Journal of Social Health and Diabetes最新文献

{"title":"Ketogenic Diet as Medical Nutrition Therapy","authors":"D. Krishnan, Chetan Mehndiratta, Tanmay Agrawal","doi":"10.1055/s-0039-3402528","DOIUrl":"https://doi.org/10.1055/s-0039-3402528","url":null,"abstract":"Abstract Medical nutrition therapy is a therapeutic approach to treat medical conditions and their associated symptoms via using a specifically tailored diet devised under the supervision of a doctor and a registered dietitian or nutrition professional. Ketogenic diet primarily consists of the high amount of fats, a moderate amount of proteins, and very low carbohydrates. It is known to stimulate the metabolic effects of starvation by forcing the body to use primarily fat as a fuel source. Ketogenic diet was developed in the 1920s. Nowadays, it is gaining considerable attention as a potential weight-loss strategy because of the low-carb diet. However, it is being considered for use in several diseases/disorders also because of the beneficial effects on the metabolic health and nervous system. This review revisits the therapeutic potential of ketogenic diets in many pathological conditions and its role as a medical nutrition therapy. It also talks about the ill effects that the keto diet can have in case of self-usage and monitoring.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128193522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and HIV","authors":"R. Salam, S. Bajaj, N. Kapoor, B. Saboo, A. Dasgupta","doi":"10.1055/s-0039-3401978","DOIUrl":"https://doi.org/10.1055/s-0039-3401978","url":null,"abstract":"Abstract In India, the prevalence of HIV infection among adults (15–49 years) is estimated at 0.26%. The total number of people living with HIV (PLHIV) in India was estimated at 21.17 lakhs in 2015. There has been a declining trend in the mortality rate of HIV-infected patients on antiretroviral therapy (ART). With HIV becoming a chronic manageable disease, metabolic complications like diabetes mellitus (DM) and dyslipidemia are coming to the forefront. Generally, protease inhibitors (PI) are implicated in metabolic derangement; however, nucleoside reverse transcriptase inhibitors (NRTI) like stavudine can also cause diabetes. Among HIV-infected patients, the prevalence of diabetes is reported to range from 2 to 19%, so there is strong case for screening of diabetes among HIV-infected cases. The South Asian Consensus Guidelines recommend that both fasting and postprandial glucose values should be checked at screening and during monitoring of therapy. National AIDS Control Organization (NACO) recommends fasting plasma glucose with value ≥ 126 mg% diagnostic of diabetes mellitus. HbA1c may underestimate the degree of hyperglycemia in HIV-infected individuals and may not be a good diagnostic tool. Lifestyle modification is recommended as part of treatment. Metformin should be used with caution in HIV patients. Concomitant use of metformin with non-nucleoside reverse transcriptase inhibitors (NNRTI) can cause lactic acidosis. Thiazolidinediones should be the drug of choice in HIV, particularly in patients with lipodystrophy. Insulin secretagogues (meglitinides and sulfonylureas) are safe but may not be effective in the presence of severe insulin resistance. There are concerns regarding the use of gliptins in HIV-infected patients as they have molecular targets on immune cells. Insulin should be the drug of choice for HIV-infected patients with marked hyperglycemia (HbA1c > 9%), ketonuria, severe liver disease, or severe kidney disease. SGLT2 inhibitor may increase the risk of urinary tract infection and genital mycotic infections in HIV-infected diabetics. Regarding the use of ART among HIV patients with diabetes, NACO guidelines recommend that Tenofovir, lamivudine, and efavirenz should be used as first-line ART for all new patients, except known cases of severe diabetes, severe hypertension, or renal disease. Tenofovir, lamivudine, and lopinavir/ritonavir should be used as first line in women ever exposed to single dose Nevirapine in the past and also for all confirmed HIV-2 or HIV-1 & 2 coinfected patients. HIV infected with diabetes mellitus and microalbuminuria or proteinuria need Abacavir-based regimen (Abacavir + Lamivudine + Efavirenz). There is some suggestion that PI-based regimes should be avoided in patients at high risk of developing diabetes, for example, those with a history of gestational diabetes, positive family history of diabetes, or impaired glucose tolerance on screening.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126255977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scope of Management of Noncommunicable Diseases in India through Ayushman Bharat","authors":"Madhur Verma","doi":"10.1055/s-0039-3401982","DOIUrl":"https://doi.org/10.1055/s-0039-3401982","url":null,"abstract":"Abstract India is a rapidly developing country, and has been going through a major epidemiological transition over the past 25 years. As per the India State-Level Disease Burden Initiative, every state of India now has a higher burden from noncommunicable diseases (NCDs) and injuries than from infectious diseases. Inspired by Sustainable Development Goal vision, mitigating the effect of NCDs will demand a comprehensive approach based on preventive, promotive, and curative cum rehabilitative services. Apart from the community-based approach, another key announcement made in the union budget of India, 2018–19, was the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABY) that intend to transform the primary, secondary, and tertiary health care system in India. In this article, we intend to analyze the scope of services offered through ABY at different levels of public health care, and possible constraints in realizing the goal of universal health coverage in terms of NCDs.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"1127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123458583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ Experiences of Barriers and Facilitators for Adherence to Type 2 Diabetes Mellitus: A Meta-Ethnography","authors":"S. Sridharan, M. Chittem, S. Maya","doi":"10.1055/s-0039-3402529","DOIUrl":"https://doi.org/10.1055/s-0039-3402529","url":null,"abstract":"Abstract Objectives The main purpose of this article is to synthesize qualitative research exploring experiences of the factors that facilitated and hindered adherence among patients with type 2 diabetes mellitus (T2DM). Methods Twenty-six qualitative studies were purposefully included in the final sample. The Critical Appraisal Skills Program criteria for quality assessment of the studies was conducted. A meta-ethnographic approach proposed by Noblit and Hare (1988) was employed to analyze the studies. Using the “reciprocal translation” process, the authors searched for and consolidated the common themes. Results Three major themes were observed: (1) psychological determinants comprising illness beliefs, locus of control, and being forgetful; (2) sociocultural determinants of family and community, culture, and financial aspects; and (3) patients’ relationship with their physicians. Discussion The meta-ethnography underlines the importance of cultural nuances in the subjective experiences of the barriers and enablers of diabetes adherence. The findings support the need to include qualitative research methods to develop and evaluate interventions to improve T2DM adherence in patients. Clinical implications of this meta-ethnography include engaging in psychoeducation sessions for patients and caregivers, helping set reminders for patients, introducing communication skills training for healthcare providers, and including female caregivers/patients actively in diabetes care.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123705895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of Metabolically Healthy Obesity—Ganesha Speaks","authors":"Rukia Surya Shaikh, Pratiksha Patil, T. Lathia","doi":"10.1055/s-0039-3402538","DOIUrl":"https://doi.org/10.1055/s-0039-3402538","url":null,"abstract":"Abstract The cherubic elephant God Ganesha, a favorite of millions of Hindu devotees, sports a round belly. Humans who have a round belly would be classified as obese. Is all obesity unhealthy? What is metabolically healthy obesity? Different definitions and criteria make the discussion of metabolically healthy obesity difficult and challenging.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129648051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and Addictive Disorders","authors":"Y. Balhara, S. Bajaj, M. Tiwaskar, A. Joshi, V. Deshmukh","doi":"10.1055/s-0039-3401980","DOIUrl":"https://doi.org/10.1055/s-0039-3401980","url":null,"abstract":"Abstract Prevalence of addictive disorders among persons with diabetes mellitus (DM) (type 1 and type 2) ranges from 9.6 to 29%. Excessive and problematic use of psychoactive substances in persons with diabetes results in poor glycemic control with frequent hyperglycemic crisis. Tobacco, alcohol, cannabis, benzodiazepines, inhalants, and stimulants are common psychoactive substances used among persons with diabetes in India. The daily use of alcohol by men and women with DM should not exceed 15 and 30 g of ethanol, respectively. Use of other psychoactive substances is not recommended for persons with DM. Various screening tools exist for assessing substance abuse like WHO-ASSIST, Alcohol Use Disorders Identification Test (AUDIT), Fagerström Test for Nicotine Dependence (FTND), and Opioid Risk Tool. Integrated management of co-occurring addictive disorder and DM is recommended. Psychosocial treatments for substances include brief interventions (BIs), motivational interviewing, contingency management, relapse prevention, and cognitive behavior therapy","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115326699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complicated Gestational Diabetes: A Challenge!","authors":"Rutul Gokalani, Vandana Amin, B. Saboo, M. Saiyed","doi":"10.1055/s-0039-3400211","DOIUrl":"https://doi.org/10.1055/s-0039-3400211","url":null,"abstract":"Abstract Gestational diabetes is a condition caused by insulin resistance and multiple metabolic abnormalities; the prevalence of gestatinal diabetes mellitus (GDM) has been rising and has almost become parallel to obesity and type 2 diabetes. However, the mechanism and treatment points are still debatable. Hyperglycemia in pregnancy (HIP) is social instability as woman infertility is associated with it. If timely screened and achieved targeted glycemic control, it gives the desired outcome of pregnancy especially in pregestational diabetes. Support of family and thorough understanding of the disease is crucial in such situations as it requires multidisciplinary management, for example, structured self monitoring blood glucose (SMBG), diet and nutrition, multiple daily insulin injections with dose adjustment, avoiding hypoglycemia, and mental stability. Hyperglycemia in pregnancy (HIP) as a whole (pregestational and gestational diabetes) is one of the leading causes of woman infertility, miscarriages, abortions, fetal complications and anomalies3 Diabetes in pregnancy is challenging task for health care professionals, as the opinion on diagnosis differ and the treatment options are limited. Main stream of treatment roam around insulin with lifestyle modification and metformin4 5 (a dilemma for the doctors). It requires more attention and discipline than usual, as it involves two lives and more emotions attached to it. Apart from health, women have to face social instability (e.g., lack of family support, family conflict, violence, and blaming a woman), once detected with GDM, making them feel isolated and unlucky for the family. This poor attitude leads to worsening mental health in the females who are already exposed to anxiety and depression. In addition, gestational diabetes is an economic burned to the common earning man, as the overall cost of the disease is high. In this case, in spite of investing a huge amount of money, the woman has to undergo multiple traumas. Therefore, management of such cases is crucial. One such case is of a 34-year-old woman detected with typical symptoms of type II diabetes since 6.5 years. She was on oral hypoglycemic agents (OHAs) for a long time. Her grandfather and father had a history of type II diabetes. At the time of diagnosis, her HbA1c was 10.8% without ketosis. She belongs to Chanasma, a rural area in Mehsana district in North Gujarat. She is well educated and working as an officer (Patwari) in the government sector. After tying a knot at the age of 23 years, she had history of multiple abortions (7 reported) culprit being hyperglycemia. In year 2017, on her 7th gestational week she was referred to Arogyam Health Care—Diabetes Clinic.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129107482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes-Care Quality among Veterans in Southwest Indiana, United States","authors":"Harsimran Kaur, Aayushi Sood, Devkarn Sandhu, V. Bhatia","doi":"10.1055/s-0039-3400215","DOIUrl":"https://doi.org/10.1055/s-0039-3400215","url":null,"abstract":"Abstract Objective Diabetes is more prevalent among U.S. veterans than the general population. The study is among the U.S. veterans in Southwest Indiana with diabetes mellitus type 2 to understand their demographics, comorbidities, and complications that could help guide strategies to address the prevalence of diabetes among U.S. veterans in the area. Previous diagnosis and referral to the specialty clinics approaches are needed to lower the prevalence of diabetes among U.S. veterans and preventing diabetes-related complications to improve their health status. Method We constructed a retrospective study of veterans in the Southwest area with medically treated diabetes type 2, who received Veterans Health Administration primary care and were referred to our specialty clinic. We categorized based on demographics, comorbidities, initial HbA1c percentage, and complications, and created multivariable models. Results In our study of 80 U.S. veterans with diabetes, 90% had comorbidities already when they presented to our clinic. Diabetes was more prevalent in patients older than 60 years. Around 60% of patients presented with complications such as neuropathy, coronary arterial disease, and heart problems. We calculated the HbA1c when the patients came, and around 42% had hemoglobin A1c (HbA1c) over 10%. Patients with exposure to Agent Orange during the Vietnam War had HbA1c over 9%. Conclusion U.S. veterans with diabetes type 2 referred to the specialty clinic have high HbA1c and more complications on their first visit. Therefore, veterans need to be referred early to the specialty clinics during the course to improve their health status. Mission’s Act 2019 empowers veterans with increased access to community care.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130321125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and Insurance","authors":"Sujoy Ghosh, P. Mukhopadhyay, S. Bajaj","doi":"10.1055/s-0039-3401979","DOIUrl":"https://doi.org/10.1055/s-0039-3401979","url":null,"abstract":"Abstract India has healthcare expenditure of more than 5 billion dollars on diabetes-related healthcare management. Globally, approximately 12% of health expenditure is spent on diabetes and related comorbidities. Hospitalization includes hospital and laboratory expenses and cost of medications as the direct cost. India is among the countries, where if the insured dies during the time period specified in the insurance policy and the policy is active, or in force, then a death benefit will be paid. Studies in India reported that medical reimbursement is availed by 21.3% in the high-income group and only 6.4% of the urban low-income group. An average cost of management of diabetic complications like diabetic foot, retinopathy, and patients with two complications was almost close to the average cost of claimed amount. Patients may be advised to take insurance for diabetes when there is any indication of future disease and risk factors contributing to diabetes like a strong family history, obesity, hypertension, and other vascular diseases. Diabetes Safe from Star Health and Varistha Mediclaim from National Insurance were among the first insurance policies to be launched in India.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124869047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assets, Aims, Actions, Alignment, Audit: 5As in Diabetes","authors":"A. Joshi","doi":"10.1055/s-0039-3402099","DOIUrl":"https://doi.org/10.1055/s-0039-3402099","url":null,"abstract":"Abstract This brief communication shares the importance of the Alignment of the 3As, that is Assets, Aims, and Actions, while managing diabetes. It describes the essence of asset analysis, target decision-making, and therapeutic planning strategies. Calling for regular Audits of diabetes care, it reinforces the importance of this policy at the level of the person with diabetes, diabetes care provider, and healthcare system.","PeriodicalId":131259,"journal":{"name":"Journal of Social Health and Diabetes","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116977222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}