Combination therapy has proven to be a popular treatment strategy for tighter diabetes control. Since the preliminary evidence is suggestive of complementary actions of American (AG) and Korean Red Ginseng (KRG) in improving glycemia, this project was designed to investigate the therapeutic potential of AG and KRG in combination. Following a randomized, double-blind, placebo-controlled parallel design in a population with diabetes at two centres, the combined use of AG and KRG for 12 weeks was safe, but did not significantly affect glycemic control, blood lipids or blood pressure. However, there was a trend toward lower glycated hemoglobin by 0.7% (p=0.1) and office systolic blood pressure by 5 mm Hg (p=0.052) compared to placebo. These findings encourage further investigation of the mechanism and roles of AG, KRG and their effective components. They also highlight limitations in ginseng research and the need to impose strict regulations to facilitate its standardization.

Combination therapy has proven to be a popular treatment strategy for tighter diabetes control. Since the preliminary evidence is suggestive of complementary actions of American (AG) and Korean Red Ginseng (KRG) in improving glycemia, this project was designed to investigate the therapeutic potential of AG and KRG in combination. Following a randomized, double-blind, placebo-controlled parallel design in a population with diabetes at two centres, the combined use of AG and KRG for 12 weeks was safe, but did not significantly affect glycemic control, blood lipids or blood pressure. However, there was a trend toward lower glycated hemoglobin by 0.7% (p=0.1) and office systolic blood pressure by 5 mm Hg (p=0.052) compared to placebo. These findings encourage further investigation of the mechanism and roles of AG, KRG and their effective components. They also highlight limitations in ginseng research and the need to impose strict regulations to facilitate its standardization.

Aim/Objectives: There were two aims; improving type II diabetes glycaemic control; and enhancing the role of community pharmacists by engaging them in type II diabetes medicine management. Methods: This quantitative study collected data from both community pharmacists and patients. In a premises survey, 426 self-administered questionnaires were distributed to community pharmacies. In a knowledge survey, 125 questionnaires were distributed to community pharmacists. In a clinical trial, 40 community pharmacies were randomly assigned to be control (18) and intervention (22) premises. Each pharmacy recruited 4 or 5 patients with type II diabetes. 225 patients were recruited and assigned to receive usual pharmacist care (n=100) or a pre-defined pharmacist intervention (n=125). Results: Community pharmacists had good knowledge of diabetes with average scores 21/29 (±3.18). The differences between control and intervention groups in patients' HbA1c and FPG changes were not significant. In the intervention group patients' diabetes knowledge was significantly improved (p=0.031). In the intervention group HbA1c and FPG improved significantly and in the control group FPG improved significantly and HbA1c did not. Patients' self-reported self-management activities improved significantly around blood glucose measurements (p < 0.001) and physical exercising (p=0.001). Attitudes around the value of tight control of diabetes improved (p < 0.001). Conclusion: The findings suggest that community pharmacists in Libya may have the ability to improve type II diabetes care. The primary outcomes were not improved in intervention versus control. The before/after analysis showed significant improvement in primary outcomes in the intervention group and also in one of the primary outcomes in the control group. Patients' self-reported self-care activities and attitudes improved significantly in the intervention group.

Introduction: Physical activity should be part of our everyday life. However, for people with Type 1 Diabetes Mellitus it is the most common cause of hypoglycemia. To control diabetes in the right way, it is therefore necessary to follow certain rules and recommendations that help preventing hypoglycemia while the physical activity remains beneficial at the same time. Aim of the work: The main aim of this study is to clarify the influence of physical activity in connection to long-term control of Type 1 Diabetes Mellitus. Methods: 102 respondents with diagnosed Type 1 Diabetes Mellitus in the age of 19-69 years participated in a quantitative analysis. This research was conducted in a form of multicentric examination at two independent medical centers. The data collection was done through questionnaires focused on physical activity and daily regime. The data from questionnaires were then compared to the values of glycated hemoglobin (HbA1C), HDL cholesterol and the total daily dose of insulin of certain patients. For statistical evaluation, analytical tools of Microsoft Office program were used (F-test and t-test). Results: We found correlation between HbA1C values in patients physically active for less than 2 hours/week compared to those who are physically active for more than 2 hours/week (62,72...

Title: Physical education of individuals with type 2 diabetes mellitus Objectives: The aim of this thesis is to evaluate the effect of physical education of individuals with type 2 diabetes mellitus cured in diabetologic outpatient clinic of Genereal University Hospital in Prague. The physical education was focused on nordic walking. Methods: Eight patients of diabetological outpatient clinic were chosen by the doctor for this survey. The physical examination was carried out with seven patients. It involved anthropometrical measurements (weight, waist circumference) and blood collection for biochemical parameters assessment (glycemia, glycated hemoglobin). Two-minute step test was chosen for assessment of subject's physical fitness. Results: The physical activity education of individuals with type 2 diabetes mellitus doesn't increase the amount of their physical activity. The physical activity of type 2 diabetes mellitus individuals is rather low as well as their exercise adherence. Nordic walking exercise program can improve anthropometrical parametres (weight, waist circumference) and can reduce HbA1c levels. Lower health-related quality of life in physical and physological aspects wasn't proved in type 2 diabetes patients. Key words: nordic walking, physical activity, type 2 diabetes management,...

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Research conducted with youth with type 1 diabetes (T1D) has shown that glycemic extremes and poorer T1D management are associated with poorer performance on measures of executive functioning (EF) compared to non-T1D counterparts. Deficits in EF may negatively impact the development of healthy T1D management skills. Our primary aim was to conduct a meta-analytic review of previous studies investigating the associations between glycemic control and EF in children with T1D across the developmental span. Comprehensive literature searches were conducted using PubMed, MedLine, PsycInfo, Google Scholar, and EBSCO for articles that met eligibility criteria. Eligibility criteria included correlational, randomized, and non-randomized studies published after 1985 involving participants ages 0-26 with a diagnosis of T1D. Studies evaluated EF using the Behavior Rating Inventory of Executive Functioning (BRIEF) or fMRI and evaluated glycemic control using Hemoglobin A1c. Across twelve studies examining the effect of glycemic control on EF in patients with T1D, 2,204 children, adolescents, and emerging adults were included in the study. Effect sizes (Hedges' g) were calculated between the T1D group and either control participants or a normative sample. Participant age was included as a moderator to determine whether the hypothesized association varied in magnitude across development. Participant A1c was used as a moderator to determine whether the hypothesized variation varied with diabetic management. A trend towards poorer performance on measures of executive functioning was observed in the T1D group compared to the normative sample (g = -0.22). In comparing age cohorts to the normative sample, a significantly poorer performance on measures of EF was observed in the 9-11, 15-17, and 18-26 age cohorts (g = -0.201, -0.258, and -0.452, respectively) compared to other age cohorts. Overall, research indicates that poor diabetic management may result in poorer performance on measures of EF compared to non-diabetic participants. These findings imply that this trend of poorer EF in children and adolescents with type 1 diabetes may lead to suboptimal diabetic management. Research suggests that suboptimal diabetic management often persists across the lifespan. Examining this association across critical periods where diabetes management may exert the most influence on the developing brain may provide guidance about when youth may benefit most from T1D management interventions.

Electrochemical biosensors are renowned for their ability to detect a wide range of analytes in biological fluids for clinical diagnosis. The implementation of biomarkers in electrochemical biosensors for clinical diagnosis is essential for the specific and accurate diagnosis of the disease with high sensitivity and selectivity. Therefore, this thesis evaluates the challenges pertaining to the stability, reproducibility, and obtaining a low limit of detection for the internal/external biomarkers associated with two distinct electrochemical biosensors. The first study tackles the challenge of detecting low analyte concentrations in a label-free biosensor. It introduces an innovative label-free electrochemical biosensing method for the detection of glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP) to predict Coronary Heart Disease (CHD) progression using tailored redox probes, proposing a dual biomarker biosensing platform for future research. Calibration curves reveal an LOD of 5 mg/mL in PBS (8) FeCN (II) and 6 mg/mL in SB for a linear range of 0 – 30 mg/mL of HbA1c. Similarly, an LOD of 0.007 mg/mL and 0.008 mg/mL in PBS (7.4) PcA-NO2 and SB, respectively, is reported for a linear range of 0 – 0.05 mg/mL of CRP. The second study focuses on stabilizing a biomolecule-free sensor for the ultra-low detection of Δ9-tetrahydrocannabinol (THC) in roadside testing. Pre-depositing THC, an external biomarker for drug-impaired driving, onto the biosensor's working electrode enhances its interaction with analytes. However, THC's oxidative nature compromises sensor stability during manufacturing. Consequently, optimal electrode storage conditions were explored, indicating frozen storage as ideal for up to six months, effectively preventing THC oxidation at -18°C, while degradation occurs at 4°C. Modified electrodes stored under optimal conditions exhibit improved calibration curves when exposed to various THC samples. / Thesis / Master of Applied Science (MASc) / An electrochemical biosensor is a sensing device with the ability to detect biological species via the transduction of a specific biological event into electrochemical signals. These sensors are extremely useful for the detection of analytes in biological fluids for clinical diagnostics, to determine the presence or absence of diseases. This manuscript addresses the challenges associated with the stability, reproducibility, and the low limits of detection associated with screen-printed carbon electrodes used in electrochemical biosensing. Subsequently, due to the strong correlation between glycated hemoglobin (HbA1c) and C-reactive protein (CRP) to connote the risk of contracting coronary heart disease (CHD), the manuscript presents a novel label-free electrochemical biosensing method for the detection of HbA1c and CRP with low detection limits. Secondly, the manuscript identifies ambient storage conditions for the long-term stability of a biomolecule-free sensing device for the roadside detection of ultra-low concentrations of Δ9-tetrahydrocannabinol (THC).

Current screening tests for type 2 diabetes mellitus (T2DM) identify less than 50% of undiagnosed T2DM patients and provide no information about how the disease will develop in prediabetic patients. Here, twenty-nine protein glycation sites were quantified after tryptic digestion of plasma samples at the peptide level using tandem mass spectrometry and isotope-labelled peptides as internal standard. The glycation degrees were determined in three groups, i.e., 48 patients with a duration of T2DM exceeding ten years, 48 non-diabetic individuals matched for gender, BMI, and age, and 20 prediabetic men. In long-term controlled diabetic patients, 27 glycated peptides were detected at significantly higher levels, providing moderate diagnostic accuracies (ACCs) from 61 to 79%, allowing a subgrouping of patients in three distinct clusters. Moreover, a feature set of one glycated peptides and six established clinical parameters provided an ACC of 95%. The same number of clusters was identified in prediabetic males (ACC of 95%) using a set of eight glycation sites (mostly from serum albumin). All patients present in one cluster showed progression of prediabetic state or advanced towards diabetes in the following five years. Overall, the studied glycation sites appear to be promising biomarkers for subgrouping prediabetic patients to estimate their risk for the development of T2DM.

Aim/Objectives: There were two aims; improving type II diabetes glycaemic control; and enhancing the role of community pharmacists by engaging them in type II diabetes medicine management. Methods: This quantitative study collected data from both community pharmacists and patients. In a premises survey, 426 self-administered questionnaires were distributed to community pharmacies. In a knowledge survey, 125 questionnaires were distributed to community pharmacists. In a clinical trial, 40 community pharmacies were randomly assigned to be control (18) and intervention (22) premises. Each pharmacy recruited 4 or 5 patients with type II diabetes. 225 patients were recruited and assigned to receive usual pharmacist care (n=100) or a pre-defined pharmacist intervention (n=125). Results: Community pharmacists had good knowledge of diabetes with average scores 21/29 (±3.18). The differences between control and intervention groups in patients' HbA1c and FPG changes were not significant. In the intervention group patients' diabetes knowledge was significantly improved (p=0.031). In the intervention group HbA1c and FPG improved significantly and in the control group FPG improved significantly and HbA1c did not. Patients' self-reported self-management activities improved significantly around blood glucose measurements (p<0.001) and physical exercising (p=0.001). Attitudes around the value of tight control of diabetes improved (p<0.001). Conclusion: The findings suggest that community pharmacists in Libya may have the ability to improve type II diabetes care. The primary outcomes were not improved in intervention versus control. The before/after analysis showed significant improvement in primary outcomes in the intervention group and also in one of the primary outcomes in the control group. Patients' self-reported self-care activities and attitudes improved significantly in the intervention group.