Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabe...Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabetes control outcomes in Singaporeans with poorly controlled type 2 diabetes.Methods:Eighteen individuals with mild-moderate DR and poor glycemic control[HbA1c≥64 mmol/mol(≥8.0%)over two consecutive 6-month readings]were randomized to DR-IPCP(n=9)or usual care(UC,n=9).The intervention included a physician consultation,an initial personalised eye consultation with a experienced diabetes nurse educator,and three behaviour change follow-up calls.HbA1c(primary outcome),lipids and blood pressure were assessed at baseline and three months post-intervention.Participant feedback regarding the DR-IPCP program was collected at three months via a semi-structured telephone interview.Results:While no significant between-group differences were observed,DR-IPCP participants experienced significant within-group reductions in HbA1c,total cholesterol,and low density lipoprotein at follow-up compared to baseline[7 mmol/mol(−0.8%),−0.64 mmol/L,and−0.66 mmol/L,respectively].No significant within-group changes in these parameters were observed in the UC group.Following the DR-IPCP intervention,participants reported a clearer understanding of the link between diabetes management;the development and progression of DR.Conclusions:DR-IPCP provides an effective short-term improvement in diabetes control parameters in DR patients with poor diabetes control.An adequately powered and longitudinal RCT is warranted to assess the clinical,patient-centred and economic potential of this programme in this population.展开更多
Type 2 diabetes mellitus(T2DM)is typified by the increment of chronic blood glucose levels that is caused by an absolute and/or a relative deficiency of insulin,accounts for 90%of diabetes and causes a range of compli...Type 2 diabetes mellitus(T2DM)is typified by the increment of chronic blood glucose levels that is caused by an absolute and/or a relative deficiency of insulin,accounts for 90%of diabetes and causes a range of complications[1].展开更多
Objective： Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementat...Objective： Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementation of an employer initiated community pharmacist-based disease management program for diabetic patients with poorly controlled diabetes. Methods： Employees with poorly controlled diabetes （glycosylated hemoglobin （A1 C） level 〉 7.5%） were identified fi＇om a large diabetes disease management program, in a rural setting in Texas, US. A longitudinal retrospective study was conducted, analyzing clinical indicators in the diabetes patients following the community pharmacist-based disease management program. The program involved a comprehensive drug therapy assessment and individualized disease management education. Primary outcome measured in the present study was A1C levels, assessed at the baseline visit and at the end of the intervention. Results： A total of 64 patients with poorly controlled diabetes were identified. Significant improvement in mean clinical outcome scores was achieved for A1C levels （p = 0.0011）. At the end of the 1 year longitudinal intervention, targeted body mass index and A1C goals were attained by 35.9% （p 〈 0.001） and 15.6% patients, respectively. The 10 patients reaching goal levels post intervention were in the group that had baseline A1C of 7.5 to 9%. However, patients with 〉 9% A1C levels at baseline had a significant reduction （mean 2.1, p 〈 0.001） post intervention. Conclusion： The community pharmacist-based diabetes disease management program improved A1C levels of patients with poorly controlled diabetes.展开更多
OBJECTIVE: To assess the renal protective effects of curcumin administration ondiabetic rats/mice.METHODS: Databases were searched electronically and conference papers searched manually for search terms to find releva...OBJECTIVE: To assess the renal protective effects of curcumin administration ondiabetic rats/mice.METHODS: Databases were searched electronically and conference papers searched manually for search terms to find relevant studies. Articles were assessed independently by two reviewers. Review Manager 5.1 was used fordata analysis.RESULTS: Fourteen randomized controlled experiments were included. Meta-analysis demonstrated that blood sugar levels and kidney weight to body weight ratios in the model group were higher than those in the normal group, and the curcumin group had significantly lower mesangial area to glomerular area ratios compared with the model group, and also lower levels of urinary protein,blood urea nitrogen and serum creatinine.CONCLUSION: Curcumin shows protective effects on the kidneys of rats/mice with diabetes.展开更多
We sought to evaluate central corneal thickness（CCT）,corneal endothelial cell density（ECD）and intraocular pressure（IOP）in patients with type 2 diabetes mellitus（DM）and to associate potential differences with d...We sought to evaluate central corneal thickness（CCT）,corneal endothelial cell density（ECD）and intraocular pressure（IOP）in patients with type 2 diabetes mellitus（DM）and to associate potential differences with diabetes duration and treatment modality in a prospective,randomized study.We measured ECD,CCT and IOP of125 patients with type 2 DM（mean age 57.1±11.5 years）and compared them with 90 age-matched controls.Measured parameters were analyzed for association with diabetes duration and glucose control modalities（insulin injection or oral medication）while controlling for age.In the diabetic group,the mean ECD（2511±252 cells/mm^2）,mean CCT（539.7±33.6μm）and mean IOP（18.3±2.5 mmHg）varied significantly from those the control group[ECD：2713±132 cells/mm^2（P〈0.0001）,CCT：525.0±45.3μm（P=0.003）and IOP：16.7±1.8 mmHg（P〈0.0001）].ECD was significantly reduced by about 32 cell/mm^2 for diabetics with duration of〉10 years when compared with those with duration of〈10 years（P〈0.05）.CCT was thicker and IOP was higher for diabetics with duration of〉10 years than those with duration of〈10 years（P〉0.05）.None of the measured parameters was significantly associated with diabetes duration and treatment modality（P〉0.05）.In conclusion,subjects with type 2DM exhibit significant changes in ECD,IOP and CCT,which,however,are not correlated with disease duration or if the patients receive on insulin injection or oral medications.展开更多
基金This study was supported by Singapore Health Services Pte Ltd.Prof Ecosse L.Lamoureux received the funding under the SingHealth Research Strategic Hires Scheme,STH-1202-SERI.The grant body had no roles in design,conduct or data analysis of the study.
文摘Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabetes control outcomes in Singaporeans with poorly controlled type 2 diabetes.Methods:Eighteen individuals with mild-moderate DR and poor glycemic control[HbA1c≥64 mmol/mol(≥8.0%)over two consecutive 6-month readings]were randomized to DR-IPCP(n=9)or usual care(UC,n=9).The intervention included a physician consultation,an initial personalised eye consultation with a experienced diabetes nurse educator,and three behaviour change follow-up calls.HbA1c(primary outcome),lipids and blood pressure were assessed at baseline and three months post-intervention.Participant feedback regarding the DR-IPCP program was collected at three months via a semi-structured telephone interview.Results:While no significant between-group differences were observed,DR-IPCP participants experienced significant within-group reductions in HbA1c,total cholesterol,and low density lipoprotein at follow-up compared to baseline[7 mmol/mol(−0.8%),−0.64 mmol/L,and−0.66 mmol/L,respectively].No significant within-group changes in these parameters were observed in the UC group.Following the DR-IPCP intervention,participants reported a clearer understanding of the link between diabetes management;the development and progression of DR.Conclusions:DR-IPCP provides an effective short-term improvement in diabetes control parameters in DR patients with poor diabetes control.An adequately powered and longitudinal RCT is warranted to assess the clinical,patient-centred and economic potential of this programme in this population.
基金supported by the National Nature Science Foundation of China[No.81872626]Science and Technology Foundation for Innovation Talent of Henan Province[No.154200510010]Science and Technology Plan of Henan Province[No.172102310029]。
文摘Type 2 diabetes mellitus(T2DM)is typified by the increment of chronic blood glucose levels that is caused by an absolute and/or a relative deficiency of insulin,accounts for 90%of diabetes and causes a range of complications[1].
文摘Objective： Patients with poorly controlled diabetes have more medical complications and are more difficult to manage. The objective of the present study was to evaluate the clinical outcomes of successful implementation of an employer initiated community pharmacist-based disease management program for diabetic patients with poorly controlled diabetes. Methods： Employees with poorly controlled diabetes （glycosylated hemoglobin （A1 C） level 〉 7.5%） were identified fi＇om a large diabetes disease management program, in a rural setting in Texas, US. A longitudinal retrospective study was conducted, analyzing clinical indicators in the diabetes patients following the community pharmacist-based disease management program. The program involved a comprehensive drug therapy assessment and individualized disease management education. Primary outcome measured in the present study was A1C levels, assessed at the baseline visit and at the end of the intervention. Results： A total of 64 patients with poorly controlled diabetes were identified. Significant improvement in mean clinical outcome scores was achieved for A1C levels （p = 0.0011）. At the end of the 1 year longitudinal intervention, targeted body mass index and A1C goals were attained by 35.9% （p 〈 0.001） and 15.6% patients, respectively. The 10 patients reaching goal levels post intervention were in the group that had baseline A1C of 7.5 to 9%. However, patients with 〉 9% A1C levels at baseline had a significant reduction （mean 2.1, p 〈 0.001） post intervention. Conclusion： The community pharmacist-based diabetes disease management program improved A1C levels of patients with poorly controlled diabetes.
文摘OBJECTIVE: To assess the renal protective effects of curcumin administration ondiabetic rats/mice.METHODS: Databases were searched electronically and conference papers searched manually for search terms to find relevant studies. Articles were assessed independently by two reviewers. Review Manager 5.1 was used fordata analysis.RESULTS: Fourteen randomized controlled experiments were included. Meta-analysis demonstrated that blood sugar levels and kidney weight to body weight ratios in the model group were higher than those in the normal group, and the curcumin group had significantly lower mesangial area to glomerular area ratios compared with the model group, and also lower levels of urinary protein,blood urea nitrogen and serum creatinine.CONCLUSION: Curcumin shows protective effects on the kidneys of rats/mice with diabetes.
文摘We sought to evaluate central corneal thickness（CCT）,corneal endothelial cell density（ECD）and intraocular pressure（IOP）in patients with type 2 diabetes mellitus（DM）and to associate potential differences with diabetes duration and treatment modality in a prospective,randomized study.We measured ECD,CCT and IOP of125 patients with type 2 DM（mean age 57.1±11.5 years）and compared them with 90 age-matched controls.Measured parameters were analyzed for association with diabetes duration and glucose control modalities（insulin injection or oral medication）while controlling for age.In the diabetic group,the mean ECD（2511±252 cells/mm^2）,mean CCT（539.7±33.6μm）and mean IOP（18.3±2.5 mmHg）varied significantly from those the control group[ECD：2713±132 cells/mm^2（P〈0.0001）,CCT：525.0±45.3μm（P=0.003）and IOP：16.7±1.8 mmHg（P〈0.0001）].ECD was significantly reduced by about 32 cell/mm^2 for diabetics with duration of〉10 years when compared with those with duration of〈10 years（P〈0.05）.CCT was thicker and IOP was higher for diabetics with duration of〉10 years than those with duration of〈10 years（P〉0.05）.None of the measured parameters was significantly associated with diabetes duration and treatment modality（P〉0.05）.In conclusion,subjects with type 2DM exhibit significant changes in ECD,IOP and CCT,which,however,are not correlated with disease duration or if the patients receive on insulin injection or oral medications.
