CONCLUSION: The risk factors that are reviewed here are hypertension, dyslipidemia, smoking, obesity, lack of exercise, hyperglycemia and diabetic nephropathy. We highlight the importance of early identification, and interventions, which include optimizing glycemic control, pharmacotherapy, regular physical activity and dietary changes.
OBJECTIVE: This study aimed to determine self-monitoring practices, awareness to dietary modifications and barriers to medication adherence among physically disabled type 2 diabetes mellitus patients.
METHODS: Interview sessions were conducted at diabetes clinic - Penang general hospital. The invited participants represented three major ethnic groups of Malaysia (Malay, Chinese & Indians). An openended approach was used to elicit answers from participants. Interview questions were related to participant's perception towards self-monitoring blood glucose practices, Awareness towards diet management, behaviour to diabetes medication and cues of action.
RESULTS: A total of twenty-one diabetes patients between the ages 35 - 67 years with physical disability (P1-P21) were interviewed. The cohort of participants was dominated by Males (n=12) and also distribution pattern showed that majority of participants were Malay (n=10), followed by Chinese (n=7) and rest Indians (n=4). When the participants were asked in their opinion what was the preferred method of recording blood glucose tests, several participants from low socioeconomic status and either divorced or widowed denied to adapt telemontoring instead preferred to record manually. There were mixed responses about the barriers to control diet/calories. Even patients with high economic status, middle age 35-50 and diabetes history of 5-10 years were influenced towards alternative treatments.
CONCLUSION: Study concluded that patients with physical disability required extensive care and effective strategies to control glucose metabolism.
OBJECTIVE: This meta-analysis aimed to assess the updated pooled effects of these polymorphisms with DN among Asian populations with type 2 diabetes mellitus.
METHODS: The PubMed electronic database was searched without duration filter until August 2017 and the reference list of eligible studies was screened. The association of each polymorphism with DN was examined using odds ratio and its 95% confidence interval based on dominant, recessive and allele models. Subgroup analyses were conducted based on region, DN definition and DM duration.
RESULTS: In the main analysis, the ACE I/D (all models) and AGTR1 A1166C (dominant model) showed a significant association with DN. The main analysis of the AGT M235T polymorphism did not yield significant findings. There were significant subgroup differences and indication of significantly higher odds for DN in terms of DM duration (≥10 years) for ACE I/D (all models), AGT M235T (recessive and allele models) and AGTR1 A1166C (recessive model). Significant subgroup differences were also observed for DN definition (advanced DN group) and region (South Asia) for AGTR1 A1166C (recessive model).
CONCLUSION: In the Asian populations, ACE I/D and AGTR1 A1166C may contribute to DN susceptibility in patients with T2DM by different genetic models. However, the role of AGT M235T needs to be further evaluated.
METHODS: Demographic and clinical variables were assessed at baseline, after three and six months in 73 type 2 diabetes patients. Regression analysis, using SPSS, evaluated the concurrent and longitudinal association of medication adherence and glycemic control. Potential confounders of variables were identified using bi-variate correlation analyses.
RESULTS: Concurrent Medication adherence and HbA1c association were significant after adjusting for ethnicity (P = 0.005). For longitudinal observation at 3 months, the association was significant after adjusting for ethnicity (P = 0.016); however, it became non-significant when baseline glycemic control was included in the model (P = 0.28).
CONCLUSION: Easy to administer MALMAS significantly predicted concurrent glycemic control independent of potential confounders. This association persisted in longitudinal observation after 3 months when adjusted for confounders and became non-significant after adjusting for baseline glycemic control.
METHODS: A Delphi questionnaire consisted of 29 Part 1 and nine Part 2 indicators which were incorporated into a tool called Simpler™. The indicators were mainly sourced from American, Australian and Malaysian diabetes management guidelines. Diabetes experts were asked to rank indicators in the order of importance in Part 1. In Part 2, indicators had to be chosen for inclusion into Simpler™ using a fivepoint Likert scale. The consensus level was pre-set at 60%.
RESULTS: A three round Delphi process was used to validate all 38 indicators by 12 experts from Australia and Malaysia: five pharmacists, four doctors, two endocrinologists and a diabetes nurse. Consensus was reached for 93.1% (27/29) of the Part 1 indicators and all nine Part 2 indicators (100%). Five out of nine indicators in Part 2 questionnaire obtained consensus disagreement for inclusion into the Simpler ™ tool.
CONCLUSION: The Simpler™ tool is the first structured diabetes multifactorial tool to address all seven evidence-based factors. The tool was refined and validated by multi-disciplinary health professionals from Australia and Malaysia. Pharmacists can use the Simpler™ tool to facilitate evidence-based comprehensive individualised care among type 2 diabetes patients.
OBJECTIVE: To examine T2D risk among university students in Malaysia and determine its relationship with socio-demographic characteristics and physical activity.
METHODS: The study was conducted cross-sectionally on 390 students selected using quota sampling method from 13 faculties in Universiti Kebangsaan Malaysia. A short form of the International Physical Activity Questionnaire and Finnish Diabetes Risk Score were used to measure the physical activity and T2D risk.
RESULTS: The T2D risk was found to be low (M = 5.23, SD = 3.32) with more than two-third of the student population at the low risk level while a significant proportion of 23.8%, 5.6% and 0.3% having slightly elevated, moderate and high risk respectively. The T2D risk was significantly related to their age (rho = 0.197, p < 0.000), gender (U = 12641, p = 0.011), ethnic group (Χ2 = 18.86, p < 0.000), marital status (Χ2 = 6.597, p = 0.037), residence (U = 10345, p = 0.008), academic year (Χ2 = 14.24, p = 0.007) and physical activity (rho = -0.205, p < 0.000 and Χ2 = 13.515, p = 0.001). Of these, only age (β=0.130) and physical activity (β=-0.159) remained significant in the regression analysis.
CONCLUSION: The findings call for a radical change in the nursing practice to target the amendable factors that are significant in order to prevent the progression of the risk towards type 2 diabetes.
METHODS: The literature related to T3cDM was thoroughly searched from the public domains and reviewed extensively to construct this article. Further, existing literature related to the other forms of diabetes is reviewed for projecting the differences among the different forms of diabetes. Detailed and updated information related to epidemiological evidence, risk factors, symptoms, diagnosis, pathogenesis and management is structured in this review.
RESULTS: T3cDM is often misdiagnosed as T2DM due to the insufficient knowledge differentiating between T2DM and T3cDM. The pathogenesis of T3cDM is explained which is often linked to the history of chronic pancreatitis, pancreatic cancer. Inflammation, and fibrosis in pancreatic tissue lead to damage both endocrine and exocrine functions, thus leading to insulin/glucagon insufficiency and pancreatic enzyme deficiency.
CONCLUSION: Future advancements should be accompanied by the establishment of a quick diagnostic tool through the understanding of potential biomarkers of the disease and newer treatments for better control of the diseased condition.
OBJECTIVES: To describe and summarise the assessment of knowledge and perceptions about CVD risk and preventive approaches among patients with T2DM.
METHODS: A scoping review methodology was adopted, and three scientific databases, Google Scholar, Science Direct and PubMed were searched using predefined search terms. A multistage screening process that considered relevancy, publication year (2009-2019), English language, and article type (original research) was followed. We formulated research questions focused on the assessment of levels of knowledge and perceptions of the illness relevant to CVD prevention and the identification of associated patients' characteristics.
RESULTS: A total of 16 studies were included. Patients were not confident to identify CVD risk and other clinical consequences that may occur in the prognostic pathway of T2DM. Furthermore, patients were less likely to identify all CV risk factors indicating a lack of understanding of the multi-factorial contribution of CVD risk. Patients' beliefs about medications were correlated with their level of adherence to medications for CVD prevention. Many knowledge gaps were identified, including the basic disease expectations at the time of diagnosis, identification of individuals' CVD risk factors and management aspects. Knowledge and perceptions were affected by patients' demographic characteristics, e.g., educational level, race, age, and area of residence.
CONCLUSION: There are knowledge gaps concerning the understanding of CVD risk among patients with T2DM. The findings necessitate educational initiatives to boost CVD prevention among patients with T2DM. Furthermore, these should be individualised based on patients' characteristics and knowledge gaps, disease duration and estimated CVD risk.
METHODS: The literature related to Y2O3 NPs and oxidative stress has been thoroughly searched using PubMed and Scopus databases and relevant studies from inception until August 2020 were included in this scoping review.
RESULTS: Y2O3 NPs altered oxidative stress-related biochemical parameters in different disease models including diabetes.
CONCLUSION: Although Y2O3 NPs are a promising antidiabetic agent due to their antioxidant and anti-inflammatory properties, more studies are required to further elucidate the pharmacological and toxicological properties of these nanoparticles.
OBJECTIVE: This study examines how patients with Diabetes Mellitus responded towards their clinical treatments, where the probability distribution of patients and the types of treatment received were derived from the Rasch probabilistic model.
METHODS: This is a retrospective study wherein data were collected from patients' medical records at a local public hospital in Selangor, Malaysia. Clinical and demographic information such as fasting blood glucose, hemoglobin A1c (HbA1c), family history, type of diabetes (Type 1 or Type 2), types of medication (oral or insulin), compliance with treatments, gender, race and age were chosen as the agents of measurement.
RESULTS: The use of Rasch analysis in the present study helped to compare the patients' responses towards the DM treatments and identify the types of treatment they received. Results from the Wright map show that a majority of the Diabetes Mellitus patients who were diagnosed with Type 2 diabetes have no controlled readings of HbA1c during their first and second visits to the medical center. However, patients with a family history of Diabetes Mellitus who took oral medication have controlled readings of fasting blood glucose based on the probabilistic outcomes of the treatment received by the patients.
CONCLUSION: Controlled readings were found only in the readings of fasting blood glucose during the first and second visits, followed by family history, types of medication received and compliance with the treatment. This study has recommended that Type 2 patients with diabetes without a family history of Diabetes Mellitus need to exercise more control over the readings of HbA1c.