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Complementary Therapies in Medicine May 2020The purpose of this up-to-date comprehensive systematic review was to evaluate and summarize all research studies in the field in order to clarify the magnitude of...
Therapeutic potentials of Nigella sativa preparations and its constituents in the management of diabetes and its complications in experimental animals and patients with diabetes mellitus: A systematic review.
OBJECTIVE
The purpose of this up-to-date comprehensive systematic review was to evaluate and summarize all research studies in the field in order to clarify the magnitude of Nigella sativa (N. sativa) effects on the management of Diabetes mellitus (DM) and its complications.
METHODS
A systematic review was conducted in a Cochrane style and in accordance PRISMA checklist using the published studies in PubMed/MEDLINE, SCOPUS, and EMBASE databases that were searched up to January 2019. Abstracts that met PICO criteria for qualitative studies underwent dual review for data extraction to evaluate study quality and details.
RESULTS
Dietary supplementation with N. sativa preparations can improve various secondary complications of diabetic patients. N. sativa preparations possess antidiabetic, hypoglycemic, anti-hyperlipidemic, antihypertensive, and anti-obesity effects. Beneficial effects of N. sativa preparations include the restoration of the antioxidant defense systems, the increase in the activity of antioxidant enzymes, the decrease of inflammatory biomarkers, the suppression of the production pro-inflammatory mediators, improvement of endothelial dysfunction, and hepatic, kidney, heart and immune system functions. They have key roles in managing diabetes-induced inflammation and oxidative stress in diabetic patients.
CONCLUSION
N. sativa preparations have key roles in herbal medicine as an adjuvant in the treatment and management of patients with DM and its complications. Moreover, the beneficial effects of N. sativa preparations were differently based on dosage forms, active ingredients, and duration of intervention. The best dosage to improve glycemic indices and lipid and lipoprotein profiles is 2 g daily powdered N. sativa for at least 12 weeks.
Topics: Animals; Diabetes Complications; Diabetes Mellitus; Dietary Supplements; Disease Models, Animal; Humans; Nigella sativa; Phytotherapy; Plant Preparations; Seeds
PubMed: 32444053
DOI: 10.1016/j.ctim.2020.102391 -
BMJ Open Diabetes Research & Care Jun 2021In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed... (Meta-Analysis)
Meta-Analysis Review
In this study, we determined the reamputation-free survival to both limbs and to the contralateral limb only following an index amputation of any-level and assessed whether reamputation rates have changed over time. We completed a systematic search using PubMed and screened a total of 205 articles for data on reamputation rates. We reported qualitative characteristics of 56 studies that included data on reamputation rates and completed a meta-analysis on 22 of the studies which enrolled exclusively participants with diabetes. The random-effects meta-analysis fit a parametric survival distribution to the data for reamputations to both limbs and to the contralateral limb only. We assessed whether there was a temporal trend in the reamputation rate using the Mann-Kendall test. Incidence rates were high for reamputation to both limbs and to the contralateral limb only. At 1 year, the reamputation rate for all contralateral and ipsilateral reamputations was found to be 19% (IQR=5.1%-31.6%), and at 5 years, it was found to be 37.1% (IQR=27.0%-47.2%). The contralateral reamputation rate at 5 years was found to be 20.5% (IQR=13.3%-27.2%). We found no evidence of a trend in the reamputation rates over more than two decades of literature analyzed. The incidence of lower extremity reamputation is high among patients with diabetes who have undergone initial amputations secondary to diabetes, and rates of reamputation have not changed over at least two decades.
Topics: Amputation, Surgical; Diabetes Mellitus; Diabetic Foot; Humans; Incidence; Lower Extremity; Reoperation
PubMed: 34112651
DOI: 10.1136/bmjdrc-2021-002325 -
Journal of Affective Disorders Oct 2012The importance of co-morbid diabetes and depression is gaining increased attention. Quantifying the socio-economic and clinical impacts of co-morbidity is important... (Review)
Review
BACKGROUND
The importance of co-morbid diabetes and depression is gaining increased attention. Quantifying the socio-economic and clinical impacts of co-morbidity is important given the high costs of these diseases. This review synthesised evidence on the economic impact of co-morbidity and potential cost-effectiveness of prevention and treatment strategies.
METHODS
11 databases from 1980 until June 2011 searched. In addition, websites and reference lists of studies scrutinised and hand search of selected journals performed. Reviewers independently assessed abstracts, with economic data extracted from relevant studies.
RESULTS
62 studies were identified. 47 examined the impact of co-morbidity on health care and other resource utilisation. 11 of these included productivity losses, although none quantified the impact of mortality. Most demonstrated an association between co-morbidity and increasing health service utilisation and cost. Adverse impacts on workforce participation and absenteeism were found. 15 economic evaluations were also identified. Most focused on primary care led collaborative and/or stepped care, suggesting actions may be cost effective. We did not identify any studies looking at actions to reduce the risk of diabetes in people with depression.
LIMITATIONS
Most studies are set in the US, which may be due to focus on English language databases. Few studies looked at impacts beyond one year or outside the health care system.
CONCLUSIONS
There is an evidence base demonstrating the adverse economic impacts of co-morbid diabetes and depression and potential for cost effective intervention. This evidence base might be strengthened through modelling studies on cost effectiveness using different time periods, contexts and settings.
Topics: Absenteeism; Comorbidity; Cost-Benefit Analysis; Depression; Diabetes Complications; Evidence-Based Medicine; Health Care Costs; Humans; Mental Health Services
PubMed: 23062857
DOI: 10.1016/S0165-0327(12)70008-3 -
Acta Diabetologica Aug 2012Post-prandial hyperglycemia is considered a relevant therapeutic target in type 2 diabetic patients, and it could represent per se an independent risk factor for... (Review)
Review
Post-prandial hyperglycemia is considered a relevant therapeutic target in type 2 diabetic patients, and it could represent per se an independent risk factor for diabetic complications. Aim of the present systematic review is to collect and summarize evidence from observational studies on the relationship between post-prandial glucose (PPG) and cardiovascular or microvascular disease in patients with diabetes. An extensive search of Medline (any date up to December 31, 2010) was performed for all longitudinal epidemiological studies with a cohort design. The following endpoints were taken into consideration: death from any cause; cardiovascular death and micro- and macrovascular complications. The number of epidemiological studies assessing the relationship between PPG and microvascular or cardiovascular disease in subjects with diabetes is surprisingly scarce. In fact, of the 391 retrieved studies, only 8 fulfilled the inclusion criteria. Most of those investigations enrolled small samples, which in many instances were not representative of the general population. Furthermore, the assessment of PPG varied widely across studies. These considerations prevent any formal meta-analysis. Despite this, the few available studies show that higher PPG is associated with increased all-cause and cardiovascular death, incidence of major cardiovascular events (including myocardial infarction and stroke), and progression of diabetic retinopathy.
Topics: Blood Glucose; Cardiovascular Diseases; Cohort Studies; Diabetes Complications; Diabetic Angiopathies; Glycated Hemoglobin; Humans; Hyperglycemia; Longitudinal Studies; MEDLINE
PubMed: 22116350
DOI: 10.1007/s00592-011-0355-0 -
Nutrients Mar 2020Food-derived bioactive compounds such as resveratrol are increasingly explored for their protective effects against metabolic complications. Evidence supports the strong... (Meta-Analysis)
Meta-Analysis
Food-derived bioactive compounds such as resveratrol are increasingly explored for their protective effects against metabolic complications. Evidence supports the strong antioxidant properties and therapeutic effects of resveratrol in managing diabetes and its associated complications. However, evidence informing on the comparative or combination effects of this natural compound with an accomplished and well-characterized antidiabetic agent like metformin has not been revised. Thus, we conducted a comprehensive systematic search of the major electronic databases which included MEDLINE, Cochrane Library, and EMBASE. The cumulative evidence strongly supports the comparative effects of metformin and resveratrol in ameliorating diabetes-associated complications in preclinical settings. In particular, both compounds showed strong ameliorative effects against hyperglycemia, dyslipidemia, insulin resistance, a pro-inflammatory response, and lipid peroxidation in various experimental models of diabetes. Enhancing intracellular antioxidant capacity in addition to activating NAD-dependent deacetylase sirtuin-1 (SIRT1) and AMP-activated protein kinase (AMPK) are the prime mechanisms involved in the therapeutic effects of these compounds. Of interest, preclinical evidence also demonstrates that the combination treatment with these compounds may have a greater efficacy in protecting against diabetes. Thus, confirmation of such evidence in well-organized clinical trials remains crucial to uncover novel therapeutic strategies to manage diabetes and its linked complications.
Topics: Animals; Antioxidants; Diabetes Complications; Dietary Supplements; Drug Therapy, Combination; Humans; Hypoglycemic Agents; Metformin; Resveratrol; Treatment Outcome
PubMed: 32168855
DOI: 10.3390/nu12030739 -
Cancer Causes & Control : CCC Jun 2011Epidemiological evidences indicate that diabetic individuals may have an increased risk of several cancers; however, the relationships between diabetes and risk of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Epidemiological evidences indicate that diabetic individuals may have an increased risk of several cancers; however, the relationships between diabetes and risk of cancers of biliary tract or its subsites remain unclear.
METHODS
To provide a quantitative assessment of this relationship, we identified studies by a literature search of Medline (from 1 January 1966) and EMBASE (from 1 January 1974), through 31 July 2010, and by searching the reference lists of pertinent articles. Summary relative risks with corresponding 95% confidence intervals were calculated with a random-effect model.
RESULTS
Analysis of 21 studies (8 case-control and 13 cohort studies) found that diabetes was associated with an increased risk of biliary tract cancer, compared with no diabetes (summary RRs = 1.43, 95% CI = 1.18-1.72), with significant heterogeneity among studies (p = 0.001). The positive association was also found between diabetes and risk of gallbladder cancer or extrahepatic cholangiocarcinoma, but not cancer of ampulla of Vater. No significant publication bias was found.
CONCLUSION
These findings strongly support the link between diabetes and increased risk of cancer of biliary tract and its subsites: gallbladder cancer or extrahepatic cholangiocarcinoma, but not cancer of ampulla of Vater.
Topics: Biliary Tract Neoplasms; Carcinoma; Case-Control Studies; Cohort Studies; Diabetes Complications; Diabetes Mellitus; Humans; Risk Factors; Up-Regulation
PubMed: 21424210
DOI: 10.1007/s10552-011-9754-3 -
American Journal of Epidemiology Sep 2007The authors conducted a systematic review of published data on the association between diabetes mellitus and fracture. The authors searched MEDLINE through June 2006 and... (Meta-Analysis)
Meta-Analysis Review
The authors conducted a systematic review of published data on the association between diabetes mellitus and fracture. The authors searched MEDLINE through June 2006 and examined the reference lists of pertinent articles (limited to studies in humans). Summary relative risks and 95% confidence intervals were calculated with a random-effects model. The 16 eligible studies (two case-control studies and 14 cohort studies) included 836,941 participants and 139,531 incident cases of fracture. Type 2 diabetes was associated with an increased risk of hip fracture in both men (summary relative risk (RR) = 2.8, 95% confidence interval (CI): 1.2, 6.6) and women (summary RR = 2.1, 95% CI: 1.6, 2.7). Results were consistent between studies of men and women and between studies conducted in the United States and Europe. The association between type of diabetes and hip fracture incidence was stronger for type 1 diabetes (summary RR = 6.3, 95% CI: 2.6, 15.1) than for type 2 diabetes (summary RR = 1.7, 95% CI: 1.3, 2.2). Type 2 diabetes was weakly associated with fractures at other sites, and most effect estimates were not statistically significant. These findings strongly support an association between both type 1 and type 2 diabetes and increased risk of hip fracture in men and women.
Topics: Data Interpretation, Statistical; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Fractures, Bone; Humans; Incidence; Risk Factors
PubMed: 17575306
DOI: 10.1093/aje/kwm106 -
Diabetes Research and Clinical Practice Mar 2020This study aimed to systematically review the prevalence of diagnosed sleep disorders in people with diabetes and to determine the association between sleep disorders...
AIM
This study aimed to systematically review the prevalence of diagnosed sleep disorders in people with diabetes and to determine the association between sleep disorders and blood glucose levels and diabetes outcomes.
METHODS
We conducted a literature search in the following databases: MEDLINE (Pubmed), EMBASE, CINAHL, PsychInfo and Web of Science Citation Index. Meta-analysis (random-effects models) was conducted to estimate the prevalence of sleep disorders in people with diabetes.
RESULTS
Forty-one articles measured the prevalence of sleep disorders in adults with diabetes. The estimated pooled prevalence of sleep disorders in diabetes was estimated to be 52% (95% CI 42-63%). The highest pooled prevalence was observed for unspecified sleep apnea (69%; 95% CI: 59-78%), followed by obstructive sleep apnea (60%; 95% CI 39-80%), and restless leg syndrome (27%; 95% CI 20-34%). Eleven studies examined the association between sleep disorders and diabetes control and complications. The presence of comorbid sleep disorders was associated with increased diabetes outcomes.
CONCLUSIONS
Diagnosed sleep disorders are highly prevalent in people with diabetes. Sleep disorders are associated with diabetes outcomes, though there was considerable heterogeneity across studies.
Topics: Adult; Diabetes Complications; Diabetes Mellitus; Humans; Outcome Assessment, Health Care; Prevalence; Prognosis; Sleep Apnea, Obstructive; Sleep Wake Disorders
PubMed: 32006640
DOI: 10.1016/j.diabres.2020.108035 -
Minerva Endocrinologica Sep 2019Oxidative stress has a key role in pathophysiology of type 2 diabetes mellitus (T2DM) and its complications as a most common health problem. Due to controversial...
INTRODUCTION
Oxidative stress has a key role in pathophysiology of type 2 diabetes mellitus (T2DM) and its complications as a most common health problem. Due to controversial evidence regarding the association between antioxidants' gene varients and T2DM, our aim was a systematic review of the current meta-analyses.
EVIDENCE ACQUISTION
All meta-analysis' studies which assessed the association of single nucleotide polymorphisms of superoxide dismutase (SOD), catalase, glutathione peroxidase (GPX), glutathione S transferase (GST), nitric oxide synthase (NOS) and nicotinamide adenine dinucleotide phosphate oxidase (NOX) with T2DM and its complications were systematically extracted from PubMed, Scopus and Web of Science databases up to January 2016. Results are reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
EVIDENCE SYNTHESIS
Among 131 articles recorded in initial search, 19 studies were in the topic just for eNOS (endothelial NOS), NOX, GST and SOD gene variants. G894T, 4b/a and T-786C variants (eNOS) were associated with DN (diabetic nephropathy). However no association between 4b/a variant and DR (diabetic retinopathy) was observed. Separate or combination of GSTM1 and GSTT1 null genotypes (GST gene) were associated with T2DM. GSTM1 and combination of GSTM1/GSTT1 null genotypes were associated with DN. Significant association between C242T variant (NOX) and T2DM or DN, and non-significant association with carotid atherosclerosis were seen. C allele of C47T variant (SOD) was protective against DN, DR and microvascular complications of diabetes.
CONCLUSIONS
Finding gene polymorphisms involved in diabetes and its complications might be helpful in discovering new therapeutic approaches, as well as prevention which is currently as a main focus in personalized medicine.
Topics: Antioxidants; Diabetes Complications; Diabetes Mellitus; Genetic Variation; Humans; Oxidative Stress; Risk Factors
PubMed: 28548478
DOI: 10.23736/S0391-1977.17.02632-3 -
Diabetes/metabolism Research and Reviews May 2023To develop and validate a risk prediction model for Chinese patients with type 2 diabetes with the recurrence of diabetic foot ulcers (DFUs) based on a systematic review... (Meta-Analysis)
Meta-Analysis
Development and validation of a risk prediction model for the recurrence of foot ulcer in type 2 diabetes in China: A longitudinal cohort study based on a systematic review and meta-analysis.
AIMS
To develop and validate a risk prediction model for Chinese patients with type 2 diabetes with the recurrence of diabetic foot ulcers (DFUs) based on a systematic review and meta-analysis.
METHODS
A prospective analysis was performed with 1333 participants and followed up for 60 months. Three models were analysed using a derived cohort. The risk factors were screened using meta-analysis and logistic regression, and the missing variables were interpolated by multiple imputation. The internal validation was performed using the bootstrap procedure, and the validation cohort was applied to the external validation. The performance of the model was evaluated in the area under the discrimination Receiver Operating Characteristic Curve (ROC). Calibration and discrimination methods were used for the validation cohort. The variables were selected according to their clinical and statistical importance to construct the nomograms.
RESULTS
Three models were developed and validated. Model 1 included seven social and clinical indicators like sex, diabetes mellitus duration, previous DFU, location of ulcer, smoking, history of amputation, and foot deformity. Model 2 included four more indicators besides those in Model 1, which were statin agents used, antiplatelet agents used, systolic blood pressure, and body mass index. Model 3 added further laboratory indicators to Model 2, such as LDL-C, HbA1C, fibrinogen, and blood urea nitrogen. In the derivation cohort, 20.1% (206/1027) participants with DFU recurred as compared to the validation cohort, which was 38.2% (117/306). The areas under the curve in the derivation cohort for Models 1-3 were 0.781 (0.744-0.817), 0.843 (0.813-0.873), and 0.899 (0.876-0.922), respectively. The Youden indexes for Models 1-3 were 0.430, 0.559, and 0.653, respectively. Model 3 showed the highest sensitivity and specificity. All models performed well for both discrimination and calibration.
CONCLUSIONS
Models 1-2 were non-invasive, which indicate their role in general screening for patients at a high risk of recurrence of DFU. However, Model 3 offers a more specific screening due to its best performance in predicting the risk of DFU recurrence amongst the three models.
Topics: Humans; Diabetes Mellitus, Type 2; Longitudinal Studies; Diabetic Foot; Cohort Studies; Risk Factors; Foot Ulcer
PubMed: 36657181
DOI: 10.1002/dmrr.3616