Conversation Maps™, an effective tool for the management of males and females with type 2 diabetes and mildly impaired glycemic control

Defeudis, Giuseppe; Khazrai, Yeganeh Manon; Rosa, Claudia Di; Secchi, Chiara; Montedoro, Anna; Maurizi, Anna Rita; Palermo, Andrea; Pozzilli, Paolo; Manfrini, Silvia

doi:10.1007/s42000-018-0005-9

Cited by 22 publications

(18 citation statements)

References 7 publications

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“…However, the treatment might not have been intensified and titrated effectively because of fear of adverse effects like hypoglycemia, and the need to educate patients about insulin administration and adverse effects would be mandatory. Patient educational on lifestyle modification and management practices could be also an important component to achieve better treatment outcome [ 22 ], and as a result patients and healthcare providers would give an equal attention to patient education as equal as medication management.…”

Section: Discussionmentioning

confidence: 99%

“…Although timely initiation of insulin for T2DM has been recommended to prevent diabetes related complications by early establishment of strict glycemic control and pancreatic beta-cell protection [ 17 ], greater proportion of patients with suboptimal glucose level tend to delay insulin therapy [ 18 ] due to fear of hypoglycemia and weight gain [ 19 , 20 ]. In some case, patients may not take medications intentionally, driven by their emotions they may conceal it and become nonadherence to the recommended medication, which in turn lead to potential diabetes related complications and dire consequences [ 21 ], therefore, the need to educate patients about management practices and lifestyle modifications to achieve good treatment outcome could be mandatory [ 22 ]. Healthcare providers-patient relationship is also very crucial in the treatment intensification and medication adherence.…”

Section: Introductionmentioning

confidence: 99%

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Glycemic control in newly insulin-initiated patients with type 2 diabetes mellitus: A retrospective follow-up study at a university hospital in Ethiopia

2022

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Background Though many trials had examined the effectiveness of taking insulin with or without oral agents, there are limited real-world data, particularly among patients with type 2 diabetes mellitus (T2DM) in the resource limited settings. This study aimed to examine level of glycemic control among patients with T2DM after initiation of insulin and factors associated with poor glycemic control. Methods An analysis of retrospective medical records of patients with T2DM who initiated insulin due to uncontrolled hyperglycemia by oral agents was conducted from 2015–2020 in the University of Gondar Comprehensive Specialized Hospital. Difference in median fasting plasma glucose (FPG) before and after insulin initiations was examined by a Wilcoxon signed-rank test. Kruskal Wallis test was performed to explore difference in the median level of FPG among treatment groups. A logistic regression model was also used to identify associated factors of poor glycemic control after insulin initiation. Statistical significance was declared at p < 0.05. Results Of 424 enrolled patients with T2DM, 54.7% were males and the mean age was 59.3±9.3 years. A Wilcoxon signed-rank test showed that there was significant deference in FPG before and after insulin initiation (P < 0.001). A declining trend of blood glucose was observed during the 1-year follow-up period of post-initiation. However, majority of the participants did not achieve target glucose levels. Participants who had higher FPG and systolic blood pressure (SBP) before insulin initiation were found more likely to have poor glycemic control after insulin initiation. Similarly, patients who received atorvastatin compared with simvastatin were found to have poor glycemic control in the post-period of initiation (P = 0.04). Premixed insulin was associated with a lower likelihood of poor glycemic control than neutral protamine Hagedorn (NPH) insulin (P < 0.001). Conclusion Following insulin initiation, a significant change in glycemic level and declining trend of FPG was observed during a 1-year follow-up period. However, the majority of patients still had a poorly controlled glycemic level. Appropriate management focusing on predictors of glycemic control would be of a great benefit to achieve glycemic control.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Glycemic control in newly insulin-initiated patients with type 2 diabetes mellitus: A retrospective follow-up study at a university hospital in Ethiopia

2022

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“…Erectile dysfunction (ED), defined as the inability to achieve or maintain penile erection sufficient to obtain satisfactory sexual activity [ 1 , 2 , 3 ], can be due to many factors, among which diabetes mellitus (DM) play an important role [ 4 , 5 , 6 , 7 ]. DM is one of the most common chronic diseases due to impaired carbohydrate metabolism; alongside diet or nutritional supplements [ 8 , 9 ], educational therapy [ 10 ], metformin, sulfonylureas (SU), thiazolinediones (TZD), and insulin therapy, new antihyperglycemic drugs are now widely used for the management of DM, such as dipeptidyl-peptidase-4 inhibitors (DPP-4i), glucagon-like peptide-1receptor agonists (GLP-1a), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes

Defeudis

Tommaso

Rosa

et al. 2022

JCM

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Background. The purpose of this study was to evaluate the effect of diet and antihyperglycemic drugs on erectile dysfunction (ED) in a setting of subjects affected by diabetes mellitus (DM) or preDM. Methods. This is a prospective observational study on 163 consecutive subjects with preDM or DM. All patients have undergone a medical evaluation (age, Body Mass Index (BMI), family history of DM, duration of DM, smoking, physical activity, dyslipidemia, cardiovascular comorbidities, and testosterone and HbA1c levels) and the International Index of Erectile Function (IIEF)-5 questionnaire. Results. Overall, the mean age was 62.8 ± 9.3 years, and the mean BMI was 28.4 ± 4.6 kg/m2. The IIEF-5 score mean value was 14.4 ± 6.2 (range 4–25). Among all confounders investigated for their association with the IIEF-5 score, only age and the duration of DM among diabetic patients showed a significant trend. The IIEF-5 score was higher in patients using GLP-1a compared to insulin (16.7 ± 4.7 vs. 12.9 ± 6.2; p = 0.02). This association was confirmed after adjustment for age and duration of DM (p = 0.01). All other treatments were similar (14.9 ± 6.2, 14.8 ± 9.2, 15.3 ± 5.4, and 13.6 ± 6.8 for metformin, sulfonylureas (SU), dipeptidyl-peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) treatment, respectively). Conclusions. This prospective observational study increases attention and focus on the effect of antihyperglycemic drugs and diet on ED, above all about the role of new classes, showing a significant higher IIEF-5 mean value in patients using GLP-1a compared to patients on insulin treatment.

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“…However, in the application of this strategy it is important to consider the age group, sociodemographic condition and current control of diabetes before its use. In addition to these variables, participants' empowerment can only be successful if there is continuity in the use of conversation maps in diabetes [36][37][38].…”

Section: Discussionmentioning

confidence: 99%

The use of conversation maps in the metabolic control of diabetes in Brazilians: a randomized clinical trial

Veras

Filho

Araújo

et al. 2019

J Diabetes Metab Disord

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Objective To evaluate effects of an educative intervention over the self-monitoring of blood glucose (SMBG) at home for metabolic control. Method A total of 91 people with diabetes participated, recruited from the home capillary blood glycemia self-monitoring program. Two groups of participants were formed: one group participated in the SMBG program at home and with usual care (control group), while the other group participated in the SMBG at home and with educative intervention (intervention group). In total there were 12 meetings, three for each conversation map in the control of diabetes, during four months in 2011 and 2012. For all the analysis, a significance statistical level of 5% (p ≤ 0.05) was adopted. Results Most part of participants were females, married, with an average age of 62.1 years old and schooling from four to seven years of study. In the intervention group, an improvement was observed in the following measures: body mass index, abdominal circumference, diastolic blood pressure, fasting plasma glucose, HDL cholesterol, LDL cholesterol and triglycerides. The control group showed improvement in measures of systolic and diastolic blood pressure, fasting plasma glucose, HDL cholesterol and LDL cholesterol. Moreover, an increase on the values of glycated hemoglobin was observed in both groups. Conclusion It was observed that there was not statistical significant improvement of the metabolic control. However, it was possible to confirm that an educative intervention for SMBG at home presented a clinical significance, which in turn, resonates in a special way on the health of participants.

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Conversation Maps™, an effective tool for the management of males and females with type 2 diabetes and mildly impaired glycemic control

Abstract: CM may also play a significant role in T2DM characterized by mildly impaired glycemic control. Moreover, a systematic use of CM could be suggested for management of diabetes together with lifestyle changes and a weight loss diet.

Cited by 22 publications

References 7 publications

Glycemic control in newly insulin-initiated patients with type 2 diabetes mellitus: A retrospective follow-up study at a university hospital in Ethiopia

Glycemic control in newly insulin-initiated patients with type 2 diabetes mellitus: A retrospective follow-up study at a university hospital in Ethiopia

The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes

The use of conversation maps in the metabolic control of diabetes in Brazilians: a randomized clinical trial

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