The effect of cinnamon cassia powder in type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes is a chronic metabolic disorder and the incidence of cardiovascular is increased two- to fourfold in its complications. Cinnamon is expected to have some degree of anti-diabetic efficacy without troublesome side effects. The objective of the present study was to investigate the anti-diabetic effect of cinnamon cassia powder in type 2 diabetic patients MATERIAL AND METHOD: Sixty type 2 diabetic patients were randomized either 1.5 g/d of cinnamon cassia powder or placebo. Both groups were in combination with their current treatment (metformin or sulfonylurea) according to single blind randomized, placebo-control trial in a 12-week period. Efficacy was evaluated by HbA1c fasting plasma glucose, Lipid profile, BUN, creatinine, liver function test and adverse effects were recorded. RESULTS: After a 12-week period, HbA1c was decreased similarly in both groups from 8.14% to 7.76% in the cinnamon group and from 8.06% to 7.87% in the placebo group. This was not found statistically significantly different. However the proportion of patients achieving HbA1c < or = 7% was also greater in patients receiving cinnamon compared with patients receiving placebo, nevertheless, it was not found statistically significantly different (35% vs 15%, x2 = 3.14, p > 0.05). No significant intergroup differences were observed in lipid profile, fasting plasma glucose except in SGOT 27.1 (8.75) to 22.1 (5) in cinnamon group and 24.08 (8.5) to 23.63 (8.88) in the placebo group (p = 0.001). CONCLUSION: The cinnamon cassia powder 1.5 g/d did not have any significant difference in reducing fasting plasma glucose, HbA1c and serum lipid profile in type 2 diabetes patients who had mean fasting plasma glucose 154.40 +/- 24.72 mg/dl.

Personality profiles of suicidal depressed patients.

OBJECTIVE: To investigate the personality profiles of depressed patients who attempted suicide. MATERIAL AND METHOD: The sample consisted of 80 patients aged above 18 years who presented with suicidal attempt and had clinical depression and 80 depressed patients who had never attempted suicide. The subjects were clinically assessed for depression and measured severity objectively with the Hamilton Depression Rating Scale (HAM-D). Personality was assessed via the Sixteen Personality Factor Questionnaire (16PF). RESULTS: The personality profile showed that patients with suicidal attempt were easily affected by feelings, emotionally less stable, concrete thinking, relatively more uninhibited and imaginative compared to those without suicidal attempt. CONCLUSION: Depressed patients who attempted suicide appeared to have a distinctive personality profile. Exploration and intervention tailored to specific personality profile particularly emotional instability, and concrete thinking in individuals with depression should be included in management of depression for prevention and reducing risk of suicide.

Effect of diabetes drug counseling by pharmacist, diabetic disease booklet and special medication containers on glycemic control of type 2 diabetes mellitus: a randomized controlled trial.

BACKGROUND: type 2 diabetes mellitus continues to increase in prevalence worldwide. Many factors have been cited as contributing to compliance, such as family and social support, education, number of tablets per dose, frequency of administration and health care provider communication. Toward these goals, the present study was developed to measure the effect offactors on glycemic control such as diabetes education by pharmacists, a diabetes disease booklet and special medication containers. MATERIAL AND METHOD: A total of 360 volunteers with type 2 DM patients were recruited, participants were simple randomized to control 180 and intervention 180 patients. Which intervention categorized to 4 groups; all intervention groups received diabetes drug counseling by a pharmacist, one group received plus a diabetes booklet, one received plus special medical containers and the last group received all of them. The interventions were done at the 1st time of visit. Both the control and intervention groups were monitored for fasting plasma glucose and HbA1c at 0, 3, 6 months and glycemic level in both groups was compared. RESULTS: After 3 months, mean fasting plasma glucose and HbA1c decreased wiih the intervention group vs. control group (152.36 +/- 39.73 to 131.52 +/- 35.22 mg%) and (150.16 +/- 41.78 to 153.98 +/- 47.95 mg%) respectively; (p < 0.001). HbA1c level 8.16 +/- 1.44 to 7.72 +/- 1.26 vs 8.01 +/- 1.51 to 8.38 +/- 1.46 respectively; (p < 0.001). After 6 months, mean fasting plasma glucose and HbA1c decreased with the intervention group vs. control group (152.36 +/- 39.73 to 145.20 +/- 46.07 mg%) and (150.16 +/- 41.78 to 159.16 +/- 54.90 mg%) respectively; (p < 0.013). HbA1c level 8.16 +/- 1.44 to 7.91 +/- 1.27 vs. 8.01 +/- 1.51 to 8.80 +/- 1.36 respectively; (p < 0.001). The most favorable glycemic outcome was the group that received all of the interventions; mean FPG was reduced from 147.46 +/- 36.07 to 125.38 +/- 31.12 mg% (p < 0.000) in 1nd visit (3 months later) and still reducing effect on the 2nd visit (6 month later) mean FPG from 147.46 +/- 36.07 to 130.21 +/- 33.96 mg% (p < 0.016) also the same way in HbA 1c level. The group that received only drug counseling by pharmacist had no significant reduction in FPG and HbA1c. (p > 0.05). CONCLUSION: Drug counseling by a pharmacist has little beneficial effect on diabetes management outcome compared to the diabetes booklet and special drug container. To improve glycemic control of type 2 DM is to integrate self-management in daily life, wide a variety of education, drug taken behavior and health care provider available communication produce improvement in patient management and is somewhat better when used in combination.

Social support in depressed patients who attempted suicide.

OBJECTIVES: To identify the level of perceived social support in depressed patients who attempted suicide and to determine whether perceived social support is associated with suicidal attempt in depressed patients. MATERIAL AND METHOD: The sample consisted of 90 patients who presented with suicidal attempt and had clinical depression and 90 depressed patients who had never attempted suicide. The subjects were clinically assessed for depression, availability of social support and their satisfaction, number of friends and consultants and family history. Subjects were recruited at King Chulalongkorn Memorial Hospital from July 2000 to June 2002. RESULTS: The depressed patients who attempted suicide had lower mean scores in all areas of perceived social support and reported having fewer friends and consultants than those without suicidal attempt. They also had a higher rate of financial problems, substance abuse and family history of alcohol or substance use disorder. The scores for severity of depression and level of perceived social support were negatively correlated with statistical significance. CONCLUSION: Depressed patients who attempted suicide were more likely to report fewer of friends and a lower level of social support. Assessment of patient's support network as well as their perception of available social support should be included in the evaluation of depressed patients particularly in those with substance use disorder and intervention to prevent suicide should focus more on increasing their capacity to obtain social resources and modulating their perception.