI:1.37–2.47, p < 0.001) and anxiety (aOR=1.36, 95 % CI:1.03–1.79, p = 0.03) after adjusting for age, systolic blood pressure, BMI, socioeconomic status, and family history of diabetes.</div></div><div><h3>Conclusion</h3><div>Women with early GDM have a higher prevalence of depression and anxiety compared to those with late GDM and women without GDM. Early and universal screening for GDM should be done and its association with mental health wellbeing should be explored and supported.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 322-328"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-10DOI: 10.1016/j.pcd.2025.03.001
Francesc Alòs , Anna Puig-Ribera , Judit Bort-Roig , Emilia Chirveches-Pérez , Anna Berenguera , Carlos Martin-Cantera , Ma Àngels Colomer
Introduction
Type 2 diabetes mellitus (DM2) is one of the main public health threats of the 21st century. Half of the people with DM2 worldwide are not diagnosed. The high prevalence, underdiagnosis and complications of diabetes highlight the need for identifying people at risk. Sedentary behaviour (SB) or prolonged sitting is a major predisposing risk factor for the increasing prevalence of DM2. Incorporating SB measures into clinical practice systems for identifying individuals more likely to have DM2 should be considered.
Objective
To develop a mathematical model for clinical practice that allows early identification of office employees at risk of DM2 based on objective data on SB.
Methods
A cross-sectional study with a cross-validation procedure was conducted. Anthropometric variables (sex, age and body mass index, BMI), sleep time (hours; measured by ActivPAL3M devices), and SB patterns (sedentary breaks and time spent in sedentary bouts of four different lengths; measured by ActivPAL3M devices) of two groups of office employees (adults with and without diabetes) were compared. Eighty-one participants had DM2 and 132 had normal glucose metabolism (NGM). The risk of having DM2 was modelled using generalized linear models (GLM), particularly a logistic regression model.
Results
Five non-invasive clinical variables that were significantly correlated to DM2 with no collinearity were included in the mathematical model: sex, age, BMI, sleep time (hours) and sedentary breaks < 20 minutes (number/day). The validated model correctly classified 94.58 % of the participants with DM2 and 97.99 % of participants with NGM. The sensitivity was 94.58 % and the specificity 97.99 %. Additionally, the model allowed the design of a preventive tool to recommend changes in the SB pattern based on the participant’s anthropometric profile, aiming to reduce the risk of developing DM2 in office employees.
Conclusion
This study highlights the importance of incorporating SB measures in primary care clinical practice. Our mathematical model suggests that including SB could enhance the early identification of adults at risk of DM2. Further research is needed to validate these findings and assess the practical application of the mathematical model in clinical practice.
{"title":"Incorporating sedentary behaviour for identifying risk of type 2 diabetes: Implications for primary care","authors":"Francesc Alòs , Anna Puig-Ribera , Judit Bort-Roig , Emilia Chirveches-Pérez , Anna Berenguera , Carlos Martin-Cantera , Ma Àngels Colomer","doi":"10.1016/j.pcd.2025.03.001","DOIUrl":"10.1016/j.pcd.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Type 2 diabetes mellitus (DM2) is one of the main public health threats of the 21st century. Half of the people with DM2 worldwide are not diagnosed. The high prevalence, underdiagnosis and complications of diabetes highlight the need for identifying people at risk. Sedentary behaviour (SB) or prolonged sitting is a major predisposing risk factor for the increasing prevalence of DM2. Incorporating SB measures into clinical practice systems for identifying individuals more likely to have DM2 should be considered.</div></div><div><h3>Objective</h3><div>To develop a mathematical model for clinical practice that allows early identification of office employees at risk of DM2 based on objective data on SB.</div></div><div><h3>Methods</h3><div>A cross-sectional study with a cross-validation procedure was conducted. Anthropometric variables (sex, age and body mass index, BMI), sleep time (hours; measured by ActivPAL3M devices), and SB patterns (sedentary breaks and time spent in sedentary bouts of four different lengths; measured by ActivPAL3M devices) of two groups of office employees (adults with and without diabetes) were compared. Eighty-one participants had DM2 and 132 had normal glucose metabolism (NGM). The risk of having DM2 was modelled using generalized linear models (GLM), particularly a logistic regression model.</div></div><div><h3>Results</h3><div>Five non-invasive clinical variables that were significantly correlated to DM2 with no collinearity were included in the mathematical model: sex, age, BMI, sleep time (hours) and sedentary breaks < 20 minutes (number/day). The validated model correctly classified 94.58 % of the participants with DM2 and 97.99 % of participants with NGM. The sensitivity was 94.58 % and the specificity 97.99 %. Additionally, the model allowed the design of a preventive tool to recommend changes in the SB pattern based on the participant’s anthropometric profile, aiming to reduce the risk of developing DM2 in office employees.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of incorporating SB measures in primary care clinical practice. Our mathematical model suggests that including SB could enhance the early identification of adults at risk of DM2. Further research is needed to validate these findings and assess the practical application of the mathematical model in clinical practice.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 214-220"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-06DOI: 10.1016/j.pcd.2025.02.008
K. Kovanur Sampath , Yan Ann-Rong , S. Brownie
Background
Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. However, the lack of cultural integration with the current management approach does not suit indigenous communities. Therefore, the aim of this scoping review is to map the existing literature related to culturally appropriate care and to establish the key characteristics of a culturally appropriate care provided to indigenous communities with T2D.
Methods
Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to September 2024. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. Studies included Indigenous people with T2D, culturally appropriate care, measurable outcomes, and any design. The research team collectively created a data charting table/form to standardize data collection that included PICO elements and PROGRESS-Plus factors for equity lens. A narrative synthesis was used to summarize the evidence.
Results
Seven studies met our eligibility criteria and were included in this scoping review. Overall, there is clear evidence that a culturally appropriate care results in better physiological outcomes and higher rates of adherence and engagement with a treatment plan and disease management processes. However, future studies need to gather and report on other PROGRESS factors that can cause inequity such as Religion, Education, Socioeconomic status of participants.
Conclusion
The findings of this review emphasise that a culturally appropriate care is crucial in improving health outcomes and engagement among Indigenous people with T2D. However, systemic barriers still exist, highlighting the need for broader structural changes.
{"title":"Culturally appropriate care for indigenous people with type 2 diabetes mellitus (T2DM)- a scoping review","authors":"K. Kovanur Sampath , Yan Ann-Rong , S. Brownie","doi":"10.1016/j.pcd.2025.02.008","DOIUrl":"10.1016/j.pcd.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. However, the lack of cultural integration with the current management approach does not suit indigenous communities. Therefore, the aim of this scoping review is to map the existing literature related to culturally appropriate care and to establish the key characteristics of a culturally appropriate care provided to indigenous communities with T2D.</div></div><div><h3>Methods</h3><div>Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to September 2024. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. Studies included Indigenous people with T2D, culturally appropriate care, measurable outcomes, and any design. The research team collectively created a data charting table/form to standardize data collection that included PICO elements and PROGRESS-Plus factors for equity lens. A narrative synthesis was used to summarize the evidence.</div></div><div><h3>Results</h3><div>Seven studies met our eligibility criteria and were included in this scoping review. Overall, there is clear evidence that a culturally appropriate care results in better physiological outcomes and higher rates of adherence and engagement with a treatment plan and disease management processes. However, future studies need to gather and report on other PROGRESS factors that can cause inequity such as Religion, Education, Socioeconomic status of participants.</div></div><div><h3>Conclusion</h3><div>The findings of this review emphasise that a culturally appropriate care is crucial in improving health outcomes and engagement among Indigenous people with T2D. However, systemic barriers still exist, highlighting the need for broader structural changes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 238-245"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-24DOI: 10.1016/j.pcd.2025.02.006
Hairya Ajaykumar Lakhani , Deepanwita Biswas , Mahima Kuruvila , Manisha Sai Chava , Kshitij Raj , Joel Thomas Varghese , N.L. Swathi
Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.
{"title":"Intermittent fasting versus continuous caloric restriction for glycemic control and weight loss in type 2 diabetes: A traditional review","authors":"Hairya Ajaykumar Lakhani , Deepanwita Biswas , Mahima Kuruvila , Manisha Sai Chava , Kshitij Raj , Joel Thomas Varghese , N.L. Swathi","doi":"10.1016/j.pcd.2025.02.006","DOIUrl":"10.1016/j.pcd.2025.02.006","url":null,"abstract":"<div><div>Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 203-213"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-24DOI: 10.1016/j.pcd.2024.11.005
Mary-Ellen Hooper , Ella Kurz , Cathy Knight-Agarwal , Mary-Jessimine Bushell , Elyse Ladbrook , Deborah Davis
Background
Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.
Methods
For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.
Results
This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.
Discussion and conclusion
There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.
{"title":"The perspectives of healthcare professionals in providing care to women with GDM in high-income nations: A qualitative systematic review","authors":"Mary-Ellen Hooper , Ella Kurz , Cathy Knight-Agarwal , Mary-Jessimine Bushell , Elyse Ladbrook , Deborah Davis","doi":"10.1016/j.pcd.2024.11.005","DOIUrl":"10.1016/j.pcd.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.</div></div><div><h3>Methods</h3><div>For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.</div></div><div><h3>Results</h3><div>This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.</div></div><div><h3>Discussion and conclusion</h3><div>There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 246-260"},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-21DOI: 10.1016/j.pcd.2025.02.003
Maria del Mar Fernandez-Alvarez , Cristina Papín-Cano , Shelini Surendran , Ruben Martin-Payo
Aim
The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (T2DM) on dietary and physical activity recommendations in a Spanish region.
Methods
A two-arm pragmatic randomized pilot trial was developed. The intervention consisted of a 6-month period with three components: face-to-face counseling, a phone call, and specially designed written guidelines focusing on dietary and physical activity recommendations The primary outcome was changes in dietary and physical activity recommendations. The secondary outcome, the impact of the intervention on HbA1c levels, body mass index, and the frequency of consultations to primary care.
Results
n = 208 patients were recruited. Individuals in the intervention experienced a significative improvement in adherence to dietary recommendations (+0.52; p-value<0.001), physical activity (+0.79; p-value<0.001), and a decrease in HbA1c levels (0.11 %; p-value=0.04).
Conclusion
The 6-month intervention, designed for T2DM patients and based on the BCW model, has demonstrated effectiveness in improving adherence to healthy dietary and physical activity recommendations, as well as reducing HbA1c levels.
{"title":"Td2Ast project: A pragmatic intervention on diet and physical activity for patients with type 2 diabetes mellitus","authors":"Maria del Mar Fernandez-Alvarez , Cristina Papín-Cano , Shelini Surendran , Ruben Martin-Payo","doi":"10.1016/j.pcd.2025.02.003","DOIUrl":"10.1016/j.pcd.2025.02.003","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this study was to assess the efficacy of an educational intervention based on the Behavior Change Wheel (BCW) framework for individuals with type 2 diabetes mellitus (T2DM) on dietary and physical activity recommendations in a Spanish region.</div></div><div><h3>Methods</h3><div>A two-arm pragmatic randomized pilot trial was developed. The intervention consisted of a 6-month period with three components: face-to-face counseling, a phone call, and specially designed written guidelines focusing on dietary and physical activity recommendations The primary outcome was changes in dietary and physical activity recommendations. The secondary outcome, the impact of the intervention on HbA1c levels, body mass index, and the frequency of consultations to primary care.</div></div><div><h3>Results</h3><div>n<!--> <!-->=<!--> <!-->208 patients were recruited. Individuals in the intervention experienced a significative improvement in adherence to dietary recommendations (+0.52; p-value<0.001), physical activity (+0.79; p-value<0.001), and a decrease in HbA1c levels (0.11 %; p-value=0.04).</div></div><div><h3>Conclusion</h3><div>The 6-month intervention, designed for T2DM patients and based on the BCW model, has demonstrated effectiveness in improving adherence to healthy dietary and physical activity recommendations, as well as reducing HbA1c levels.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 270-276"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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