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management of type 2 diabetes mellitus

Sanjay Kalra, Yatan Pal Singh Balhara, Komal Verma, Bharti Kalra
Diabetes distress - commonly encountered as a part of life with diabetes mellitus - can be effectively managed by coping skills training. Systematic assessment and documentation of the existing coping skills (and lack thereof) is a pre-requisite for planning such coping skills training. A six-item tool, the GlucoCoper - which assesses two negative (resistance, blame) and four positive (acceptance, optimism, planning and action) coping mechanisms - was administered to English-literate adult participants with type 2 diabetes (T2DM) at an endocrine centre in India...
April 2018: European Endocrinology
Thomas Danne, Torben Biester, Olga Kordonouri
The sodium-glucose cotransporter type 1 (SGLT1) is the primary transporter for absorption of glucose and galactose in the gastrointestinal tract. Inhibition blunts and delays postprandial glucose (PPG) excursion. Sodium-glucose cotransporter type 2 (SGLT2) is expressed in the kidney, where it reabsorbs 90% of filtered glucose. Thus, a dual SGLT1 and SGLT2 inhibition (compared with selective SGLT2 inhibition) could result in lower PPG and robust A1c reduction even in patients with reduced kidney function. Sotagliflozin is an oral potent dual inhibitor of the insulin-independent SGLT1 and SGLT2...
June 2018: Diabetes Technology & Therapeutics
Shengxian Li, Jixue Wang, Jinghai Hu, Liang He, Chunxi Wang
This present case report describes a 64-year-old female patient with type 2 diabetes mellitus who also had emphysematous pyelonephritis (EPN) and emphysematous cystitis (EC). Computed tomography revealed well defined emphysematous pyelonephritis and cystitis. Broad-spectrum antibiotic and percutaneous drainage of the right kidney were used as part of a conservative management regimen. The patient achieved clinical recovery and was discharged 12 days after admission. Furthermore, 13 other cases of EPC and EC that were reported between 1962 and 2017 were reviewed and discussed...
January 1, 2018: Journal of International Medical Research
Sylvie Hall, Diana Isaacs, Jennifer N Clements
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) came to market in the year 2005, as a new therapeutic classification, for clinical use in the management of type 2 diabetes mellitus (T2DM). Since 2005, there have been six approved products on the market, with the newest product being semaglutide (Novo Nordisk). Several studies have been conducted and completed evaluating its pharmacokinetics as a once-weekly subcutaneous injection. As a dose of 0.5 or 1 mg, semaglutide has a half-life of 7 days; therefore, it would reach steady state in 4-5 weeks...
June 19, 2018: Clinical Pharmacokinetics
Sawako Kato, Masahiko Ando, Takaaki Kondo, Yasuko Yoshida, Hiroyuki Honda, Shoichi Maruyama
Modification of lifestyle habits, including diet and physical activity, is essential for the prevention and control of type 2 diabetes mellitus (T2DM) in elderly patients. However, individualized treatment is more critical for the elderly than for general patients. This study aimed to determine lifestyle interventions that resulted in lowering hemoglobin A1c (HbA1c ) in Japanese pre- and early diabetic elderly subjects. The BEST-LIFE trial is an ongoing, open-label, 6-month, randomized (1:1) parallel group trial...
May 2018: Nagoya Journal of Medical Science
Ana María Gómez, Diana Cristina Henao, Angelica Imitola, Oscar Mauricio Muñoz, Martín Alonso Rondón Sepúlveda, Laura Kattah, Juan Sebastian Guerrero, Elly Morros, Juan Pablo Llano, Maira García Jaramillo, Fabián León-Vargas
BACKGROUND: Sensor-augmented insulin pump therapy (SAPT) with low-glucose suspend (LGS) is an effective and safe alternative for treating patients with type 1 diabetes mellitus (T1DM). New predictive low-glucose management (PLGM) systems decrease the severity and duration of hypoglycemic events. However, evidence of benefits in patients previously treated with SAPT-LGS is limited. METHODS: A prospective before-after study was conducted in patients with T1DM treated with SAPT-LGS, who were switched to the Minimed® 640G system with SmartGuard® to assess the impact on A1c levels, severe hypoglycemia (SH), hypoglycemia unawareness (HU), and area under the curve (AUC) <70mg/dL after three months of follow-up...
June 15, 2018: Endocrinología, Diabetes y Nutrición
Kazuko Yonezaki, Toshihiro Kobayashi, Hitomi Imachi, Takuo Yoshimoto, Fumi Kikuchi, Kensaku Fukunaga, Seisuke Sato, Tomohiro Ibata, Nao Yamaji, Jingya Lyu, Tao Dong, Koji Murao
BACKGROUND: Recently, immune checkpoint inhibitors have widely been used for the management of advanced melanoma. However, high-grade immune-related adverse events can occur, particularly with combination immunotherapy. We report a case of a patient with melanoma who developed thyroid storm following treatment with ipilimumab and nivolumab. CASE PRESENTATION: An 85-year-old Japanese man with a history of malignant melanoma presented to our department with severe thyrotoxicosis and poor blood glucose control...
June 19, 2018: Journal of Medical Case Reports
Ahmed Elgebaly, Nesrine Abdelazeim, Bassant Abdelazeim, Gehad El Ashal, Omar Mattar, Lubaba Namous, Noha Nasreldin
AIM: Ipragliflozin is a new antidiabetic agent that works through enhancing renal glucose excretion. We aim to synthesize evidence from published randomized controlled trials (RCTs) on the safety and efficacy of ipragliflozin in the management of type 2 diabetes mellitus (T2DM). METHODS: We searched PubMed, Scopus, Web of Science, and Cochrane Central register of clinical trials using relevant keywords. Records were screened for eligible studies and data were extracted and synthesized using Review Manager Version 5...
June 18, 2018: Experimental and Clinical Endocrinology & Diabetes
Claudia Barreda-Velit, Rodrigo Salcedo-Pereda, Jesús Ticona
Background: Schmidt’s syndrome, also known as poliglandular autoimmune syndrome type 2, is a rare disease that has a prevalence between 1.5-4.5 cases per 100 000 inhabitants. The diagnosis consists in the concomitant presentation of Addison disease, autoimmune thyroid disease and other autoimmune endocrinological conditions. The aim of this paper is to describe a case of Schmidt’s syndrome in the peruvian context and to analyze the difficulties in the diagnosis. Clinical case: We present the case of a 43-year-old woman that presents to the emergency room with headache, nausea, vomits and a “syncope episode”...
March 2018: Revista Médica del Instituto Mexicano del Seguro Social
Zahra Mostafavian, Sahar Ghareh, Farnaz Torabian, Mohammad Sarafraz Yazdi, Mahmood Reza Khazaei
Insulin has been considered as a therapy option of last resort in type 2 diabetes (T2DM) management. Delay in insulin therapy is common in these patients. This study collected the data on the factors associated with insulin refusal in poorly controlled T2DM patients prior to insulin therapy. The data collected from two endocrinology outpatient clinics affiliated by Islamic Azad University of Mashhad, Iran (IAUM) from January 2016 to September 2017. Study population was adults with non-insulin-using type 2 diabetes mellitus who refused insulin therapy...
June 2018: Data in Brief
Mohammad J Alkhatatbeh, Khalid K Abdul-Razzak, Lubna Q Khasawneh, Nesreen A Saadeh
The aim of the present study was to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes mellitus (T2DM) in association with 25-hydroxyvitamin D levels, anxiety, depression and neuropathy. A cross-sectional study was conducted involving a total of 124 T2DM patients. Musculoskeletal pain was determined by self-reporting of painful body sites. Pain intensity was assessed using a scale of 0-10. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Neuropathy was assessed using the PainDETECT questionnaire...
June 2018: Biomedical Reports
Deldar Morad Abdulah, Alan Bapeer Hassan, Farsat Saeed Saadi, Ary Habeeb Mohammed
OBJECTIVES: Dietary and physical activity advice have been considered to be seminal ingredients in prevention and management of type 2 diabetes mellitus. In this regard, the impacts of a three-month self-management intervention on glycemic control in patients with type 2 diabetes were examined in the present study. STUDY DESIGN: A Double-arm post-test intervention study. METHODS: In the current post-test intervention study, three two-hour educational sessions on dietary habits and physical activity designed according to Health Belief Model were presented to 16 non-complicated type 2 diabetic patients and their dietary, physical activities, and biochemical outcomes were compared to a 23 patient-control arm in Iraq in 2017...
June 7, 2018: Diabetes & Metabolic Syndrome
Philip Teg-Nefaah Tabong, Vitalis Bawontuo, Doris Ningwiebe Dumah, Joseph Maaminu Kyilleh, Tolgou Yempabe
BACKGROUND: One of the non-communicable diseases which is on the rise is type 2 diabetes (T2D). T2D is largely preventable with healthy lifestyle. We therefore conducted this study to explore premorbid perception of risk, behavioural practices and the coping strategies of patients with T2D. METHODS: Using descriptive phenomenology approach to qualitative enquiry, we conducted eight focus group discussions (N = 73) with diabetic patients; four among males (N = 36) and four among females (N = 37)...
2018: PloS One
Annie C H Fung, Gary Tse, Hiu Lam Cheng, Eric S H Lau, Andrea Luk, Risa Ozaki, Tammy T Y So, Rebecca Y M Wong, Joshua Tsoh, Elaine Chow, Yun Kwok Wing, Juliana C N Chan, Alice P S Kong
Background and objectives: Undiagnosed depression is an important comorbidity in type 2 diabetes (T2D) which can be detected using the Geriatric Depression Scale (GDS-15) questionnaire. In this cross-sectional study, we examined the associations of depression using GDS score with control of cardiometabolic risk factors and health status in elderly patients with T2D. Setting and participants: Between February and December 2013, patients aged ≥65 years who underwent structured comprehensive assessment as a quality improvement program at the Diabetes Center of a teaching hospital were invited to complete the GDS-15 questionnaire...
2018: Frontiers in Endocrinology
Fumika Shigiyama, Naoki Kumashiro, Ayako Fuchigami, Takahisa Hirose
BACKGROUND: Recent studies reported that sodium glucose cotransporter 2 (SGLT2) inhibitors reduced the cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) compared to placebo in contrast to no reduction with dipeptidyl peptidase 4 (DPP4) inhibitors. However, there are no comparative studies on the effects of SGLT2 inhibitors and DPP4 inhibitors on HbA1c, body weight and hypoglycemia as risk factors of cardiovascular diseases. The aim of the present ongoing study is to compare the effects of dapagliflozin, a SGLT2 inhibitor, with those of sitagliptin, a DPP4 inhibitor, on cardiovascular risk factors in T2DM patients with inadequate glycemic control...
June 12, 2018: Cardiovascular Diabetology
John S Leeds, Marios Hadjivassiliou, Solomon Tesfaye, David S Sanders
Objectives: Lower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes. Research design and methods: This is a prospective, cohort study in secondary care. Patients with type 1 diabetes completed a gastrointestinal symptom questionnaire and the Short Form 36 V...
2018: BMJ Open Diabetes Research & Care
Xiang-Hua Weng, Yu-Qiong Wen, Shu-Ting Zhang, Xiao-Ying Fu, Hong-Mei Chen, Liang Chen, Jian-Hao Pei, Si-Min Liu, Jian Kuang
OBJECTIVE: To investigate the hypoglycemic characteristics of hospitalized elderly patients with type 2 diabetes mellitus (T2DM). METHODS: From January, 2014 to December, 2015, the data of 58 565 blood measurements using a standard blood glucose monitoring system (BGMS) were collected from 1187 cases of patients with type 2 diabetes during hospitalization in the Department of Endocrinology, Guangdong General Hospital (Guangzhou, China). Stratified analyses were conducted by dividing the patients into 3 age groups, namely <45 years group (128 cases), 45-64 years group (594 cases), and ≥65 years group (465 cases)...
May 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Chris Estes, Quentin M Anstee, Maria Teresa Arias-Loste, Heike Bantel, Stefeno Bellentani, Joan Caballeria, Massimo Colombo, Antonio Craxi, Javier Crespo, Christopher P Day, Andreas Geier, Loreta A Kondili, Jeffrey V Lazarus, Rohit Loomba, Michael P Manns, Giulio Marchesini, Francesco Negro, Salvatore Petta, Vlad Ratziu, Manuel Romero-Gomez, Arun Sanyal, Jörn M Schattenberg, Frank Tacke, Christian Trautwein, Lai Wei, Stefan Zeuzem, Homie Razavi
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) with resulting nonalcoholic steatohepatitis (NASH) are increasingly a cause of cirrhosis and hepatocellular carcinoma (HCC) globally. This burden is expected to increase as epidemics of obesity, diabetes and metabolic syndrome continue to grow. The goal of this analysis was to use a Markov model to forecast NAFLD disease burden using currently available data. METHODS: A model was used to estimate NAFLD and NASH disease progression in 8 countries based on data for adult prevalence of obesity and type 2 diabetes mellitus (DM)...
June 7, 2018: Journal of Hepatology
Kyung Soo Kim, Seok Won Park, Yong Wook Cho, Soo Kyung Kim
BACKGROUND: To evaluate the prevalence of chronic kidney disease (CKD) and progression rate to CKD in elderly patients with type 2 diabetes mellitus (T2DM). METHODS: We investigated the medical records of 190 elderly patients (65 years or older) with T2DM from 2005 to 2011 in 6-month increments. Mean follow-up duration was 64.5 months. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² and/or the presence of albuminuria. RESULTS: The mean age was 70...
May 31, 2018: Diabetes & Metabolism Journal
Seung Jin Han, Edward J Boyko
Although overweight/obesity is a major risk factor for the development of type 2 diabetes mellitus, there is increasing evidence that overweight or obese patients with type 2 diabetes mellitus experience lower mortality compared with patients of normal weight. This paradoxical finding, known as the "obesity paradox," occurs in other chronic diseases, and in type 2 diabetes mellitus is particularly perplexing given that lifestyle intervention with one goal being weight reduction is an important feature of the management of this condition...
May 31, 2018: Diabetes & Metabolism Journal
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