Glycemia and peak incremental indices of six popular fruits in Taiwan: healthy and Type 2 diabetes subjects compared

The aim of this study was to evaluate the glycemic index and peak incremental indices of six popular fruits in Taiwan, comparing healthy subjects (n = 20) and patients with Type 2 diabetes (n = 17). The six kinds of fruits tested were grapes, Asian pears, guavas, golden kiwifruit, lychees and bananas. Glycemic index values were tested according to the standard glycemic index testing protocol. The glycemic index and peak incremental indices were calculated according to published formulas. In Type 2 diabetes subjects, the glycemic index values of grapes, Asian pears, guavas, golden kiwifruit, lychees and bananas were 49.0 ± 4.5, 25.9 ± 2.9, 32.8 ± 5.2, 47.0 ± 6.5, 60.0 ± 8.0 and 41.3 ± 3.5. In healthy subjects, the glycemic index values were 49.1 ± 7.3, 18.0 ± 5.4, 31.1 ± 5.1, 47.3 ± 12.1, 47.9 ± 6.8 and 35.1 ± 5.6. There was no significant difference in glycemic index values between healthy and Type 2 diabetes subjects. There was also no significant difference in PII when comparing healthy subjects and subjects with Type 2 diabetes. In conclusion, glycemic index and peak incremental indices in healthy subjects can be approximately the same for Type 2 diabetes

Is the level of serum lactate dehydrogenase a potential biomarker for glucose monitoring with type 2 diabetes mellitus?

IntroductionType 2 diabetes mellitus (T2DM) is a metabolic disorder due to defects in insulin secretion or insulin resistance leading to the dysfunction and damage of various organs. To improve the clinical evaluation of short-term blood glycemic variability monitoring, it is critical to identify another blood cell status and nutritional status biomarker that is less susceptible to interference. This study identifies the significance of serum lactate dehydrogenase (LDH) level among T2DM patients treated in outpatient clinics and investigates the relationship of LDH level with other variables.MethodsThis study comprised 72 outpatients with T2DM over 20 years of age. Blood samples were collected followed by a hematological analysis of serum glycated albumin (GA), LDH, fasting blood glucose, glycosylated hemoglobin, C-peptide, and insulin antibodies (insulin Ab).ResultsSerum LDH level was significantly correlated with GA (p < 0.001), C-peptide (p = 0.04), insulin Ab (p = 0.03), and thyroid-stimulating hormone (TSH) levels (p = 0.04). Hence, we performed a linear regression analysis of hematological markers. GA (p < 0.001, r2 = 0.45) and insulin Ab (p < 0.001, r2 = 0.40) were significantly associated with LDH level. Then, we classified patients into low (<200 U/L) and high (≥200 U/L) serum LDH level groups, respectively. GA (p < 0.001), C-peptide (p = 0.001), and TSH (p = 0.03) showed significant differences in patients with high LDH levels compared with those in patients with low LDH levels.ConclusionIn conclusion, we suggested that LDH level was independent of long-term but associated with short-term blood glucose monitoring. The results indicated that changes in serum GA induced cell damage and the abnormal elevation of the serum level of LDH may occur simultaneously with glycemic variability. It has been reported that many biomarkers are being used to observe glucose variability in T2DM. However, LDH could provide a more convenient and faster evaluation of glycemic variability in T2DM

Continuity of care: evaluating a multidisciplinary care model for people with early CKD via a nationwide population-based longitudinal study

Objectives To control and prevent the burdens associated with chronic kidney disease (CKD), Taiwan’s National Health Insurance Administration (NHIA) launched the ‘early-CKD programme’ in 2011 to extend care and education to patients with CKD. This study aims to evaluate the effectiveness of the early-CKD programme in terms of continuity of care (COC).Design and participants This study used secondary data from 2010 to 2014 provided by the NHIA to identify 86 581 participants each for the intervention and control groups. Patients with CKD who participated in the early-CKD programme between 2011 and 2013 were defined as the intervention group. For the control group, propensity score matching was used to select patients with CKD who did not participate in the programme, but were seen by the same group of physicians.Intervention A multidisciplinary care model for patients with early CKD launched in 2011.Primary outcome measures Outcome variables included the continuity of care index (COCI), which measures a physician’s COC; number of essential examinations; and resource utilisation. To better identify the difference between groups, we separated COCI into two groups based on mean: high (above mean) and low (below mean). A generalised estimating equation model was used to examine the effects of the early-CKD programme.Results The programme significantly increased the number of essential examinations/tests administered to patients (β=0.61, p<0.001) and improved COCI between physicians and patients (OR=4.18, p<0.001). Medical expenses (β=1.03, p<0.001) and medication expenses (β=0.23, p<0.001) significantly increased after the programme was implemented, but patients’ kidney-related hospitalisations and emergency department visits decreased (β=−0.13, p<0.001).Conclusion From the COC viewpoint, the programme in Taiwan showed a positive effect on COCI, number of essential examinations and resource utilisation

Clinical Features of Sudden Sensorineural Hearing Loss in Diabetic Patien

Objectives: Clinical studies of sudden sensorineural hearing loss (SSNHL) rarely focus on diabetic patients. We attempted to elucidate the clinical features of SSNHL in diabetic patients and to evaluate the factors influencing hearing deficits. Study Design: Retrospective. Methods: A retrospective review of diabetic patients with SSNHL was conducted at National Taiwan University Hospital from 1984 to 2003. The demographic and clinical characteristics, audiometries, and course of hearing recovery were reviewed. Results: Sixty-seven patients (38 men and 29 women) with a mean age of 60.1 +/-11.9 years were recruited. The mean duration of diabetes was 7. 5 +/- 7.7 years. The mean fasting plasma glucose (FPG), postprandial plasma glucose ( PPG), and glycosylated hemoglobin (HbA1C) at admission were 12.4 +/- 5.3 mmol/L, 14.5 +/- 5.4 mmol/L, and 9.9 +/- 2.9 mmol/L, respectively. Profound hearing loss was very common in this series (44.8%). Hearing impairment was also noted in the opposite ear, especially in the high frequencies. Presenting symptoms, the duration of diabetes, the FPG, and the HbA1C had no significant correlations with the severity of hearing loss. After adjusting for sex and age, a high PPG level was significantly associated with opposite-ear hearing deficits in the middle frequencies. In follow-up, the low and middle tone hearing thresholds in the lesion ears improved more than that at high frequencies, but they still did not return to baseline. Hearing consistently improved within 2 months after disease onset, but improvements were rare thereafter . With suitable treatment, optimal glycemic control could be achieved even under high- dose steroid regimens. Conclusions: In diabetic patients with SSNHL, hearing loss in the contralateral ear and the profound type hearing loss in the lesion ear were commonly noted. The age and PPG level had significant correlations to contra-ear hearing loss. The poor prognosis of sudden deafness in diabetes patients may be caused by preexisting microvascular lesions in the inner ear, and the PPG level could be a risk factor indicator for cochlear dysfunction in diabetic patients. High-dose glucocorticoid should not be contraindicant in diabetic patients with SSNHL. Whether a longer duration of treatment will result in more hearing improvement is worthy of further study

Small Cell Lung Cancer and Acromegaly: A Case Report

Growth hormone is a growth factor for normal and abnormal tissues. Patients with acromegaly are postulated to be at greater risk for cancer development. To date, small cell lung cancer in such patients is not reported in the literature. We report a 76-year-old man with frank acromegaly resulting from a growth hormone-secreting pituitary macroadenoma. Small cell lung cancer in an early stage was diagnosed with a presentation of cough and hemoptysis. After considering the poor prognosis of small cell lungcancer and the differences of various treatment modalities for acromegaly, bromocriptine was administered for the pituitary tumor. The patient underwent chemotherapy and radiotherapy for small cell lung cancer. To our knowledge, this is the first report of small cell lung cancer in a patient with acromegaly

Disease-specific health literacy, disease knowledge, and adherence behavior among patients with type 2 diabetes in Taiwan

Abstract Background To examine the association between health literacy, level of disease knowledge, and adherence behavior among patients with type 2 diabetes. Methods A cross-sectional survey study of 1059 Mandarin- and Taiwanese-speaking patients aged 20 years or older with type 2 diabetes was conducted. The demographic profiles of the sample strata were determined by analyzing the Taiwanese National Health Insurance Database. Participants were enrolled and completed questionnaires between April and November of 2015. The patients were assessed using a self-developed questionnaire with high internal consistency (KR-20 = .84). Results Construct validity was supported by Confirmatory Factor Analysis. Respondents scored lowest in diet-related knowledge. Health literacy and diabetes knowledge were significantly greater when patients cared for themselves with additional caretaker assistance. Patient age, gender, and educational attainment were associated with adherence behavior. Conclusion This study conducted a nation-wide survey of patients with diabetes and the results showed that respondents possessed fairly strong diabetes-specific health literacy and knowledge. However, health literacy shouldn’t be assessed as an isolated concept. Instead, it should be assessed in conjunction with adherence behavior

Health Service Access among Indonesian Migrant Domestic Workers in Taiwan

The number of migrant workers in Taiwan increases annually. The majority is from Indonesia and most of them are female caregivers. This study aims to determine the access to health services and the associated factors among Indonesian female domestic workers in Taiwan. In this cross-sectional study, data were collected from February to May 2019, using a structured questionnaire. Subsequently, multiple logistic regression was used to examine the association between socio-demographic factors and health service access. Two hundred and eighty-four domestic migrant workers were interviewed. Eighty-five percent of the respondents declared sickness at work, but only 48.8% seek health care services. Factors associated with health service access were marital status, income, and the availability of an attendant to accompany the migrant workers to the healthcare facilities. Language barrier and time flexibility were the main obstacles. Further research and an effective health service policy are needed for the domestic migrant workers to better access health care services

Effects of Spirituality, Knowledge, Attitudes, and Practices toward Anxiety Regarding COVID-19 among the General Population in INDONESIA: A Cross-Sectional Study

Background: Currently, the determinants of anxiety and its related factors in the general population affected by COVID-19 are poorly understood. We examined the effects of spirituality, knowledge, attitudes, and practices (KAP) on anxiety regarding COVID-19. Methods: Online cross-sectional data (n = 1082) covered 17 provinces. The assessment included the Daily Spiritual Experiences Scale, the Depression, Anxiety, and Stress Scale, and the KAP-COVID-19 questionnaire. Results: Multiple linear regression revealed that individuals who had low levels of spirituality had increased anxiety compared to those with higher levels of spirituality. Individuals had correct knowledge of early symptoms and supportive treatment (K3), and that individuals with chronic diseases and those who were obese or elderly were more likely to be severe cases (K4). However, participants who chose incorrect concerns about there being no need for children and young adults to take measures to prevent COVID-19 (K9) had significantly lower anxiety compared to those who responded with the correct choice. Participants who disagreed about whether society would win the battle against COVID-19 (A1) and successfully control it (A2) were associated with higher anxiety. Those with the practice of attending crowded places (P1) had significantly higher anxiety. Conclusions: Spirituality, knowledge, attitudes, and practice were significantly correlated with anxiety regarding COVID-19 in the general population