Lifestyle Intervention for Weight Loss: a group-based program for Emiratis in Ajman, United Arab Emirates

Background: Lifestyle Intervention for Weight Loss (LIFE-8) is developed as a structured, group-based weight management program for Emiratis with obesity and type 2 diabetes. It is a 3-month program followed by a 1-year follow-up. The results from the first 2 years are presented here to indicate the possibility of its further adaptation and implementation in this region. Methodology: We recruited 45 participants with obesity and/or type 2 diabetes based on inclusion/exclusion criteria. The LIFE-8 program was executed by incorporating dietary modification, physical activity, and behavioral therapy, aiming to achieve up to 5% weight loss. The outcomes included body weight, fat mass, waist circumference, blood pressure, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and nutritional knowledge at 3 months and 12 months. Results: We observed a reduction of 5.0% in body weight (4.8±2.8 kg; 95% CI 3.7–5.8), fat mass (–7.8%, P,0.01), and waist circumference (Δ=4±4 cm, P,0.01) in the completed participants (n=28). An improvement (P,0.05) in HbA1c (7.1%±1.0% vs 6.6%±0.7%) and FBG (8.2±2.0 mmol/L vs 6.8±0.8 mmol/L) was observed in participants with obesity and type 2 diabetes after the program. Increase in nutritional knowledge (,0.01) and overall evaluation of the program (9/10) was favorable. On 1-year follow-up, we found that the participants could sustain weight loss (–4.0%), while obese, type 2 diabetic participants sustained HbA1c (6.6%±0.7% vs 6.4%±0.7%) and further improved (P,0.05) the level of FBG (6.8±0.8 mmol/L vs 6.7±0.4 mmol/L). Conclusion: LIFE-8 could be an effective, affordable, acceptable, and adaptable lifestyle intervention program for the prevention and management of diabetes in Emiratis. It was successful not only in delivering a modest weight loss but also in improving glycemic control in diabetic participants

A pharmaceutico-analytical study of Vidangarishta

In Ayurveda, Sandhana Kalpana is particular dosage form. In Sandhana Kalpana, Asava and Arishta are included. Arishta are self generated herbal fermentation formulation in traditional medicinal system; they are considered as unique and valuable therapeutics in Ayurveda. Through traditional knowledge in literature as well as in practice exists about Arishtas and Asavas. There was great efforts to document, preserve and improve knowledge for the betterment of mankind. Vidangarishta is prepared by traditional method with special reference to Sharangdhara Samhita. This is alcoholic medicaments prepared by allowing the decoction to undergoes fermentation with addition of honey. Vidangarishta keep for fermentation about one month. After fermentation process is completed, was tested according to both Ayurvedic and modern method. Vidangarishta commonly used for Krumi (worm infection) Vyadhi. Pharmaceutical and analytical study discussed in this research article

A STUDY TO ASSESS THE CONTRAST SENSITIVITY OF THE HUMAN VISUAL SYSTEM IN PATIENTS WITH OR WITHOUT DIABETES IN A TERTIARY CARE HOSPITAL

Objective: The objective of our study was to assess the variations in contrast sensitivity values of normoglycemic subjects and that of type II diabetic subjects of the same age group. It was also aimed at finding the visual acuities and study the associations of it with contrast sensitivity if any. Methods: It was a hospital-based comparative cross-sectional descriptive study conducted in the out-patient department of the Department of Ophthalmology, Saveetha Medical College, Hospital, Chennai. Visual Acuity and Contrast Sensitivity of 50 Type II Diabetic individuals and 50 age-equivalent control group subjects were measured using the Snellen’s chart and Pelli-Robson chart, respectively, during the months of January to March 2020. Results: Contrast Sensitivity measurements from 50 subjects with Non-Insulin dependent Diabetes Mellitus (NIDDM) were obtained. The subjects were the ones who had minimal or no diabetic retinopathy. It was observed that there is a significant association between reduced contrast sensitivity and Diabetes (P value<.00008). We also noted that CS may be reduced without corresponding loss of Visual Acuity. Hence, both visual acuity and contrast sensitivity measurements are helpful in the assessment of visual impairment due to diabetic eye disease. Conclusion: The contrast sensitivity can be seen as an early marker for visual impairment in diabetic eye care

Cardiovascular and renal outcomes with canagliflozin according to baseline diuretic use:a post hoc analysis from the CANVAS Program

Aims The CANVAS Program identified the effect of canagliflozin on major adverse cardiovascular events (MACE) differed according to whether participants were using diuretics at study commencement. We sought to further evaluate this finding related to baseline differences, treatment effects, safety, and risk factor changes.Methods and results The CANVAS Program enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomized to canagliflozin or placebo and followed for a mean of 188 weeks. The primary outcome was major cardiovascular events, a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Secondary outcomes included multiple cardiovascular, renal, and safety events. In this post hoc subgroup analysis, participants were categorized according to baseline use of any diuretic. The effect on outcomes was compared using Cox proportional hazards models, while risk factor changes were compared using mixed-effect models. At baseline, 4490 (44.3%) participants were using a diuretic. Compared with those not using a diuretic, participants using a diuretic were more likely to be older (mean age +/- standard deviation, 64.3 +/- 8.0 vs. 62.5 +/- 8.3), be female (38.9% vs. 33.4%), and have heart failure (19.6% vs. 10.3%) (all P-difference &lt; 0.0001). The effect of canagliflozin on major cardiovascular events was greater for those using diuretic at baseline than for those who were not [adjusted hazard ratio 0.65 (95% confidence interval 0.54-0.78) vs. adjusted hazard ratio 1.13 (95% confidence interval 0.93-1.36), P-heterogeneity &lt; 0.0001]. Changes in most risk factors, including blood pressure, body weight, and urine albumin-to-creatinine ratio, were similar between groups (all P-difference &gt; 0.11), although the effect of canagliflozin on haemoglobin A1c reduction was slightly weaker in participants using compared with not using diuretics at baseline (-0.52% vs. -0.64%, P-heterogeneity = 0.0007). Overall serious adverse events and key safety outcomes, including adverse renal events, were also similar (all P-heterogeneity &gt; 0.07).Conclusions Participants on baseline diuretics derived a greater benefit for major cardiovascular events from canagliflozin, which was not fully explained by differences in participant characteristics nor risk factor changes.</p

Vitamin D Receptor Gene Polymorphisms Modify Cardiometabolic Response to Vitamin D Supplementation in T2DM Patients

There is conflicting evidence on the favorable effects of vitamin D supplementation on metabolic profile in Type 2 diabetes mellitus (T2DM) patients and this might be due to genetic variations in vitamin D receptors (VDRs). Thus, we studied the metabolic effects of a 12-month vitamin D supplementation in T2DM patients according to VDR polymorphisms. A total of 204 T2DM subjects received 2000 IU vitamin D3 daily for 12 months. Serum 25(OH)D and metabolic profiles were measured at baseline and after 12 months. VDR polymorphisms (Taq-I, Bsm-I, Apa-I and Fok-I) were identified using TaqMan genotyping assays. Vitamin D supplementation significantly increased HOMA β-cell function (p = 0.003) as well as significantly decreased triglycerides, total and LDL-cholesterol (p < 0.001). The lowest increment in 25(OH)D levels was detected in patients with Fok-I CC genotypes (p < 0.0001). With vitamin D supplementation, Taq-I GG genotype carriers showed significant improvements in triglycerides, LDL- and total cholesterol, insulin, HbA1c and HOMA-IR (p < 0.005, 0.01, < 0.001, < 0.005, 0.03 and 0.01, respectively). Similarly, Bsm-I TT genotype carriers showed significant improvements in triglycerides (p = 0.01), insulin and HOMA-IR (p-values < 0.05). In conclusion, improvements in metabolic profile due to vitamin D supplementation is influenced by VDR polymorphisms, specifically for carriers of Taq-I GG and Bsm-I TT genotypes