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Contrasting Features of Type 1 and Type 2 Diabetes Mellitus 13 

Contrasting Features of Type 1 and Type 2 Diabetes Mellitus 13 

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Diabetes mellitus (DM) is a common disease in which excessive levels of blood glucose (sugar) occur. In simple terms, diabetes is generally due to failure in the effective functioning of insulin. Common types of diabetes include type 1 and type 2, which have different treatment options. In the general population, type 2 diabetes is more prevalent t...

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Background and objectives: Type 2 diabetes (T2D) is a major problem of public health in Mexico. We investigated the influence of five polymorphisms, previously associated with obesity and cardiovascular disease in Europeans and Asians, on T2D in Mexican Mestizos. Materials and Methods: A total of 1358 subjects from 30 to 85 years old were genotyped...

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... There is an increasing role for pharmacists in improving adherence in patients with T2D. Studies show pharmacists can improve adherence and HbA1c concentrations through comprehensive medication management (CMM) [13]. CMM is part of the patient care process that guarantees each medication is individually assessed for appropriateness, effectiveness, and safety for the individualized patient [14]. ...
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Objective The primary objective was to develop a computerized culturally adapted health literacy intervention for older Hispanics with type 2 diabetes (T2D). Secondary objectives were to assess the usability and acceptability of the intervention by older Hispanics with T2D and clinical pharmacists providing comprehensive medication management (CMM). Materials and methods The study occurred in three phases. During phase I, an integration approach (i.e., quantitative assessments, qualitative interviews) was used to develop the intervention and ensure cultural suitability. In phase II, the intervention was translated to Spanish and modified based on data obtained in phase I. During phase III, the intervention was tested for usability/acceptability. Results Thirty participants (25 older Hispanics with T2D, 5 clinical pharmacists) were included in the study. Five major themes emerged from qualitative interviews and were included in the intervention: 1) financial considerations, 2) polypharmacy, 3) social/family support, 4) access to medication/information, and 5) loneliness/sadness. Participants felt the computerized intervention developed was easy to use, culturally appropriate, and relevant to their needs. Pharmacists agreed the computerized intervention streamlined patient counseling, offered a tailored approach when conducting CMM, and could save them time. Conclusion The ability to offer individualized patient counseling based on information gathered from the computerized intervention allows for precision counseling. Future studies are needed to determine the effectiveness of the developed computerized intervention on adherence and health outcomes.
... It also proved that the MBI has an impact on complications of the disease. It also discussed the pharmacist's contribution to the prognosis of the disease [32,33]. Ley et al. had done a study that proved the behavioral risk factor in type 2 diabetes. ...
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There is a tremendous increase in severe cases of type 2 diabetes in the day today's life. Therefore, proper assessment of the disease is critical to saving society. Many prediction models help identify type 2 diabetes. At the same time, every model varies based on the performance measures. Various kinds of algorithms such as Decision Tree, Logistic Regression, KNN, Random Forest algorithm are applied to identify type 2 diabetes. At this juncture, used the implementation of type 2 Classification by AdaBoost algorithms, an ensemble approach. Here, the proposed methodology of the paper is to implement an ensemble approach of machine learning to receive a better efficiency compared to other existing algorithms for the classification of type 2 diabetes. When compared to all different algorithms, this ensemble approach shows an efficiency of 83%. The accuracy is calculated based on various performance measures.
... Health policy recommends using primary care resources, including community pharmacists, to identify and manage the needs of vulnerable populations. 19 Primary health care has been shown to be most effective when it is accessible and ORIGINAL RESEARCH PAPER delivered by collaborative teams. 20 Although this study did not explore consumer perspectives, research and policy documents identify pharmacists as an accessible health provider, [21][22][23][24][25] and interview data confirm that pharmacists in NZ are well placed to support people on opioid substitution treatment. ...
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INTRODUCTIONPeople receiving opioid substitution treatment are a vulnerable population who experience significant health inequities and stigma, but have regular interactions with community pharmacists. Many pharmacists now work collaboratively with other health providers to ensure effective and safe use of medicines, as well as being involved in the prevention and management of chronic health conditions. AIMTo explore the role of New Zealand community pharmacists in the provision of opioid substitution treatment and how they perceive their role as part of the wider opioid substitution treatment team. METHODS Semi-structured video interviews with a purposive sample of 13 diverse pharmacists explored their current practices in providing opioid substitution treatment, and their perceived role in the treatment team. Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed using an inductive thematic approach. RESULTSThis study found that pharmacists are providing accessible support to a population with known barriers to accessing health care. However, participants also identified challenges with communication and a perceived lack of understanding of the pharmacist role as barriers to collaboration with the wider opioid substitution treatment team. DISCUSSIONCollaboration within health-care teams has been shown to improve health outcomes, and pharmacists are well placed to provide health-care services as well as offer valuable insight into clients’ mental and physical wellbeing. Improved communication channels that facilitate information sharing, as well as the opioid substitution treatment team’s recognition of a pharmacist’s role, may facilitate collaboration and, in turn, improve the quality of health care provided to this vulnerable population.
... Hyperglycaemia or raised blood sugar level is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels (1). In the current days, type 2 Diabetes Mellitus (T2DM) seem to have more prominent than type 1 Diabetes Mellitus (T1DM) across the globe (2). It has shown that more than 90% of all known cases of diabetes fall under T2DM (2). ...
... In the current days, type 2 Diabetes Mellitus (T2DM) seem to have more prominent than type 1 Diabetes Mellitus (T1DM) across the globe (2). It has shown that more than 90% of all known cases of diabetes fall under T2DM (2). According to Malaysia's National Health and Morbidity Survey (NHMS) conducted in the year 2019, 1 in 5 adults in Malaysia has diabetes. ...
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Introduction: The prevalence of diabetes among adults is increasing globally in the 21st century. However, the knowledge of diabetes and practice of medication adherence among people living with diabetes mellitus are still questionable. Aims: This literature review aimed to look for the literature that related to the level of knowledge about diabetes and its correlation with medication adherence among people living with diabetes mellitus. Methods: The studies included in this review were identified through a search of Proquest, ClinicalKey for Nursing, CINAHL and Ovid databases. The published articles from year 2010 onwards are included in this study. Results: A total of 18 articles were analysed in this review. It was found that having good or poor knowledge of diabetes does not guarantee their health-seeking practice of medication adherence. It was also reported that some of the factors that have been found to predict the level of knowledge and their practices include their sociodemographic characteristic. Conclusion: Therefore, the findings of this review giving alarm about future interventions and study in this particular area.
... 13 Several studies have recommended the involvement of a pharmacist in a diabetes multidisciplinary healthcare team including those by the American Diabetes Association and Canadian Diabetes Association. 12,14 Previous literature reviews have proven that the contribution of pharmacists in achieving better control of diabetes is significant [15][16] .These reviews focused on many types of pharmacist interventions including selfcare related interventions, adherence, and compliance or on counselling but always resulted in a significant effect on the outcomes of diabetes mellitus [17][18] . ...
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Diabetes mellitus is a rapidly growing major health problem world-wide. The management of type 2 diabetes mellitus is complex, requiring continuous medical care by health care professionals and considerable self-care efforts by patients. A collaborative and integrated team approach in which pharmacists can play a pivotal role should be sought when managing patients with diabetes. Pharmacist-led care programs have been shown to help patients with diabetes succeed in achieving treatment goals and improving outcomes. Hence, the aim of this narrative review is to address and summarize the effectiveness of pharmacist interventions in the management of diabetic patients. A comprehensive literature search was conducted in PubMed/Medline, Scopus, web of Science and the Cochrane Library were searched from the date of database inception to June 2019. All randomized controlled trials evaluating the effectiveness of pharmacist-based interventions on diabetic patients in comparison with usual care were included in study. Outcomes of interest included short-term and long-term measures such as glycated haemoglobin (HbA1c), and secondary outcomes were blood glucose level, blood pressure (BP), lipid profile, body mass index (BMI), 10-year coronary heart disease (CHD) risk, medication adherence, health related quality of life (HRQoL), and economic outcomes. Twenty-five studies were included in this systematic study. They were heterogeneous in terms of interventions, participants, settings and outcomes. Pharmacist-led self-management interventions included education on diabetes and its complications, medication adherence, lifestyle and education of self-management skills. Few studies even focussed on patients need through a tailored intervention. We found that those who received the pharmacist care had a statistically significant improvement in HbA1C, blood pressure, lipid profile, health-related quality of life, and CHD risk. These results underline the added value of pharmacists in patient-related care. Hence this review supports the involvement of pharmacists as a member of health- care teams in managing diabetic patients at diverse settings worldwide. Keywords: diabetes, self-management, HbA1C, pharmaceutical care, randomized controlled trial
... [11][12][13][14] Looking into the past, numerous reviews have proven that the contribution of pharmacists in achieving better control of diabetes is significant. [14][15][16] These reviews focused on many types of pharmacist interventions including self-carerelated interventions, adherence, and compliance or on counseling but always resulted in a significant effect on the outcomes of diabetes mellitus. ...
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A strict and adherence treatment is required by the patient with diabetes mellitus and it demands a proper self-medication by the patient. Pharmacists are involved in providing self-management support to the patients. This review evaluates the interventions of pharmacist for patients to improve self-management with diabetes mellitus and also to improve the clinical outcomes of diabetes mellitus. A comprehensive literature search was performed by using different keywords “pharmacist-led intervention,” “diabetes,” “effect of pharmacist on outcome of diabetes,” and “self-management of diabetes” with the help of various electronic databases such as PubMed, Science Direct, Embase, Web of Science, and the Cochrane Library from the beginning of the database through September 2018. The primary outcome was glycated hemoglobin (HbA1c), whereas the secondary outcomes were blood glucose level, blood pressure (BP) measure, body mass index, lipids, adherence to medication, and quality of life. Twenty-five studies comprising 2997 diabetic patients were included in the analysis. Pharmacist-led intervention was involved in all included studies in the form of education on diabetes and its complications, medication adherence, lifestyle, and education about self-management skills. Pharmacist-led interventions are able to reduce HbA1c levels with a mean of 0.75%. Most studies do not expose the material and methods used in pharmacist-led intervention. The variation in the reduction of HbA1c, fasting blood sugar, BP, and lipid profile was due to the lack of this standardization. The included studies indicated that pharmacist-led interventions in diabetes mellitus can significantly improve the outcomes of diabetes mellitus and its complication later on. Hence, these long-term improvements in outcomes added more value of pharmacists in health-care system of the world.
... Despite the variability of methods used to measure and report data on adherence, it was clear that pharmacist intervention resulted in significant improvement of Int J Diabetes Dev Ctries medication adherence rate (increased by 26.9 to 58.1%). A similar finding was found in many other studies that evaluate pharmacist intervention among DM patients [43,44]. This improvement may be related to the pharmacist's role in educating and encouraging patients to adhere to their prescribed therapy. ...
Article
Introduction Diabetes mellitus (DM) is a highly prevalent metabolic disorder in the Arab world. Uncontrolled DM is associated with serious microvascular and macrovascular complications. Reduction of such complications can be achieved by good glycemic control through utilization of pharmacological and non-pharmacological treatments. Patient education programs can improve treatment outcomes. Thus, the present study reviewed articles that evaluate pharmacist’s interventional (educational/care) programs in the management of diabetic patients in Arab countries in order to quantify benefits of such programs. Methods A careful manual literature search was done in PubMed and Google Scholar for clinical trials that focus on the role of the pharmacist in care, education, or management of all types of DM in Arab countries. Information from these studies was summarized in relation to general study characteristics (study design and area of study); description of study population, sample size, and the type and components of pharmaceutical intervention; follow-up time, frequency, and duration of contact moments during intervention; and assessment criteria, results, and conclusions. The risk of bias in individual studies was assessed using the Cochrane risk of bias tool. Results Six studies were included in this review. The included studies were conducted in four Arabic countries, two in Jordan and United Arab Emirates, and one each in Sudan and Iraq. Five studies assessed the benefits of implementing pharmaceutical interventions (pharmaceutical-led patient care or education) among type 2 DM patients and only one study assessed such benefits among patients with gestational DM. Follow-up of patients ranged from 15 weeks to 12 months. Only one study had a high risk of bias. All studies showed a significant improvement in patient knowledge, adherence to treatment, and glycemic control. Conclusion Pharmacists’ interventions in the management of DM patients in Arab countries tend to result in positive outcomes such as enhanced patient knowledge, greater adherence to treatment, and eventually better glycemic, lipid, and blood pressure control.
... For example, in reviews of patients with diabetes receiving pharmacist interventions, extensive evidence is documented of significant improvements in hemoglobin A1c (HbA1c), a key measure of diabetes control, as well as medication adherence, patient knowledge, and other CVD risk factors such as cholesterol and blood pressure. [17][18][19][20][21][22][23] The Asheville Project demonstrates the potential to implement complex interventions and produce meaningful, long-term improvements in risk factors such as HbA1c. 24 Clifford et al demonstrated significant reductions in both HbA1c and, using a validated risk algorithm, median 10-year risk of CVD and stroke onset (from 26.1% to 20.3% in the intervention group) in patients who received pharmaceutical care, compared with control group participants whose CVD risk slightly increased. ...
... However, evidence that the interventions above can deliver a prospectively assessed and meaningful reduction in hard endpoints such as CV events, CVD onset, and CV-related mortality associated with such interventions appears to be missing. [17][18][19][20][21][22] This apparent absence of clinical endpoints mirrors the conclusion of a recent systematic review examining the impact of all pharmacist interventions and which examined CVD outcomes, all-cause mortality, and other outcomes. 26 There is also commentary in the systematic review literature about the need to improve the general quality of pharmacist studies in this area. ...
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Kevin Mc Namara,1–3 Hamzah Alzubaidi,4 John Keith Jackson3 1School of Medicine, Deakin University, Geelong, VIC, Australia; 2Deakin Health Economics, Centre for Population Health, Deakin University, Geelong, VIC, Australia; 3Centre for Medicine Use & Safety, Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; 4Institute for Medical Research and College of Pharmacy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates Abstract: Cardiovascular diseases (CVDs) are a leading cause of death globally. This article explores the evidence surrounding community pharmacist interventions to reduce cardiovascular events and related mortality and to improve the management of CVD risk factors. We summarize a range of systematic reviews and leading randomized controlled trials and provide critical appraisal. Major observations are that very few trials directly measure clinical outcomes, potentially owing to a range of challenges in this regard. By contrast, there is an extensive, high-quality evidence to suggest that improvements can be achieved for key CVD risk factors such as hypertension, dyslipidemia, tobacco use, and elevated hemoglobin A1c. The heterogeneity of interventions tested and considerable variation of the context under which implementation occurred suggest that caution is warranted in the interpretation of meta-analyses. It is highly important to generate evidence for pharmacist interventions in developing countries where a majority of the global CVD burden will be experienced in the near future. A growing capacity for clinical registry trials and data linkage might allow future research to collect clinical outcomes data more often. Keywords: health services, chronic disease management, cardiovascular risk factors, preventative health, disease screening
... Among the subcriteria of patient-oriented care, improvement in medication use had the highest weighting, apparently because of the patients' perspective of the importance of pharmaceutical care services in improving and maintaining their own health, including self-care, home medication, and adherence. Reductions in cost and burden of disease had relatively low weightings, indicating that pharmaceutical care services need to focus primarily on improving the quality of patient care and that reducing costs is subservient to this [25]. In some studies, pharmaceutical care services were effective in reducing costs, but, in other studies, they did not show any benefit in terms of cost reduction [26,27]. ...
Article
Objective: Drug therapy plays a critical role in most chronic diseases. Effectiveness of pharmaceutical care services in the improvement of clinical, social, or economic outcomes has been scientifically proven through numerous studies. In South Korea, to optimize and standardize pharmaceutical care for patients with chronic metabolic diseases, the development of a pharmaceutical care service model is needed. Materials: To determine the priority of diseases in developing pharmaceutical care service models, analytic hierarchny process (AHP)analysis was used. A survey questionnaire standardized with detailed evaluation areas and an index, to ensure sufficient understanding and identical standards of evaluators, was designed. It was prepared for pair-wise comparisons of individual criteria of candidate diseases. Methods: Medical specialists and pharmacists who have clinical experience and expertise in chronic metabolic diseases or at least 10 years of experience in pharmacy practice were recruited. They responded to a survey consisting of nine sections by using the pair-wise comparison method. Results: A total of seven candidate diseases were selected for prioritization. Diabetes mellitus was given the highest score of 0.2695, cardiovascular disease (0.2598) being the next, followed by chronic kidney disease (0.2000), and cerebrovascular diseases (0.1087). The criteria were weighted as follows: disease characteristics (0.4964), patient-oriented care (0.3649), and improvement in services (0.1386). Conclusion: Diabetes, cardiovascular diseases, and chronic kidney disease were found to have high priority in developing a pharmaceutical care service model in South Korea. In the future, further research for the development and application of pharmaceutical care services models for different types of diseases is required. .
... It is evident that glycemic control in diabetics is very important for each patient. Several studies have demonstrated the benefit of glycemic control through pharmacist intervention [6][7][8][9][10]. This study originated as a way to justify pharmacist involvement with diabetes management. ...
... Pharmacists were able to serve a more active role in the management of diabetic medications through initiating and adjusting both oral and injectable medications in these studies. [6][7][8][9][10] This study demonstrates the impact that pharmacists can have through management of only injectable diabetic medications. HbA 1c reductions were obtained through close monitoring and follow-up of glucose readings, conservative dosing guidelines and protocols, and direct pharmacist to patient interactions. ...