Effect of Diet on Type 2 Diabetes Mellitus: A Review

Globally, type 2 diabetes mellitus (T2DM) is considered as one of the most common diseases. The etiology of T2DM is complex and is associated with irreversible risk factors such as age, genetic, race, and ethnicity and reversible factors such as diet, physical activity and smoking. The objectives of this review are to examine various studies to explore relationship of T2DM with different dietary habits/patterns and practices and its complications. Dietary habits and sedentary lifestyle are the major factors for rapidly rising incidence of DM among developing countries. In type 2 diabetics, recently, elevated HbA1c level has also been considered as one of the leading risk factors for developing microvascular and macrovascular complications. Improvement in the elevated HbA1c level can be achieved through diet management; thus, the patients could be prevented from developing the diabetes complications. Awareness about diabetes complications and consequent improvement in dietary knowledge, attitude, and practices lead to better control of the disease. The stakeholders (health-care providers, health facilities, agencies involved in diabetes care, etc.) should encourage patients to understand the importance of diet which may help in disease management, appropriate self-care and better quality of life

Psychometric Evaluation of Dietary Habits Questionnaire for Type 2 Diabetes Mellitus

This research evaluated the psychometric properties of English version of dietary habits questionnaires developed for type 2 diabetic patients. There is scarcity of literature about availability of standardized questionnaires for assessing dietary habits of type 2 diabetics in Saudi Arabia. As dietary habits vary from country to country, therefore, this was an attempt to develop questionnaires that can serve as a baseline. Through intensive literature review, four questionnaires were developed / modified and subsequently tested for psychometric properties. Prior to pilot study, a pre-test was conducted to evaluate the face validity and content validity. The pilot study was conducted from 23 October – 22 November, 2016 to evaluate the questionnaires’ reliability and validity. Systematic random sampling technique was used to collect the data from 132 patients by direct investigation method. Questionnaires assessing diabetes mellitus knowledge (0.891), dietary knowledge (0.869), dietary attitude (0.841) and dietary practices (0.874) had good internal consistency reliability. Factor analysis conducted on dietary attitude questionnaire showed a valid 5 factor solution. Directions of loadings were positive and free from factorial complexity. Relying on the data obtained from type 2 diabetics, these questionnaires can be considered as reliable and valid for the assessment of dietary habits in Saudi Arabia and neighbouring Gulf countries population

A computational offloading optimization scheme based on deep reinforcement learning in perceptual network

Currently, the deep integration of the Internet of Things (IoT) and edge computing has improved the computing capability of the IoT perception layer. Existing offloading techniques for edge computing suffer from the single problem of solidifying offloading policies. Based on this, combined with the characteristics of deep reinforcement learning, this paper investigates a computation offloading optimization scheme for the perception layer. The algorithm can adaptively adjust the computational task offloading policy of IoT terminals according to the network changes in the perception layer. Experiments show that the algorithm effectively improves the operational efficiency of the IoT perceptual layer and reduces the average task delay compared with other offloading algorithms

Resilient TCP variant enabling smooth network updates for software-defined data center networks

Network updates have become increasingly prevalent since the broad adoption of software-defined networks (SDNs) in data centers. Modern TCP designs, including cutting-edge TCP variants DCTCP, CUBIC, and BBR, however, are not resilient to network updates that provoke flow rerouting. In this paper, we first demonstrate that popular TCP implementations perform inadequately in the presence of frequent and inconsistent network updates, because inconsistent and frequent network updates result in out-of-order packets and packet drops induced via transitory congestion and lead to serious performance deterioration. We look into the causes and propose a network update-friendly TCP (NUFTCP), which is an extension of the DCTCP variant, as a solution. Simulations are used to assess the proposed NUFTCP. Our findings reveal that NUFTCP can more effectively manage the problems of out-of-order packets and packet drops triggered in network updates, and it outperforms DCTCP considerably

Association between metabolically healthy obesity and metastasis in lung cancer patients – a systematic review and meta-analysis

BackgroundMany clinical trials have looked at the relationship between obesity and lung cancer (LC), however, there is scarcity of literature specifically addressing the association between metabolically healthy obesity and metastasis in LC patients. To address this gap in the body of evidence, the study was conducted to observe the association between metabolically healthy obesity and metastasis in LC patients.MethodsWe conducted a pre-registered systematic review by searching six major online databases to identify studies relevant related to our investigation, in adherence with the PRISMA guidelines. A proper data extraction protocol was further established to synthesize the findings from the selected papers through a meta-analysis.ResultsEleven (11) studies met the requisite selection criterion and were included in the study. A random-effect model was used. Obesity was found to have a significant impact on readmission in LC patients. The combined analysis showed a significant effect size of 0.08 (95% CI 0.07 to 0.08), indicating a noticeable impact of obesity. It was also assessed that obese individuals had a 34% reduced risk of LC compared to normal weight individuals. Obesity was associated with a lower risk of surgical complications with a pooled risk ratio of 0.13 (95% CI 0.12 to 0.14). A statistically significant decreased risk of LC (pooled RR = 0.72, 95% CI: 0.68 to 0.77) was also observed in the obese individuals.ConclusionThe analysis reveals that obesity is associated with a noticeable increase in readmissions, although the impact on LC risk itself is negligible. Moreover, obesity appears to have a beneficial effect by reducing the risk of surgical complications. These results highlight the complex relationship between the two aforementioned factors, emphasizing the importance of considering obesity as a significant factor in patient management and healthcare decision-making.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023427612

Association between metabolically healthy obesity and metastasis in lung cancer patients – a systematic review and meta-analysis

Background: Many clinical trials have looked at the relationship between obesity and lung cancer (LC), however, there is scarcity of literature specifically addressing the association between metabolically healthy obesity and metastasis in LC patients. To address this gap in the body of evidence, the study was conducted to observe the association between metabolically healthy obesity and metastasis in LC patients. Methods: We conducted a pre-registered systematic review by searching six major online databases to identify studies relevant related to our investigation, in adherence with the PRISMA guidelines. A proper data extraction protocol was further established to synthesize the findings from the selected papers through a meta-analysis. Results: Eleven (11) studies met the requisite selection criterion and were included in the study. A random-effect model was used. Obesity was found to have a significant impact on readmission in LC patients. The combined analysis showed a significant effect size of 0.08 (95% CI 0.07 to 0.08), indicating a noticeable impact of obesity. It was also assessed that obese individuals had a 34% reduced risk of LC compared to normal weight individuals. Obesity was associated with a lower risk of surgical complications with a pooled risk ratio of 0.13 (95% CI 0.12 to 0.14). A statistically significant decreased risk of LC (pooled RR = 0.72, 95% CI: 0.68 to 0.77) was also observed in the obese individuals. Conclusion: The analysis reveals that obesity is associated with a noticeable increase in readmissions, although the impact on LC risk itself is negligible. Moreover, obesity appears to have a beneficial effect by reducing the risk of surgical complications. These results highlight the complex relationship between the two aforementioned factors, emphasizing the importance of considering obesity as a significant factor in patient management and healthcare decision-making. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023427612.Open Access funding provided by the Qatar National Library

Enhancing Cardiovascular Health and Functional Recovery in Stroke Survivors: A Randomized Controlled Trial of Stroke-Specific and Cardiac Rehabilitation Protocols for Optimized Rehabilitation

Background: Stroke is a major contributor to disability and mortality globally. It leads to physical impairments, including weakness and cardiovascular deconditioning, posing significant challenges to stroke survivors’ quality of life. Exercise-based cardiac rehabilitation has shown promise as a rehabilitation strategy. This study aims to assess and compare the impacts of stroke-specific rehabilitation and individualized cardiac rehabilitation exercises on various health parameters in stroke patients. Methods: A randomized controlled trial was conducted, involving 38 stroke patients aged 40–75 years. Group A received stroke-specific rehabilitation, which consisted of a combination of range of motion exercises, strength training for the paralyzed side, balance and coordination training, gait training, functional mobility exercises, neuromuscular reeducation, and breathing exercises. This program was conducted five days per week for 12 weeks. Group B received individually designed cardiac rehabilitation exercises, in addition to stroke-specific rehabilitation. They engaged in this exercise for at least 30–45 min per day, four days per week, and incorporated two days of resistive training over a 12-week period. Baseline and post-intervention assessments included measures of cardiac autonomic function, balance (Berg Balance Scale), mobility (Timed Up and Go Test), cardiovascular fitness indicators, respiratory parameters, exercise efficiency, and perceived exertion. Results: Group B receiving individualized cardio rehab showed significant improvements in balance and mobility compared to Group A receiving conventional stroke-specific rehab. Moreover, Group B exhibited enhanced cardiovascular fitness, respiratory performance, exercise efficiency, and autonomic function post-intervention. Notably, Group A displayed no significant improvements in these parameters. Conclusions: Individualized cardiac rehabilitation exercises demonstrated favorable outcomes in improving certain health parameters, highlighting the potential benefits of individualized rehabilitation strategies for stroke patients.The publication of this article is funded by College of Nursing, QU-Health, Qatar University

The Study of Learning Styles among Medical Students at Majmaah University, Saudi Arabia

The main objectives of this research were to detect types of learning styles (LS), time spending in studying, to know the relation with GPA, and to determine which LS is suitable with teaching style used in the College of Medicine at Majmaah University. The study was cross-sectional self-survey conducted among male and female medical students at College of Medicine at Majmaah city over 6 months. Cluster sampling was used and total participants were 194 students from College of Medicine (males & females). The data was collected using a designed questionnaire and analysis of data was performed by SPSS (V26).This study showed that majority of participants preferred the Visual learning (VL) style (27.79%), the second most used type was Kinesthetic (24.79%), and the least used type was Auditory (24.53%). It also showed that students who prefer VL style score more than students who prefer other learning styles. It was observed that the student who prefers kinesthetic style spent more time in the studying the more use of this type. In Conclusion, The study concluded that the majority of participants were preferred the VL style. It is also showed that student who prefers visual learning style score more than students who prefer other learning styles. It is important to increase awareness of students regarding types of their learning styles and teaching strategies in college during admission

Type 2 diabetes mellitus: Link between diet, HbA1c and complications

BackgroundDiabetes mellitus is now globally considered as a leading cause of morbidity and mortality. It is associated with high rates of microvascular and macrovascular complications. Regular consumption of high caloric food, poor dietary habits and adoption of sedentary life style has been linked with the development of type 2 diabetes mellitus.AimsThe purpose of this review is; to highlight the influence of diet on HbA1c in type 2 diabetics, to explore association between HbA1c and diabetes complications and to propose a dietary consultation model for more effective diabetes care.MethodsThe literature was reviewed intensively from January – March 2016 through PubMed central, Medscape, Google Scholar and other databases. The keywords and MeSH terms used in this search were “diabetes mellitus”, “glycated haemoglobin”, “type 2 diabetes mellitus”, “diet and type 2 diabetes mellitus” and “diabetes complications”.ResultsDietary management is a superior option for glycaemic control in type 2 diabetes mellitus. It is important to keep the HbA1c level in acceptable range to delay the onset and progression of diabetes complications. In this review, various food groups that can have beneficial and adverse effects on HbA1c have been identified. Moreover, Diabetic Retinopathy (DR) stood out as the most prevalent complication of poorly managed diabetes mellitus in Saudi Arabia.ConclusionThe dimensions of the proposed dietary consultation model are based on the assessment of diabetics’ diabetes mellitus knowledge, dietary knowledge, dietary attitude and dietary practices. This assessment if carried out at the initial stage of Diabetes mellitus can be helpful in delaying the early onset and progression of microvascular and macrovascular diabetes complications

Towards blockchain-based secure BGP routing, challenges and future research directions

Border Gateway Protocol (BGP) is a standard inter-domain routing protocol for the Internet that conveys network layer reachability information and establishes routes to different destinations. The BGP protocol exhibits security design defects, such as an unconditional trust mechanism and the default acceptance of BGP route announcements from peers by BGP neighboring nodes, easily triggering prefix hijacking, path forgery, route leakage, and other BGP security threats. Meanwhile, the traditional BGP security mechanism, relying on a public key infrastructure, faces issues like a single point of failure and a single point of trust. The decentralization, anti-tampering, and traceability advantages of blockchain offer new solution ideas for constructing secure and trusted inter-domain routing mechanisms. In this paper, we summarize the characteristics of BGP protocol in detail, sort out the BGP security threats and their causes. Additionally, we analyze the shortcomings of the traditional BGP security mechanism and comprehensively evaluate existing blockchain-based solutions to address the above problems and validate the reliability and effectiveness of blockchain-based BGP security methods in mitigating BGP security threats. Finally, we discuss the challenges posed by BGP security problems and outline prospects for future research