scholarly journals The Impact of Mindfulness-Based Stress Reduction on Emotional Wellbeing and Glycemic Control of Patients with Type 2 Diabetes Mellitus

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
A. Armani Kian ◽  
B. Vahdani ◽  
A. A. Noorbala ◽  
A. Nejatisafa ◽  
M. Arbabi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Stress Reduction ◽  
Rating Scale ◽  
Intervention Group ◽  
Control Group ◽  
Emotional Wellbeing ◽  
Mindfulness Based Stress Reduction ◽  
The Impact

Objective. The aim of the study was to determine the effect of mindfulness-based stress reduction (MBSR) intervention on emotion regulation and glycemic control of patients with type 2 diabetes. Materials and Methods. Sixty patients with type 2 diabetes were recruited for this randomized controlled trial from an outpatient clinic at Imam Hospital in Iran. The intervention group participated in 8 sessions of MBSR, and the control group continued the treatment as usual. Fasting blood sugar and HbA1c were measured as two indices of glycemic control. Overall mental health, depression, and anxiety were measured using the General Health Questionnaire (GHQ-28), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Rating Scale (HARS), respectively. All the assessments were performed at baseline and after 8 weeks and 3 months as follow-up. Results. In comparison with the control group, the MBSR intervention group showed a significant reduction on all outcome measures including FBS, HbA1C, HARS, and HDRS scores (p<0/05). Conclusion. MBSR had a remarkable improvement on emotional wellbeing and glycemic control of patients with type 2 diabetes.

scholarly journals The Effects of Oral Magnesium Supplementation on Glycemic Response among Type 2 Diabetes Patients

Nutrients ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 44 ◽  
Author(s):  
Wafaa ELDerawi ◽  
Ihab Naser ◽  
Mahmmoud Taleb ◽  
Ayman Abutair
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Trials ◽  
Glycemic Response ◽  
Intervention Period ◽  
Magnesium Supplementation ◽  
Stabilization Phase

Background: Magnesium (Mg) supplementation may help control glycemic response among type 2 diabetes (T2D) patients. Objective: This study means to determine whether Mg supplementation improves glycemic control indicators in patients with T2D. Methods: After one week of the dietary stabilization phase, 42 T2D patients were stratified according to sex, age, fasting blood sugar (FBS) and Mg levels and then randomly allocated into two groups. The intervention group was on 250 mg/day of elemental Mg for three months while the control group did not receive any type of supplements throughout the intervention period. Results: The daily administration of 250 mg of elemental Mg indicated a significant improvement in HbA1C (8.32 to 7.96%, p < 0.001), insulin levels (IL) (15.56 to 12.18 μIU/mL, p < 0.001), C-peptide (2.28 to 1.90 ng/mL, p = 0.001), HOMA.IR (6.16 to 4.44, p < 0.001) and HOMA.β% (59.99 to 52.37, p = 0.036) of the intervention group when compared with the control group after three months of intervention. Conclusion: The results of this study revealed that oral Mg supplementation reduces insulin resistance and improves the glycemic control indicators among T2D patients. Trial registration: current controlled trials PHRC/HC/32/15. Registered 5 October 2015.

scholarly journals The Teach-Back Effect on Self-Efficacy in Patients with Type 2 Diabetes

2020 ◽  
Vol 16 (1) ◽  
pp. 46-50
Author(s):  
Marhamat Farahaninia ◽  
Tahere Sarboozi Hoseinabadi ◽  
Rasool Raznahan ◽  
Shima Haghani
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Self Efficacy ◽  
Intervention Group ◽  
Self Management ◽  
Control Group ◽  
Training Procedure ◽  
Treatment Regimens ◽  
The Impact

BACKGROUND: Diabetes is a chronic, metabolic disease, which is commonly associated with increased blood glucose levels caused by impaired secretion or function of insulin. Therefore, daily blood glucose control, adherence to a dietary and pharmaceutical regimen, regular physical activity, and foot care are fundamental components of disease management. In order to optimize effective self-management, patients need to be trained. Teach-back is a method which aims to improve patients' understanding and perception of treatment regimens based on the interaction between patient and caregiver. AIM: This study was conducted to investigate the impact of the teach-back method on the effectiveness of self-management in patients with type 2 diabetes (T2D). METHODS: A total of 74 patients with T2D were included in the study by convenience sampling at the Endocrine and Metabolism Clinic. The subjects were assigned to control or intervention group. Data collection was performed by using a demographic data form and a self-efficacy questionnaire that were provided to the patients before and 1 month after training. The patients in the intervention group received a 5-session training program using the teach-back method. The control group received only routine programs. One month after completion of the training sessions, the questionnaires were completed by the subjects in the 2 groups, and the data obtained were analyzed. RESULTS: In contrast to the control group, mean and standard deviation of self-efficacy were significantly higher in the intervention group one month after training by the teach-back method than before training. The two groups did not significantly differ regarding mean score of self-efficacy before training, but there was a significant difference one month after training: the mean score of self-efficacy in the intervention group was significantly higher than in the control group (p < 0.001). CONCLUSIONS: Teach-back is a training procedure aimed at improving patients' understanding of treatment regimens. This study showed that teach-back significantly improved patients' self-efficacy even over as short a period as one month. It may be interesting to study the long-term effects of this simple but effective training method.

scholarly journals Low-energy total diet replacement intervention in patients with type 2 diabetes mellitus and obesity treated with insulin: a randomized trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001012 ◽  
Author(s):  
Adrian Brown ◽  
Anne Dornhorst ◽  
Barbara McGowan ◽  
Omar Omar ◽  
Anthony R Leeds ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Glycemic Control ◽  
Controlled Trial ◽  
Intervention Group ◽  
Low Energy ◽  
Control Group ◽  
Total Diet ◽  
Diabetes And Obesity

ObjectivesThe management of patients with long-standing type 2 diabetes and obesity receiving insulin therapy (IT) is a substantial clinical challenge. Our objective was to examine the effect of a low-energy total diet replacement (TDR) intervention versus standardized dietetic care in patients with long-standing type 2 diabetes and obesity receiving IT.Research design and methodsIn a prospective randomized controlled trial, 90 participants with type 2 diabetes and obesity receiving IT were assigned to either a low-energy TDR (intervention) or standardized dietetic care (control) in an outpatient setting. The primary outcome was weight loss at 12 months with secondary outcomes including glycemic control, insulin burden and quality of life (QoL).ResultsMean weight loss at 12 months was 9.8 kg (SD 4.9) in the intervention and 5.6 kg (SD 6.1) in the control group (adjusted mean difference −4.3 kg, 95% CI −6.3 to 2.3, p<0.001). IT was discontinued in 39.4% of the intervention group compared with 5.6% of the control group among completers. Insulin requirements fell by 47.3 units (SD 36.4) in the intervention compared with 33.3 units (SD 52.9) in the control (−18.6 units, 95% CI −29.2 to –7.9, p=0.001). Glycated Hemoglobin (HbA1c) fell significantly in the intervention group (4.7 mmol/mol; p=0.02). QoL improved in the intervention group of 11.1 points (SD 21.8) compared with 0.71 points (SD 19.4) in the control (8.6 points, 95% CI 2.0 to 15.2, p=0.01).ConclusionsPatients with advanced type 2 diabetes and obesity receiving IT achieved greater weight loss using a TDR intervention while also reducing or stopping IT and improving glycemic control and QoL. The TDR approach is a safe treatment option in this challenging patient group but requires maintenance support for long-term success.Trial registration numberISRCTN21335883.

scholarly journals Effectiveness of Mindfulness-Based Stress Reduction Training on Emotional Expressiveness and Fear of Hypoglycemia in Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Mojgan Moghareh Abed ◽  
Maryam Azadi ◽  
Maryam Dehghan ◽  
Javad Ardeshirpey
Keyword(s):  
Type 2 Diabetes ◽  
Stress Reduction ◽  
Emotional Expressiveness ◽  
Control Group ◽  
P Value ◽  
Statistical Population ◽  
Fear Of Hypoglycemia ◽  
Mindfulness Based Stress Reduction ◽  
Diabetes Center

Objective: Diabetes is a common chronic disorder in which there is a high risk of physical complications and psychological problems such as hypoglycemia and inability to express emotions. Psychological interventions can be effective in this regard. The aim of this study was to investigate the effectiveness of mindfulness-based stress reduction (MBSR) training on emotional expressiveness and fear of hypoglycemia (FOH) in patients with type 2 diabetes visiting Yazd Diabetes Center. Materials and Methods: This study was a quasi-experimental study with a pretest and posttest design. The statistical population was all patients with type 2 diabetes visiting Yazd Diabetes Center in 2020. Forty men and women were selected using purposeful sampling and were randomly allocated to case and control groups. The case group received 8 sessions of MBSR training, 2 hours each and the control group received no interventions. Emotional Expressiveness Questionnaire (EEQ) and the Hypoglycemia Fear Survey (HFS) were used to collect data. Results: Results of ANCOVA showed that MBSR training significantly increases emotional expressiveness and its components (P-value< 0.0001) and decreases the fear of hypoglycemia (P-value< 0.0001) in patients with type 2 diabetes (P-value< 0.035). Conclusion: Based on the results of the study, MBSR training could improve emotional expressiveness, prevent hypoglycemia and reduce the fear of it.

scholarly journals Differential Impact of an Education-Based Intervention for Patients with Type 2 Diabetes Mellitus in Rural China

2019 ◽  
Vol 16 (15) ◽  
pp. 2676 ◽  
Author(s):  
Shaofan Chen ◽  
Bo Burström ◽  
Vibeke Sparring ◽  
Dongfu Qian ◽  
Kristina Burström
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Rural China ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Control Group ◽  
Related Quality ◽  
The Impact

The study aimed to assess the impact of an education-based intervention to improve vertical integration and management of type 2 diabetes mellitus in primary care in rural China. Patients with type 2 diabetes mellitus in three townships in Jingjiang county, Jiangsu Province were randomly divided into intervention and control groups. Participants in the intervention group received an education-based intervention. Patients’ data including the fasting blood glucose (FBG) level, health-related quality of life (HRQoL), and sociodemographic characteristics were collected at baseline (2015) and follow-up (2016). The FBG levels decreased significantly in the intervention group compared to the control group in the overall analysis. In the stratified analysis, FBG levels and some aspects of HRQoL improved in the intervention group more for females, married persons, those with low education, and those in farming or house working. Participants in the control group deteriorated in FBG levels but improved in some aspects of HRQoL. The intervention improved in FBG levels and some aspects of HRQoL among participants. Furthermore, the intervention seemed to differentially benefit females, married persons, lowly educated persons, and those in farming or house working more than other groups. (Trial registration: ISRCTN, ISRCTN13319989. Retrospectively registered 4 April 2017).

Personalized Behavioral Nutrition Intervention in Older Asian Americans with Type 2 Diabetes during COVID-19 Pandemic: Study Protocol for a Pilot, Hybrid, Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Jisook Ko ◽  
Yan Du ◽  
Rozmin Jiwani ◽  
Chengdong Li ◽  
Jing Wang
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Pilot Study ◽  
Glycemic Control ◽  
Asian Americans ◽  
Control Group ◽  
Management Approach ◽  
Self Monitoring ◽  
Behavioral Nutrition

BACKGROUND The COVID-19 pandemic has challenged the in-person-based self-management approach (i.e., face-to-face or group approach) of type 2 diabetes (T2D). Older adults with T2D, including Asian Americans (AAs), have experienced worsening of diabetes control due to various reasons, including uncertainty of continuous access to essential diabetes medications, devices, education, limited health literacy, as well as constant anxiety and stress. Hybrid clinical trials that incorporate virtual elements into the in-person-based study could provide these vulnerable populations with accessible and timely interventions OBJECTIVE The primary aims of this pilot study are to determine (1) the effect of personalized behavioral nutrition (PBN) intervention on glycemic control, weight control, and metabolites profiles; and (2) the acceptability of PBN. to enhance glycemic control using personalized behavioral nutrition. METHODS Participants will be recruited with a web-based registry, advertisements in ethnic newspapers, and social network services popular among AAs. A total of 60 AAs, aged 65 years or older, who are descendants of Chinese, Korean, or South Asian, and have a diagnosis of T2D will be randomized into two groups: a PBN group (n=30) and a control group (n=30). A 4-week PBN intervention comprises three components: 1) digital self-monitoring; 2) personal nutrition change goals and recommendations; and 3) diabetes nutrition educations. All participants will complete digital self-monitoring on diet, physical activity, and blood glucose. In addition, all participants will access an interactive digital platform to track their self-monitoring data and communicate with the research team. The effectiveness and acceptability of implementing the intervention will be assessed. RESULTS Funding support and institutional review board approval for this study have been secured. Data collection started in August 2020 and is ongoing. CONCLUSIONS To our knowledge, this is the first study to determine the effectiveness and acceptability of PBN utilizing a metabolomics approach and digital-assisted intervention with hybrid RCT among older AAs. The findings of this pilot study will inform the development of a full-scale PBN protocol and hybrid clinical trials that can be adapted for people with T2D in the ongoing pandemic.

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

scholarly journals Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Anja Wollny ◽  
Christin Löffler ◽  
Eva Drewelow ◽  
Attila Altiner ◽  
Christian Helbig ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Decision Making ◽  
Type 2 Diabetes Mellitus ◽  
Shared Decision Making ◽  
Intervention Group ◽  
Control Group ◽  
Shared Decision ◽  
Patient Centeredness

Abstract Background We investigate whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus? Methods We performed a cluster-randomized controlled trial in German primary care. Patients with type 2 diabetes mellitus defined as HbA1c levels ≥ 8.0% (64 mmol/mol) at the time of recruitment (n = 833) from general practitioners (n = 108) were included. Outcome measures included subjective shared decision making (SDM-Q-9; scale from 0 to 45 (high)) and patient-centeredness (PACIC-D; scale from 1 to 5 (high)) as secondary outcomes. Data collection was performed before intervention (baseline, T0), at 6 months (T1), at 12 months (T2), at 18 months (T3), and at 24 months (T4) after baseline. Results Subjective shared decision making decreased in both groups during the course of the study (intervention group: -3.17 between T0 and T4 (95% CI: -4.66, -1.69; p < 0.0001) control group: -2.80 (95% CI: -4.30, -1.30; p = 0.0003)). There were no significant differences between the two groups (-0.37; 95% CI: -2.20, 1.45; p = 0.6847). The intervention's impact on patient-centeredness was minor. Values increased in both groups, but the increase was not statistically significant, nor was the difference between the groups. Conclusions The intervention did not increase patient perceived subjective shared decision making and patient-centeredness in the intervention group as compared to the control group. Effects in both groups might be partially attributed to the Hawthorne-effect. Future trials should focus on patient-based intervention elements to investigate effects on shared decision making and patient-centeredness. Trial registration The trial was registered on March 10th, 2011 at ISRCTN registry under the reference ISRCTN70713571.

scholarly journals Influence of physical activity on periodontal health in patients with type 2 diabetes mellitus. A blinded, randomized, controlled trial

2021 ◽  
Author(s):  
K. Wernicke ◽  
J. Grischke ◽  
M. Stiesch ◽  
S. Zeissler ◽  
K. Krüger ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Periodontal Health ◽  
Randomized Controlled ◽  
Hba1c Levels

Abstract Objectives The aim was to investigate the effect of physical activity on periodontal health and HbA1c levels in patients with type 2 diabetes mellitus (T2DM) over a period of 6 months. Materials and methods Thirty-seven patients with non-insulin-dependent T2DM were included in the study. The intervention group (n=20) performed physical activity over a period of 6 months. The control group (n=17) did not receive any intervention. Baseline and final examinations included dental parameters and concentrations of glycosylated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hsCRP). Results Physical activity showed a positive effect on periodontal health. Both the BOP (p= 0.005) and the severity of periodontitis (p= 0.001) were significantly reduced in the intervention group compared to the control group. Furthermore, HbA1c levels were reduced (p= 0.010) significantly in the intervention group while hsCRP levels significantly increased in the control group (p= 0.04). Conclusions Within the limitations of this randomized, controlled trial, physical activity over a period of 6 months is a health-promoting measure for patients with T2DM and improves both periodontal health and HbA1c concentrations.

scholarly journals The effects of professional continuous glucose monitoring as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dulce Adelaida Rivera-Ávila ◽  
Alejandro Iván Esquivel-Lu ◽  
Carlos Rafael Salazar-Lozano ◽  
Kyla Jones ◽  
Svetlana V. Doubova
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Outcome Variable ◽  
Control Group ◽  
Educational Tool ◽  
Study Objective ◽  
Hba1c Levels

Abstract Background The study objective was to evaluate the effects of professional continuous glucose monitoring (CGM) as an adjuvant educational tool for improving glycemic control in patients with type 2 diabetes (T2D). Methods We conducted a three-month quasi-experimental study with an intervention (IGr) and control group (CGr) and ex-ante and ex-post evaluations in one family medicine clinic in Mexico City. Participants were T2D patients with HbA1c > 8% attending a comprehensive diabetes care program. In addition to the program, the IGr wore a professional CGM sensor (iPro™2) during the first 7 days of the study. Following this period, IGr participants had a medical consultation for the CGM results and treatment adjustments. Additionally, they received an educational session and personalized diet plan from a dietitian. After 3 months, the IGr again wore the CGM sensor for 1 week. The primary outcome variable was HbA1c level measured at baseline and 3 months after the CGM intervention. We analyzed the effect of the intervention on HbA1c levels by estimating the differences-in-differences treatment effect (Diff-in-Diff). Additionally, baseline and three-month CGM and dietary information were recorded for the IGr and analyzed using the Student’s paired t-test and mixed-effects generalized linear models to control for patients’ baseline characteristics. Results Overall, 302 T2D patients participated in the study (IGr, n = 150; control, n = 152). At the end of the three-month follow-up, we observed 0.439 mean HbA1C difference between groups (p = 0.004), with an additional decrease in HbA1c levels in the IGr compared with the CGr (Diff-in-Diff HbA1c mean of − 0.481% points, p = 0.023). Moreover, compared with the baseline, the three-month CGM patterns showed a significant increase in the percentage of time in glucose range (+ 7.25; p = 0.011); a reduction in the percentage of time above 180 mg/dl (− 6.01; p = 0.045), a decrease in glycemic variability (− 3.94, p = 0.034); and improvements in dietary patterns, shown by a reduction in total caloric intake (− 197.66 Kcal/day; p = 0.0001). Conclusion Professional CGM contributes to reducing HbA1c levels and is an adjuvant educational tool that can improve glycemic control in patients with T2D. Trial registration ClinicalTrials.gov: NCT04667728. Registered 16/12/2020

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