Cutaneous Manifestations Associated with Diabetes Mellitus-A Retrospective Study

A Comparative Analysis of Clinical Features of Diabetes Mellitus Type 2 With Respect to Duration of Diabetes

Objectives Diabetes mellitus type 2 is a chronic metabolic disorder characterized by insulin resistance and progressive beta-cell dysfunction. As diabetes persists over time, more pronounced symptoms like polyuria, polydipsia, fatigue, and complications like neuropathy, retinopathy, and cardiovascular issues may develop. Therefore, this study assessed the clinical symptoms associated with type 2 diabetes regarding the duration of diabetes. Methodology This cross-sectional study was conducted in a secondary care hospital, using a non-probability convenient sampling method. Patients visiting the outpatient clinics were recruited in the study after obtaining informed written consent from them. The duration of the study was about six months from March 1, 2024, to August 31, 2024. A sample of 450 type 2 diabetic patients, aged 40-65 years, was included in this study. The study identified patients with type 2 diabetes by using their altered glycosylated hemoglobin (HbA1c) level recorded within the last 30 days, which reflects glycemic control. The demographic information, including age, gender, socioeconomic status, health condition, co-existing illnesses, and diabetes-related symptoms was also collected from the patients. SPSS software was used for data analysis. A chi-square and one-way analysis of variance (ANOVA) were employed to determine the association of clinical symptoms in type 2 diabetes mellitus. Results The study findings showed that the mean age was significantly higher in patients with diabetes for less than one year (60.44±15.88 years) compared to those with diabetes for one to five years (52.26±14.37 years) and more than five years (53.95±14.28 years) (p<0.001). The association of gender, comorbidities, and socioeconomic status with the duration of diabetes revealed a significant difference (p<0.001). Frequent urination was significantly more common in the less than one-year group 89(59.3%) compared to the one to five years 54(36.0%) and more than five years 11(7.3%) (p<0.001). Conclusion Diabetes mellitus is a very prevalent systemic disease, with various musculoskeletal and psychosocial symptoms. The frequency of these symptoms varies with respect to the duration of diabetes. In this study, we outlined the various symptoms of diabetes and their relation to the duration of diabetes. Among various symptoms, dyspnea, chest tightness, and muscle cramps increase with increasing duration of diabetes.

Comprehensive Review of the Latest Investigations of the Health-Enhancing Effects of Selected Properties of Arthrospira and Spirulina Microalgae on Skin

Arthospira platensis and Spirulina platensis microalgae are a rich source of pro-health metabolites (% d.m.): proteins (50.0-71.3/46.0-63.0), carbohydrates (16.0-20.0/12.0-17.0), fats (0.9-14.2/6.4-14.3), polyphenolic compounds and phenols (7.3-33.2/7.8-44.5 and 4.2/0.3 mg GAE/g), and flavonoids (1.9/0.2 QUE/g) used in pharmaceutical and cosmetic formulations. This review summarises the research on the chemical profile, therapeutic effects in dermatological problems, application of Arthrospira and Spirulina microalgae, and contraindications to their use. The pro-health properties of these microalgae were analysed based on the relevant literature from 2019 to 2024. The antiviral mechanism of microalgal activity involves the inhibition of viral replication and enhancement of immunity. The anti-acne activity is attributed to alkaloids, alkanes, phenols, alkenes, phycocyanins, phthalates, tannins, carboxylic and phthalic acids, saponins, and steroids. The antibacterial activity generally depends on the components and structure of the bacterial cell wall. Their healing effect results from the inhibition of inflammatory and apoptotic processes, reduction of pro-inflammatory cytokines, stimulation of angiogenesis, and proliferation of fibroblasts and keratinocytes. The photoprotective action is regulated by amino acids, phlorotannins, carotenoids, mycosporins, and polyphenols inhibiting the production of tyrosinase, pro-inflammatory cytokines, and free oxygen radicals in fibroblasts and the stimulation of collagen production. Microalgae are promising molecular ingredients in innovative formulations of parapharmaceuticals and cosmetics used in the prophylaxis and therapy of dermatological problems. This review shows the application of spirulina-based commercial skin-care products as well as the safety and contraindications of spirulina use. Furthermore, the main directions for future studies of the pro-health suitability of microalgae exerting multidirectional effects on human skin are presented.

Pathology of Diabetes-Induced Immune Dysfunction

Diabetes is associated with numerous comorbidities, one of which is increased vulnerability to infections. This review will focus on how diabetes mellitus (DM) affects the immune system and its various components, leading to the impaired proliferation of immune cells and the induction of senescence. We will explore how the pathology of diabetes-induced immune dysfunction may have similarities to the pathways of "inflammaging", a persistent low-grade inflammation common in the elderly. Inflammaging may increase the likelihood of conditions such as rheumatoid arthritis (RA) and periodontitis at a younger age. Diabetes affects bone marrow composition and cellular senescence, and in combination with advanced age also affects lymphopoiesis by increasing myeloid differentiation and reducing lymphoid differentiation. Consequently, this leads to a reduced immune system response in both the innate and adaptive phases, resulting in higher infection rates, reduced vaccine response, and increased immune cells' senescence in diabetics. We will also explore how some diabetes drugs induce immune senescence despite their benefits on glycemic control.

Multicausal analysis of mortality due to diabetes mellitus in Spain, 2016-2018

OBJECTIVES

This study aimed to assess multicausal mortality due to diabetes from 2016-2018 in Spain. Specific objectives were to quantify the occurrence of diabetes as an underlying cause or as any registered cause on the death certificate.

MATERIALS AND METHODS

A cross-sectional descriptive study taking a multicausal approach.

RESULTS

Diabetes appears as an underlying cause of 2.3% of total deaths in Spain, and as any cause in 6.2%. In patients in whom Diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases in men(prevalence ratio 1,59)and women (PR1,31). In men, the causes associated with diabetes as any cause were skin diseases(prevalence ratio 1.33), followed by endocrine diseases(prevalence ratio 1.26)and genitourinary diseases (prevalence ratio1.14). In women, the causes associated with the presence of diabetes as any cause were endocrine (prevalence ratio 1.13)and genitourinary (prevalence ratio 1.04)diseases.

CONCLUSIONS

In patients in whom diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases. In men, the causes associated with the presence of diabetes as any cause of death are skin, endocrine and genitourinary diseases. In women, the causes associated with diabetes as any cause are endocrine and genitourinary.

The Intersection of Dermatological Dilemmas and Endocrinological Complexities: Understanding Necrobiosis Lipoidica-A Comprehensive Review

BACKGROUND

Necrobiosis lipoidica (NL) is a rare granulomatous skin disorder with a predilection for females, often associated with diabetes mellitus (DM). This paper aims to comprehensively review the literature on NL, focusing on its association with DM, thyroid disorders, and the metabolic syndrome.

METHODS

A systematic search was conducted in English-language literature from inception to October 2023, utilizing PubMed. We identified 530 studies and selected 19 based on clinical significance, statistical support, and relevance to the paper's goals.

RESULTS

The coexistence of NL and DM is prevalent, with rates ranging from 11% to 65.71%. NL may precede DM diagnosis and a correlation between NL and increased daily insulin requirements has been observed in such patients. NL is suggested as a potential prognostic marker for DM complications; however, recent studies question this association, highlighting the need for further research. Studies in the context of NL and Thyroid Disease indicate a correlation, especially with autoimmune thyroiditis. Regarding NL and Metabolic Syndrome, the prevalence of metabolic syndrome among NL patients is notably higher than in the general population. Additionally, DM patients with ulcerated NL commonly exhibit hypertension or obesity, raising questions about the potential influence of hypertension and obesity on NL ulcerations.

CONCLUSION

Additional research is required to untangle the complex connections between NL and various comorbidities.