Diabetes mellitus (DM) with poor glycemic control is often linked to oral manifestations. This study aimed to investigate the association between dental caries (DC) and glycated hemoglobin (HbA1c) among patients with type 2 DM (T2DM). A health center-based cross-sectional study was conducted comprising 91 eligible patients with T2DM (21 males and 70 females) with a mean age (± standard deviation) of 61.49 ± 9.71 years. A structured interview, screening for DM-related factors, and oral examination were performed. Serum HbA1c levels were used as an index for glycemic control. A comparison between patients with controlled T2DM, i.e., HbA1c ≤7.0% (n = 46), and uncontrolled T2DM, i.e., HbA1c >7.0% (n = 45), showed significant differences in mean values of decayed teeth (DT) (P = 0.045); missing teeth (P = 0.002); and decayed, missing, and filled teeth (DMFT) index (P < 0.001). Results of multiple linear regression analysis revealed that the number of DT was significantly correlated with serum HbA1c levels (95% confidence interval [CI] 0.173 to 0.972, P = 0.005). Furthermore, DMFT index values and serum HbA1c levels (95% CI 0.532 to 1.658, P < 0.001) showed a significant association. This study provides substantial evidence on the association between DC indicators and serum HbA1c levels.

Background Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. Methods A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a selfefficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, roleplaying, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants' selfefficacy for management of their diabetes. Secondary outcomes were participants' knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. Results At 12 and 18 months after the intervention, participants' knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. ConclusionThe training program significantly improved participants' knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes.

The aim of this prospective study was to assess whether accelerometry-based gait analysis is associated with the incidence of falls among individuals who are ambulatory and recently had a fracture, and to compare the ability to discriminate body function and structure and activity measures. A total of 100 patients who fulfilled our inclusion criteria were enrolled. At hospital discharge, the following outcomes were assessed: timed-up-and-go test, five-times-sit-to-stand test, one-leg standing test, 5-m gait test, and gait analysis using a wireless three-axis accelerometer. Root mean square (RMS) and autocorrelation (AC) values were analyzed on the basis of the acceleration waveform. Follow-up assessment of falls and subsequent fractures was performed 12 months after the fracture. Eighty-five percent of the participants completed the follow-up at 12 months. During the 12 months of follow-up, 61 falls were reported by 34 patients (31 women, three men), for a fall rate of 40.0% (34/85). The fall group had significantly poorer body function and structure and activity measures compared with the no-fall group. In accelerometry-based gait analysis, RMS and AC in the vertical axis and RMS in the anteroposterior axis were significantly lower in the fall group compared with the no-fall group. Multivariate logistic regression analysis showed that only AC in the vertical axis was a significant predictor of falls. This finding suggests that trunk acceleration AC in the vertical axis showed good discriminative ability for predicting the incidence of falls among patients who are ambulatory and recently had a fracture.

Background The increased prevalence of chronic diseases is a social issue in developing countries. Methods To create a conceptual model representing the quality of life of low-income people with type 2 diabetes in the Philippines, 117 low-income adult participants in a public support group were studied, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores on quality of life (QOL) were analyzed in terms of their relationships with the following factors: basic attributes, physical factors (glycated hemoglobin level, complications, comorbidities, and symptoms), social factors (support, education, and financial status), and cognitive factors (knowledge, attitude, self-efficacy, and self-management behavior). Results Based on correlation coefficients among variables and goodness-of-fit test results through a path analysis, 2 models representing causal relationships were created, both of which showed sufficient goodness-of-fit. Conclusion Glycated hemoglobin levels, knowledge of blood glucose levels, self-efficacy, and self-management behavior (exercise) influenced PCS scores, while age, glycated hemoglobin levels, neuropathy, knowledge of insulin, self-efficacy, and self-management behavior (exercise) influenced MCS scores. The influence of self-efficacy was prominent in both cases, providing an important insight for healthcare professionals to develop effective support methods.

Diabetes self-management education through peer support has been beneficial, especially in regions with limited medical resources. Studying the effects of education offered by trained peers of patients will facilitate tailoring the peer-led education programs to the regions’ specific needs. Here, we evaluated changes in diabetes-related indicators in Filipino patients who received a peer-led education. We used data on 23 patients (age, 67.83 ± 6.69 years; 82.6% female) who participated in all five surveys performed every 6 months from March 2017 to March 2019. After the second survey until the end of this study, the participants were educated in diabetes self-management by their 13 peers who previously had received the training in diabetes self-management. Participants’ knowledge of diabetes and the related ‘cause, risk factors, nature of diabetes and complications’ subindicator were greater on all surveys after starting the peer-led education compared with those on the second survey (i.e. before starting the education); these values did not differ between the first two surveys. Because increasing patients’ knowledge can enhance their ability to self-manage their disease and thus improve their quality of life, strategies to expand patients’ knowledge about diabetes should be included when organizing peer-led education in regions with limited medical resources.