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  1. Zaman R, Karim ME, Othman I, Zaini A, Chowdhury EH
    Pharmaceutics, 2020 Jul 29;12(8).
    PMID: 32751231 DOI: 10.3390/pharmaceutics12080710
    Oral delivery is considered as the most preferred and yet most challenging mode of drug administration; especially a fragile and sensitive peptide like insulin that shows extremely low bioavailability through the gastro-intestinal (GIT) route. To address this problem, we have designed a novel drug delivery system (DDS) using precipitation-induced Barium (Ba) salt particles. The DDS can load insulin molecules and transport them through the GIT route. There were several in vitro simulation tests carried out to prove the efficiency of Ba salt particles as oral delivery candidates. All three Ba salt particles (BaSO4, BaSO3, and BaCO3) showed very good loading of insulin (>70% in all formulations) and a degree of resistance throughout a wide range of pHs from basic to acidic conditions when assessed by spectrophotometry. Particles and insulin-associated particles were morphologically assessed and characterized using FE-SEM and FT-IR. A set of tests were designed and carried out with mucin to predict whether the particles are potentially capable of overcoming one of the barriers for crossing intestinal epithelium. The mucin binding experiment demonstrated 60-100% of mucin adhesion to the three different particles. FT-IR identifies the characteristic peaks for mucin protein, particles, and particle-mucin complex re-confirming mucin adhesion to the particles. Finally, the effectiveness of nano-insulin was tested on streptozotocin (STZ) induced diabetic rats. A short acting human insulin analog, insulin aspart, was loaded into Ba salt particles at a dose of 100 IU/Kg prior to oral administration. Among the three formulations, insulin aspart-loaded BaSO4 and BaCO3 particles dramatically reduced the existing hyperglycemia. BaSO4 with loaded Insulin showed an onset of glucose-lowering action within 1 hr, with blood glucose level measured significantly lower compared to the 2nd and 3rd h (p < 0.05). Insulin-loaded BaCO3 particles showed a significant decrease in blood glucose level at 1-2 h, although the glucose level started to show a slight rise at 3rd h and by 4th h, it was back to baseline level. However, although BaSO3 particles with loaded insulin showed a trend of reduction in blood glucose level, the reduction was not found to be significant (p < 0.05) at any point in time. Therefore, oral formulations of insulin/BaSO4 and insulin/BaCO3 particles were observed as effective as native insulin aspart subcutaneous formulation in terms of onset and duration of action. Further investigation will be needed to reveal bioavailability and mechanism of action of this novel Nano-Insulin formulations.
    Matched MeSH terms: Blood Glucose
  2. Mazlan MZ, Zainal Abidin H, Wan Hassan WMN, Nik Mohamad NA, Salmuna ZN, Ibrahim K, et al.
    IDCases, 2020;22:e01001.
    PMID: 33204633 DOI: 10.1016/j.idcr.2020.e01001
    We present a case study of a 26-year-old morbidly obese man with a three-day history of right leg pain and swelling. The swelling was associated with low grade fever. He was alert and conscious upon presentation to the hospital. His physical examination showed gross swelling of the entire right lower limb with no systemic manifestations. There was no discharge and bullae from the swelling area of the leg. He had high blood sugar and was newly diagnosed with type 2 diabetes mellitus. He was diagnosed with necrotizing fasciitis. An intravenous imipenem-cilastatin 500 mg every 6 h together with clindamycin 900 mg every 8 h was started empirically. Extensive wound debridement was performed. The swab culture obtained intraoperatively grew Pseudomonas aeruginosa. He required an above knee amputation due to worsening infection despite wound debridement. Post-operatively, he developed acute kidney injury with severe metabolic acidosis, which required daily hemodialysis. However, the patient deteriorated due to septic shock with multi-organ failure, resulting in his death.
    Matched MeSH terms: Blood Glucose
  3. Tan JN, Mohd Saffian S, Buang F, Jubri Z, Jantan I, Husain K, et al.
    Front Pharmacol, 2020;11:504624.
    PMID: 33328981 DOI: 10.3389/fphar.2020.504624
    Background:Gynura species have been used traditionally to treat various ailments, such as fever, pain, and to control blood glucose level. This systematic review critically discusses studies regarding Gynura species that exhibited antioxidant and anti-inflammatory effects, thus providing perspectives and instructions for future research of the plants as a potential source of new dietary supplements or medicinal agents. Methods: A literature search from internet databases of PubMed, Scopus, Science Direct, e-theses Online Service, and ProQuest was carried out using a combination of keywords such as "Gynura," "antioxidant," "anti-inflammatory," or other related words. Research articles were included in this study if they were experimental (in vitro and in vivo) or clinical studies on the antioxidant or anti-inflammatory effects of Gynura species and if they were articles published in English. Results: Altogether, 27 studies on antioxidant and anti-inflammatory effects of Gynura species were selected. The antioxidant effects of Gynura species were manifested by inhibition of reactive oxygen species production and lipid peroxidation, modulation of glutathione-related parameters, and enzymatic antioxidant production or activities. The anti-inflammatory effects of Gynura species were through the modulation of inflammatory cytokine production, inhibition of prostaglandin E2 and nitric oxide production, cellular inflammatory-related parameters, and inflammation in animal models. The potential anti-inflammatory signaling pathways modulated by Gynura species are glycogen synthase kinase-3, nuclear factor erythroid 2-related factor 2, PPARγ, MAPK, NF-κB, and PI3K/Akt. However, most reports on antioxidant and anti-inflammatory effects of the plants were on crude extracts, and the chemical constituents contributing to bioactivities were not clearly understood. There is a variation in quality of studies in terms of design, conduct, and interpretation, and in-depth studies on the underlying mechanisms involved in antioxidant and anti-inflammatory effects of the plants are in demand. Moreover, there is limited clinical study on antioxidant and anti-inflammatory effects of Gynura species. Conclusion: This review highlighted antioxidant and anti-inflammatory effects of genus Gynura and supported their traditional uses to treat oxidative stress and inflammatory-related diseases. This review is expected to catalyze further studies on genus Gynura. However, extensive preclinical data need to be generated from toxicity and pharmacokinetic studies before clinical studies can be pursued for their development into clinical medicines to treat oxidative stress and inflammatory conditions.
    Matched MeSH terms: Blood Glucose
  4. Shaila Kabir, Sadia Choudhury Shimm, M. Tanveer Hossain Parash, Mya Sanda Khaing, A. B. M. Tofazzal Hossain
    MyJurnal
    Introduction:Obesity or overweight and its consequences are important public health problems globally resulting in a significant cause of morbidity such as hypertension, Diabetes Mellitus, hypercholesterolaemia, coronary artery disease, stroke, sleep apnoea, cancers and mortality which also render distressing financial burden on everyone. It is imperative to intervene in momentous strategies for early detection to prevent the weight-related epidemic. Methods:It was a health survey conducted in June 2019 to detect the prevalence of obesity and overweight problems and the resultant detrimental health conditions among the year 1 and year 2 medical students of the University Malaysia Sa-bah. The survey was done on 145 students aged between 19-23 years. The height, weight, BMI, waist circumference, blood pressure and capillary random blood glucose were measured. Pearson correlation and Chi-square tests were done to find an association between BMI and probable factors using SPSS. Results: The prevalence of obesity was 8.2%. High blood pressure was recorded in 23.45% participants where both systolic and diastolic blood pressure was high in 18.6%, only systolic blood pressure was high in 37.2% and only diastolic blood pressure was high in 28.3% among 145 students. There was no impaired glucose tolerance among the participants. There was a positive correlation between BMI and systolic (r=0.518, p
    Matched MeSH terms: Blood Glucose
  5. Erwan Ershad Ahmad Khan, Kamilah Mohamed, Salmiah Sidek, Noriah Mahmud
    MyJurnal
    Introduction:The objectives of this study were to measure the status of glycaemic control and identify factors asso-ciated with good glycaemic control among diabetic patients treated at primary health clinics. Methods: All diabetic patients registered and under follow up of Ministry of Health facilities were monitored for their glycaemic controls through HbA1c levels. Data obtained from line listing of diabetic patients that received treatment from four health clinics at Hulu Terengganu in 2019. All of patients’ data including socio demographic characteristics, latest labo-ratory investigations and treatment modalities were recorded in the line listing. In this study, 350 active patients were randomly selected systematically. Logistic regression analysis was done to predict factors associated with good glycaemic control which is defined as having HbA1c less or equal to 6.5%. Results: In this study, the proportion of patients with good glycaemic control was lower than other published studies. It is found that 99 patients (28.3%) have good glycaemic control while 251 patients (71.7%) have poor glycemic control. Factors significantly associ-ated with good glycaemic control included age (odds ratio 0.965; 95% confidence interval 0.940-0.991), presence of comorbidity (odds ratio 0.326; 95% confidence interval 0.107- 0.995) and type of treatment (odds ratio 0.302; confidence interval 0.171-0.533). Those who were not on insulin were more likely to have good glycaemic control. Older patients were also tend to have good glycaemic control. Conclusion: Multi-disciplinary approaches and great-er efforts by healthcare providers at primary health clinics are needed in order to help more patients to achieve good glycaemic control. Younger patients and those who do not have comorbidities yet should be closely monitored as they are prone to have poor glycaemic control. Extra cautions is warranted in patients with insulin in order to achieve glycaemic target thus reducing complications and making the treatment more cost-effective.
    Matched MeSH terms: Blood Glucose
  6. Zahari Sham SY, Hanif E, Thambiah SC, Samsudin IN, Mohd Noor S, Osman M, et al.
    Malays J Pathol, 2021 04;43(1):33-40.
    PMID: 33903303
    INTRODUCTION: Cardiovascular disease (CVD) remains the leading cause of death in Malaysia. Identification of asymptomatic at-risk individuals is often achieved by means of a risk prediction algorithm. Traditional CVD risk factors and their associated algorithms are, however, limited by residual CVD risk. High sensitivity C-reactive protein (hsCRP) has emerged as a novel CVD risk factor. This study aimed to evaluate hsCRP as an adjunct CVD risk marker among the adult Malaysian population by determining its correlation with the Framingham Risk Score (FRS). Comparison analyses were done according to sociodemographic, clinical and laboratory factors and between subjects with and without Metabolic Syndrome (MetS).

    METHOD: This cross-sectional study involved eighty-three (n=83) adults attending a health screening program at Universiti Putra Malaysia (UPM). Demographic data, anthropometric measurements and blood samples for fasting blood glucose (FBG), fasting lipid profile (FSL), glycated haemoglobin (HbA1c) and hsCRP were taken. Respondents were grouped according to FRS and the Joint Interim Statement into 10-year CVD risk categories (low, intermediate and high) and MetS, respectively.

    RESULTS: hsCRP was significantly increased in patients with high body mass index (BMI) (p=0.001), at-risk waist circumference (WC) (p=0.001) and MetS (p=0.009). Spearman's correlation coefficient showed a significant positive correlation between hsCRP level and total FRS score (r=0.26, p<0.05) and HDL-C score (r=0.22, p<0.05).

    CONCLUSION: The significant difference of hsCRP levels across obesity levels and MetS with its modest correlation with FRS scores supported the adjunctive role of hsCRP in CVD risk prediction, most likely capturing the inflammatory pathological aspect and thus partly accounting for the residual CVD risk.

    Matched MeSH terms: Blood Glucose
  7. Jun TJ, Jelani AM, Omar J, Rahim RA, Yaacob NM
    Indian J Endocrinol Metab, 2020 04 30;24(2):191-195.
    PMID: 32699789 DOI: 10.4103/ijem.IJEM_305_19
    Objectives: This study was done to estimate serum anti-Müllerian hormone (AMH) level in polycystic ovary syndrome (PCOS) patients and to correlate serum AMH level with insulin resistance, lipid profile, and adiponectin levels.

    Materials and Methods: A cross-sectional study was conducted at Hospital Universiti Sains Malaysia (Hospital USM), Health Campus, Kubang Kerian, Kelantan, Malaysia. Thirty newly diagnosed patients with PCOS attending gynecology clinic between July 2016 and April 2017 were recruited. Fasting venous blood samples were collected from the subjects. Serum AMH, insulin, adiponectin, triglycerides, high-density lipoprotein cholesterol (HDL-C), and plasma glucose levels were measured, and insulin resistance was calculated based on homeostasis model of assessment-insulin resistance (HOMA-IR). The serum AMH level was estimated, and the correlation of serum AMH level with the metabolic parameters was analyzed.

    Results: The median of serum AMH levels in women with PCOS was 6.8 ng/mL (interquartile range: 7.38 ng/mL). There was a significant negative correlation between serum AMH and HOMA-IR or triglyceride levels (r = -0.49, P = 0.006 and r = -0.55, P = 0.002, respectively). A significant positive correlation was observed between serum AMH and serum HDL-C or serum adiponectin levels (r = 0.56, P = 0.001 and r = 0.44, P = 0.014, respectively) in all study subjects.

    Conclusion: The serum AMH level is associated with HOMA-IR, triglycerides, HDL-C, and adiponectin levels, and hence it may be used as a potential cardiometabolic risk marker in women with PCOS.

    Matched MeSH terms: Blood Glucose
  8. Chekima, K., Wong, B. T. Z., Ooi, Y. B. H., Ismail M. N., Tan, C. H.
    MyJurnal
    Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.
    Matched MeSH terms: Blood Glucose
  9. Flaherty GT, Leong SW, Finn Y, Sulaiman LH, Noone C
    J Travel Med, 2020 Sep 26;27(6).
    PMID: 32634210 DOI: 10.1093/jtm/taaa110
    BACKGROUND: Little is known about the awareness of travellers with diabetes about the health effects of international travel. This study aimed to design and validate a questionnaire to examine the travel health knowledge, attitudes and practices of people living with type 1 diabetes.

    METHODS: A set of 74 items based on a conceptual framework analysis underwent revision and its content validity was established. Items were grouped into three domains. A development study was conducted to establish evidence regarding their factorial structure. A construct validation study was then conducted in which the retained items were tested in an independent sample using confirmatory factor analysis (CFA).

    RESULTS: Four factors emerged from our development study and were labelled as pre-travel preparation-insect bites, pre-travel preparation-consultation, insulin and glycaemic control and travel risk behaviour. A CFA confirmed the factorial structure identified in the development study in an independent sample. Each factor loading had a significant (P 

    Matched MeSH terms: Blood Glucose
  10. Farah Izzati binti Farush Khan, Yasmin Ooi Beng Houi, Patricia Matanjun, Fredie Robinson
    MyJurnal
    Introduction: Coronary heart disease (CHD) has become the number one cause of death worldwide. Past studies have established the efficiency of prebiotics, probiotics, and their combination on lowering blood lipids. However, the mechanism(s) on the reduction of cholesterol involved is not fully understood due to limited in-vivo studies. Therefore, the reported hypocholesterolaemic potential of probiotics and prebiotics supplementations warrants fur-ther research. This study examined the effectiveness of the intervention products on improving lipid profiles, (to-tal cholesterol (TC), HDL-C, LDL-C, TG). Methods: A randomized, single blind intervention involving 8 weeks of treatment followed by 4 weeks of washout period was carried out on 29 volunteers with TC 5.2-6.0 mmol/L who were screened from 517 volunteers. Exclusion criteria included chronic diseases, immune-compromised diseases, consumption of cholesterol-lowering drugs, and pregnancy if female. Informed consent was obtained before com-mencement of the study. Participants were randomly assigned to receive 2g/d Lactobacillus Acidophilus NCFM pro-biotic powder, 10g/d inulin, 10g/d dietary fibre, control intervention of 20mg/d statin, or control intervention of diet counseling. Results: No significant (p>0.05) changes were observed in the fasting blood glucose, physical activities and total nutrient intake of all the groups. Inulin reduced LDL-C by 12.13%. Probiotic reduced TC by 6.98%. Dietary fibre reduced TC by 8.6%, and LDL-C by 16.08%. Conclusion: Although the results showed no significant changes, it may be clinically significant as the intervention products improve the lipid profiles. It was concluded that the im-provement in the lipid profiles may be attributable to the intervention products.
    Matched MeSH terms: Blood Glucose
  11. Mishra S, Shetty A, Rao CR, Nayak S, Kamath A
    Diabetes Metab Syndr, 2020 07 08;14(5):1163-1169.
    PMID: 32673836 DOI: 10.1016/j.dsx.2020.06.048
    BACKGROUND AND AIMS: A variety of risk factors have been reported for the development of gestational diabetes mellitus (GDM). But limited review on the role of antenatal perceived stress necessitated the design of the present study to evaluate the association between GDM and perceived stress during pregnancy.

    METHODS: A prospective case-control study was carried out among 100 GDM cases and 273 matched controls, attending regular antenatal clinic at two private hospitals of Karnataka. Data was collected by personal interviews using a standard questionnaire. Perceived stress was assessed using the Cohen 10-item Perceived Stress Scale. Score of ≥20 was identified as high stress. Statistical Package for the Social Sciences version 15 was used for analysis.

    RESULTS: Exposure rates for high maternal perceived stress among cases during pregnancy were noted. The odds of GDM were 13 folds higher among those with high antenatal stress (≥20) compared to those with low (<20) (p blood glucose following OGTT was noted.

    CONCLUSIONS: The study identified high perceived stress during pregnancy as a potential risk factor for GDM.

    Matched MeSH terms: Blood Glucose
  12. Norfazilah Ahmad, Santhna Letchmi Panduragan, Yee,San Khor, Kalaiarasan Gemini, Nur Atikah Bahrin, Nur Husnina Azhar, et al.
    Borneo Epidemiology Journal, 2020;1(1):35-45.
    MyJurnal
    Strategising, which is an effective workplace intervention to curb cardiovascular disease (CVD), requires understanding of the CVD risk related to a specific working population. The Framingham Risk Score (FRS) is widely used in predicting the ten-year CVD risk of various working populations. This study aimed to use FRS to determine the ten-year CVD risk amongst workers in a tertiary healthcare setting and its associated factors. A cross-sectional study was conducted on workers who participated in the special health check programme at the staff clinic of a tertiary healthcare institution in Kuala Lumpur, Malaysia. A set of data sheets was used to retrieve the workers’ sociodemographic and CVD risk information. The prevalence of high, moderate and low ten-year CVD risk was 12.8%, 20.0% and 67.2%, respectively. Workers in the high-risk group were older [mean age: 54.81 (standard deviation, 5.72) years], male (44%), smokers (72.7%) and having hyperglycaemia (46.7%) and hypertriglyceridemia [median triglycerides: 1.75 (interquartile range, 1.45) mmol/L]. Diastolic blood pressure (aOR 1.07, 95% CI: 1.01,1.14), hyperglycaemia (aOR 8.80, 95% CI: 1.92,40.36) and hypertriglyceridemia (aOR 4.45, 95% CI: 1.78,11.09) were significantly associated with high ten-year CVD risk. Diastolic blood pressure (aOR 1.08, 95% CI: 1.03,1.13) and hypertriglyceridemia (aOR 2.51, 95% CI: 1.12-5.61) were significantly associated with moderate ten-year CVD risk. The prevalence of high and moderate ten-year CVD risk was relatively high. Amongst the workers in the high-risk group, they were older, male, smokers and with high fasting blood sugar and triglyceride. Understanding the ten-year CVD risk and its associated factors could be used to plan periodic workplace health assessment and monitor to prevent CVD
    Matched MeSH terms: Blood Glucose
  13. Abbavannagari Bharath Kumar, Marakanam Srinivasan Umashankar, Sandeep Podda
    MyJurnal
    Introduction: Diabetes is a chronic metabolic disease and noted to be incidence is intensifying globally and contem- plated as epidemic. The study is aimed to assess the coronary artery disease risk profile associated diabetes mellitus patient and to identify the clinical pharmacist care services in the management and to control the risk burden in the clinical practice. Method: A prospective observational study was conducted among the consecutive patients of coronary artery disease associated diabetic patients in a tertiary care teaching hospital over 6 months period. A sam- ple of 150 patients was recruited in the study. Data analysis was done with graph pad prism software 5.01. Results: The present study revealed that coronary artery disease in diabetes was more prevalent in age group between 41-50 years. About 54.66% patients with hyperlipidemia were at risk to develop the coronary artery disease complication. Glycated hemoglobin test was detected in 40% of the patient showing abnormal levels and around 43.33% of patient had an abnormal fasting blood sugar level. The study showed only 32% of patients was prescribed Insulin & oral hy- poglycemic agents and 13 % were treated with statins. Conclusion: It could be concluded that the causative factors should be controlled and treated with an early need for amalgamation of clinical pharmacist care services with the health care team on life style modification counseling could ultimately improve the patient health outcomes and also lowers progression of coronary artery disease risk complications among diabetic patients.
    Matched MeSH terms: Blood Glucose
  14. Norfarhana Mohd Anuar, Barakatun Nisak Mohd Yusof, Farah Yasmin Hasbullah, Siti Nur’Asyura Adznam, Zuriati Ibrahim, Nor Fadhlina Zakaria, et al.
    MyJurnal
    Introduction: Low glycemic index (GI) diet is recommended as part of medical nutrition therapy for the management of gestational diabetes mellitus (GDM). While the clinical benefits are evident, data assessing knowledge of the GI concept among women with GDM are scarce. This was a needs assessment study to determine the level of knowl- edge about the GI concept among women with GDM. Methods: Using a cross-sectional design, we included 85 women with GDM (mean age: 30.6 ± 4.0, pre-pregnancy BMI: 24.8 ± 4.1 kg/m2, gestational age: 34.0 ± 4.0 weeks) from Hospital Serdang, Malaysia. Knowledge about the GI concept was assessed using a developed questionnaire. Additional questions on GDM were assessed using Gestational Diabetes Mellitus Knowledge Questionnaire (GDM- KQ). Subjects with less than 50%, 51-74%, and more than 75% total score were categorized as having poor, fair, and good knowledge levels, respectively. Results: The mean knowledge score obtained by the subjects was 12.8 ± 3.5. More subjects scored correctly for GDM-related knowledge (68.2%). More than half (58.8%) had heard about the GI concept previously and 55.3% understood the definition of GI. The average knowledge score about the GI con- cept was 55.6%; subjects scored highest on the influence of different carbohydrates (teh tarik versus milk) on blood glucose level (87.1%). However, the majority of the subjects had fair knowledge level (62.4%). Conclusion: Women with GDM had moderate knowledge about the GI concept. Results of the needs assessment served as preliminary data for the development of a GI-based nutrition education program in Malaysia.
    Matched MeSH terms: Blood Glucose
  15. Zheng-Yii Lee, Ibrahim Noor Airini, Osama Hamdy, Mohd-Yusof Barakatun-Nisak
    MyJurnal
    Introduction: This study aimed to compare the nutritional characteristics and clinical outcomes among critically ill patients with diabetes (DM) and without diabetes (WDM). Methods: Mechanically ventilated, critically ill patients who were admitted into the intensive care unit (ICU) within 48 hours and remained in ICU 72 hours were prospec- tively recruited and followed for up to 12 days. They were stratified to DM or WDM, depending on their diabetes status at ICU admission and comparison were made for nutritional characteristics and clinical outcomes including 60-day mortality. Results: A total of 154 patients were included with 73 (47.4%) DM patients. In comparison to WDM, patients with DM were older, more severely ill, had higher nutritional risk and body mass index, presented with a higher blood glucose level, and required more insulin. DM was fed relatively earlier but had lower energy adequacy. They experienced more frequent EN interruption. Both groups had comparable ICU and hospital stay, ventilation support duration and mortality. In multivariable logistic regression, no association was found between diabetes status and for ICU and hospital mortality. However, There was a trend towards an increase in 60-day mor- tality in DM patients (Odds Ratio: 2.220, 95% Confidence Interval: 0.764-6.452; p=0.143). Conclusion: Critically ill patients with DM had higher nutritional risks, were fed relatively earlier, but with frequent EN interruption leading to lower energy adequacy than patients WDM. Diabetes status does not affect clinical outcomes.
    Matched MeSH terms: Blood Glucose
  16. Khan AH, Iqbal MZ, Syed Sulaiman SA, Ibrahim A, Azmi NSBY, Iqbal MS, et al.
    J Pharm Bioallied Sci, 2020 12 21;13(1):108-115.
    PMID: 34084056 DOI: 10.4103/jpbs.JPBS_475_20
    Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia.

    Materials and Methods: In two tertiary care selected hospitals, the included diabetic patients were randomly divided into two study arms. In the control group, 200 patients who were receiving usual treatment from hospitals were included. However, in the intervention group, those 200 patients who were receiving usual treatment along with counseling sessions from pharmacists under the Diabetes Medication Therapy Adherence Clinic (DMTAC) program were included. The study continued for 1 year, and there were four follow-up visits for both study arms. A prevalidated data collection form was used to measure the improvement in predictors of diabetic foot in included patients. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 24.0.

    Results: With the average decrease of 1.97% of HbA1c values in the control group and 3.43% in the intervention group, the univariate and multivariate analysis showed a statistically significant difference between both of the study arms in the improvement of predictors belonging to the diabetic foot (P < 0.05). The proportion of patients without any signs and symptoms of the diabetic foot in the intervention group was 91.7%, which increased from 42.3% at baseline (P < 0.05). However, this proportion in the control group was 76.9% at the fourth follow-up, from 48.3% at baseline (P < 0.05).

    Conclusion: A statistically significant reduction in the signs and symptoms of diabetic foot was observed in the intervention group at the end of 1 year. The progression of diabetic foot was significantly decreased in the pharmacist intervention group.

    Matched MeSH terms: Blood Glucose
  17. Hassanein M, Al Sifri S, Shaikh S, Raza SA, Akram J, Rudijanto A, et al.
    Diabetes Ther, 2021 Jun;12(6):1703-1719.
    PMID: 33974216 DOI: 10.1007/s13300-021-01067-1
    INTRODUCTION: To analyse the safety and effectiveness of gliclazide modified release (MR) in adults with type 2 diabetes mellitus participating in Ramadan from three geographically and culturally different regions of the world included in the DIA-RAMADAN study.

    METHODS: DIA-RAMADAN was a real-world, observational, international, non-comparative study. The global study population was divided into three regional subgroups, with data gathered at inclusion 6-8 weeks prior to Ramadan (V0), during Ramadan (4.5 weeks) and 4-6 weeks after Ramadan (V1). Primary endpoint was the proportion of patients reporting ≥ 1 symptomatic hypoglycaemic events (HE), which were collected using a patient diary along with other adverse events.

    RESULTS: Patient numbers from the three regions were n = 564 (46.5%; Indian sub-continent), n = 354 (29.1%; Middle East) and n = 296 (24.4%; South-East Asia). Patient baseline characteristics, demographics, fasting habits and antidiabetic treatments varied between regions. There were similar proportions of symptomatic HE between regions, with no severe HE. Significant weight reductions were observed in all regions following Ramadan, along with reductions in HbA1c and fasting plasma glucose.

    CONCLUSION: These real-world study data indicate that gliclazide MR is safe and effective for management of type 2 diabetes during Ramadan in all three regions studied as part of DIA-RAMADAN.

    TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT04132934. INFOGRAPHIC.

    Matched MeSH terms: Blood Glucose
  18. Tan JWC, Sim D, Ako J, Almahmeed W, Cooper ME, Dalal JJ, et al.
    Eur Cardiol, 2021 Feb;16:e14.
    PMID: 33976709 DOI: 10.15420/ecr.2020.52
    The Asian Pacific Society of Cardiology convened a consensus statement panel for optimising cardiovascular (CV) outcomes in type 2 diabetes, and reviewed the current literature. Relevant articles were appraised using the Grading of Recommendations, Assessment, Development and Evaluation system, and consensus statements were developed in two meetings and were confirmed through online voting. The consensus statements indicated that lifestyle interventions must be emphasised for patients with prediabetes, and optimal glucose control should be encouraged when possible. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are recommended for patients with chronic kidney disease with adequate renal function, and for patients with heart failure with reduced ejection fraction. In addition to SGLT2i, glucagon-like peptide-1 receptor agonists are recommended for patients at high risk of CV events. A blood pressure target below 140/90 mmHg is generally recommended for patients with type 2 diabetes. Antiplatelet therapy is recommended for secondary prevention in patients with atherosclerotic CV disease.
    Matched MeSH terms: Blood Glucose
  19. Noor SZ, Lua PL, Nik MM
    Malays J Nutr, 2011 Apr;17(1):55-66.
    PMID: 22135865 MyJurnal
    The recommendation to lose weight has been the guiding principle in the treatment of type 2 diabetic patients. However, to facilitate this process, it is vital to understand factors associated with personal feelings about body weight and related behaviour.
    Matched MeSH terms: Blood Glucose
  20. Koo, H.C., S, Daniel Robert, Hamid Jan
    Malays J Nutr, 2013;19(2):163-172.
    MyJurnal
    Introduction: The increasing prevalence of adiposity is associated with the development of type 2 diabetes mellitus (T2DM). The two most popular methods to measure adiposity are body mass index (BMI) and waist-hip-ratio (WHR), which measure the overall and abdominal adiposity, respectively. The aim of this study was to determine whether BMI or WHR was more strongly associated with macronutrient intakes and lipid profiles in T2DM patients. Methods: In this cross-sectional study, a total of 210 T2DM patients, mean age of 56.73(SD 10.23) years, were recruited from Penang. Information on socio-demographic, body measurements (height, weight, waist circumference and hip circumference)and macronutrient intakes (three 24-hour dietary recalls) were recorded. Routine laboratory tests (fasting blood glucose, HbA1c, LDL, HDL, triglyceride and total cholesterol) were performed according to standard procedure. Results:Among the respondents, 84% had abdominal and 63% had overall adiposity respectively.There was a significant correlation between WHR and the total calorie(r=0.27; p
    Matched MeSH terms: Blood Glucose
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