International Journal of Diabetes Management

Mapping Hypertension Case Distribution as the Comorbidity of Diabetes Mellitus

2024-12-31T22:00:36-06:00

Non-Communicable Diseases (NCDs) have become an increasingly significant public health issue annually, emerging as a leading cause of mortality worldwide. Diabetes mellitus is prevalent among the population, often accompanied by comorbidities such as hypertension. Hypertension frequently manifests without symptoms, leading affected individuals unaware of their condition. Data processing is essential to transform hypertension cases due to diabetes mellitus into comprehensible information. Mapping the distribution of hypertension cases using Quantum GIS (Q-GIS) is one method to achieve this. This study aims to map the distribution of hypertension cases using the Q-GIS application in 2022 in Cipaku District, Ciamis Regency, based on village or sub-district, age, and gender.This study employs a descriptive quantitative research design. The instruments utilized include Geographic Information Systems, observation sheets, hardware, software, and digital maps. Data analysis involves univariate analysis, with a simple random sampling technique applied. Preliminary research conducted in January by the Ciamis District Health Office identified Cipaku District as having the highest number of hypertension cases in Ciamis Regency in 2022, totaling 5,528 cases of hypertension.

Self-Centered Intelligent Care (SCIC) in Patients with Diabetes: A Futuristic Scenario

2024-12-31T22:00:36-06:00

Diabetes is a global epidemic that accounts for about 12% of the world's health costs. Diabetes is the main cause of kidney failure, lower limb disorders and blindness in adulthood and it nearly doubles the risk of heart attack and all-cause mortality, leading to hospitalizations, long-term complications, and high costs. In this way, the value of self-care and especially self-centered health care at the individual, institutional, and social levels, in maintaining and improving the health of patients with diabetes becomes more visible. This manuscript introduces the Self-centered intelligent care (SCIC) scenario, which probably patients with diabetes will benefit from in the future.

Insulin Efsitora a Useful Addition to Treatment of Type 2 Diabetes but not Type 1 Diabetes

2024-12-31T22:00:36-06:00

Efsitora is a once-weekly basal insulin under investigation in a series of 5 phase 3 clinical trials called the QWINT development program. In QWINT-2 and QWINT-5 trials including insulin-naïve patients with type 2 diabetes and adults with type 1 diabetes, respectively, efsitora was compared to once-daily degludec. In both trials, efsitora was found non inferior to degludec in lowering glycated hemoglobin (HbA1c) levels after 52 weeks. In patients with type 2 diabetes, 6 episodes of level 3 hypoglycemia (i.e. severe hypoglycemia associated with cognitive impairment) occurred with degludec versus none with efsitora. However, incidence of level 1 hypoglycemia or hypoglycemia alert [blood glucose (BG) 54-69 mg/dl] was numerically greater with efsitora versus degludec, estimated rate ratio (ERR) 1.24 (95% CI, 0.99-1.55). Moreover, rates of level 2 hypoglycemia or clinically significant hypoglycemia (BG <54 mg/dl) were also numerically increased with efsitora versus degludec, ERR 1.34 (0.94-1.78). In type 1 diabetes, the QWINT-5 study showed that incidence of all levels of hypoglycemia was significantly increased with efsitora versus degludec, with relative rates of 1.15 (95% CI, 1.03-1.29; P=0.016) and 3.44 (95% CI, 1.64-7.19; P=0.0011) for levels 1 and 3 hypoglycemia, respectively. Incidence of nocturnal hypoglycemia was similar in efsitora and degludec groups in both QWINT-2 and QWINT-5 trials. Patients’ satisfaction was significantly improved with efsitora versus degludec in patients with type 1 and type 2 diabetes. In conclusion, efsitora might be a convenient basal insulin for patients with type 2 diabetes to decrease number of insulin injections. However, efsitora may be unsafe in patients with type 1 diabetes due to increased risk of hypoglycemia. Further studies are required to determine a safe dose-titration strategy to decrease incidence of hypoglycemia with efsitora.

Correlation between Toe Spread and Toe Hold Pressure: Influence of Flip-Flop Strap Design

2024-12-31T22:00:36-06:00

Background: Every year 9 million diabetics develop foot ulcers (DFU) and 1 million of these will result in an amputation every year resulting in a significant disability burden. Footwear design has been implicated as a major cause of these ulcers resulting in international guidelines recommending specialized protective footwear for diabetics. Unfortunately, in low- and middle-income countries (LMIC), where 80% of diabetics reside, sandals or flip-flops are primary footwear as they are affordable. Studies on flip-flops have focused on plantar pressure and ulcers even though evidence supports that 50% of ulcers are caused by straps on the dorsum of the foot particularly at the toehold. Strap redesign, as evidenced by rolled inner seam (RIS) vs standard straight edge straps, has been shown to reduce pressure on the dorsum of the foot.

Objective: This study aims to understand the relationship between toe spread and toehold pressure as toe spread is a modifiable factor in flip-flops by adjusting the thickness of toe posts in the strap. Further, it aims to validate findings from a smaller sample size prior study that RIS design resulted in lesser pressure at the toehold when compared to standard straight edge design.

Methods: This cross-over study recruited sixteen patients with 64 measures recorded for toehold pressure during a 5-step walking trial. Toes spread was measured by uploading still images to a convolutional neural network keypoint implementation algorithm which marked the midpoints of the great and second toes and measured the distance between them. Pearson correlation and linear regression models were used to assess the relationship between toe spread and toe hold pressure across and within each flip-flop design. Additionally, a t-test was conducted to compare toehold pressures between the two designs to validate prior study findings.

Results: Overall, there was a very weak correlation (r=-0.322) between toe spread and toehold pressure. Regression analysis showed toe spread accounted for a modest variance (R² = 0.104) in toehold pressure overall, with straight edge design showing a slightly stronger association (R² = 0.121) compared to RIS design (R² = 0.022). The t-test validated prior study findings of a statistically significant difference in toehold pressure between RIS and standard straight edge designs, with RIS resulting in lower pressures at the toehold.

Conclusion: Toe spread minimally impacts toehold pressure, suggesting further investigation is needed. However, the Rolled Inner Seam (RIS) design effectively reduces toehold pressures and should be adopted in flip-flop manufacturing to potentially mitigate foot ulcer risks in diabetic populations.

Knowledge, Practice and Associated Factors towards Hypoglycemia Prevention among Caregivers of Diabetic Children: Cross Sectional Study Design

2024-12-31T22:00:36-06:00

Background: Hypoglycemia is an acute medical condition that occurs when blood sugar falls below 70 mg/dl. It is a common and potentially life-threatening complication in children with diabetes. Caregivers play a crucial role in managing and caring for their child's diabetes. This thesis was aimed at assessing hypoglycemia prevention knowledge, practice, and factors associated among caregivers of diabetic children on follow-up at the Ayder Comprehensive specialized hospital Pediatric Endocrinology Clinic in 2024.

Methods: An institutional-based cross-sectional study was carried out between September 2023 and April 2024. A structured questionnaire was used to gather data, and statistical tools for social sciences software, version 25.0, was used for analysis. The dependent and independent variables were tested for relationships using bivariate and multivariate analyses.

Result: Of the 162 enrolled caregivers of diabetic children, 50.6% were mothers, and 81.5% were urban dwellers. In this study, thirty (18.5%) of the caregivers had good knowledge, and sixty-eight (42%) of them had good practices towards hypoglycemia prevention. Formal training and education programs had a significant association with good knowledge (AOR = 17.9, CI: 4.6-70.2). Good hypoglycemia prevention knowledge had a significant association with hypoglycemia prevention practice (AOR = 0.32; CI: 0.13–0.76).

Conclusion: The knowledge and practice of hypoglycemia prevention among caregivers of diabetic children were found to be low. Providing formal training and education to the caregivers and counseling regarding hypoglycemia during their visit are essential for the improvement of their knowledge and practice in hypoglycemia prevention.

Lacto Vegetarianism, Probiotics, and Prevention of Hypertension-A Short Review

2024-12-31T22:00:36-06:00

The lactovegetarian diet, primarily followed throughout the Indian subcontinent, including India, Sri Lanka, Nepal, and Bhutan, is centred on plants and milk. This diet includes Polyphenols, plant and milk-based lipids, and high-fiber carbohydrates. Plant-based diets mostly promote the growth of good bacteria such as Lactobacillus, Akkermansia, and Bifidobacterium while reducing the numbers of Clostridium and Enterococcus. Probiotics have recently been the topic of scientific investigation about their ability to lower the risk of cardiovascular disease. The production of SCFAs, CLA, GABA, and ACE-inhibitory peptides by the probiotic strains Lactobacilli and Bifidobacteria has been linked to possible hypotensive effects.