{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:55:41Z","timestamp":1789682141653,"version":"4.0.1"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":118,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome","doi-asserted-by":"publisher","award":["MR\/T003537\/1"],"award-info":[{"award-number":["MR\/T003537\/1"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is prevalent in Nepal, with many seeking primary care through Ayurveda, a widely practiced traditional system. However, concerns exist about suboptimal care and variability in clinical practice among Ayurvedic practitioners. No evidence\u2010based clinical practice guideline (EB\u2010CPG) is available for managing T2DM. Therefore, an EB\u2010CPG was developed, and a feasibility study was conducted to inform a future cluster randomized controlled trial (RCT) assessing whether EB\u2010CPG improves T2DM management compared with usual practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A two\u2010arm feasibility cluster RCT was conducted in Ayurveda centers. Centers were randomized (1:1) by an independent statistician. Adults with newly diagnosed, treatment\u2010na\u00efve T2DM and glycated hemoglobin (HbA1c) of 6.5%\u2013&lt;\u20099% were recruited. Data collectors and the analyst were blinded to group allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen Ayurveda centers were approached, all recruited (seven\/group) and completed the study. One center withdrew and did not enroll participants. Of 151 potential participants, 121 (80%) were recruited (60 in intervention and 61 in control). Of those, 84% were followed up to 6 months (51\/group). The median adherence score to EB\u2010CPG among practitioners was 1\u20132 (partial to adequate adherence). The median (interquartile range) number of EB\u2010CPG\u2013recommended medicines not consumed by participants and days without consumption was 0 (0\u201310) and 0 (0\u20132.5), respectively. No serious adverse events occurred. Preliminary estimates suggest EB\u2010CPG\u2032s beneficial effects on HbA1c, fasting plasma glucose, and health\u2010related quality\u2010of\u2010life, though not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This feasibility trial demonstrated successful recruitment, follow\u2010up, and intervention adherence. A definitive trial is feasible to evaluate the intervention\u2032s effectiveness in T2DM management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration Number<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT05259735; first posted on March 02, 2022.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jdr\/2602864","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:56:33Z","timestamp":1777524993000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diabetes Management by Ayurvedic Practitioners Using a Clinical Guideline Versus Usual Practice: A Feasibility Cluster Randomized Trial in Nepal"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3235-8168","authenticated-orcid":false,"given":"Kaushik","family":"Chattopadhyay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shristi","family":"Karki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiquan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prerok","family":"Regmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradip","family":"Gyanwali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasudev","family":"Upadhyay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Heinrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bihungum","family":"Bista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4604-1986","authenticated-orcid":false,"given":"Nikhil","family":"Tandon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Kinra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8796-4114","authenticated-orcid":false,"given":"Sheila Margaret","family":"Greenfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhin Kanti","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panniyammakal","family":"Jeemon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Leonardi-Bee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Anne","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghnath","family":"Dhimal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_10_1_2","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation (IDF)","year":"2021"},{"key":"e_1_2_10_2_2","volume-title":"Guideline on Clinical Investigation of Medicinal Products in the Treatment or Prevention of Diabetes Mellitus","author":"European Medicines Agency (EMA)","year":"2023"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.53970.1"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.11.001"},{"key":"e_1_2_10_5_2","volume-title":"Annual Health Report 2079\/80","author":"Department of Health Services (DoHS)","year":"2024"},{"key":"e_1_2_10_6_2","volume-title":"Mapping the Availability of Ayurveda and Other Complementary Medicine Services Centers in Nepal","author":"Dhimal M.","year":"2018"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.405"},{"key":"e_1_2_10_8_2","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.2147\/PPA.S113467","article-title":"Nepalese Patients\u2032 Perceptions of Treatment Modalities for Type 2 Diabetes","volume":"10","author":"Sapkota S.","year":"2016","journal-title":"Patient Preference and Adherence"},{"key":"e_1_2_10_9_2","first-page":"177","article-title":"Quality and Effectiveness of Service Provision of Traditional Medicine Based Health Service Centres in Kathmandu, Nepal","volume":"11","author":"Koirala R. 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