Functional characterization of alternative splicing in the C terminus of L-type CaV1.3 channels.

Ca(V)1.3 channels are unique among the high voltage-activated Ca(2+) channel family because they activate at the most negative potentials and display very rapid calcium-dependent inactivation. Both properties are of crucial importance in neurons of the suprachiasmatic nucleus and substantia nigra, where the influx of Ca(2+) ions at subthreshold membrane voltages supports pacemaking function. Previously, alternative splicing in the Ca(V)1.3 C terminus gives rise to a long (Ca(V)1.3(42)) and a short form (Ca(V)1.3(42A)), resulting in a pronounced activation at more negative voltages and faster inactivation in the latter. It was further shown that the C-terminal modulator in the Ca(V)1.3(42) isoforms modulates calmodulin binding to the IQ domain. Using splice variant-specific antibodies, we determined that protein localization of both splice variants in different brain regions were similar. Using the transcript-scanning method, we further identified alternative splicing at four loci in the C terminus of Ca(V)1.3 channels. Alternative splicing of exon 41 removes the IQ motif, resulting in a truncated Ca(V)1.3 protein with diminished inactivation. Splicing of exon 43 causes a frameshift and exhibits a robust inactivation of similar intensity to Ca(V)1.3(42A). Alternative splicing of exons 44 and 48 are in-frame, altering interaction of the distal modulator with the IQ domain and tapering inactivation slightly. Thus, alternative splicing in the C terminus of Ca(V)1.3 channels modulates its electrophysiological properties, which could in turn alter neuronal firing properties and functions.

Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

OBJECTIVE: To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. METHODS: Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). RESULTS: Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). CONCLUSION: There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. PRACTICE IMPLICATIONS: This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

What role could community pharmacists in Malaysia play in diabetes self-management education and support? The views of individuals with type 2 diabetes.

OBJECTIVES: This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia. METHODS: A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively. KEY FINDINGS: Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services. CONCLUSION: This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia.

The relationship of health beliefs and complication prevention behaviors of Chinese individuals with Type 2 Diabetes Mellitus.

This study aimed to identify the relationship of health beliefs and complication prevention behaviors among Chinese individuals with Type 2 Diabetes Mellitus in Malaysia. A correlation study using the Health Belief Model (HBM) framework was undertaken with 128 Chinese subjects with Type 2 Diabetes of both gender, mean age 60.5 +/- 8.42 years from one urban hospital and four rural health centers. Research tool was a 60-item questionnaire with responses recorded on 5-point Likert scale. Data was analyzed with descriptive statistics, Spearmen correlation and Mann-Whitney U-test. The majority of the subjects had less than 6 years of education. Seventy-two percent of them were aware of diabetes complications and its risk factors. However, few subjects practiced complication preventive measures because of lack of perceived seriousness of diabetes and lack of perceived susceptibility to diabetes complications. There were significant correlations between complication prevention behaviors and perceived severity (P < 0.05), perceived susceptibility (P < 0.05 ) and perceived barrier (P < 0.05 ); subjects' education level and perceived severity (P < 0.05), perceived susceptibility (P < 0.05) and complication prevention behavior (P < 0.05). There was no significant correlation between health beliefs and settings; genders; disease duration and treatment mode. In conclusion, poor complication preventive behavior among the subjects was associated with lack of perceived seriousness of diabetes and lack of perceived susceptibility to diabetes complications.