Diabetology最新文献

{"title":"Prevention of Type 2 Diabetes: The Role of Intermittent Fasting","authors":"Bright Test, Jay H. Shubrook","doi":"10.3390/diabetology4040044","DOIUrl":"https://doi.org/10.3390/diabetology4040044","url":null,"abstract":"Despite the progress in treatment options and improved understanding of pathophysiology, type 2 diabetes remains one of the costliest and most harmful global chronic diseases. The current guidelines encourage physicians to fight an uphill battle and react to an incubated disease state that has been propelled forward by clinical inertia. The authors completed a literature search of PubMed, ScienceDirect, and NIH, searching with the terms intermittent fasting, type 2 diabetes, and prediabetes, and excluded studies related to religion-based fasting. There is emerging evidence that intermittent fasting could be an option to aid in weight loss, reduce hepatic steatosis, and lower the level of biomarkers such as fasting glucose while improving insulin resistance. If incorporated into the lives of patients with risk factors for type 2 diabetes, intermittent fasting could prove to be a cost-effective and efficient tool for preventing this insidious disease. This clinical review examines current evidence supporting the implementation of this lifestyle to prevent the onset or exacerbation of type 2 diabetes and the hurdles that must still be overcome for physicians to confidently prescribe this to their patients.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"56 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346596","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":"Advanced Technology (Continuous Glucose Monitoring and Advanced Hybrid Closed-Loop Systems) in Diabetes from the Perspective of Gender Differences","authors":"Maria Grazia Nuzzo, Marciano Schettino","doi":"10.3390/diabetology4040045","DOIUrl":"https://doi.org/10.3390/diabetology4040045","url":null,"abstract":"An ever-growing body of evidence suggests that sex and gender influence the pathophysiology, incidence, prevalence, clinical manifestations, course, and response to therapy of diabetes. Sex and gender differences are particularly evident in type 1 diabetes, especially in patients using advanced technologies (CGM and AHCL), as they are factors that interact with each other and have an impact on adherence to therapy, which affects not only metabolic compensation, but also, therefore, the prevention of complications and quality of life.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"58 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346929","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":"Educating Medical Students on How to Prescribe Anti-Hyperglycaemic Drugs: A Practical Guide","authors":"Erik M. Donker, Andrej Belančić, Joost D. Piët, Dinko Vitezić, Jelle Tichelaar","doi":"10.3390/diabetology4040043","DOIUrl":"https://doi.org/10.3390/diabetology4040043","url":null,"abstract":"In the light of the rapidly increasing global incidence of, and therapeutic arsenal for, diabetes type 2, this brief report underscores the need for advancements in clinical pharmacology and therapeutics (CPT) education with regard to diabetes type 2. We advocate for the comprehensive training of medical students and junior doctors in line with current guidelines, and emphasize the importance of teaching how to draw up individualized treatment plans based on patients’ specific risk factors and conditions, such as cardiovascular risks, weight, and risk of hypoglycaemia. Within the curriculum, traditional teaching approaches should be replaced by innovative methods such as problem-based learning, which has been shown to be more effective in developing prescribing knowledge and skills. The inclusion of real-world experience and interprofessional learning via so-called student-run clinics is also recommended. Subsequently, innovative assessment methods like the European Prescribing Exam and objective structured clinical examinations (OSCE) are highlighted as essential for evaluating knowledge and practical skills. By adopting these educational advances, medical education can better equip future practitioners to adequately manage the complex pharmacological treatment of diabetes.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"58 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539708","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":"Exploring Diabetic Retinopathy Patterns in Saudi Arabia: Gender and Diabetes Type Comparison","authors":"Samraa Hussain, Naji AlJohani","doi":"10.3390/diabetology4040042","DOIUrl":"https://doi.org/10.3390/diabetology4040042","url":null,"abstract":"Aims: To determine the prevalence and predictors of diabetic retinopathy (DR) in Saudi males and females with diabetes. Methods: This cross-sectional study enrolled 507 patients with diabetes between May and August 2018. The data extracted from patients’ records included demographic and clinical information and laboratory investigations. The retinopathy data were based on fundus photography graded into five categories: no DR, NPDR, MNPDR, SNPDR, and PDR. Results: The patients’ mean age was 47.3 years, the majority (59.3%) being female and T2DM being the most common type (52.4%). The prevalence of no DR was 51.4%; NPDR, 4.4%; MNPDR, 7.7%; SNPDR, 3.7%; and PDR, 5.1%. The duration of DM, as well as the severity of hypertension and neuropathy values rose significantly as DR progressed, underlining the pivotal role of hyperglycemia as the primary driver of diabetic complications. The odds ratio for the presence of hypertension was 1.8 (95% CI 0.9–3.5); hypertension showed the highest risk of DR. Stratification according to gender showed a significantly higher DR risk in females than males. Interestingly, nephropathy played a significant role in the DR risk in T1DM. Conclusions: Among T1DM and T2DM patients, the severity of DR is associated with risk factors including the DM duration, hyperglycemia, hypertension, and neuropathy. The impact of these factors varies with gender and diabetes type. Therefore, the severity of DR could define patients at a high risk of macro/microvascular complications and enable earlier interventions to reduce morbidity and mortality among T1DM and T2DM patients.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"73 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539544","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":"Recent Advances in Psychotherapeutic Treatment and Understanding of Alexithymia in Patients with Obesity and Diabetes Mellitus Type 2","authors":"Filip Mustač, Tin Galijašević, Eva Podolski, Andrej Belančić, Martina Matovinović, Darko Marčinko","doi":"10.3390/diabetology4040041","DOIUrl":"https://doi.org/10.3390/diabetology4040041","url":null,"abstract":"Alexithymia is the inability to describe one’s own feelings and is being increasingly researched. According to contemporary psychodynamic theories, negative emotions cannot be adequately named and externalized, but remain trapped in the body. Recent research shows the connection of alexithymia with numerous somatic diseases. Diabetes mellitus type 2 and obesity represent great challenges in treatment, and the psychological profiles in these diseases are being studied more and more often. Therefore, alexithymia enters the focus of some research as a factor that could play a significant role in these diseases, namely as the one that makes a difference. The aim of this paper is a review of the literature with the purpose of understanding the current knowledge about the interconnection between alexithymia, obesity and type 2 diabetes mellitus.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135810399","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 Mellitus—Digital Solutions to Improve Medication Adherence: Scoping Review","authors":"Nikol Georgieva, Viktor Tenev, Maria Kamusheva, Guenka Petrova","doi":"10.3390/diabetology4040040","DOIUrl":"https://doi.org/10.3390/diabetology4040040","url":null,"abstract":"Medication adherence (MA) is a major problem. On average 50% of chronic disease management medications are not taken as prescribed While digital healthcare tools like mobile apps offer benefits such as informative messages and prescription management, they must be personalized and offer support across all medication phases to effectively address individual patient factors and optimize adherence, with room for further improvements. This scoping review examined the impact of digital health technologies on MA in adults with diabetes as well as their benefits and barriers. Using PubMed and Scopus databases, 11 out of 385 studies (2.86%) from January 2017 to August 2023 met the criteria for digital health interventions in diabetes MA, assessed through the Chronic Care Model. The Chronic Care Model (CCM) is a patient-centered, evidence-based framework designed to improve the care and outcomes for chronic illness patients, consisting of six core elements and enhanced by eHealth tools that facilitate self-management and support through digital innovations. The results demonstrate the effectiveness of digital health technology in improving medication adherence among adults with diabetes. Specific digital interventions, including mobile apps like Gather and Medisafe, SMS text messaging, telemonitoring, and tailored care management have demonstrated effectiveness in enhancing MA. These interventions have shown positive outcomes, including enhanced glycemic control and increased patient engagement. Some of the limitations, which these technologies face, are the poor usability, digital illiteracy among the patients, low rates of sustainability and low accessibility among the elderly population. Digital health technology shows promise in enhancing medication adherence among adults with diabetes, as revealed in this scoping review. However, ongoing research is necessary to fine-tune these interventions for improved outcomes and the overall well-being of individuals with diabetes. Additional improvement of the technologies and adaptation to the diverse population might be a good field for exploration.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135780031","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":"Best Practices in the Use of Sodium–Glucose Cotransporter 2 Inhibitors in Diabetes and Chronic Kidney Disease for Primary Care","authors":"Jay H. Shubrook, Joshua J. Neumiller, Radica Z. Alicic, Tom Manley, Katherine R. Tuttle","doi":"10.3390/diabetology4040039","DOIUrl":"https://doi.org/10.3390/diabetology4040039","url":null,"abstract":"Diabetes is the leading cause of chronic kidney disease (CKD), with nearly half of all cases of kidney failure requiring kidney replacement therapy. While attention is often focused on the profound effects kidney failure has on the quality of life, the principal cause of complications and death among patients with diabetes and CKD is cardiovascular disease (CVD). These risks are often underappreciated by both healthcare professionals and patients. Sodium–glucose cotransporter 2 (SGLT-2) inhibitors were originally developed and approved as glucose-lowering agents for treating type 2 diabetes (T2D). However, agents within the SGLT-2 inhibitor class have since demonstrated robust benefits for CKD, atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF) outcomes. Specifically, dedicated kidney disease and HF outcome trials have shown markedly reduced rates of kidney failure, CVD and HF events, and death among people (with and without diabetes) with CKD. SGLT-2 inhibitors will be used by primary care clinicians, nephrologists, and cardiologists across a range of cardiovascular and kidney conditions and diabetes. Knowledge and awareness of the benefits and key safety considerations, and risk mitigation strategies for these medications is imperative for clinicians to optimize the use of these life-saving therapies.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135729819","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":"A Systematic Review of Economic Evaluations of Insulin for the Management of Type 2 Diabetes","authors":"Elvira Meni Maria Gkrinia, Andrea Katrin Faour, Andrej Belančić, Jacques Bazile, Emma Marland, Dinko Vitezić","doi":"10.3390/diabetology4040038","DOIUrl":"https://doi.org/10.3390/diabetology4040038","url":null,"abstract":"Diabetes is a chronic, metabolic disease characterized by hyperglycemia, which occurs as a result of inadequate production or utilization of insulin. Type 2 diabetes (T2D) is the most common type of diabetes with estimates projecting a prevalence of more than 1 billion people living with T2DM by 2050. Hence, it was decided to conduct a systematic literature review of health economic evaluations of insulin, the most common medication used for the treatment of the disease, to inform policy. Pharmacoeconomic analyses, written in English and published after 2016, were considered for inclusion. PubMed/Medline, Global Health, Embase and Health Management Consortium were searched separately between 5 July 2023 and 17 July 2023. Grey literature articles were searched on ISPOR and the Cost-Effectiveness Analysis Registry during the same period. After the exclusion criteria were applied, 21 studies were included. Using the BMJ checklist, a quality appraisal was performed on all included studies. Data extraction was performed manually. Regarding evidence synthesis, data were heterogenous and are presented based on study type. The results showed a variety of treatment combinations being available for the treatment of diabetes, with insulin degludec/DegLira and semaglutide being cost-effective despite their high cost, due to the effectiveness of managing the disease. Research around the cost-effectiveness or cost-utility of insulin has potential to progress further, to ensure informed policy-making in the future.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135917803","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":"The Quality of Life of Caregivers of People with Type 2 Diabetes Estimated Using the WHOQOL-BREF Questionnaire","authors":"Vilma Kolarić, Valentina Rahelić, Zrinka Šakić","doi":"10.3390/diabetology4040037","DOIUrl":"https://doi.org/10.3390/diabetology4040037","url":null,"abstract":"Type 2 diabetes (T2D) poses a growing global health challenge, impacting patients’ and their caregivers’ well-being. This study investigates the influence of T2D complications on caregivers’ quality of life (QoL) using the WHOQOL-BREF questionnaire, accounting for factors like age, disease duration, and control. The research involved 382 T2D patients and 300 caregivers from Vuk Vrhovac University Clinic for Diabetes, Endocrinology, and Metabolic Diseases. The WHOQOL-BREF questionnaire assessed caregivers’ QoL across physical, psychological, social, and environmental domains. Complications, including retinopathy, neuropathy, and kidney disease, were examined for their effects on QoL. Patients’ age impact, gender differences, and disease duration were analyzed. T2D complications had varying impacts on different QoL domains. Caregivers of patients with multiple complications showed significant social functioning impairment. Those without complications reported lower psychological health. Age correlated with poorer physical health scores. Female caregivers rated higher in psychological and environmental health. Disease duration and T2D control had no significant impact on caregiver QoL. Caregivers’ concerns included medication adherence and worry about their partner’s health. This study illustrates the delicate interplay between T2D patients and caregivers, highlighting the multifaceted effects of chronic illness. Comprehensive healthcare techniques that address emotional and social components in addition to medical care are critical for improving the well-being of both patients and their caregivers. The findings contribute to a broader understanding of T2D care dynamics, advocating for empathetic and all-encompassing healthcare practices.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"249 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208618","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":"Prevention of Type 2 Diabetes with Lifestyle Interventions: Evidence vs. Reality","authors":"Thirunavukkarasu Sathish, Freya MacMillan","doi":"10.3390/diabetology4040036","DOIUrl":"https://doi.org/10.3390/diabetology4040036","url":null,"abstract":"Type 2 diabetes is a serious global public health concern that affects every country in the world [...]","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135481207","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}