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- Brennan, Marian C., et al.
(author)
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Acceptability of Self-Management Group Education to Reduce Fear of Hypoglycemia as a Barrier to Physical Activity in Adults With Type 1 Diabetes : A Mixed Methods Approach
- 2021
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In: Canadian Journal of Diabetes. - Amsterdam : Elsevier B.V.. - 1499-2671. ; 46:1, s. 16-25.e2
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Journal article (peer-reviewed)abstract
- Objectives: Mixed methods were used to evaluate a group self-management education intervention to address type 1 diabetes (T1D)-specific barriers to physical activity (PA). We evaluated the acceptability of study resources and procedures. Methods: Consenting participants from a quantitative evaluation (n=70) were invited to participate in 1 of 5 focus groups. Interviews explored the acceptability of procedures across the randomized controlled trial schedule, acceptability of the intervention/control workshops and resources and the perceived effectiveness of the intervention/control on participant outcomes. The use and helpfulness of intervention take-home resources, Facebook data and fidelity coding were also examined to inform other aspects of intervention acceptability. Results: Twenty-one focus group participants from control or intervention arms participated in 1 of the 5 focus groups. Participants were 46±10 years of age; about half were female and had been living with T1D for 23±16 years. Study procedures were widely accepted; however, randomization and some aspects of the questionnaire were of concern to a small number of participants. Group education was acceptable and preferred, but participants expressed ambivalence toward the private Facebook group. Control participants indicated that basic information on PA guidelines and hypoglycemia risk are not currently being provided in standard care. Fidelity assessment confirmed the intervention was delivered consistently and was facilitated using behaviours and communication skills based on Social Cognitive Theory. Conclusions: Future definitive evaluation of this promising intervention should utilize a blinded randomized controlled trial study design. Alterations to the control workshop are required to better reflect standard care in Australia. Our qualitative findings suggest that group education can be an acceptable and preferred method of education in T1D management for PA. © 2021 Canadian Diabetes Association
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- Caesar, Robert, 1973
(author)
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Pharmacologic and Nonpharmacologic Therapies for the Gut Microbiota in Type 2 Diabetes
- 2019
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In: Canadian Journal of Diabetes. - : Elsevier BV. - 1499-2671. ; 43:3, s. 224-231
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Journal article (peer-reviewed)abstract
- The gut microbiota is an important regulator of host metabolism. Metagenome analyses have demonstrated that the gut microbiota differs between patients with type 2 diabetes and healthy subjects, and several studies have shown that impaired glucose metabolism is associated with decreased levels of butyrate-producing bacteria. Gut microbiota-produced metabolites, such as short-chain fatty acids, amino acid derivatives and secondary bile acids, participate in metabolic and immunologic processes and, hence, pose putative links between the gut microbiota and glucose homeostasis. Strategies to prevent and treat type 2 diabetes through manipulation of the gut microbiota are being developed. These include replacement of the gut microbiota by fecal transplantation, consumption of fibres to promote the function and growth of beneficial bacteria and treatment with probiotic bacterial strains. Furthermore, it has been shown that many drugs, including drugs used for treatment of diabetes, have major impacts on gut microbiota and, thereby, potentially on glucose metabolism. In particular, the commonly used drug metformin has been shown to influence the functional capacity of the gut microbiota, and recent evidence indicates that this may contribute to the antidiabetes effect of metformin. (C) 2019 Canadian Diabetes Association.
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- Xu, Weili, et al.
(author)
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Detection of Prediabetes and Undiagnosed Type 2 Diabetes : A Large Population-Based Study
- 2012
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In: Canadian Journal of Diabetes. - : Elsevier BV. - 1499-2671. ; 36:3, s. 108-113
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Journal article (peer-reviewed)abstract
- Objective: Prediabetes and undiagnosed diabetes have been commonly ignored. We aimed to investigate the prevalence of prediabetes and undiagnosed type 2 diabetes mellitus, and to verify the hypothesis that vascular risk factors (VRFs) may indicate prediabetes and undiagnosed type 2 diabetes.Methods: A total of 7567 adults, who were 20 to 79 years of age, and living in Tianjin, China, participated in this study. Type 2 diabetes was assessed based on medical history, hypoglycemic drugs use, fasting plasma glucose level >= 7.0 mmol/L, or postprandial 2-hour plasma glucose level >= 11.1 mmol/L. Undiagnosed type 2 diabetes was defined among subjects with type 2 diabetes when neither a medical history of diabetes nor hypoglycemic drugs use was present. Prediabetes was ascertained as fasting plasma glucose level of 6.1 to 6.9 mmol/L, or postprandial 2-hour plasma glucose level of 7.8 to 11.0 mmol/L (WHO 1999) among diabetes-free participants. Data were analyzed using multinomial logistic regression with adjustment for potential confounders.Results: Of all participants, 655 (8.7%) had prediabetes, and 721 (9.5%) were patients with type 2 diabetes, including 321 (4.2%) undiagnosed type 2 diabetes accounting for 44.5% patients with diabetes. The prevalence of prediabetes and undiagnosed type 2 diabetes increased with age, and was higher in women than in men. In a fully adjusted multinomial logistic regression model, hypertension, overweight, obesity, central obesity, and family history of diabetes were significantly associated with prediabetes and undiagnosed diabetes, whereas physical inactivity was independently related to undiagnosed diabetes.Conclusion: The prevalence of prediabetes and undiagnosed diabetes is approximately 13%, and almost 45% of patients with diabetes are undiagnosed. VRFs, such as hypertension, high adiposity, and family history of diabetes can be indicators for detecting prediabetes and undiagnosed diabetes.
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