No abstract available.
Diabetes Mellitus, Type 2*

No abstract available.
Diabetes Mellitus, Type 2*

No abstract available.
Diabetes Mellitus, Type 2

Introduction: In 2021, the International Diabetes Federation, reported 536 million people with diabetes, mainly from countries with lower income. Methods: A cross-sectional descriptive study was employed using the Finnish Diabetes Risk Score (FINDRISC), a validated questionnaire which determines the risk of developing diabetes. The questionnaire was conducted online to be accomplished by students enrolled in universities located in Quezon City. Results: Among the 178 college students in Quezon City, with average age of 20 years old, 28.1% are at risk of developing T2DM. The factors contributing to the risk were: (1) Lack of physical activity of at least 30 minutes a day (51.7%); (2) lack of daily intake of vegetables and fruits or berries (52.8%); and (3) family history of DM (74.7%). Conclusion The study found that one in every four college students in Quezon City is at risk of developing T2DM in the next ten years.
Diabetes Mellitus, Type 2

In 2021, 537 million adults were living with diabetes. Being a progressive disease, there would eventually be failure of oral hypoglycemic agents (OHA) to maintain good glycemic control and a majority will require insulin. However, optimal glycemic control has not been satisfactory in a significant proportion of patients who were on insulin therapy. Patient factors (eg, awareness, compliance, socioeconomic) have been identified but physician-related factors are as important. These include incorrect choice and inappropriate combination of insulin therapy which could be corrected by making the treatment physiologic. The purpose of this article is to improve management decisions in type 2 diabetes by reviewing its pathophysiology and identifying the optimum insulin regimen that could mimic such. Since eventual beta cell failure is central to its pathophysiology, it is but reasonable to replace insulin by mimicking its physiologic secretion. Hence, the term Insulin Replacement Therapy (IRT) should be utilized. This could be provided by the combination of premix insulin (ie, NPH + regular insulin) and rapid-acting insulin which has been reported to provide an initial 17.5% HbA1c reduction and even 18% reduction on 5-year follow-up providing sustainable control. A stepwise approach is an effective tool for insulin intensification. Hypoglycemia in insulin therapy could be prevented with an appropriate dietary regimen through automatic snacking.

Background: Diabetes is one of the major health concerns worldwide. Self-care is one of the most important methods in controling this disease and preventing development of complications. Objective: The study aimed to determine the level of adherence to self care behavior among Type 2 diabetic patients consulting at the Out Patient Department of Batangas Medical Center and Bolbok Health Center from January 2020 to December 2020 Methods: This analytic cross-sectional study consists of administration of a validated Behavior Score Instrument and Family APGAR questionnaire among 143 diagnosed Type 2 Diabetic patients in the Family Medicine OPD Clinic and Bolbok Health Center. A purposive nonprobability sampling method was used. Data obtained were encoded and analyzed using the Stata version 17. To compare the levels of adherence between family function groups, Chi-square test and Fisher Exact test were used. Results: Over-all adherence to the self-care behaviors showed good adherence 94.4% (135) of the participants. None of the patients had poor adherence to self care behaviors. Majority had highly functional families (n 131; 91.6%) and none of the patients had severely dysfunctional families. Overall levels of adherence were comparable among family function groups. Good adherence to glucose monitoring was noted among higher proportions of participants with highly functional families. Conclusions The study showed that the least followed behavior was medication adherence and risk reduction. Having patients adhere to anti diabetic medications is important in achieving blood glucose control and following the behaviors under risk reduction can help them from developing more complications due to their disease.
Diabetes Mellitus, Type 2

Abstract: This current study aims to report the clinical profiles and characteristics of diabetic patients who had been admitted for hyperglycemic crises from 2007 to 2017 at our institution. Methodology: We conducted a retrospective study in a tertiary care university hospital outside Metro Manila. The data gathered were divided into three categories: clinical data, biochemical data and precipitating factors. Results: A total of 3,120 adult patients with diabetes mellitus were admitted for various reasons, and 71 cases presented with DKA or HHS over the 10-year period of review which is equivalent to 2% of all diabetes mellitus cases admitted. Forty-six (64.79%) of the patients with hyperglycemic crises were known diabetics with a duration of 7-13 years. Majority of patients were not taking anti diabetic medications upon admission. Most patients with hyperglycemic crises were tachycardic and hypertensive upon admission. Majority were discharged and improved. Majority of the cases 53 (81.69%) had DKA. The most common precipitating factor in DKA and HHS was infection. Conclusion In conclusion, the biochemical profiles in our series did not significantly differ from the past study by Gatbonton et.al (1998). Despite the advent of new therapies for diabetes mellitus control, mortality among the patients with hyperglycemic crises was slightly higher in our study at 11% compared to the global reported data of 2-10%. One of the reasons could be the minimal improvements in our health care delivery system that is still unable to cater to the needs of diabetic Filipinos. Early screening programs should be done for patients beginning age 40 years and even earlier for those with risk factors for prompt detection and treatment of diabetes mellitus. Education and awareness should be strengthened for patients with diabetes mellitus to avoid the crises by emphasizing the importance of regular follow-up, monitoring and compliance with a diabetic regimen, especially with insulin and multiple OADs (oral anti- diabetic drugs) since the disease is progressive, and timely intensification of therapy is needed.
Diabetes Mellitus, Type 2

Background: Among the various glycemic indices in current use, glycemic variability has the greatest contribution in the development of microvascular and macrovascular complications in Type 2 Diabetes mellitus (T2DM). Most metrics that are currently used to measure glycemic variability are derived from continuous glucose monitoring (CGM) data. However, CGM is burdensome to the patient due to its relatively high cost as well as the need for multiple visits with the health care provider. With the use of serum 1,5-anhydroglucitol (1,5-AG) as a biomarker of glucose fluctuations, physicians and patients alike could have an easier surrogate measure of glycemic variability thus aiding in achieving target glucose control. This study aims to determine the diagnostic accuracy of 1,5-AG as compared to the glycemic variability metrics derived from CGM as a surrogate measure of glycemic variability among adult Filipinos with T2DM. Methods: Retrospective analysis of data of adult patients aged 20 years old and above diagnosed with T2DM referred for CGM at the Diabetes, Endocrine, Metabolic, and Nutrition Center of Cardinal Santos Medical Center from January 2017 to October 2021 who underwent serum 1,5-AG level determination within 2 weeks of CGM were collected. Diagnostic accuracy was obtained by computing the sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and Youden index. Pearson correlation coefficient was used to determine the correlation of 1,5-AG and the different metrics. Analysis of variance (ANOVA) was used to check for statistical significance with 99% confidence interval and a p < 0.05 considered as statistically significant. Results: This study involving 37 subjects showed a good diagnostic accuracy of serum 1,5-AG levels with the different measures of glycemic variability derived from CGM namely mean amplitude of glycemic excursion (MAGE), continuous overlapping net glycemic action at 1-hour intervals (CONGA-1), and mean of daily differences (MODD) with significant correlation among patients with HbA1c ≤ 7%. Subjects were on CGM for approximately 6 ± 1 day with statistically significant difference between the good and poor glucose control group (p<0.05). Determination of diagnostic accuracy between 1,5- AG and MAGE showed good accuracy (Sensitivity = 95.3%, Specificity = 100%, PPV = 100%, NPV = 75.43%, Diagnostic accuracy 96%, and a Youden Index of 92.3) with a statistically significant correlation among subjects with HbA1c level ≤ 7% (p=0.021). There is likewise good diagnostic accuracy between CONGA-1 and 1,5-AG level (Sensitivity = 99%, Specificity = 75.29%, PPV = 89.1%, NPV = 97%, Accuracy = 89.50% and Youden index of 58.41) with a statistically significant correlation among subjects with HbA1c ≤ 7% (p=0.038). Comparison with interday glycemic variability showed fair diagnostic accuracy between MODD and 1,5-AG (Sensitivity = 79.17%, Specificity = 78%, PPV = 97%, NPV = 32%, Accuracy = 76.89%, and Youden index of 49.07) and a statistically significant correlation among subjects with HbA1c ≤ 7% (p=0.009). Conclusion There is good diagnostic accuracy of serum 1,5-AG levels with the different measures of glycemic variability derived from CGM namely MAGE, CONGA-1, and MODD with significant correlation among patients with HbA1c ≤ 7%. Among diabetics with HbA1c ≤7%, 1,5-AG could be used as a surrogate measure of glycemic variability and excursions.
Diabetes Mellitus, Type 2

Introduction: There are a significant number of diabetic patients who remain uncontrolled despite basal insulin therapy due to lack of intensification of treatment. Different insulin titration algorithms are recommended by different treatment guidelines. This study compared two basal insulin titration algorithms in terms of time to achieve target glucose, adherence, hypoglycemia episodes, and HbA1c reduction. Methods: This is a 12-week randomized clinical trial conducted on insulin-naïve patients with uncontrolled type 2 diabetes mellitus from outpatient clinic of St. Luke’s Medical Center Quezon City. Patients on oral hypoglycemic agent/s with HbA1c seven percent and above were included in the study. They were randomized to either daily titration or twiceweekly insulin titration algorithms using basal insulin glargine. Results: Forty-one patients were included in the study. The daily titration algorithm achieved target capillary blood glucose (CBG) at stable insulin dose earlier (33 vs 41.3 days, p-value=0.042) than the twice-weekly titration. Better adherence was also seen among patients on daily titration algorithm as compared to twice weekly (94.94% vs. 91.12%, p-value = 0.009). There was no significant difference in incidence of hypoglycemia (p-value 0.0.62) for both algorithms. All patients from the two groups had significant HbA1c reduction at the end of the study period. Conclusion Daily titration algorithm achieved earlier target fasting plasma glucose and better patient adherence as compared to twice-weekly titration in the adjustment of basal insulin dose. HbA1c reduction and risk of hypoglycemia were similar in both titration algorithms.
Diabetes Mellitus, Type 2

Objective: The aim of the study was to investigate the association between single nucleotide polymorphisms (SNP) at rs 1501299 (SNP+276 G>T) of the adiponectin gene and plasma adiponectin levels in type 2 diabetes mellitus (T2DM) patients in Myanmar. Methodology: One hundred T2DM patients and 104 non-diabetic subjects were included in this cross-sectional analytical study. Genotype frequencies were determined by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) method. Plasma adiponectin level was measured by enzyme-linked immunosorbent assay (ELISA). Result: Genotype frequencies (GG, GT, TT) of SNP+276 in diabetic patients were 39%, 48% and 13%, respectively. The GT and TT genotypes were more frequent in T2DM patients (OR 1.98, 95% CI, 1.10-3.55; p=0.02 and OR 4.07, 95% CI, 1.34-12.3; p=0.01), respectively. The T allele of SNP+276 was significantly associated with T2DM (OR 1.96, 95% CI, 1.27-3.01; p=0.002). Mean plasma adiponectin level was significantly lower than in T2DM patients (27.41±16.7 μg/mL) compared to non-diabetic subjects (37.19±26.77 μg/mL) (p=0.002) Conclusion SNP+276 at rs 1501299 of the adiponectin gene was associated with type 2 diabetes and low plasma adiponectin levels in this Myanmar population.
Diabetes Mellitus, Type 2