Journal des complications et de la médecine du diabète

Objective: Diabetes (DM) is a complex chronic illness with multiple complications and co-morbid conditions. DM affects 9.3% of the U.S. population and costs $245 billion or more annually. Most U.S. states have enacted laws requiring coverage of DM care and supplies but the effect of these public health laws is not well understood. This study aims to examine whether state’s legislative actions can improve access to care and mitigate DM’s rising prevalence thereby reducing complications.

Methods: Econometric modelling provided DM-related trends and assessed state-level variation in DM prevalence. Ordinary least squares (OLS) regression assessed the impact of different law enactment dates and key factors that contribute to the effectiveness of DM-related state laws, including demographic characteristics related to DM: median household income, educational attainment, obesity, and state population size.

Results: All but four US states have enacted diabetes-related laws requiring coverage of diabetes care and treatment. States that had enacted DM-related laws and had a higher percentage of people covered by insurance, experienced lower increases in diagnosed DM over time. Education proved to be a key factor in helping to decrease the prevalence of DM and its complications. Conversely, increasing obesity rates explain much of the rising prevalence of diagnosed DM.

Conclusion: Enactment of DM-related laws at the state-level has proven somewhat beneficial in mitigating the rise in DM rates and alleviating complications. There is a need for future research to further examine the various payers’ reimbursement policies for healthcare professionals providing services such as diabetes self-management education within each state. The findings from this study offer policy insights about the benefits of state-level DM laws for controlling the disease, reducin

Introduction: Insulin is a valuable drug for, those who are in need of it. Insulin will have tremendous impact,
when used properly. Intensive insulin therapy was essential in the maintenance of strict glycemic control among
insulin requiring patients with diabetes. However this presents challenges in the face of the complexities associated
with insulin use and also taking in the consideration the potential danger associated with inappropriate use.
Insufficient knowledge and attitude of insulin self administration can result in preventable complication, adverse
patient outcome, poor adherence to therapy and invariably poor glycemic control.
Objectives: To assess knowledge and attitude on insulin self administration among type 1 DM patients in Mekele
hospital 2015.
Methodology: Institution based descriptive cross sectional study was conducted. The study subject where type 1
DM patients in Mekele hospital (attending chronic follow up). Data was collected by interview using pre-tested
structured questionnaires. The data was entered and analyzed using SPSS version 16. All type one DM patients
were included in the study.
Result: Among 141 respondents, more than half 78 (55.3%) of them had average knowledge and majority 96
(68.0%) of the participants had favorable attitude.
Conclusion and recommendation: The finding of this showed that type 1 diabetic patient had average
knowledge and favorable attitude towards self administration of insulin injection. It is suggested that more should be
done on areas like medias, health professionals on health education towards insulin self administration for type 1
DM patients.

The ocular lens of the ground squirrel is an excellent model for studies of eye light interactions that may apply to the human system. UV-B radiation induced damage to the eye lens is believed to be mediated through ROS Antioxidant systems, both enzymatic and non- enzymatic aid in preventing the damage to the lens. The activity of indoleamine 2,3- dioxygenase (IDO), a first rate limiting enzyme of tryptophan catabolism, has been studied in the lenses of Indian ground squirrel exposed to UV-B radiation. Further, antioxidants and oxidative stress markers have also been investigated to assess the oxidative status. Our investigation revealed an increased indoleamine 2,3-dioxygenase activity and tryptophan metabolites suggesting their protective role in UV stress. The study indicates that UV-B irradiation for 12 h and 24 h (300 nm; 100 μw/cm2) of lens samples led to a marginal decrease in GSH and increase in carbonyls and MDA levels reflecting the role of indoleamine 2,3-dioxygenase in protecting the lens tissue.

The EndoBarrier has a weak point caused by a Teflon membrane, which completely inhibits the movement of water and food. We developed a new type of gastro jejunal inner lumen bypass device (GJB) using an artificial net that has a hole instead of a membrane. We inserted a net in the gastric antrum-duodenum–jejunum via open laparotomy. The growth of pigs with long nets was suppressed compared with the sham operation. However, there were no differences in blood biochemistry or anatomical findings at autopsy between the groups. As a result, GJB can control the growth of pigs without requiring dietary restriction.

Background: TraditionallyVitamin K antagonists (VKAs), such as warfarin, have been used to reduce the
risks of stroke and systemic embolism in patients with atrial fibrillation (AF). However, they are associated with increased risk of haemorrhage. Thus, there is a need for new oral anticoagulant agents that are effective, safe, and convenient to use. Recent, observational and randomized controlled clinical trials, have examined the long-term use and efficacy of new oral anticoagulants. However, their results pertaining to important secondary efï¬Ã‚cacy end points as well as safety outcomes were inconclusive.
Aim: We, therefore, performed a systematic review to examine the long-term efï¬Ã‚cacy and safety of the new oral anticoagulants namely; dabigatran, rivaroxaban and apixaban in patients with AF.
Methods: In total 286 abstracts have been screened and 21 articles have been selected and considered as relevant for this epidemiological review. The primary efï¬Ã‚cacy endpoint was the incidence of stroke or systemic embolism. The primary safety endpoint was the incidence of major bleeding.
Results: We observed that dabigatran and rivaroxaban are more efï¬Ã‚cacious than warfarin for the prevention of stroke, death and systemic embolism. Also, they decrease the risk for intracranial bleeding and appear to have a favorable safety proï¬Ã‚le, making them promising alternatives to warfarin.
Conclusions: Overall, our results support the use of the new oral anticoagulants as alternatives to warfarin for long-term anticoagulation therapy in patients with AF.