ABSTRACT
AIM: To evaluate the effectiveness of DiabeText, a low-intensity, multifaceted, mobile health (mHealth) intervention to support medication taking and lifestyle change targeted to people with type 2 diabetes (T2D). DESIGN: Phase III, 12-months, two-arm (1:1 allocation ratio), randomized parallel-group trial. METHODS: We will recruit 740 adults with glycated hemoglobin (A1c) >8% (>64 mmol/mol) and with at least one prescription of a non-insulin antidiabetic drug. They will be allocated to a control (usual care) group or an intervention (DiabeText messaging intervention) group. The primary outcome measure will be A1c at 12 months follow-up. Secondary outcomes will include medication possession ratio and behavioral and psychological outcomes. DISCUSSION: Recent trials suggest that digital health interventions can effectively support diabetes self-management improving T2D control and reducing important T2D complications. In Spain this type of interventions is understudied. IMPACT: This trial will strengthen the evidence base of the impact of mHealth interventions to support diabetes self-management. If effective, DiabeText may offer a low-cost and highly scalable strategy to improve health at the population level in a sustainable way. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT05006872; Official Title: Supporting People with Type 2 Diabetes in Effective Use of their Medicine Through a System Comprising Mobile Health Technology Integrated with Clinical Care.
Subject(s)
Diabetes Mellitus, Type 2 , Telemedicine , Text Messaging , Adult , Humans , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/psychology , Glycated Hemoglobin , Healthy Lifestyle , Telemedicine/methods , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Non-alcoholic fatty liver disease is a chronic disease caused by the accumulation of fat in the liver related to overweight and obesity, insulin resistance, hyperglycemia, and high levels of triglycerides and leads to an increased cardiovascular risk. It is considered a global pandemic, coinciding with the pandemic in 2020 caused by the "coronavirus disease 2019" (COVID-19). Due to COVID-19, the population was placed under lockdown. The aim of our study was to evaluate how these unhealthy lifestyle modifications influenced the appearance of metabolic alterations and the increase in non-alcoholic fatty liver disease. METHODS: A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. RESULTS: Differences in the mean values of anthropometric and clinical parameters before and after lockdown were revealed. There was a statistically significant worsening in non-alcoholic fatty liver disease (NAFLD) and in the insulin resistance scales, with increased body weight, BMI, cholesterol levels with higher LDL levels, and glucose and a reduction in HDL levels. CONCLUSIONS: Lockdown caused a worsening of cardiovascular risk factors due to an increase in liver fat estimation scales and an increased risk of presenting with NAFLD and changes in insulin resistance.
Subject(s)
COVID-19 , Insulin Resistance , Non-alcoholic Fatty Liver Disease , Adult , COVID-19/epidemiology , Communicable Disease Control , Humans , Liver/metabolism , Longitudinal Studies , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/metabolism , Pandemics , Prospective Studies , Risk FactorsABSTRACT
In December 2019, 27 cases of pneumonia were reported in Wuhan. In 2020, the causative agent was identified as a virus called SARS-CoV-2. The disease was called "coronavirus disease 2019" (COVID-19) and was determined as a Public Health Emergency. The main measures taken to cope with this included a state of lockdown. The aim of this study was to assess how the unhealthy lifestyles that ensued influenced different parameters. A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Anthropometric, clinical, and analytical measurements were performed, revealing differences in the mean values of anthropometric and clinical parameters before and after lockdown due to the pandemic, namely increased body weight (41.1 ± 9.9-43.1 ± 9.9), BMI (25.1 ± 4.7-25.9 ± 4.7), and percentage of body fat (24.5 ± 9.1-26.9 ± 8.8); higher total cholesterol levels, with a statistically significant increase in LDL levels and a reduction in HDL; and worse glucose levels (90.5 ± 16.4-95.4 ± 15.8). Lockdown can be concluded to have had a negative effect on health parameters in both sexes in all age ranges, causing a worsening of cardiovascular risk factors.
Subject(s)
COVID-19 , Glucose , Adult , Blood Pressure , COVID-19/epidemiology , Communicable Disease Control , Female , Humans , Lipids , Longitudinal Studies , Male , Pandemics , Prospective Studies , SARS-CoV-2Subject(s)
Basal Ganglia Diseases/etiology , Brain Diseases, Metabolic/etiology , Calcinosis/etiology , Hypoparathyroidism/complications , Calcitriol/therapeutic use , Calcium/blood , Cognition Disorders/etiology , Depressive Disorder/complications , Diagnosis, Differential , Dyslipidemias/complications , Female , Gait Disorders, Neurologic/etiology , Gluconates/therapeutic use , Humans , Hypoparathyroidism/blood , Hypoparathyroidism/diagnosis , Levodopa/therapeutic use , Magnesium/blood , Magnesium/therapeutic use , Middle Aged , SyndromeABSTRACT
Hypoglycemia is a common emergency, and is usually due to insulin therapy or oral hypoglycemic treatment in diabetic patients. In some cases, hypoglycemia can be a paraneoplastic sign. We report the case of a 61-year-old woman with a malignant peritoneal mesothelioma, who was admitted to hospital because of diminished consciousness. The final diagnosis was paraneoplastic hypoglycemia with a positive response to glucagon. The patient was finally discharged with glucagon perfusion.
Subject(s)
Glucagon/therapeutic use , Hypoglycemia/drug therapy , Paraneoplastic Syndromes/drug therapy , Antineoplastic Agents/therapeutic use , Coma/etiology , Fatal Outcome , Female , Glucagon/administration & dosage , Humans , Hypoglycemia/etiology , Infusions, Intravenous , Insulin-Like Growth Factor II/metabolism , Mesothelioma/complications , Mesothelioma/drug therapy , Mesothelioma/metabolism , Middle Aged , Models, Biological , Palliative Care , Paraneoplastic Syndromes/etiology , Perfusion , Peritoneal Neoplasms/complications , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/metabolism , Protein Precursors/metabolism , RecurrenceABSTRACT
La hipoglucemia es una urgencia médica frecuente, en la mayoría de los casos, secundaria a sobredosificación de tratamiento con insulina o hipoglucemiantes orales en pacientes diabéticos. No obstante, en algunos casos puede ser una manifestación paraneoplásica. Presentamos el caso de una paciente de 61 años con un mesotelioma peritoneal maligno, que ingresó por disminución del nivel de conciencia, y finalmente, diagnosticada de hipoglucemia paraneoplásica, con respuesta positiva a la administración de glucagón, por lo que se le dio el alta con perfusión intravenosa continua (AU)
Hypoglycemia is a common emergency, and is usually due to insulin therapy or oral hypoglycemic treatment in diabetic patients. In some cases, hypoglycemia can be a paraneoplastic sign. We report the case of a 61-year-old woman with a malignant peritoneal mesothelioma, who was admitted to hospital because of diminished consciousness. The final diagnosis was paraneoplastic hypoglycemia with a positive response to glucagon. The patient was finally discharged with glucagon perfusion (AU)
