Pub Date : 2022-05-19DOI: 10.3390/diabetology3020025
M. Kirwan, K. Gwynne, Thomas Laing, Mellissa Hay, Noureen Chowdhury, C. Chiu
Background: Older people consistently report a desire to remain at home. Beat It is a community-based exercise and lifestyle intervention that uses evidence-based strategies to assist older people with type 2 diabetes mellitus (T2DM) to improve physical and functional fitness, which are crucial to maintain independence. This follow up, real-world study assessed the efficacy of Beat It and whether older adults with T2DM were able to maintain improvements in physical activity, waist circumference and fitness one year post completion. Methods: We have previously reported methods and results of short-term outcomes of Beat It. This paper reports anthropometric measurements and physical fitness outcomes of Beat it at 12-months post program completion and compares them to validated standards of fitness required to retain physical independence. Results: Improvements that were observed post program were maintained at 12 months (n = 43). While the number of participants who met fitness standards increased post program, not all increases were maintained at 12 months. Conclusions: This study provides promising early evidence that an eight-week, twenty-hour community-based clinician-led exercise and lifestyle program can improve health outcomes in older adults with T2DM which were retained for at least a year after program completion.
{"title":"Can Health Improvements from a Community-Based Exercise and Lifestyle Program for Older Adults with Type 2 Diabetes Be Maintained? A Follow up Study","authors":"M. Kirwan, K. Gwynne, Thomas Laing, Mellissa Hay, Noureen Chowdhury, C. Chiu","doi":"10.3390/diabetology3020025","DOIUrl":"https://doi.org/10.3390/diabetology3020025","url":null,"abstract":"Background: Older people consistently report a desire to remain at home. Beat It is a community-based exercise and lifestyle intervention that uses evidence-based strategies to assist older people with type 2 diabetes mellitus (T2DM) to improve physical and functional fitness, which are crucial to maintain independence. This follow up, real-world study assessed the efficacy of Beat It and whether older adults with T2DM were able to maintain improvements in physical activity, waist circumference and fitness one year post completion. Methods: We have previously reported methods and results of short-term outcomes of Beat It. This paper reports anthropometric measurements and physical fitness outcomes of Beat it at 12-months post program completion and compares them to validated standards of fitness required to retain physical independence. Results: Improvements that were observed post program were maintained at 12 months (n = 43). While the number of participants who met fitness standards increased post program, not all increases were maintained at 12 months. Conclusions: This study provides promising early evidence that an eight-week, twenty-hour community-based clinician-led exercise and lifestyle program can improve health outcomes in older adults with T2DM which were retained for at least a year after program completion.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"s5-35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90931666","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 : 2022-05-05DOI: 10.3390/diabetology3020023
F. Ena
There are about 200 million people on the move in the world, and approximately 50% of them are women. There are no clear migration plans for women leaving as a result of persecution, war, famine, climatic disasters or moving away from contexts of external abuse and even intrafamily violence. Gender-related violence, to which women are exposed in cultural contexts characterized by a patriarchal social organization, is manifested through different ways including, but not limited to, early marriages and genital mutilation, with reproductive health already being seriously impaired at an early age. To this must be added the consideration that low-income countries are not able to deal with chronic degenerative diseases with a multidisciplinary approach such as diabetes. Fragile or non-existent health systems are not prepared for this need, which now affects a third of all deaths from this cause. Compared to Italian mothers, women from high-migration pressure countries had a higher risk of gestational diabetes; in addition, young women of Ethiopian ethnicity are more exposed to increased diabetes risk, in an age- and BMI-dependent way. Gender inequalities are also more evident in migrants for other non-communicable diseases besides diabetes. A major effort is needed in terms of training practitioners and reorganization of basic health services, making them competent in an intercultural sense. Health education of the population as a whole and of women specifically is also needed to contain risk behavior and prevent the early onset of metabolic syndromes in general and of type 2 diabetes in particular.
{"title":"Gender Differences in Migration","authors":"F. Ena","doi":"10.3390/diabetology3020023","DOIUrl":"https://doi.org/10.3390/diabetology3020023","url":null,"abstract":"There are about 200 million people on the move in the world, and approximately 50% of them are women. There are no clear migration plans for women leaving as a result of persecution, war, famine, climatic disasters or moving away from contexts of external abuse and even intrafamily violence. Gender-related violence, to which women are exposed in cultural contexts characterized by a patriarchal social organization, is manifested through different ways including, but not limited to, early marriages and genital mutilation, with reproductive health already being seriously impaired at an early age. To this must be added the consideration that low-income countries are not able to deal with chronic degenerative diseases with a multidisciplinary approach such as diabetes. Fragile or non-existent health systems are not prepared for this need, which now affects a third of all deaths from this cause. Compared to Italian mothers, women from high-migration pressure countries had a higher risk of gestational diabetes; in addition, young women of Ethiopian ethnicity are more exposed to increased diabetes risk, in an age- and BMI-dependent way. Gender inequalities are also more evident in migrants for other non-communicable diseases besides diabetes. A major effort is needed in terms of training practitioners and reorganization of basic health services, making them competent in an intercultural sense. Health education of the population as a whole and of women specifically is also needed to contain risk behavior and prevent the early onset of metabolic syndromes in general and of type 2 diabetes in particular.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90272420","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 : 2022-05-05DOI: 10.3390/diabetology3020024
Kristine Zoëga Mikkelsen, Anna-Sofie Holtze Rosholm, Kim Lee, D. Grabowski
During the first lockdown of the COVID-19 pandemic, people with type 1 diabetes (T1D) were worried, stressed, and experienced changes in their self-management practices. Studies found that many had difficulties managing their disease, while others showed improvements. Since the first lockdown, the virus and subsequent lockdowns have become a more regular part of everyday life. The present study investigated how the COVID-19 pandemic, one year after its outbreak, has affected self-management in people with T1D. The dataset consisted of seven semi-structured interviews with adults with T1D, which were interpreted using Antonovsky’s theory of Sense of Coherence (SOC). We found that the pandemic and the ensuing lockdowns had contributed to better self-management in people with T1D, as they had developed a strong SOC. Knowledge from healthcare professionals and their own experiences with the COVID-19 pandemic had caused them to experience stronger comprehensibility, which had been crucial to experiencing strong manageability, enabling them to make active choices to maintain good glycemic control. Furthermore, better opportunities and more motivation had allowed them to experience stronger meaningfulness regarding immersing themselves in their treatment. Our findings show that, during health crises, having a strong SOC is important for disease management among people with T1D.
{"title":"Improved Self-Management in People with Type 1 Diabetes: A Qualitative Study of Sense of Coherence in Daily Life One Year after the First COVID-19 Lockdown in Denmark","authors":"Kristine Zoëga Mikkelsen, Anna-Sofie Holtze Rosholm, Kim Lee, D. Grabowski","doi":"10.3390/diabetology3020024","DOIUrl":"https://doi.org/10.3390/diabetology3020024","url":null,"abstract":"During the first lockdown of the COVID-19 pandemic, people with type 1 diabetes (T1D) were worried, stressed, and experienced changes in their self-management practices. Studies found that many had difficulties managing their disease, while others showed improvements. Since the first lockdown, the virus and subsequent lockdowns have become a more regular part of everyday life. The present study investigated how the COVID-19 pandemic, one year after its outbreak, has affected self-management in people with T1D. The dataset consisted of seven semi-structured interviews with adults with T1D, which were interpreted using Antonovsky’s theory of Sense of Coherence (SOC). We found that the pandemic and the ensuing lockdowns had contributed to better self-management in people with T1D, as they had developed a strong SOC. Knowledge from healthcare professionals and their own experiences with the COVID-19 pandemic had caused them to experience stronger comprehensibility, which had been crucial to experiencing strong manageability, enabling them to make active choices to maintain good glycemic control. Furthermore, better opportunities and more motivation had allowed them to experience stronger meaningfulness regarding immersing themselves in their treatment. Our findings show that, during health crises, having a strong SOC is important for disease management among people with T1D.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"198 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76960016","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 : 2022-04-26DOI: 10.3390/diabetology3020022
G. Guarino, F. Strollo, T. Della-Corte, E. Satta, C. Romano, C. Alfarone, G. Corigliano, M. Corigliano, G. Cozzolino, C. Brancario, C. Martino, D. Oliva, A. Vecchiato, C. Lamberti, Luca Franco, S. Gentile
Introduction: Metabolic Syndrome (MS) is a pathologic condition characterized by Type 2 diabetes mellitus (T2DM), insulin resistance, abdominal obesity, hypertension, and hyperlipidemia. Until now, specific drugs such as metformin (MET) have been used to address its individual components; however, according to the recommendation of WHO, various plant extracts might be used as alternative medicines due to the side effects of pharmacologic agents. Policaptil Gel Retard® (PGR), a macromolecule complex based on polysaccharides which slows down the absorption rates of carbohydrates and fats, proved effective against glucose abnormalities. Our study aimed to verify the short-term efficacy and safety of PGR under real-life conditions. Methods: We evaluated both the 6-month changes in metabolic parameters in Italian patients with MS and T2DM, and the 10-year CV risk score (10-y-CV-RS) from the CUORE equation, competitively randomized to Policaptil Gel Retard (2172 mg before each main meal); Group A, n = 75, or Metformin (1500–2000 mg/day equally divided between the two main meals), and Group B, n = 75. Results: Fasting plasma glucose and HbA1c decreased significantly and similarly (p < 0.001) in the two groups. A significant decrease in BMI (−20% in the PGR group (p < 0.01), −14.3% in the MET group (p < 0.05)), % visceral fat, and UA levels was also apparent in both groups (p < 0.01). The opposite occurred for lipid profile, which improved significantly in the PGR group but remained unchanged in the MET group. Consequently, only the PGR group experienced a significant decrease in the 10-y-CV-RS (31.4 ± 8.0 vs. 19.7 ± 5.2, p < 0.0001), whereas this remained unchanged in the MET group (32.2 ± 3.3 vs. 30.5 ± 8.7; p n.s.). Conclusions: PGR could represent a suitable alternative to MET as a first-line treatment option, especially now that an ever-increasing number of people prefer natural products based on plant extracts. This is particularly pertinent given that, besides trying to avoid gastrointestinal side-effects as much as possible, patients might be sensitive to ecotoxicology-related problems involving plants and animals caused by the worldwide spread of environmental MET metabolites.
{"title":"Comparison between Policaptil Gel Retard and Metformin by Testing of Temporal Changes in Patients with Metabolic Syndrome and Type 2 Diabetes","authors":"G. Guarino, F. Strollo, T. Della-Corte, E. Satta, C. Romano, C. Alfarone, G. Corigliano, M. Corigliano, G. Cozzolino, C. Brancario, C. Martino, D. Oliva, A. Vecchiato, C. Lamberti, Luca Franco, S. Gentile","doi":"10.3390/diabetology3020022","DOIUrl":"https://doi.org/10.3390/diabetology3020022","url":null,"abstract":"Introduction: Metabolic Syndrome (MS) is a pathologic condition characterized by Type 2 diabetes mellitus (T2DM), insulin resistance, abdominal obesity, hypertension, and hyperlipidemia. Until now, specific drugs such as metformin (MET) have been used to address its individual components; however, according to the recommendation of WHO, various plant extracts might be used as alternative medicines due to the side effects of pharmacologic agents. Policaptil Gel Retard® (PGR), a macromolecule complex based on polysaccharides which slows down the absorption rates of carbohydrates and fats, proved effective against glucose abnormalities. Our study aimed to verify the short-term efficacy and safety of PGR under real-life conditions. Methods: We evaluated both the 6-month changes in metabolic parameters in Italian patients with MS and T2DM, and the 10-year CV risk score (10-y-CV-RS) from the CUORE equation, competitively randomized to Policaptil Gel Retard (2172 mg before each main meal); Group A, n = 75, or Metformin (1500–2000 mg/day equally divided between the two main meals), and Group B, n = 75. Results: Fasting plasma glucose and HbA1c decreased significantly and similarly (p < 0.001) in the two groups. A significant decrease in BMI (−20% in the PGR group (p < 0.01), −14.3% in the MET group (p < 0.05)), % visceral fat, and UA levels was also apparent in both groups (p < 0.01). The opposite occurred for lipid profile, which improved significantly in the PGR group but remained unchanged in the MET group. Consequently, only the PGR group experienced a significant decrease in the 10-y-CV-RS (31.4 ± 8.0 vs. 19.7 ± 5.2, p < 0.0001), whereas this remained unchanged in the MET group (32.2 ± 3.3 vs. 30.5 ± 8.7; p n.s.). Conclusions: PGR could represent a suitable alternative to MET as a first-line treatment option, especially now that an ever-increasing number of people prefer natural products based on plant extracts. This is particularly pertinent given that, besides trying to avoid gastrointestinal side-effects as much as possible, patients might be sensitive to ecotoxicology-related problems involving plants and animals caused by the worldwide spread of environmental MET metabolites.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74496443","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 : 2022-04-24DOI: 10.3390/diabetology3020021
N. Chellan, C. Muller
Technological advances in the management and treatment of type 1 diabetes have afforded some patients the resources to better manage their condition and live full, healthy lives. One of these technologies is continuous glucose monitoring which allows patients and medical practitioners alike to receive real-time blood glucose readings, evaluate trends, and tailor insulin dosing to avoid both hyper- and hypoglycemic events. The benefit of such technology during exercise, particularly running or cycling, is invaluable. In this case report, we describe the effect of using a continuous glucose monitoring technology in a 38-year-old, brittle, type 1 diabetic female runner over two years. The combined effect of continuous glucose monitoring and exercise, primarily running, resulted in an almost two-fold reduction in HbA1C, a 21% reduction in total daily insulin usage from diagnosis approximately 20 years ago. The patient recorded an over 100% improvement in running capacity.
{"title":"Running with Type 1 Diabetes: A Case Report on the Benefit of Sensor Technology","authors":"N. Chellan, C. Muller","doi":"10.3390/diabetology3020021","DOIUrl":"https://doi.org/10.3390/diabetology3020021","url":null,"abstract":"Technological advances in the management and treatment of type 1 diabetes have afforded some patients the resources to better manage their condition and live full, healthy lives. One of these technologies is continuous glucose monitoring which allows patients and medical practitioners alike to receive real-time blood glucose readings, evaluate trends, and tailor insulin dosing to avoid both hyper- and hypoglycemic events. The benefit of such technology during exercise, particularly running or cycling, is invaluable. In this case report, we describe the effect of using a continuous glucose monitoring technology in a 38-year-old, brittle, type 1 diabetic female runner over two years. The combined effect of continuous glucose monitoring and exercise, primarily running, resulted in an almost two-fold reduction in HbA1C, a 21% reduction in total daily insulin usage from diagnosis approximately 20 years ago. The patient recorded an over 100% improvement in running capacity.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87972724","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 : 2022-04-24DOI: 10.3390/diabetology3020020
A. Charlot, J. Zoll
Metabolic syndrome (MetS) is a major societal concern due to its increasing prevalence and its high risk of cardiovascular complications. The ketogenic diet (KD), a high fat, low carbohydrate, and non-caloric restrictive diet, is a new popular weight loss intervention but its beneficial effects are controversial. This study aims to gather all of the relevant studies using KD for metabolic disease treatment to determine its beneficial effects and evaluate its safety and efficacy for patients. Following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 20 articles in the final review. Overall, most of the studies showed a significant effect of KD on weight loss (17/19 articles), BMI (7/7), glucose levels (9/13), insulin levels (7/9), HOMA-IR (4/5), HbA1c (7/7), total cholesterol (6/9), TG (13/15), AST (3/4), and ALT (3/5), and no major side effects. The results heterogeneity seems to be explained by a difference of diet composition and duration. In conclusion, KD is a safety diet which seems to be a promising approach for obesity and MetS treatment, even if the optimal carbohydrate proportion and diet duration must be explored to enhance the beneficial effects of KD.
{"title":"Beneficial Effects of the Ketogenic Diet in Metabolic Syndrome: A Systematic Review","authors":"A. Charlot, J. Zoll","doi":"10.3390/diabetology3020020","DOIUrl":"https://doi.org/10.3390/diabetology3020020","url":null,"abstract":"Metabolic syndrome (MetS) is a major societal concern due to its increasing prevalence and its high risk of cardiovascular complications. The ketogenic diet (KD), a high fat, low carbohydrate, and non-caloric restrictive diet, is a new popular weight loss intervention but its beneficial effects are controversial. This study aims to gather all of the relevant studies using KD for metabolic disease treatment to determine its beneficial effects and evaluate its safety and efficacy for patients. Following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 20 articles in the final review. Overall, most of the studies showed a significant effect of KD on weight loss (17/19 articles), BMI (7/7), glucose levels (9/13), insulin levels (7/9), HOMA-IR (4/5), HbA1c (7/7), total cholesterol (6/9), TG (13/15), AST (3/4), and ALT (3/5), and no major side effects. The results heterogeneity seems to be explained by a difference of diet composition and duration. In conclusion, KD is a safety diet which seems to be a promising approach for obesity and MetS treatment, even if the optimal carbohydrate proportion and diet duration must be explored to enhance the beneficial effects of KD.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89112879","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 : 2022-04-11DOI: 10.3390/diabetology3020019
Sumera Ahmed, Natasha Khokhar, J. Shubrook
Diabetes mellitus has become a non-infectious pandemic. The incidence of T2D has risen dramatically and recent rates have increased in many countries including Muslim countries. As the number of people who participate in Ramadan increases, health care professionals will need to become familiar with the traditions and help people stay healthy during the holy month of Ramadan. A key part of Ramadan is the practice of one month of fasting from sunrise to sunset. While this is a religious practice, it has significant impacts on the management of people with diabetes. This article will discuss the traditions associated with Ramadan and how to help people safely manage their diabetes while participating in Ramadan.
{"title":"Fasting during Ramadan: A Comprehensive Review for Primary Care Providers","authors":"Sumera Ahmed, Natasha Khokhar, J. Shubrook","doi":"10.3390/diabetology3020019","DOIUrl":"https://doi.org/10.3390/diabetology3020019","url":null,"abstract":"Diabetes mellitus has become a non-infectious pandemic. The incidence of T2D has risen dramatically and recent rates have increased in many countries including Muslim countries. As the number of people who participate in Ramadan increases, health care professionals will need to become familiar with the traditions and help people stay healthy during the holy month of Ramadan. A key part of Ramadan is the practice of one month of fasting from sunrise to sunset. While this is a religious practice, it has significant impacts on the management of people with diabetes. This article will discuss the traditions associated with Ramadan and how to help people safely manage their diabetes while participating in Ramadan.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"AES-2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84445608","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 : 2022-04-11DOI: 10.3390/diabetology3020018
J. M. Velasco, Marta Botella-Serrano, A. Sánchez-Sánchez, Aranzazu Aramendi, R. Martínez, E. Maqueda, O. Garnica, Sergio Contador, J. Lanchares, J. Hidalgo
Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood and stress influence blood glucose levels and variability. Material and Methods: Continuous glucose monitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucose values were recorded every 15 min. A daily survey was conducted through Google Forms, collecting information on mood and stress. The day was divided into six slots of 4-h each, asking the patient to assess each slot in relation to mood (sad, normal or happy) and stress (calm, normal or nervous). Different measures of glycemic control (arithmetic mean and percentage of time below/above the target range) and variability (standard deviation, percentage coefficient of variation, mean amplitude of glycemic excursions and mean of daily differences) were calculated to relate the mood and stress perceived by patients with blood glucose levels and glycemic variability. A hypothesis test was carried out to quantitatively compare the data groups of the different measures using the Student’s t-test. Results: Statistically significant differences (p-value < 0.05) were found between different levels of stress. In general, average glucose and variability decrease when the patient is calm. There are statistically significant differences (p-value < 0.05) between different levels of mood. Variability increases when the mood changes from sad to happy. However, the patient’s average glucose decreases as the mood improves. Conclusions: Variations in mood and stress significantly influence blood glucose levels, and glycemic variability in the patients analyzed with type 1 diabetes mellitus. Therefore, they are factors to consider for improving glycemic control. The mean of daily differences does not seem to be a good indicator for variability.
{"title":"Evaluating the Influence of Mood and Stress on Glycemic Variability in People with T1DM Using Glucose Monitoring Sensors and Pools","authors":"J. M. Velasco, Marta Botella-Serrano, A. Sánchez-Sánchez, Aranzazu Aramendi, R. Martínez, E. Maqueda, O. Garnica, Sergio Contador, J. Lanchares, J. Hidalgo","doi":"10.3390/diabetology3020018","DOIUrl":"https://doi.org/10.3390/diabetology3020018","url":null,"abstract":"Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood and stress influence blood glucose levels and variability. Material and Methods: Continuous glucose monitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucose values were recorded every 15 min. A daily survey was conducted through Google Forms, collecting information on mood and stress. The day was divided into six slots of 4-h each, asking the patient to assess each slot in relation to mood (sad, normal or happy) and stress (calm, normal or nervous). Different measures of glycemic control (arithmetic mean and percentage of time below/above the target range) and variability (standard deviation, percentage coefficient of variation, mean amplitude of glycemic excursions and mean of daily differences) were calculated to relate the mood and stress perceived by patients with blood glucose levels and glycemic variability. A hypothesis test was carried out to quantitatively compare the data groups of the different measures using the Student’s t-test. Results: Statistically significant differences (p-value < 0.05) were found between different levels of stress. In general, average glucose and variability decrease when the patient is calm. There are statistically significant differences (p-value < 0.05) between different levels of mood. Variability increases when the mood changes from sad to happy. However, the patient’s average glucose decreases as the mood improves. Conclusions: Variations in mood and stress significantly influence blood glucose levels, and glycemic variability in the patients analyzed with type 1 diabetes mellitus. Therefore, they are factors to consider for improving glycemic control. The mean of daily differences does not seem to be a good indicator for variability.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73842658","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 : 2022-04-01DOI: 10.3390/diabetology3020017
P. Clifton
We begin this editorial with a discussion about insulin [...]
我们以讨论胰岛素开始这篇社论[…]
{"title":"Editorial: Diabetology: Feature Papers 2021","authors":"P. Clifton","doi":"10.3390/diabetology3020017","DOIUrl":"https://doi.org/10.3390/diabetology3020017","url":null,"abstract":"We begin this editorial with a discussion about insulin [...]","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86240587","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 : 2022-03-16DOI: 10.3390/diabetology3010016
R. Beernink, J. Schuitemaker, M. Faas, L. Poston, S. White
Background: The aim of this study was to evaluate whether secreted frizzled-related protein 4 (sFRP4), secreted frizzled-related protein 5 (sFRP5), and chemerin serum concentrations in early pregnancy are associated with the development of gestational diabetes mellitus (GDM) in an obese cohort. In previous studies, increased sFRP4 and chemerin, and decreased sFRP5 concentrations were associated with the development of GDM in normal and overweight women. Methods: In this exploratory case control study, sFRP4, sFRP5, and chemerin serum concentrations were determined by ELISA in 50 obese women who developed GDM and 100 uncomplicated control pregnancies. Serum samples were obtained between 15+0–18+6 weeks’ gestational age and based on a priori known associations with the development of GDM, body mass index (BMI) and maternal age were selected for adjustment in multivariate analyses. Results: In this obese cohort (median BMI 35.7 kg/m2, IQR 33.2–40.3 kg/m2), the biochemical markers showed no association with GDM: sFRP5 odds ratio (OR) 0.44 (95% confidence interval (CI) 0.01–23.18, p = 0.687), sFRP4 OR 0.55 (95% CI 0.09–3.52, p = 0.528), and chemerin OR 3.47 (95% CI 0.05–227.72, p = 0.560). Adjustment for BMI and maternal age did not influence the association. None of the markers were significantly correlated with insulin resistance (HOMA2-IR). Conclusion: No association was found between sFRP4, sFRP5, or chemerin concentration and the development of GDM in a cohort of obese pregnant women. The absence of the association may indicate that these proteins play a lesser biological role in the pathophysiology of GDM in obese women.
背景:本研究的目的是评估在肥胖队列中，妊娠早期分泌卷曲相关蛋白4 (sFRP4)、分泌卷曲相关蛋白5 (sFRP5)和趋化素血清浓度是否与妊娠期糖尿病(GDM)的发生有关。在以往的研究中，在正常和超重女性中，sFRP4和趋化素的升高以及sFRP5浓度的降低与GDM的发生有关。方法:在本探索性病例对照研究中，采用ELISA法检测50例发生GDM的肥胖妇女和100例无并发症的对照妊娠的血清sFRP4、sFRP5和趋化素浓度。血清样本采集于15+ 0-18 +6周孕龄之间，根据已知与GDM发生的先验关联，选择体重指数(BMI)和母亲年龄进行多变量分析调整。结果:在该肥胖队列中(中位BMI为35.7 kg/m2, IQR为33.2-40.3 kg/m2)，生化指标与GDM无相关性:sFRP5比值比(OR) 0.44(95%可信区间(CI) 0.01-23.18, p = 0.687)， sFRP4比值比(OR) 0.55 (95% CI 0.09-3.52, p = 0.528)， chemerin比值比(OR) 3.47 (95% CI 0.05-227.72, p = 0.560)。BMI和母亲年龄的调整对这种关联没有影响。这些指标与胰岛素抵抗(HOMA2-IR)均无显著相关性。结论:在肥胖孕妇队列中，未发现sFRP4、sFRP5或趋化素浓度与GDM的发生相关。相关性的缺失可能表明这些蛋白在肥胖女性GDM的病理生理中发挥的生物学作用较小。
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