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This study aims to design to assess the traditional, complementary and alternate medicine (TCAM) usage and its association with the quality of life (QOL) of Type 2 diabetic patients in a tertiary hospital (Hospital Universiti Sains Malaysia) in Malaysia.

A total of 300 respondents included in this study were divided into the following two major categories: TCAM (34.33% of respondents) and non-TCAM users (65.67% of the respondents), respectively. The mean ages of the respondents were 59.3 ± 10.2 for the TCAM users and 57.7 ± 12.0 for the non-TCAM users.

A greater percentage of non-TCAM users reported poor control of diabetes (14.7%) and blood glucose (55.8%) compared with the TCAM users (9.7% and 48.5%, respectively). Further, the diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Additionally, the diabetic patients with TCAM usage had a significantly better physical (p = 0.02) and overall (p = 0.03) qualities of life compared to the non-TCAM users. However, psychological, social and environmental health did not show any significant difference.

The prevalence of TCAM usage among diabetic patients was lower than in other comparable studies. Diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Further, diabetes patients on TCAM reported better QOL compared to non-TCAM users especially in terms of physical health.

The purpose of this study is to examine the acute toxicity and antidiabetic activity of Asystacia gangetica leaf ethanol extract.

The study was designed as completely randomized in vivo experimental model. Where acute toxicity study was carried out using 30 albino mice, randomly assigned into six groups of five mice each. Toxicity signs and mortality were observed in the rats within a period of 24 h. The acute and sub-acute antidiabetic study was carried out using 50 rats, randomly assigned into five groups of 10 rats each. The rats’ blood glucose levels were determined and used to assess the acute and sub-acute antidiabetic activity of the extract.

Results obtained from the acute toxicity study indicated no death in any of the study groups, even at 5,000 mg/kg body weight and showed no signs of toxicity. The acute antidiabetic study showed that treatment with 400 mg/kg of the extract significantly (p = 0.01) lowered glucose level in the diabetic rats from 430.6 to 177.4 mg/dl while 800 mg/kg brought down glucose level from 370 to 144.2 mg/dl by the end of 6 h following administration when compared with the diabetic control group. It was observed that the effect of the extract mostly at 800 mg/kg also compared favorably with that of the standard drug (glibenclamide), which lowered glucose level in diabetic rats from 374.2 to 176.4 mg/dl. Furthermore, the significant reduction was evident from 4, 2 and 2 h for 400 mg/kg extract, 800 mg/kg extract and 5 mg/kg glibenclamide, respectively. At sub-acute level the blood glucose was lowered from 155.6 to 127.2 mg/dl, 137 to 124.4 mg/dl and 151.8 to 121.8 mg/dl for diabetic rats treated with 400 mg/kg, 800 mg/kg and 5 mg/kg glibenclamide, respectively, when compared to the diabetic untreated rats, which ranged from 417.6 to 358.6 mg/dl. The biochemical profile, lipid profile and hematological examination were all positively restored near to normal with the herbal treatment at the different doses. At histopathology level, the liver of the rats treated with 400 mg/kg had moderate portal inflammation without interface or lobular hepatitis while that of 800 mg/kg showed severe portal inflammation with the interface and lobular hepatitis with extensive confluents necrosis. The pancreatic cells of the treated rat showed no significant difference in the β-cells of the islets of Langerhans with hyperplasia of the acinar cell when compared to the diabetic untreated.

The record of no death and signs of toxicity implies that the extract is safe for consumption even at a high dosage of 5,000 mg/kg body weight. The significant (p = 0.01) reduction in the plasma glucose level of the treated rats as compared to the control is an indication of blood glucose-lowering potential of the extract at two different doses. The significant reduction evident of the extract at different hours and days for the two doses implies that the extract rate of lowering potentials is dose-dependent. The evidence of moderate-severe portal inflammation with the interface and lobular hepatitis at 800 mg/kg treatment is an indication that the intake of this herb at high dosage for long period is not safe for the liver tissue.

The outcome of this study suggested that the Asystacia gangetica should also be used as a vegetable in-home food preparation and food processing to use its antidiabetic effect. The herbal extract could also be incorporated into a food product and processed into herbal tea bag for convenient. The subjection of this herbal plant to heat treatment during processing could be a possible avenue to make it safe.

The economic burden and complications of diabetes mellitus management will be reduced if the practical implication of this research finding is implemented in foods as vegetable and in functional food production.

This study revealed that Asystacia gangetica leaf extract may be safe and effective for use at a low dose for acute management of diabetes mellitus. This research may be of value to those living with diabetes mellitus.

Addresses the use of special diabetic products in diabetes. These foods are currently available in health food shops and chemists and are often considered to be “slimming” or therapeutically beneficial. They are, however, no lower in fat or calories than their standard equivalents and they are expensive. Such products have no place in the current management of diabetes and it is recommended that a wide variety of low‐fat, high‐fibre and low‐sugar foods is selected instead.

This paper aims to study the anti-diabetes activity of the Kombucha prepared from different snake fruit cultivars.

The juices of snake fruits of Suwaru, Madura, Pondoh and Bali cultivars were fermented for 14 days. Anti-diabetes activity of the products was analyzed. Twenty-four male albino Wistar rats were used and randomly divided into six experimental groups, i.e. four groups of the diabetic rats treated with the Kombucha, plus the normal group and diabetic control group. The Kombucha were orally administered to the streptozotocin induced-diabetic rats at 5 mL/kg body weight per day during the 28-day experiment. The fasting plasma glucose (FPG), oxidative stress indices (superoxide dismutase [SOD] activity and Malondialdehyde [MDA] level) and lipid profile of the blood plasma were measured. The pancreas was used for immunohistochemical study and β-cells quantification. Data were analysed by ANOVA followed by Fisher test using Minitab version 16.0.

FPG of the diabetic rats treated with the Kombucha (110.3-189.3 mg/dL) was significantly lower (p = 0.000) than the diabetic control group (413.3 mg/dL). Those were in line with the number of pancreatic β-cells of 42.1 in diabetic rats that lower (p = 006) than those in treated the diabetic rats (61.2-73.5). The treated diabetic rats had lower oxidative stress (SOD activity: 20.9-44.6 unit/100 µL with p = 0.000; MDA level: 0.37-0.48 ng/100 µL with p = 0.000) than those in the diabetic rats (SOD activity: 18.7 unit/100µL; MDA level: 0.84 ng/100 µL). The treated diabetic rats also showed better lipid profile than those in the diabetic control rats. There were cultivar differences, and the Suwaru and Madura snake fruit Kombucha demonstrated the most potential for diabetes management.

This is the first study on in vivo anti-diabetes activity of snake fruit Kombucha prepared from different snake fruit cultivars.

The purpose of this study was to investigate diabetes self-care behaviors, stigmatization and A1C as predictors of a negative perception of insulin treatment in insulin-treated type 2 diabetic patients.

A descriptive cross-sectional and relational design was used. The study was carried out in the Diabetes Training Centre and Endocrine and Metabolism Clinic of a university hospital in the southeast of Turkey between May and October 2017. The research sample consisted of 100 type 2 diabetic patients determined by using a convenience sampling method. An introductory information form for type 2 diabetic patients, the Insulin Treatment Appraisal Scale (ITAS), Diabetes Self-Care Activities Survey (DSCAS) and Barriers to Insulin Treatment Scale (BIT) were used to collect the research data. The data were analyzed using descriptive statistics, correlations and step wise multi-linear regression.

The number of daily insulin injections, training received about insulin and stigmatization was significant predictors of a negative perception of insulin treatment.

Strategies to decrease diabetic individuals' fear of stigmatization should be utilized to minimize their negative insulin treatment perception (giving diabetic individuals training about diabetes, planning public training to inform society and using mass media tools). Diabetes educators should know that diabetic individuals' perception of the severity of the illness could influence the daily number of injections applied and decrease the negative perception regarding insulin.

The prevalence of diabetes among 915 sexual, violent, and non‐violent non‐sex offenders was found to be more than twice the prevalence in the general population. Diabetes was most common among violent offenders and among sex offenders who victimized children. The older diabetics presented significantly more often with cognitive impairment and younger diabetics more often with manic and psychotic symptoms. Younger diabetics were significantly more likely to use force and a weapon in their offenses and were most likely to injure their victims when compared to older diabetics and younger and older non‐diabetic offenders. In more than one in four cases, the diabetes was undiagnosed at the time of their offenses prior to clinical assessment, suggesting that undiagnosed diabetes may be a possible mitigating factor in some sexual and violent offenses. Results indicate that a routine endocrine evaluation with blood tests would be a valuable addition to the assessment of violent and sexual offenders.

Diabetic foot ulcers are associated with considerable morbidity, mortality and costs to the NHS. This paper describes a review of publications reporting randomised controlled trials examining the clinical effectiveness of interventions for diabetic foot ulcers for 1986–1996. Only 23 studies were identified that described randomised controlled trials and, of these, only 4 fulfilled three criteria shown to influence reliability of results: adequate description of randomisation, double blinding and description of withdrawals and drop‐outs. No cost‐effectiveness studies conducted alongside trials were identified from the searches. This shortage of rigorous trials highlights the need for more well designed research in the prevention and treatment of diabetic foot ulcers to determine clinical effectiveness as well as relative cost‐effectiveness.

Pakistan is a developing country where one of the rapidly growing diseases is diabetes. Well-informed diabetic patients are expected to improve the quality of life, self-care behaviors and better cooperation with the health care team. The present study is designed to investigate the information behavior of diabetic patients, and to investigate the role of one institution that is working for diabetes management, treatment, education and counseling in Pakistan i.e. Diabetic's Institute Pakistan (DIP).

The “Embedded Design” based on the mixed methods research approach was adopted to carry out the current research. The study was mainly based on quantitative research design, quantitative data were collected through an adapted questionnaire, the supportive/supplementary qualitative data was collected through an in-depth interview of the medical director, observation record sheets and analysis of the available relevant documents i.e. prescription (prescription notepad with information), brochure and the website was applied.

Diabetic patients want to know about how to control diabetes and mostly rely on humans particularly health professionals and interpersonal networks. The use of books, journals, seminars, libraries is comparatively low. It is an important finding that health-related information is mostly required in national language by Pakistani patients. Lack of computer literacy and information overload were among the barriers that were reported by diabetic patients.

Health information seeking channels, formats and language preferences should be considered to design patients' cantered information services. Health information service providers i.e. government, health practitioners, health-related institutions and libraries should work in a liaison for creating health awareness. Identified barriers faced by diabetic patients are important to consider for designing health-related information services.

Investigating health information behavior is crucial particularly of the patients from developing countries. The study is first of its kind that is reported from Pakistan. The results of the study may help libraries, health professionals and diabetes-related organizations to design patient's centered policies and information-based services. These institutions may work together to create awareness and to help patients in managing their disease. The study findings are maybe helpful for other developing countries also.

This study identifies and synthesizes existing literature on the integration of diabetic and dental services and explores a service integration model for optimising diabetic patient health outcomes and improving healthcare systems in low and middle-income countries.

Peer-reviewed literature that analysed the integration of health services regarding dental and medical services were reviewed. The articles were identified using the Academic Search Complete, Business Source Complete, CINAHL Complete, Google Scholar and MEDLINE databases and screened using the PRISMA guidelines.

A total of 40 full-text articles were examined for eligibility out of which 26 were selected for analysis. Diabetes was shown to contribute significantly to the global disease burden and this is also reflected in most low and middle-income countries. It is found that the integration of medical and dental services could help alleviate this burden. Hence, locally adapted Rainbow-Modified Integrated Care model is proposed to fill this integration gap.

The integration of dental and medical services has been proven to be useful in improving diabetic patient outcomes. Hence, the need to facilitate cross-professional collaboration between dentists and physicians cannot be overemphasised and this can be extended and locally adapted by different health systems across the world.

The integration of dental and diabetic services using models such as the Rainbow Model of Integrated Care is recommended to optimise health outcomes of diabetic patients and enhancing service delivery, especially in resource-poor healthcare systems.

This paper aims to study how diabetics/pre-diabetics (D) and non-diabetic (regular consumers of sweeteners (C) or not (NC)) perceive and consume sweetened processed food in Brazil.

A cross-sectional study (n = 2,204) was carried out to gather information about: consumption of 14 sweetened food/beverage categories, perception of sugar/sweeteners (check-all-that-apply (CATA) test), understanding of sugar claims and socioeconomic/demographic/consume profile. Chi-square test/Fisher exact tests were used to analyze the contingency tables. CATA test results were evaluated using Cochran Q test, RV coefficient and Kruskal-Wallis test.

Results revealed that although diabetics/pre-diabetics consumed less sugary products than non-diabetics (p < 0.001), >50.0% of them preferred sugary candies, bakeries, ready-to-drink fruit juice, ice cream, chocolate and ready-to-eat desserts. D, NC and C similarly perceived (RV = 0.99) sugar (sensory desirable, but penalized due to its health impact), naturally extracted sweeteners (opposite description of sugar) and chemically synthesized sweeteners (penalized by sensory and health impacts). Regarding the claims, those that mean the absence of sugar were correctly understood for = 90.0% participants, while incorrect interpretations were observed for “containing sugars from own ingredients” (42.7%) and “light on sugar” (21.0%), without differences between consumer groups (p = 0.93).

This study was carried out with a convenience sample.

Results can be applied to support food policies and educational campaigns (improving consumer information on processed sweetened foods) and to guide product development in the food industry.

This is the first study to evaluate the Brazilians’ behavior regarding the perception of sugar and sweeteners, the choice of different sweetened processed food, and understanding of sugar claims.