Effect of Health Information Technologies on Cardiovascular Risk Factors among Patients with Diabetes

Yoshida, Yilin; Boren, Suzanne Austin; Soares, Jesus; Popescu, Mihail; Nielson, Stephen D.; Koopman, Richelle J.; Kennedy, Diana; Simões, Eduardo J.

doi:10.1007/s11892-019-1152-3

Cited by 4 publications

(7 citation statements)

References 71 publications

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“…Encouraging motivated patients to prepare questions before a consultation, and to bring a companion, can increase active participation in decision-making [ 117 ]. Outside of the clinic, patient access to digital information can help to reduce the levels of CV risk factors, underscoring the importance of education [ 118 ].…”

Section: A Manifesto To Defeat Clinical Inertiamentioning

confidence: 99%

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

Schernthaner

Shehadeh

Аметов

et al. 2020

Cardiovasc Diabetol

109

108

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The disclosure of proven cardiorenal benefits with certain antidiabetic agents was supposed to herald a new era in the management of type 2 diabetes (T2D), especially for the many patients with T2D who are at high risk for cardiovascular and renal events. However, as the evidence in favour of various sodium–glucose transporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) accumulates, prescriptions of these agents continue to stagnate, even among eligible, at-risk patients. By contrast, dipeptidyl peptidase-4 inhibitors (DPP-4i) DPP-4i remain more widely used than SGLT2i and GLP-1 RA in these patients, despite a similar cost to SGLT2i and a large body of evidence showing no clear benefit on cardiorenal outcomes. We are a group of diabetologists united by a shared concern that clinical inertia is preventing these patients from receiving life-saving treatments, as well as placing them at greater risk of hospitalisation for heart failure and progression of renal disease. We propose a manifesto for change, in order to increase uptake of SGLT2i and GLP-1 RA in appropriate patients as a matter of urgency, especially those who could be readily switched from an agent without proven cardiorenal benefit. Central to our manifesto is a shift from linear treatment algorithms based on HbA1c target setting to parallel, independent considerations of atherosclerotic cardiovascular disease, heart failure and renal risks, in accordance with newly updated guidelines. Finally, we call upon all colleagues to play their part in implementing our manifesto at a local level, ensuring that patients do not pay a heavy price for continued clinical inertia in T2D.

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Section: A Manifesto To Defeat Clinical Inertiamentioning

confidence: 99%

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

Schernthaner

Shehadeh

Аметов

et al. 2020

Cardiovasc Diabetol

109

108

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“…Twenty-six reviews, published between 2017 and 2020, conducted in multiple countries, were included in this umbrella review, 19-44 See Table 2. The number of studies in the selected reviews ranged from 7 to 111, and the number of participants ranged from 30 to 23,648.…”

Section: Resultsmentioning

confidence: 99%

“…19,22,25,[29][30][31][33][34][35][36][37]39,40,42 Over half of the studies assessed non-glycemic physiological outcomes (other physiological outcomes) (n = 14, 53.8%). 19,21,25,[27][28][29][30][31][32]35,38,40,43,44 The most common other physiological outcome measured was BMI (n = 8, 33.3%), [19][20][21]25,27,29,30,43 which was assessed in relation to smartphone and mobile application interventions (n = 6/8, 75.0%). 19,20,25,27,29,30 No studies assessing BMI reported statistical significance.…”

Section: Phasementioning

confidence: 99%

“…Twenty reviews described studies with 2-way communication, with one study including only one-directional texts. 23 while 18 (85.7%) 19,20,22,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][39][40][41][42][43][44] of the studies included both one-way and 2-way communication. PGHD was defined as either tracked or tracked and analyzed (both).…”

Section: The Most Common Technology Interventions and Glycemicmentioning

confidence: 99%

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A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review

Greenwood

Litchman

Isaacs

et al. 2021

J Diabetes Sci Technol

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Background: A 2017 umbrella review defined the technology-enabled self-management (TES) feedback loop associated with a significant reduction in A1C. The purpose of this 2021 review was to develop a taxonomy of intervention attributes in technology-enabled interventions; review recent, high-quality systematic reviews and meta-analyses to determine if the TES framework was described and if elements contribute to improved diabetes outcomes; and to identify gaps in the literature. Methods: We identified key technology attributes needed to describe the active ingredients of TES interventions. We searched multiple databases for English language reviews published between April 2017 and April 2020, focused on PwD (population) receiving diabetes care and education (intervention) using technology-enabled self-management (comparator) in a randomized controlled trial, that impact glycemic, behavioral/psychosocial, and other diabetes self-management outcomes. AMSTAR-2 guidelines were used to assess 50 studies for methodological quality including risk of bias. Results: The TES Taxonomy was developed to standardize the description of technology-enabled interventions; and ensure research uses the taxonomy for replication and evaluation. Of the 26 included reviews, most evaluated smartphones, mobile applications, texting, internet, and telehealth. Twenty-one meta-analyses with the TES feedback loop significantly lowered A1C. Conclusions: Technology-enabled diabetes self-management interventions continue to be associated with improved clinical outcomes. The ongoing rapid adoption and engagement of technology makes it important to focus on uniform measures for behavioral/psychosocial outcomes to highlight healthy coping. Using the TES Taxonomy as a standard approach to describe technology-enabled interventions will support understanding of the impact technology has on diabetes outcomes.

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“…However, these compounds were reported as ineffective and their application was associated with cardiovascular adverse reactions (7). Therefore, additional novel therapeutic strategies are necessary for the treatment of this disease (8). A previous study highlighted that conventional western medicine combined with traditional Chinese medicine could be used to treat DMCM (9).…”

Section: Introductionmentioning

confidence: 99%

25‑OH‑PPD inhibits hypertrophy on diabetic cardiomyopathy via the PI3k/Akt/GSK‑3β signaling pathway

et al. 2020

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The present study investigated the inhibitory effects and the associated mechanism of the compound 25-OH-PPD (PPD) on cardiac hypertrophy, fibrosis and inflammation. The signaling pathways associated with diabetic mellitus cardiomyopathy (DMCM) were investigated using a rat model. DMCM Sprague-Dawley rats were induced by injection of streptozotocin. The animals were divided into 5 groups as follows: Normal group (NG group), diabetic group, PPD treatment group, PPD/LY294002 group (inhibitor of PI3K/Akt) and PPD/LiCl group [inhibitor of glycogen synthase kinase (GSK) 3β]. The studies were carried out during the 12 weeks following induction of diabetes and the levels of plasma brain natriuretic peptide (BNP), creatine phosphokinase isoenzyme (CK-MB) were measured. In addition, the volume of myocardial collagen fraction (CVF) was tested. The expression levels of the inflammatory cytokines, including transforming growth factor beta 1 (TGF-β1), connective tissue growth factor (CTGF), cell adhesion molecules α-smooth muscle actin (α-SMA) and vascular adhesion molecule 1 (VCAM-1) and associated signaling proteins (Akt, GSK-3β) were measured by biochemical analyses. The levels of BNP and CK-MB, the volume of CVF, the expression levels of TGF-β1, CTGF, α-SMA and VCAM-1 in the diabetic group were higher compared with those of the normal control group (P<0.05). Conversely, the levels of these molecules were significantly decreased in the PPD treatment groups (P<0.05). The aforementioned effects were partially eliminated in the PPD/LY294002 and PPD/LiCl groups. In addition, PPD treatment significantly increased the expression levels of p-Akt and decreased the levels of phosphorylated GSK-3β compared with those of the DMCM group (P<0.05). The data demonstrated that the protective effects of 25-OH-PPD against DMCM may be attributed to the PI3k/Akt/GSK-3β signaling pathway, via the suppression of the α-SMA/VCAM axis and the downregulation of TGF-β1 and CTGF expression.

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Effect of Health Information Technologies on Cardiovascular Risk Factors among Patients with Diabetes

Cited by 4 publications

References 71 publications

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes

A New Taxonomy for Technology-Enabled Diabetes Self-Management Interventions: Results of an Umbrella Review

25‑OH‑PPD inhibits hypertrophy on diabetic cardiomyopathy via the PI3k/Akt/GSK‑3β signaling pathway

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