scholarly journals Diet, Inflammation, and Glycemic Control in Type 2 Diabetes: An Integrative Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-21 ◽  
Author(s):  
Sarah Y. Nowlin ◽  
Marilyn J. Hammer ◽  
Gail D'Eramo Melkus
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Inflammatory Markers ◽  
Glycosylated Hemoglobin ◽  
The United States ◽  
Adverse Outcomes ◽  
Integrative Review ◽  
Review Of The Literature ◽  
The Mediterranean

Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ≥20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA1c). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted.

scholarly journals Relationship between Lipid Profiles and Glycemic Control Among Patients with Type 2 Diabetes in Qingdao, China

2020 ◽  
Vol 17 (15) ◽  
pp. 5317
Author(s):  
Shukang Wang ◽  
Xiaokang Ji ◽  
Zhentang Zhang ◽  
Fuzhong Xue
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Health Management ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Lipid Profiles ◽  
Lipoprotein Cholesterol ◽  
Confounding Factors ◽  
The Relationship

Glycosylated hemoglobin (HbA1c) was the best indicator of glycemic control, which did not show the dynamic relationship between glycemic control and lipid profiles. In order to guide the health management of Type 2 diabetes (T2D), we assessed the levels of lipid profiles and fasting plasma glucose (FPG) and displayed the relationship between FPG control and lipid profiles. We conducted a cross-sectional study that included 5822 participants. Descriptive statistics were conducted according to gender and glycemic status respectively. Comparisons for the control of lipid profiles were conducted according to glycemic control. Four logistic regression models were generated to analyze the relationship between lipid profiles and glycemic control according to different confounding factors. The metabolic control percentage of FPG, triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) was 27.50%, 73.10%, 28.10%, 64.20% and 44.80% respectively. In the fourth model with the most confounding factors, the odds ratios (ORs) and 95% confidence intervals (CIs) of TG, TC, LDL-C and HDL-C were 0.989 (0.935, 1.046), 0.862 (0.823, 0.903), 0.987 (0.920, 1.060) and 2.173 (1.761, 2.683). TC and HDL-C were statistically significant, and TG and LDL-C were not statistically significant with adjustment for different confounding factors. In conclusion, FPG was significantly associated with HDL and TC and was not associated with LDL and TG. Our findings suggested that TC and HDL should be focused on in the process of T2D health management.

Management of Patients with Type 2 Diabetes by Pharmacists in Primary Care Clinics

1998 ◽  
Vol 32 (6) ◽  
pp. 636-641 ◽  
Author(s):  
Elizabeth A Coast-Senior ◽  
Beverly A Kroner ◽  
Catherine L Kelley ◽  
Lauren E Trilli
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Face To Face ◽  
Primary Care Clinics ◽  
Blood Glucose Concentrations

OBJECTIVE: To determine the impact of clinical pharmacists involved in direct patient care on the glycemic control of patients with type 2 diabetes mellitus. DESIGN: Eligible patients included those with type 2 diabetes who received insulin or were initiated on insulin therapy by the pharmacists and were willing to perform self-monitoring of blood glucose. The pharmacists provided diabetes education, medication counseling, monitoring, and insulin initiation and/or adjustments. All initial patient interactions with the pharmacists were face-to-face. Thereafter, patient–pharmacist interactions were either face-to-face or telephone contacts. SETTING: Two primary care clinics in a university-affiliated Veterans Affairs Medical Center. PARTICIPANTS: Study subjects were patients with type 2 diabetes who were referred to the pharmacists by their primary care providers for better glycemic control. OUTCOME MEASURES: Primary outcome variables were changes from baseline in glycosylated hemoglobin, fasting blood glucose, and random blood glucose measurements. Secondary outcomes were the number and severity of symptomatic episodes of hypoglycemia, and the number of emergency room visits or hospitalizations related to diabetes. Twenty-three veterans aged 65 ± 9.4 years completed the study. Fifteen (65%) patients were initiated on insulin by the pharmacists; 8 (35%) were already using insulin. Patients were followed for a mean ± SD of 27 ± 10 weeks. Glycosylated hemoglobin, fasting blood glucose concentrations, and random blood glucose concentrations significantly decreased from baseline by 2.2% (p = 0.00004), 65 mg/dL (p < 0.01), and 82 mg/dL (p = 0.00001), respectively. Symptomatic hypoglycemic episodes occurred in 35% of patients. None of these episodes required physician intervention. CONCLUSIONS: This study demonstrates that pharmacists working as members of interdisciplinary primary care teams can positively impact glycemic control in patients with type 2 diabetes requiring insulin.

Clinical Efficacy of Colesevelam in Type 2 Diabetes Mellitus

2011 ◽  
Vol 24 (4) ◽  
pp. 417-425 ◽  
Author(s):  
Luigi Brunetti ◽  
R. Keith Campbell
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Tolerability Profile ◽  
Diet And Exercise

Purpose: The clinical experience and role in therapy of colesevelam in type 2 diabetes mellitus (T2DM) is discussed. Summary: Colesevelam HCl is a bile acid sequestrant (BAS) with proven efficacy in reducing elevated low-density lipoprotein cholesterol (LDL-C) in patients with primary hyperlipidemia. Colesevelam HCl gained food and drug administration (FDA) approval in 2008 as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. In randomized controlled studies, colesevelam (add-on therapy with metformin, sulfonylureas, and insulin) has shown significant percentage reductions in glycosylated hemoglobin A1c (HbA1c) ranging from 0.5% to 0.54%. Reductions in LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) ranging from –12.8% to –16.7% and –4.0% to –10.3%, respectively, were also observed. Although no direct comparisons have been made, the safety and tolerability profile of this agent appears to be better than other BAS, with the most common side effects being gastrointestinal related. Conclusion: Colesevelam is effective as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. Due to its effects upon LDL-C and glycemic parameters and favorable safety profile, colesevelam can play a role in an array of T2DM patients.

scholarly journals Effects of an Herbal Combination on Glycemic Control and Lipid Profile in Diabetic Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

2017 ◽  
Vol 22 (4) ◽  
pp. 798-804 ◽  
Author(s):  
Reyhaneh Shokoohi ◽  
Saeed Kianbakht ◽  
Mohammad Faramarzi ◽  
Masoud Rahmanian ◽  
Farzaneh Nabati ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Controlled Clinical Trial ◽  
Cholesterol Levels

The present study was conducted to explore the efficacy and safety of a herbal combination in the treatment of women with hyperlipidemic type 2 diabetes. The herbal combination capsule (600 mg) contained Terminalia chebula fruit extract (200 mg), Commiphora mukul (200 mg), and Commiphora myrrha oleo-gum-resin (200 mg), and the placebo capsule contained 600 mg toast powder. The patients in one group took the herbal combination and those in the other group took placebo capsules 3 times a day for 3 months. In the herbal combination–treated patients, the fasting blood glucose, total cholesterol, and low-density lipoprotein cholesterol levels were decreased and hidh-density lipoprotein cholesterol levels was increased significantly at the endpoint compared with the placebo and baseline. Other blood parameters such as glycosylated hemoglobin, triglyceride, blood urea nitrogen, creatinine, SGOT, and SGPT levels were not significantly changed after 3 months in both groups. In conclusion, the herbal combination improves glycemic control and lipid profile in women with hyperlipidemic type 2 diabetes without any adverse events.

Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States

2015 ◽  
Vol 25 (2) ◽  
pp. 120-138 ◽  
Author(s):  
Lidia G. Compeán Ortiz ◽  
Beatriz Del Ángel Pérez ◽  
Eunice Reséndiz González ◽  
Socorro Piñones Martínez ◽  
Nora H. González Quirarte ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Low Income ◽  
Self Care ◽  
The United States ◽  
Mexican Heritage

scholarly journals Ambulatory glucose profile in managing hypoglycemia in patients with type 2 diabetes mellitus: a case report

2020 ◽  
Vol 7 (2) ◽  
pp. 340
Author(s):  
B. M. Makkar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Glucose Monitoring ◽  
Postprandial Glucose ◽  
Glucose Profile ◽  
Glucose Fluctuations

Continuous glucose monitoring (CGM) was done in a 41 years-old female patient with type 2 diabetes mellitus (T2DM) to evaluate the glucose fluctuations, to achieve better glycemic control. The patient presented to the clinic with lethargy, on/off episodes of extreme weakness, sweating, and tingling sensation in the feet (B/L), with leg pains for the past 3 months. She did not have any history of hypertension and cardiovascular disease. On examination, her blood pressure was found to be 120/70 mm Hg. The fasting plasma glucose was 96 mg/dL, postprandial glucose was 160 mg/dL, and glycosylated hemoglobin was 6.8%. The patient was on metformin (500mg)- glimepiride (2mg) combination, once daily, before breakfast, and metformin (500mg) after dinner. Since the symptoms were related to glucose fluctuations and hypoglycemia, the patient was consequently recommended professional CGM to analyze the complete glycemic profile. The profile obtained from Ambulatory Glucose Profile (AGP) revealed glucose fluctuations observed as hypoglycaemia and hyperglycemic episodes. Consequently, the patient’s treatment regimen was changed. The use of glimepiride was discontinued, and the patient was recommended with vildagliptin (50 mg) and metformin combination (1000 mg) bid with meals. This case study indicates that the use of CGM may help in improving our understanding of glycemic patterns and may have a beneficial effect on glycemic control.

scholarly journals The insulin resistance indices: necessity and opportunities in type 2 diabetes mellitus management

2020 ◽  
Vol 96 (7) ◽  
pp. 529-535
Author(s):  
Yu. A. Sorokina ◽  
O. V. Zanozina ◽  
A. D. Postnikova
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Glycemic Control ◽  
Metabolic Disorders ◽  
Glycosylated Hemoglobin ◽  
Tissue Sensitivity

The article provides a review of the literature on the possibilities of using various indices of insulin resistance in type 2 diabetes (T2DM) treatment. The main mechanisms of insulin resistance and its role in the formation of type 2 diabetes mellitus and other metabolic disorders are described. The main indices of insulin resistance, used in real clinical practice nowadays, are considered. Methods of their calculation are given. The effect of metformin and incretin active medications on insulin resistance is described. It was shown that the combination of these medications improves tissue sensitivity to insulin in patients with T2DM. Standard indicators for assessing glycemic control, such as fasting glucose and glycosylated hemoglobin (HbA1c), do not reflect the patient’s lipid metabolism. The use of insulin resistance assessment indices in patients with type 2 diabetes mellitus allows both, exercising glycemic control, and the metabolic disorders, often associated with carbohydrate metabolism disorders, monitoring. Using insulin resistance indices, it is possible to select the optimal treatment regimen for type 2 diabetes mellitus for a particular patient, to predict and evaluate the effectiveness of treatment in dynamics. Simple, generally available laboratory indicators and anthropometric data are used to calculate the indices of insulin resistance, and they are easy to measure. In this regard, the use of insulin resistance indices is possible in routine clinical practice.

scholarly journals Dapagliflozin, as Add-on Therapy in Type 2 Diabetes Patients, Is Associated With a Reduction in Albuminuria and Serum Transaminase Levels

2021 ◽  
Vol 2 ◽  
Author(s):  
Silas Benjamin ◽  
Manjunath Ramanjaneya ◽  
Alexandra E. Butler ◽  
Imran Janjua ◽  
Firjeeth Paramba ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Group Analysis ◽  
Serum Transaminase ◽  
Hypoglycemic Agents ◽  
Combination Group ◽  
Creatinine Ratio ◽  
Urine Albumin

IntroductionSGLT-2 inhibitors are shown to be nephroprotective, slowing progression of nonalcoholic steatohepatitis (NASH) in addition to improving glycemic control in patients with type 2 diabetes (T2D). To date, no real-life clinical data is available on the effect of SGLT-2 inhibitors on urine albumin-creatinine ratio (ACR) and liver enzymes in a Middle Eastern population. Therefore, we evaluated the effect of dapagliflozin (DAPA) on urine ACR, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) when added to standard therapy for T2D.MethodsThis is an observational study of 40 patients with T2D in whom DAPA was added to their existing anti-diabetic regimen to improve glycemic control. The primary outcomes were changes in serum transaminase level and urine albumin-to-creatinine ratio (ACR). Secondary outcomes include changes in glycosylated hemoglobin (HbA1C), body mass index (BMI), oral hypoglycemic agents and insulin dose.ResultsWhole group analysis showed a reduction in ALT (p&lt;0.0001), (AST) (p=0.009), ACR (p=0.009) and BMI (p&lt;0.0001) following DAPA treatment. Further sub-group analysis showed that patients on insulin and DAPA combination had a reduction in ACR (p=0.0090), ALT (p=0.0312), BMI (p=0.0007) and HbA1c (p&lt;0.0001) compared to the sulfonylurea and DAPA combination group. In the sulfonylurea and DAPA combination group, there was a reduction in the sulfonylurea requirement following DAPA therapy (p=0.0116), with reductions in ALT (p=0.0122), AST (p=0.0362), BMI (p=0.0026) and HbA1c (p&lt;0.0001) but with no change in ACR (p=0.814).ConclusionIn routine clinical practice, the addition of DAPA to standard medical therapy is well tolerated and beneficial for T2D patients and is associated with a reduction of ALT and ACR.

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