bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of Pregabalin Treatment and Quality of Life in Patients Treated with Pregabalin in Painful Diabetic Peripheral Neuropathy
Authors: RADHAKRISHNAN CHANDNI , UT ANJUSHA , K SREEJITH , MANIKATH NEERAJ , CR RINU R. 
Published: June 2018

The treatment modalities for painful diabetic peripheral neuropathy (PDPN) include antidepressants, anticonvulsants, capsaicin, membrane stabilizers and analgesics. Recent guidelines recommend pregabalin as a first line treatment for PDPN. But controversy exists about its efficacy and safety.
The main objective of the study is to determine the safety, efficacy of pregabalin treatment for PDPN. An interventional cohort study was carried out in a tertiary care teaching hospital. Subjects who satisfy the inclusion criteria were included in the study after obtaining written informed consent. A total of 52 subjects were enrolled in the study. PDPN was confirmed by means of (1) Diabetic neuropathy symptom (DNS) score of more than one point, (2) Diabetic neuropathy examination score (DNE) of more than three points, (3) Neuropathic disability score (NDS) of more than 6 points and (4) Pain of more than 50% assessed by Visual Analog Scale (VAS). The subjects received pregabalin 75mg once daily for one week followed by 75 mg twice daily for further 3 weeks based on patient’s tolerability. Pain intensity was measured by using Short-Form McGill pain questionnaire. Safety of therapy was assessed from the incidence of adverse events including physical as well as laboratory evaluations. All study subjects’s enrolled received pregabalin. Study showed that pregabalin treatment significantly reduced pain in diabetic peripheral neuropathy with mean pain score 11.52 ± 9.30 (P value 0.00). The most common adverse effects of pregabalin were dizziness, peripheral edema, and somnolence.
The study concluded that pregabalin significantly reduces pain and improve quality of life in PDPN.There was a dose-related increase in efficacy of pregabalin treatment. Moreover, there was a dose-related increase in incidence of most adverse events which are generally mild to moderate.

Disclosure
C. Radhakrishnan: None. A. Ut: None. S. K: None. N. Manikath: None. R.R. Cr: None.
Retrospective Analysis of Correlation between Peripheral Artery Disease and Diabetic Retinopathy in Type 2 Diabetes Patients
Authors: CHANDARANA HARDIK , SABOO BANSHI D. , PATEL AMISH , HASNANI DHRUVI , SHAH SMITA , GOKLANI RUTUL , PANCHAL DHARMENDRA , SAIYED MAHIRA , CHUDASAMA DIPAK B. 
Published: June 2018

There are no enough evidences which show the correlation of peripheral arterial disease (PAD) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). We have tried to explore the relationship between PAD and DR in this study.
Method: Patients with T2DM since more than 5 years with HbA1c &gt; 7% and patients with DR or with no DR were included in this cross-sectional study. As a part of our clinical protocol at the first visit all type 2 DM patients are assessed through ABI, VPT, CAN and retinoscope for their complications. A history of addiction including smoking and tobacco were recorded. Stages of DR were graded by digital retinal photographs using Zeiss VISUCAM. PAD assessment was done by using Ankle Brachial Index (ABI), Toe Brachial Index (TBI) and ultrasound doppler.
Result: It was found that out of 573 patients attended OPD in month of November 2017 at Dia Care - Diabetes Care and Hormone Clinic were taken into this study. Out of these 573 patients, the HbA1c of 475 patients was uncontrolled (&gt;8%) with duration of diabetes of 7.5 ± 1.2 years.Out of this, 138 patients were having DR [34 Proliferative Diabetic Retinopathy (PDR) and 104 Non-Proliferative Diabetic Retinopathy (NPDR)].It was seen that patients with DR had a significantly higher proportion of Peripheral Arterial Disease (ABI &lt; 1 and &gt; 1.3) compare to patients who did not have DR (53 out of 138 vs. 59 out of 337). The patients with DR also had lower TBI and abnormal duplex ultrasound than patients who did not have DR. This showed the correlation between DR and PAD that in patients with DR the incidence of PAD was more common. We also observed the relation between duration of diabetes and uncontrolled glycemic status with that of PAD and DR. We are still evaluating these patients further to establish a positive relation between these variables.
Conclusion: We should focus on screening PAD in patients with DR in clinical practice.

Disclosure
H. Chandarana: None. B.D. Saboo: None. A. Patel: None. D. Hasnani: None. S. Shah: None. R. Goklani: None. D. Panchal: None. M. Saiyed: None. D.B. Chudasama: None.
The Charcot Foot and Mortality from 2000 to 2016
Authors: ENGBERG SUSANNE , KIRKETERP-MØLLER KLAUS , RASMUSSEN ANNE 
Published: June 2018

Introduction: The Charcot foot is a relatively rare but serious foot complication in patients with diabetes and neuropathy. The aim was to study the mortality and compare baseline characteristics at diagnosis between Charcot patients who died or survived during follow-up.
Materials and Methods: A retrospective cohort study including all patients with a Charcot diagnosis at our centre from 2000 to 2016. Poisson regression analyses were done.
Results: A total of 164 patients had the diagnosis Charcot (DM146) and 52 (31.1%) died during follow-up. They lived for 1973 days (range: 219-4895) i.e., 5.4 years. Patients were followed for 1122 years in total, median 6.0 years/patient (Q1-Q3=3.2-10.0). The mortality rate was 4.6/100 person-years-at-risk. Patients who died were significantly older (61±10 vs. 54±11 years), had less often type 1 diabetes (40 (27-55) vs. 60% (50-70)), were less often non-smokers (35 (22-49) vs. 52% (42-61)), had a lower hemoglobin (7.9±1.2 vs. 8.3±0.9), a higher creatinine (114 [88-161] vs. 85 [69-109]) and were more often treated with antitrombotic agents (71 (57-83) vs. 53% (43-62)) compared to survivors. Rate ratios for death were insignificantly different among smokers and non-smokers, among patients with type 1 and 2 diabetes, among patients with a diabetes duration below or above 10 years and among patients with HbA1c above or below 60 mmol/mol-both in univariate analyses and after adjustment for age and gender.
Conclusion: The mortality rate among patients with Charcot feet was 4.6%/person-years-at-risk and was not affected by diabetes type, smoking, diabetes duration or HbA1c-level.

Disclosure
S. Engberg: None. K. Kirketerp-Møller: None. A. Rasmussen: None.
Effects of Essential Oils on Biofilm-Forming Microorganisms from Patients with Diabetic Foot
Authors: NIKOLAYEVA ANTONINA B. , AKHMETOVA SAULE B. , GAZALIYEVA MERUERT A. , SIROTA VALENTINA B. , ZHUMALIYEVA VERA A. , ZHAKENOVA SAULE R. 
Published: June 2018

Our study was focused on the possibility of using essential oils (EOs) in the prevention of biofilm development by microorganisms isolated from patients with diabetic foot. Dominant microorganisms with a strong production of biofilms and effects of EOs on them are presented on the Table. Growth of biofilms was carried out in polystyrene microplates at 37°C for 24 hours. The EOs were extracted from following plants: Matricaria chamomilla (Asteraceae) (MCEO), Eucalyptus (Myrtaceae) (EEO), Tanacetum fruticulosum (Asteraceae) (TFEO), Thymus marschallianus (Labiatae) (TMEO) and Artemisia sieversiana (Asteraceae) (ASEO). Serial dilutions of EOs were prepared with dimethyl sulfoxide (1:1 v/v) and then in Mueller-Hinton broth with 0.5% Tween 20. The EOs were diluted to the following dilutions: 12.5%, 6.25%, 3.13%, 1.56%, 0.78%, 0.39%, 0,195%, 0,097%, 0,048%, and 0,024%. The EOs were deposited in wells of microplates with bacterial suspensions at 37°C for 24 hours and then we determined minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of EOs by OD (optical density) reading at a wave length of 600 nm. According to our study, strong effects of MCEO on gram-positive and gram-negative microbes were shown. The moderate effects were detected for other investigated EOs. Our results encourage research related to the application of essential oils to fight diabetic complications.Activity of essential oils against biofilm-forming microorganisms from patients with diabetic footEssential oilsMCEOEEOTFEOTMEOASEOMicroorganismsMIC,%: MBC,%MIC,%: MBC,%MIC,%: MBC,%MIC,%: MBC,%MIC,%: MBC,%Staphylococcus aureus0.195:0.396.25:6.250.78:3.131.56:3.133.13:6.25Staphylococcus haemolyticus0.097:0.1956.25:12.50.78:1.560.39:0.783.13:3.13Escherichia coli0.024:0.0480.78:3.130.39:0.390.78:3.130.39:0.78Enterococcus cloaceae0.024:0.0973.13:3.130.195:0.1950.39:0.780.39:0.39Enterococcus faecalis0.048:0.0970.78:3.130.195:0.780.39:0.390.78:1.56Klebsiella spp.0.097:0.1953.13:3.130.097:0.390.195:0.780.78:0.78

Disclosure
A.B. Nikolayeva: None. S.B. Akhmetova: None. M.A. Gazaliyeva: None. V.B. Sirota: None. V.A. Zhumaliyeva: None. S.R. Zhakenova: None.
Orthosis DCFzO in Charcot Neuroarthropathy Management
Authors: IMMANUEL JULIUS N. 
Published: June 2018

Study was aimed to evaluate the effectiveness of Innovative Orthosis: Diabetic Charcot Foot Customized Orthosis [DCFzO] in terms of Comfort, Distortion Containment and Rehabilitation Care in patients with Charcot Neuroarthropathy(CN). DCFzO is a unique pattern Custom Designed and Fabricated Poly Ethylene Orthosis: for patients with CN/Diabetic Charcot Foot. CN develops among Diabetic patients with peripheral neuropathy, leading to pathological fracture/dislocation at Ankle and foot. “CN” potentially compromises normal Gait-Pattern [Ambulation] at Early-stage, Causes disability at Later-stage and can potentially end up in Amputation if neglected.
Data: Involved group (3:1) Charcots Stage- 2 and Stage- 3. Patients* [CN Ankle/foot depended on Orthosis (Rehabilitation Aid)for independent Standing and Walking].
Method: Alignment comparison with and with-out DCFzO(W and WOD) : CN ankle/foot Stability during weight bearing stance. Ability to Ambulate (W and WOD) : Balance and Confidence. Data comparison of Girth record: Follow-up schedule. Visual reports comparison [Photograph records]. Patients* personal Feed-back: Orthosis effect in terms of comfort as AID device and suggestions.
Conclusion: Orthosis “DCFzO” exhibited efficacy in aiding CN Foot: in terms of Comfort, Protection, Assistance in ambulation and Restore maximum possible ankle foot anatomical structure’ at Stage 2 and 3 treated at ALD- PMR hospital.

Disclosure
J.N. Immanuel: None.
Impacting Postprandial Glucose (PPG) Control with Faster-Acting Insulins—Effect of Online Education on Physician Knowledge and Confidence
Authors: SENDAYDIEGO ANNE M. , TRIER JOACHIM , MONTANYA EDUARD 
Published: June 2018

Purpose: To determine if online medical education for diabetologists/endocrinologists (diabs/endos) and primary care physicians (PCPs) can improve knowledge regarding the consequences of elevated PPG, the need for better PPG control and more physiologic mealtime insulin replacement, PK/PD profiles, and latest clinical data of investigational faster-acting insulin analogs.
Methods: The educational activity consisted of a 30-min online video panel discussion amongst four experts with synchronized slides. Educational effect was assessed with a repeated pairs pre- and post-assessment study using a 3-item, multiple-choice, knowledge and competence questionnaire plus a confidence assessment in which participants act as their own controls. A χi-squared test assessed statistical significance at the P &lt;.level. The activity launched December 21, 2016; data collected until February 1, 2017.
Results: Participation in the activity significantly improved knowledge of diabs/endos (average from 47% to 69%; n=73) and PCPs (from 55% to 72%; n=112) with respect to latest clinical data and potential benefits of new and emerging faster-acting insulins. On pre-assessment, clinicians showed high levels of knowledge (87%/82%) about the consequences of elevated PPG which was primarily reinforced on post-assessment. After participation, 51% of diabs/endos and 67% of PCPs demonstrated greater confidence in their understanding of the clinical profile of emerging faster-acting insulins for PPG management.
Conclusions: Participation in online education resulted in improvement or reinforcement of knowledge and confidence regarding the importance of good PPG control and the clinical profile of investigational faster-acting insulins. Further education is warranted on complications that correlate with elevated PPG, physiologic action of mealtime insulin replacement and latest clinical data of new and emerging faster-acting insulins.

Disclosure
A.M. Sendaydiego: None. J. Trier: None. E. Montanya: Employee; Spouse/Partner; Almirall, S.A.. Advisory Panel; Self; AstraZeneca. Consultant; Self; Intarcia Therapeutics, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Menarini Group. Consultant; Self; MSD K.K.. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S, AstraZeneca, Medscape. Advisory Panel; Self; Servier. Speaker's Bureau; Self; Servier. Consultant; Self; Novartis Pharmaceuticals Corporation.
Assessing Efficacy of Diabetes School by Diabetes Knowledge Scale in Turkey
Authors: TASKIRAN BENGUR , CANSU GUVEN B. , MUTLUAY RUYA 
Published: June 2018

Aim: The prevalence of DM increased dramatically from 7.2% to 13.7% in Turkey. Ministry of Health has been supporting diabetes school, a model of structured group education, since 2014. The efficacy of this programme has not been evaluated beyond hemoglobin A1c control. In this study, we aimed to evaluate knowledge of diabetes before and immediately after the school.
Methods: We recruited patients with a diagnosis of DM who were registered to diabetes school in September 2017. The programme was executed by a multidiciplinary team as 90 minutes sessions a week for 4 consecutive weeks. The participants who attended at least 3 sessions were given certificates. Due to low sociocultural profile true/false version of Michigan Diabetes Knowledge Scale (MDKS), which was translated into Turkish, was used. The scale includes 20 items regarding nutrition, comorbidities, blood glucose control, exercise, medication, and complications. The patients chose true/false or “don’t know” for each statement in the questionaire.
Results: Ninety four patients registered to the school. However only 54 attended the programme and 41 agreed to take the survey. Among them 25 patients completed ≥3 sessions and 23 participated in the survey before and after the programme. The most common correctly identified answers were related to the items regarding the importance of regular check-up in detecting and preventing complications (before: 69%, after: 100%). The number of patients correctly identifying more than half of the statements was 15 (38%) before and 17 (73%) after the programme. Among 23 patients who completed both the programme and the surveys, 19 (82%) showed significant improvement in correct answers.
Conclusions: Participation and adherence to diabetes school programme was low. Despite low number of patients studied, knowledge of diabetes improved after the programme. MDKS can be used along with school programmes to select the subgroup of patients that need more simplified, interactive, and repetitive sessions.

Disclosure
B. Taskiran: None. G.B. Cansu: None. R. Mutluay: None.
Implementation of Person-Centered Methods in Group-Based Diabetes Education
Authors: STENOV VIBEKE , WIND GITTE , VALLIS MICHAEL , REVENTLOW SUSANNE , HEMPLER NANA F. 
Published: June 2018

Healthcare professionals’ (HCPs) skills in person-centeredness are pivotal for delivering successful diabetes self-management education and support (DSMES). Many HCPs favor person-centered methods as a concept but implementation in practice remains challenging. The main focus is on information about diabetes, complications, medications, diet and exercise. This study explored how HCPs implement new methods to facilitate person-centered DSMES in groups.
The study was guided by action research and divided into three phases (investigation, action, and pilot) using a variety of qualitative methods. In step one, observations were conducted across five educational settings including 49 persons with T2DM and 13 HCPs to explore HCPs’ person-centered skills. In step two, 14 HCPs collaborated in two workshops to develop new methods e.g., exercises and dialog tools to prompt discussions about psychosocial aspects of diabetes and to fit educational needs to both the individual and the group. In step three, we pilot-tested the methods using observations in three settings and interviewed 5 HCPs and 27 participants with T2DM. A final workshop was conducted to evaluate the methods. Systematic text condensation and hermeneutic analysis were used to analyze data.
Implementation of the methods was characterized by three categories. Some HCPs chose not to implement the methods because they conflicted with their usual practice relying on the biomedical model. Other HCPs agreed with the concept but was unable to structure the process, leaving participants uncertain about the aim. Finally, some HCPs succeeded with implementation promoting participants’ needs, reflections and discussions in groups.
Implementing methods to deliver person-centeredness is complex and requires systematic training of HCPs. The training should be structured stepwise incorporating techniques directed towards existing skills including ample time to train and reiterate skills.

Disclosure
V. Stenov: None. G. Wind: None. M. Vallis: Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Novo Nordisk Inc.. Speaker''s Bureau; Self; AbbVie Inc.. Advisory Panel; Self; Valeant Pharmaceuticals International, Inc.. Speaker's Bureau; Self; Merck & Co., Inc.. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. S. Reventlow: None. N.F. Hempler: None.
The Development and Testing of MyT1DHope—A Website for Parents of Children with Type 1 Diabetes
Authors: HOLTZ BREE , MURRAY KATHARINE , HERSHEY DENISE , NUTTALL AMY K. , COTTEN SHELIA , PARK TAIWOO , DUNNEBACK JULIE K. , WOOD MICHAEL A. 
Published: June 2018

Background: Caring for a child with type 1 diabetes (T1D) may be stressful for the entire family. Management is complex and requires parents to take on this complex responsibility. As a result, parents are at risk of being diagnosed with depression and anxiety, and may experience feelings of isolation. Diabetes education and support group involvement can lead to successful adjustment to life with a child with T1D. Websites have the ability to provide this type of support, and many T1D websites exist. However, a well-organized, parent-focused tool with social support capabilities is needed.
Objective: The objective of this study was to develop and conduct a randomized controlled pilot test of a website, MyT1DHope, for parents of children with T1D.
Methods: Once the website was developed, participants were recruited through a Michigan family network, to begin the 8-week testing. Participants (N=102) were randomly assigned to receive access to our website (n=51) or receive a PDF packet (n=51) on T1D. All participants were assessed pre- and post-intervention on validated measures of parents’ diabetes knowledge, health literacy, social support, self-efficacy, quality of life as well as usability and acceptability of the website.
Results: Our concept for the website was well received by participants in the formative research phases. Specifically, parents stated a need for a “one-stop-shop” for all information a parent with a child with T1D may need and to organize that information by stages of the child’s development. Our preliminary results suggest that parents in both groups started the study with high diabetes knowledge, social support, self-efficacy, and quality of life. Data analysis of the 8-week pilot test is ongoing.
Conclusion: Many websites exist with the purpose of providing information to those impacted by T1D. This paper reports results of testing a website, MyT1DHope, for parents with children with T1D. MyT1DHope has the potential to improve the lives of parents caring for a child with T1D.

Disclosure
B. Holtz: None. K. Murray: None. D. Hershey: None. A.K. Nuttall: None. S. Cotten: None. T. Park: None. J.K. Dunneback: None. M.A. Wood: Research Support; Self; Medtronic MiniMed, Inc..
Magnetic Resonance Diffusion Tensor Imaging of the Human Calf in Subjects With and Without Type 2 Diabetes during Rest and Isometric Plantarflexion Exercise
Authors: EDALATI MASOUD , SORENSEN CHRISTOPHER J. , HASTINGS MARY , ZAYED MOHAMED A. , MUELLER MICHAEL J. , ZHENG JIE 
Published: June 2018

Aim: This project aims to study differences in diffusion properties of the human calf muscle in subjects with and without type 2 diabetes mellitus (DM) using diffusional properties of water molecule.
Methods: Twenty-one subjects were examined in a 3T MRI scanner after obtaining consents. Two groups were tested: 8 participants without DM (WDM) and 13 participants with DM. We used a custom-made MRI compatible ergometer that allows a constant exercise load. Finally, we calculated diffusion indices including fractional anisotropy (FA), mean diffusivity (MD), and eigenvalues (λ1, λ2, λ3) for further analysis.
Results: Statistical analysis revealed no significant differences (P&gt;0.05) in diffusion indices of muscles between WDM and DM at the rest position. However, all the muscles in DM showed (Figure) an overall statistically significant increase (P&lt;0.05) in MD, λ2, and λ3 in response to exercise, in comparison with the WDM (MD= 15.02%; λ2= 16.50%; λ3= 14.22% for the MG).
Conclusion: There were considerable changes in diffusion indices between WDM and DM groups during the calf exercise. This study demonstrated that structural muscle damage due to the diabetes can be readily distinguished from nondiabetes using DTI.

Disclosure
M. Edalati: None. C.J. Sorensen: None. M. Hastings: None. M.A. Zayed: None. M.J. Mueller: None. J. Zheng: None.
Predictor of Mortality after Hospital Discharge in the Elderly with Type 2 Diabetes Mellitus—Follow-Up of Two Years
Authors: BERETTA MILENI V. , FELDMAN JULIANE V. , RODRIGUES TICIANA 
Published: June 2018

Muscle-related loss of the aging process can worsen the individual’s functionality as well as reduce gait and strength of the handgrip. The Gait speed test reflects the health and functional status of the elderly as well as being a predictor of survival. In older adults with diabetes there seems to be a strong correlation between gait and worse outcomes.
Objective: To determine the relationship between gait speed test and all-cause mortality after discharge in the elderly with type 2 diabetes melito (T2DM).
Methodology: A prospective study that included hospitalized patients at the Hospital de Clínicas of Porto Alegre (HCPA, South of Brazil) from July 2015 to December 2016, with T2DM, aged over 60 years and up to 48 hours of hospitalization in one unit. Follow-up was done by telephone and by consulting the medical records. In order to evaluate the walk, a 6-meter walking test, such as Time Up and Go (TUG), was performed, muscle strength was measured using an dynamometer and muscle mass was measured in the largest region of the circumference of the calf (CC). The patients were considered with reduced gait when they completed the test in the value below 0.8 m/s. This project was approved by the HCPA Ethics Committee under Number150068.
Results: 312 patients with T2DM were included, mean age 71.31 ± 6.45 of which 51% were women, 82% were Caucasian. The mean velocity in the TUG was 0.54 m/s (0.46-0.66) and presented a positive correlation with age (r = 0.283, p &lt;0.001), duration of hospitalization (r = 0.081, p = 0.17) and negative correlation with BMI (r = -0.42, p = 0.48). The mortality was 45.3%. In the multivariate analysis after adjustment for age, sex, physical activity, and BMI the lower gait speed test and the CC maintained an association with post-high mortality (OR = 2.064, 95% CI 1.048-4.063 p = 0.036 and OR = 0.872, 95% CI 0.78-0.96 p = 0.010).
Conclusion: patients with DM2 who had reduced speed gait and CP, had a greater risk of death after hospital discharge.

Disclosure
M.V. Beretta: None. J.V. Feldman: None. T. Rodrigues: None.