An ethnopharmacological survey in Paphos district of Cyprus: the hypoglycemic and other therapeutical properties of Salvia fruticosa Mill

The current report is analyzing the results of an extensive ethnopharmacological survey accomplished in Paphos district of Cyprus. Local people seem to be very familiar with the use, preparation and therapeutic properties of medical plants, most of which grow in the wild. According to the study, Salvia fruticosa Mill., a specific species of sage, is widely used in Cyprus, especially by local people of Paphos villages as a hypoglycemic agent. Further experimental studies need to be accomplished so as to validate the use of Salvia fruticosa Mill. as a hypoglycemic agent

Trends in HbA1c thresholds for initiation of hypoglycemic agents:Impact of changed recommendations for older and frail patients

Aims: Less strict glycated hemoglobin (HbA1c) thresholds have been recommended in older and/or frail type 2 diabetes (T2D) patients than in younger and less frail patients for initiating hypoglycemic agents since 2011. We aimed to assess trends in HbA1c thresholds at initiation of a first hypoglycemic agent(s) in T2D patients and the influence of age and frailty on these trends. Materials and methods: The groningen initiative to analyze type 2 diabetes treatment (GIANTT) database was used, which includes primary care T2D patients from the north of the Netherlands. Patients initiating a first non-insulin hypoglycemic agent(s) between 2008 and 2014 with an HbA1c measurement within 120 days before initiation were included. The influence of calendar year, age, or frailty and the interaction between calendar year and age or frailty were assessed using multilevel regression analyses adjusted for confounders. Results: We included 4588 patients. The mean HbA1c threshold at treatment initiation was 7.4% up to 2010, decreasing to 7.1% in 2011 and increasing to 7.4% in 2014. This quadratic change over the years was significant (P 0.05). Conclusions: HbA1c thresholds at initiation of a first hypoglycemic agent(s) changed significantly over time, showing a decrease after 2010 and an increase after 2012. The HbA1c threshold at initiation was not influenced by age or frailty, which is in contrast with recommendations for more personalized treatment

Factors Associated with Long-Term Oral Hypoglycemic Agent Responsiveness in Korean Patients with Type 2 Diabetes Mellitus

BackgroundThis study was performed to determine the factors associated with long-term oral hypoglycemic agent (OHA) responsiveness in Korean type 2 diabetic patients.MethodsTwo groups of patients were selected among the type 2 diabetic patients who were followed for more than two years at a university hospital diabetes clinic. The OHA responsive group consisted of 197 patients whose HbA1c levels were maintained at ≤7% with OHA for more than two years. The OHA failure group consisted of 180 patients whose HbA1c levels were >8% in spite of optimal combined OHA therapy or patients who required insulin therapy within the two years of the study.ResultsThe OHA failure group had higher baseline values of fasting and postprandial glucose, HbA1c, and lower fasting, postprandial, and delta C-peptide compared to those of the OHA responsive group. The OHA failure group also had a higher proportion of female patients, longer diabetic duration, and more family history of diabetes. There were no significant differences in body mass index (BMI) or insulin resistance index between the two groups. Multiple logistic regression analysis showed that the highest quartile of baseline fasting, postprandial glucose, and HbA1c and the lowest quartile of postprandial and delta C-peptide were associated with an increased odds ratio of OHA failure after adjustment for age, sex, body mass index, and family history of diabetes.ConclusionLower baseline values of postprandial and delta C-peptide and elevated fasting glucose and HbA1c are associated with long-term OHA responsiveness in Korean patients with type 2 diabetes mellitus

Risk of Diabetes Mellitus on Incidence of Out-of-Hospital Cardiac Arrests: A Case-Control Study.

Background This study aimed to determine the risk of diabetes mellitus (DM) on incidence of out-of-hospital cardiac arrest (OHCA) and to investigate whether difference in effects of DM between therapeutic methods was observed. Methods This study was a case-control study using the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES) project database and 2013 Korean Community Health Survey (CHS). Cases were defined as EMS-treated adult (18 year old and older) OHCA patients with presumed cardiac etiology collected at 27 emergency departments from January to December 2014. OHCA patients whose arrest occurred at nursing homes or clinics and cases with unknown information on DM were excluded. Four controls were matched to one case with strata including age, gender, and county from the Korean CHS database. Multivariable conditional logistic regression analysis was conducted to estimate the risk of DM and treatment modality on incidence of OHCA. Results Total 1,386 OHCA patients and 5,544 community-based controls were analyzed. A total of 370 (26.7%) among cases and 860 (15.5%) among controls were diagnosed with DM. DM was associated with increasing risk of OHCA (AOR: 1.92 (1.65-2.24)). By DM treatment modality comparing with non-DM group, AOR (95% CI) was the highest in non-pharmacotherapy only group (4.65 (2.00-10.84)), followed by no treatment group (4.17 (2.91-5.96)), insulin group (2.69 (1.82-3.96)), and oral hypoglycemic agent group (1.55 (1.31-1.85)). Conclusion DM increased the risk of OHCA, which was the highest in the non-pharmacotherapy group and decreased in magnitude with pharmacotherapy.This study was supported and funded by the Korea Centers for Disease Control and Prevention (2013-2014) (Grant No. 2013E3300500/2014E3300100)

A Brief Adherence Intervention that Improved Glycemic Control: Mediation by Patterns of Adherence

This study examined whether longitudinal adherence profiles mediated the relationship between a brief adherence intervention and glycemic control among patients with type 2 diabetes. Adherence was assessed using the Medication Event Monitoring System. Longitudinal analysis via growth curve mixture modeling was carried out to classify patients according to patterns of adherence to oral hypoglycemic agents. Hemoglobin A1c assays were used to measure glycemic control as the clinical outcome. Across the whole sample, longitudinal adherence profiles mediated 35.2% (13.2, 81.0%) of the effect of a brief adherence intervention on glycemic control [from odds ratio (OR) = 8.48, 95% confidence interval (CI) (3.24, 22.2) to 4.00, 95% CI (1.34, 11.93)]. Our results suggest that patients in the intervention had better glycemic control largely due to their greater likelihood of adherence to oral hypoglycemic agents