المؤلفون: Ali, Namam, El Hamdaoui, Soumia, Nefs, Giesje, Tack, Cornelis J, De Galan, Bastiaan E

المصدر: BMJ Open Diabetes Res Care

مصطلحات موضوعية: Clinical care/Education/Nutrition, edu, socio

الوصف: INTRODUCTION: Various studies have shown a number of glycemic parameters to improve over several weeks in people with type 1 diabetes during the first surge of the COVID-19 pandemic. Whether and to what extent such improvement is sustained during following COVID-19 surges remains unknown. Therefore, the aim of this study was to investigate glycemic parameters during the first year of the COVID-19 pandemic in people with type 1 diabetes and to determine factors associated with glycemic improvement. RESEARCH DESIGN AND METHODS: This was an observational cohort study in people with type 1 diabetes, aged ≥16 years. We compared glycated hemoglobin (HbA(1c)) and flash glucose monitoring (FGM) downloads between the prelockdown period and approximately 1 year thereafter. Using logistic regression analysis, we assessed associations between an HbA(1c) reduction of at least 0.5% (~5.5 mmol/mol) with baseline clinical characteristics and self-reported changes in psychological well-being and lifestyle behavior related to COVID-19. RESULTS: A total of 437 participants were included. As compared with prepandemic data, 1 year after the start of the COVID-19 pandemic and associated lockdowns, HbA(1c) had decreased from 7.9%±1.1% (63±12 mmol/mol) to 7.5%±1.0% (59±11 mmol/mol) (p13.9 mmol/L) range and glucose variability all decreased (all p<0.05). FGM use, higher HbA(1c) at baseline and current smoking were independently associated with an HbA(1c) decrease of at least 0.5%, whereas self-reported changes in psychological well-being and lifestyle behavior related to the first surge of the COVID-19 pandemic and associated lockdowns were not. CONCLUSIONS: The COVID-19 pandemic and related lockdown measures were associated with improvement in glucometrics, including HbA(1c) and FGM data, in individuals with type 1 diabetes, particularly in FGM users, those with higher HbA(1c) at baseline or current .

العلاقة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125382Test/

الإتاحة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125382Test/

المؤلفون: Anders L Carlson, Timothy Dilon Daniel, Andrea DeSantis, Serge Jabbour, Esra Karslioglu French, Davida Kruger, Eden Miller, Kerem Ozer, Tom Elliott

المصدر: BMJ Open Diabetes Research & Care, Vol 10, Iss 1 (2022)
BMJ Open Diabetes Research & Care

مصطلحات موضوعية: Adult, Blood Glucose, Canada, insulin, Blood Glucose Self-Monitoring, Endocrinology, Diabetes and Metabolism, RC648-665, United States, Diseases of the endocrine glands. Clinical endocrinology, Diabetes Mellitus, Type 2, type 2, glycated hemoglobin A, diabetes mellitus, Humans, Clinical care/Education/Nutrition, Retrospective Studies

الوصف: IntroductionEvidence supporting use of continuous glucose monitoring in type 2 diabetes treated with basal insulin is unclear. This real-world study aimed to assess the impact on glycated hemoglobin (HbA1c) of flash glucose monitoring use in adults with type 2 diabetes managed with basal insulin.Research design and methodsMedical records were reviewed for adult individuals with type 2 diabetes using basal insulin for ≥1 year with or without additional antihyperglycemic medication, HbA1c 8.0%–12.0% prior to FreeStyle Libre Flash Glucose Monitoring use for ≥90 days and an HbA1c measurement recorded between 90 and 194 days after device use. Exclusion criteria included utilization of bolus insulin. Meta-analysis data are from the current study (USA) and a similar Canadian cohort.ResultsMedical record analysis (n=100) from 8 USA study sites showed significant HbA1c decrease of 1.4%±1.3%, from 9.4%±1.0% at baseline to 8.0%±1.2% after device use, pMeta-analysis of medical records from USA and Canada sites (n=191) showed HbA1c significantly decreased by 1.1%±0.14% (mean±SE), from baseline 9.2%±1.0% to 8.1%±1.1%, p≤0.0001, with moderate to high heterogeneity between sites (Q=43.9, I2=74.9, pThe HbA1c improvement in both groups was observed by age group, body mass index, duration of insulin use and sex at birth.ConclusionsIn a real-world retrospective USA study and a meta-analysis of a larger USA and Canada cohort, HbA1c significantly reduced in basal insulin-treated type 2 diabetes, without bolus insulin initiation and following the commencement of flash glucose monitoring technology.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5852317dfdda8f87f5f641c31a614f41Test
https://drc.bmj.com/content/10/1/e002590.fullTest

المؤلفون: Anthony L. McCall, Mark R. Conaway, Matthew Moncrief, Tamara K. Oser, Daniel J. Cox

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 2 (2021)
BMJ Open Diabetes Research & Care

مصطلحات موضوعية: Research design, Adult, Blood Glucose, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Diseases of the endocrine glands. Clinical endocrinology, law.invention, Randomized controlled trial, Weight loss, law, Diabetes mellitus, Internal medicine, Weight Loss, Medicine, Humans, Glycemic, Aged, Aged, 80 and over, business.industry, Blood Glucose Self-Monitoring, life style, Middle Aged, medicine.disease, RC648-665, Regimen, Diabetes Mellitus, Type 2, type 2, diabetes mellitus, glycated hemoglobin A, Clinical care/Education/Nutrition, hyperglycemia, medicine.symptom, business, Body mass index, Follow-Up Studies

الوصف: IntroductionWe previously reported the physical, psychological and behavioral 3-month post-treatment results of a randomized controlled trial comparing glycemic excursion minimization (GEM) versus conventional weight loss (WL) therapy in the management of type 2 diabetes (T2D). GEM is a paradigm shift in the lifestyle management of T2D that focuses on reducing postnutrient glucose excursions, rather than reducing weight. We now present the 13-month follow-up results.Research design and methodsThe initial study sample of 172 were 30–80 years old, had T2D for ≤10 years, an HbA1c ≥6.8% (51 mmol/mol), and were not using insulin. Participants were randomized to 6 hours of group treatment, either to WL or one of three versions of GEM. GEM groups differed in degree of blood glucose (BG) feedback provided during treatment: no recommended feedback, systematic capillary BG feedback before and after nutrient intake and physical activity, or continuous glucose monitoring. Since these GEM groups did not differ in pre-post improvement they were combined for initial and current analyses. Of those who completed the 3-month postassessment, 100% and 96% of the WL and GEM participants completed the 13-month follow-up assessment.ResultsPre to follow-up within-group comparisons indicated WL participants sustained improvement in body mass index (BMI) (−0.9±1.4, p=0.001). GEM participants continued to benefit in their HbA1c (−0.5±1.4, pConclusionsWhile WL sustained improvement in BMI, GEM sustained benefits across a broad range of physical, behavioral and psychological parameters, beneficial for clinicians and adults with T2D. This may be especially relevant for primary care physicians who manage about 90% of patients with T2D.Trial registration numberNCT03196895.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7e2482439ac4be3bab83a024a624790aTest
https://drc.bmj.com/content/9/2/e002403.fullTest

المؤلفون: Xu-Pei Gan, Li Chen, Wen-Yu Liu, Hong-Hui Qiu, Xian-Ming Xu, Yan-Nan Cao, De-Cui Cheng, Dong-Yao Zhang, Yao Su, Fei-Fei Li, Hong-Kun Wang, Jian-Fei Zu

المصدر: BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care, Vol 9, Iss 2 (2021)

مصطلحات موضوعية: medicine.drug_class, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Antibiotics, Physiology, Diseases of the endocrine glands. Clinical endocrinology, Pregnancy, Diabetes mellitus, Medicine, antibodies, Humans, Insulin, Child, reproductive and urinary physiology, Fetus, business.industry, nutritional sciences, gynecology, Environmental exposure, computer.file_format, RC648-665, medicine.disease, Gut microbiome, Anti-Bacterial Agents, Gastrointestinal Microbiome, Glucose, Female, Clinical care/Education/Nutrition, gastrointestinal tract, Pregnant Women, ABX test, business, computer

الوصف: IntroductionExposure to antibiotics (ABX) during pregnancy can have a systematic effect on both fetal and maternal health. Although previous biomonitoring studies have indicated the effects on children of extensive exposure to ABX, studies on pregnant women remain scarce. To explore the effect on pregnant women of environmental exposure to ABX through accidental ingestion and identify potential health risks, the present study investigated 122 pregnant women in East China between 2019 and 2020.Research design and methodsThe presence of six categories of ABX (quinolones, sulfonamides, lincosamides, tetracyclines, amide alcohol ABX, and β-lactams) in plasma samples taken from the pregnant women was investigated using an ABX kit and a time-resolved fluorescence immunoassay.ResultsAll six ABX were detected in the plasma, with a detection rate of 17.2%. It was discovered that the composition of intestinal flora in pregnant women exposed to ABX was different from that of pregnant women who had not been exposed to ABX. The intestinal flora of pregnant women exposed to ABX also changed at both the phylum and genus levels, and several genera almost disappeared. Furthermore, the metabolic levels of glucose and insulin and the alpha diversity of pregnant women exposed to ABX were higher than those of pregnant women not exposed to ABX.ConclusionPregnant women are potentially at higher risk of adverse microbial effects. Glucose metabolism and insulin levels were generally higher in pregnant women exposed to ABX than in unexposed women. Also, the composition and color of the gut microbiome changed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::57f98dbc36a7831bc86fa5262f58abe6Test
http://europepmc.org/articles/PMC8572386Test

المؤلفون: Mei Zhang, Yanying Li, Fupeng Liu, Kejun Wang, Peng Sun, Hongshan Shen, Bo Ban, Huichao Xu, Qing Yang

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 2 (2021)
BMJ Open Diabetes Research & Care

مصطلحات موضوعية: medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Diseases of the endocrine glands. Clinical endocrinology, chemistry.chemical_compound, Diabetes mellitus, Internal medicine, medicine, Humans, Muscle, Skeletal, muscle weakness, Macrovascular disease, Creatinine, Integrases, biology, nutritional sciences, business.industry, diabetes complications, Muscle weakness, medicine.disease, RC648-665, Cross-Sectional Studies, Glucose, Endocrinology, Postprandial, Diabetes Mellitus, Type 2, chemistry, Cystatin C, Sarcopenia, biology.protein, Clinical care/Education/Nutrition, type 2 diabetes, medicine.symptom, business, Biomarkers

الوصف: IntroductionSince the ratio of creatinine to cystatin C (Cre/CysC) can reflect muscle volume, it has been proven to be a predictor of sarcopenia in patients with or without diabetes. Here, we investigated the predictive value of Cre/CysC for the skeletal muscle composition and its correlations with glucose disposal ability and diabetic complications in patients with type 2 diabetes.Research design and methodsThe skeletal muscle index (SMI) and mean skeletal muscle attenuation (MMA) values of 193 patients with type 2 diabetes were obtained through analyses of CT images at the lumbar 3 level.ResultsSerum Cre/CysC was significantly correlated with both the SMI (r=0.375, pConclusionsCre/CysC may be a valuable predictor of skeletal muscle composition in type 2 diabetes. Patients with a higher Cre/CysC may have a better ability to dispose of postprandial glucose and are at a lower risk of macrovascular disease.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f2d9755451d98b071619799ae725d7b6Test
https://drc.bmj.com/content/9/2/e002430.fullTest

المؤلفون: Jen Cross, Gerry Rayman, W. Garry John, Sanjeev Sharma

المصدر: BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care, Vol 9, Iss 2 (2021)

مصطلحات موضوعية: Research design, diabetes mellitus type 1, diabetes mellitus type 2, HbA1c, Coronavirus disease 2019 (COVID-19), Endocrinology, Diabetes and Metabolism, Feedback form, Sample (statistics), Diseases of the endocrine glands. Clinical endocrinology, Healthy volunteers, medicine, Humans, Pandemics, Glycated Hemoglobin, business.industry, SARS-CoV-2, COVID-19, Negative bias, medicine.disease, RC648-665, Clinical Practice, Feasibility Studies, Medical emergency, Sample collection, Clinical care/Education/Nutrition, business

الوصف: IntroductionThe COVID-19 pandemic has reduced the accessibility to hemoglobin A1c (HbA1c) tests required for virtual diabetes clinics. The aim was to develop and validate a user-friendly postal system for remote HbA1c monitoring.Research design and methodsValidation: A total of 123 capillary blood samples from people with diabetes (PWD) needing face-to-face consultations along with healthy volunteers were measured on a point-of-care (POC) Siemens DCA Vantage Analyzer. Another sample of 5–10 drops was simultaneously collected in a K2EDTA tube (BD Microtainer) and stored for up to 12 days at room temperature for subsequent retesting. Feasibility: During October to December 2020, a total of 286 postal HbA1c kits were sent to PWD prior to their virtual consultation. These contained sample collection guidance, the necessary equipment and a feedback form. As per Packing Instruction 650 regulations, these were posted back to the diabetes center for HbA1c testing on the POC analyzer.ResultsThere was a strong correlation between the first and the stored sample (R2=0.978). There was a small clinically insignificant negative bias −1.53 mmol/mol (2 SD = 3.10 mmol/mol). Bland-Altman plots showed 93% of results within 2 SD. Of the 87% of returned kits, only one sample failed to be analyzed. 94% of PWD who provided feedback were happy to use the postal HbA1c system again.ConclusionsA robust user-friendly postal HbA1c system has been created and successfully integrated into clinical practice using the existing POC equipment at the diabetes center. It provides accurate HbA1c results and is an invaluable tool for remote monitoring of HbA1c in PWD—both during and after the pandemic.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::681db6c85efe45605e0ef869f07aa094Test
http://europepmc.org/articles/PMC8593276Test

المؤلفون: Philip C Johnston, Tunde Peto, Nicola Quinn, Catherine Jamison, Laura Cushley, Rossella D'Aloisio

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021)
BMJ Open Diabetes Research & Care
Jamison, C, Peto, T, Quinn, N, D'Aloisio, R, Cushley, L N & Johnston, P C 2021, ' Screening attendance, prevalence and severity of diabetic retinopathy (DR) in a cohort of patients with diabetes mellitus secondary to chronic pancreatitis (DMsCP) in Northern Ireland ', BMJ open diabetes research & care, vol. 9, e002267 . https://doi.org/10.1136/bmjdrc-2021-002267Test

مصطلحات موضوعية: medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, prevalence, pancreatitis, Type 2 diabetes, Northern Ireland, Diseases of the endocrine glands. Clinical endocrinology, diabetic eye screening, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Diabetes mellitus, Pancreatitis, Chronic, Prevalence, Medicine, Humans, pancreas, Diabetic Retinopathy, diabetes, business.industry, Attendance, eye diseases, diabetes complications, Diabetic retinopathy, medicine.disease, RC648-665, Diabetes Mellitus, Type 2, Cohort, Etiology, Pancreatitis, Clinical care/Education/Nutrition, business, Body mass index

الوصف: IntroductionThis study investigated Northern Ireland Diabetic Eye Screening Programme (NIDESP) attendance and diabetic retinopathy (DR) prevalence/severity in patients with diabetes mellitus secondary to chronic pancreatitis (PwDMsCP).Research design and methodsMedical/NIDESP records for all PwDMsCP attending the pancreatic diabetes clinic were analyzed in 2017 (n=78) and 2019 (n=94).ResultsBetween 2017 and 2019, those without DR decreased (76% to 63%); mild non-proliferative DR (NPDR), severe NPDR and PDR were found in 30%, 2% and 5%, respectively (previously 18%, 4%, 2%); diabetic maculopathy (DMac) was present in 12% (previously 10%). There was no significant difference between worst-eye DR/DMac grade and HbA1c, gender, body mass index, pancreatitis etiology and screening attendance (p>0.05). Patients with proliferative DR had longer diabetes and pancreatitis duration than DR-free patients (both p=0.001).ConclusionsDR prevalence was similar in PwDMsCP and patients with type 2 diabetes of similar disease duration. This work demonstrates the importance of reaching all patients for establishing DR severity reliably and to provide accessible, equitable care to PwDMsCP.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::25ed8c1a07473acd005dd468cb6f3bbaTest
https://drc.bmj.com/content/9/1/e002267.fullTest

المؤلفون: Amber B. Amspoker, Salim S. Virani, Ashok Balasubramanyam, Craig A. Johnston, Joshua D Landrum, Aanand D. Naik, John P. Foreyt, Elizabeth M Vaughan, Christie M. Ballantyne

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021)
BMJ Open Diabetes Research & Care

مصطلحات موضوعية: Research design, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Blood Pressure, Pilot Projects, Type 2 diabetes, Telehealth, community medicine, Diseases of the endocrine glands. Clinical endocrinology, Mentorship, Medicine, Humans, Glycated Hemoglobin, business.industry, Mentors, Health services research, medicine.disease, RC648-665, health services research, Diabetes Mellitus, Type 2, Cohort, medication adherence, Physical therapy, Observational study, Clinical care/Education/Nutrition, telemedicine, business, Body mass index

الوصف: IntroductionCommunity clinics often face pragmatic barriers, hindering program initiation and replication of controlled research trial results. Mentoring is a potential strategy to overcome these barriers. We piloted an in-person and telehealth mentoring strategy to implement the Telehealth-supported, Integrated Community Health Workers (CHWs), Medication-access, group visit Education (TIME) program in a community clinic.Research design and methodsParticipants (n=55) were low-income Latino(a)s with type 2 diabetes. The study occurred in two, 6-month phases. Phase I provided proof-of-concept and an observational experience for the clinic team; participants (n=37) were randomized to the intervention (TIME) or control (usual care), and the research team conducted TIME while the clinic team observed. Phase II provided mentorship to implement TIME, and the research team mentored the clinic team as they conducted TIME for a new single-arm cohort of participants (n=18) with no previous exposure to the program. Analyses included baseline to 6-month comparisons of diabetes outcomes (primary outcome: hemoglobin A1c (HbA1c)): phase I intervention versus control, phase II (within group), and research-run (phase I intervention) versus clinic-run (phase II) arms. We also evaluated baseline to 6-month CHW knowledge changes.ResultsPhase I: compared with the control, intervention participants had superior baseline to 6-month improvements for HbA1c (mean change: intervention: −0.73% vs control: 0.08%, p=0.016), weight (p=0.044), target HbA1c (p=0.035), hypoglycemia (p=0.021), medication non-adherence (p=0.0003), and five of six American Diabetes Association (ADA) measures (pConclusionsA novel, mentored approach to implement TIME into a community clinic resulted in improved diabetes outcomes. Larger studies of longer duration are needed to fully evaluate the potential of mentoring community clinics.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::91e2ec26ab1d5af1e3c6d8c42243b039Test
https://drc.bmj.com/content/9/1/e002320.fullTest

المؤلفون: Brian M. Frier, John B. Buse, Melanie J. Davies, Athena Philis-Tsimikas

المصدر: BMJ Open Diabetes Research & Care, Vol 9, Iss 1 (2021)
BMJ Open Diabetes Research & Care

مصطلحات موضوعية: diabetes mellitus type 1, insulin, diabetes mellitus type 2, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Type 2 diabetes, Diseases of the endocrine glands. Clinical endocrinology, Insulin, Regular, Human, Diabetes mellitus, Usually fatal, medicine, Humans, Intensive care medicine, Type 1 diabetes, business.industry, Insulin, medicine.disease, RC648-665, Diabetes Mellitus, Type 1, Transformative learning, Diabetes Mellitus, Type 2, Clinical care/Education/Nutrition, business

الوصف: Throughout history, up to the early part of the 20th century, diabetes has been a devastating disorder, particularly when diagnosed in childhood when it was usually fatal. Consequently, the successful pancreatic extraction of insulin in 1921 was a miraculous, life-changing advance. In this review, the truly transformative effect that insulin has had on the lives of people with type 1 diabetes and on those with type 2 diabetes who are also dependent on insulin is described, from the time of its first successful use to the present day. We have highlighted in turn how each of the many facets of improvements over the last century, from advancements in the properties of insulin and its formulations to the evolution of different methods of delivery, have led to continued improvement in clinical outcomes, through the use of illustrative stories from history and from our own clinical experiences. This review concludes with a brief look at the current challenges and where the next century of technological innovation in insulin therapy may take us.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::afdb332362a813d6c077d5332f410f6dTest
https://drc.bmj.com/content/9/1/e002373.fullTest

المؤلفون: Paolo Rossetti, Jorge Bondia, Alia García, Vanessa Moscardó, Julián Díaz, Agustín Ramos-Prol, Miguel Boronat

المصدر: BMJ Open Diabetes Research & Care

مصطلحات موضوعية: medicine.medical_specialty, Low protein, Alcohol Drinking, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Hypoglycemia, Glucagon, Internal medicine, Diabetes mellitus, medicine, Dietary Carbohydrates, blood glucose, Humans, Meals, Glycemic, Cross-Over Studies, business.industry, Insulin, medicine.disease, Crossover study, Endocrinology, Postprandial, type 1, Diabetes Mellitus, Type 1, Glucose, diabetes mellitus, Clinical care/Education/Nutrition, business

الوصف: IntroductionMeal composition is known to affect glycemic variability and glucose control in type 1 diabetes. The objective of this work was to evaluate the effect of high carbohydrate meals of different nutritional composition and alcohol on the postprandial glucose response in patients with type 1 diabetes.Research design and methodsTwelve participants were recruited to this randomized crossover trial. Following a 4-week run-in period, participants received a mixed meal on three occasions with the same carbohydrate content but different macronutrient composition: high protein-high fat with alcohol (0.7g/kg body weight, beer), high protein-high fat without alcohol, and low protein-low fat without alcohol at 2-week intervals. Plasma and interstitial glucose, insulin, glucagon, growth hormone, cortisol, alcohol, free fatty acids, lactate, and pH concentrations were measured during 6 hours. A statistical analysis was then carried out to determine significant differences between studies.ResultsSignificantly higher late postprandial glucose was observed in studies with higher content of fats and proteins (p=0.0088). This was associated with lower time in hypoglycemia as compared with the low protein and fat study (p=0.0179), at least partially due to greater glucagon concentration in the same period (p=0.04). Alcohol significantly increased lactate, decreased pH and growth hormone, and maintained free fatty acids suppressed during the late postprandial phase (pConclusionsOur data suggest that the addition of proteins and fats to carbohydrates increases late postprandial blood glucose. Moreover, alcohol consumption together with a mixed meal has relevant metabolic effects without any increase in the risk of hypoglycemia, at least 6 hours postprandially.Trial registration numberNCT03320993.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d306edccc02bde7b2e6b66f2417359b7Test
http://europepmc.org/articles/PMC8499260Test