scholarly journals Barriers and Strategies to Lifestyle and Dietary Pattern Interventions for Prevention and Management of TYPE-2 Diabetes in Africa, Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Hirut Bekele ◽  
Adisu Asefa ◽  
Bekalu Getachew ◽  
Abebe Muche Belete
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Professionals ◽  
Dietary Pattern ◽  
English Language ◽  
Cultural Influences ◽  
Pharmacological Therapy ◽  
Cochrane Library ◽  
Lifestyle Interventions ◽  
Smoking Cessation Counseling

Background. Diabetes mellitus is a major chronic illness in Africa that requires lifelong lifestyle interventions and pharmacological therapy. Lifestyle change is the most important aspect of diabetes care and includes diabetes self-management education and support, medical nutrition therapy, physical activity, smoking cessation counseling, and psychosocial care. Purpose. The purpose of this project was to review published articles that investigate lifestyle and dietary pattern interventions for diabetes prevention and management in Africa. Barriers to lifestyle interventions and strategies to overcome the barriers are also reviewed in this study. Methods. The article search was conducted in an electronic database search of PubMed, Google Scholar, and Cochrane Library. Studies were included if they were published between 2011 and 2019, if they were conducted in an African country, and were written in the English language. Results. Articles reviewed included several that examined the basic lifestyle and dietary pattern changes for all patients diagnosed with type 2 diabetes, on self-care behavior of type 2 diabetes patients, on the cost of diabetes in Africa, and on barriers for adherence to lifestyle and dietary changes in Africa, with strategies to address those barriers. Conclusion. Lifestyle interventions including regular physical exercise, weight management, and adherence to health care professionals’ recommendations on a healthy diet are the cornerstone in the prevention and management of diabetes in Africa. The main barriers to adherence were both systemic (population changes, poor access, western cultural influences, and low-quality healthcare) and personal (poverty and cost, educational status, and perceptions about the disease) in nature. The strategies for the barriers include health education programs, advocacy, and capacity building.

Oral Semaglutide: First-in-Class Oral GLP-1 Receptor Agonist for the Treatment of Type 2 Diabetes Mellitus

2019 ◽  
Vol 54 (5) ◽  
pp. 478-485 ◽  
Author(s):  
Kevin Cowart
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Receptor Agonist ◽  
English Language ◽  
Data Extraction ◽  
Pharmacological Therapy ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Objective:The purpose of this article is to review the pharmacological characteristics and clinical evidence of oral semaglutide for the treatment of type 2 diabetes mellitus (T2DM). Data Sources: A MEDLINE/PubMed search was conducted between January 1, 2005, and September 30, 2019. Search terms included semaglutide, glucagon-like peptide 1 receptor agonist, GLP-1 receptor agonist, and type 2 diabetes. Study Selection and Data Extraction Quantification: The following study designs were included in the analysis: systematic review and/or meta-analyses, clinical trial, or observational study design. Narrative reviews were excluded. Articles were included only if they were published in the English language or evaluated oral semaglutide with regard to pharmacology, pharmacokinetics, safety, and efficacy in humans. Data Synthesis: Oral semaglutide has been Food and Drug Administration approved for the treatment of T2DM as an adjunct to diet and exercise. Oral semaglutide has been shown to result in an absolute hemoglobin A1C reduction between −0.5% and −1.5% and weight reductions between −1 and −4.7 kg. Oral semaglutide has been shown to be noninferior to placebo for cardiovascular (CV) safety although additional CV outcomes trials are ongoing. Adverse effects appear to be similar to those of other glucagon-like peptide-1 receptor agonists and are gastrointestinal in nature. Relevance to Patient Care and Clinical Practice: Oral semaglutide may be appropriate as second- or third-line add-on therapy for patients with T2DM who are not meeting treatment goals on metformin and are overweight and reluctant to use an injectable drug. Conclusions: Oral semaglutide appears safe and effective as monotherapy and add-on pharmacological therapy for the treatment of T2DM.

Pharmacological therapy of hyperglycaemia in type 2 diabetes mellitus

2011 ◽  
pp. 1779-1794 ◽  
Author(s):  
Clifford J. Bailey ◽  
Melanie J. Davies
Keyword(s):  
Type 2 Diabetes ◽  
Health Care Professionals ◽  
Treatment Process ◽  
Pharmacological Therapy ◽  
Metabolic Disturbances ◽  
Care Plans ◽  
Clinical Complications

The management of type 2 diabetes is complex, due to the diverse, variable, and progressive nature of its pathogenesis, clinical complications, and societal impact (Box 13.4.2.1). Care plans need to be individualized, flexible, and realistic, with provision for patient education and empowerment to enable optimal benefit from the guidance and interventions offered by health care professionals. Relief of acute symptoms and attention to long-term complications and co-morbidities often preoccupy and sometimes overwhelm the treatment process. However, early and sustained remediation of endocrine and metabolic disturbances, plus containment of modifiable cardiovascular risk factors, prevent the onset and limit the severity of chronic pathology. Glycaemic control is a crucial part of the treatment process, and serves as the conventional indicator of metabolic status. This chapter will focus on the treatment of hyperglycaemia, and, particularly, the role of pharmacological therapies.

scholarly journals The Efficacy and Tolerability of Sitagliptin, Saxagliptin, Vildagliptin, Lindagliptin, Alogliptin, Omarigliptin and Trelagliptin in Patients with Type 2 Diabetes: Protocol for a Network Meta-Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
guoquan chen ◽  
Jiale Chen ◽  
Xiaoxia Hu ◽  
Jianqing Chen ◽  
Yiling He
Keyword(s):  
Type 2 Diabetes ◽  
English Language ◽  
Meta Analysis ◽  
Hypoglycemic Agents ◽  
Cochrane Library ◽  
Maintenance Hemodialysis ◽  
Dipeptidyl Peptidase 4 ◽  
Language Studies ◽  
The Difference

Abstract Backgound: Type 2 diabetes mellitus remains a major public health challenge in the worldwide. The control of blood glucose is essential in the metabolic management of diabetes. Dipeptidyl peptidase-4 (DPP-4) inhibitors are new hypoglycemic agents with good hypoglycemic effect. However, the difference of efficacy and tolerability among different kinds of DPP-4 inhibitors remains unclear and no network meta-analysis(NMA) has been performed yet to compare different kinds of DPP-4 inhibitors comprehensively. Our research aims to investigate and rank different kinds of DPP-4 inhibitors on efficacy and tolerability.Methods/design: English language studies will be searched in the electronic databases(PubMed, the Cochrane Library and EMBASE), without time restriction. Parallel-group randomized controlled trials (RCTs) meeting the following criteria will be included, regardless of the blinding design: (1) T2DM patients aged over 18, pregnant or breastfeeding female patients and patients with T2DM on Maintenance Hemodialysis will be excluded, (2) interventions with DPP-4 inhibitors (sitagliptin, saxagliptin, vildagliptin, lindagliptin, alogliptin, omarigliptin and trelagliptin), traditional antidiabetic agents includes α-glucosidase inhibitors, sulphonylureas, non-sulfonylureas and thiazolidinediones, or placebo and (3) change in HbA1c concentration, weight and FPG from baseline to the end of treatment and proportions of patients in achieving HbA1c < 7.0%, patients with treatment-emergent adverse events leading to treatment discontinuation and patients with hypoglycaemia. Random effects pairwise and Bayesian NMA will be performed for these outcomes. Subgroup analyses are carried out for race and dosing frequency.Discussion: Our NMA will be the first to systematically summarize, compare and rank the efficacy and tolerability of different kinds of DPP-4 inhibitors in T2DM patients. We are confident that our research project will significantly contribute to optimizing hypoglycemic therapy.Systematic review registration:PROSPERO:CRD42021253822

Association of Major Dietary Patterns with General and Abdominal Obesity in Iranian Patients with Type 2 Diabetes Mellitus

2015 ◽  
Vol 85 (3-4) ◽  
pp. 145-155 ◽  
Author(s):  
Marjan Ghane Basiri ◽  
Gity Sotoudeh ◽  
Mahmood Djalali ◽  
Mohammad Reza Eshraghian ◽  
Neda Noorshahi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Abdominal Obesity ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Diabetic Patients ◽  
General Obesity ◽  
Healthy Dietary Pattern

Abstract. Background: The aim of this study was to identify dietary patterns associated with general and abdominal obesity in type 2 diabetic patients. Methods: We included 728 patients (35 - 65 years) with type 2 diabetes mellitus in this cross-sectional study. The usual dietary intake of individuals over 1 year was collected using a validated semi-quantitative food frequency questionnaire. Weight, height, and waist circumference were measured according to standard protocol. Results: The two major dietary patterns identified by factor analysis were healthy and unhealthy dietary patterns. After adjustment for potential confounders, subjects in the highest quintile of the healthy dietary pattern scores had a lower odds ratio for the general obesity when compared to the lowest quintile (OR = 0.45, 95 % CI = 0.26 - 0.79, P for trend = 0.02), while patients in the highest quintile of the unhealthy dietary pattern scores had greater odds for the general obesity (OR = 3.2, 95 % CI = 1.8 - 5.9, P for trend < 0.001). There were no significant associations between major dietary patterns and abdominal obesity, even after adjusting for confounding factors. Conclusion: This study shows that in patients with type 2 diabetes mellitus, a healthy dietary pattern is inversely associated and an unhealthy dietary pattern is directly associated with general obesity.

1574-P: Plasma Glycolysis/Gluconeogenesis and TCA-Related Metabolites, Mediterranean Dietary Pattern, and Risk of Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1574-P
Author(s):  
MARTA GUASCH ◽  
JOSÉ L. SANTOS ◽  
MIGUEL A. MARTINEZ-GONZALEZ ◽  
CLARY B. CLISH ◽  
CRISTINA RAZQUIN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Pattern ◽  
Mediterranean Dietary Pattern

scholarly journals Potential Therapeutic Effects of Curcumin on Glycemic and Lipid Profile in Uncomplicated Type 2 Diabetes—A Meta-Analysis of Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 404
Author(s):  
Emma Altobelli ◽  
Paolo Matteo Angeletti ◽  
Ciro Marziliano ◽  
Marianna Mastrodomenico ◽  
Anna Rita Giuliani ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Effect Size ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Glycosylated Hemoglobin ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Model Assessment

Diabetes mellitus is an important issue for public health, and it is growing in the world. In recent years, there has been a growing research interest on efficacy evidence of the curcumin use in the regulation of glycemia and lipidaemia. The molecular structure of curcumins allows to intercept reactive oxygen species (ROI) that are particularly harmful in chronic inflammation and tumorigenesis models. The aim of our study performed a systematic review and meta-analysis to evaluate the effect of curcumin on glycemic and lipid profile in subjects with uncomplicated type 2 diabetes. The papers included in the meta-analysis were sought in the MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library databases as of October 2020. The sizes were pooled across studies in order to obtain an overall effect size. A random effects model was used to account for different sources of variation among studies. Cohen’s d, with 95% confidence interval (CI) was used as a measure of the effect size. Heterogeneity was assessed while using Q statistics. The ANOVA-Q test was used to value the differences among groups. Publication bias was analyzed and represented by a funnel plot. Curcumin treatment does not show a statistically significant reduction between treated and untreated patients. On the other hand, glycosylated hemoglobin, homeostasis model assessment (HOMA), and low-density lipoprotein (LDL) showed a statistically significant reduction in subjects that were treated with curcumin, respectively (p = 0.008, p < 0.001, p = 0.021). When considering HBA1c, the meta-regressions only showed statistical significance for gender (p = 0.034). Our meta-analysis seems to confirm the benefits on glucose metabolism, with results that appear to be more solid than those of lipid metabolism. However, further studies are needed in order to test the efficacy and safety of curcumin in uncomplicated type 2 diabetes.

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

iGlarLixi: A Fixed-Ratio Combination of Insulin Glargine 100 U/mL and Lixisenatide for the Treatment of Type 2 Diabetes

2017 ◽  
Vol 51 (11) ◽  
pp. 990-999 ◽  
Author(s):  
Jennifer Goldman ◽  
Jennifer M. Trujillo
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
English Language ◽  
Data Extraction ◽  
Safety Data ◽  
Fixed Ratio ◽  
Postprandial Glucose ◽  
The United States ◽  
Glucagon Like Peptide 1

Objective: To review the safety and efficacy of iGlarLixi, a titratable fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide, a glucagon-like peptide-1 receptor agonist. Data Sources: A literature search of MEDLINE for all English-language primary articles through June 2016, using the terms LixiLan, iGlarLixi and insulin glargine and lixisenatide, and a search of abstracts presented at the 2016 Scientific Sessions of the American Diabetes Association were performed. Study Selection and Data Extraction: All studies assessing the efficacy and/or safety of iGlarLixi were evaluated. Data Synthesis: iGlarLixi has been approved in the United States for glycemic control in people with type 2 diabetes (T2D) inadequately controlled with basal insulin (<60 U/d) or lixisenatide. In clinical trials, iGlarLixi was associated with significantly greater reductions from baseline in glycated hemoglobin A1C (A1C) than iGlar or lixisenatide alone. Reductions in postprandial glucose were also greater with iGlarLixi than with iGlar or lixisenatide. iGlarLixi was weight neutral compared with the weight gain with iGlar and loss with lixisenatide alone, and there was no increase in hypoglycemia with iGlarLixi compared with iGlar despite the greater A1C reduction. Gastrointestinal events, frequently associated with lixisenatide, were less common with iGlarLixi. Potential drawbacks of iGlarLixi include reduced flexibility in dosing and the absence of long-term efficacy and safety data. Conclusions: iGlarLixi is a titratable fixed-ratio combination that shows improved efficacy and comparable or improved safety outcomes relative to its separate constituents, offering an alternative approach to intensification of therapy in T2D.

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