Maboo wirriya,be healthy: Community-directed development of an evidence-based diabetes prevention program for young Aboriginal people in a remote Australian town

Supporting healthy lifestyle behaviours is a key aspect of preventing type 2 diabetes which disproportionately affects disadvantaged groups from a younger age. Formative participatory research was undertaken to design a program for young Aboriginal people in a remote town in North West Australia with a high level of health needs and relatively few prevention initiatives. Focus groups and advisory discussions with Aboriginal community members were used to determine the nature of the program. The need for a comprehensive program was consistently expressed and limited healthy lifestyle knowledge and difficulties with healthy eating influenced by food environments were noted to be important. With guidance from the Derby Aboriginal Health Service, findings were integrated with previous international research evidence to develop a program tailored to local Aboriginal people aged 15–25 years and refine it after piloting. This 8-session program, ‘Maboo wirriya, be healthy’ involved an education component consistent with the US Diabetes Prevention Program and practical activities including group exercise. Changes to program structure and documentation were made after piloting for future use. The community-directed approach used in this study is vital to ensure relevance of localised chronic disease prevention programs in a range of settings.     

Factors associated with early cessation of breastfeeding in women with gestational diabetes mellitus

AimTo determine factors associated with early cessation of breastfeeding (≤3 months) in women with recent gestational diabetes mellitus (GDM).MethodsA cross-sectional online survey of women aged ≥18 years, diagnosed with GDM in 2010 and registered with the National Diabetes Services Scheme in Australia. The 59 questions examined breastfeeding duration, intention, attitudes, exclusivity and support.Results738 women completed the survey (15% response rate). Data was analysed for 729 eligible respondents. Of these 97% reported ‘ever’ breastfeeding and 19% had breastfed for ≤3 months. Cessation of breastfeeding at or before 3 months was associated with breastfeeding problems at home [adjusted odds ratio 8.01, 95% confidence interval (4.57, 14.05)], return to work prior to three months [OR 3.39 (95% CI 1.53, 7.55)], inadequate breastfeeding support [OR 1.88 (95% CI 1.10, 3.22)], caesarean delivery [OR 1.70 (95% CI 1.04, 2.76)], low socioeconomic status (SEIFA 1 unit increase) [OR 0.89 (95% CI 0.81, 0.97)] and BMI (2 unit increase) [OR 1.08 (95% CI 1.01, 1.57)]. Being married or de facto [OR 0.14 (95% CI 0.03, 0.62)] was a protective against early cessation of breastfeeding.ConclusionStrategies to improve breastfeeding duration in women with GDM need to address those most at risk of early cessation and provide appropriate postpartum breastfeeding support in this group.     

Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus

Background: The prevalence rates for both sarcopenia and erectile dysfunction (ED) gradually increase in middle-aged and elderly diabetic male population and they impair physical functioning, sexual functioning, and quality of life. The aim of the present study was to evaluate the sarcopenia in patients with diabetic ED.

Methods: The study included 98 male patients with type II diabetes mellitus (DM) aged 18–80?years. Blood chemistry and hormone levels were obtained. The International Index of Erectile Function (IIEF-5) questionnaire was administered to the patients. The patients were divided into three groups according to the IIEF-5 score; a score of 5–10 points indicated severe ED, a score of 11–20 indicated moderate ED, and a score of 21–25 points indicated no ED. The muscle mass, handgrip strength, timed up and go test, upper mid-arm circumference, calf circumference, and body mass index were obtained. The statistical analysis was performed using MedCalc Statistical Software version 12.7.7. All parameters were compared between the three groups.

Results: Of 98 patients included in the study, 84 patients had severe sarcopenia, 13 had moderate sarcopenia, while only one patient had normal muscle mass. The mean age was 56.59?±?11.46?years. When patients were divided into three groups according to IIEF-5 score, 38 had severe ED, 39 had moderate ED, and 21 had no ED. There was a significant difference between the three groups in terms of handgrip strength, timed up and go test scores, upper mid-arm circumference, and calf circumference (p?Conclusions: Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.     

Diabetes education program for people with type 2 diabetes: An international perspective

BackgroundIn the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range.ObjectiveThis study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health.MethodsA short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4 h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval.ResultsThe participant’s mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81 ± 14.95 kg (82.6 kg for males and 79.5 kg for females) that decreased to 78.9 ± 14.33 kg (81.1 kg for males and 77.3 kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65 ± 71.45 mg/dL before educational intervention that decreased to 177.7 ± 66.11 mg/dL after the educational intervention (p = 0.049). The mean glycosylated hemoglobin was 8.57 ± 1.21 before educational intervention that decreased to 7.95 ± 1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27 ± 37.74 mg/dL that decreased to 169.57 ± 34.23 mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85 ± 171.04 mg/dL to 183.28 ± 152.4 mg/dL (p = 0.025). The mean score of knowledge questionnaire before educational intervention was 60.6 ± 20.65 that increased to 78.1 ± 13.4 after conducting educational intervention.ConclusionsDiabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge.RecommendationsDiabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient’s family, diabetes care team, community, and decision makers in the education process.     

妊娠期糖尿病孕妇系统健康教育效果的观察——以南京市妇幼保健院为例

文章选取了120名妊娠期糖尿病孕妇,随机分为系统健康教育组和传统健康教育组,观察两组血糖控制情况及妊娠结局,以探讨系统健康教育对妊娠期糖尿病孕妇的干预效果。结果发现,系统教育组和传统教育组均可使血糖下降,且系统教育组要优于传统教育组,差异有统计学意义。两组在分娩方式、新生儿体重、巨大儿、妊高症、羊水过多、早产儿、胎儿宫内窘迫等方面比较无显著差异;在胎膜早破、产时失血方面,系统健康教育组低于传统健康教育组,差异有统计学意义。据此认为,系统健康教育有助于妊娠期糖尿病孕妇控制血糖和降低产科并发症。     

“Just a Typical Teenager”: The Social Ecology of “Normal Adolescence”—Insights from Diabetes Care

In Western society “normal adolescence” is understood to be a biologically driven phase characterized by emotional turmoil and irrational behavior. Despite being discredited within academic literature this discourse persists both in formal theory and everyday use. Drawing on the case of diabetes care, I argue that the discourse of “normal adolescence” derives its power from its value as a vocabulary of motive through which to navigate the contradictions inherent in the social order at this stage of the life‐course. While helping us to comprehend sociologically the ecological niche in which “normal adolescence” is sustained, this analysis raises questions about the persistence of this discourse for social action.     

踝臂指数与老年男性糖尿病动脉硬化的相关性

目的探讨踝臂指数与老年男性糖尿病动脉硬化的相关性。方法选择112例老年糖尿患者进行踝臂指数、下肢螺旋CT血管成像、颈动脉血管多普勒、眼底动脉检查及动脉硬化危险因素资料的收集,按病变程度进行对比分析。结果下肢血管无狭窄踝臂指数明显高于重度狭窄组,下肢血管阻塞越严重踝臂指数下降越显著（P〈0.01）。颈动脉内膜中层厚度及斑块程度,随斑块积分的增高踝臂指数降低明显（P〈0.01）。不同眼底动脉组间ABI比较有显著差异（P〈0.05）,随着眼底动脉病变为程度加重踝臂指数越小。以踝臂指数〈0.9为二分类变量做Logistic回归分析,显示踝臂指数与年龄、甘油三酯、低密度脂蛋白、吸烟量、糖化血红蛋白相关。结论踝臂指数与糖尿病动脉硬化危险因素存在相关性,并可作为动脉硬化的危险因素之一,是预测全身动脉硬化的指标。     

浆细胞膜糖蛋白基因K121Q变异与老年人2型糖尿病的关联研究

目的探讨浆细胞膜糖蛋白基因(PC-1)4号外显子K121Q变异与老年人2型糖尿病的相关性。方法自2006年北京市社区2型糖尿病调查资料中选出有糖尿病家族史,且相互间无亲缘关系的老年2型糖尿病患者228例,同时选择非糖尿病健康老年对照人群308例。所有受试者均签署知情同意书,所有受试者均为汉族。应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,检测PC-1基因K121Q的多态性分布情况。结果老年2型糖尿病患者中KK基因型177例(77.6%),KQ基因型46例(20.2%),QQ基因型5例(2.2%),K、Q等位基因频率分别是87.7%和12.3%;正常老年对照组中KK基因型239例(77.6%),KQ基因型63例(20.5%),QQ基因型6例(1.9%),K、Q等位基因频率分别是87.8%和12.2%;PC-1基因K121Q变异的基因型频率和等位基因频率在两组中的分布差异无显著性(P>0.05);PC-1基因K121Q变异的基因型频率和等位基因频率在男性和女性中的分布差异也无显著性(P>0.05);PC-1基因K121Q变异的KK基因型组与KQ QQ基因型组中的肥胖指标的特征差异也无显著性(P>0.05)。结论PC-1基因K121Q变异可能与老年人2型糖尿病的易感性无关联。     

Regular physical exercise in patients with type II diabetes mellitus

It is widely accepted that regular physical exercise helps diabetic patients control blood glucose, reduce cardiovascular risk factors, and prevent other related complications. In spite of the undoubted benefits of regular physical exercise, diabetic patients with chronic complications should be aware of potential hazards of practicing exercise. To avoid some harmful consequences of acute exercise, it is necessary to adopt a vigilant attitude with these risk patients and to carefully adjust type and intensity of exercise to the individual situation. This article intends to summarize and analyze the current literature concerning the preventive and therapeutic effects of regular exercise in diabetic patients, pointing out its physiological influence on blood glucose regulation, and to analyze the potential risks of acute physical exercise and the precautions given to patients with a variety of complications.     

Medicine on the line? Computer‐mediated social support and advice for people with diabetes

The advent of thousands of Usenet groups on the Internet, covering a vast range of medical and welfare issues and ostensibly devoted to the mutual social support of participating members, has raised the potential for the development of new forms of 'virtual' health care. This article critically analyses the use by people with diabetes of one such Usenet group. It seeks to establish, first, the extent to which such a site provides some demonstrable measure of social support to its participants. This is approached by undertaking a structural analysis of the site to identify the extent of usage, and the nature of supporting interventions using a fivefold classification (instrumental, informational, esteem and social companionship and other). Second, the article attempts to identify any disparity between the lay health-knowledge in evidence and biomedical opinions proffered by the use of a panel of consultant diabetiologists. The results of the analysis suggest that the diabetes newsgroup provides an example of an active forum for largely well-informed participants who routinely use the media as an aid to the reflexive management of their medical condition. It also raises the prospect of a renegotiated relationship between medical knowledge and lay experience based upon shared learning