Background and Objectives: Prediabetes is associated with a high risk of developing diabetes and cardiovascular disease. Early treatment with exercise and dietary interventions can reduce the progression of prediabetes to diabetes or even lead to a return of glucose levels to normal. The aim of the study was to evaluate the effect of a dietary supplement with Portulaca oleracea and titrated Cistus creticus extract on the glycemic profile of people with prediabetes. Materials and Methods: Participants were assigned to a dietary supplement with Portulaca oleracea and titrated Cistus creticus extract, along with vitamins and minerals, received once daily for 90 days. Demographics and medical history were obtained, and a complete clinical examination, measurement of somatometric characteristics, and laboratory parameters were performed at baseline. The measurement of somatometric characteristics and laboratory tests were repeated at the end of the study. Results: A total of 26 people with prediabetes participated, 11 females and 15 males. There was a tendency for a decrease in HbA1c after intervention [baseline: 5.9 (5.7–6.1)%; at the end of the study: 5.7 (5.7–6.0)%, p = 0.062] and a significant decrease in fasting glucose levels (from 110.8 ± 7.0 mg/dL to 103.9 ± 10.3, p = 0.005). Fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) decreased significantly [baseline fasting insulin: 20.7 (9.3–34.20) μU/mL; at the end of the study: 15.1 (8.6–19.0) μU/mL, p = 0.028; baseline HOMA-IR: 3.6 (2.5–8.9); at the end of the study: 3.5 (2.0–4.6), p = 0.035]. Significant reductions were observed in alkaline phosphatase and uric acid levels. No significant change was observed in body weight, body mass index, or waist circumference after the intervention. No treatment-emergent adverse events were observed, and all participants completed the study. Conclusions: The dietary supplement from Portulaca oleracea and titrated Cistus creticus extract, along with vitamins and minerals, may improve the metabolic profile of people with prediabetes.
{"title":"A Pilot Study on the Glucose-Lowering Effects of a Nutritional Supplement in People with Prediabetes","authors":"Thrasyvoulos Bemplidakis, Ioanna Eleftheriadou, Ourania Kosta, Konstantinos Tentolouris, Ioanna Anastasiou, Christina Agelaki, Dimitrios Lamprinos, Anastasia Papaioannou, Ioanna Kolovou, Vasiliki Kouka, Magdalini Bristianou, Leonidas Lanaras, Nikolaos Tentolouris","doi":"10.3390/diabetology4040035","DOIUrl":"https://doi.org/10.3390/diabetology4040035","url":null,"abstract":"Background and Objectives: Prediabetes is associated with a high risk of developing diabetes and cardiovascular disease. Early treatment with exercise and dietary interventions can reduce the progression of prediabetes to diabetes or even lead to a return of glucose levels to normal. The aim of the study was to evaluate the effect of a dietary supplement with Portulaca oleracea and titrated Cistus creticus extract on the glycemic profile of people with prediabetes. Materials and Methods: Participants were assigned to a dietary supplement with Portulaca oleracea and titrated Cistus creticus extract, along with vitamins and minerals, received once daily for 90 days. Demographics and medical history were obtained, and a complete clinical examination, measurement of somatometric characteristics, and laboratory parameters were performed at baseline. The measurement of somatometric characteristics and laboratory tests were repeated at the end of the study. Results: A total of 26 people with prediabetes participated, 11 females and 15 males. There was a tendency for a decrease in HbA1c after intervention [baseline: 5.9 (5.7–6.1)%; at the end of the study: 5.7 (5.7–6.0)%, p = 0.062] and a significant decrease in fasting glucose levels (from 110.8 ± 7.0 mg/dL to 103.9 ± 10.3, p = 0.005). Fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) decreased significantly [baseline fasting insulin: 20.7 (9.3–34.20) μU/mL; at the end of the study: 15.1 (8.6–19.0) μU/mL, p = 0.028; baseline HOMA-IR: 3.6 (2.5–8.9); at the end of the study: 3.5 (2.0–4.6), p = 0.035]. Significant reductions were observed in alkaline phosphatase and uric acid levels. No significant change was observed in body weight, body mass index, or waist circumference after the intervention. No treatment-emergent adverse events were observed, and all participants completed the study. Conclusions: The dietary supplement from Portulaca oleracea and titrated Cistus creticus extract, along with vitamins and minerals, may improve the metabolic profile of people with prediabetes.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135245790","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}
There is a correlation between the existence of type 2 diabetes mellitus (T2DM) and the development of thyroid disorders. Prediabetes is a progressive state of moderate insulin resistance that often precedes the onset of T2DM. However, the association between prediabetes and thyroid function is unknown. This study assessed changes in markers of thyroid function in diet-induced prediabetes. Twelve male Sprague Dawley rats (n = 12) were randomly assigned into two groups. Rats in the non-prediabetic (NPD) group were fed a standard rat diet, while rats in the prediabetic (PD) were fed a high-fat high-carbohydrate diet for 20 weeks to induce prediabetes. Thereafter, fasting blood glucose levels were measured. Plasma samples were assessed for triiodothyronine (T3), thyroxine (T4), thyroxine peroxidase (TPO) antibody, insulin, and glycated hemoglobin (HbA1c) concentrations. The elevated blood glucose, HbA1c, and plasma insulin levels coincided with increased T3 and reduced T4 levels in the PD group when compared to the NPD group. There was also an increase in the concentration of TPO antibodies in the PD group. Additionally, there was a significant correlation between the thyroid hormone concentrations and HbA1c levels. In conclusion, these results indicated that there is a positive association between thyroid dysfunction and diet-induced prediabetes in rats.
{"title":"Association between Altered Thyroid Function and Prediabetes in Diet-Induced Prediabetic Male Sprague Dawley Rats","authors":"Malishca Pillay, Palesa Mosili, Akinjide Akinnuga, Ntethelelo Sibiya, Phikelelani Ngubane, Andile Khathi","doi":"10.3390/diabetology4030034","DOIUrl":"https://doi.org/10.3390/diabetology4030034","url":null,"abstract":"There is a correlation between the existence of type 2 diabetes mellitus (T2DM) and the development of thyroid disorders. Prediabetes is a progressive state of moderate insulin resistance that often precedes the onset of T2DM. However, the association between prediabetes and thyroid function is unknown. This study assessed changes in markers of thyroid function in diet-induced prediabetes. Twelve male Sprague Dawley rats (n = 12) were randomly assigned into two groups. Rats in the non-prediabetic (NPD) group were fed a standard rat diet, while rats in the prediabetic (PD) were fed a high-fat high-carbohydrate diet for 20 weeks to induce prediabetes. Thereafter, fasting blood glucose levels were measured. Plasma samples were assessed for triiodothyronine (T3), thyroxine (T4), thyroxine peroxidase (TPO) antibody, insulin, and glycated hemoglobin (HbA1c) concentrations. The elevated blood glucose, HbA1c, and plasma insulin levels coincided with increased T3 and reduced T4 levels in the PD group when compared to the NPD group. There was also an increase in the concentration of TPO antibodies in the PD group. Additionally, there was a significant correlation between the thyroid hormone concentrations and HbA1c levels. In conclusion, these results indicated that there is a positive association between thyroid dysfunction and diet-induced prediabetes in rats.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135879062","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}
Pub Date : 2023-09-11DOI: 10.3390/diabetology4030033
Bismark Owusu-Afriyie, Theresa Gende, Martin Tapilas, Nicholas Zimbare, Jeffrey Kewande
This study was conducted to determine the barriers to the utilization of diabetic retinopathy (DR) screening in Papua New Guinea (PNG). A list of patients booked for DR screening at Madang Provincial Hospital Eye Clinic (MPHEC) between January 2017 and December 2021 who had not been screened was retrieved, and the patients were invited to participate in the study. The data were collected using a structured questionnaire, and IBM Statistical Package for Social Sciences version 26 was used for the analysis. p < 0.05 was considered statistically significant. One hundred and twenty-nine patients (37.4%) did not attend DR screening for the period under study. The study response rate was 80.6%. The mean ± SD age of the respondents was 51.5 ± 10.9 years. The majority of the study respondents were female (62.5%), people living in rural settings (53.8%), and farmers (22.1%). Time constraints, poor knowledge about DR, and long waiting periods at the DR screening center were the main barriers to the uptake of DR screening. Compared to respondents in urban communities, those in rural settings were significantly concerned about cost (p < 0.001), travel distance to the MPHEC (p < 0.001), and poor information about DR screening (p = 0.002). More than half of the respondents (63.5%) had discontinued using pharmacotherapy for DM. There is a high rate of nonadherence to diabetes (DM) and DR treatment in PNG. There is a need for public health campaigns about DM and strategic DR screening at the community level in PNG and similar countries.
本研究旨在确定巴布亚新几内亚(PNG)使用糖尿病视网膜病变(DR)筛查的障碍。检索2017年1月至2021年12月期间在马当省医院眼科诊所(MPHEC)预约进行DR筛查的患者名单，这些患者未接受筛查，并被邀请参加研究。使用结构化问卷收集数据，并使用IBM Statistical Package for Social Sciences version 26进行分析。p & lt;0.05认为有统计学意义。129名患者(37.4%)在研究期间没有参加DR筛查。研究应答率为80.6%。受访者的平均±SD年龄为51.5±10.9岁。大多数调查对象为女性(62.5%)、农村居民(53.8%)和农民(22.1%)。时间限制、DR知识贫乏、DR筛查中心等待时间过长是阻碍DR筛查的主要障碍。与城市社区的受访者相比，农村地区的受访者非常关注成本(p <0.001)，到MPHEC的行程距离(p <0.001)，以及DR筛查信息匮乏(p = 0.002)。超过一半的应答者(63.5%)已停止使用糖尿病药物治疗。巴布亚新几内亚糖尿病(DM)和DR治疗的不依从率很高。在巴布亚新几内亚和类似的国家，有必要在社区一级开展关于糖尿病和战略耐多药筛查的公共卫生运动。
{"title":"Patients’ Perspective on Barriers to Utilization of a Diabetic Retinopathy Screening Service","authors":"Bismark Owusu-Afriyie, Theresa Gende, Martin Tapilas, Nicholas Zimbare, Jeffrey Kewande","doi":"10.3390/diabetology4030033","DOIUrl":"https://doi.org/10.3390/diabetology4030033","url":null,"abstract":"This study was conducted to determine the barriers to the utilization of diabetic retinopathy (DR) screening in Papua New Guinea (PNG). A list of patients booked for DR screening at Madang Provincial Hospital Eye Clinic (MPHEC) between January 2017 and December 2021 who had not been screened was retrieved, and the patients were invited to participate in the study. The data were collected using a structured questionnaire, and IBM Statistical Package for Social Sciences version 26 was used for the analysis. p < 0.05 was considered statistically significant. One hundred and twenty-nine patients (37.4%) did not attend DR screening for the period under study. The study response rate was 80.6%. The mean ± SD age of the respondents was 51.5 ± 10.9 years. The majority of the study respondents were female (62.5%), people living in rural settings (53.8%), and farmers (22.1%). Time constraints, poor knowledge about DR, and long waiting periods at the DR screening center were the main barriers to the uptake of DR screening. Compared to respondents in urban communities, those in rural settings were significantly concerned about cost (p < 0.001), travel distance to the MPHEC (p < 0.001), and poor information about DR screening (p = 0.002). More than half of the respondents (63.5%) had discontinued using pharmacotherapy for DM. There is a high rate of nonadherence to diabetes (DM) and DR treatment in PNG. There is a need for public health campaigns about DM and strategic DR screening at the community level in PNG and similar countries.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135935458","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}
Pub Date : 2023-09-07DOI: 10.3390/diabetology4030032
Ridhi R. Gudoor, A. Suits, Jay H. Shubrook
Type 2 diabetes mellitus (T2DM) is a debilitating, lifelong condition with a rising incidence. A wide variety of antihyperglycemic agents are available on the market to treat diabetes. However, the number of patients living with diabetes under suboptimal control remains relatively high. This calls into question whether the application of the current treatment standards is effective and durable to truly manage the disease well. This paper aims to highlight the various classes of antihyperglycemic agents from a pathophysiologic perspective and explore the best possible combination that can have a durable effect on diabetes management. To determine this, an eight-piece pathophysiologic puzzle was created, each piece representing an organ system affected by the disease—liver, pancreas (alpha and beta cells), muscle, adipose tissue, gut, brain, and kidneys. Choosing a combination therapy that is both durable and can effectively address all eight pieces of the puzzle can theoretically create sustainable ameliorating effects. This combination can potentially lead to reduced microvascular and macrovascular complications, as well as work towards creating an ideal long-term, affordable diabetes care plan.
{"title":"Perfecting the Puzzle of Pathophysiology: Exploring Combination Therapy in the Treatment of Type 2 Diabetes","authors":"Ridhi R. Gudoor, A. Suits, Jay H. Shubrook","doi":"10.3390/diabetology4030032","DOIUrl":"https://doi.org/10.3390/diabetology4030032","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is a debilitating, lifelong condition with a rising incidence. A wide variety of antihyperglycemic agents are available on the market to treat diabetes. However, the number of patients living with diabetes under suboptimal control remains relatively high. This calls into question whether the application of the current treatment standards is effective and durable to truly manage the disease well. This paper aims to highlight the various classes of antihyperglycemic agents from a pathophysiologic perspective and explore the best possible combination that can have a durable effect on diabetes management. To determine this, an eight-piece pathophysiologic puzzle was created, each piece representing an organ system affected by the disease—liver, pancreas (alpha and beta cells), muscle, adipose tissue, gut, brain, and kidneys. Choosing a combination therapy that is both durable and can effectively address all eight pieces of the puzzle can theoretically create sustainable ameliorating effects. This combination can potentially lead to reduced microvascular and macrovascular complications, as well as work towards creating an ideal long-term, affordable diabetes care plan.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75108626","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}
Pub Date : 2023-08-28DOI: 10.3390/diabetology4030030
Samira Sidani, K. Patel
Diabetes is a leading non-communicable disease with a huge and predictably increasing burden on individuals, societies and governments. Interprofessional education (IPE) aims to enhance healthcare providers’ competence and patient care by providing well-organised, coordinated interprofessional care (IPC) within teams of healthcare professionals of different disciplines. Interprofessional practices are crucial in diabetes care. However, evidence on the effect of diabetes-specific IPE on diabetes outcomes is limited. This study aims to survey and report recent findings on the impact of interprofessional approaches on the outcomes of diabetes management. A systematic search of PubMed and Google Scholar from 2008 was adopted to identify relevant studies. After screening for relevance, the studies used in this review were thematically analysed, and two main categories of the findings were isolated: the impact of IPE and IPC on enhanced care provision and on improved diabetes self-management. The results indicate that healthcare professionals and students and people with diabetes benefit from IPE/IPC to improve diabetes outcomes and quality of care. However, improving diabetes care is achieved when inhibitors are addressed to incorporate IPE in health professions curricula and to support IPC in clinical settings.
{"title":"Interprofessional Education in Diabetes Care—Findings from an Integrated Review","authors":"Samira Sidani, K. Patel","doi":"10.3390/diabetology4030030","DOIUrl":"https://doi.org/10.3390/diabetology4030030","url":null,"abstract":"Diabetes is a leading non-communicable disease with a huge and predictably increasing burden on individuals, societies and governments. Interprofessional education (IPE) aims to enhance healthcare providers’ competence and patient care by providing well-organised, coordinated interprofessional care (IPC) within teams of healthcare professionals of different disciplines. Interprofessional practices are crucial in diabetes care. However, evidence on the effect of diabetes-specific IPE on diabetes outcomes is limited. This study aims to survey and report recent findings on the impact of interprofessional approaches on the outcomes of diabetes management. A systematic search of PubMed and Google Scholar from 2008 was adopted to identify relevant studies. After screening for relevance, the studies used in this review were thematically analysed, and two main categories of the findings were isolated: the impact of IPE and IPC on enhanced care provision and on improved diabetes self-management. The results indicate that healthcare professionals and students and people with diabetes benefit from IPE/IPC to improve diabetes outcomes and quality of care. However, improving diabetes care is achieved when inhibitors are addressed to incorporate IPE in health professions curricula and to support IPC in clinical settings.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88084419","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}
Pub Date : 2023-08-17DOI: 10.3390/diabetology4030029
Marco Mancuso, Rocco Bulzomì, M. Mannisi, F. Martelli, C. Giacomozzi
3D-printed insoles are increasingly used for the management of foot pathologies, and the recent literature reports on various experimental studies dealing with either whole foot orthoses or pads fabricated through 3D-printing processes. In the case of diabetic foot disease, the main aim is to deliver more effective solutions with respect to the consolidated processes to reduce compressive risk forces at specific plantar foot sites. Clinical studies are, however, still limited, at least in peer-review journals. Additionally, in Italy, the manufacturing process of these medical devices has not been formally integrated yet into the list of care processes approved for reimbursement by the public healthcare service. Within the Italian DIAPASON project (DIAbetic PAtients Safe ambulatiON), a feasibility pilot study has been conducted in the territory on 21 patients with diabetic foot complications to assess the pros and cons of an innovative process. The process, which relies on in-shoe pressure measurements and on a patented 3D modeling and printing procedure, includes the prescription, design, manufacturing and testing of 3D-printed personalized insoles. The process has been tested in an ambulatory setting and showed the potential to be also implemented in community settings. In this paper, we report a case study on a single volunteer, and we describe and comment on how the whole process has been proven safe and suitable for the purpose.
{"title":"3D-Printed Insoles for People with Type 2 Diabetes: An Italian, Ambulatory Case Report on the Innovative Care Model","authors":"Marco Mancuso, Rocco Bulzomì, M. Mannisi, F. Martelli, C. Giacomozzi","doi":"10.3390/diabetology4030029","DOIUrl":"https://doi.org/10.3390/diabetology4030029","url":null,"abstract":"3D-printed insoles are increasingly used for the management of foot pathologies, and the recent literature reports on various experimental studies dealing with either whole foot orthoses or pads fabricated through 3D-printing processes. In the case of diabetic foot disease, the main aim is to deliver more effective solutions with respect to the consolidated processes to reduce compressive risk forces at specific plantar foot sites. Clinical studies are, however, still limited, at least in peer-review journals. Additionally, in Italy, the manufacturing process of these medical devices has not been formally integrated yet into the list of care processes approved for reimbursement by the public healthcare service. Within the Italian DIAPASON project (DIAbetic PAtients Safe ambulatiON), a feasibility pilot study has been conducted in the territory on 21 patients with diabetic foot complications to assess the pros and cons of an innovative process. The process, which relies on in-shoe pressure measurements and on a patented 3D modeling and printing procedure, includes the prescription, design, manufacturing and testing of 3D-printed personalized insoles. The process has been tested in an ambulatory setting and showed the potential to be also implemented in community settings. In this paper, we report a case study on a single volunteer, and we describe and comment on how the whole process has been proven safe and suitable for the purpose.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78083451","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}
Pub Date : 2023-08-14DOI: 10.3390/diabetology4030028
Bohyun Kim, J. Efird, Jie Hu
Diabetes is an independent risk factor for cognitive impairment, with the latter presenting challenges for diabetes self-management and glycemic control in individuals with type 2 diabetes. Predicated on the theory of unpleasant symptoms, the purpose of the current narrative review of the literature was to identify etiologic factors that influence cognitive impairment as a precursor to dementia in individuals with diabetes. Physiological, psychological, and situational factors were recognized as important life course components of cognitive impairment in later adulthood. Developing interventions targeting modifiable factors is warranted in preventing cognitive impairment in adults with diabetes.
{"title":"A Life Course Approach to Understanding Cognitive Impairment in Adults with Type 2 Diabetes: A Narrative Literature Review","authors":"Bohyun Kim, J. Efird, Jie Hu","doi":"10.3390/diabetology4030028","DOIUrl":"https://doi.org/10.3390/diabetology4030028","url":null,"abstract":"Diabetes is an independent risk factor for cognitive impairment, with the latter presenting challenges for diabetes self-management and glycemic control in individuals with type 2 diabetes. Predicated on the theory of unpleasant symptoms, the purpose of the current narrative review of the literature was to identify etiologic factors that influence cognitive impairment as a precursor to dementia in individuals with diabetes. Physiological, psychological, and situational factors were recognized as important life course components of cognitive impairment in later adulthood. Developing interventions targeting modifiable factors is warranted in preventing cognitive impairment in adults with diabetes.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"264 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77778009","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}
Pub Date : 2023-08-01DOI: 10.3390/diabetology4030027
T. Nguyen, Thu Thuy Thi Pham, M. Burns, T. Nguyen
Background: There is limited evidence on the association between chronic kidney disease (CKD) and frailty in older people in Vietnam. This study aimed to investigate the prevalence of frailty and its impact on mortality in older patients with end-stage renal disease. Method: This is a prospective, observational study performed at two large Dialysis Centres in Vietnam from November 2020 to June 2021. Consecutive older patients diagnosed with end-stage renal disease and on haemodialysis were recruited. Participants’ frailty status was defined by the Clinical Frailty Scale (CFS). The study outcome was all-cause mortality at the sixth month. Results: A total of 175 participants were recruited (mean age 72.4 years, 58.9% female). Using the cut point of CFS ≥ 4, 87.4% of the participants were frail. Mortality at the sixth month was 14.9%, 31.9% in participants with CFS ≥ 7, 12.8% in participants with CFS = 6, 7.5% in participants with CFS from 4 to 5, and 4.5% in participants with CFS ≤ 3 (p = 0.001). Cox regression analysis showed that, compared with the non-frail participants, the probability of death over 6 months was nearly two-fold higher in the mildly frail, three-fold higher in the moderately frail, and nine-fold higher in the severely frail participants. Conclusions: This study demonstrated a very high prevalence of frailty in older patients with end-stage renal disease and dialysis and the significant impact of frailty severity on mortality. Healthcare providers should consider incorporating frailty screening into routine care for older patients with end-stage renal disease and dialysis.
{"title":"Frailty in Older Patients with End-Stage Renal Disease and Undergoing Chronic Haemodialysis in Vietnam","authors":"T. Nguyen, Thu Thuy Thi Pham, M. Burns, T. Nguyen","doi":"10.3390/diabetology4030027","DOIUrl":"https://doi.org/10.3390/diabetology4030027","url":null,"abstract":"Background: There is limited evidence on the association between chronic kidney disease (CKD) and frailty in older people in Vietnam. This study aimed to investigate the prevalence of frailty and its impact on mortality in older patients with end-stage renal disease. Method: This is a prospective, observational study performed at two large Dialysis Centres in Vietnam from November 2020 to June 2021. Consecutive older patients diagnosed with end-stage renal disease and on haemodialysis were recruited. Participants’ frailty status was defined by the Clinical Frailty Scale (CFS). The study outcome was all-cause mortality at the sixth month. Results: A total of 175 participants were recruited (mean age 72.4 years, 58.9% female). Using the cut point of CFS ≥ 4, 87.4% of the participants were frail. Mortality at the sixth month was 14.9%, 31.9% in participants with CFS ≥ 7, 12.8% in participants with CFS = 6, 7.5% in participants with CFS from 4 to 5, and 4.5% in participants with CFS ≤ 3 (p = 0.001). Cox regression analysis showed that, compared with the non-frail participants, the probability of death over 6 months was nearly two-fold higher in the mildly frail, three-fold higher in the moderately frail, and nine-fold higher in the severely frail participants. Conclusions: This study demonstrated a very high prevalence of frailty in older patients with end-stage renal disease and dialysis and the significant impact of frailty severity on mortality. Healthcare providers should consider incorporating frailty screening into routine care for older patients with end-stage renal disease and dialysis.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88770163","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}
Pub Date : 2023-07-28DOI: 10.3390/diabetology4030026
Mariza Brandão Palma, Elisa Paolin, I. M. Ferreira de Melo, Francisco de Assis Leite Souza, Álvaro Aguiar Coelho Teixeira, Leucio Duarte Vieira, F. Naro, A. Graziano, A. F. Soares
Background: Tissue healing consists of four main phases: coagulation, inflammation, proliferation, and remodeling. In diabetic patients, this process is stagnant in the inflammatory stage, leading to chronic wounds. The aim of this study is to evaluate in an animal model the biological evidence related to the use of the Rigenera® technology (Turin Italy), an innovative mechanical procedure to isolate autologous micrografts (AMG). Methods: Fifty male Wistar rats were divided into four groups: control (C), control treated with micrografts (CM), diabetic (DB), and diabetic treated with micrografts (DBM). The experimental setup involved: the quantification of the total collagen and elastic fibers; histopathological analysis; immunohistochemical analysis for collagen type I (COL1), collagen type III (COL3), vascular endothelial growth factor (VEGF-A), and interleukin 4 (IL4) and 10 (IL10); evaluation of the oxidative stress; measurement of gluthatione (GSH); and, finally, an enzyme-linked immunosorbent assay (ELISA) on tumor necrosis factor-α (TNF-α). Results: The AMG technology induces a faster healing process: VEGF-A, IL4, IL10, and GSH increased, while TNF-α and oxidative stress decreased. Conclusions: Animals treated with micrografts showed more favorable results for healing compared to those that did not receive treatment, demonstrating a positive participation of the micrografts in the treatment of difficult-to-heal wounds.
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