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https://www.readbyqxmd.com/read/28636186/views-of-general-practice-staff-about-the-use-of-a-patient-oriented-treatment-decision-aid-in-shared-decision-making-for-patients-with-type-2-diabetes-a-mixed-methods-study
#1
Anita Wildeboer, Esther du Pon, Jan Schuling, Flora M Haaijer-Ruskamp, Petra Denig
BACKGROUND: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. OBJECTIVES: To explore views of practice staff towards SDM and the DA. DESIGN: A mixed-methods study within the Dutch PORTDA-diab trial. SETTING AND PARTICIPANTS: Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28635648/deoxyelephantopin-and-isodeoxyelephantopin-as-potential-anticancer-agents-with-effects-on-multiple-signaling-pathways
#2
REVIEW
Tahir Mehmood, Amara Maryam, Hamed A Ghramh, Muhammad Khan, Tonghui Ma
Cancer is the 2nd leading cause of death worldwide. The development of drugs to target only one specific signaling pathway has limited therapeutic success. Developing chemotherapeutics to target multiple signaling pathways has emerged as a new prototype for cancer treatment. Deoxyelephantopin (DET) and isodeoxyelephantopin (IDET) are sesquiterpene lactone components of "Elephantopus scaber and Elephantopus carolinianus", traditional Chinese medicinal herbs that have long been used as folk medicines to treat liver diseases, diabetes, diuresis, bronchitis, fever, diarrhea, dysentery, cancer, and inflammation...
June 21, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28635331/network-meta-analysis-of-liraglutide-versus-dpp-4-inhibitors-for-the-treatment-of-type-2-diabetes-in-japanese-patients
#3
Dieter Ayers, Steve Kanters, Rachel Goldgrub, Monica Hughes, Ryo Kato, Nana Kragh
AIMS: To determine the comparative efficacy and safety of liraglutide and dipeptidyl peptidiase-4 (DPP-4) inhibitors as antidiabetics for Japanese patients with uncontrolled type 2 diabetes (T2DM). METHODS AND MATERIALS: We searched for randomized-controlled trials (RCTs) evaluating outcomes among Japanese adults with uncontrolled T2DM and including liraglutide or DPP-4 inhibitors up to August 2016. We extracted data on trial and patient characteristics, and the following outcomes: HbA1c, weight, patients meeting HbA1c <7%, patients experiencing hypoglycemic events, microalbuminuria, estimated glomerular filtration rate (eGFR) and creatinine...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28634587/exercise-metabolism-in-nonobese-patients-with-type-2-diabetes-following-the-acute-restoration-of-normoglycaemia
#4
Christopher J Gaffney, Peter Mansell, Francis B Stephens, Ian A Macdonald, Kostas Tsintzas
This study investigated how acute restoration of normoglycaemia affected energy metabolism during exercise in nonobese patients with type 2 diabetes. Six subjects (mean ± SEM) aged 56.2 ± 2.7 years, with a BMI of 24.5 ± 1.5 kg/m(2) and a VO2 peak of 28.7 ml/kg/min, attended the lab on two randomised occasions for a four-hour resting infusion of insulin or saline, followed by 30 minutes cycling at 50% VO2 peak. During the 4 h resting infusion, there was a greater (P < 0.0001) reduction in blood glucose in insulin treatment (INS) (from 11...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28634268/30-years-of-the-mineralocorticoid-receptor-mineralocorticoid-receptor-antagonists-60-years-of-research-and-development
#5
REVIEW
Peter Kolkhof, Lars Bärfacker
The cDNA of the mineralocorticoid receptor (MR) was cloned 30 years ago, in 1987. At that time, spirolactone, the first generation of synthetic steroid-based MR antagonists (MRAs), which was identified in preclinical in vivo models, had already been in clinical use for 30 years. Subsequent decades of research and development by Searle & Co., Ciba-Geigy, Roussel Uclaf and Schering AG toward identifying a second generation of much more specific steroidal MRAs were all based on the initial 17-spirolactone construct...
July 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28633804/protective-effect-of-n-acetylcysteine-on-progression-to-end-stage-renal-disease-necessity-for-prospective-clinical-trial
#6
Chen-Yi Liao, Chi-Hsiang Chung, Chai-Chao Wu, Fu-Huang Lin, Chang-Huei Tsao, Chih-Chiang Wang, Wu-Chien Chien
BACKGROUND: We aimed to evaluate the potential benefits of N-acetylcysteine (NAC) on the risk of chronic kidney disease (CKD) progression to dialysis-requiring end-stage renal disease (ESRDd). METHODS: In a population-based cohort study of 145,062 individuals, 123,608 CKD patients who were followed up for 10years were included, and CKD patients treated with NAC (ICD-9-CM) were compared with those who were not treated. Using propensity score matching, we analyzed the predictors of CKD progression to ESRDd by Cox proportional hazards regression with adjustments for sex, age, and comorbidities, and evaluated the effect of NAC using cumulative defined daily dose (cDDD)...
June 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28632962/a-novel-minimally-invasive-wireless-technology-for-neuromodulation-via-percutaneous-intercostal-nerve-stimulation-pns-for-post-herpetic-neuralgia-a-case-report-with-short-term-follow-up
#7
Bart Billet, Roel Wynendaele, Niek E Vanquathem
BACKGROUND: Peripheral nerve stimulation (PNS) of primary afferent neurons provides control of localized chronic pain. This technique applies permanent electrical stimulation at the target area via a minimally invasive, subcutaneous placement of an electrode. OBJECTIVE: To assess analgesic effects of a minimally invasive wireless neuromodulation in the treatment of chronic intractable pain secondary to post-herpetic neuralgia. CASE SUMMARY: A 78-year-old man presented with severe intractable post herpetic neuralgic pain...
June 20, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28632180/preview-prevention-of-diabetes-through-lifestyle-intervention-and-population-studies-in-europe-and-around-the-world-design-methods-and-baseline-participant-description-of-an-adult-cohort-enrolled-into-a-three-year-randomised-clinical-trial
#8
Mikael Fogelholm, Thomas Meinert Larsen, Margriet Westerterp-Plantenga, Ian Macdonald, J Alfredo Martinez, Nadka Boyadjieva, Sally Poppitt, Wolfgang Schlicht, Gareth Stratton, Jouko Sundvall, Tony Lam, Elli Jalo, Pia Christensen, Mathijs Drummen, Elizabeth Simpson, Santiago Navas-Carretero, Teodora Handjieva-Darlenska, Roslyn Muirhead, Marta P Silvestre, Daniela Kahlert, Laura Pastor-Sanz, Jennie Brand-Miller, Anne Raben
Type-2 diabetes (T2D) is one of the fastest growing chronic diseases worldwide. The PREVIEW project has been initiated to find the most effective lifestyle (diet and physical activity) for the prevention of T2D, in overweight and obese participants with increased risk for T2D. The study is a three-year multi-centre, 2 × 2 factorial, randomised controlled trial. The impact of a high-protein, low-glycaemic index (GI) vs. moderate protein, moderate-GI diet in combination with moderate or high-intensity physical activity on the incidence of T2D and the related clinical end-points are investigated...
June 20, 2017: Nutrients
https://www.readbyqxmd.com/read/28631849/experiences-of-closed-loop-insulin-delivery-among-pregnant-women-with-type-1-diabetes
#9
C Farrington, Z A Stewart, K Barnard, R Hovorka, H R Murphy
AIMS: To explore the experiences of pregnant women with Type 1 diabetes, and the relationships between perceptions of glucose control, attitudes to technology and glycaemic responses with regard to closed-loop insulin delivery. METHODS: We recruited 16 pregnant women with Type 1 diabetes [mean ± sd age 34.1 ± 4.6 years, duration of diabetes 23.6 ± 7.2 years, baseline HbA1c 51±5 mmol/mol (6.8 ± 0.6%)] to a randomized crossover trial of sensor-augmented pump therapy vs automated closed-loop therapy...
June 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28631216/safety-and-tolerability-of-empagliflozin-in-patients-with-type-2-diabetes-pooled-analysis-of-phase-i-iii-clinical-trials
#10
Sven Kohler, Cordula Zeller, Hristo Iliev, Stefan Kaspers
INTRODUCTION: We characterized the safety and tolerability of empagliflozin in patients with type 2 diabetes (T2DM) randomized 1:1:1 to placebo, empagliflozin 10 mg, or empagliflozin 25 mg in clinical trials. METHODS: Pooled data were analyzed from patients with T2DM treated with placebo (N = 4203), empagliflozin 10 mg (N = 4221), or empagliflozin 25 mg (N = 4196) in 15 randomized phase I-III trials plus four extension studies. Adverse events (AEs) were assessed descriptively in participants who took at least one dose of study drug...
June 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28630037/a-mobile-app-for-the-self-management-of-type-1-diabetes-among-adolescents-a-randomized-controlled-trial
#11
Shivani Goyal, Caitlin A Nunn, Michael Rotondi, Amy B Couperthwaite, Sally Reiser, Angelo Simone, Debra K Katzman, Joseph A Cafazzo, Mark R Palmert
BACKGROUND: While optimal blood glucose control is known to reduce the long-term complications associated with type 1 diabetes mellitus, adolescents often struggle to achieve their blood glucose targets. However, their strong propensity toward technology presents a unique opportunity for the delivery of novel self-management interventions. To support type 1 diabetes self-management in this population, we developed the diabetes self-management app bant, which included wireless blood glucose reading transfer, out-of-range blood glucose trend alerts, coaching around out-of-range trend causes and fixes, and a point-based incentive system...
June 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#12
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28629656/clinical-practice-points-for-diabetes-management-during-ramadan-fast
#13
REVIEW
Shaukat Sadikot, K Jothydev, A H Zargar, Jamal Ahmad, S R Arvind, Banshi Saboo
Diabetes management during Ramadan is very crucial from the patient perspective as it can present significant risk of hypoglycemia and death when proper care is not taken. Moreover, managing diabetes in fasting Ramadan patients require different mechanisms than the routine diabetes management and pose significant challenge to the health care practitioners. Here we set forth to review the available literature of various clinical trials and studies on different antidiabetic agents in the context of Ramadan. On the basis of available evidence, we suggest that gliclazide is effective and it could be safely recommended in type 2 diabetic patients fasting during Ramadan...
June 13, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28629468/improving-detection-and-initial-management-of-gestational-diabetes-through-the-primary-level-of-care-in-morocco-protocol-for-a-cluster-randomized-controlled-trial
#14
Bettina Utz, Bouchra Assarag, Amina Essolbi, Amina Barkat, Nawal El Ansari, Bouchra Fakhir, Alexandre Delamou, Vincent De Brouwere
BACKGROUND: Morocco is facing a growing prevalence of diabetes and according to latest figures of the World Health Organization, already 12.4% of the population are affected. A similar prevalence has been reported for gestational diabetes (GDM) and although it is not yet high on the national agenda, immediate and long-term complications threaten the health of mothers and future generations. A situational analysis on GDM conducted in 2015 revealed difficulties in access to screening and delays in receiving appropriate care...
June 19, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28628658/effects-of-obesogenic-diet-and-estradiol-on-dorsal-raphe-gene-expression-in-old-female-macaques
#15
Cynthia L Bethea, Kevin Mueller, Arubala P Reddy, Steven G Kohama, Henryk F Urbanski
The beneficial effects of bioidentical ovarian steroid hormone therapy (HT) during the perimenopause are gaining recognition. However, the positive effects of estrogen (E) plus or minus progesterone (P) administration to ovariectomized (Ovx) lab animals were recognized in multiple systems for years before clinical trials could adequately duplicate the results. Moreover, very large numbers of women are often needed to find statistically significant results in clinical trials of HT; and there are still opposing results being published, especially in neural and cardiovascular systems...
2017: PloS One
https://www.readbyqxmd.com/read/28627980/long-term-follow-up-of-a-hospital-based-multi-intervention-programme-in-type-2-diabetes-mellitus-impact-on-cardiovascular-events-and-death
#16
Anne Pernille Ofstad, Geir Reinvik Ulimoen, Elsa Orvik, Kåre Inge Birkeland, Lars L Gullestad, Morten Wang Fagerland, Odd Erik Johansen
Objective To report the long-term impact on cardiovascular (CV) outcomes and mortality of a 2-year hospital-based multi-interventional care programme as compared with general practitioner (GP)-provided standard care. Methods Patients with type 2 diabetes with ≥ 1 additional CV risk factor were randomized to 2 years of specialist-based, multi-intervention comprising lifestyle modification and specific pharmacological treatment, or GP-based standard care. After the 2-year intervention period, all participants returned to pre-study care, but were followed up for CV outcomes and mortality...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28627305/variability-of-diabetes-alert-dog-accuracy-in-a-real-world-setting
#17
Linda A Gonder-Frederick, Jesse H Grabman, Jaclyn A Shepard, Anand V Tripathi, Dallas M Ducar, Zachary R McElgunn
BACKGROUND: Diabetes alert dogs (DADs) are growing in popularity as an alternative method of glucose monitoring for individuals with type 1 diabetes (T1D). Only a few empirical studies have assessed DAD accuracy, with inconsistent results. The present study examined DAD accuracy and variability in performance in real-world conditions using a convenience sample of owner-report diaries. METHOD: Eighteen DAD owners (44.4% female; 77.8% youth) with T1D completed diaries of DAD alerts during the first year after placement...
January 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28627045/heart-rate-and-its-reduction-in-chronic-heart-failure-and-beyond
#18
REVIEW
Aleksandra Nikolovska Vukadinović, Davor Vukadinović, Jeffrey Borer, Martin Cowie, Michel Komajda, Mitja Lainscak, Karl Swedberg, Michael Böhm
Heart rate (HR) is associated with cardiovascular outcomes in all the stages of the cardiovascular continuum as well as in patients with pulmonary, cerebrovascular, and renal disease, sepsis, cancer, and erectile dysfunction. In patients with cardiovascular disease, but also in the general population, increased HR represents an important indicator of mortality with each acceleration of HR over 70 b.p.m. increasing the risk. In patients in sinus rhythm with chronic heart failure with reduced ejection fraction (HFrEF), a HR >70 b...
June 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28626631/chronic-eosinophilic-pneumonia-adjunctive-therapy-with-inhaled-steroids
#19
Christopher Chan, David DeLapp, Perry Nystrom
Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare form of diffuse parenchymal lung disease first identified by Carrington et al. in 1969. It is characterized by the presence of constitutional and respiratory symptoms with associated peripheral opacities on imaging and elevated serum and/or bronchoalveolar eosinophilia. Although data is limited regarding etiology or prevalence, it is known that ICEP has a 2:1 female: male predominance and typically affects non-smokers. Diagnosis rests on the clinical constellation of respiratory symptoms of at least 2-4 weeks duration, the presence of diffuse pulmonary alveolar consolidation, classically described as the "photographic negative of pulmonary edema", the presence of eosinophils ≥40% on bronchoalveolar lavage or ≥1000/mm(3) eosinophils on peripheral blood and the exclusion of other known causes of eosinophilic lung diseases such as drugs, toxins, fungi, parasites, and collagen-vascular disorders...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626088/secondary-prevention-of-cardiovascular-disease-in-patients-with-type-2-diabetes-international-insights-from-the-tecos-trial
#20
Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel, Sigrun Halvorsen, Timo E Strandberg, Tuncay Delibasi, Rury R Holman, Eric D Peterson
Background -Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Methods -Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status-was evaluated among 13,616 patients from 38 countries with diabetes and known CVD at entry into TECOS...
June 16, 2017: Circulation
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