scholarly journals Factors Associated with Poor Glycemic Control Amongst Rural Residents with Diabetes in Korea

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 391
Author(s):  
Junhee Ahn ◽  
Youngran Yang

(1) Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes. The purpose of this study was to identify the factors associated with poor glycemic control amongst rural residents with diabetes in Korea. (2) Methods: This cross-sectional analysis was conducted amongst a total of 522 participants who had completed baseline health examinations for the Korean Genome and Epidemiology Study (KoGES) Rural Cohort from 2005 to 2011. The subjects were divided into two groups: the good glycemic control group (GCG) (glycosylated hemoglobin (HbA1C) < 7%) and the poor GCG (HbA1C ≥ 7%). Logistic regression was used to examine the role of sociodemographics, health-related behavior, comorbidity and diabetes-related and clinical factors in poor glycemic control amongst rural residents with diabetes. (3) Results: In total, 48.1% of participants were in the poor GCG. Poor GCG was significantly associated with drinking (odds ratio (OR) = 0.42, 95% CI = 0.24–0.71), lack of regular physical activity (OR = 1.68, 95% CI = 1.03–2.76), fasting blood glucose (FBG) > 130 mg/dL (OR = 7.80, 95% CI = 4.35–13.98), diabetes for > 7 years (OR = 1.79, 95% CI = 1.08–2.98), cholesterol ≥ 200 mg/dL (OR = 1.73, 95% CI = 1.05–2.84) and positive urine glucose (OR = 6.24, 95% CI = 1.32–29.44). (4) Conclusion: Intensive glucose control interventions should target individuals amongst rural residents with diabetes who do not engage in regular physical activity, have been diagnosed with diabetes for more than seven years and who have high fasting-blood glucose, high cholesterol levels and glucose-positive urine.

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Kejela Bula ◽  
Getu Bayisa

Abstract Background: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics’ lives in developing countries. Similar to the rest of sub Saharan African countries, Ethiopia is experiencing significant burden of diabetes with increased prevalence, complications and mortality as well as life threatening disabilities. Reasons for poor glycemic control in type 2 diabetes are complex and multivariable. Hence, this study was aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. Method: A hospital based cross sectional study was conducted on type 2 diabetic patients attending diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose of last three clinic visits were obtained and the mean fasting blood glucose measurements was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable with P< 0.05 was considered statistically significant. Result: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of participants was 43±12.4 years and 154(67.5%) were found not following their general dietary program correctly. Nearly one third, 73(32%) of participants never attended diabetic education and 52(22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148(64.9%) of patients had poor blood glucose control. Age range of 40-60 years (AOR=2.01, 95% CI 0.04-0.06, P=0.044), being illiterate (AOR = 3.12, 95 % CI 1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI 2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR = 3.94, 95 % CI 1.51-27.83, P=0.012), inadequate physical exercise (AOR = 3.19, 95 % CI 1.05-19.84, P=0.019), smoking (AOR = 4.51, 95 % CI 0.00-0.50, p=0.022) were independent predictors of poor glycemic control up on a multivariable logistic regression analysis. Conclusion: Nearly two third of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education as well as barriers of glycemic control should be explored with further research.


2018 ◽  
Vol 9 (8) ◽  
pp. 4469-4479 ◽  
Author(s):  
Shirin Pourafshar ◽  
Neda S. Akhavan ◽  
Kelli S. George ◽  
Elizabeth M. Foley ◽  
Sarah A. Johnson ◽  
...  

Daily consumption of one large egg for 12 weeks improves fasting blood glucose, ATP-binding cassette protein family A1, and apolipoprotein A1 in overweight or obese individuals with pre- and type II diabetes.


2021 ◽  
Author(s):  
Graňák Karol ◽  
Vnučák Matej ◽  
Skálová Petra ◽  
Pytliaková Margaréta ◽  
Laca Ľudovít ◽  
...  

Abstract Introduction: Insulin resistance (IR) at the time of kidney transplant (KT) is the most significant risk factor for the development of post-transplant diabetes mellitus (PTDM) and is a strong predictor of cardiovascular morbidity and mortality in patients after KT. It is possible to improve long-term survival of grafts and patients by influencing just modifiable risk factors, including obesity and the associated IR. The aim of this work is to determine the effect of regular physical activity and lifestyle changes on IR and other risk factors for PTDM in patients after KT.Material and methods: The primary goal was to complete at least 150 minutes of moderate intensity physical exertion per week. Study group (n = 22) performed an aerobic or combined (aerobic + anaerobic) type of sports activity. Monitoring was provided by a sports tracker (Xiaomi Mi Band 4 compatible with Mi Fit mobile application). Control group was consisted of 22 stable patients after KT. Patients in both groups have the same immunosuppressive protocol. The duration of follow-up was 6 months.Results: There were significantly lower waist circumference (P = 0.0437, P = 0.0372), better graft function (P = 0.0036, P = 0.0137), lower value of fasting blood glucose (P = 0.0016, P = 0.0003), C-peptide (P = 0.0447, P = 0014) in the 3rd and 6th month of monitoring and lower low-density lipoprotein at 6 months (P = 0.0444) in the observed group compared to the control group. IR was statistically significantly lower at 6 months (P = 0.0202) and fasting blood glucose at 3 and 6 months (P = 0.0227) in the observed group. In the monitored group, the subgroup performing intensive training achieved a significant additional effect on the reduction of waist circumference (P = 0.0173). Conclusion: In our study, we confirmed a significant effect of regular physical activity in preventing the development of IR and impaired fasting glucose in patients after KT. It is necessary to perform at least 150 minutes of medium-intensity aerobic or combined sport effort per week to achieve this goal.


2018 ◽  
Vol 28 (1) ◽  
pp. 123-132
Author(s):  
Herpreet Thind ◽  
Joseph L. Fava ◽  
Kate M. Guthrie ◽  
Laura Stroud ◽  
Geetha Gopalakrishnan ◽  
...  

Abstract Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management.


Author(s):  
Kartika Yulianti ◽  
◽  
Aris Wibudi ◽  
Mila Citrawati ◽  
◽  
...  

ABSTRACT Background: Diabetes Mellitus (DM) is a group of symptoms that arise due to increased blood sugar levels. Diabetes Mellitus type 2 has a higher risk of developing thyroid dysfunction. Thyroid dysfunction can affect various body metabolism and result in insulin resistance, significantly affecting glycemic control in DM patients. This study aimed to determine the relation between thyroid status as assessed by the level of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and glycemic control (HbA1c). Subjects and Method: A cross-sectional study. A sample of 38 DM patients was selected by purposive sampling. The dependent variable was glycemic control. The independent variables were TSH and FT4. Patients were classified into 4 quartiles (Q) based on their TSH and FT4 levels. Statistic test used was non parametric for category group of variables, which was Chi square test. Results: Mean of fasting blood glucose was 200,56 mg/dL (modus 137 mg/dL), mean of 2 hours post prandial blood glucose was 247 mg/dL (modus 305 mg/dL). Subjetcs with poor glycemic control dominated as much as 76%. Most subjects had TSH level at Q4 (36%), while most of the subjects had FT4 level at Q1 (34%). The results showed that 38 samples with poor glycemic control were 72% in the 4th quartile (Q4) (> 3.1750 mU / L) TSH, and 64.7% were in Q1 (≤ 11.8400) FT4. The analysis showed that there was a significant relation between TSH (p = 0.047) and FT4 (p = 0.041) with glycemic control in type 2 DM patients. Conclusion: FT4 and TSH levels relate to glycemic control in type 2 DM patients Keywords: TSH, FT4, HbA1c, Diabetes Mellitus Correspondence: Mila Citrawati. Department of Faal, Faculty of Medicine, UPN Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta 12450, Telp. (021) 7656971. E-mail: [email protected]. Mobile: 081282990515 DOI: https://doi.org/10.26911/the7thicph.05.12


2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.


2021 ◽  
Vol 14 ◽  
pp. 117863882110352
Author(s):  
Yordanos Mengistu ◽  
Gobena Dedefo ◽  
Mesay Arkew ◽  
Gebeyehu Asefa ◽  
Gutema Jebessa ◽  
...  

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.


2021 ◽  
Author(s):  
Zhiyang Wang ◽  
Carine Ronsmans ◽  
Benjamin Woolf

Background: Although previous studies suggested the protective effect of zinc for type-2 diabetes, the unitary causal effect remains inconclusive. Objective: We investigated the causal effect of zinc as a single intervention on glycemic control in type-2 diabetes patients, using a systematic review of RCTs and two-sample Mendelian randomization (MR). Methods: Four outcomes were identified: fasting blood glucose/fasting glucose, hemoglobin A1c (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), and serum insulin/fasting insulin level. In the systematic review, four databases were searched up to June 2021. Results were synthesized through the random-effects meta-analysis. Single nucleotide polymorphisms (SNPs) that are independent and are strongly related to zinc supplements were selected from MR-base to perform the two-sample MR with inverse-variance weighted (IVW) coefficient. Results: In the systematic review, 14 trials were included. The zinc supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): -26.52, 95%CI: -35.13, -17.91), HbA1C (MD: -0.52, 95%CI: -0.90, -0.13), and HOMA-IR (MD: -1.65, 95%CI: -2.62, -0.68), compared to the control group. In the two-sample MR, zinc supplement with 2 SNPs associated with lower fasting glucose (IVW coefficient: -2.04, 95%CI: -3.26, -0.83), but not specified type-2 diabetes. Conclusion: Although the study was limited by the few trials (review) and SNPs (two-sample MR), we demonstrated that the single zinc supplementary improved glycemic control among type-2 diabetes patients with causal evidence to a certain extent.


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