Objective. The positive effects of exercise on adiponectin and vitamin D have independently been reported. Recent studies have suggested that vitamin D increases adiponectin synthesis through inhibition of the rennin-angiotensin system in adipose tissue. However, studies evaluating the effects of an aerobic exercise on adiponectin and vitamin D simultaneously investigating the potential mechanism of vitamin D-dependent adiponectin pathways in patients with type 2 diabetes mellitus (T2DM) are still limited. This study was undertaken to examine the effects of aerobic exercise on adiponectin and its association with vitamin D in patients with T2DM.
Methods. Total twenty-two patients with T2DM were randomly divided into intervention and control group. The intervention group underwent a moderate intensity of a walking mode treadmill aerobic exercise for four weeks. The exercise protocol was adapted from modified Bruce test with a periodic speed and inclination increase. In both groups, body mass index (BMI), vitamin D, and adiponectin levels, were measured before and after four weeks of the lasting program.
Results. The mean of the increased adiponectin and vitamin D levels after exercise was significantly higher in the intervened than the control group, but statistically significant difference was only found in the adiponectin effect (p=0.017). There was a significant association found between vitamin D and adiponectin in the intervention group after data adjustments to age and BMI (p=0.005).
Conclusion. Moderate intensity of treadmill exercise with increased speed and inclination periodically increased adiponectin level in patients with T2DM. The increased adiponectin might potentially be mediated by increased vitamin D, but the level of their association impact was dependent on the age and BMI.
Introduction: The success of therapy did not follow the increasing number of type 2 diabetes mellitus patients. This systematic review aimed to evaluate the relationship between diabetes distress and HbA1c in type 2 diabetes mellitus patients during therapy.
Methods: The authors systematically searched databases (PubMed, Cochrane library, and ScienceDirect) up to January 2021. Articles were screened according to PRISMA 2020 statements. The selection criteria of this study were patients’ characteristics, type of therapy, and outcomes.
Results: The search started from 1.303 articles to 17 eligible articles. Furthermore, seventeen studies included 11,976 patients. The mean HbA1c level was around 6.4% to 9.9%. The result of diabetes distress scores were five studies with low scores, eight moderate scores, and two high scores. Emotional burden and regimen-related distress were the highest domain score. Age, health facilities, and type of therapy affected diabetes distress. The correlation between diabetes distress and HbA1c was dominant in the range of 0.15 to 0.26.
Conclusion: Diabetes distress had a low-moderate correlation with HbA1c. The dominant domains were emotional burden and regiment-related distress. There were two mechanisms of effect, direct by hormones and indirect through medication adherence, self-management, and 12 months of quality of life.
Sindrom cushing eksogen merupakan jenis sindrom cushing yang paling sering dijumpai dalam praktik klinis. Penyebab yang paling sering adalah efek samping terapi glukokortikoid yang diberikan dalam bentuk tablet maupun obat tradisional. Manifestasi klinis sindrom cushing eksogen mirip dengan sindrom cushing endogen, dikuatkan dengan adanya riwayat konsumsi glukokortikoid dalam berbagai bentuk. Artikel ini melaporkan serial kasus sindrom cushing eksogen akibat pemberian glukokortikoid eksogen dan obat tradisional dengan manifestasi utama infeksi oportunistik. Pada kasus pertama tidak diberikan suplementasi glukokortikoid sedangkan pada kasus kedua diperlukan terapi suplementasi glukokortikoid. Tata laksana komprehensif sindrom cushing eksogen seyogyanya dilakukan secara komprehensif dengan pertimbangan pemberian dosis stres glukokortikoid dan terapi ditujukan terhadap edukasi penghentian glukokortikoid disertai tata laksana penyakit dasar pada pasien.
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