scholarly journals 4125 Plan for a Retrospective Evaluation of a Multi-Modal Weight-centric Prediabetes Intervention.

2020 ◽  
Vol 4 (s1) ◽  
pp. 33-33
Author(s):  
Raoul J Manalac ◽  
Tiffany Stewart ◽  
Donna Ryan
Keyword(s):  
Glycemic Control ◽  
Lifestyle Modification ◽  
Model Program ◽  
Retrospective Evaluation ◽  
Initial Treatment Period ◽  
Weight Loss Goal ◽  
Calorie Diet ◽  
Blood Pressures ◽  
Study Population ◽  
Diabetes Progression

OBJECTIVES/GOALS: To determine if a multi-modal, interdisciplinary intervention delivered to a group of prediabetic patients will result in reduced rates of diabetes progression. This project is a retrospective evaluation that will exam the feasibility and possibly efficacy of this intervention. METHODS/STUDY POPULATION: We will evaluate outcomes of 50 participants for the clinic, aged 21-60 inclusive. Patients will have a Body Mass Index >25kg/m2 with a diagnosis of prediabetes. Patients must be non-pregnant, using approved contraception, and agree to not become pregnant for 1 year after enrollment. After enrollment, the initial treatment period is for 1 year and includes a 12 week low calorie diet plan, a 6-month intensive behavioral and lifestyle modification plan followed by a 6 month behavior reinforcement extension. Weight management medications may be used if appropriate for the patient from a clinical perspective during the 6-month intensive behavioral/lifestyle modification. RESULTS/ANTICIPATED RESULTS: It is anticipated that there will be decreased weight with a mean weight loss goal of approximately >10%. Furthermore, it is expect that there will be improvement of other markers of metabolic disease. These include improvement of lipid values (LDL-C, HDL-C, Triglycerides, Total Cholesterol) as well as blood pressure with expected blood pressures of below 130/80 in greater than 50% of participants. Finally, It is expected that 50% or greater participants will have improvement of glycemic control. It is anticipated that greater than 50% of participants will have improvement of glycemic control and achieve normoglycemia. These values will be determined based upon fasting glucose or A1c. DISCUSSION/SIGNIFICANCE OF IMPACT: The significance of this intervention is enormous. By demonstrating feasibility in this trial, we can work toward both assessing efficacy and possibly dissemination of this model program. If these interventions provide durable changes at scale, this could help slow the epidemic of obesity and obesity related comorbid conditions.

scholarly journals TO COMPARE THE EFFECT OF CHITOSAN, LIFESTYLE MODIFICATION, AND COMBINATION OF CHITOSAN AND LIFESTYLE MODIFICATION ON BODY MASS INDEX IN OBESE PATIENTS

2019 ◽  
pp. 230-233
Author(s):  
VASUNDHARA BHOPLE ◽  
DEEPAK BHOSLE
Keyword(s):  
Body Mass Index ◽  
Comparative Study ◽  
Body Mass ◽  
Lifestyle Modification ◽  
T Test ◽  
Pronounced Effect ◽  
Obese Patients ◽  
Open Label ◽  
Study Population ◽  
Pronounced Reduction

Objective: The objective of this study was to compare the effect of chitosan, lifestyle modification, and combination of chitosan and lifestyle modification on body mass index (BMI) in obese patients. Methods: A prospective, randomized, open-label comparative study conducted for the period of 24 weeks. The study population was enrolled in three groups (chitosan 500 mg BD, lifestyle modification, and chitosan 500 mg BD and lifestyle modification). Data were analyzed using “t”-test and ANOVA. Results: There is a reduction in BMI in all the three groups. However, when we combined chitosan and lifestyle modification, there is pronounced reduction in BMI, which is statistically significant (p<0.0001). Conclusions: Chitosan and lifestyle modification have more pronounced effect on reduction on BMI as compared to monotherapy alone.

Abstract P178: Sentinel Platform Reduces Blood Pressure And Crisis Hypertension (2020 Update)

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Nirav H Shah
Keyword(s):  
Blood Pressure ◽  
New York ◽  
Monitoring Program ◽  
Pressure Control ◽  
Uncontrolled Hypertension ◽  
Cloud Platform ◽  
Pressure Data ◽  
Blood Pressures ◽  
Study Population ◽  
Mobile Health Monitoring

Introduction: We assessed the efficacy of mobile healthhypertension monitoring for patients enrolled inMedicare’s Remote Physiologic Monitoring (RPM)program. Hypothesis: Uncontrolled hypertension is an increasingepidemic associated with cardiovascular disease.Despite many available treatments, the averagetime to blood pressure control is slow. Lack ofaccess to patient information including bloodpressure data outside of the clinic setting meansthat clinicians cannot easily titrate medications. Wehypothesized that mobile health monitoring andcommunication with clinicians in a Medicare cohortwould decrease the hypertension burden andmitigate crisis blood pressure in patients. Methods: 1,544 patients who had contributed ≥ 20 bloodpressure readings in a remote monitoring programwere included in the study population, spanningclinics in Florida, Tennessee, Arizona, Ohio, Texas,New York, and California. Eligible patients carried adiagnosis of hypertension and had been seen bytheir doctor within the year they were referred. Themobile health platform was utilized to aggregateblood pressure data, which was analyzed by aremote care team and provided to clinicians on amonthly basis. Patients’ doctors and their teamsreviewed and managed the patients based on thedata provided by the mobile-cloud platform. Theremote monitoring program provided alerts to clinicstaff for patients who had blood pressures greaterthan 180mm Hg systolic (crisis hypertension) forexpedited decision making. Results: 1,544 patients who provided >20 BP readingsfrom January 2018 to January 2020 wereincluded in the study. A total of 297,731 bloodpressure readings were included in thisanalysis. Patient readings were stratified byepoch chronologically. The first epoch (E1),represented the first 25% of readings in theremote monitoring system, and the fourth epoch(E4) represented the final 25% of readings.From E1 to E4, patients saw an averagedecrease of 3.8 mmHg in systolic bloodpressure (132.9 vs. 129.1; p<0.001). Theproportion of readings in crisis hypertensionrange decreased from 2.3% to 1.1%; p=0.03). Conclusions: RPM offers a scalable solution to resistant hypertension.

scholarly journals Risk and management of pre-diabetes

2019 ◽  
Vol 26 (2_suppl) ◽  
pp. 47-54 ◽  
Author(s):  
JWJ Beulens ◽  
F Rutters ◽  
L Rydén ◽  
O Schnell ◽  
L Mellbin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Early Stage ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Haemoglobin A1c ◽  
Risk Assessment Models ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Diabetes Progression

Type 2 diabetes mellitus (T2DM) is associated with a two- to four-fold increased risk of developing cardiovascular disease (CVD) and microvascular complications, which may already be present before diagnosis. It is, therefore, important to detect people with an increased risk of T2DM at an early stage. In order to identify individuals with so-called ‘pre-diabetes’, comprising impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), current guidelines have developed definitions based on fasting plasma glucose, two-hour glucose concentrations and haemoglobin A1c. Subjects with pre-diabetes are at an increased risk of developing T2DM and CVD. This elevated risk seems similar according to the different criteria used to define pre-diabetes. The risk of progression to T2DM or CVD does, however, depend on other risk factors such as sex, body mass index and ethnicity. Based on the risk factors to develop T2DM, many risk assessment models have been developed to identify those at highest risk. These models perform well to identify those at risk and could be used to initiate preventive interventions. Many studies have shown that lifestyle modification and metformin are effective in preventing the development of T2DM, although lifestyle modification seems to have a more sustainable effect. In addition, lifestyle modification seems more effective in those with IGT than those with IFG. In this review, we will describe the different definitions used to define pre-diabetes, progression from pre-diabetes to T2DM or other vascular complications, risk factors associated with progressions and the management of progression to T2DM, ending with clinical recommendations.

scholarly journals Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Jinming Fu ◽  
Yupeng Liu ◽  
Lei Zhang ◽  
Lu Zhou ◽  
Dapeng Li ◽  
...  
Keyword(s):  
Usual Care ◽  
Lifestyle Modification ◽  
Weighted Mean Difference ◽  
High Quality ◽  
High Potassium ◽  
Low Calorie ◽  
Low Calorie Diet ◽  
High Quality Evidence ◽  
Calorie Diet ◽  
Quality Evidence

Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta‐analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta‐analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow‐up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high‐quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50–9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80–5.28). Compared with usual care, moderate‐ to high‐quality evidence indicated that aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, breathing‐control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate‐ to high‐quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low‐calorie diet and low‐calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, salt restriction, breathing‐control, meditation and low‐calorie diet also have obvious effects on BP reduction.

scholarly journals Measures adopted for weight reduction among overweight and obese adults: a community based cross sectional study

2020 ◽  
Vol 7 (5) ◽  
pp. 1972
Author(s):  
Radhakrishnan A. ◽  
Karthik R. C. ◽  
Balaji Arumugam ◽  
M. Ezhilvanan
Keyword(s):  
Weight Reduction ◽  
Lifestyle Modification ◽  
Weight Maintenance ◽  
Cross Sectional Study ◽  
Obesity Prevalence ◽  
Sectional Study ◽  
Obese Adults ◽  
Community Based ◽  
Cross Sectional ◽  
Study Population

Background: Worldwide obesity prevalence has nearly doubled since 1980. Current guidelines recommend that “overweight” and “obese” individuals lose weight through engaging in lifestyle modification involving diet, exercise and other behaviour changes. It is necessary to prevent obesity so that the subsequent complications can be prevented.Methods: This community based cross sectional study was conducted in the field practice area of tertiary medical college from June 2019 to August 2019. Totally 154 participants enrolled in the study. Only those individuals who had body mass index (BMI) of more than 23 kg/m2 were included in the study.Results: Majority of the study subjects 57.1% (88) belonged to the age group of 21-40 years. We included only overweight and obese adults in the present study. In this study, 61% (94) of the study population belonged to obese- I category while 33.8% (52) belonged to obese- II and only 5.2% (3) of study population were overweight. Only 43% (66) of the study population had adopted some measures to reduce their weight. Out of these majority 69.7% (46) preferred walking while 12.1% (8) preferred jogging for reducing weight. Mean days of walking adopted was 3.7 days and mean minutes per day was 29.67 minutes.Conclusions: As seen in this study more than half of the study population had not taken any measures for weight reduction. Increased health awareness will improve their level of active participation in the weight reduction program such as diet modification and physical exercise promotes weight loss and weight maintenance.

scholarly journals An analytical study of the prevalence and prescribed pattern vascular complication for type II diabetic patient in Indian tertiary care hospitals

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 310-314
Author(s):  
Satya Preethi ◽  
Beeraka Chandra Sekhar ◽  
Pandiyan K R ◽  
Rajkumar R
Keyword(s):  
Glycemic Control ◽  
Lifestyle Modification ◽  
Patient Adherence ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Blood Glucose Control ◽  
Vascular Complications ◽  
Vascular Complication ◽  
Diabetic Patients ◽  
Diabetic Vascular Complications

Diabetes mellitus (DM) is a common metabolic disorder. It is associated with complications which will affect the quality of life. Failure to control elevated blood sugar or inadequate treatment of diabetes could cause many complications.  A prospective observational study is used to assess the prevalence of diabetic vascular complications in 105 types of II diabetic patients. A date was collected regarding patient's demographic and clinical characteristics. Based on our study criteria, males were more when compared to females in getting vascular complications & also. Complications were more prominent in the age group of 50-65years. Of all microvascular complications, Nephropathy was major, whereas, in macro-vascular complications, CAD was prominent. Poor glycemic control and a long length of ailment appear to be the most significant danger factors for these complexities. Doctors assume a significant function to endorse hostile to diabetic meds and Pharmacist plays a sharp task to assess the medicine design so as to accomplish fruitful treatment. The currently anti-diabetic drugs are effective, but a lot of factors such as patient adherence, education related to diabetes, lifestyle modification, cost and type of medication have an association with glycemic control. The commonly prescribed anti-diabetic drug was Insulin. Metformin was the most preferred drug both as monotherapy and combination therapy.  Although polypharmacy was observed, drug utilization pattern can be rational owing to a higher prevalence of complications. Minimization of the occurrence of complications should be courage by early diagnosis, intensive blood glucose control and rational drug selections.

scholarly journals Intraocular pressure following 18 hours of systemic dehydration in ocular normotensive healthy subjects

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Faustina K. Idu ◽  
Gladys O. George ◽  
Leonard F.O. Obika
Keyword(s):  
Intraocular Pressure ◽  
Plasma Osmolality ◽  
Baseline Measurement ◽  
Healthy Humans ◽  
Applanation Tonometer ◽  
Before And After ◽  
Blood Pressures ◽  
Study Population ◽  
The Mean

Aim: To investigate the effect of dehydration on intraocular pressure (IOP). Subjects: The study population comprised 50 subjects (27 men and 23 women) with a mean age of 42.84 ± 2.64 years.Method: The subjects dehydrated for 18 hours. IOP was assessed in both eyes using the Perkins handheld applanation tonometer. Baseline measurement of IOP was taken before the subjects dehydrated for 18 hours and repeated after dehydration. Blood samples were taken before and after dehydration for the determination of plasma osmolality and plasma antidiuretic hormone (ADH) concentrations.Results: A statistically significant (p < 0.001) reduction in the mean weight of subjects occurred after dehydration. There was a significant reduction in IOP from 16.68 mmHg ± 0.32 mmHg to 13.08 mmHg ± 0.31 mmHg after dehydration (p < 0.001). Mean plasma osmolality showed a statistically significant increase (p < 0.05) from baseline of 290.02 mOsmol/kg ± 1.25 mOsmol/kg to 294.96 mOsmol/kg ± 1.33 mOsmol/kg after dehydration. There was also a significant increase (p < 0.05) in mean plasma ADH concentration from 5.36 pg/mL ± 0.21 pg/mL to 6.40 pg/mL ± 0.20 pg/mL after dehydration. There were no significant differences in both systolic and diastolic blood pressures before and after dehydration.Conclusion: Dehydration decreases IOP in healthy humans; this decrease probably results from an increase in plasma osmolality and plasma ADH concentrations.

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