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1.
Braz. j. biol ; 84: e250739, 2024. tab
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1355896

ABSTRACT

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.


Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.


Subject(s)
Humans , Receptors, Calcitriol/genetics , Diabetes Mellitus, Type 2/genetics , Diabetes Mellitus, Type 2/epidemiology , Saudi Arabia , Case-Control Studies , Polymorphism, Single Nucleotide , Gene Frequency , Genotype
2.
Braz. j. biol ; 83: e242818, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285628

ABSTRACT

Abstract The study was aimed to assess impact of high fat diet (HFD) and synthetic human gut microbiota (GM) combined with HFD and chow diet (CD) in inducing type-2 diabetes (T2D) using mice model. To our knowledge, this is the first study using selected human GM transplantation via culture based method coupled dietary modulation in mice for in vivo establishment of inflammation leading to T2D and gut dysbiosis. Twenty bacteria (T2D1-T2D20) from stool samples of confirmed T2D subjects were found to be morphologically different and subjected to purification on different media both aerobically and anerobically, which revealed seven bacteria more common among 20 isolates on the basis of biochemical characterization. On the basis of 16S rRNA gene sequencing, these seven isolates were identified as Bacteroides stercoris (MT152636), Lactobacillus acidophilus (MT152637), Lactobacillus salivarius (MT152638), Ruminococcus bromii (MT152639), Klebsiella aerogenes (MT152640), Bacteroides fragilis (MT152909), Clostridium botulinum (MT152910). The seven isolates were subsequently used as synthetic gut microbiome (GM) for their role in inducing T2D in mice. Inbred strains of albino mice were divided into four groups and were fed with CD, HFD, GM+HFD and GM+CD. Mice receiving HFD and GM+modified diet (CD/HFD) showed highly significant (P<0.05) increase in weight and blood glucose concentration as well as elevated level of inflammatory cytokines (TNF-α, IL-6, and MCP-1) compared to mice receiving CD only. The 16S rRNA gene sequencing of 11 fecal bacteria obtained from three randomly selected animals from each group revealed gut dysbiosis in animals receiving GM. Bacterial strains including Bacteroides gallinarum (MT152630), Ruminococcus bromii (MT152631), Lactobacillus acidophilus (MT152632), Parabacteroides gordonii (MT152633), Prevotella copri (MT152634) and Lactobacillus gasseri (MT152635) were isolated from mice treated with GM+modified diet (HFD/CD) compared to strains Akkermansia muciniphila (MT152625), Bacteriodes sp. (MT152626), Bacteroides faecis (MT152627), Bacteroides vulgatus (MT152628), Lactobacillus plantarum (MT152629) which were isolated from mice receiving CD/HFD. In conclusion, these findings suggest that constitution of GM and diet plays significant role in inflammation leading to onset or/and possibly progression of T2D. .


Resumo O estudo teve como objetivo avaliar o impacto da dieta rica em gordura (HFD) e da microbiota intestinal humana sintética (GM) combinada com HFD e dieta alimentar (CD) na indução de diabetes tipo 2 (T2D) usando modelo de camundongos. Para nosso conhecimento, este é o primeiro estudo usando transplante de GM humano selecionado através do método baseado em cultura acoplada à modulação dietética em camundongos para o estabelecimento in vivo de inflamação que leva a T2D e disbiose intestinal. Vinte bactérias (T2D1-T2D20) de amostras de fezes de indivíduos T2D confirmados verificaram ser morfologicamente diferentes e foram submetidas à purificação em meios diferentes aerobicamente e anaerobicamente, o que revelou sete bactérias mais comuns entre 20 isolados com base na caracterização bioquímica. Com base no sequenciamento do gene 16S rRNA, esses sete isolados foram identificados como Bacteroides stercoris (MT152636), Lactobacillus acidophilus (MT152637), Lactobacillus salivarius (MT152638), Ruminococcus bromii (MT152639), Klebsiella aerogenides (MT152640), Bacteroides fragilis (MT152909), Clostridium botulinum (MT152910). Esses sete isolados foram, posteriormente, usados ​​como microbioma intestinal sintético (GM) por seu papel na indução de T2D em camundongos. Linhagens consanguíneas de camundongos albinos foram divididas em quatro grupos e foram alimentadas com CD, HFD, GM + HFD e GM + CD. Camundongos que receberam a dieta modificada com HFD e GM + (CD / HFD) mostraram um aumento altamente significativo (P < 0,05) no peso e na concentração de glicose no sangue, bem como um nível elevado de citocinas inflamatórias (TNF-α, IL-6 e MCP-1) em comparação com os ratos que receberam apenas CD. O sequenciamento do gene 16S rRNA de 11 bactérias fecais obtidas de três animais selecionados aleatoriamente de cada grupo revelou disbiose intestinal em animais que receberam GM. Cepas bacterianas, incluindo Bacteroides gallinarum (MT152630), Ruminococcus bromii (MT152631), Lactobacillus acidophilus (MT152632), Parabacteroides gordonii (MT152633), Prevotella copri (MT152634) e Lactobacillus Gasseri (MT152635D), foram tratadas com dieta modificada / CD) em comparação com as linhagens Akkermansia muciniphila (MT152625), Bacteriodes sp. (MT152626), Bacteroides faecis (MT152627), Bacteroides vulgatus (MT152628), Lactobacillus plantarum (MT152629), que foram isoladas de camundongos recebendo CD / HFD. Em conclusão, esses resultados sugerem que a constituição de GM e dieta desempenham papel significativo na inflamação levando ao início ou/e possivelmente à progressão de T2D.


Subject(s)
Humans , Animals , Rabbits , Diabetes Mellitus, Type 2 , Gastrointestinal Microbiome , Bacteroides , RNA, Ribosomal, 16S/genetics , Prevotella , Bacteroidetes , Ruminococcus , Diet, High-Fat/adverse effects , Dysbiosis , Inflammation , Mice, Inbred C57BL
3.
Rev. bras. med. esporte ; 28(2): 85-88, Mar-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365681

ABSTRACT

ABSTRACT Introduction: There is an annual increase in type 2 diabetes (T2DM) incidence in middle-aged people. Aerobic exercise is known to influence glucose metabolic pathways positively. Few studies concerning calisthenic aerobic exercise and its influence on elderly patients with T2DM. Objective: To measure the therapeutic effect of calisthenic exercise in obese Middle-aged people with T2DM. Methods: A total of 86 patients with T2DM were selected from the physical examination of employees of the same unit. They were randomly divided into the exercise group and the control group. The exercise intervention lasted for 16 weeks, with sessions held 3-5 times per week, varying from 60 to 90 minutes per session. The markers evaluated were defined according to the literature and statistically verified. Results: After 16 weeks of calisthenic exercise intervention, compared to the control group or before the experiment, we observed significant reductions in variables VFA (visceral fat area), FPG (fasting glucose), Fins (fasting insulin), HOMA-IR (homeostasis model evaluation of insulin resistance), 2hPBG (postprandial two hours glucose) and HbAlc (hemoglobin Alc) of the exercise group were significantly reduced (P<0.01). Conclusion: Calisthenic exercise intervention can reduce the levels of VFA, FPG. FIns, HOMA-HR, 2hPBG and HbAlc in patients with T2DM. It was also found to reduce the visceral fat content of obese elderly patients with T2DM, reducing obesity risks. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução: Há um aumento anual na incidência de diabetes tipo 2 (T2DM) nas pessoas de meia idade. O exercício aeróbico é conhecido por influenciar positivamente as vias metabólicas da glicose. Porém há poucos estudos sobre o exercício aeróbico calistênico e sua influência em pacientes entre 40 a 60 anos com T2DM. Objetivo: Medir o efeito terapêutico do exercício calistênico em pacientes de meia idade com obesidade e T2DM. Métodos: Um total de 86 pacientes com T2DM foram selecionados a partir do exame físico dos funcionários da mesma unidade. Eles foram divididos aleatoriamente entre o grupo de exercícios e o grupo de controle. A intervenção do exercício durou 16 semanas, com sessões realizadas de 3 a 5 vezes por semana, variando de 60 a 90 minutos por sessão. Os marcadores avaliados foram definidos de acordo com a literatura e verificados estatisticamente. Resultados: Após 16 semanas de intervenção de exercício aeróbico calistênico, em comparação ao grupo controle ou antes do experimento, observamos reduções significativas nas variáveis VFA (área de gordura visceral), FPG (glicose de jejum), Fins (insulina em jejum), HOMA-IR (avaliação do modelo de homeostase de resistência à insulina), 2hPBG (glicose pós-prandial de duas horas) e HbAlc (hemoglobina Alc) do grupo exercício foram significativamente reduzidas (P<0,01). Conclusão: A intervenção de exercício aeróbico calistênico pode reduzir os níveis de VFA, FPG. FIns, HOMA-HR, 2hPBG e HbAlc em pacientes com T2DM. Também foi constatado que reduz o conteúdo de gordura visceral de pacientes idosos obesos com T2DM, reduzindo os riscos de obesidade. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción: Cada año aumenta la incidencia de la diabetes tipo 2 (T2DM) en personas de mediana edad. Se sabe que el ejercicio aeróbico influye positivamente en las vías metabólicas de la glucosa. Pero hay pocos estudios sobre el ejercicio aeróbico calisténico y su influencia en pacientes de 40-60 años con T2DM. Objetivo: Medir el efecto terapéutico del ejercicio calisténico en pacientes de mediana edad con obesidad y T2DM. Métodos: Se seleccionó un total de 86 pacientes con T2DM a partir de la exploración física de los empleados de la misma unidad. Se dividieron aleatoriamente entre el grupo de ejercicio y el grupo de control. La intervención de ejercicios duró 16 semanas, con sesiones realizadas de 3 a 5 veces por semana, de 60 a 90 minutos por sesión. Los marcadores evaluados se definieron según la literatura y se verificaron estadísticamente. Resultados: Después de 16 semanas de intervención de ejercicio aeróbico calisténico, en comparación con el grupo de control o antes del experimento, observamos reducciones significativas en las variables VFA (área de grasa visceral), FPG (glucosa en ayunas), Fins (insulina en ayunas), HOMA-IR (evaluación del modelo de homeostasis de resistencia a la insulina), 2hPBG (glucosa postprandial de dos horas) y HbAlc (hemoglobina Alc) del grupo de ejercicio se redujeron significativamente (P<0,01). Conclusión: La intervención de ejercicio aeróbico calisténico puede reducir los niveles de AGV, FPG. FIns, HOMA-HR, 2hPBG y HbAlc en pacientes con T2DM. También se ha comprobado que reduce el contenido de grasa visceral en pacientes ancianos obesos con T2DM, reduciendo el riesgo de obesidad. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

4.
Arch. endocrinol. metab. (Online) ; 66(1): 32-39, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1364313

ABSTRACT

ABSTRACT Objetivo: Maturity onset diabetes of the young (MODY) patients have clinical heterogeneity as shown by many studies. Thus, often it is misdiagnosed to type 1 or type 2 diabetes(T2DM). The aim of this study is to evaluate MODY mutations in adult T2DM patients suspicious in terms of MODY, and to show clinical and laboratory differences between these two situations. Subjects and methods: In this study, we analyzed 72 type 2 diabetic patients and their relatives (35F/37M) who had been suspected for MODY and referred to genetic department for mutation analysis. The gene mutations for MODY have been assessed in the laboratory of Marmara University genetics. Totally 67 (32F/35M; median age 36.1) diabetic patients were analyzed for 7 MODY mutations. Twelve patients who have uncertain mutation (VUS) were excluded from study for further evaluation. MODY(+) (n:30) patients and T2DM patients (n:25) were compared for clinical and laboratory parameters. Results: In MODY(+) subjects, mutations in GCK (MODY 2) (n:12; 40%) were the most common followed by HNF4A (MODY 1) (n:4; 13.3%). Diabetes diagnosis age was younger in MODY(+) group but not statistically significant. Sixty-six percent of MODY(+) subjects had diabetes history at 3-consecutive generations in their family compared with 28% of T2DM patients statistically significant (p:0.006). Gender, BMI, C-peptide, HbA1c, lipid parameters, creatinine, GFR, microalbuminuria, vitamin D and calcium were not statistically different between the groups. Conclusion: According to present study results, MODY mutation positivity is most probable in young autoantibody (-) diabetic patients diagnosed before 30 years of age, who have first degree family history of diabetes.


Subject(s)
Humans , Adult , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/genetics , C-Peptide , Hepatocyte Nuclear Factor 1-alpha/genetics , Mutation/genetics
5.
Arch. endocrinol. metab. (Online) ; 66(1): 68-76, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364297

ABSTRACT

ABSTRACT The lowest dosage of empagliflozin (10 mg) showed similar benefits on glycated hemoglobin (HbA1c) level, body weight, blood pressure, and total and cardiovascular mortality in comparison with the highest available dose (25 mg) in the EMPAREG trial. These findings have not been clearly demonstrated for canagliflozin and dapagliflozin. The objective was to compare the effect of different doses of SGLT2 inhibitors commercially available in Brazil on HbA1c and body weight of patients with type 2 diabetes. MEDLINE, Cochrane and Embase databases were searched from inception until 11th October 2021 for randomized controlled trials of SGLT2 inhibitors in type 2 diabetes patients, lasting at least 12 weeks. HbA1c and body weight variations were described using standard mean difference. We performed direct and indirect meta-analysis, as well as a meta-regression with medication doses as covariates. Eighteen studies were included, comprising 16,095 patients. In the direct meta-analysis, SGLT2 inhibitors reduced HbA1c by 0.62% (95% CI −0.66 to −0.59) and body weight by 0.60 kg (95% CI −0.64 to −0.55). In the indirect meta-analysis, canagliflozin 300 mg ranked the highest regarding reductions in HbA1c and body weight. The remaining medications and dosages were clinically similar, despite some statistically significant differences among them. Canagliflozin 300 mg seems to be more potent in reducing HbA1c and body weight in patients with type 2 diabetes. The remaining SGLT2 inhibitors at different doses lead to similar effects for both outcomes. Whether these glycemic and weight effects are reflected in lower mortality and cardiovascular events is still uncertain and may be a topic for further studies.


Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Hypoglycemic Agents/therapeutic use , Blood , Body Weight , Brazil , Glycated Hemoglobin A/analysis , Randomized Controlled Trials as Topic , Canagliflozin/therapeutic use
7.
Journal of Preventive Medicine ; (12): 258-262, 2022.
Article in Chinese | WPRIM | ID: wpr-920763

ABSTRACT

Objective@#To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM.@*Methods@#T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis.@*Results@#The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM.@*Conclusions@#The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.

8.
Journal of Preventive Medicine ; (12): 123-128, 2022.
Article in Chinese | WPRIM | ID: wpr-920564

ABSTRACT

Objective@#To investigate the degree and influencing factors of glycosylated hemoglobin ( HbA1c ) control among patients with type 2 diabetes ( T2DM ) living in rural communities of Zhejiang Province, so as to provide the reference for optimizing the management of diabetes patients in rural communities.@*Methods@#Permanent adult patients with T2DM that were registered and received standardized management in all communities of Jiashan County and Suichang County, and 6 communities of Yongkang City, Zhejiang Province in 2016 were recruited, and their demographic characteristics were captured from the health record system and chronic disease management system. The height, body weight, waist circumstance and blood pressure were measured, and HbA1c and blood lipid parameters were detected. The degree of HbA1c control ( <7% ) was analyzed, and its influencing factors were identified using a multivariable logistic regression model.@*Results@#A total of 10 339 patients with T2DM were enrolled, including 4 520 men ( 43.72% ) and 5 819 women ( 56.28% ), with a mean age of ( 63.54±9.78 ) years and the mean course of diabetes of ( 6.36±4.73 ) years. The rate of HbA1c control was 47.89%. Multivariable logistic regression analysis showed that males ( OR=1.123, 95%CI: 1.024-1.233 ), region ( Suichang, OR=2.413, 95%CI: 2.106-2.765; Yongkang, OR=2.460, 95%CI: 2.188-2.767 ), course of disease ( 5-9 years, OR=1.724, 95%CI: 1.504-1.977; 10 years and longer, OR=2.881, 95%CI: 2.477-3.351 ), use of hypoglycemic drugs ( OR=1.203, 95%CI: 1.089-1.329 ), development of chronic complications ( OR=1.190, 95%CI: 1.027-1.379 ), uncontrolled blood pressure ( OR=1.140, 95%CI: 1.030-1.261 ), uncontrolled blood lipid ( OR=1.258, 95%CI: 1.104-1.433 ), and smoking ( OR=1.318, 95%CI: 1.165-1.491 ) were statistically associated with HbA1c control among T2DM patients.@*Conclusion@#The rate of HbA1c control was 47.89% among T2DM patients in rural communities of Zhejiang Province. HbA1c control should be given a high priority among men living in low-economic-level regions with long course of disease, use of hypoglycemic drugs, chronic complications, smoking, uncontrolled blood pressure and lipid.

9.
International Eye Science ; (12): 336-339, 2022.
Article in Chinese | WPRIM | ID: wpr-913049

ABSTRACT

@#AIM: To investigate the changes of tear film function and symptoms of dry eye in patients with diabetic peripheral neuropathy(DPN).METHODS: Retrospective case-control study was conducted. A total of 59 patients(59 eyes)with tear film abnormalities who were diagnosed with type 2 diabetes mellitus(T2DM)were divided into group T2DM(31 cases, 31 eyes)and group DPN(28 cases, 28 eyes)depending on the presence or absence of diabetic peripheral neuropathy. Patients at the Department of Ophthalmology who met the criteria of tear film abnormalities and without diabetes were selected as the non-T2DM group(33 cases, 33 eyes). All subjects were completed the Ocular Surface Disease Index(OSDI), and underwent fluorescein breakup time test(BUT), fluorescein staining(FL), Schirmer Ⅰ test(SchirmerⅠ)and infrared meibomian gland photography.RESULTS: A statistically significant difference was observed among the three groups for the BUT values(<i>F</i>=9.43, <i>P</i><0.01), and differences still existed between any two of the three groups(<i>P</i><0.05). There were no statistically differences among the three groups for the Schirmer Ⅰ and the positive rates of fluorescein staining(<i>P</i>>0.05). There was statistically difference among the three groups for meibomian gland loss scores(χ2=8.433, <i>P</i><0.05). Statistically differences only were observed between DPN group with non-T2DM group or T2DM group(<i>P</i><0.05). Difference of OSDI scores of three groups was statistically significant(<i>P</i><0.05). There was no significant difference between T2DM group and non-T2DM group(<i>P</i>>0.05), meanwhile between DPN group with non-T2DM group or T2DM group, the differences were statistically significant(<i>P</i><0.05).CONCLUSION: T2DM patients with DPN are more likely to have shorter BUT and more meibomian gland loss than T2DM patients without DPN and patients without T2DM, but the symptoms of dry eye are less obvious. Ocular surface abnormalities should be followed up closely in DPN patients.

10.
Ann. Health Res. (Onabanjo Univ. Teach. Hosp.) ; 8(1): 49-62, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1362843

ABSTRACT

Background:The co-existence of diabetes mellitus (DM) and hypertension (HTN) has been rising globally with subclinical atherosclerotic complications. These vascular changes can be detected using carotid ultrasonography. Objectives: To determine and compare the carotid arterial structural wall changes and blood flow velocities of adults with co-existing DM and HTN with age-and sex-matched non-diabetic, non-hypertensive controls. Methods: A cross-sectional comparative study of 300 participants comprising 200 adults with co-existing DM and HTN and 100 age-and sex-matched controls was done. Their carotid arteries were examined bilaterally for plaques, carotid intima media thickness (CIMT) and flow velocities ­peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI) and resistive index (RI) using 4­12MHz linear array transducer. Visceral obesity and serum lipids were also assessed. Results: The mean age of the subjects was 56.13 ± 6.93 years; they comprised 38% males and 62% females. The subjects' CIMT was statistically significantly higher (p = 0.001) with a three-fold mean increase (45.5%) compared to the controls (13.7%). Lower flow velocities but higher indices were also observed in the subjects. Strong and significant correlations were observed between EDV and PI r =-0.663, p=>0.001), EDV and RI (r = -0.661, p=>0.001) and PI and RI (r =0.988, p= >0.001)among the subjects. Conclusion: Significant reduction in flow velocities with increased CIMT may be an early indication of subclinical atherosclerosis. Therefore, carotid ultrasonography should be mandatory in individuals at risk for early detection and possible prevention of atherosclerotic complications.


Subject(s)
Humans , Male , Female , Middle Aged , Blood Flow Velocity , Carotid Artery Diseases , Ultrasonography, Doppler , Diabetes Mellitus, Type 2 , Hypertension
11.
Article in English | AIM, AIM | ID: biblio-1353239

ABSTRACT

Background: Non-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse. Aim: This study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave. Setting: Two public health sector primary care sites in the Cape Town Metro, including a Community Orientated Primary Care (COPC) learning site. Methods: A rapid appraisal with convergent mixed-methods design, including semi-structured interviews with facility and community health workers (CHWs) (n = 20) and patients living with NCDs (n = 8), was used. Interviews were conducted in English and Afrikaans by qualified interviewers. Transcripts were analysed by thematic content analysis. Quantitative data of health facility attendance, chronic dispensing unit (CDU) prescriptions and routine diabetes control were sourced from the Provincial Health Data Centre and analysed descriptively. Results: Qualitative analysis revealed three themes: disruption (cancellation of services, fear of infection, stress and anxiety), service reorganisation (communication, home delivery of medication, CHW scope of work, risk stratification and change management) and outcomes (workload and morale, stigma, appreciation and impact on NCD control). There was a drop in primary care attendance and an increase in CDU prescriptions and uncontrolled diabetes. Conclusion: This study described the service disruption together with rapid reorganisation and change management at primary care level during the first COVID-19 wave. The changes were strengthened by the COPC foundation in one of the study sites. The impact of COVID-19 on primary-level NCD care and management requires more investigation.


Subject(s)
Quality of Health Care , Delivery of Health Care , Noncommunicable Diseases , COVID-19 , Disease Management , Diabetes Mellitus, Type 2 , Hypertension
12.
Motriz (Online) ; 28(spe1): e10220012821, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1356494

ABSTRACT

Abstract Aim: The objective of this study was to compare the global cognitive function and depressive symptoms in hypertensive and/or diabetic middle-aged and elderly women (52-76 years old). Methods: Sixteen participants with hypertension (HT) and 12 with hypertension and type 2 diabetes mellitus (HT+DM) were included; sociodemographic data, anthropometric measurements, and blood pressure were analyzed, and questionnaires for cognitive screening (Mini-Mental State Examination - MMSE) and depressive symptoms (Geriatric Depression Scale - GDS-30) were administered. For statistical analysis, independent Student's t-test, chi-square test (dichotomous variables), and the Mann-Whitney test (ordinal variables) were used and p < 0.05 was adopted. Results: Results indicate that there were no significant differences pertaining to depressive symptoms (HT = 7.4 ± 5.5; HT+DM = 10.2 ± 4.6 points; p = 0.1658) and global cognitive function (HT = 22.3 ± 4.2; HT+DM = 21.0 ± 3.2 points; p = 0.4015) between hypertensive women and hypertensive and diabetic women, contradicting the hypothesis that the presence of two comorbidities would intensify cognitive impairment and mental health. However, clinically relevant cognitive decline (HT = 63%; HT+DM = 75%; χ2 = 0.4834) and depressive symptoms (HT = 38%; HT+DM = 33%; χ2 = 0.8199) were found in both groups. Conclusion: It has been shown that the presence of two comorbidities: type 2 diabetes mellitus and hypertension, does not intensify cognitive impairment and mental health when compared to hypertension alone in middle-aged and elderly women.

13.
Rev. bras. enferm ; 75(4): e20210260, 2022. tab
Article in English | LILACS-Express | LILACS, BDENF | ID: biblio-1360869

ABSTRACT

ABSTRACT Objectives: to analyze the sociodemographic and clinical variables related to the adherence to self-care activities in people with diabetes mellitus type 2. Methods: quantitative, cross-sectional study, carried out with 270 people with diabetes from December 2019 to October 2020, in São Luís, Maranhão. Results: the adherence to self-care was greater when it comes to medications (Md=7.0) and foot care (Md= 6.0), but lower in regard to blood sugar testing (Md=1.0), exercise (Md=2,0), and diet (general) (Md=4.0). The variables age group (p=0.007), educational level (p=0.015), body mass index (p=0.035), complications with diabetes (p=0.009), and nutritional follow-up (p=0.000) had associations with self-care activities. Conclusions: identifying the factors related to the adherence to self-care was found to be essential to strengthen the line of care in chronic diseases and to direct educational actions, aiming to improve the quality of life of people with diabetes.


RESUMEN Objetivos: analizar variables sociodemográficas y clínicas relacionadas a la adhesión a actividades de autocuidado en personas con diabetes mellitus tipo 2. Métodos: estudio cuantitativo, transversal, realizado con 270 personas con diabetes, entre diciembre de 2019 y octubre de 2020, en São Luís, Maranhão. Resultados: hubo adhesión más favorable al autocuidado cuanto al uso del medicamento (Md=7,0) y cuidados con los pies (Md= 6,0) y adhesión menos deseable cuanto al monitoreo de la glucemia (Md=1,0), práctica de actividad física (Md=2,0) y alimentación general (Md=4,0). Las variables franja etaria (p=0,007), escolaridad (p=0,015), índice de masa corporal (p=0,035), complicación del diabetes (p=0,009) y acompañamiento nutricional (p=0,000) presentaron relación con las actividades de autocuidado. Conclusiones: la identificación de factores relacionados a la adhesión al autocuidado se mostró esencial para el fortalecimiento de la línea de cuidados en enfermedades crónicas y direccionamiento de acciones educativas, visando mejorar la calidad de vida de personas con diabetes.


RESUMO Objetivos: analisar as variáveis sociodemográficas e clínicas relacionadas com a adesão às atividades de autocuidado em pessoas com diabetes mellitus tipo 2. Métodos: estudo quantitativo, transversal, realizado com 270 pessoas com diabetes, entre dezembro de 2019 e outubro de 2020, em São Luís, Maranhão. Resultados: houve adesão mais favorável ao autocuidado quanto ao uso do medicamento (Md=7,0) e cuidados com os pés (Md= 6,0) e adesão menos desejável quanto à monitorização da glicemia (Md=1,0), prática da atividade física (Md=2,0) e alimentação geral (Md=4,0). As variáveis faixa etária (p=0,007), escolaridade (p=0,015), índice de massa corporal (p=0,035), complicação do diabetes (p=0,009) e acompanhamento nutricional (p=0,000) apresentaram associação com as atividades de autocuidado. Conclusões: a identificação dos fatores relacionados com a adesão ao autocuidado mostrou-se essencial para o fortalecimento da linha de cuidados em doenças crônicas e direcionamento das ações educativas, visando melhorar a qualidade de vida das pessoas com diabetes.

14.
Braz. j. med. biol. res ; 55: e11821, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364561

ABSTRACT

Evidence has shown that women with type 2 diabetes mellitus (T2DM) have a greater risk of cardiovascular complications compared with men, but this sex difference is not clearly understood. This study assessed the microvascular function and circulatory biomarkers in postmenopausal women (PMW) with T2DM compared with diabetic men and their non-diabetic counterparts. Sixty participants were divided into nondiabetic PMW, PMW with T2DM, non-diabetic men, and diabetic men. Microvascular function was assessed using non-invasive equipment (EndoPAT®) and reported as reactive hyperemia index (RHI). Anthropometric and cardiovascular parameters were also measured. Two-way ANOVA was performed using sex (women or men) and T2DM (non-diabetic and diabetic) as the two factors. RHI impairment (1.97±0.14) was detected in diabetic PMW compared with women without T2DM (2.5±0.13) accompanied by lower adiponectin levels (T2DM: 9.3±1.2 and CTL: 13.8±1.8 ug/mL, P<0.05). An increase in the Nε-carboxymethyllysine (CML), nitrate/nitrite, and C-reactive protein (CRP) levels were observed in diabetic PMW compared to the other groups. Although a poor glycemia control was seen in diabetic men, neither RHI nor circulatory biomarkers were affected by T2DM. Multiple linear regression stratified by sex and T2DM identified some variables with RHI only in PMW with T2DM: HbA1c (P=0.003), body mass index (P=0.029), CML (P=0.032), and CRP (P=0.006). Diabetic PMW were more susceptible to the deleterious effects of hyperglycemia than men, showing microvascular dysfunction with high levels of pro-inflammatory mediators (CML and CRP) and a lower adiponectin concentration.

15.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1366183

ABSTRACT

Objetivo: avaliar a frequência e os fatores associados à dislipidemia em pessoas com Diabetes Mellitus Tipo 2. Método: estudo transversal, desenvolvido com 45 pessoas diagnosticadas com diabetes e acompanhadas por uma Unidade Básica de Saúde. Foram investigadas variáveis sociodemográficas, relacionadas ao estilo de vida e referentes à análise do perfil lipídico. Resultados: a prevalência de dislipidemia foi de 82,2%, significativamente associada ao sexo feminino (p=0,005), ao tabagismo (p=0,002) e ao sedentarismo (p=0,050). Nos componentes da dislipidemia, as taxas de colesterol total, triglicérides e LDL se mostraram elevados em 68,9%, 57,8%, 11,1%, respectivamente. Já a taxa de HDL se mostrou diminuída em 2,2% dos investigados. Conclusão: a prevalência de dislipidemia mostrou-se elevada nos pacientes analisados. A existência de associação significativa entre a ocorrência de dislipidemia e variáveis como o sexo feminino, os hábitos de tabagismo e sedentarismo chama a atenção para a necessidade de melhores condutas para essa população


Objective: to evaluate the frequency and factors associated with dyslipidemia in people with type 2 Diabetes Mellitus. Method: cross-sectional study, carried out with 45 people diagnosed with diabetes and followed up at a Basic Health Unit. Sociodemographic variables related to lifestyle and related to lipid profile analysis were investigated. Results: the prevalence of dyslipidemia was 82.2%, significantly associated with female gender (p = 0.005), smoking (p = 0.002) and sedentary lifestyle (p = 0.050). The components of dyslipidemia, total cholesterol, triglycerides and low-density lipoproteins were elevated in 68.9%, 57.8% and 11.1%, respectively. Conclusion: the prevalence of dyslipidemia was high in the patients analyzed. The existence of a significant association between the occurrence of dyslipidemia and different types of females, smoking habits and sedentary lifestyle calls attention to the need for better conduct for this population


Objetivo: evaluar la frecuencia y los factores asociados a la dislipidemia en personas con Diabetes Mellitus tipo 2. Método: estudio transversal, desarrollado con 45 personas diagnosticadas con diabetes y acompañadas por una Unidad Básica de Salud. Se investigaron las variables sociodemográficas, de estilo de vida y de análisis del perfil lipídico. Resultados: la prevalencia de dislipidemia fue del 82,2%, asociada significativamente al sexo femenino (p=0,005), al tabaquismo (p=0,002) y al sedentarismo (p=0,050). En los componentes de la dislipidemia, las tasas de colesterol total, triglicéridos y lipoproteínas de baja densidad estaban elevadas en el 68,9%, 57,8% y 11,1%, respectivamente. Conclusión: la prevalencia de la dislipidemia fue elevada en los pacientes analizados. La existencia de una asociación significativa entre la ocurrencia de dislipidemia y variables como el sexo femenino, los hábitos de tabaquismo y el sedentarismo hace que se preste atención a la necesidad de mejores conductas para esta población


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diabetes Mellitus, Type 2/prevention & control , Dyslipidemias/epidemiology , Life Style , Primary Health Care , Tobacco Use Disorder , Cross-Sectional Studies , Sedentary Behavior
16.
Acta Pharmaceutica Sinica ; (12): 568-575, 2022.
Article in Chinese | WPRIM | ID: wpr-922892

ABSTRACT

Type 2 diabetes is a hypermetabolic disease characterized with disorders of glucose/lipid metabolism, absolute or relative lack of insulin, and can induce skeletal muscle atrophy. Hyperglycemia, hyperlipidemia, insulin resistance, and abnormal release of inflammatory factors can lead to abnormal signal transduction in skeletal muscle, thus make protein synthesis and degradation imbalance and eventually causing muscle atrophy. Under normal conditions, insulin-like growth factor 1 (IGF-1)/insulin can activate phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT). AKT not only increases protein synthesis through mammalian target protein of rapamycin (mTOR), but also phosphorylates forkhead box O (FoxO) transcription factor and then inhibits the transcription of several ubiquitin ligases (such as MAFbx/atrogin-1 and MuRF1), or autophagy related genes. The weakened IGF-1/PI3K/AKT pathway in type 2 diabetes is an important factor leading to skeletal muscle atrophy. Studies have shown that the commonly used anti-type 2 diabetic drugs have different effects in regulating the synthesis and degradation of skeletal muscle protein. Studies reported that drugs with effect of anti-diabetic muscle atrophy include thiazolidinediones, glucagon-like peptide analogs, glucose-sodium cotransporter 2 inhibitors, etc.; drugs that are still in controversial or even promote skeletal muscle atrophy include metformin, and some sulfonylurea or non-sulfonylurea insulin secretagogues. This article overviewed and analyzed the currently commonly used drugs for type 2 diabetes and summarized the related mechanisms, with the aim to provide references for the rational applications of drugs for type 2 diabetes.

17.
International Eye Science ; (12): 623-628, 2022.
Article in Chinese | WPRIM | ID: wpr-922864

ABSTRACT

@#AIM: To explore the risk factors of xerophthalmia after cataract surgery in patients with type 2 diabetes mellitus, and to construct a risk prediction model.METHODS: A total of 212 patients(212 eyes)with type 2 diabetes who underwent cataract surgery in our hospital from April 2019 to April 2021 were selected. The patients were divided into dry eye group(43 cases, 43 eyes)and non-xerophthalmia eye(169 cases, 169 eyes). The general data, laboratory examination index and quality of life score of the two groups were compared; multivariate Logistic regression analysis was used to analyze the risk factors of postoperative xerophthalmia; constructed a line chart prediction model and evaluated its prediction accuracy. RESULTS: There were significant differences in the history of keratoconjunctival disease, pterygium, meibomian gland dysfunction, lens nucleus hardness, disease cognition, postoperative anxiety, postoperative depression, surgical incision, medication compliance, and the levels of interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and HbA1c at 1wk after operation between the two groups(<i>P</i><0.05). The results of multivariate Logistic regression analysis showed that postoperative anxiety, postoperative depression, 3.0mm of surgical incision, IL-1β>31.26ng/mL, IL-6>29.42ng/mL, TNF-α>77.68ng/mL and HbA1c≥6.50% were risk factors for postoperative xerophthalmia(<i>P</i><0.05). The calibration curve and standard curve of the nomogram prediction model were fit well, and the prediction probabilities were mostly distributed around 0 and 1, with high accuracy.The visual function evaluation, environmental trigger factors, ocular discomfort symptoms and ocular surface disease index(OSDI)score in the dry eye group was significantly higher than those in the non-xerophthalmia group(<i>P</i><0.05). CONCLUSION: Surgical incision, postoperative anxiety, depression, medication compliance, serum inflammatory factors and HbA1c are all related to xerophthalmia after cataract surgery in patients with type 2 diabetes. Early identification of risk factors and timely intervention are helpful to reduce the incidence of postoperative xerophthalmia and improve the quality of life.

18.
China Pharmacy ; (12): 84-89, 2022.
Article in Chinese | WPRIM | ID: wpr-907018

ABSTRACT

OBJECTIVE To observe the effects of Xuesaitong soft capsule on the complement-inflammatory receptor system in patients with type 2 diabetic nephropathy. METHODS A total of 92 patients with type 2 diabetic nephropathy were divided into control group and observation group by random number table method ,with 46 cases in each group. Patients in the control group were given basic treatment programs (including low-salt and low-protein diet ,quitting smoking and alcohol ,appropriate exercise , lowering blood pressure ,blood sugar and lipid ,etc.). The patients in the observation group took Xuesaitong soft capsules orally on the basis of the treatment of the control group ,0.55 g each time ,3 times a day. The treatment course of both groups was 4 weeks. Compare the renal function of the two groups of patients [24 h urine protein quantification ,serum creatinine (Scr),blood urea nitrogen,glomerular filtration rate (GFR)],fasting blood glucose ,glycosylated hemoglobin ,complement factors [C3,C5, complement factor H (CFH),C5b-9],inflammatory factors [interleukin 1(IL-1),tumor necrosis factor α(TNF-α),IL-6,monocyte chemoattractant protein- 1(MCP-1)],renal tubular injury markers [β2-microglobulin(β2-MG),retinol binding protein 4(RBP4), neutrophil gelatinase associated lipocalin] levels;correlation between renal tubular damage and complement-inflammatory receptor system was analyzed in the observation group before and after treatment. RESULTS Compared with before treatment ,24 h urine protein quantity ,Scr,C3,IL-1,TNF-α,MCP-1,β2-MG and RBP 4 of 2 groups were reduced significantly after treatment ,while GFR and CFH were significantly increased ;except for C 3,the observation group was significantly better than the control group (P< 0.05). C 5 of the observation group was significantly decreased after treatment and was significantly lower than the control group (P<0.05). There were no statistically significant 60979837。E-mail:shanght126@126.com differences in other indicators of the two groups before and after treatment and between groups (P>0.05). C 3,MCP-1 and TNF-α were significantly correlated with renal tubular com damage (P<0.05),and esp ecially C 3. CONCLUSIONS Xuesaitong soft capsule can reduce renal tubular damage in patients with type 2 diabetic nephropathy and improve renal function by acting on the complement system and reducing inflammation.

19.
Arch. endocrinol. metab. (Online) ; 65(6): 801-810, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1349996

ABSTRACT

ABSTRACT Objective: To evaluate the prevalence of osteosarcopenia and the association of osteosarcopenia with trabecular bone score (TBS) in a group of patients with type 2 diabetes mellitus(T2DMG) compared with a paired control group (CG). Materials and methods: Cross-sectional study with men and women ≥ 50 years recruited by convenience. Patients in both groups answered questionnaires and underwent evaluation of bone mineral density (BMD), handgrip strength (HGS), and TBS. The T2DMG also underwent a gait speed (GS) test. Sarcopenia was defined as low lean mass plus low HGS or GS according to the Foundation for the National Institute of Health Sarcopenia Project, and osteosarcopenia was deemed present when sarcopenia was associated with osteopenia, osteoporosis, or low-energy trauma fractures. Results: The T2DMG (n = 177) and CG (n = 146) had, respectively, mean ages of 65.1 ± 8.2 years and 68.8 ± 11.0 years and 114 (64.4%) and 80 (54.7%) women. T2DMG versus the CG had higher rates of osteosarcopenia (11.9% versus 2.14%, respectively, p = 0.010), sarcopenia (12.9% versus 5.4%, respectively, p < 0.030), and fractures (29.9% versus 18.5%, respectively, p = 0.019), and lower HGS values (24.4 ± 10.3 kg versus 30.9 ± 9.15 kg, respectively, p < 0.001), but comparable BMD values. Mean TBS values were 1.272 ± 0.11 and 1.320 ± 0.12, respectively (p = 0.001). On multivariate analysis, age, greater waist circumference, fractures, and osteoporosis increased the risk of degraded TBS. Osteosarcopenia was associated with diabetes complications (p = 0.03), calcium and vitamin D supplementation (p = 0.01), and all components of osteosarcopenia diagnosis (p < 0.05). Conclusion: Compared with the CG, the T2DMG had a higher prevalence of osteosarcopenia, sarcopenia, and fractures and lower bone quality assessed by TBS.


Subject(s)
Humans , Male , Female , Aged , Osteoporosis/etiology , Osteoporosis/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Sarcopenia/etiology , Sarcopenia/epidemiology , Absorptiometry, Photon , Bone Density , Cross-Sectional Studies , Hand Strength , Cancellous Bone/diagnostic imaging , Middle Aged
20.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1357574

ABSTRACT

Introducción: Las tecnologías de información y comunicación pueden ayudarnos a mejorar el control metabólico y la adherencia de las personas con diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de una intervención con llamadas telefónicas en pacientes ambulatorios con DM2 mal controlada de un hospital en Perú. Material y Métodos: Ensayo clínico aleatorizado. Incluimos adultos con DM2 con mal control glicémico (HbA1c > 7%), quienes fueron aleatorizados al grupo control (cuidado usual) o al grupo intervención (cuidado usual más una intervención con llamadas telefónicas cada dos semanas por tres meses). El desenlace principal fue la reducción ≥ 1% de hemoglobina glicosilada a los tres meses. Resultados: Se reclutó 94 participantes (47 en cada grupo). La edad promedio fue 59,8 años (DE: 10,2), 69,2 % fueron mujeres. A los tres meses, solo 14/47 participantes del grupo control y 13/47 participantes del grupo intervención tuvieron medición de HbA1c. Entre estos, el porcentaje de los que lograron una disminución ≥ 1% de HbA1c fue de 35,7% (5/14) en el grupo control y 53,8% (7/13) en el grupo intervención (RR: 0,72, IC 95%: 0,35-1,47). No se encontró diferencias en la adherencia al tratamiento entre ambos grupos. Conclusiones: No se encontró diferencias estadísticamente significativas para los desenlaces de interés. Posiblemente esto se deba al bajo porcentaje de participantes a los que se logró completar el seguimiento.


Introduction: Information and communication technologies can help us improve metabolic control and adherence in people with type 2 diabetes mellitus (DM2). Objective: To evaluate the effects of an intervention with telephone calls in outpatients with poorly controlled DM2 in a hospital in Peru. Material and Methods: Randomized clinical trial. We included adults with DM2 with poor glycemic control, who were randomized to the control group (usual care) or to the intervention group (usual care plus a telephone intervention every two weeks for three months). The primary outcome was a ≥ 1% reduction in glycosylated hemoglobin at three months. Results: 94 participants were recruited (47 in each group). Mean age was 59.8 years (SD: 10.2), 69.2 % were women. At three months, only 14/47 participants in the control group and 13/47 participants in the intervention group had HbA1c measurement. Among these, the percentage of those who achieved a ≥ 1% decrease in HbA1c was 35,7% (5/14) in the control group and 53,8% (7/13) in the intervention group (RR: 0,72, 95% CI: 0,35-1,47). No differences were found in adherence to treatment between groups. Conclusions: No statistically significant differences were found for the outcomes of interest. This is possibly due to the low percentage of participants who were able to complete follow-up. Innovative solutions are needed to improve the control of people with DM2.

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