Summary: In patients with complex diabetic foot ulcers (DFUs) involving exposed bone, tendon, muscle, and/or joint capsule with controlled osteomyelitis, adjunctive cryopreserved ultra-thick human amniotic membrane derived from umbilical cord (cUC) demonstrated comparable healing rates to standard of care (SOC) alone, which included debridement, wound management, offloading, and systemic antibiotics, though it was associated with similar adverse event rates. PICO Description Population Adults with complex diabetic foot ulcers (DFUs) exhibiting exposed bone, tendon, muscle, and/or joint capsule, with controlled osteomyelitis. Intervention Adjunctive treatment with cryopreserved ultra-thick human amniotic membrane derived from umbilical cord (cUC), applied at baseline and reapplied every…
Author: FWA
Summary: In young patients with obesity and generalized gingivitis, systemic administration of cerium oxide nanoparticles (Cerera) for 10 days following professional dental hygiene demonstrated significant reductions in oxidative and nitrosative stress markers, increased catalase activity, and normalization of oral colonization resistance compared to local treatment with Nanosept solution (CNPs combined with chlorhexidine) applied twice daily for 5 days, with both groups achieving gingivitis resolution without adverse effects. PICO Description Population Young patients diagnosed with obesity and generalized gingivitis, representing a population with both systemic metabolic dysfunction and local oral disease. Intervention Systemic administration of Cerera (cerium oxide nanoparticles) for 10…
Summary: In adults with obesity and/or type 2 diabetes (mean age 47.9 years, 74% female) referred for physical activity intervention, the Kiplin digital health program combining face-to-face sessions, online supervised sessions, and app-based gamified modules over 3 months demonstrated significantly greater increases in daily steps (+1085 during intervention, +1775 at follow-up) and moderate-to-vigorous physical activity compared to standard hospital-based supervised physical activity with 36 in-person sessions over 12 weeks, with notable individual variability in response patterns and comparable cost-effectiveness. PICO Description Population Adults with obesity and/or type 2 diabetes (mean age 47.9 years, 74% female) referred to University Hospital of…
Summary: In adults with obesity seeking to increase physical activity and improve weight management, a digital health physical activity program integrating gamification elements (points, achievements, challenges, social features) demonstrated significantly increased physical activity levels with potential for sustained behavior change compared to standard usual care without digital or gamified components, though it was associated with marked individual heterogeneity in response, with some participants thriving while others showed minimal engagement. PICO Description Population Adults with obesity enrolled to assess physical activity engagement and weight management outcomes. Intervention Digital health physical activity program integrating gamification elements including points, achievements, challenges, leaderboards, and…
Summary: In pregnant women diagnosed with hyperglycemia during pregnancy, a behavioral physical activity intervention promoting unsupervised moderate-intensity walking or stepping in conjunction with clinical medical nutrition therapy significantly mitigated late pregnancy declines in moderate-intensity physical activity compared to the typical reduction seen as pregnancy progresses compared to clinical medical nutrition therapy alone without behavioral physical activity intervention, though it was associated with no serious adverse effects and was deemed acceptable to participants, supporting feasibility for larger trials. PICO Description Population Pregnant women diagnosed with hyperglycemia during pregnancy, including gestational diabetes mellitus (GDM) and other forms of pregnancy-related glucose intolerance. Intervention…
Summary: In patients with chronic diabetes-related foot ulcers of at least 4 weeks’ duration, extracorporeal shockwave therapy (ESWT) at either high dose (500 shocks/cm²) or low dose (100 shocks/cm²) demonstrated significantly improved ulcer healing rates over 24 weeks compared to sham ESWT (device application without energy delivery) plus standard wound care, and was associated with only mild-to-moderate local discomfort during treatment and transient skin erythema, with no serious adverse events. PICO Description Population Patients with diabetes-related foot ulcers of at least 4 weeks’ duration, representing chronic wounds that have failed to progress with standard care alone. Intervention Extracorporeal shockwave therapy…
Summary: In adults diagnosed with diabetic polyneuropathy experiencing neuropathic pain (n=55), low-power laser therapy (LPLT) using 808 nm and 905 nm wavelengths at 6 J/cm² administered three times weekly for four weeks significantly reduced pain scores and improved quality of life compared to low-frequency ultrasound (LFU) therapy and control group receiving no active treatment, though it was associated with no significant adverse effects, demonstrating safety and tolerability of both physical therapy modalities. PICO Description Population Fifty-five adults diagnosed with diabetic polyneuropathy (DPN) experiencing neuropathic pain requiring symptomatic management. Intervention Low-power laser therapy (LPLT) using dual wavelengths (808 nm and 905…
Clinical Context The global obesity epidemic affects over 650 million adults worldwide, driving demand for effective and safe weight management interventions. While lifestyle modification remains foundational, many patients struggle to achieve meaningful weight loss through diet and exercise alone. Pharmacological options are limited by side effects, contraindications, or insufficient efficacy, creating interest in natural product supplements that might augment lifestyle interventions. Cyperus rotundus (nutgrass or purple nutsedge) has been used in traditional medicine systems including Ayurveda for various conditions. The rhizome contains stilbene compounds with documented antioxidant, anti-inflammatory, and metabolic effects in preclinical studies. These phytochemicals may influence lipid metabolism,…
Clinical Context Gestational diabetes mellitus (GDM) affects approximately 6-9% of pregnancies in the United States and up to 14% globally, with prevalence rising alongside the obesity epidemic. The consequences extend beyond pregnancy: women with GDM face a 7-fold increased lifetime risk of developing type 2 diabetes, while their offspring have elevated risks of childhood obesity, metabolic syndrome, and future diabetes. Preventing GDM therefore offers an opportunity to interrupt intergenerational cycles of metabolic disease. The Mediterranean diet—characterized by high intake of vegetables, fruits, legumes, nuts, whole grains, fish, and olive oil, with moderate wine consumption and limited red meat and processed…
Summary: In socioeconomically disadvantaged women with type 2 diabetes mellitus, a structured 12-week yoga program designed for glycemic control and diabetes self-care enhancement demonstrated significant improvements in HbA1c and diabetes self-care behaviors compared to standard diabetes management including usual care and education, and was associated with no significant adverse events throughout the intervention period. PICO Description Population Socioeconomically disadvantaged women diagnosed with type 2 diabetes mellitus, representing an underserved population with limited access to conventional diabetes lifestyle interventions. Intervention A structured 12-week yoga program specifically designed to improve glycemic control and enhance diabetes self-care behaviors, delivered in a group format…