scholarly journals Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1022 ◽  
Author(s):  
Kerstin Kempf ◽  
Martin Röhling ◽  
Katja Niedermeier ◽  
Babette Gärtner ◽  
Stephan Martin
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Control Group ◽  
Meal Replacement ◽  
Low Carbohydrate ◽  
Meal Replacements

Background Formula diets can improve glycemic control or can even induce remission in type 2 diabetes. We hypothesized that especially an individualized intense meal replacement by a low-carbohydrate formula diet with accompanied self-monitoring of blood glucose (SMBG) contributes to long-term improvements in HbA1c, weight, and cardiometabolic risk factors in poorly controlled type 2 diabetes. Methods Type 2 diabetes patients were randomized into either a moderate group (M-group) with two meal replacements/day (n = 160) or a stringent group (S-group) with three meal replacements/day (n = 149) during the first week of intervention (1300–1500 kcal/day). Subsequently, both groups reintroduced a low-carbohydrate lunch based on individual adaption due to SMBG in weeks 2–4. After week 4, breakfast was reintroduced until week 12. During the follow-up period, all of the participants were asked to continue replacing one meal per day until the 52-weeks follow-up. Additionally, an observational control group (n = 100) remained in routine care. Parameters were compared at baseline, after 12 and 52 weeks within and between all of the groups. Results 321 participants (83%) completed the acute meal replacement phase after 12 weeks and 279 participants (72%) the whole intervention after 52 weeks. Both intervention groups achieved improvements in HbA1c, fasting blood glucose, blood pressure, and weight (all p < 0.001) within 12 weeks. However, these results were not significantly different between both of the intervention groups. The estimated treatment difference in HbA1c reduction was (mean (95% confidence interval [CI]) -0.10% with 95% CI [−0.40; 0.21] also (p > 0.05) (S-group vs. M-group) not statistically different after 12 weeks. However, only the S-group showed a clinically relevant improvement in HbA1c of −0.81% [−1.06; −0.55] (p < 0.001) after 52 weeks of follow-up, whereas HbA1c was not statistically different between the M- and control group. Conclusion Individualized meal replacement with SMBG demonstrated beneficial effects on HbA1c and cardiometabolic parameters in type 2 diabetes. Furthermore, the initiation of a weight loss program with one week of full meal replacement (three meals per day) resulted in a clinically relevant long-term HbA1c reduction, as compared to an observational control group that had standard care.

scholarly journals Effectiveness of Solution-based Therapy on Self-Compassion and Reducing Blood Glucose in Elderly Patients with Type 2 Diabetes

2020 ◽  
pp. 158-164
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Elderly Patients ◽  
Control Group ◽  
Old Patients ◽  
Statistical Population ◽  
Self Compassion ◽  
Effect Of Treatment

Introduction and Objectives: One of the problems of diabetes in the elderly is the likelihood of another condition that makes it more difficult to control blood sugar. This study aimed to investigate the effectiveness of solution-based therapy on self-compassion and blood glucose reduction in elderly patients with type 2 diabetes. Materials and Methods: This quasi-experimental study was conducted based on a pretest-posttest design with a control group and follow-up. The statistical population of the study consisted of 60-75-year-old patients with type 2 diabetes referring to Iranian Diabetes Association treatment centers in Tehran, Iran. A total of 36 patients were selected and randomly assigned into two groups of experimental and control. The data were collected using a self-compassion questionnaire and glycated hemoglobin test (HbA1c). The HbA1c test was also administered two months after the end of the training to follow-up and evaluate the sustainability of the treatment effects. The data were analyzed in SPSS software (version 26) through repeated measure ANOVA. Results: The results showed that the solution-based therapy increased self-compassion in the posttest phase (P<0.01), and the effect of treatment was maintained after two months (P<0.01). Moreover, solution-based therapy reduced blood glucose levels in the posttest phase (P<0.01) and retained the effect of treatment after two months (P<0.01). Conclusion: It can be concluded that solution-based therapy has effects on self-compassion and hyperglycemia in elderly patients with type 2 diabetes; moreover, it can be used in treatment centers to improve the status of patients with diabetes.

scholarly journals Effects of Fasting-Mimicking Diet and Specific Meal Replacement Foods on Blood Glucose Control in Patients with Type 2 Diabetes: A Randomized Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Fang Tang ◽  
Xuan Lin
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Venous Blood ◽  
Fasting Blood Glucose ◽  
Blood Glucose Control ◽  
Density Lipoprotein ◽  
Control Group ◽  
Meal Replacement ◽  
Experimental Group

Type 2 diabetes represents a serious societal health problem due to the vulnerability to cardiovascular events. Diet therapy is the most basic treatment for type 2 diabetes. The present study was conducted to study the effect of a fasting-mimicking diet and specific meal replacement foods on blood glucose control in patients with type 2 diabetes. Our study included 100 patients with type 2 diabetes who underwent a physical examination which were enrolled and randomly assigned as 50 patients each to the test group (with low energy-specific meal replacement meals during a fasting-mimicking diet) and the control group (with specific meal replacement foods given normal adult doses). After 4 months, efficacy indicators which were fasting blood glucose, 2-hour postprandial venous blood glucose, and glycosylated haemoglobin of the experimental group were all lower than those of the control group ( P < 0.05 ); observation indicators that include body mass index, waist circumference, blood lipids (triglyceride, cholesterol, and low-density lipoprotein), and blood pressure levels were all lower than the control group, and high-density lipoprotein levels were all higher than the control group (all P < 0.05 ). Both groups of fasting blood glucose, 2-hour postprandial venous blood glucose, and blood pressure had a relatively stable downward trend, but the experimental group had a more significant decline. In conclusion, the study revealed that a fasting-mimicking diet and specific meal replacement foods can safely and effectively reduce weight and improve metabolic syndrome in patients with type 2 diabetes.

scholarly journals The Effects of an Educational Self-Efficacy Intervention on Osteoporosis Prevention and Diabetes Self-Management Among Adults With Type 2 Diabetes Mellitus

2014 ◽  
Vol 16 (4) ◽  
pp. 357-367 ◽  
Author(s):  
Mei Ha ◽  
Jie Hu ◽  
Marcia A. Petrini ◽  
Thomas P. McCoy
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Calcium Intake ◽  
Self Efficacy ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
Control Group ◽  
Chinese Adults

Background: Prevalence of osteoporosis (OP) is high among Chinese adults with diabetes. Assessment of OP and fracture risk as well as patient education should be included as part of the management of diabetes. Purpose: The purpose of this pilot study was to test the effectiveness of an educational self-efficacy intervention on knowledge about OP, dietary calcium intake, the importance of physical activity (PA), and glycemic control among Chinese adults with type 2 diabetes residing in Wuhan, China. Method: A quasi-experimental design with repeated measures was employed. Participants were assigned to either the intervention ( n = 23) or the control group ( n = 23). Intervention participants attended 6 weekly 1-hr educational sessions comprising presentations, demonstration, and discussions. Control participants received standard care. Data were collected via questionnaires at pre- and postintervention and at 3-month follow-up, and blood was drawn at preintervention and 3-month follow-up. Results: Participants in the intervention group had significant improvement in OP knowledge, F(2, 43) = 11.504, p < .001; OP self-efficacy, F(2, 43) = 6.915, p = .003; dietary calcium intake, F(2, 43) = 7.856, p = .002; level of PA, F(2, 43) = 4.787, p = .011; diabetes self-care activities, F(2, 43) = 14.009, p < .001; diabetes self-efficacy, F(2, 43) = 19.722, p < .001; and glycemic control (A1C level; t = 2.809, p = .010) compared to the control group at the 3-month follow-up. Conclusion: The results demonstrate the effectiveness of OP prevention education based on self-efficacy theory among Chinese adults with type 2 diabetes.

Long-Term Glycemic Control after a One Week Hospital Education Program for Inpatients with Type 2 Diabetes

2007 ◽  
Vol 23 (5) ◽  
pp. 263-269 ◽  
Author(s):  
Michiya Akabane ◽  
Hiroki Konishi ◽  
Yoshihiko Nishio ◽  
Akira Yamaji
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Education Program ◽  
Control Group ◽  
Team Approach ◽  
Education Group ◽  
Significant Difference ◽  
Short And Long Term

Background: Clinical usefulness of short-term education for long-term glycemic control has been unclear in patients with type 2 diabetes. Objective: To conduct a one week education program, incorporating a clinical path with group education and a team approach, for inpatients with type 2 diabetes and assess the effect of our program on short- and long-term glycemic control in these patients. Methods: Changes in hemoglobin A1c (A1C) values of 29 patients were serially examined for 3 years after discharge at completion of the education program, and findings were compared with those of 22 patients with diabetes who did not participate in the program. Results: A1C values of patients in the education group at the first and third year after discharge were maintained at lower levels than those of patients in the control group. The proportion of patients with A1C values less than 7% was greater in the education group than in the control group during the first and third years. No significant differences in the number of hospital visits were noted over 3 years, and no significant difference between the 2 groups was found in the ratio of patients receiving drug therapy to those supported by a diet/exercise regimen only. Conclusions: Our findings suggest that a one week in-hospital education program contributes to improvement of short- and long-term glycemic control in patients with type 2 diabetes.

scholarly journals Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort

2020 ◽  
Vol 8 (1) ◽  
pp. e000980 ◽  
Author(s):  
Shabina Roohi Ahmed ◽  
Sridevi Bellamkonda ◽  
Mihail Zilbermint ◽  
Jiangxia Wang ◽  
Rita Rastogi Kalyani
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Glycemic Control ◽  
Usual Care ◽  
Care Group ◽  
High Fat ◽  
Community Based ◽  
Low Carbohydrate

ObjectiveThe optimal diet to improve glycemia in patients with type 2 diabetes remains unclear. Low carbohydrate, high fat (LCHF) diets can improve glycemic control, but have not been investigated in real-world settings.Research design and methodsWe investigated effects of the LCHF diet compared with usual care in a community-based cohort of patients with type 2 diabetes by performing a retrospective study of 49 patients who followed the LCHF diet for ≥3 months, and compared glycemic outcomes with age-matched and body mass index (BMI)-matched controls who received usual care (n=75). The primary outcome was change in A1C from baseline to the end of follow-up.ResultsCompared with the usual care group, the LCHF group showed a significantly greater reduction in A1C (−1.29% (95% CI −1.75 to −0.82; p<0.001)) and body weight (−12.8 kg (95% CI −14.7 to −10.8; p<0.001) at the end of follow-up after adjusting for age, sex, baseline A1C, BMI, baseline insulin dose. Of the patients initially taking insulin therapy in the LCHF group, 100% discontinued it or had a reduction in dose, compared with 23.1% in the usual care group (p<0.001). The LCHF group also had significantly greater reduction in fasting plasma glucose (−43.5 vs −8.5 mg/mL; p=0.03) compared with usual care.ConclusionsIn a community-based cohort of type 2 diabetes, the LCHF diet was associated with superior A1C reduction, greater weight loss and significantly more patients discontinuing or reducing antihyperglycemic therapies suggesting that the LCHF diet may be a metabolically favorable option in the dietary management of type 2 diabetes.

scholarly journals Long Term Evaluation of Intensive Insulin Therapy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2 (3) ◽  
pp. 88-94
Author(s):  
Leilani B Mercado-Asis ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Demographic Data

Background: This study aimed to determine long-term effect of intensive insulin therapy on prevention, progression, and development of chronic diabetes complications, both micro and macrovascular events. This study also aimed to evaluate long-term sustainability of glycemic control of patients on intensive insulin treatment. Methods: A retrospective review of adult type 2 diabetes mellitus (T2DM) patients on intensive insulin therapy for ≥7 years. Demographic data, co-morbidities, body mass index (BMI), hemoglobin A1c (HbA1c), hospitalization were collated. Majority received intensive insulin therapy with combination of premixed 70/30 given two times a day and fast short acting analogue given premeal three times a day, with the addition of glargine or degludec once a day in some. Results: Among 76 patients, 62% were males and 38% were females. Mean age at diagnosis and last visit were 53 and 65 years, respectively. At time of diagnosis, patient had the following co-morbidities: hypertension (32%), dyslipidemia (13%), non-dialyzable chronic kidney disease (CKD) (4%), thyroid disease (1%), pulmonary tuberculosis (1%). In terms of long-term complications, event rates during follow up period are as follows: 0.001 per person-year for acute coronary event; 0.002 per person-year for CKD needing dialysis, 0.009 per person-year for cerebrovascular accident. There were no blindness and amputation observed. There is a statistical difference between HbA1c levels at time of diagnosis (8.53 ± 1.86) and last follow up (7.83 ± 1.71) (P = 0.00). After a median follow up of 12 years (7–22 years), glycemic control was sustained with an HbA1c of ≤7% and ≤8% in 32% and 45% of patients, respectively. Conclusion: With intensive insulin therapy, micro and macrovascular complications can be prevented significantly. Long-term sustainability of glycemic control was also achieved.

scholarly journals Effects of incentive spirometry on cardiopulmonary parameters, functional capacity and glycemic control in patients with Type 2 diabetes

2020 ◽  
Vol 40 (02) ◽  
pp. 121-132
Author(s):  
Happiness Anulika Aweto ◽  
Esther Onyinyechi Obikeh ◽  
Bosede Abidemi Tella
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Blood Glucose Level ◽  
Functional Capacity ◽  
Medical Management ◽  
Control Group ◽  
Incentive Spirometry

Background: Patients with Type 2 diabetes mellitus (T2DM) suffer cardiopulmonary impairment and may present with weakness of the inspiratory muscles. Objective: This study was designed to determine the effects of incentive spirometry (IS) on selected cardiopulmonary parameters, functional capacity and glycemic control in patients with T2DM. Methods: Fifty-nine participants (25 males and 34 females) recruited from the out-patient clinic of the Department of Medicine of two hospitals in Lagos State, Nigeria, who were randomly assigned into two groups, completed the study. In addition to the medical management of T2DM, IS group received incentive spirometry while control group continued with the medical management of T2DM alone. Selected cardiovascular parameters, pulmonary parameters, functional capacity (using 6-min walk test) and fasting blood glucose level were assessed at baseline and at the end of eight weeks intervention period. Data were analyzed using the Statistical Package for Social Sciences (SPSS Version 21). Level of significance was set at [Formula: see text]. Results: There were statistically significant improvements in all the cardiovascular parameters ([Formula: see text]) of IS group except systolic blood pressure. There were significant changes in all the pulmonary parameters, functional capacity and glycemic control ([Formula: see text]) of IS group while there was none in control group. There were significant differences between the mean changes of various selected outcome measures of the two groups ([Formula: see text]) except for diastolic blood pressure and blood glucose level. Conclusion: IS had positive effects in improving cardiopulmonary function, functional capacity and glycemic control in patients with T2DM.

scholarly journals Poor Control of Plasma Triglycerides Is Associated with Early Decline of Estimated Glomerular Filtration Rates in New-Onset Type 2 Diabetes in China: Results from a 3-Year Follow-Up Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Chuan Wang ◽  
Lingshu Wang ◽  
Kai Liang ◽  
Fei Yan ◽  
Xinguo Hou ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Kidney Function ◽  
Renal Outcome ◽  
Onset Type ◽  
Follow Up Study ◽  
New Onset

Objective. Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease (ESRD). Even after strict control of obesity, hyperglycemia, and hypertension, some patients still progress rapidly. Previous studies suggested diabetic dyslipidemia might be one of the factors responsible for this high residual risk. This study aims to explore the impact of long-term lipid control on renal outcome in new-onset type 2 diabetes mellitus (T2DM). Methods. We conducted a 3-year follow-up study, involving 283 subjects with new-onset T2DM, and observed the effect of baseline and follow-up metabolic abnormalities, especially dyslipidemia, on the early damage of kidney function using multiple logistic regression analysis. Results. After 3 years follow-up, patients achieved a better control of body weight, hypertension, and blood glucose. The most reduced eGFR group shared the least reduced BMI and LDL-C, as well as the greatest increase in TG levels. Only TG in the follow-up, not any of the baseline data, nor obesity, blood glucose, BP, or LDL-C in the follow-up, was found to be significantly correlated with the most reduced eGFR. Compared with patients with constantly abnormal TG levels, the risks were even higher in the subjects who experienced a transition from normal TG to hypertriglyceridemia ( OR = 2.576 versus OR = 2.184 , after multiple adjustment), and by tight controlling of TG, patients started with abnormal baseline TG levels could reduce the risk of DKD progression to the same low levels as the TG-constantly-normal group. Conclusion. This study emphasized the importance of long-term TG control in East Asian patients with new-onset T2DM: TG control can delay the decline of kidney function in the early stage of DKD, and reversal of hypertriglyceridemia may undo the risks of the past. It is time to pay more attention to the control of TG in new-onset T2DM.

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