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Changing Era of Diabetes Management – A New Perspective for Dapagliflozin
Manish Maladkar,
Ashok Yadav,
Shraddha Ghorui
Issue:
Volume 7, Issue 2, June 2022
Pages:
22-28
Received:
21 February 2022
Accepted:
26 March 2022
Published:
9 April 2022
DOI:
10.11648/j.ijde.20220702.11
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Abstract: Type 2 Diabetes Mellitus (T2DM) treatment has progressed dramatically in recent decades. The recent major expansion of the evidence base for T2DM treatment has resulted in frequent revisions of guidelines for hyperglycemia management. When there were few pharmaceutical options, the management strategy was glucocentric or hyperglycemic control. There has been a significant change from the glucocentric era to a more patient-centered and organ-protection era evident in clinical practice guidelines of diabetes management. In addition, since the diabetes armamentarium has grown and new information has been available, the focus has shifted from hyperglycemia control to a more holistic approach, including cardiovascular and renal benefits of the drugs and safety concerns such as weight gain, hypoglycemia. The introduction of the Sodium-Glucose Cotransporter 2 (SGLT2) inhibitor class of medications has had a substantial impact on diabetes management. The constant positive findings of multiple Cardiovascular Outcome Trials (CVOTs) with SGLT2 inhibitors prompted a paradigm shift: from hyperglycemia control to a patient-centered approach. As a result, SGLT2 inhibitors have been identified by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) as an ideal class for a more patient-centered approach to T2DM treatment, become a driving force in diabetes care. Dapagliflozin, an SGLT2 inhibitor, has recently emerged as a glucose-lowering medication that has been found to not only be successful in lowering glycemic levels but also to improve cardio-renal outcomes in diabetic patients. Furthermore, Dapagliflozin is the first anti-diabetic drug to show cardiac and renal benefits even in those who do not have diabetes. As a result, Dapagliflozin has paved the way for a future organ protection strategy for diabetes as well as non-diabetes.
Abstract: Type 2 Diabetes Mellitus (T2DM) treatment has progressed dramatically in recent decades. The recent major expansion of the evidence base for T2DM treatment has resulted in frequent revisions of guidelines for hyperglycemia management. When there were few pharmaceutical options, the management strategy was glucocentric or hyperglycemic control. Ther...
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Oral Manifestations of Diabetes Mellitus in Patients Receiving Care at the Out-Patient Department of the University of Uyo Teaching Hospital
Onung Samuel,
Akhimienho Kingsley,
Nwashindi Arthur,
Ogbode Sylvester,
Ekanem Anyiekere
Issue:
Volume 7, Issue 2, June 2022
Pages:
29-37
Received:
3 May 2022
Accepted:
16 May 2022
Published:
31 May 2022
DOI:
10.11648/j.ijde.20220702.12
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Abstract: Diabetes mellitus is known to affect virtually every system of the human body including the oral cavity. The effect of diabetes on the oral cavity is well documented globally but underreported in Nigeria. Hence, this study attempted to fill this gap in knowledge by evaluating the pattern of oral changes among persons living with diabetes in Uyo, Southern Nigeria. Methods: This was a crossectional descriptive study conducted in the Endocrinology and Dental clinics of the University of Uyo Teaching Hospital. A total of 150 participants consisting of 100 diabetes patients and 50 controls were interviewed orally, physically examined and blood samples taken for fasting plasma glucose and glycated haemoglobin. Data obtained was analysed using descriptive/comparative statistics. Results: Poor oral health was present in 98 out of the 100 diabetes Patients and 11 out of the 50 controls (p < 0.001). Gingivitis was present in 96 out of the 100 diabetes patients and 4 out of the 50 controls (p < 0.001). Periodontitis was found in 51 out of the 100 diabetes patients and absent in the controls (p < 0.001). Mean HbA1c of the diabetes patients with poor oral health was 7.65 +/- 0.94. Diabetics were 62.34 times significantly more likely to have poor oral health compared to the controls (OR 62.34, 95%CI = 1.45-2668.94, p = 0.03). Conclusion: Oral health of diabetes patients in Uyo, Southern Nigeria is poor with periodontal disease being the predominant abnormality present. Poor glycaemic control was implicated as a likely reason for this finding.
Abstract: Diabetes mellitus is known to affect virtually every system of the human body including the oral cavity. The effect of diabetes on the oral cavity is well documented globally but underreported in Nigeria. Hence, this study attempted to fill this gap in knowledge by evaluating the pattern of oral changes among persons living with diabetes in Uyo, So...
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Effects of Kundalini Yoga on Diabetic Depression in China
Zhou Yunfei,
Wang Hong,
Wu Lili,
Chen Taoyu,
Xu Tongtong
Issue:
Volume 7, Issue 2, June 2022
Pages:
38-42
Received:
9 May 2022
Accepted:
20 May 2022
Published:
31 May 2022
DOI:
10.11648/j.ijde.20220702.13
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Abstract: Background: Yoga is good for both diabetes mellitus (DM) and depression, and Kundalini seems to be one of the most powerful types of yoga. So we tried to explore the effects of Kundalini Yoga on diabetic depression in China. Methods: 56 subjects were divided equally into two groups, a study group and a control group. The study group was trained with Kundalini Yoga, while the control group with walking. Both groups underwent a three-month follow-up. At the very beginning and the end of the follow-up we did Hamilton depression rating and the short form 36 (SF-36), as well as HbA1c. Results: After doing the Hamilton depression rating, we found that the effective rate in the study group was 34.62%, while that of the control group was 11.54%. The difference of HAM-D scores of post-intervention in the two groups was statistically significant (p = 0.040). After intervention, six out of eight scales (SF-36) had an inter-group statistically significant difference (p < 0.05). However, the inter-group difference of HbA1c wasn’t statistically significant (p > 0.05). Conclusion: Kundalini yoga is effective on diabetic depression. Its definite effects together with no obvious side effects make it a promising intervention in diabetic depression.
Abstract: Background: Yoga is good for both diabetes mellitus (DM) and depression, and Kundalini seems to be one of the most powerful types of yoga. So we tried to explore the effects of Kundalini Yoga on diabetic depression in China. Methods: 56 subjects were divided equally into two groups, a study group and a control group. The study group was trained wit...
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Determining Factors of Mortality by Ketoacidosis as Seen in the Unit of Endocrinology at Joseph Raseta Befelatanana Teaching Hospital, Antananarivo-Madagascar
Thierry Razanamparany,
Sitraka Angelo Raharinavalona,
Haritsiky Robertini Ramalanjaona,
Rija Eric Raherison,
Miora Maeva Arielle Andrianiaina,
Tsikinirina Valisoa Randrianomanana,
Fenitrasoa Randrianarizao,
Andrianirina Dave Patrick Rakotomalala,
Hanta Marie Danielle Vololontiana,
Radonirina Lazasoa Andrianasolo
Issue:
Volume 7, Issue 2, June 2022
Pages:
43-49
Received:
8 June 2022
Accepted:
21 June 2022
Published:
30 June 2022
DOI:
10.11648/j.ijde.20220702.14
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Abstract: Introduction: Ketoacidosis is one of the acute metabolic complications of diabetes. It is more common and has a higher death rate in sub-Saharan Africa. To our knowledge, there are very few studies done on diabetic ketoacidosis in Madagascar. The aim of our study was to determine the hospital prevalence of diabetic ketoacidosis, to describe their epidemioclinical features as well as to look for determinants of hospital mortality in patients with ketoacidosis in the unit of endocrinology at Joseph Raseta Befelatanana University Hospital, Antananarivo. Methods: This is a descriptive retrospective study of diabetics admitted to this unit for ketoacidosis, over a period of 15 months (from January 1, 2017, to March 30, 2018). Results: Sixty-four patients were selected for the study. The hospital prevalence of ketoacidosis was 5.61%. The mean age of the patients was 46.3 years with a sex ratio of 0.94. Type 2 diabetes predominated in terms of frequency (62.5%). In 37.5% of cases, ketoacidosis was the inaugural diabetes. For patients known to be diabetic before admission, infection was the most common etiologic factor (48.44%), followed by discontinuation of treatment (31.25%). The death rate was 3.13%. Epidemioclinical variables: age [50-60 years], disturbance of consciousness, Glasgow scale < 10 as well as paraclinical variables: glycemia > 500 mg/dl, hyperkalaemia and ketonuria at 4+ at entry are determinants of mortality. Conclusion: Ketoacidosis exposes people to mortality, the rate of which is not negligible. There are determinants of hospital mortality from this complication of diabetes. The therapeutic education of patients and the improvement of screening tools are very important for prevention.
Abstract: Introduction: Ketoacidosis is one of the acute metabolic complications of diabetes. It is more common and has a higher death rate in sub-Saharan Africa. To our knowledge, there are very few studies done on diabetic ketoacidosis in Madagascar. The aim of our study was to determine the hospital prevalence of diabetic ketoacidosis, to describe their e...
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