1
|
Kiran A, Shah NA, Khan SM, Ahmed H, Kamran M, Yousafzai BK, Ahmad Z, Yoo S, Han H, Alasqah I, Raposo A. Assessment of knowledge, attitude, and practices regarding the relationship of obesity with diabetes among the general community of Pakistan. Heliyon 2024; 10:e29081. [PMID: 38644838 PMCID: PMC11033058 DOI: 10.1016/j.heliyon.2024.e29081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/23/2024] Open
Abstract
This study sought to evaluate the influence of knowledge, attitude, and practices assessment on diabetes related to obesity in Pakistani society. Data was collected both through door to door and online survey approaches from 518 participants by using a pre-validated questionnaire. A total of 15.6% were underweight, 61.2% were normal weight, 17.2% were overweight and 5.8% were in obesity class I and 2.9% were classified as obesity class II. The co-occurrence of obesity and diabetes was 29% (n = 22) among diabetic individuals (n = 84). A majority of the residents (59.1%) were from cities. While 94% of the participants responded to what obesity was, 83.8% knew what diabetes was. Fast food, soft drinks, and mayonnaise were deemed to be healthy by 75.1% of the respondents. Obesity was viewed as a disease by 94.8%, a major health issue by 78.2%, and a weight-loss necessity by 44.6% of participants. Only 24.9% exercised every day, and 23.9% engaged in any physical activity daily. The majority of respondents (50.6%) never tried to lose weight and 23.2% ate junk food daily. The sociodemographic variables showed that the age ranges of 25-34 years (P < 0.001; OR 0.531), 45-54 years (P < 0.05; OR 0.527), and urban residency (P < 0.001; OR 0.128) had a significant association with knowledge. The factors of urban residency (P < 0.001; OR 3.996), being unmarried (P < 0.001; OR 1.95), and having an income of 51,000-70,000 (P < 0.001; OR 11.29) showed a very highly significant association with a good attitude regarding the relationship of obesity with diabetes (P < 0.05). Similarly, practices of the participants showed significant association with BMI range of 18.5-24.9 and 25-29.9 (P < 0.001). Our study revealed significant knowledge and understanding of the relationship between obesity with diabetes. However, it was observed that majority of respondents exhibited fundamental knowledge regarding obesity and diabetes, there was a notable absence of understanding regarding crucial elements, such as the significance of maintaining a healthy body weight, participating in physical activity, and implementing appropriate dietary strategies for weight control. We recognize the necessity for education initiatives and strongly encourage them to assist individuals in managing diabetes resulting from obesity.
Collapse
Affiliation(s)
- Arooj Kiran
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Naseer Ali Shah
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Shujaul Mulk Khan
- Department of Plant Sciences, Quaid-i-Azam University Islamabad, Pakistan
- Pakistan Academy of Sciences Islamabad, Pakistan
- International Society of Ethnobiology, Marrakech, Morocco
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Muhammad Kamran
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | | | - Zeeshan Ahmad
- Department of Plant Sciences, Quaid-i-Azam University Islamabad, Pakistan
| | - Sunghoon Yoo
- Hanmoo Convention (Oakwood Premier), 49, Teheran-ro 87-gil, Gangnam-gu, Seoul 06164, South Korea
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, South Korea
| | - Ibrahim Alasqah
- Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, P.O. Box 6666, Saudi Arabia
- School of Health, University of New England, Armidale, NSW, 2351, Australia
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024, Lisboa, Portugal
| |
Collapse
|
2
|
da Silva SMSD, Ferreira CL, Rizzato JMB, Toledo GDS, Furukawa M, Rovai ES, Nogueira MS, de Carvalho LFDCES. Infrared spectroscopy for fast screening of diabetes and periodontitis. Photodiagnosis Photodyn Ther 2024:104106. [PMID: 38677501 DOI: 10.1016/j.pdpdt.2024.104106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/12/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024]
Abstract
SIGNIFICANCE FT-IR is an important and emerging tool, providing information related to the biochemical composition of biofluids. It is important to demonstrate that there is an efficacy in separating healthy and diseased groups, helping to establish FT-IR uses as fast screening tool. AIM Via saliva diagnosis evaluate the accuracy of FT-IR associate with machine learning model for classification among healthy (control group), diabetic (D) and periodontitis (P) patients and the association of both diseases (DP). APPROACH Eighty patients diagnosed with diabetes and periodontitis through conventional methods were recruited and allocated in one of the four groups. Saliva samples were collected from participants of each group (n=20) and were processed using Bruker Alpha II spectrometer in a FT-IR spectral fingerprint region between 600 and-1800 cm-1, followed by data preprocessing and analysis using machine learning tools. RESULTS Various FTI-R peaks were detectable and attributed to specific vibrational modes, which were classified based on confusion matrices showed in paired groups. The highest true positive rates (TPR) appeared between groups C vs D (93.5% ± 2.7%), groups C vs. DP (89.2% ± 4.1%), and groups D and P (90.4% ± 3.2%). However, P vs DP presented higher TPR for DP (84.1% ±3.1%) while D vs. DP the highest rate for DP was 81.7% ±4.3%. Analyzing all groups together, the TPR decreased. CONCLUSION The system used is portable and robust and can be widely used in clinical environments and hospitals as a new diagnostic technique. Studies in our groups are being conducted to solidify and expand data analysis methods with friendly language for healthcare professionals. It was possible to classify healthy patients in a range of 78-93% of accuracy. Range over 80% of accuracy between periodontitis and diabetes were observed. A general classification model with lower TPR instead of a pairwise classification would only have advantages in scenarios where no prior patient information is available regarding diabetes and periodontitis status.
Collapse
Affiliation(s)
| | | | | | | | - Monique Furukawa
- Science Health Post-graduate Program, University of Taubaté - UNITAU, SP, Brazil.
| | - Emanuel Silva Rovai
- Department of Diagnosis and Surgery, Institute of Science and Technology of São José dos Campos, Universidade Estadual Paulista (Unesp), São José Dos Campos, SP, Brazil.
| | - Marcelo Saito Nogueira
- Tyndall National Institute, University College Cork, Cork, Ireland; Department of Physics, University College Cork, Cork, Ireland.
| | | |
Collapse
|
3
|
Giakoumaki M, Lambrou GI, Vlachodimitropoulos D, Tagka A, Vitsos A, Kyriazi M, Dimakopoulou A, Anagnostou V, Karasmani M, Deli H, Grigoropoulos A, Karalis E, Rallis MC, Black HS. Type I Diabetes Mellitus Suppresses Experimental Skin Carcinogenesis. Cancers (Basel) 2024; 16:1507. [PMID: 38672589 PMCID: PMC11048394 DOI: 10.3390/cancers16081507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
This study explores the previously uncharted territory of the effects of ultraviolet (UV) radiation on diabetic skin, compared to its well-documented impact on normal skin, particularly focusing on carcinogenesis and aging. Employing hairless SKH-hr2, Type 1 and 2 diabetic, and nondiabetic male mice, the research subjected these to UV radiation thrice weekly for eight months. The investigation included comprehensive assessments of photoaging and photocarcinogenesis in diabetic versus normal skin, measuring factors such as hydration, trans-epidermal water loss, elasticity, skin thickness, melanin, sebum content, stratum corneum exfoliation and body weight, alongside photo documentation. Additionally, oxidative stress and the presence of hydrophilic antioxidants (uric acid and glutathione) in the stratum corneum were evaluated. Histopathological examination post-sacrifice provided insights into the morphological changes. Findings reveal that under UV exposure, Type 1 diabetic skin showed heightened dehydration, thinning, and signs of accelerated aging. Remarkably, Type 1 diabetic mice did not develop squamous cell carcinoma or pigmented nevi, contrary to normal and Type 2 diabetic skin. This unexpected resistance to UV-induced skin cancers in Type 1 diabetic skin prompts a crucial need for further research to uncover the underlying mechanisms providing this resistance.
Collapse
Affiliation(s)
- Maria Giakoumaki
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - George I. Lambrou
- Choremeio Research Laboratory, First Department of Pediatrics, School of Health Sciences, Medical School, National and Kapodistrian University of Athens, Thivon & Levaeias 8, Goudi, 11527 Athens, Greece;
- Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Thivon & Levadeias 8, 11527 Athens, Greece
| | - Dimitrios Vlachodimitropoulos
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Street, 11527 Athens, Greece;
| | - Anna Tagka
- First Department of Dermatology and Venereology, ‘Andreas Syggros” Hospital, School of Medicine, National and Kapodistrian University of Athens, Ionos Dragoumi 5, 11621 Athens, Greece;
| | - Andreas Vitsos
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Maria Kyriazi
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Aggeliki Dimakopoulou
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Vasiliki Anagnostou
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Marina Karasmani
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Heleni Deli
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Andreas Grigoropoulos
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Evangelos Karalis
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Michail Christou Rallis
- Division of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, Panepistimiopolis, 15784 Athens, Greece; (M.G.); (A.V.); (M.K.); (A.D.); (V.A.); (M.K.); (H.D.); (A.G.); (E.K.)
| | - Homer S. Black
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA;
| |
Collapse
|
4
|
Piñas García P, Ruíz Romero MV, Luque Romero LG, Gómez Jiménez CA, Castillón Torre L, Hernández Martínez FJ. [Evaluation of the management and follow-up of diabetic patients in the prevention of diabetic retinopathy]. Rev Esp Salud Publica 2024; 98:e202404030. [PMID: 38597266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/23/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE Diabetes mellitus is a chronic disease with high morbidity and mortality, affecting 537 million adults worldwide. Spain is the second European country in prevalence, with 14.8% in the population aged twenty/seventy-nine years; with 11.6 cases per 1,000 people/year. Diabetic retinopathy (DR) is the fifth cause of vision loss worldwide and the seventh cause of blindness/visual impairment among members of the National Organization of the Blind in Spain (ONCE). Early detection of DR prevents blindness in diabetics and is conditioned by glycosylated hemoglobin. The aim of this paper was to analyze the management of diabetic patients in Aljarafe region (Seville) and identify opportunities for improvement in the coordination of their follow-up between the Primary Care physician and the ophthalmologist. METHODS A retrospective observational study (2016-2019) was carried out, with patients registered in the diabetic census of the twenty-eight municipalities of Aljarafe. The primary care and hospital health history, and telemedicine program were consulted. About statistical analysis, for qualitative variables, totals and percentages were calculated; for quantitative variables, mean and standard deviation (if normally distributed) and median and quartiles (if non-normally distributed). RESULTS There were 17,175 diabetics registered in Aljarafe (5.7% of the population); 14,440 patients (84.1%) had some determination of hemoglobin during the period, 9,228 (63.9%) had all of them in the appropriate range. Fundoscopic control was performed on 12,040 diabetics (70.1%), and of those who did not, 346 (10.6%) had all of them out of range. There were 1,878 (10.9%) patients without fundoscopic or metabolic control, 1,019 (54.3%) were women, 1,219 (64.9%) were under sixty-five years of age, 1,019 (54.3%) had severe comorbidity. CONCLUSIONS Most patients have adequate screening, and more than half have determinations within range. However, a significant percentage with no glycated hemoglobin within range lack fundoscopic control, and another smaller group lack fundoscopic or metabolic control, with inter-municipal variability. We propose to improve communication channels between levels.
Collapse
Affiliation(s)
| | - María Victoria Ruíz Romero
- Unidad de Calidad e Investigación. Hospital San Juan de Dios Aljarafe (HSJDA). Bormujos (Sevilla). España
| | | | | | - Luis Castillón Torre
- Servicio de Oftalmología. Jefe de servicio. Hospital San Juan de Dios Aljarafe (HSJDA). Bormujos (Sevilla). España
| | | |
Collapse
|
5
|
Shah R, Kong Ibanez A, De Melo SW, Boktor M, Henriquez R, Mandalia A, Samant H, Alvarez C, Mansi I. EXPRESS: Association of Statins with Onset and Progression of Non-Alcoholic Fatty Liver Disease in Patients with Diabetes. J Investig Med 2024:10815589241248076. [PMID: 38594224 DOI: 10.1177/10815589241248076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease in patients with diabetes; limited data suggested that statins may reduce the risk of NAFLD progression. This study aimed to examine the association between statins and the development or progression of NAFLD in veterans with diabetes. In a new-user negative control design, we conducted a retrospective propensity-score (PS) matched cohort study of patients with diabetes between 2003 and 2015. After excluding patients with other causes of liver disease, we formed PS using 85 characteristics. The primary outcome was a composite NAFLD progression outcome. Primary analysis examined odds of outcome in PS matched cohort. Post-hoc analysis included PS-matched cohort of statin users with intensive lowering of LDL-cholesterol versus low-intensity lowering. We matched 34,102 pairs from 300,739 statin users and 38,038 non-users. The composite outcome occurred in 8.8% of statin users and 8.6% of non-users (odds ratio [OR]: 1.02; 95% confidence interval [95%CI]: 0.97-1.08). In the post-hoc analysis, intensive lowering of LDL-cholesterol compared to low-intensity showed increased NAFLD progression (OR: 1.21, 95%CI: 1.13-1.30). This study showed that statin use in patients with diabetes was not associated with decreased or increased risk of NAFLD progression. Intensive LDL-cholesterol lowering compared to low-intensity LDL-cholesterol lowering was associated with an increased risk of NAFLD progression.
Collapse
Affiliation(s)
- Raj Shah
- University of Central Florida/HCA Florida Healthcare, Greater Orlando, FL
- Department of Education, Orlando VA Healthcare System, Orlando, FL
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
| | - Alexander Kong Ibanez
- University of Central Florida/HCA Florida Healthcare, Greater Orlando, FL
- Department of Education, Orlando VA Healthcare System, Orlando, FL
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
| | - Silvio W De Melo
- Section of Gastroenterology, Orlando VA Healthcare System, Orlando, FL
| | - Moheb Boktor
- Department of Gastroenterology, UT Southwestern, Dallas TX
| | - Richard Henriquez
- University of Central Florida/HCA Florida Healthcare, Greater Orlando, FL
- Department of Education, Orlando VA Healthcare System, Orlando, FL
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
| | - Amar Mandalia
- Section of Gastroenterology, Orlando VA Healthcare System, Orlando, FL
| | | | - Carlos Alvarez
- Department of Pharmacy Practice, Texas Tech University Health Sciences Center, Dallas, Texas, United States of America
| | - Ishak Mansi
- University of Central Florida/HCA Florida Healthcare, Greater Orlando, FL
- Department of Education, Orlando VA Healthcare System, Orlando, FL
- Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL
| |
Collapse
|
6
|
Cheema MRS. Unveiling the interplay: Diabetes and lumbar stenosis surgery outcomes. Clin Neurol Neurosurg 2024; 239:108207. [PMID: 38458056 DOI: 10.1016/j.clineuro.2024.108207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
|
7
|
Jang SA, Min Kim K, Jin Kang H, Heo SJ, Sik Kim C, Won Park S. Higher mortality and longer length of stay in hospitalized patients with newly diagnosed diabetes. Diabetes Res Clin Pract 2024; 210:111601. [PMID: 38432469 DOI: 10.1016/j.diabres.2024.111601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
AIMS We investigated the association between diabetes status at admission and in-hospital outcomes in all hospitalized patients, regardless of the reason for admission. METHODS All individuals aged 20 years or older who were admitted to Yongin Severance Hospital between March 2020 and February 2022 were included in study. Subjects were categorized into three groups: non-DM, known DM, and newly diagnosed DM, based on medical history, anti-diabetic medications use, and laboratory test. Hospitalization-related outcomes, including in-hospital mortality and length of hospital stay, were compared between groups. RESULTS 33,166 participants were enrolled. At hospitalization, 6,572 (19.8 %) subjects were classified as known DM, and another 2,634 (7.9 %) subjects were classified as newly diagnosed DM. In-hospital mortality was highest in newly diagnosed DM (HR 1.89, 95% CI 1.58-2.26, p < 0.001) followed by known DM (HR 1.41, 95% CI 1.18-1.69, p < 0.001) compared to non-DM. Length of hospital stay was significantly longer in newly diagnosed DM (median [IQR] 9.0 [5.0-18.0],days) than known DM (median [IQR] 5.0 [3.0-10.0],days)(p < 0.001) and non-DM (median [IQR] 4.0 [2.0-7.0],days). After adjusting for multiple covariates, newly diagnosed diabetes was independently associated with increased in-hospital mortality (p < 0.001). CONCLUSIONS Diabetes status at admission was closely linked to hospitalization-related outcomes. Notably, individuals with newly diagnosed diabetes demonstrated a higher risk of in-hospital mortality and a prolonged length of hospital stay.
Collapse
Affiliation(s)
- Seol A Jang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Kyoung Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Hye Jin Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Sik Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Seok Won Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
| |
Collapse
|
8
|
Tayyib HMU, Ali A, Jabeen S, Habib-Ur-Rehman, Kamran H, Bajaber MA, Usman M, Zhang X. Restoration of gut dysbiosis through Clostridium butyricum and magnesium possibly balance blood glucose levels: an experimental study. BMC Microbiol 2024; 24:105. [PMID: 38561662 PMCID: PMC10983686 DOI: 10.1186/s12866-024-03218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024] Open
Abstract
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by an elevated level of blood glucose due to the absence of insulin secretion, ineffectiveness, or lack of uptake of secreted insulin in the body. The improperly diagnosed and poorly managed DM can cause severe damage to organs in the body like the nerves, eyes, heart, and kidneys. This study was aimed at investigating the effect of Clostridium butyricum (probiotic) with magnesium supplementation to evaluate the effect on gut microbial dysbiosis and blood glucose levels. In the laboratory, 6-8 weeks old 24 male albino rats weighing 200-250 g were given free access to water and food. Diabetes was induced using streptozotocin (60 mg/kg) in overnight fasted rats. Diabetic rats were randomly divided into four groups (n = 6, 6 replicates in each group). Metformin (100 mg/kg/day) with a standard basal diet was provided to control group (G0), Clostridium butyricum (1.5 × 105 CFU/day) with standard basal diet was provided to treatment group (G1), magnesium (500 mg/kg/day) was provided to group (G2). Clostridium butyricum (1.5 × 105 CFU/day) and magnesium (300 mg/kg/day) in combination with a standard basal diet was provided to group (G3). Blood Glucose, Magnesium blood test and microbial assay were done. Random blood glucose levels were monitored twice a week for 21 days and were represented as mean of each week. The results conclude that Clostridium butyricum (1.5 × 105 CFU) is very effective in balancing random blood glucose levels from 206.6 ± 67.7 to 85.1 ± 3.8 (p = 0.006) compared to other groups (p > 0.005). The results of stool analysis showed that Clostridium butyricum as probiotic restores microbial dysbiosis as evident by the 105 CFU Clostridium butyricum load in G1, which was higher than G0, G2 and G3 which were 103 and 104 CFU respectively. The findings of this study conclude that Clostridium butyricum supplementation improved blood glucose levels and intestinal bacterial load in type II diabetes mellitus.
Collapse
Affiliation(s)
- Hafiz Muhammad Ubaid Tayyib
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Amjed Ali
- University Institute of Physical therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Shaista Jabeen
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Habib-Ur-Rehman
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Hafsa Kamran
- University Institute of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Majed A Bajaber
- Department of Chemistry, Faculty of Science, King Khalid University, P.O. Box 9004, Abha, 61413, Saudi Arabia
| | - Muhammad Usman
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China.
| | - Xiao Zhang
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, P. R. China.
- Yantai Longch Technologies. CO., LTD, Yantai, P. R. China.
| |
Collapse
|
9
|
Chika-Igwenyi NM, Unigwe US, Ajayi NA, Onwe OE, Ewa RL, Ojide CK, Una AF, Igwenyi C, Chukwu KS, Okorie GM, Nnadozie UU, Ifebunandu NA, Ugwu CN, Emeka S, Ibemesi D, Nnaji TO, Primus NO, Odianosen E. Atypical Mpox in a Nigerian Tertiary Health Facility. J Infect Dis 2024; 229:S181-S187. [PMID: 38157416 DOI: 10.1093/infdis/jiad607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND We describe diverse clinical characteristics and course of confirmed mpox cases managed in a Nigerian tertiary health facility. METHODS Clinical and epidemiologic data were analyzed, highlighting the unusual presentations of polymerase chain reaction (PCR)-confirmed mpox cases observed during the 2022 outbreak. RESULTS Out of 17 suspected cases, 13 (76.4%) were PCR confirmed for mpox. The mean ± SD age for the participants was 28.62 ± 10.29 years (range, 2-55), of which 9 (64.3%) were male. Of the 13 PCR-confirmed cases, 5 (38.5%) had varicella zoster virus coinfection, 2 (15.4%) had HIV coinfection, and 1 (7.7%) had diabetes mellitus comorbidity. All patients experienced rash, with 6 (46.2%) having significant genital lesions and 1 (7.7%) having a severe perianal lesion. A lack of prodromal symptoms was reported in 3 (23.1%), and a prolonged prodrome (>1 week) occurred in 5 (38.5%). Skin lesions were polymorphic in 6 (46.2%), and solitary skin lesions occurred in 3 (23.1%), which persisted for >120 days in 7.7%. CONCLUSIONS Clinical recognition, diagnosis, and prevention remain a concern in resource-limited settings. Our findings highlight the need to further evaluate unusual skin lesions and to include mpox screening for genital skin lesions that are presumed to be sexually transmitted infections. Revision of clinical case definition and enhanced surveillance are key to early recognition and prevention of spread.
Collapse
Affiliation(s)
- Nneka M Chika-Igwenyi
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Uche S Unigwe
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla
| | - Nnennaya A Ajayi
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Ogah E Onwe
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
- Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Richard L Ewa
- Department of Anaesthesia, Alex Ekwueme FederalUniversity Teaching Hospital Abakliki
| | - Chiedozie K Ojide
- Department of Medical Microbiology, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Alfred F Una
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla
| | - Chikaodiri Igwenyi
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Kyrian S Chukwu
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Gabriel M Okorie
- Department of Plastic Surgery, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Ugochukwu U Nnadozie
- Department of Plastic Surgery, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Ngozi A Ifebunandu
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | - Collins N Ugwu
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | | | - Desi Ibemesi
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla
| | - Thomas O Nnaji
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki
| | | | | |
Collapse
|
10
|
Prazeres F. [Family Physicians and Nutritionists in Health Centers, Commentary on "Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study"]. ACTA MEDICA PORT 2024. [PMID: 38527333 DOI: 10.20344/amp.21218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/09/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Filipe Prazeres
- Unidade de Saúde Familiar Beira Ria. Gafanha da Nazaré; Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal
| |
Collapse
|
11
|
Silverii GA, Fumagalli C, Rozzini R, Milani M, Mannucci E, Marchionni N. Is Metformin Use Associated with a More Favorable COVID-19 Course in People with Diabetes? J Clin Med 2024; 13:1874. [PMID: 38610639 PMCID: PMC11012895 DOI: 10.3390/jcm13071874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Diabetes Mellitus (DM) has been associated with a higher Coronavirus disease-19 (COVID-19) mortality, both in hospitalized patients and in the general population. A possible beneficial effect of metformin on the prognosis of COVID-19 has been reported in some observational studies, whereas other studies disagree. Methods: To investigate the possible effect of metformin on COVID-19 in-hospital mortality, we performed a retrospective study that included all SARS-CoV-2-positive patients with DM who were admitted to two Italian hospitals. In order to adjust for possible confounders accounting for the observed reduction of mortality in metformin users, we adopted the COVID-19 Mortality Risk Score (COVID-19 MRS) as a covariate. Results: Out of the 524 included patients, 33.4% died. A binomial logistic regression showed that metformin use was associated with a significant reduction in case fatality (OR 0.67 [0.45-0.98], p = 0.039), with no significant effect on the need for ventilation (OR 0.75 [0.5-1.11], p = 0.146). After adjusting for COVID-19 MRS, metformin did not retain a significant association with in-hospital mortality [OR 0.795 (0.495-1.277), p = 0.342]. Conclusions: A beneficial effect of metformin on COVID-19 was not proven after adjusting for confounding factors. The use of validated tools to stratify the risk for COVID-19 severe disease and death, such as COVID-19 MRS, may be useful to better explore the potential association of medications and comorbidities with COVID-19 prognosis.
Collapse
Affiliation(s)
- Giovanni Antonio Silverii
- Experimental and Clinical Biomedical Sciences “Mario Serio” Department, University of Florence, 50134 Florence, Italy (G.A.S.)
| | - Carlo Fumagalli
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Renzo Rozzini
- Department of Internal Medicine and Geriatrics, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy;
| | - Marta Milani
- Experimental and Clinical Biomedical Sciences “Mario Serio” Department, University of Florence, 50134 Florence, Italy (G.A.S.)
| | - Edoardo Mannucci
- Experimental and Clinical Biomedical Sciences “Mario Serio” Department, University of Florence, 50134 Florence, Italy (G.A.S.)
| | - Niccolò Marchionni
- Experimental and Clinical Medicine Department, University of Florence, 50134 Florence, Italy;
| |
Collapse
|
12
|
Chen GC, Nyarko Hukportie D, Fan WD, Lyu JQ, Wang HP, Qin L, Wu XB, Li FR. Microvascular disease, modifiable risk factor profiles and incident arrhythmias in type 2 diabetes. Heart 2024:heartjnl-2023-323527. [PMID: 38514173 DOI: 10.1136/heartjnl-2023-323527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 03/04/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND To assess the roles of diabetic microvascular disease and modifiable risk factors and their combination in the development of arrhythmias. METHODS We included participants with type 2 diabetes (T2D) who were free of arrhythmias during recruitment in the UK Biobank study. The associations of microvascular disease states (defined by the presence of retinopathy, peripheral neuropathy or chronic kidney disease), four modifiable arrhythmic risk factors (body mass index, smoking, systolic blood pressure and glycosylated haemoglobin) and their joint associations with incident arrhythmias were examined. RESULTS Among the 25 632 participants with T2D, 1705 (20.1%) of the 8482 with microvascular disease and 2017 (11.8%) of the 17 150 without microvascular disease developed arrhythmias during a median follow-up of 12.3 years. Having any of the three microvascular diseases was associated with a 48% increase in the hazard of developing arrhythmias. Incorporating microvascular disease states into a model alongside 11 traditional risk factors significantly enhanced arrhythmia prediction. Furthermore, individuals with microvascular disease who had optimal levels of zero to one, two, three or four arrhythmic risk factors showed an HR of 2.05 (95% CI 1.85, 2.27), 1.67 (95% CI 1.53, 1.83), 1.35 (95% CI 1.22, 1.50) and 0.91 (95% CI 0.73, 1.13), respectively, compared with those without microvascular disease. CONCLUSIONS Although microvascular disease, a non-traditional risk factor, was associated with incident arrhythmias in individuals with T2D, having optimal levels of risk factors may mitigate this risk.
Collapse
Affiliation(s)
- Guo-Chong Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | | | - Wei-Dong Fan
- Southern Medical University School of Public Health, Guangzhou, Guangdong, China
| | - Jie-Qiong Lyu
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Hai-Peng Wang
- Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Liqiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Xian-Bo Wu
- Southern Medical University School of Public Health, Guangzhou, Guangdong, China
| | - Fu-Rong Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, China
| |
Collapse
|
13
|
Nouri H, Abtahi SH, Mazloumi M, Samadikhadem S, Fernando Arevalo J, Ahmadieh H. Optical coherence tomography angiography in diabetic retinopathy: A major review. Surv Ophthalmol 2024:S0039-6257(24)00021-3. [PMID: 38521424 DOI: 10.1016/j.survophthal.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
Diabetic retinopathy (DR) is characterized by retinal vasculopathy and is a leading cause of visual impairment. Optical coherence tomography angiography (OCTA) is an innovative imaging technology that can detect various pathologies and quantifiable changes in retinal microvasculature. We briefly describe its functional principles and advantages over fluorescein angiography and perform a comprehensive review on its clinical applications in the screening or management of people with prediabetes, diabetes without clinical retinopathy (NDR), nonproliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME). OCTA reveals early microvascular alterations in prediabetic and NDR eyes, which may coexist with sub-clinical neuroretinal dysfunction. Its applications in NPDR include measuring ischemia, detecting retinal neovascularization, and timing of early treatment through predicting the risk of retinopathy worsening or development of DME. In PDR, OCTA helps characterize the flow within neovascular complexes and evaluate their progression or regression in response to treatment. In eyes with DME, OCTA perfusion parameters may be of predictive value regarding the visual and anatomical gains associated with treatment. We further discussed the limitations of OCTA and the benefits of its incorporation into an updated DR severity scale.
Collapse
Affiliation(s)
- Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mazloumi
- Eye Research Center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sanam Samadikhadem
- Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Quesada JA, López-Pineda A, Orozco-Beltrán D, Carratalá-Munuera C, Barber-Vallés X, Gil-Guillén VF, Nouni-García R, Carbonell-Soliva Á. Diabetes mellitus as a cause of premature death in small areas of Spain by socioeconomic level from 2016 to 2020: A multiple-cause approach. Prim Care Diabetes 2024:S1751-9918(24)00064-0. [PMID: 38514366 DOI: 10.1016/j.pcd.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/12/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE This study aimed to assess premature mortality due to Diabetes in small areas of Spain between 2016 and 2020, and its relationship with socioeconomic level and the immediate cause of death. As a secondary objective, we evaluated the effect of the Covid 19 pandemic. METHODS This was an ecological study of premature mortality due to Diabetes from 2016 to 2020, with a focus on small areas. All deaths in people under 75 years of age due to Diabetes as the underlying cause were included RESULTS: The final sample comprised 7382 premature deaths in 5967 census tracts. Women living in census tracts with an high level of deprivation(RR=2.40) were at a significantly higher risk. Mortality from Diabetes increased with deprivation, especially people aged 0-54(RR=2.40). People with an immediate cause of death related to a circulatory disease, living in census tracts with an high level of deprivation(RR=3.86) was associated with a significantly greater risk of death with underlying Diabetes. When a disease of the circulatory system was recorded as the immediate cause of death, being 65-74 years (RR=71.01) was associated with a significantly higher risk of premature mortality. CONCLUSIONS Living in geographic areas with higher levels of socioeconomic deprivation is associated with a higher risk of premature death from Diabetes in Spain. This relationship has a greater impact on women, people under 54 years, and people at risk of death caused directly by diseases of the circulatory system. Premature mortality due to diabetes saw a modest increase in 2020.
Collapse
Affiliation(s)
- José A Quesada
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Adriana López-Pineda
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Domingo Orozco-Beltrán
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Concepción Carratalá-Munuera
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain
| | - Xavier Barber-Vallés
- Center for Operations Research, University Miguel Hernández of Elche, Elche, Alicante, Spain
| | - Vicente F Gil-Guillén
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain; Primary care research center, Miguel Hernández University, Elche, Alicante, Spain; Institute of Health and Biomedical Research of Alicante, General University Hospital of Alicante. Diagnostic Center, Fifth floor. Pintor Baeza street, 12, Alicante 03110, Spain
| | - Rauf Nouni-García
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), San Juan de Alicante 03550, Spain; Institute of Health and Biomedical Research of Alicante, General University Hospital of Alicante. Diagnostic Center, Fifth floor. Pintor Baeza street, 12, Alicante 03110, Spain.
| | - Álvaro Carbonell-Soliva
- Clinical Medicine Department, School of Medicine, University of Miguel Hernández de Elche, Ctra. Nacional N-332 s/n, San Juan de Alicante 03550, Spain
| |
Collapse
|
15
|
Aguree S, Owora A, Hawkins M, Gletsu Miller N. EXPRESS: Obesity modifies the association between diabetes and iron biomarkers and red cell indices in reproductive-aged women in the US. J Investig Med 2024:10815589241240059. [PMID: 38445643 DOI: 10.1177/10815589241240059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Obesity and diabetes are associated with impaired iron metabolism. We aimed to examine the independent relationship between diabetes and iron after controlling for body weight (or obesity) in women aged 20-49 y. Data from the 2015-2018 NHANES was used in this investigation. Body composition data, HbAc1, and iron biomarkers (serum ferritin (SF), soluble transferrin receptor (sTfR), and body iron index (BII)), mean corpuscular volume (MCV), mean hemoglobin concentration (MCH), and red cell distribution width (RDW), and hemoglobin were used. Linear regression models were used to examine how and to what extent BMI modified the relationship between diabetes and iron status biomarkers. A total of 1585 women aged 20-49 were included in the analysis with a mean (SD) age of 32 .2 ± 6.1 y and BMI of 29.5 ± 6.9 kg/m2. The mean SF (p=0.014) and BII (p<0.001) were lower, while sTfR (p<0.001) was higher in women with diabetes than those with no diabetes. Mean estimates for MCV and MCH were lower, while RDW (p=0.001) was higher in diabetes patients (all p<0.001). Women with diabetes were more likely to have iron deficiency, anemia, and iron deficiency anemia than those without diabetes (18.1% vs. 8.6%, p<0.001), (24.4% vs. 8.4%, p<0.001) and (14.8% vs. 5.2%, p<0.001), respectively. Among women with obesity, those with diabetes had lower predicted ferritin (β=-0.19, p=0.016), BII (β=-0.99, p=0.016), and hemoglobin (β=-0.27, p=0.042) than those without diabetes. The study shows that diabetes is linked to lower iron stores, this is exacerbated in those with obesity.
Collapse
Affiliation(s)
- Sixtus Aguree
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN
| | - Arthur Owora
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Misty Hawkins
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN
| | - Nana Gletsu Miller
- Department of Applied Health Science, Indiana University School of Public Health- Bloomington, Bloomington, IN
| |
Collapse
|
16
|
Almeida DM, Santos-de-Araújo AD, Júnior JMCB, Cacere M, Pontes-Silva A, Costa CP, Gonçalves MC, Leite JMS, Dibai-Filho AV, Bassi-Dibai D. The best internal structure of the Diabetes Quality of Life Measure (DQOL) in Brazilian patients. BMC Public Health 2024; 24:580. [PMID: 38395813 PMCID: PMC10885374 DOI: 10.1186/s12889-024-18090-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is considered a chronic disease with numerous secondary complications that negatively affect the quality of life of patients. However, the specific, known and validated instruments for Brazilian Portuguese are too extensive, which often makes their use infeasible. OBJECTIVE To validate the internal structure of the Brazilian version of the Diabetes Quality of Life (DQOL) measure. METHODOLOGY Patients with DM type 1 or 2, between the ages of 18 and 76, were evaluated between April 2022 and May 2022. The survey was conducted online using the Google Forms platform. The original DQOL contains 46 multiple-choice questions organized into four domains. For structural validity, confirmatory factor analysis (CFA) was performed using RStudio software (Boston, MA, USA) with the packages lavaan and semPlot. RESULTS A total of 354 subjects were evaluated. The 3-domain, 24-item version of the DQOL was the most adequate, with acceptable values for all fit indices (chi-square/GL < 3, TLI and CFI > 0.90, and RMSEA and SRMR < 0.08). CONCLUSION The structure with three domains and 24 items is the most appropriate based on factor analysis. The Brazilian version of the DQOL with a structure of 3 domains and 24 items has adequate measurement properties that support its use in the clinical and scientific context in patients with DM.
Collapse
Affiliation(s)
- Denilson Menezes Almeida
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil
| | | | | | - Marcela Cacere
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Maria Cláudia Gonçalves
- Department of Physical Therapy, Universidade Ceuma, São Luís, Brazil
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Brazil
| | - José Márcio Soares Leite
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil
- Department of Medicine, Universidade Ceuma, São Luís, Brazil
| | | | - Daniela Bassi-Dibai
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil.
- Department of Physical Therapy, Universidade Ceuma, São Luís, Brazil.
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, Brazil.
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Brazil.
| |
Collapse
|
17
|
Shiba S, Harao M, Saito A, Sakuragi M, Kitayama J, Sata N. Metformin Alters Tumor Immune Microenvironment, Improving the Outcomes of Breast Cancer Patients With Type 2 Diabetes Mellitus. J Breast Cancer 2024; 27:27.e10. [PMID: 38529589 DOI: 10.4048/jbc.2023.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 03/27/2024] Open
Abstract
This study investigated the clinical effect of metformin on breast cancer patients with preexisting type 2 diabetes mellitus (T2DM). We analyzed 177 patients with T2DM who underwent breast cancer surgery and assessed tumor-associated macrophages (TAMs) and tumor-infiltrating lymphocytes (TILs) in patients who underwent tumor resection with or without metformin treatment using multiplex immunohistochemistry (IHC). Patients who received metformin either pre- or postoperatively exhibited reduced distant organ recurrence and improved postoperative recurrence-free survival compared to those of patients who did not. Additionally, in a subgroup of 40 patients receiving preoperative systemic therapy, metformin treatment was associated with increased rates of pathological complete response. IHC analysis revealed significantly lower levels of cluster of differentiation (CD) 68(+) CD163(+) M2-type TAMs (p < 0.01) but higher CD3(+) and CD8(+) TIL densities in the metformin-treated group compared with the same parameters in those without metformin treatment, with a significant difference in the CD8(+)/CD3(+) TIL ratio (p < 0.01). Despite the constraints posed by our small sample size, our findings suggest a potential role for metformin in modulating the immunological microenvironment, which may contribute to improved outcomes in diabetes patients with breast cancer.
Collapse
Affiliation(s)
- Satomi Shiba
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
- Department of Breast Oncology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Michiko Harao
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
- Department of Breast Oncology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Akira Saito
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Masako Sakuragi
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
- Department of Breast Oncology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Joji Kitayama
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
- Department of Breast Oncology, Jichi Medical University Hospital, Shimotsuke, Japan.
| | - Naohiro Sata
- Department of Surgery, Jichi Medical University, Shimotsuke, Japan
| |
Collapse
|
18
|
Mupfuti R, Kabudula C, Francis J. The Association Between Alcohol Use and Chronic Diseases' Treatment Outcomes Among Adults Aged 40 Years and Above in Rural South Africa. Res Sq 2024:rs.3.rs-3385716. [PMID: 38463992 PMCID: PMC10925412 DOI: 10.21203/rs.3.rs-3385716/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Chronic diseases are significant problems in South Africa. Chronic diseases' treatment outcomes are critical to the reduction of morbidity and mortality. There is limited data in South Africa on alcohol use and treatment outcomes of chronic diseases in older people. We analysed data from wave 1 of the Health and Ageing in Africa-a longitudinal Study in an INDEPTH community (HAALSI) study. We performed descriptive analysis to determine the prevalence of optimal chronic diseases' treatment outcomes (suppressed HIV viral load, normal blood pressure and normal blood sugar) and applied multivariate modified Poisson regression to determine the association between alcohol use and chronic diseases' treatment outcomes. The prevalence of optimal treatment outcomes were 87.4% for HIV, 42.7% for hypertension, 53.6% for diabetes mellitus and 52.4% for multimorbidity. Alcohol use did not negatively impact the treatment outcomes for HIV (aRR=1.00, 95%CI:0.93-1.09), hypertension (aRR=0.88, 95%CI:0.68-1.14), diabetes mellitus (aRR=0.73, 95%CI:0.44-1.22), and multimorbidity (aRR=1.00, 95%CI:0.93-1.09). Alcohol use was not significantly associated with treatment outcomes possibly due to underreporting of alcohol use. There is need to incorporate objective alcohol measurements in chronic diseases care settings. Furthermore, there is urgent need to strengthen the management of hypertension and diabetes, by adopting the strategies deployed for HIV management.
Collapse
|
19
|
Khera R, Aminorroaya A, Dhingra LS, Thangaraj PM, Camargos AP, Bu F, Ding X, Nishimura A, Anand TV, Arshad F, Blacketer C, Chai Y, Chattopadhyay S, Cook M, Dorr DA, Duarte-Salles T, DuVall SL, Falconer T, French TE, Hanchrow EE, Kaur G, Lau WC, Li J, Li K, Liu Y, Lu Y, Man KK, Matheny ME, Mathioudakis N, McLeggon JA, McLemore MF, Minty E, Morales DR, Nagy P, Ostropolets A, Pistillo A, Phan TP, Pratt N, Reyes C, Richter L, Ross J, Ruan E, Seager SL, Simon KR, Viernes B, Yang J, Yin C, You SC, Zhou JJ, Ryan PB, Schuemie MJ, Krumholz HM, Hripcsak G, Suchard MA. Comparative Effectiveness of Second-line Antihyperglycemic Agents for Cardiovascular Outcomes: A Large-scale, Multinational, Federated Analysis of the LEGEND-T2DM Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.05.24302354. [PMID: 38370787 PMCID: PMC10871374 DOI: 10.1101/2024.02.05.24302354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Background SGLT2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1-RAs) reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM). However, their effectiveness relative to each other and other second-line antihyperglycemic agents is unknown, without any major ongoing head-to-head trials. Methods Across the LEGEND-T2DM network, we included ten federated international data sources, spanning 1992-2021. We identified 1,492,855 patients with T2DM and established cardiovascular disease (CVD) on metformin monotherapy who initiated one of four second-line agents (SGLT2is, GLP1-RAs, dipeptidyl peptidase 4 inhibitor [DPP4is], sulfonylureas [SUs]). We used large-scale propensity score models to conduct an active comparator, target trial emulation for pairwise comparisons. After evaluating empirical equipoise and population generalizability, we fit on-treatment Cox proportional hazard models for 3-point MACE (myocardial infarction, stroke, death) and 4-point MACE (3-point MACE + heart failure hospitalization) risk, and combined hazard ratio (HR) estimates in a random-effects meta-analysis. Findings Across cohorts, 16·4%, 8·3%, 27·7%, and 47·6% of individuals with T2DM initiated SGLT2is, GLP1-RAs, DPP4is, and SUs, respectively. Over 5·2 million patient-years of follow-up and 489 million patient-days of time at-risk, there were 25,982 3-point MACE and 41,447 4-point MACE events. SGLT2is and GLP1-RAs were associated with a lower risk for 3-point MACE compared with DPP4is (HR 0·89 [95% CI, 0·79-1·00] and 0·83 [0·70-0·98]), and SUs (HR 0·76 [0·65-0·89] and 0·71 [0·59-0·86]). DPP4is were associated with a lower 3-point MACE risk versus SUs (HR 0·87 [0·79-0·95]). The pattern was consistent for 4-point MACE for the comparisons above. There were no significant differences between SGLT2is and GLP1-RAs for 3-point or 4-point MACE (HR 1·06 [0·96-1·17] and 1·05 [0·97-1·13]). Interpretation In patients with T2DM and established CVD, we found comparable cardiovascular risk reduction with SGLT2is and GLP1-RAs, with both agents more effective than DPP4is, which in turn were more effective than SUs. These findings suggest that the use of GLP1-RAs and SGLT2is should be prioritized as second-line agents in those with established CVD. Funding National Institutes of Health, United States Department of Veterans Affairs.
Collapse
Affiliation(s)
- Rohan Khera
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
- Center for Outcomes Research and Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, 06510, USA
- Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, 06520, USA
| | - Arya Aminorroaya
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
| | - Lovedeep Singh Dhingra
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
| | - Phyllis M Thangaraj
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
| | - Aline Pedroso Camargos
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
| | - Fan Bu
- Department of Biostatistics, University of Michigan - Ann Arbor, Ann Arbor, MI, 48105, USA
| | - Xiyu Ding
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Akihiko Nishimura
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Tara V Anand
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Faaizah Arshad
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Clair Blacketer
- Observational Health Data Analytics, Janssen Research and Development, LLC, Titusville, NJ, 8560, USA
| | - Yi Chai
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong
| | - Shounak Chattopadhyay
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Michael Cook
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - David A Dorr
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, 8007, Spain
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Scott L DuVall
- Veterans Affairs Informatics and Computing Infrastructure, United States Department of Veterans Affairs, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Thomas Falconer
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Tina E French
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elizabeth E Hanchrow
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Guneet Kaur
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD1 9SY, United Kingdom
| | - Wallis Cy Lau
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, WC1H 9JP, United Kingdom
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, Hong Kong
| | - Jing Li
- Data Transformation, Analytics, and Artificial Intelligence, Real World Solutions, IQVIA, Durham, NC, USA
| | - Kelly Li
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yuntian Liu
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
- Center for Outcomes Research and Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, 06510, USA
| | - Yuan Lu
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
| | - Kenneth Kc Man
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, WC1H 9JP, United Kingdom
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, Hong Kong
| | - Michael E Matheny
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nestoras Mathioudakis
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jody-Ann McLeggon
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Michael F McLemore
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Evan Minty
- Faculty of Medicine, O'Brien Institute for Public Health, University of Calgary, Calgary, AB, T2N4N1, Canada
| | - Daniel R Morales
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD1 9SY, United Kingdom
| | - Paul Nagy
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anna Ostropolets
- Observational Health Data Analytics, Janssen Research and Development, LLC, Titusville, NJ, 8560, USA
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, 8007, Spain
| | | | - Nicole Pratt
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Carlen Reyes
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, 8007, Spain
| | - Lauren Richter
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Joseph Ross
- Section of General Medicine and National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Center for Outcomes Research and Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, 06510, USA
| | - Elise Ruan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Sarah L Seager
- Data Transformation, Analytics, and Artificial Intelligence, Real World Solutions, IQVIA, London, UK
| | - Katherine R Simon
- Tennessee Valley Healthcare System, Veterans Affairs Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benjamin Viernes
- Veterans Affairs Informatics and Computing Infrastructure, United States Department of Veterans Affairs, Salt Lake City, UT, USA
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Jianxiao Yang
- Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Can Yin
- Data Transformation, Analytics, and Artificial Intelligence, Real World Solutions, IQVIA, Shanghai, China
| | - Seng Chan You
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
- Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin J Zhou
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90024, USA
| | - Patrick B Ryan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Martijn J Schuemie
- Epidemiology, Office of the Chief Medical Officer, Johnson & Johnson, Titusville, NJ, 8560, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation (CORE), Yale New Haven Hospital, New Haven, CT, 06510, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, 06510, USA
- Section of Cardiovascular Medicine, Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, 06510, USA
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, 10027, USA
| | - Marc A Suchard
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Biomathematics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Veterans Affairs Informatics and Computing Infrastructure, United States Department of Veterans Affairs, Salt Lake City, UT, USA
| |
Collapse
|
20
|
Monteiro Lopes S, Maia A, Melo P, Abreu S, Paiva I, Barros L. [Non-Insulin Antidiabetic Agents in the Management of Hyperglycaemia of Non-Critical Hospitalized Patients]. ACTA MEDICA PORT 2024; 37:207-214. [PMID: 38316163 DOI: 10.20344/amp.20858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024]
Abstract
Hyperglycaemia affects more than 30% of adults hospitalized for non-critical illness and is associated with an increased risk of adverse clinical outcomes. Insulin therapy is widely used for its safety and efficacy. However, given the growing availability of new drugs and new classes of antidiabetic agents with benefits beyond glycaemic control, challenges arise regarding their use in the hospital setting. This article aims to review and summarize the most recently available evidence and recommendations on the role of non-insulin antidiabetic agents in the management of hyperglycaemia in hospitalized patients. Insulin therapy remains the method of choice. Dipeptidyl peptidase 4 inhibitors can be considered in mild to moderate hyperglycaemia. Glucagon-like peptide 1 receptor agonists have recently shown promising results, with high efficacy in glycaemic control and low risk of hypoglycaemia. There are concerns regarding the increased risk of acidosis with metformin use, especially in cases of acute illness, although there is no evidence to support its suspension in selected patients with relative clinical stability. Sodium-glucose cotransporter-2 inhibitors should be discontinued in clinical situations that may predispose to ketoacidosis, including episodes of acute illness. The hospital use of sulfonylureas and thiazolidinediones is not advised.
Collapse
Affiliation(s)
- Sofia Monteiro Lopes
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Ariana Maia
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia. Centro Hospitalar Universitário do Porto. Porto. Portugal
| | - Pedro Melo
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia. Unidade Local de Saúde de Matosinhos. Portugal
| | - Silvestre Abreu
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço Regional de Saúde da Região Autónoma da Madeira. Funchal. Portugal
| | - Isabel Paiva
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Luísa Barros
- Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| |
Collapse
|
21
|
Liu Z, Huang H, Zhao L. Systematic review and meta-analysis of the effects of exercise on cognitive impairment and neuroprotective mechanisms in diabetes mellitus animal models. Metab Brain Dis 2024; 39:295-311. [PMID: 37979091 DOI: 10.1007/s11011-023-01324-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
This study aims to assess the effects of exercise on cognitive impairment behavioral performance and neuroprotective mechanisms in diabetes mellitus (DM) animal models. PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database (VIP), and China Biomedical Literature Database (CBM) were systematically searched for studies investigating the impact of exercise on cognitive impairment in animal models of diabetes mellitus (DM) from the inception of these databases through July 2023. Rigorous quality assessments were conducted on the included literature. Primary outcome measures comprised fasting blood glucose (FBG) levels and performance in the Morris water maze test, while secondary outcomes focused on mechanisms related to neuroprotection. Statistical analysis of outcome data was conducted using RevMan 5.3 and R software. A total of 17 studies were included, encompassing 399 animals. The results of the meta-analysis of primary outcome measures revealed that, compared to the control group, exercise effectively reduced fasting blood glucose (FBG) levels in diabetic animal models. In the Morris water maze experiment, exercise also significantly decreased the escape latency of diabetic animal models, increased the number of platform crossings, improved the percentage of time spent in the target quadrant, extended the time spent in the target quadrant, and enhanced swimming speed. Meta-analysis of secondary outcome measures indicated that exercise effectively reduced Aβ deposition, attenuated oxidative stress, enhanced synaptic function, suppressed cellular apoptosis and neuroinflammation, and promoted neurogenesis. Exercise represents a promising non-pharmacological therapy with a positive impact on diabetes-related cognitive function and neuroprotection. Moreover, this study provides a theoretical foundation for further preclinical and clinical trials.
Collapse
Affiliation(s)
- Zhiyao Liu
- Department of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hailiang Huang
- Department of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Liuyang Zhao
- Department of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
22
|
Westreich R, Tsaban G, Barrett O, Kezerle L, Tsadok MA, Akriv A, Bachrach A, Leventer-Roberts M, Senderey AB, Haim M. Estimated glomerular filtration rate and the risk of stroke in individuals with diabetes mellitus and atrial fibrillation insight from a large contemporary population study. J Thromb Thrombolysis 2024; 57:322-329. [PMID: 37945939 DOI: 10.1007/s11239-023-02913-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Diabetes mellitus (DM) is associated with increased risk of embolic complications in non-valvular atrial fibrillation (NVAF). Impaired renal function (IRF) increases the risk of stroke as well, but this finding is not consistent among all studies. Our aim was to assess the incidence rates and risk of ischemic stroke and mortality by baseline Estimated Glomerular Filtration Rate (eGFR) levels Among individuals with AF and DM. METHODS A prospective, historical cohort study using the Clalit Health Services electronic medical records database. Among patients with AF and DM, we compared three groups according to eGFR levels: eGFR ≥ 60, between 30 and 60, and ≤ 30 (mL/min/1.73m2). RESULTS A total of 17,567 cases were included in the final analysis; of them, 11,013 (62.7%) had eGFR ≥ 60, 4930 (28%) had eGFR between 30 and 60, and 1624 (9.24%) with eGFR ≤ 30. The incidence of stroke per 100 person-years in the three study groups was: 1.88, 2.69, and 3.34, respectively (p < 0.001). IRF was associated with increased risk of stroke in univariate analysis, but not after multivariate adjustment (Adjusted Hazard Ratio (AHR) 0.96 {95%CI; 0.74-1.25} for eGFR 30-60 and 0.96 {95%CI; 0.60-1.55} for eGFR ≤ 30). Mortality per 100 person-years was 10.78, 21.49, and 41.55, respectively (p < 0.001). IRF was associated with increased mortality risk in univariate analysis, as well as in multivariate analysis (AHR 1.08 {95%CI; 0.98-1.18} for eGFR 30-60, and 1.59 {95%CI; 1.37-1.85} for eGFR ≤ 30. CONCLUSION In patients with NVAF and DM, IRF was not associated with an increased risk of stroke, but severe IRF (eGFR ≤ 30) was associated with increased mortality risk.
Collapse
Affiliation(s)
- Roi Westreich
- Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben- Gurion University of the Negev, PO Box 141, 84101, Beer-Sheva, Beer-Sheva, Israel.
| | - Gal Tsaban
- Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben- Gurion University of the Negev, PO Box 141, 84101, Beer-Sheva, Beer-Sheva, Israel
| | - Orit Barrett
- Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben- Gurion University of the Negev, PO Box 141, 84101, Beer-Sheva, Beer-Sheva, Israel
| | - Louise Kezerle
- Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben- Gurion University of the Negev, PO Box 141, 84101, Beer-Sheva, Beer-Sheva, Israel
| | - Meytal Avgil Tsadok
- Clalit Research Institute, Clalit Health Services, Chief Physician's Office, Tel Aviv, Israel
| | - Amichay Akriv
- Clalit Research Institute, Clalit Health Services, Chief Physician's Office, Tel Aviv, Israel
| | - Asaf Bachrach
- Clalit Research Institute, Clalit Health Services, Chief Physician's Office, Tel Aviv, Israel
| | - Maya Leventer-Roberts
- Clalit Research Institute, Clalit Health Services, Chief Physician's Office, Tel Aviv, Israel
| | - Adi Berliner Senderey
- Clalit Research Institute, Clalit Health Services, Chief Physician's Office, Tel Aviv, Israel
| | - Moti Haim
- Cardiac Electrophysiology and Pacing, Cardiology Department, Soroka Medical Center, Ben- Gurion University of the Negev, PO Box 141, 84101, Beer-Sheva, Beer-Sheva, Israel
| |
Collapse
|
23
|
Munch L, Stensgaard S, Feinberg MB, Elwyn G, Lomborg K. Evaluating the effect of Conversation Cards on agenda-setting in annual diabetes status visits: A multi-method study. Patient Educ Couns 2024; 119:108084. [PMID: 38029577 DOI: 10.1016/j.pec.2023.108084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To evaluate Conversation Cards for shared agenda-setting between patients and nurses in status visits for type 2 diabetes. METHODS Non-randomized comparison of survey responses between intervention and control groups. Content analysis of interview data of patient experiences from a purposive sample of the intervention group. RESULTS The survey included 52 patients in the intervention and 55 in the control group. Survey data showed no significant differences between the groups. Regardless of the intervention, patients experienced that topics relevant to them were addressed. One in four patients rated the Conversation Cards as very supportive. Interview data indicated that the Conversation Cards added structure, commitment to the conversation, and support to raise topics not previously considered diabetes related. CONCLUSION Topics of concern were addressed in both intervention and control groups. The Conversation Cards for agenda-setting clarified a mutually agreed structure of the conversation, eased raising hitherto ignored topics, and increased engagement. PRACTICE IMPLICATIONS The Conversation Cards have potential to improve shared agenda-setting, but implementation requires efforts from both parties. Patients are expected to consider their concerns and take an active part in agenda-setting. Nurses are expected to collaborate with the patient in the agenda-setting, which might challenge the nurses' habitual practice.
Collapse
Affiliation(s)
- Lene Munch
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
| | - Sebrina Stensgaard
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark
| | - Mie Buron Feinberg
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Kirsten Lomborg
- Department of Clinical Research, Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
24
|
Pontoppidan JRN, Nielsen EE, Olsen MH, Skjødt MK, Christensen JO, Raymond IE, Møller SH, Soja AMB, Gæde PH. A multidisciplinary, shared care clinic using personalized medicine and coordinated care in patients with concomitant type 2 diabetes and cardiovascular disease. Protocol and baseline characteristics. Prev Med Rep 2024; 38:102594. [PMID: 38283962 PMCID: PMC10821603 DOI: 10.1016/j.pmedr.2024.102594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/30/2024] Open
Abstract
Background Concomitant type 2 diabetes (T2DM) and cardiovascular disease (CVD) is frequent with a poor prognosis with high risk of comorbidities. Strict risk factor control reduces the risk for complications - yet many people do not achieve treatment targets. The complexity and fragmentation of the healthcare system may, together with the vulnerability of these patients, be a reason. Objective The purpose of this paper is to describe the protocol of a non-randomized interventional pilot study testing the feasibility and effect of a multidisciplinary, shared care clinic using personalized medicine and coordinated care in people living with concomitant T2D and CVD. Methods Participants were included from the Holbaek area in Denmark. People suffered from T2DM and CVD and were dysregulated regarding to HbA1c, cholesterol, micro/macroalbuminuaria or blood pressure. Participants went through a thorough evaluation to identify their needs and resources and received consultations every three months for one year. Results A total of 63 participants with T2DM and CVD were enrolled in the clinic. The participants had a mean age of 69 years and a BMI of 30.9 kg/m2. Almost 50 % had heart failure, 95 % dyslipidemia and 91 % hypertension. Around 54 % received GLP-1 agonists and 39 % received SGLT-2-inhibitors. Perspectives To our knowledge, a similar study with a multidisciplinary, shared care, outpatient clinic treating people living with concomitant T2DM and CVD, has not been performed previously. This study will provide information about the feasibility and efficacy of a multidisciplinary clinic based on changes in cardiovascular risk factors and medication.
Collapse
Affiliation(s)
- Julie Rye Noer Pontoppidan
- Department of Internal Medicine, Cardiology Section, Holbæk Sygehus, Denmark
- Department of Endocrinology and Cardiology, Slagelse Sygehus, Denmark
| | - Emil Eik Nielsen
- Department of Internal Medicine, Cardiology Section, Holbæk Sygehus, Denmark
| | - Michael Hecht Olsen
- Department of Internal Medicine, Cardiology Section, Holbæk Sygehus, Denmark
| | - Michael Kriegbaum Skjødt
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Denmark
- Department Internal Medicine, Holbæk Sygehus, Denmark
| | | | | | - Sara Hedlund Møller
- Department of Internal Medicine, Cardiology Section, Holbæk Sygehus, Denmark
| | | | - Peter Haulund Gæde
- Department of Endocrinology and Cardiology, Slagelse Sygehus, Denmark
- University of Southern Denmark, Institute for Regional Health, Denmark
| |
Collapse
|
25
|
Kumar G, Arora AS. Automated Prediction of Diabetes Mellitus using Infrared Thermal Foot Images: Recurrent Neural Network Approach. Biomed Phys Eng Express 2024. [PMID: 38295406 DOI: 10.1088/2057-1976/ad2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Millions of people worldwide are affected by Diabetes Mellitus (DM), which is a chronic disease. Evaluation of the DM indicator, namely blood glucose level, requires invasive methods such as glucometer or blood tests, which cause discomfort to the patient. Automated noninvasive monitoring methods are urgently needed to ensure consistency and better treatment. The regular monitoring of DM can prevent or delay the onset of complications. Thermal foot images have been proposed as noninvasive methods for the prediction of DM. Thermograms were acquired at Mittal Eye Hospital, Sangrur, India, from 50 participants in the diabetic (without neuropathic conditions) and non-diabetic groups using a thermal camera (FLIR E-60). This study proposes an automated prediction system for DM using thermal foot images and Recurrent Neural Network (RNN) approach. The proposed system processes the thermal images and extracts relevant features using a CNN (Convolutional Neural Network). The extracted features were then fed to the RNN to predict the presence or absence of the DM. The experimental results demonstrate that the proposed framework attains an accuracy of (97.14 ± 1.5) %, surpassing the predictive capabilities of light-weight convolutional neural network (Lw-CNN), which only achieves an accuracy of (82.9 ± 3) % in predicting DM. This performance outperformed other state-of-the-art methods in the field. Our approach has the potential to be used as prediction tool for DM. Therefore, the proposed system has the potential for prediction of DM and improve patient outcomes by enabling timely intervention. Future work should focus on evaluating the proposed system on a larger dataset and integrating it with clinical decision support systems for personalized care. This study holds the promise of transforming DM screening and diagnosis, leading to enhanced patient outcomes.
Collapse
Affiliation(s)
- Gulshan Kumar
- Sant Longowal Institute of Engineering and Technology, Type-I (New), II Floor, Quarter No-65, SLIET CAMPUS, Longowal, 148106, INDIA
| | - Ajat Shatru Arora
- Sant Longowal Institute of Engineering and Technology, TYPE V, QUATER NO.25, GROUND FLOOR, SLIET,LONGOWAL, PUNJAB, Longowal, Punjab, 148106, INDIA
| |
Collapse
|
26
|
Rajab F, Mujahid A, Naseer B. Letter to the editor: one-year clinical outcomes of bivalirudin versus unfractionated heparin in patients with type 2 diabetes undergoing elective percutaneous coronary intervention. Eur Heart J Cardiovasc Pharmacother 2024:pvae010. [PMID: 38285615 DOI: 10.1093/ehjcvp/pvae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
|
27
|
Wu Z, Wang J, Ullah R, Chen M, Huang K, Dong G, Fu J. Covid 19 and diabetes in children: advances and strategies. Diabetol Metab Syndr 2024; 16:28. [PMID: 38287388 PMCID: PMC10823738 DOI: 10.1186/s13098-024-01267-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Throughout the COVID-19 pandemic, there has been a notable increase in the incidence of new-onset diabetes and diabetic ketoacidosis (DKA). Simultaneously, children diagnosed with type 1 diabetes (T1D) have encountered difficulties in maintaining optimal blood glucose levels. The mechanisms underpinning these correlations still remain a puzzle. We reviewed the studies that examined changes in incidence during the pandemic. These studies utilized various metrics for comparison, which encompassed the timing of data collection, diagnostic criteria, as well as the numbers and incidence rates of diabetes and DKA. We found the incidence of diabetes and DKA was higher during the pandemic. As to mechanisms, the invivo and invitro study revealed the factors such as direct viral damage, metabolic dysfunction, and immune responses all attribute to the process of T1D after suffering from COVID-19. Furthermore, we provide some useful strategies to prevent and treat children suffering from diabetes and COVID-19. CONCLUSIONS Strong correlations have been observed between new-onset diabetes and COVID-19. Insights gleaned from clinical descriptions and basic research can offer valuable experience and recommendations for the treatment and prevention of diabetes during future pandemics.
Collapse
Affiliation(s)
- Zhaoyuan Wu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jinling Wang
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Rahim Ullah
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Minghao Chen
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Ke Huang
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Guanping Dong
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junfen Fu
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
| |
Collapse
|
28
|
Wang X, Chen L, Shi K, Lv J, Sun D, Pei P, Yang L, Chen Y, Du H, Liu J, Yang X, Barnard M, Chen J, Chen Z, Li L, Yu C. Diabetes and chronic kidney disease in Chinese adults: a population-based cohort study. BMJ Open Diabetes Res Care 2024; 12:e003721. [PMID: 38267203 PMCID: PMC10823934 DOI: 10.1136/bmjdrc-2023-003721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Cohort evidence of the association of diabetes mellitus (DM) with chronic kidney disease (CKD) is limited. Previous studies often describe patients with kidney disease and diabetes as diabetic kidney disease (DKD) or CKD, ignoring other subtypes. The present study aimed to assess the prospective association of diabetes status (no diabetes, pre-diabetes, screened diabetes, previously diagnosed controlled/uncontrolled diabetes with/without antidiabetic treatment) and random plasma glucose (RPG) with CKD risk (including CKD subtypes) among Chinese adults. RESEARCH DESIGN AND METHODS The present study included 472 545 participants from the China Kadoorie Biobank, using baseline information on diabetes and RPG. The incident CKD and its subtypes were collected through linkage with the national health insurance system during follow-up. Cox regression models were used to calculate the HR and 95% CI. RESULTS During 11.8 years of mean follow-up, 5417 adults developed CKD. Screened plus previously diagnosed diabetes was positively associated with CKD (HR=4.52, 95% CI 4.23 to 4.83), DKD (HR=33.85, 95% CI 29.56 to 38.76), and glomerulonephritis (HR=1.66, 95% CI 1.40 to 1.97). In those with previously diagnosed diabetes, participants with uncontrolled diabetes represented higher risks of CKD, DKD, and glomerulonephritis compared with those with controlled RPG. The risk of DKD was found to rise in participants with pre-diabetes and increased with the elevated RPG level, even in those without diabetes. CONCLUSIONS Among Chinese adults, diabetes was positively associated with CKD, DKD, and glomerulonephritis. Screen-detected and uncontrolled DM had a high risk of CKD, and pre-diabetes was associated with a greater risk of DKD, highlighting the significance of lifelong glycemic management.
Collapse
Affiliation(s)
- Xue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lu Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Kexiang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jiaqiu Liu
- NCDs Prevention and Control Department, Pengzhou CDC, Pengzhou, China
| | - Xiaoming Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maxim Barnard
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
| |
Collapse
|
29
|
Chaudhary R, Bansal S, Goel A, Gupta S, Malik D, Bansal N. Unravelling the Crosstalk between Estrogen deficiency and Gut-biota Dysbiosis in the development of Diabetes Mellitus. Curr Diabetes Rev 2024; 20:CDR-EPUB-137766. [PMID: 38275037 DOI: 10.2174/0115733998275953231129094057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 01/27/2024]
Abstract
Estrogens are classically considered essential hormonal signals, but they exert profound effects in a number of physiological and pathological states, including glucose homeostasis and insulin resistance. Estrogen deficiency after menopause in most women leads to increased androgenicity and changes in body composition, and it is recommended to manipulate the β-cell function of the pancreas, insulin-induced glucose transport, and hepatic glucose output, hence, the increasing incidence of type 2 diabetes mellitus. Recently, studies have reported that gut biota alteration due to estrogen deficiency contributes to altered energy metabolism and, hence, accentuates the pathology of diabetes mellitus. Emerging research suggests estrogen deficiency via genetic disposition or failure of ovaries to function in old age modulates the insulin resistance and glucose secretion workload on pancreatic beta cells by decreasing the levels of good bacteria such as Akkermansia muciniphila, Bifidobacterium spp., Lactobacillus spp., Faecalibacterium prausnitzii, Roseburia spp., and Prevotella spp., and increasing the levels of bad bacteria's such as Bacteroides spp., Clostridium difficile, Escherichia coli, and Enterococcus spp. Alteration in these bacteria's concentrations in the gut further leads to the development of impaired glucose uptake by the muscles, increased gluconeogenesis in the liver, and increased lipolysis and inflammation in the adipose tissues. Thus, the present review paper aims to clarify the intricate interactions between estrogen deficiency, gut microbiota regulation, and the development of diabetes mellitus.
Collapse
Affiliation(s)
- Rishabh Chaudhary
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be university) Mullana-Ambala, Haryana
| | - Seema Bansal
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be university) Mullana-Ambala, Haryana
| | - Akriti Goel
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be university) Mullana-Ambala, Haryana
| | - Sumeet Gupta
- M.M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be university) Mullana-Ambala, Haryana
| | - Deepti Malik
- Department of Biochemistry, All India Institute of Medical Sciences Bilaspur, HP
| | - Nitin Bansal
- Department of Pharmacy, Chaudhary Bansilal University, Bhiwani
| |
Collapse
|
30
|
Moosan H, Thakor M, Sharma AK, Mohanty SS, Panigrahi A, Dhikav V, Yadav S, Huda RK, Parmar M, Singh P, John D. Protocol of systematic reviews on implementation research on cardiovascular diseases, diabetes mellitus and mental ailments in India. F1000Res 2024; 12:100. [PMID: 38434648 PMCID: PMC10904959 DOI: 10.12688/f1000research.128549.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The burden of non-communicable diseases (NCDs) is a major public health concern across the world. Various initiatives have tried to address these with varying degrees of success. Objective The objective is to assess and collate existing evidence in implementation research done in India on three broad domains of NCDs namely, cardiovascular diseases (CVD), diabetes mellitus (DM), and mental health (MH) in India. Materials and methods Three systematic review protocols have been drafted to explore and collate extant evidence of implementation research on cardiovascular diseases, diabetes mellitus, and mental health in India, in accordance with the PRISMA-P statement. Academic databases including PubMed, Embase and Science Direct will be searched. Search strategies will be formulated in iterative processes and in accordance with the formats that are specific to the databases that will be searched. In addition, grey literature and non-academic databases will also be explored. Data extracted from the selected studies will be analysed and a narrative summary of the selected articles, using the SWiM (Synthesis without meta-analysis) guidelines will be produced. Intended Outcomes The outputs of these systematic reviews could help in a better understanding of implementation research gaps and also how to address them. Apart from giving insights into how healthcare initiatives for CVDs, diabetes and mental health could be implemented in a better way, the study could also advocate the need to build and consolidate capacity for implementation research in the country.
Collapse
Affiliation(s)
- Hisham Moosan
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Mahendra Thakor
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Arun Kumar Sharma
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - S. S. Mohanty
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Ansuman Panigrahi
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Vikas Dhikav
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Suresh Yadav
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Ramesh Kumar Huda
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Mukesh Parmar
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Poonam Singh
- Department of Health Research, ICMR-National Institute for Implementation Research on Non-Communicable Diseases,, Jodhpur, Rajasthan, 342005, India
| | - Denny John
- Professor, Faculty of Life and Allied Health Sciences, MS Ramaiah University of Applied Sciences, Bengaluru, Karnataka, 560054, India
| |
Collapse
|
31
|
Baker JF, England BR, Wysham KD, Sauer B, Joseph AM, Lenert A, Roul P, Xiao R, Gillcrist R, Johnson T, Cannon GW, Duryee M, Thiele GM, Mikuls TR. Associations between Adiponectin and the Development of Diabetes in Rheumatoid Arthritis. J Clin Endocrinol Metab 2024:dgae010. [PMID: 38189426 DOI: 10.1210/clinem/dgae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
PURPOSE We evaluated associations between adiponectin and the risk of diabetes among patients with rheumatoid arthritis (RA), a systemic inflammatory disease associated with metabolic disturbance. METHODS This prospective cohort study included adults with RA from the Veteran's Affairs Rheumatoid Arthritis Registry. Adiponectin and inflammatory cytokines/chemokines were measured at enrollment on stored serum samples. Adiponectin levels were categorized and clinical variables were described across categories (<10 μg/mL; 10-40 μg/mL; > 40 μg/mL. Multivariable Cox proportional hazard models evaluated associations between adiponectin and incident diabetes adjusting for age, sex, race, smoking status, body mass index (BMI), disease-modifying therapy use, calendar year, and comorbidity. Testing for modification of effect in the context of elevated cytokines/chemokines was performed. RESULTS Among 2595 patients included in the analysis, those with adiponectin levels >40 μg/mL (N = 379; 15%) were older and had lower BMI. There were 125 new cases of diabetes among 1,689 patients without prevalent disease at enrollment. There was an inverse association between adiponectin and incident diabetes, however, the association was positive among patients with adiponectin levels >40 μg/mL. Patients with levels >40 μg/mL were at higher risk compared to those with levels 10-40 μg/mL [HR: 1.70 (1.34,2.16) p < 0.001]. Those with adiponectin levels >40 μg/mL had significantly higher levels of inflammatory cytokines with evidence of a modified effect of adiponectin on diabetes risk in the setting of inflammation. CONCLUSIONS The relationship between adiponectin and incident diabetes risk is U-shaped in RA. Patients with very high adiponectin levels have greater systemic inflammation and an altered relationship between adiponectin and diabetes risk.
Collapse
Affiliation(s)
- Joshua F Baker
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Bryant R England
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| | - Katherine D Wysham
- VA Puget Sound Health Care System, Seattle, WA & University of Washington School of Medicine, Seattle, WA
| | - Brian Sauer
- Salt Lake City VA Medical Center and University of Utah, Salt Lake City, UT
| | | | | | - Punyasha Roul
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| | - Rui Xiao
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rachel Gillcrist
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Tate Johnson
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| | - Grant W Cannon
- Salt Lake City VA Medical Center and University of Utah, Salt Lake City, UT
| | - Michael Duryee
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| | - Geoffrey M Thiele
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| | - Ted R Mikuls
- Medicine Service, VA Nebraska-Western Iowa Health Care System and Department of Internal Medicine, Division of Rheumatology & Immunology, University of Nebraska Medical Center, Omaha, NE
| |
Collapse
|
32
|
Hammad H, Shaltout I, Fawzy MM, Rashed LA, A Mahfouz N, Abdelaziz TS. Brain-derived Neurotrophic Factor Level and Gene Polymorphism as Risk Factors for Depression in Patients with type 2 Diabetes Mellitus- A Case-Controlled Study. Curr Diabetes Rev 2024; 20:CDR-EPUB-137084. [PMID: 38192135 DOI: 10.2174/0115733998274778231218145449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Diabetes mellitus and depression are comorbidities that can be caused by each other. Brain-derived neurotrophic factor (BDNF) functions as a neuronal growth factor. It maintains the functional integrity of the nervous system. AIM To study the possible association between BDNF levels and gene polymorphism with depression in patients diagnosed with type 2 diabetes mellitus. METHODS The Elisa technique measured BDNF, and rs6265 gene polymorphism was detected using real-time PCR. Depression was assessed utilizing a clinical interview tool designed to establish the diagnosis of depression and differentiate it from other psychiatric diseases. RESULTS BDNF levels were significantly lower in patients with type 2 diabetes mellitus and symptoms of depression than in patients with type 2 diabetes mellitus and no symptoms of depression (82.6±16.1. Vs 122± 17.47, p˂ 0.001). There was a statistically significant difference in BDNF levels in patients with diabetes among the three genotypes of the BDNF gene (p-value < 0.001). Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. Subgroup analysis showed statistically significant genotype-related differences in serum BDNF levels among the three subgroups in the Depression group. Val/ Val carriers had the highest serum BDNF levels, and Met/ Met carriers had the lowest serum BDNF levels. BDNF Val66Met polymorphism had no significant association with the presence of depression, yet there was a trend towards significance (p = 0.05) Conclusion: In this pilot, Low levels of BDNF were associated with depression in patients with type 2 diabetes. Carriers of the Met/ Met allele have the lowest serum BDNF levels. Multicenter studies with more participants are required.
Collapse
Affiliation(s)
- Hany Hammad
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Inass Shaltout
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Mai M Fawzy
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Laila A Rashed
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Kasr Alainy University Hospitals Cairo University, Egypt
| | - Noha A Mahfouz
- Psychiatry Department, Faculty of Medicine, Kasr Alainy Cairo University, Egypt
| | - Tarek S Abdelaziz
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| |
Collapse
|
33
|
Wu YR, Lai YH, Wang CC. Type 2 diabetes mellitus increases the risk of circumcision among men aged between 30 and 69 years using a nationwide population-based dataset in Taiwan: a five-year follow-up study. BMC Urol 2024; 24:3. [PMID: 38172825 PMCID: PMC10765904 DOI: 10.1186/s12894-023-01392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Diabetes is an important factor in the development of penile inflammation. We studied whether type 2 diabetes (DM), with/without hypertension and hyperlipidemia increased the risk of circumcision among men aged between 30 and 69 using a population-based dataset in Taiwan during a 5-year follow-up period. METHODS The research data in this study were obtained from Taiwan's National Health Insurance Research Database between 1997 and 2010. We identified 23,197 patients who had a new diagnosis of DM and randomly matched 115,985 subjects as controls. We observed whether circumcision was the treatment after a new DM diagnosis. The initial step involved analyzing the data using Poisson regression analysis. To address potential confounding factors, this study employed propensity score matching based on three variables. Additionally, a Cox regression with a Gamma frailty was utilized to compare outcomes between different groups. RESULTS Poisson regression analysis showed that DM (RR = 1.75, 95CI = 0.10 ~ 1.22), but not hypertension (RR = 1.14, 95CI=-0.44 ~ 0.70), hyperlipidemia (RR = 0.94, 95CI=-0.66 ~ 0.53), or age (RR = 0.83, 95CI=-0.43 ~ 0.62), had an impact on circumcision treatment. Cox regression with a frailty model found that DM was a risk factor associated with circumcision (HR = 2.31, 95% CI = 1.74 ~ 3.06, p-value < 0.01), whereas no significant difference was noted between circumcision and hypertension (HR = 1.10, 95% CI = 0.80 ~ 1.51), hyperlipidemia (HR = 1.05, 95% CI = 0.79 ~ 1.40), or age (HR = 1.00, 95% CI = 0.99 ~ 1.02). CONCLUSIONS Type 2 diabetes mellitus, but not hypertension, hyperlipidemia or age increases the risk of circumcision in men aged between 30 and 69 years.
Collapse
Affiliation(s)
- Yun-Rui Wu
- Department of Urology, College of Medicine, En Chu Kong Hospital, National Taiwan University, 399 Fu-hsing Road, Sanxia District, New Taipei City, 23702, Taiwan
| | - Yi-Horng Lai
- Department of Healthcare Administration, Asia Eastern University of Science and Technology, New Taipei City, 22061, Taiwan
| | - Chung-Cheng Wang
- Department of Urology, College of Medicine, En Chu Kong Hospital, National Taiwan University, 399 Fu-hsing Road, Sanxia District, New Taipei City, 23702, Taiwan.
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, 32023, Taiwan.
| |
Collapse
|
34
|
Correia Rodriguez B, Rosendo I, Santos Coelho TI, Duarte Mendes P, Dos Santos Rodrigues G, Faustino Francisco Â, Cerqueira Martins AS, Boto T, Guerra Fernandes F, Figueiredo Costa Â, Lamarão C, Miguéis Ferreira I, Andrade Glória J, Vicente Osório I, Couto Gonçalves TD, Rosas Pereira A, Almeida Guedes AS, Fernandes Mendes C, Pires da Silva S, Carvalhal A, Vasconcelos Costa P, Alves Dos Reis B. [Eating Habits of People with Type 2 Diabetes Mellitus in Portugal: A Cross-Sectional Study]. ACTA MEDICA PORT 2024; 37:27-35. [PMID: 38183233 DOI: 10.20344/amp.19738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/28/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Nutrition is a cornerstone of diabetes mellitus prevention and management; therefore, it is essential to enable patients to adopt healthy eating habits. Previous studies have not yet documented the main errors in the eating habits of Portuguese people with type 2 diabetes mellitus. This study aims to identify the main errors in the eating habits of people living with type 2 diabetes mellitus in Portugal and to evaluate its associations with sociodemographic variables. METHODS Cross-sectional multicentric study in a convenience sample of people with type 2 diabetes mellitus in Primary Health Care Units. The UK Diabetes and Diet Questionnaire (UKDDQ) - translated and adapted, was applied from July to October 2022. Descriptive and inferential statistical analyses were conducted. RESULTS Of the 550 participants, 52.2% were female, 68.3% were 65 years or over, 55.8 % had an education level up to the fourth grade, 24.7% had economic deprivation, and the mean time since diagnosis was 10.60 ± 8.13 years. Only 36.2% of the sample had a healthy UKDDQ score. Less than 50% of the sample had healthy scores for the items "high-fiber rice or pasta", "high-fiber bread", "butter, margarine and vegetable oils" and "vegetables and pulses". Only 8.9% of the sample had a healthy consumption of fiber. About 70.4% reported healthy scores for the consumption of "high-added-sugar foods" and 54.7% for "high-saturated fat". A statistically significant weak positive correlation was found between the UKDDQ score and age (ρ = 0.201, p < 0.001) with a more frequent choice of healthy foods with increasing age. Female respondents reported healthier habits, particularly in the consumption of "high-saturated fat" and "high-fiber foods". CONCLUSION The majority of our sample did not take advantage of the potential benefits of healthy eating habits. The main food groups whose consumption should be emphasized or discouraged were individualized, particularly the need to encourage the consumption of high-fiber foods. Targeted educational actions must focus especially on younger and/or male patients.
Collapse
Affiliation(s)
| | - Inês Rosendo
- Faculdade de Medicina. Universidade de Coimbra. Coimbra; Unidade de Saúde Familiar Coimbra Centro. Coimbra. Portugal
| | | | | | | | | | | | - Tânia Boto
- Unidade de Saúde Familiar Infante D. Henrique. Viseu. Portugal
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Sousa S, Pereira AM, Santiago LM. Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study. ACTA MEDICA PORT 2024; 37:3-9. [PMID: 37000414 DOI: 10.20344/amp.18584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/12/2022] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients' (T2DM) in two Family Health Units in Central Portugal, according to gender and age. MATERIAL AND METHODS A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days. RESULTS A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030). CONCLUSION Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine.
Collapse
Affiliation(s)
- Solange Sousa
- Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Albino Miguel Pereira
- Mondego Family Health Unit; General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Luiz Miguel Santiago
- General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| |
Collapse
|
36
|
Kim J, Kim D, Bae HJ, Park BE, Kang TS, Lim SH, Lee SY, Chung YH, Ryu JW, Lee MY, Yang PS, Joung B. Associations of combined polygenic risk score and glycemic status with atrial fibrillation, coronary artery disease and ischemic stroke. Cardiovasc Diabetol 2024; 23:5. [PMID: 38172896 PMCID: PMC10765629 DOI: 10.1186/s12933-023-02021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/10/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND It is unknown whether high hemoglobin A1c (HbA1c) is associated with increases in the risk of cardiovascular disease among individuals with elevated genetic susceptibility. We aimed to investigate the association between HbA1c and atrial fibrillation (AF), coronary artery disease (CAD), and ischemic stroke according to the polygenic risk score (PRS). METHODS The UK Biobank cohort included 502,442 participants aged 40-70 years who were recruited from 22 assessment centers across the United Kingdom from 2006 to 2010. This study included 305,605 unrelated individuals with available PRS and assessed new-onset AF, CAD, and ischemic stroke. The participants were divided into tertiles based on the validated PRS for each outcome. Within each PRS tertiles, the risks of incident events associated with HbA1c levels were investigated and compared with HbA1c < 5.7% and low PRS. Data were analyzed from November 2022 to May 2023. RESULTS Of 305,605 individuals, 161,605 (52.9%) were female, and the mean (SD) age was 56.6 (8.1) years. During a median follow-up of 11.9 (interquartile range 11.1-12.6) years, the incidences of AF, CAD, and ischemic stroke were 4.6, 2.9 and 1.1 per 100 person-years, respectively. Compared to individuals with HbA1c < 5.7% and low PRS, individuals with HbA1c ≥ 6.5% and high PRS had a 2.67-times higher risk for AF (hazard ratio [HR], 2.67; 95% confidence interval (CI), 2.43-2.94), 5.71-times higher risk for CAD (HR, 5.71; 95% CI, 5.14-6.33) and 2.94-times higher risk for ischemic stroke (HR, 2.94; 95% CI, 2.47-3.50). In the restricted cubic spline models, while a U-shaped trend was observed between HbA1c and the risk of AF, dose-dependent increases were observed between HbA1c and the risk of CAD and ischemic stroke regardless PRS tertile. CONCLUSIONS Our results suggest that the nature of the dose-dependent relationship between HbA1c levels and cardiovascular disease in individuals with different PRS is outcome-specific. This adds to the evidence that PRS may play a role together with glycemic status in the development of cardiovascular disease.
Collapse
Affiliation(s)
- Juntae Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Dongmin Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Han-Joon Bae
- Department of Cardiology, Daegu Catholic University Medical Center, 33 Duryugongwonro 17- gil, Nam-gu, Daegu, 42472, Republic of Korea
| | - Byoung-Eun Park
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Tae Soo Kang
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Seong-Hoon Lim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Su Yeon Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Young Hak Chung
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Ji Wung Ryu
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Myung-Yong Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam, 31116, Republic of Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam, 13496, Gyeonggi-do, Republic of Korea.
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonseiro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| |
Collapse
|
37
|
Chuang TL, Koo M, Wang YF. The impact of diabetes, anemia, and renal function in the relationship between osteoporosis and fasting blood glucose among Taiwanese women: a cross-sectional study. BMC Womens Health 2024; 24:23. [PMID: 38172731 PMCID: PMC10765617 DOI: 10.1186/s12905-023-02851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between fasting blood glucose and osteoporosis in women with diabetes, anemia, and renal function. METHODS The medical records of women who underwent a general health examination at a regional hospital in southern Taiwan were retrospectively reviewed. Logistic regression analysis was performed to assess the association between osteoporosis and fasting blood glucose separately for the eight subgroups (diabetes or non-diabetes, anemia or non-anemia, normal or decreased renal function), adjusting for other clinical characteristics and laboratory findings. RESULTS A total of 11,872 women were included in the study. Among women with diabetes, anemia, and decreased renal function, an increment of 10 mg/dL in fasting blood glucose was associated with an increased risk of osteoporosis (adjusted odds ratio [aOR] = 1.57, p = 0.004). Among women without diabetes, fasting blood glucose was significantly associated with an increased risk of osteoporosis in those with anemia and normal renal function (OR = 1.14, p = 0.023) and those without anemia and normal renal function (OR = 1.04, p = 0.015), but these associations were not significant after adjusting for other covariates. CONCLUSIONS Higher fasting blood glucose levels in women with diabetes, anemia, and decreased renal function were associated with an increased risk of osteoporosis. Clinicians should be vigilant about glucose control in patients with diabetes to reduce the risk of fracture.
Collapse
Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Malcolm Koo
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, 970302, Taiwan.
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11217, Taiwan.
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan.
| |
Collapse
|
38
|
Zhao Z, Wang Q, Zhao F, Ma J, Sui X, Choe HC, Chen P, Gao X, Zhang L. Single-cell and transcriptomic analyses reveal the influence of diabetes on ovarian cancer. BMC Genomics 2024; 25:1. [PMID: 38166541 PMCID: PMC10759538 DOI: 10.1186/s12864-023-09893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND There has been a significant surge in the global prevalence of diabetes mellitus (DM), which increases the susceptibility of individuals to ovarian cancer (OC). However, the relationship between DM and OC remains largely unexplored. The objective of this study is to provide preliminary insights into the shared molecular regulatory mechanisms and potential biomarkers between DM and OC. METHODS Multiple datasets from the GEO database were utilized for bioinformatics analysis. Single cell datasets from the GEO database were analysed. Subsequently, immune cell infiltration analysis was performed on mRNA expression data. The intersection of these datasets yielded a set of common genes associated with both OC and DM. Using these overlapping genes and Cytoscape, a protein‒protein interaction (PPI) network was constructed, and 10 core targets were selected. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were then conducted on these core targets. Additionally, advanced bioinformatics analyses were conducted to construct a TF-mRNA-miRNA coregulatory network based on identified core targets. Furthermore, immunohistochemistry staining (IHC) and real-time quantitative PCR (RT-qPCR) were employed for the validation of the expression and biological functions of core proteins, including HSPAA1, HSPA8, SOD1, and transcription factors SREBF2 and GTAT2, in ovarian tumors. RESULTS The immune cell infiltration analysis based on mRNA expression data for both DM and OC, as well as analysis using single-cell datasets, reveals significant differences in mononuclear cell levels. By intersecting the single-cell datasets, a total of 119 targets related to mononuclear cells in both OC and DM were identified. PPI network analysis further identified 10 hub genesincludingHSP90AA1, HSPA8, SNRPD2, UBA52, SOD1, RPL13A, RPSA, ITGAM, PPP1CC, and PSMA5, as potential targets of OC and DM. Enrichment analysis indicated that these genes are primarily associated with neutrophil degranulation, GDP-dissociation inhibitor activity, and the IL-17 signaling pathway, suggesting their involvement in the regulation of the tumor microenvironment. Furthermore, the TF-gene and miRNA-gene regulatory networks were validated using NetworkAnalyst. The identified TFs included SREBF2, GATA2, and SRF, while the miRNAs included miR-320a, miR-378a-3p, and miR-26a-5p. Simultaneously, IHC and RT-qPCR reveal differential expression of core targets in ovarian tumors after the onset of diabetes. RT-qPCR further revealed that SREBF2 and GATA2 may influence the expression of core proteins, including HSP90AA1, HSPA8, and SOD1. CONCLUSION This study revealed the shared gene interaction network between OC and DM and predicted the TFs and miRNAs associated with core genes in monocytes. Our research findings contribute to identifying potential biological mechanisms underlying the relationship between OC and DM.
Collapse
Affiliation(s)
- Zhihao Zhao
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Qilin Wang
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Fang Zhao
- Institute of Innovation and Applied Research in Chinese Medicine, Department of Rheumatology of The First Hospital, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Junnan Ma
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Xue Sui
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Hyok Chol Choe
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
- Department of Clinical Medicine, Sinuiju Medical University, Sinuiju, Democratic People's Republic of Korea
| | - Peng Chen
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Xue Gao
- Department of Pathology, the First Hospital of Dalian Medical University, Dalian, Liaoning Province, 116027, China.
| | - Lin Zhang
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China.
| |
Collapse
|
39
|
Han BC, Kim J, Choi J. Prediction of complications in diabetes mellitus using machine learning models with transplanted topic model features. Biomed Eng Lett 2024; 14:163-171. [PMID: 38186952 PMCID: PMC10769946 DOI: 10.1007/s13534-023-00322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/05/2023] [Accepted: 09/16/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose: This study aims to predict the progression of Diabetes Mellitus (DM) from the clinical notes through machine learning based on latent Dirichlet allocation (LDA) topic modeling. Particularly, 174,427 clinical notes of DM patients were collected from the electronic medical record (EMR) system of the Seoul National University Hospital outpatient clinic. Method: We developed a model to predict the development of DM complications. Topics developed by the topic model were exploited as the key feature of our machine-learning model. The proposed model generalized a correlation between topic structures and complications. Results: The model provided acceptable predictive performance for all four types of complications (diabetic retinopathy, diabetic nephropathy, nonalcoholic fatty liver disease, and cerebrovascular accident). Upon employing extreme gradient boosting (XGBoost), we obtained the F1 scores of the predictions for each complication type as 0.844, 0.921, 0.831, and 0.762. Conclusion: This study shows that a machine learning project based on topic modeling can effectively predict the progress of a disease. Furthermore, a unique way of topic model transplanting, which matches the dimension of the topic structures of the two data sets, is presented. Supplementary Information The online version contains supplementary material available at 10.1007/s13534-023-00322-7.
Collapse
Affiliation(s)
- Benedict Choonghyun Han
- Interdisciplinary Program in Bioengineering, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul, 08826 Republic of Korea
| | - Jimin Kim
- English Language and Literature, Seoul National University, 1 Gwanak-ro Gwanak-gu, Seoul, 08826 Republic of Korea
| | - Jinwook Choi
- Department of Biomedical Engineering, College of Medicine, Seoul National University, 101 Daehak-ro Jongno-gu, Seoul, 03080 Republic of Korea
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 103 Daehak-ro Jongno-gu, Seoul, 03080 Republic of Korea
| |
Collapse
|
40
|
Mohamed Z, Al-Natour M, Al Rahbi H. Prevalence of Diabetic Retinopathy Among Individuals with Diabetes in Gulf Cooperation Council countries: A Systematic Review and
Meta-analysis. Oman Med J 2024; 39:e585. [PMID: 38651051 PMCID: PMC11033453 DOI: 10.5001/omj.2024.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/28/2024] [Indexed: 04/25/2024] Open
Abstract
Objectives To determine the proportion of diabetic retinopathy (DR) among individuals with diabetes mellitus in the Gulf Cooperation Council (GCC) countries. Methods This study was executed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Online databases including Scopus, Web of Sciences, PubMed, Index Medicus for the eastern Mediterranean region, Medline, and ProQuest, were utilized to retrieve studies on the prevalence of DR in GCC countries that were conducted from 2003 to 2019. Results Twenty articles were included in the meta-analysis, involving 61 855 patients. The prevalence of DR was 20.5% (95% CI: 20.212-20.850). The highest prevalence rate was observed in Saudi Arabia (69.8%; 95% CI: 64.989-74.216) and the lowest in the UAE (6.0%; 95% CI: 2.780-11.084). There was a significant heterogeneity between the reviewed studies (p < 0.001). Conclusions The prevalence of DR was high in the GCC countries. Our findings provide crucial information for the public healthcare systems in these countries to actively educate the public and screen at-risk populations for undiagnosed cases of diabetes, detect early stages of retinopathy, and provide required care to minimize the number of untreated cases.
Collapse
Affiliation(s)
| | - Malek Al-Natour
- College of Health Sciences, University of Buraimi, Al Buraimi, Oman
| | - Hilal Al Rahbi
- College of Health Sciences, University of Buraimi, Al Buraimi, Oman
| |
Collapse
|
41
|
Ashebir N, Hailesilassie H, Girma S, Nigusu E, Ezo E. Prevalence of Cognitive Impairment and Associated Factors Among Diabetes Mellitus Patients Attending Follow-up Treatment at Fiche General Hospital, North Ethiopia. SAGE Open Nurs 2024; 10:23779608241227752. [PMID: 38292043 PMCID: PMC10826377 DOI: 10.1177/23779608241227752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/22/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024] Open
Abstract
Introduction Cognitive impairment is having trouble remembering, learning new things, concentrating, or making decisions that affect the daily life of diabetic patients. The worldwide prevalence of diabetes mellitus (DM) was 2.8% in 2000 and is estimated to be 4.4% by 2030. Objective To assess the prevalence of cognitive impairment and associated factors among DM patients attending follow-up treatment at Fiche General Hospital, North Ethiopia, 2022. Methods A hospital-based cross-sectional study was conducted from July 15 to September 15, 2022. The total sample size was 421 and a systematic random sampling technique was used. Data were collected through a face-to-face interview. Data were entered using EpiData Version 3.1 and exported to SPSS Version 24 for analysis. Statistically significant was declared at a P-value of less than .05 with an adjusted odds ratio (AOR) and 95% confidence interval (CI). Result The prevalence of cognitive impairment in the current study was 56.3% with (95% CI: 51.5-60.8). Primary educational status (AOR 6.73, 95% CI: 2.92-15.51), having Type II DM (AOR 4.93, 95% CI: 2.84-8.56), uncontrolled blood sugar (AOR 6.24, 95% CI: 3.84-10.17), and current alcohol use (AOR 1.94, 95% CI: 1.11-3.36) were significantly associated. Conclusion About three in 5 DM patients attending follow-up treatment at Fiche General Hospital were suffering from cognitive impairment. Educational status, type of DM, status of fasting blood sugar, and current alcohol use were associated with cognitive impairment among DM patients. Therefore, improving educational status, controlling blood sugar, and avoiding alcohol use may reduce the risk of cognitive impairment in DM patients.
Collapse
Affiliation(s)
- Nimona Ashebir
- Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Hailemariam Hailesilassie
- Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Shimelis Girma
- Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Elias Nigusu
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Elias Ezo
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| |
Collapse
|
42
|
Cacheux M, Rudokas M, Tieu A, Rizk JA, Hummel ME, Akar FG. Quantitative Assessment of Mitochondrial Morphology and Electrophysiological Function in the Diabetic Heart. Methods Mol Biol 2024; 2803:75-86. [PMID: 38676886 DOI: 10.1007/978-1-0716-3846-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Mitochondria within a cardiomyocyte form a highly dynamic network that undergoes fusion and fission events in response to acute and chronic stressors, such as hyperglycemia and diabetes mellitus. Changes in mitochondrial architecture and morphology not only reflect their capacity for oxidative phosphorylation and ATP synthesis but also impact their subcellular localization and interaction with other organelles. The role of these ultrastructural abnormalities in modulating electrophysiological properties and excitation-contraction coupling remains largely unknown and warrants direct investigation considering the growing appreciation of the functional and structural coupling between the mitochondrial network, the calcium cycling machinery, and sarcolemmal ion channels in the cardiac myocyte. In this Methods in Molecular Biology chapter, we provide a protocol that allows for a quantitative assessment of mitochondrial shape and morphology in control and diabetic hearts that had undergone detailed electrophysiological measurements using high resolution optical action potential (AP) mapping.
Collapse
Affiliation(s)
- Marine Cacheux
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Michael Rudokas
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Andrew Tieu
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Joanna Abi Rizk
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Madelyn E Hummel
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Fadi G Akar
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.
- Department of Biomedical Engineering, Yale University Schools of Engineering and Applied Sciences, New Haven, CT, USA.
- Yale University Schools of Medicine, Engineering and Applied Sciences, Electro-biology and Arrhythmia Therapeutics Laboratory, New Haven, CT, USA.
| |
Collapse
|
43
|
Shimony H, Miller L, Reich P, Banull NR, Burch M, Bryan M, María Arbeláez A. Pediatric diabetes mellitus hospitalizations and COVID-19 pandemic response measures. Diabetes Res Clin Pract 2024; 207:111060. [PMID: 38110121 DOI: 10.1016/j.diabres.2023.111060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023]
Abstract
AIMS In the United States, evidence suggests that during the COVID-19 pandemic, admissions of patients with diabetes mellitus (DM) have increased. This study assessed hospital admission rates for pediatric type 1 (T1DM) and type 2 (T2DM) diabetes mellitus during 2019-2021, and the potential influence of the timing of various pandemic response measures. METHODS Retrospective chart reviews were conducted of 854 T1DM and 135 T2DM hospital admissions between January 2019 and December 2021 in patients < 20 years old to collect demographic data, admission type, body mass index (BMI), and area deprivation index (ADI, a measure of socioeconomic vulnerability). Patients were divided into three cohorts based on their admission year: 2019 (Pre-pandemic), 2020 (Pandemic, Pre-vaccine), and 2021 (Pandemic, Post-vaccine). Admissions were categorized within each cohort by diagnosis (T1DM or T2DM) and clinical presentation (new onset, diabetic ketoacidosis: DKA). Cohorts were compared using an independent samples t-test for continuous variables or a chi-square test for categorical variables. RESULTS The incidence of T2DM hospitalizations tripled during the pandemic, increasing from 18 in 2019 (Pre-pandemic), to 55 in 2020 (Pandemic, Pre-vaccine), and 62 in 2021 (Pandemic, Post-vaccine). The rate of patients presenting with DKA was 15.4 % (95 % CI: 4 %-26.9 %) higher in 2020 (Pandemic, Pre-vaccine) among patients with new-onset T1DM (72/139 vs. 52/143), and 22.5 % (95 % CI: 9.6 %-35.4 %) higher in 2020 (Pandemic, Pre-vaccine) among T2DM patients (9/40 vs. 0/14). This increased rate of new onset T2DM significantly correlated with younger age (P = 0.046) and higher ADI score (P = 0.017), but not with BMI. CONCLUSION The incidence of T1DM hospitalizations did not increase during the pandemic; however, they tripled for T2DM patients. All new onset DM pediatric patients during the pandemic were more likely to present in DKA. Patients admitted with new onset T2DM were socioeconomically more vulnerable. For T1DM, the peak of local pediatric diabetes admissions in 2020 occurred slightly later coinciding with the reopening of primary care physicians (PCP) offices and schools.
Collapse
Affiliation(s)
- Hope Shimony
- Washington University School of Medicine, Pediatric Endocrinology, St. Louis, MO, USA
| | - Lauren Miller
- Washington University School of Medicine, Pediatric Endocrinology, St. Louis, MO, USA
| | - Patrick Reich
- Washington University School of Medicine, Pediatric Infectious Diseases, St. Louis, MO, USA
| | - Nicholas R Banull
- Washington University School of Medicine, Pediatric Endocrinology, St. Louis, MO, USA
| | - Maureen Burch
- Saint Louis Children's Hospital, Certified Diabetes Education Program, St. Louis, MO, USA
| | - Melanie Bryan
- Washington University School of Medicine, Pediatric Endocrinology, St. Louis, MO, USA
| | - Ana María Arbeláez
- Washington University School of Medicine, Pediatric Endocrinology, St. Louis, MO, USA.
| |
Collapse
|
44
|
Shojaee-Mend H, Velayati F, Tayefi B, Babaee E. Prediction of Diabetes Using Data Mining and Machine Learning Algorithms: A Cross-Sectional Study. Healthc Inform Res 2024; 30:73-82. [PMID: 38359851 PMCID: PMC10879823 DOI: 10.4258/hir.2024.30.1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES This study aimed to develop a model to predict fasting blood glucose status using machine learning and data mining, since the early diagnosis and treatment of diabetes can improve outcomes and quality of life. METHODS This crosssectional study analyzed data from 3376 adults over 30 years old at 16 comprehensive health service centers in Tehran, Iran who participated in a diabetes screening program. The dataset was balanced using random sampling and the synthetic minority over-sampling technique (SMOTE). The dataset was split into training set (80%) and test set (20%). Shapley values were calculated to select the most important features. Noise analysis was performed by adding Gaussian noise to the numerical features to evaluate the robustness of feature importance. Five different machine learning algorithms, including CatBoost, random forest, XGBoost, logistic regression, and an artificial neural network, were used to model the dataset. Accuracy, sensitivity, specificity, accuracy, the F1-score, and the area under the curve were used to evaluate the model. RESULTS Age, waist-to-hip ratio, body mass index, and systolic blood pressure were the most important factors for predicting fasting blood glucose status. Though the models achieved similar predictive ability, the CatBoost model performed slightly better overall with 0.737 area under the curve (AUC). CONCLUSIONS A gradient boosted decision tree model accurately identified the most important risk factors related to diabetes. Age, waist-to-hip ratio, body mass index, and systolic blood pressure were the most important risk factors for diabetes, respectively. This model can support planning for diabetes management and prevention.
Collapse
Affiliation(s)
- Hassan Shojaee-Mend
- Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad,
Iran
| | - Farnia Velayati
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran,
Iran
| | - Batool Tayefi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran,
Iran
| | - Ebrahim Babaee
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran,
Iran
- Vaccine Research Center, Iran University of Medical Sciences, Tehran,
Iran
| |
Collapse
|
45
|
Yu H, Lee CM, Oh SW. Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort. Korean J Fam Med 2024; 45:44-50. [PMID: 37993763 PMCID: PMC10822724 DOI: 10.4082/kjfm.23.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND To determine the association between type 2 diabetes mellitus and the consumption of various fruits. METHODS The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40-69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels. RESULTS A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99-1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88-1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84-0.96; P<0.001) for grapes. CONCLUSION Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.
Collapse
Affiliation(s)
- Hojun Yu
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
46
|
Isa HM, Khalaf SD, Janahi S, Naser MM, Al Hamad N, Alhaddar H, Busehail M. A Novel PTRH2 Gene Mutation Causing Infantile-onset Multisystem Neurologic, Endocrine, and Pancreatic Disease in a Bahraini Patient. Oman Med J 2024; 39:e599. [PMID: 38510576 PMCID: PMC10951560 DOI: 10.5001/omj.2024.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/29/2022] [Indexed: 03/22/2024] Open
Abstract
Infantile-onset multisystem neurologic, endocrine, and pancreatic disease (IMNEPD) is a rare autosomal recessive multisystemic disease with a prevalence of < 1/1 000 000. The wide spectrum of symptoms and associated diseases makes the diagnosis of this disease particularly challenging. Here, we report a 12-year-old Bahraini male who presented with the core clinical features of IMNEPD including intellectual disability, global developmental delay, sensorineural hearing loss, endocrine dysfunction, and exocrine pancreatic insufficiency. The diagnosis was confirmed by genetic testing using whole exome sequencing. This is the first reported case of IMNEPD from Bahrain and was found to have a novel homozygous peptidyl-tRNA hydrolase 2 (PTRH2) gene mutation (NM_001015509.2: c.370del p.(Glu124Lysfs*4)). Moreover, we conducted an extensive literature review with an emphasis on the variable clinical spectrum and genotypes of previously reported patients in comparison to our case.
Collapse
Affiliation(s)
- Hasan M. Isa
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
- Pediatric Department, Arabian Gulf University, Manama, Bahrain
| | - Sara D. Khalaf
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Sara Janahi
- Pediatric Department, Arabian Gulf University, Manama, Bahrain
| | - Mohamed M. Naser
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Noor Al Hamad
- Pediatric Department, Arabian Gulf University, Manama, Bahrain
| | - Hasan Alhaddar
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Maryam Busehail
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
- Pediatric Department, Arabian Gulf University, Manama, Bahrain
| |
Collapse
|
47
|
Lu CY, Chen HH, Chi KH, Chen PC. Obesity indices and the risk of total and cardiovascular mortality among people with diabetes: a long-term follow-up study in Taiwan. Cardiovasc Diabetol 2023; 22:345. [PMID: 38093333 PMCID: PMC10720223 DOI: 10.1186/s12933-023-02072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The association between obesity indicators and mortality in individuals with diabetes remains unclear, and data on cardiovascular mortality are scarce. Therefore, we investigated the associations between the five adiposity indices and both all-cause and cardiovascular mortality in patients with diabetes. METHODS This cohort study included 34,686 adults with diabetes who underwent a standard health-screening program between 1996 and 2017 in Taiwan. The dates and causes of death till January 2022 were retrieved from the National Death Registry. Cox proportional hazards models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cardiovascular mortality in relation to body mass index (BMI), waist circumference, waist-hip ratio (WHR), body fat percentage (BF%), and A Body Shape Index (ABSI), using the third quintile as the reference group. RESULTS During a median follow-up of 15 years, there were 8,324 deaths, of which 1,748 were attributed to cardiovascular disease. After adjusting for demographics, lifestyle factors and comorbidities, ABSI was associated with all-cause mortality in an exposure-response manner; the HR (95% CI) for first and fifth vs. third quintile was 0.78 (0.69-0.89) and 1.24 (1.14-1.35), respectively. A similar but weaker exposure-response relationship was found between WHR and mortality. People with a lower BMI and BF% had an increased risk of mortality (HR [95% CI] for the first vs. third quintiles, 1.33 [1.22, 1.44] and 1.42 [1.30, 1.56], respectively). No association was observed between waist circumference categories and risk of mortality. Similar results were observed for the association of BF%, waist circumference, and ABSI with cardiovascular mortality. However, no significant association was observed between BMI and cardiovascular mortality. The association between WHR and cardiovascular mortality was stronger than that between WHR and all-cause mortality. CONCLUSIONS ABSI demonstrated a consistent exposure-response relationship with both all-cause and cardiovascular mortality in this Asian cohort with diabetes. Our findings highlight the importance of monitoring ABSI, a surrogate index of central adiposity, in patients with diabetes.
Collapse
Affiliation(s)
- Chung-Yen Lu
- Department of Sport and Health Management, Da-Yeh University, Changhua, 515, Taiwan
- Long Health Chinese Medicine Clinic, Taipei, 106, Taiwan
| | - Hsiao-Hui Chen
- Department of Public Health, China Medical University, Taichung, 406, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407, Taiwan
| | - Kuan-Hui Chi
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Road, Miaoli, 350, Taiwan
| | - Pei-Chun Chen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, 35 Keyan Road, Miaoli, 350, Taiwan.
- Big Data Center, China Medical University Hospital, Taichung, 404, Taiwan.
| |
Collapse
|
48
|
Li Z, Xiong J, Guo Y, Tang H, Guo B, Wang B, Gao D, Dong Z, Tu Y. Effects of diabetes mellitus and glycemic traits on cardiovascular morpho-functional phenotypes. Cardiovasc Diabetol 2023; 22:336. [PMID: 38066511 PMCID: PMC10709859 DOI: 10.1186/s12933-023-02079-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The effects of diabetes on the cardiac and aortic structure and function remain unclear. Detecting and intervening these variations early is crucial for the prevention and management of complications. Cardiovascular magnetic resonance imaging-derived traits are established endophenotypes and serve as precise, early-detection, noninvasive clinical risk biomarkers. We conducted a Mendelian randomization (MR) study to examine the association between two types of diabetes, four glycemic traits, and preclinical endophenotypes of cardiac and aortic structure and function. METHODS Independent genetic variants significantly associated with type 1 diabetes, type 2 diabetes, fasting insulin (FIns), fasting glucose (FGlu), 2 h-glucose post-challenge (2hGlu), and glycated hemoglobin (HbA1c) were selected as instrumental variables. The 96 cardiovascular magnetic resonance imaging traits came from six independent genome-wide association studies. These traits serve as preclinical endophenotypes and offer an early indication of the structure and function of the four cardiac chambers and two aortic sections. The primary analysis was performed using MR with the inverse-variance weighted method. Confirmation was achieved through Steiger filtering and testing to determine the causal direction. Sensitivity analyses were conducted using the weighted median, MR-Egger, and MR-PRESSO methods. Additionally, multivariable MR was used to adjust for potential effects associated with body mass index. RESULTS Genetic susceptibility to type 1 diabetes was associated with increased ascending aortic distensibility. Conversely, type 2 diabetes showed a correlation with a reduced diameter and areas of the ascending aorta, as well as decreased distensibility of the descending aorta. Genetically predicted higher levels of FGlu and HbA1c were correlated with a decrease in diameter and areas of the ascending aorta. Furthermore, higher 2hGlu levels predominantly showed association with a reduced diameter of both the ascending and descending aorta. Higher FIns levels corresponded to increased regional myocardial-wall thicknesses at end-diastole, global myocardial-wall thickness at end-diastole, and regional peak circumferential strain of the left ventricle. CONCLUSIONS This study provides evidence that diabetes and glycemic traits have a causal relationship with cardiac and aortic structural and functional remodeling, highlighting the importance of intensive glucose-lowering for primary prevention of cardiovascular diseases.
Collapse
Affiliation(s)
- Zhaoyue Li
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Jie Xiong
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Yutong Guo
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Hao Tang
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Bingchen Guo
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Bo Wang
- Harbin Medical University, Harbin, China
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Dianyu Gao
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Zengxiang Dong
- Harbin Medical University, Harbin, China.
- The Key Laboratory of Cardiovascular Disease Acousto-Optic Electromagnetic Diagnosis and Treatment in Heilongjiang Province, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
- NHC Key Laboratory of Cell Transplantation, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Yingfeng Tu
- Harbin Medical University, Harbin, China.
- Department of Cardiology, the First Affiliated Hospital, Harbin Medical University, Harbin, China.
| |
Collapse
|
49
|
Chen YY, Chen CH, Chen YF. A Rare Cause of Poorly Controlled Diabetes Mellitus. Gastroenterology 2023; 165:e1-e3. [PMID: 37286094 DOI: 10.1053/j.gastro.2023.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/09/2023]
Affiliation(s)
- Yang-Yuan Chen
- Division of Gastroenterology, Endoscopic Center, Changhua Christian Hospital and Yuan Lin Branch, Department of Hospitality Management, MingDao University, Changhua, Taiwan.
| | - Chih-Hsuan Chen
- Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Fang Chen
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
50
|
Tang FY, Guo XT, Zhang L, Yuan L, Gan T, Wang M, Chen X, Feng CC, Qin Y, Li J, Yu YF. The prevalence of diabetes distress in Chinese patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2023; 206:110996. [PMID: 37956943 DOI: 10.1016/j.diabres.2023.110996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/29/2023] [Accepted: 11/08/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVE To systematically evaluate the prevalence of Diabetes Distress (DD) in type 2 diabetes mellitus (T2DM) patients in China. METHODS The PubMed, PsycInfo, Web of Science, The Cochrane Library, EMBASE, China Knowledge Resource in Integrated Database (CNKI), WanFang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) electronic databases were searched from inception to August 2022, for cross-sectional studies, that reported prevalence of DD. RESULTS This study included 55 articles involving 13,160 patients with T2DM. The pooled prevalence of DD was 53.2%. The results of the subgroup analysis showed that among the five regions in China, the highest prevalence of DD was observed in Central China (66%), while the lowest prevalence was recorded in North China (23%). The highest prevalence of DD was 82% in unmarried people. while the lowest prevalence of DD among outpatients was as low as 42%. The results of meta-regression showed that there was no correlation between the prevalence of DD and the year of publication, the average age of the patients, or the duration of the disease. CONCLUSION More than half of T2DM patients in China may suffer from DD, which is not conducive to the self-management of diabetes patients. The burden on the healthcare system and the burden of disease on individual patients may increase as a result. Medical staff should pay attention to the monitoring and management of the mental health status of patients with T2DM.
Collapse
Affiliation(s)
- Fu-You Tang
- Department of Anesthesiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan, 621900, China
| | - Xin-Tong Guo
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lu Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Lei Yuan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ting Gan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Mei Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xu Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Cen-Cen Feng
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yu Qin
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jing Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yu-Feng Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
| |
Collapse
|