METHODS: Single embedded qualitative case study design using in-depth individual face to face interviews were adopted. Twelve diabetes educators from three diabetes clinics in urban areas in Malaysia were purposively selected and interviewed within the period of eight months (November 2012-June 2013). The data were transcribed verbatim and analyzed using Framework technique.
RESULT: The practice of diabetes educators revolved around the traditional paternalistic approach but emphasize on individualized support. However, their practice was restricted by several factors, including patients' acceptance and interest in self-care, lack of confidence and opportunity to practice, and fragmented health care system.
CONCLUSION: The current practice of diabetes educators is very limited to knowledge provision and rather a generalist. Considering a more specialized role would increase opportunities for diabetes educators to provide high-quality self-care support provision.
METHODS: Literature search was performed using electronic databases. Relevant studies were identified, extracted and assessed for risk of bias. The primary outcome of this systematic review was the composition of gut microbiota in healthy controls and T2DM while the secondary outcomes included the correlation of gut microbiota with metabolic parameters.
RESULTS: Thirteen case-control studies involving 575 T2DM and 840 healthy controls were included. T2DM patients exhibited a marked increase in lactobacilli. Six studies found lactobacilli to predominate the gut of T2DM patients; however, this could be confounded by the types of antihyperglyacemic medications. Conversely, butyrate producers dominate the gut of healthy controls. In T2DM patients, butyrate producers were surprisingly higher in those taking metformin intake than those not taking the drug. Whilst lactobacilli were found to be higher with increased plasma glucose, conflicting correlations were observed between various genera and anthropometric measurements, dietary intake, lipid profiles and inflammatory markers. There were moderate to strong significant positive correlations between the class Clostridia and phylum Firmicutes with pro-inflammatory IFN-γ as well as between Negativicutes and IL-6.
CONCLUSIONS: Altogether, butyrate-producing bacteria are negatively correlated to glycaemic parameters. Lactobacilli are higher in T2DM patients and Firmicutes is correlated with inflammation.
MATERIALS AND METHODS: We retrospectively analysed hospital records and DXA scan measurements of 635 patients at tertiary hospital in Ajman, UAE. Patients with T2DM were compared to non-diabetic control group. Data were analysed using SPSS version 20. Student’s t test was used for continuous variables, while chi-square test for categorical variables. Relative risk (RR) and it’s 95% Confidence Interval (95%CI) were calculated for prevalence
of osteoporosis among the two group.
RESULTS: In all 141 patients in the diabetic group and 428 patients in the control group, while 66 patients were
excluded based on exclusion criteria. Prevalence of osteoporosis was significantly higher in diabetic group (RR:
1.2, 95%CI: 1.1, 1.2). BMD and T-score values were similar in diabetic and control groups. Z-score values of lumbar spine, L1 and L3 were significantly higher in diabetic group. Obese patients have significantly higher BMD than non-obese in both studied groups. Younger diabetic patient had significantly higher value of BMD, T-score and Z-score in left femur total hip.
CONCLUSION: Although BMD and T-score values were similar between the two groups, women with T2DM had significant higher prevalence of osteoporosis.