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The purpose of this paper is to pilot‐test the feasibility and impact of protocol‐driven point‐of‐care HbA1c testing on levels of glycemic control and on rates of diabetic regimen intensification in an urban community health center serving low‐income patients.

The paper suggests a primary care process re‐design, using point of care finger‐stick HbA1c testing under a standing order protocol that provided test results to the provider at patient visit.

The paper finds that the protocol was well received by both nurses and physicians. HbA1c testing rates increased from 73.6 percent to 86.8 percent (p=0.40, n=106). For the 69 patients who had both pre‐ and post‐intervention results, HbA1c levels decreased significantly from 8.55 to 7.84 (p=0.004, n=69). At baseline, the health center as a system was relatively ineffective in responding to elevated HbA1c levels. An opportunity to intensify, i.e. a face‐to‐face visit with lab results available, occurred for only 68.6 percent of elevated HbA1c levels before the intervention, vs. 100 percent post‐intervention (p<0.001). Only 28.6 percent of patients with HbA1c levels >8.0 had their regimens intensified in the pre‐intervention phase, compared with 53.8 percent in the post‐intervention phase (p=0.03).

This was a pilot‐study in one urban health center. Larger group‐randomized controlled trials are needed.

The health center's performance as a system, improved significantly as a way of intensifying diabetic regimens thereby achieving improved glycemic control.

This intervention is feasible, replicable and scalable and does not rely on changing physician behaviors to improve primary care diabetic outcomes.

This study aimed to examine the effects of a three-month mobile health diabetes self-management program (MHDSMP) on glycemic control, diabetes self-management (DSM) behaviors and patient satisfaction in adults with uncontrolled type 2 diabetes (T2DM) in Thailand.

This was a three-arm, parallel-group, randomized controlled trial among 129 adults with uncontrolled T2DM who attended the medical outpatient department in a medical center. The participants were randomly assigned to the three study groups (n = 43 per group), including MHDSMP, telephone follow-up (TF) and usual care (UC). MHDSMP encompassed four components, including DSM engagement, DSM mobile application, motivational text messages and telephone coaching. Outcomes were evaluated at three-month end-of-study by using HbA1C and response to the Summary of Diabetes Self-Care Activities (SDSCA) and the Client Satisfaction Questionnaire (CSQ-8). Data were analyzed by using descriptive statistics and multivariate analysis of covariance (MANCOVA).

The findings revealed that at the end-of-study, HbA1C decreased from 7.80 to 7.17% (p < 0.001) in MHDSMP group, from 7.72 to 7.65% (p = 0.468) in TF group, and from 7.89 to 7.72% (p = 0.074) in UC group. Significantly higher SDSCA and CSQ-8 scores were also observed in MHDSMP compared to TF and UC groups (F = 12.283, F = 19.541, F = 8.552, p < 0.001, respectively).

This study demonstrated that MHDSMP adjunct with usual care is beneficial for patient outcomes in adults with uncontrolled T2DM in Thailand, compared to TF and UC groups.

The purpose of this systematic review and meta-analysis was to investigate the efficacy of propolis on glycemic indices in type 2 diabetic patients.

Web of science (ISI), Embase, Scopus and PubMed were systematically searched to find randomized controlled trials (RCTs) assessing the effects of propolis intake on glycemic controls in type 2 diabetic patients, from inception up to September 1, 2020. A random-effects model was used to pool weighted mean difference (WMD). Meta-regression was performed to detect the potential sources of inter-study heterogeneity.

Seven trials were included in the meta-analysis. Compared to controls, propolis intake significantly improved serum fasting blood sugar (FBS) (WMD = −13.62 mg/dl, 95% CI = [−23.04, −4.20], P = 0.005, I2 = 58.5%) and hemoglobin A1C (HbA1c) (WMD = −0.52%, 95% CI = [−0.86, −0.18], P = 0.002, I2 = 64.0%). In contrast, receiving propolis did not change serum insulin (WMD = −1.46 (uIU/ml), 95% CI = [−2.94, 0.02], P = 0.05, I2 = 75.0%) and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = −0.98 (%), 95% CI = [−2.00, 0.04], P = 0.06, I2 = 82.3%) compared to controls.

The present meta-analysis demonstrated that propolis intake significantly reduces serum FBS and HbA1c in diabetic patients but does not alter serum insulin and HOMA-IR. Further large-scale RCT’s are needed to approve these effects.

Recent studies have shown that hyperuricemia is a predictor of non-communicable disease and an increment of mortality rate. Also, elevated serum uric acid may be associated with obesity in the adult population. This study aims to evaluate the association between serum uric acid levels with metabolic parameters and risk of obesity in the Iranian population.

The cross-sectional study was done on 550 participants, who were referred to a hospital for elective angiography in Rasht, Iran; anthropometric indices (waist circumference (WC) and body mass index (BMI)) and hematological factors were measured using the standard approaches. Based to the angiography results, the severity of atherosclerosis was defined.

The mean (SD) concentration of serum uric acid for all participants was 5.15 (1.37) mg/dl. Individuals who were at the highest tertile had higher mean (SD) of weight (p = 0.004), creatinine and blood urea nitrogen (p < 0.001) lower fasting blood sugar (FBS) (p = 0.000) and HbA1c (p = 0.016), and they were mostly men compared with those in the lowest tertile. After adjusting for confounders, FBS (ß = –0.145, p = 0.001) and HbA1c (%) (ß = –0.130, p = 0.019) had inverse and weight (ß = 0.156, p = 0.001) had direct association with serum uric acid. After adjustment for additionally potential confounders subjects in the highest tertile of serum uric acid had 92 per cent higher chance of obesity compared with subjects in the lowest tertile (OR 1.92; 95 per cent CI 1.13, 3.23).

The present study has concluded that increase serum uric acid related to high risk of obesity and low mean of FBS and HbA1c.

Some studies on anthocyanins have revealed their antioxidant activity and beneficial effects for diabetes control and reducing the risk of coronary heart diseases. It has been found that sour cherries contain high levels of anthocyanins that possess insulin‐releasing stimulatory properties on pancreatic β‐cells in vitro. The purpose of this paper is to investigate whether concentrated sour cherry juice (CSCJ) beneficially alters serum glucose and some cardiovascular risk factors in diabetes type 2 subjects.

In this quasi‐experimental study, 19 diabetic women with FBS ≥ 110 mg/dl were recruited from patients referred to the Diabetes Clinic of Shariati Hospital. Subjects were asked to consume 40 g of CSCJ daily for 6 weeks. Before the onset of the study (week 0) and after 6 weeks, weight and blood pressure measurements were done and fasting blood samples were drawn. FBS, hemoglobin A1c (HbA1c) and blood lipid profiles were measured. In addition, a 24‐hour food record was taken from all of the individuals in both stages. The Wilcoxon signed test was used for statistical analysis.

After six weeks' consumption of CSCJ, significant reductions in body weight (p < 0.01), blood pressure and HbA1c (p < 0.05) was seen. Total cholesterol and LDL‐C decreased significantly in a sub‐group of patients (n = 12) with LDL‐C ≥ 100 mg/dl as well.

Based on the results of this study, consuming 40 g/day of CSCJ decreases body weight, blood pressure and HbA1c in diabetes type 2 women after 6 weeks and improves blood lipids in diabetic patients with hyperlipidemia.

This study aims to identify the relationships among self-efficacy, health literacy, self-care and glycemic control in older people with type 2 Diabetes Mellitus (DM).

This study was a descriptive analytics correlational study with a cross-sectional design. The sampling method was purposive sampling involving 68 older people with type 2 DM.

The results showed that self-efficacy, health literacy and self-care correlated with glycemic control at significant levels of p = 0.020, p = 0.002 and p = 0.022, respectively.

Nurses should help older people with type 2 DM in maintaining their self-efficacy and self-care and increasing their health literacy to ensure their glycemic control is in normal state.

This study showed that self-care, self-efficacy and health literacy had a significant correlation with glycemic control in older people with type 2 DM. It indicates that the better self-care, self-efficacy and health literacy of patients, the more likely the patients’ blood HbA1C level to be in the normal range.

Diabetes is one of the health problems of increasing importance owing to the increase in its incidence and the problems it causes, and it is closely related to nutrition. This study aims to determine the relationship between the dietary inflammatory index (DII) scores of individuals with type 2 diabetes, depression, anxiety and quality of life.

In this cross-sectional study, 158 individuals with type 2 diabetes who applied to a nutrition and diet outpatient clinic of a private hospital in Istanbul were included. Their depression status was evaluated using the Beck Depression Inventory; their anxiety status was evaluated using the Beck Anxiety Inventory; and their quality of life was evaluated using the Short Form 36 Quality of Life scale. One-way ANOVA test was used to define the difference between groups. All test results were evaluated at a significance level of 0.05.

There was no significant relationship between DII scores, depression (p = 0.814) and anxiety (p = 0.817). However, a significant decrease was observed in the scores of the quality of life criterion in the groups with high depression and anxiety scores (p < 0.05). In addition, participants with high anxiety states had higher HbA1c levels (p = 0.043).

Individuals in this sample with no known psychiatric diagnosis or treatment history demonstrated a significant relationship between depression and anxiety scores and quality of life.

Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.

A global trend of type 2 diabetes prevalence is rising. Preventing and managing of systemic and dental complications is crucial to decrease negative effects on glycemic control. The purpose of this paper is to estimate the efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs to decrease glycemic level and improve periodontal status in patients with type 2 diabetes.

Health Center 54 conducted randomized controlled trial among 192 patients (96 intervention and 96 control) from February to August 2018. Group education for lifestyle modification, individual oral hygiene instruction and lifestyle counseling by motivational interviewing was provided to the intervention group at baseline. Motivation of lifestyle modification every month by multimedia was also provided to the intervention group. The usual program was provided to the control group. At baseline and a six-month follow-up, glycemic level and periodontal status were assessed from participants. Data were analyzed by descriptive statistic, t-test, χ² test, Fisher’s exact test, Repeated measure ANOVA and multiple linear regression.

Glycemic level and periodontal status were lower in the intervention group than the control group at the sixth-month followed up with statistical significances. Glycemic level and periodontal status had negatively correlated to intervention group with statistically significant.

Brief-LCDC Program which incorporated lifestyle modification and oral health care had efficacious to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Early prevention program by Brief-LCDC Program is crucial to prevent dental complications.

We investigate how career disruptions in terms of job loss may impact morbidity for individuals diagnosed with type 2 diabetes (T2D). Combining unique, high-quality longitudinal data from the Swedish National Diabetes Register (NDR) with matched employer–employee data, we focus on individuals diagnosed with T2D, who are established on the labor market and who lose their job in a mass layoff. Using a conditional difference-in-differences evaluation approach, our results give limited support for job loss having an impact on health behavior, diabetes progression, and cardiovascular risk factors.