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Objetivo: Evaluar el rol de las intervenciones basadas en el Modelo Transteórico (MTT) para mejorar el autocuidado de pacientes con diabetes mellitus tipo 1 ó tipo 2 (DM1, DM2). Metodología: Se realizó una búsqueda (mayo 2017), en las bases de datos Pubmed, Academic Search Complete y PsycInfo, utilizando términos en inglés relacionados con Glucose Metabolic Disorder, Motivational Interviewing y Randomized Control Trial. Criterios de inclusión: pacientes diabéticos, mayores de 18 años, estudios realizados en atención primaria y cuyo resultado primario fuere el control glicémico. La selección de estudios fue realizada de forma independiente por MP y LR, resolviendo discrepancias con CC. Los resultados son presentados en base al protocolo PRISMA. Resultados: Se identificaron 455 estudios, en base a título y resumen se seleccionaron 68, de los cuales 8 cumplían con los criterios de inclusión. Los participantes presentaban entre 53 y 64 años de edad. No se encontraron estudios con población con DM1. No se encontraron resultados significativos para el control metabólico. Sin embargo, cuatro de los estudios demostraron que el MTT fue efectivo para aumentar la actividad física y dos reportaron mejorar la adherencia al tratamiento farmacológico y mitigar las barreras percibidas para la toma de medicamentos. Conclusiones: Intervenciones psicológicas basadas en el MTT para el cambio de estilo de vida de los pacientes con DM2, favorecen el autocuidado de la enfermedad a través de la adherencia al tratamiento farmacológico y actividad física. No existe evidencia que sugiera que estas intervenciones impacten directamente en el control metabólico. (AU)
Objetive: To establish the role of health behavior interventions based on the Transtheorical Model (TTM), in the treatmentand management of type 1 and type diabetes mellitus (DM1, DM2). Methods: The databases Pubmed, Academic Search Complete and PsycInfo were searched for studies published before May 2017, with the Mesh terms Glucose Metabolic Disorder, Transtheoretical Model. Randomized controlled trials were analyzed. Inclusion criteria: adults with DM1 or DM2, studies conducted in primary care services, glycemic control as primary outcome. Study selection and inclusion was conducted by MP and LR, solving discrepancies with CC. Results :are presented according to the PRISMA statement. Results: 455 studies were initially identified from the selected databases. 68 studies were identified through title and abstract, and analyzed in detail. 8 studies fulfilled inclusion criteria. Participant's age ranged from 53 to 64 years old. There were no studies conducted with DM1patients. There were no significant results for glycemic control. Nonetheless, 4 studies showed that TTM is effective in increasing physical activity and 2 studies showed a significant improvement in treatment adherence and lower psychological limitations to pharmacological adherence. Conclusions: Health behavior interventions based on the TTM for lifestyle changes, have a positive impact in the self-management of patients with type 2 diabetes mellitus. (AU)
Subject(s)
Humans , Male , Female , Diabetes Mellitus , Biobehavioral Sciences , Motivational Interviewing , Life StyleABSTRACT
Objective To observe the effects of salidroside regulating glucose metabolism in type 2 diabetic mice,then to explore the molecular mechanism. Methods Type 2 diabetes model was induced by feeding high-fat diet and intraperitoneal injecting STZ to male C56BL/6J mice,then the glucose related indexes,micro RNA-370 levels in the serum and liver tissue and the expression of gluconeogenesis key protein(G6Pase and PEPCK) in the liver tissue to observe the treatment effects of salidro-side on type 2 diabetic-caused gluose metabolic disorder.In cell test,we isolated primary hepatocytes,then silenced or over-ex-pressed micro RNA-370 in mouse primary hepatocytes to observe the molecular mechanism of glucose metabolic regulation of the micro RNA-370 and salidroside. Results Treated with salidroside 40,80 and 160 mg·kg-1,the results showed that compared with the model control group,the glucose related indexes were all improved significantly.The relative expression levels of micro RNA-370 in serum and liver,and that of PEPCK and G6Pase all reduced in different degrees,dose-dependently.The changes of middle and high dose group decreased significantly(P<0.05),that of low dose group had a decreasing trend but no statistically significant.In the cell test,compared with the normal control group,salidroside alone group and micro RNA-370 inhibitor group were able to reduce the protein expression level of PEPCK and G6Pase(P<0.05),micro RNA-370mimic alone group can signifi-cantly increase the protein expression level of PEPCK and G6Pase(P<0.05),compared with the micro RNA-370mimic alone group,combining micro RNA-370 mimic and salidroside can significantly reverse the increasing caused by micro RNA-370 mimic alone(P<0.05). Conclusion Our research found that salidroside can improve glucose metabolism disorder in type 2 diabetic mice,and at least in part,through the suppression of micro RNA-370 expression for the first time.
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Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.
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Objective To observe the effects of salidroside on regulating glucose and lipid metabolism in high sugar high fat induced primary mouse hepatocytes,and to explore the molecular mechanism. Methods Primary hepatocytes were extracted from mice and cultured, then divided into normal control group, model control group ( high sugar high fat induced) ,and salidroside group(high sugar high fat induced and salidroside treated).Model control group and salidroside group were cultured in a high sugar and fatty medium with the optimal concentration of salidroside for 24 h. The glucose consumption, glycogen, and triglyceride concentration were detected, and key proteins of glucose and lipid metabolism were detected by RT-PCR in all three groups. Results Compared with model control group, the glucose consumption and glycogen concentration were both increased ( P<0. 05 ) in salidroside group ( P<0. 05 ) , triglyceride concentration were decreased ( P<0. 05 ) , the mRNA level of gluconeogenesis key protein ( G6Pase and PEPCK) and lipid synthesis key protein ( SREBP-1c, FAS-1, DGAT-2) mRNA expression level were increased (P<0.05),and the level of lipid oxidation key protein (CPT-1α) was decreased (P<0.05). Conclusion Salidroside can reduce insulin resistance and correct glucose and lipid metabolic disorder in high sugar high fat induced primary mouse hepatocytes.