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The purpose of this study was to evaluate the effect of redesigning the education program from individual instructional sessions to a format where the majority of instruction was provided through small group classes. Patient outcomes of lifestyle changes as evidenced by weight loss, improved glycemic control, adoption of a consistent pattern of blood glucose monitoring, and increased physical activity were evaluated using a physician satisfaction survey and a patient satisfaction and lifestyle change survey. The findings indicate that the changes in the education program accommodated a variety of needs; facilitated cost-effectiveness; were convenient for the patients, educators, and physicians; and still promoted adaptive lifestyle changes in behavior leading to improved glycemic control, increased levels of physical activity, and weight loss in persons with type 2 diabetes. 相似文献
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Glycogen in the placenta and its appendages is important for fetal well-being. The precise location of the glycogen stores, however, is unknown. This study was initiated to quantitate glycogen levels at well-defined sampling sites in more than 641 samples from 10 uncomplicated pregnancies and to correlate these glycogen levels with clinical and morphological variables. By biochemical assay, glycogen levels were greatest in the midumbilical cord section (29.08 +/- 1.18 mg/g dry wt) and lowest in the amnionic membrane (2.31 +/- 0.08 mg/g dry wt). Within the placental disk, parenchymal glycogen levels were greatest near the cord insertion (9.31 +/- 2.68 mg/g dry wt) and lowest at the periphery (5.71 +/- 1.14 mg/g dry wt). The midumbilical cord glycogen level showed strong direct correlations (P < .001) with birth weight, umbilical cord weight, and total calculated umbilical cord glycogen and somewhat lower but significant (P < .037) direct correlations with the calculated mean umbilical cord glycogen level, total calculated placental glycogen content, and placental weight. The glycogen level in the middisk parenchymal section from the fetal surface correlated directly with gestational age. Periodic acid-Schiff stains showed that magenta glycogen granules were most abundant in the cytoplasm of the vascular smooth muscle cells. These data show significant variations in glycogen levels among sampling sites. Definition of the precise sampling site is important for clinicopathologic studies of placental glycogen and for interstudy correlations. 相似文献
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