Tailoring interventions to close gaps in diabetes mellitus care.

There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and this study aimed to assess feasibility and results of screening patients with TB for DM within the routine healthcare setting of six health facilities. Agreement on how to screen, monitor and record was reached in May 2011 at a stakeholders' meeting, and training was carried out for staff in the six facilities in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012. There were 8886 registered patients with TB. They were first asked whether they had DM. If the answer was no, they were screened with a random blood glucose (RBG) followed by fasting blood glucose (FBG) in those with RBG ≥ 6.1 mm (one facility) or with an initial FBG (five facilities). Those with FBG ≥ 7.0 mm were referred to DM clinics for diagnostic confirmation with a second FBG. Altogether, 1090 (12.4%) patients with DM were identified, of whom 863 (9.7%) had a known diagnosis of DM. Of 8023 patients who needed screening for DM, 7947 (99%) were screened. This resulted in a new diagnosis of DM in 227 patients (2.9% of screened patients), and of these, 226 were enrolled to DM care. In addition, 575 (7.8%) persons had impaired fasting glucose (FBG 6.1 to <7.0 mm). Prevalence of DM was significantly higher in patients in health facilities serving urban populations (14.0%) than rural populations (10.6%) and higher in hospital patients (13.5%) than those attending TB clinics (8.5%). This pilot project shows that it is feasible to screen patients with TB for DM in the routine setting, resulting in a high yield of patients with known and newly diagnosed disease. Free blood tests for glucose measurement and integration of TB and DM services may improve the diagnosis and management of dually affected patients.

BackgroundNon-communicable diseases, including diabetes mellitus and hypertension, continue to disproportionately burden low- and middle-income countries. However, little research has been done to establish current practices and management of chronic disease in these settings. The objective of this study was to examine current clinical management and identify potential gaps in care of patients with diabetes mellitus and hypertension in the district of Toledo, Belize.MethodsThe study used a mixed methodology to assess current practices and identify gaps in diabetes mellitus and hypertension care. One hundred and twenty charts of the general clinic population were reviewed to establish disease epidemiology. One hundred and seventy-eight diabetic and hypertensive charts were reviewed to assess current practices. Twenty providers completed questionnaires regarding diabetes mellitus and hypertension management. Twenty-five individuals with diabetes mellitus and/or hypertension answered a questionnaire and in-depth interview.ResultsThe prevalence of diabetes mellitus and hypertension was 12%. Approximately 51% (n = 43) of patients with hypertension were at blood pressure goal and 26% (n = 21) diabetic patients were at glycemic goal based on current guidelines. Of the patients with uncontrolled diabetes, 49% (n = 29) were on two oral agents and only 10% (n = 6) were on insulin. Providers stated that barriers to appropriate management include concerns prescribing insulin and patient health literacy. Patients demonstrated a general understanding of the concept of chronic illness, however lacked specific knowledge regarding disease processes and self-management strategies.ConclusionsThis study provides an initial overview of diabetes mellitus and hypertension management in a diverse patient population in rural Belize. Results indicate areas for future investigation and possible intervention, including barriers to insulin use and opportunities for lifestyle-specific disease education for patients.

There is a high burden of both diabetes (DM) and tuberculosis (TB) in China, and as DM increases the risk of TB and adversely affects TB treatment outcomes, there is a need for bidirectional screening of the two diseases. How this is best performed is not well determined. In this pilot project in China, we aimed to assess the feasibility and results of screening DM patients for TB within the routine healthcare setting of five DM clinics. Agreement on how to screen, monitor and record was reached in May 2011 at a national stakeholders meeting, and training was carried out for staff in the five clinics in July 2011. Implementation started in September 2011, and we report on 7 months of activities up to 31 March 2012. DM patients were screened for TB at each clinic attendance using a symptom-based enquiry, and those positive to any symptom were referred for TB investigations. In the three quarters, 72% of 3174 patients, 79% of 7196 patients and 68% of 4972 patients were recorded as having been screened for TB, resulting in 7 patients found who were already known to have TB, 92 with a positive TB symptom screen and 48 of these newly diagnosed with TB as a result of referral and investigation. All patients except one were started on anti-TB treatment. TB case notification rates in screened DM patients were several times higher than those of the general population, were highest for the five sites combined in the final quarter (774/100 000) and were highest in one of the five clinics in the final quarter (804/100 000) where there was intensive in-house training, special assignment of staff for screening and colocation of services. This pilot project shows that it is feasible to carry out screening of DM patients for TB resulting in high detection rates of TB. This has major public health and patient-related implications.

COVID-19 boosters and building trust among UK minority ethnic communities

Several high-income countries are currently experiencing an unprecedented and multifaceted housing crisis. The crisis is escalating rapidly, and its negative ramifications are shared disproportionately by migrant and refugee communities. Although housing is often cited as an important social determinant of health, the relationship between housing inequalities and health outcomes in the context of migrant and refugee populations remain under-explored, particularly in high-income countries. This paper presents a protocol for a mixed-methods systematic review which will synthesize the evidence on the key housing and health inequalities faced by migrant and refugee populations in high-income countries. It will inform the identification of pathways linking housing inequalities to health outcomes. The protocol for this systematic review was developed with guidance from the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration, and the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. Quantitative, qualitative and mixed-methods studies reporting the association of housing inequalities with physical and mental health outcomes among refugee and migrant populations in high-income countries will be included. Medline, Web of Science, Embase, PsycINFO, Scopus and CINAHL will be searched for peer-reviewed literature. This will be supplemented by gray literature searches using Google Scholar, MedNar and WHOLIS. Two reviewers will independently screen and select studies, assess the methodological quality and conduct data extraction. This systematic review will elucidate the different pathways linking housing inequalities and health outcomes, which may guide the development of targeted housing and public health interventions to improve the health and wellbeing of migrant and refugee populations. The review is registered with PROSPERO (CRD42022362868).

Introduction and aim. In this review, we suggest ways to improve diabetes mellitus (DM) care in Nigeria from a Health Promotion and Education (HPE) perspective by addressing the gap in DM care through the adoption of strategies from the Ottawa Charter and National Health Promotion Policy (NHPP) guidelines. Material and methods. This review conducted a comprehensive literature search on Africa Journal Online, PubMed, Google Scholar, and Science Direct, from 1986 to 2023, using relevant keywords. Analysis of the literature. The adoption of the Ottawa charter and NHPP remains a key strategy in addressing the gap in DM care in Nigeria. This could be achieved by the adoption of population-focused multi-sectoral interventions encompassing legislation, regulation, and fiscal measures, creating sustaining and expanding health-promoting environments to reduce modifiable risk factors, and reorienting the primary health care services to aid the diagnosis, treatment and rehabilitation of DM patients. Conclusion. This review concluded that the government and other critical stakeholders should adopt the HPE strategies that covers increased financing, strict legislation on DM modifiable risk factors, reorientation of the primary healthcare system, and capacity building for HPE practitioners into DM care in Nigeria as a strategy to improving DM care and prevention in Nigeria.

Introduction: The HCHS/SOL demonstrated that diabetes mellitus (DM) was associated with elevated risk for CVD in a diverse Hispanic/Latino (H/L) cohort. However, the nature of these relationships as a function of H/L background, sex and other relevant variables is still unknown. Objective: We examined across approximately 6 years, the prevalence and incidence of DM and CVD and the CVD-DM relationship in diverse H/L. Methods: Participants at Visit 1:V1 (2008-2011) were 16,386 individuals with DM relevant data, whereas participants at Visit 2:V2 (2014-2016) were 8,401 individuals with similar data who attended the ongoing examination, constituting approximately 60% of the cohort to be studied. Descriptive characteristics were age-standardized to the 2010 U.S. population, and stratified by sex and H/L background. Prevalence estimates were weighted to the known population distribution, adjusting for sampling probability and nonresponse, and trimmed to handle extreme values of weights. Age-adjusted incidence rates /100 person years were estimated across Visit 1, based upon Poisson regression with robust variance taking into account the complex survey design. Both prevalence and incidence values are presented as % (95% CI). Prevalence and incidence of DM were examined by sex, age, H/L background, field center and BMI. We also examined the prevalence and incidence of CVD in those with and without DM by sex, H/L background, age and BMI. Results: Overall prevalence of DM was 17.8 (17.0, 18.6) at V1 and 19.4 (18.3, 20.5) at V2. The prevalence of DM at V2 was lowest, 11.2 (8.2, 15.3) for those of South American and highest for those of Puerto Rican, 22.5 (19.5, 25.8) background. While the prevalence of DM did not differ between women and men, the overall incidence rate for DM was significantly higher for men, 1.53 (1.32, 1.76) than for women, 1.06 (0.94, 1.18). The overall prevalence of CVD was significantly higher for DM than for non-DM individuals at V2: 9.2 (7.9, 10.7) vs. 4.5 (3.9, 5.2). The incidence rate across Visits, 0.71 (0.55, 0.92) vs. 0.20 (0.15, 0.27) was also higher for DM individuals. At V2 the CVD prevalence for DM men, 12.0 (9.7, 14.6) was greater than for DM women, 7.2 (5.6, 9.2). The relationship of CVD prevalence to DM status revealed different patterns among H/L background groups. At V2, for example, those of South American background showed relatively low CVD prevalence: 5.3 (2.6, 10.4) with DM vs. 4.2 (2.3, 7.5) without DM. In contrast, those of Puerto Rican background showed relatively high CVD prevalence: 15.6 (11.0, 21.6) with DM vs. 5.7 (4.1, 8.0) without DM. Conclusions: Overall prevalence and incidence of CVD was significantly higher for DM than for non-DM individuals and these CVD-DM relationships varied markedly across H/L background groups.

IntroductionNoncommunicable diseases (NCDs) are associated with high and rising burden of morbidity and mortality in sub-Saharan Africa, including Nigeria. Diabetes mellitus (DM) is among the leading causes of NCD-related deaths worldwide and is a foremost public health problem in Nigeria. As part of National policy, Nigeria has committed to implement the World Health Organization (WHO) Package of Essential Non-communicable Disease interventions for primary care. Implementing the intervention requires the availability of essential elements, including guidelines, trained staff, health management information systems (HMIS), equipment, and medications, in primary healthcare centers (PHCs). This study assessed the availability of the DM component of the WHO package, and the readiness of the health workers in these PHCs to implement a DM screening, evaluation, and management program to inform future adoption and implementation.MethodsThis cross-sectional formative assessment adapted the WHO Service Availability and Readiness Assessment (SARA) tool to survey 30 PHCs selected by multistage sampling for readiness to deliver DM diagnosis and care in Abuja, Nigeria, between August and October 2021. The SARA tool was adapted to focus on DM services and the availability and readiness indicator scores were calculated based on the proportion of PHCs with available DM care services, minimum staff requirement, diagnostic tests, equipment, medications, and national guidelines/protocols for DM care within the defined SARA domain.ResultsAll 30 PHCs reported the availability of at least two full-time staff (median [interquartile range] = 5 [4–9]), which were mostly community health extension workers (median [interquartile range]) = 3 [1–4]. At least one staff member was recently trained in DM care in 11 PHCs (36%). The study also reported high availability of paper-based HMIS (100%), and DM screening services using a glucometer (87%), but low availability of DM job aids (27%), treatment (23%), and national guidelines/protocols (0%).ConclusionThis formative assessment of PHCs’ readiness to implement a DM screening, evaluation, and management program in Abuja demonstrated readiness to integrate DM care into PHCs regarding equipment, paper-based HMIS, and nonphysician health workers' availability. However, strategies are needed to promote DM health workforce training, provide DM management guidelines, and supply essential DM medications.

Objectives: This cross-sectional study was conducted to find out the prevalence of type 2 diabetes and pre-diabetes ((PD) (Impaired fasting glucose-IFG, impaired glucose tolerance-IGT)) and to see the associations with risk factors.&#x0D; Methods: Two villages were randomly selected from rural area of Mymensingh district. 125 study subjects (≥30 years) were selected with systematic procedure but 118 samples were participated in the study. Below 30 years, diagnosed case of diabetes and urban people were excluded from study. Socio-demographic data were collected on a pre-tested interview schedule through face to face interview. DM, PD were interpreted by estimating fasting blood glucose level and 2 hour after 75 gm glucose load. Obesity was assigned by BMI. SPSS program (version 11.5) used for data analysis.&#x0D; Results: Mean age of participants was 46.68 with SD ± 12.698. Female participation (66.9%) was double compare to male, literacy rate was (64.4%) with female illiteracy of 29.67%. House wives (61.9%) were more than other professions. Middle class people were nearly 73%, Poor 14.4%, sedentary life style 11% and depressives 14.4% evident in study. A 20.3% people did laborious works. 17.8% had the family history of diabetes. Smokers (53.4%) were more than the non-smokers. Majority (89.0%) of rural people eat rice thrice a day. Normal BMI 61.0%, underweight 31.4% and 7.6% overweight observed. Overall prevalence of T2 DM was 11.0% showing increase trend of diabetes compared to 8.6% estimated in 2000 and higher than several studies of home and abroad. Female showed higher prevalence (7.6%) compare to male (P&gt;0.05). The overall prevalence of PD was 16.1% evident in this study. The prevalence of IFG and IGT were 8.5% and 7.6% respectively. Female showed higher prevalence of IFG (5.1%) and IGT (5.9%) than male (P&gt;0.05). House wives showed higher prevalence (5.6%) of DM compare to other professions (P&gt;0.05). Illiterates showed more PD (10.3%) and less DM (1.7%) but literates showed more (9.3%) DM (P &gt;0.05). DM (6.7%) and PD (11.8%) more were among the middle class (P=0.018). A high prevalence of PD (13.6%) and DM (9.3%) noticed among non-sedentary lifestyle (P &gt;0.05). Smoker showed higher DM (8.5%) and PD (11.8%). (P-0.071). Prevalence of PD and DM were high among the people with physically less active (P =0.795). Depressives showed more prevalence of DM (8.5%) and PD (13.5%), (P=0.345). increased frequency of rice eating (P=0.004), people with normal BMI (P=0.081) and family history of DM (P=0.000) showed positive association with diabetes mellitus.&#x0D; CBMJ 2015 January: Vol. 04 No. 01 P: 22-29

Background: The association between pre-existing diabetes mellitus (DM) and subsequent increased incidence of breast cancer (BC), as well as worse survival after BC diagnosis, is well described. However, the reverse relationship of BC or metastases to development of new onset DM is unknown. Preclinical evidence suggests that increased bone destruction due to bone metastases or endocrine therapy impairs insulin secretion via TGFβ-mediated oxidation of the ryanodine receptor in pancreatic β- cells, predisposing patients to development of new onset DM. This analysis describes the prevalence and new onset of DM in metastatic BC compared to matched, unaffected controls and non-metastatic BC. Methods: This retrospective study collected data on women from the Indiana Network for Patient Care (INPC, a multi-health system electronic health record data warehouse), and the Indiana State Department of Health Cancer Registry from 2015 to 2017. Diagnosis of BC and metastases were established using ICD codes from INPC and confirmed in the cancer registry. DM was defined using a combination of ICD codes, diabetic medication prescriptions, and hemoglobin A1c &amp;gt;6.5%. Controls without BC were matched to all BC cases by birth year and race. The prevalence of DM before, or &amp;lt; 30 days after, BC diagnosis is described for non- cancer controls, all patients with BC, and subgroups without metastases, any metastases, and with bone metastases. In patients without evidence of DM prior to or &amp;lt; 30 days after BC diagnosis, the incidence of new onset DM was compared to matched controls over the same time period. The occurrence of new DM was evaluated both including and excluding the first 6 months after BC diagnosis to account for potential DM diagnosis simply due to medical attention. Prevalence and subsequent incidence of DM was compared between cases and controls using Pearson’s chi-square tests. Variables including demographics, comorbidities, BC treatment, A1c values, and DM treatments were also collected. Results: Any DM diagnosis, pre-existing DM, and new onset DM were higher in breast cancer cases compared to controls (Table). While pre-existing DM was similar between those with metastatic and non-metastatic DM (35.0% vs. 32.2%, p=0.22), new onset DM was higher in metastatic disease compared to non-metastatic BC (14.4% vs. 7.0%, p&amp;lt;0.001). Hemoglobin A1c was higher in those with metastatic disease, particularly those with bone metastases (8.8 vs 7.5, p&amp;lt;0.001). Conclusions: Diabetes is highly prevalent in this Indiana BC cohort. Incidence of new onset DM after BC is higher in those with metastatic BC compared to both controls and BC cases without metastatic disease. Hemoglobin A1c was highest in those with bone metastases, further supporting the hypothesis that bone turnover may influence insulin secretion and glucose metabolism. Additional investigation will analyze the influence of medications (chemo-, endocrine, and bone protective therapy) on development of DM. As more patients live longer with metastatic BC, identification and management of DM will be imperative given its impact on BC survival, treatment delivery, healthcare costs, and quality of life. ControlsBreast cancer (BC) casesAllNon-metAll metBone metNon-bone metTotal n10212102129760452236216Any DM, n (%)2464 (24.1)4406 (43.1)3823 (39.2)223 (49.3)111 (47.0)112 (51.9)p-value2&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001Pre-existing DM1, n (%)2111 (20.1)3301 (32.2)3143 (32.2)158 (35.0)81 (34.3)77 (35.6)p-value2&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001New DM after BC1, n (%)353 (3.5)745 (7.3)680 (7.0)65 (14.4)30 (12.7)35 (16.2)p-value2&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001New DM &amp;gt; 6 months after BC1, n (%)336 (3.3)621 (6.1)565 (5.8)56 (12.4)27 (11.4)29 (13.4)p-value2&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001&amp;lt;0.001HgbA1c in those with DM, Mean (SD)7.6 (1.6)7.6 (1.6)7.5 (1.6)8.3 (2.1)7.5 (1.6)8.8 (2.3)p-value21.00.001&amp;lt;0.0010.40&amp;lt;0.0011- For controls, values in relation to index date. 2 - p-values versus controls. Citation Format: Tarah Ballinger, Sarah El-Azab, Ziyue Liu, Theresa Guise, Erik Imel. High prevalence and incidence of new onset diabetes in metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-08-11.

Objective: Diabetes Mellitus (DM) is a common chronic illness and a preventable risk factor for cardiovascular morbidity and mortality worldwide. Almost two-thirds of these deaths occurred in low-middle-income countries. In Argentina, Chile and Uruguay, only the prevalence of self-reported diagnosed DM are available. We conducted a population-based cross-sectional study in a multistage-probabilistic sample of around 8,000 subjects aged 35-74 years old from 4 cities: Bariloche and Marcos Paz in Argentina and Temuco in Chile and Canelones in Uruguay, to estimate the prevalence and distribution of diagnosed and undiagnosed diabetes and pre-diabetes, as well as the level of glycemic control. Methods: Data on history of diagnosed DM and use of antidiabetic drugs were obtained using a standard questionnaire. An overnight-fasting blood sample was drawn to measure plasma glucose (FPG). DM was defined by self-reported history of DM or a FPG ≥126 mg/dl (7.0 mmol/l), while pre-diabetes was defined as FPG 100-125 mg/dl (5.6-6.9 mmol/l). Prevalence of DM was calculated by weighting sampling factors derived from population census data for each city. FPG ≤ 130 (≤7.2 mmol/l) was considered a proxy for good glycemic control and FPG ≥200 mg/dl (11 mmol/l) for very poor control. Results: In our study, 11.9 % (11.0% in men and 13.1% in women) had DM and 4.6% had prediabetes (6.1% in men and 2.9% in women). The age-specific prevalence of DM was 4.3%, 10.9%, 17.5%, and 24.2% for ages 35-44, 45-54, 55-64 and 65-74 yrs, respectively. In addition, DM prevalence decreased with the levels of education (15.1%, 10.8% and 9.1% for primary, secondary and tertiary/university education, respectively). Overall, 20.3% of subjects with DM were not aware of their condition (230% in men and 17.6% in women) with age-specific rates of 32.2%, 27.8%, 17.2%, and 11.7% for ages 35-44, 45-54, 55-64, and 65-74 yrs, respectively. The overall rate of good glycemic control in diabetics was 46.1%, and the rate of very poor control of DM was 16,4%, with variation across sites (25,5 % in Marcos Paz, 22,4% in Temuco, 16,4% in Bariloche, and 11,6% in Canelones) but no variation by sex, age, education level or health coverage. Conclusion: DM appears as an increasingly challenging public health issue as the Southern Cone of Latin America is completing the demographic, epidemiological and nutritional transition. We found a prevalence of DM higher than was observed in previous studies for the region with dismal rates of unknown DM, also varying by age, gender, and level of education. It is a matter of concern the striking variability shown in the rates of very poorly controlled DM across sites, not associated with socio-demographic factors, which might reflect distinct characteristics related to the sites that need to be explored in further analysis. These data provide a basis for targeting public health policies to reduce the prevalence of DM in the region.

Cervical cancer is currently the fourth leading cause of cancer in women. It is primarily caused by Human Papilloma Virus (HPV) infections. Primary prevention methods, such as vaccines, and secondary prevention strategies, such as screening, have significantly reduced the burden of these diseases. The screening could be a crucial factor in the early diagnosis. This study aims to estimate the access of migrant and refugee populations to cervical cancer screening (CCS). A meta-analysis of scientific literature present in Pubmed and Scopus databases was conducted according to the PRISMA 2020 guidelines. Eighty-seven cross-sectional and five cohort unique studies were examined, to evaluate the participation of migrant and refugee populations to CCS programs in different world regions. Statistical analysis was performed using STATA 14.2 software. Among cross-sectional studies, mean regular adherence to CCS for migrant and refugees resulted being 56% (95% CI 53-60), while participation at least once is 60% (95% CI 54-65). In cohort studies, regular adherence and participation at least once are, respectively, 55% (95% CI 50-59) and 56% (95% CI 52-61). The results of this review show how migrant and refugee populations have limited access to prevention interventions due to several socio-cultural factors. Our work calls for public health professionals' efforts in order to promote more inclusive policies and prevention strategies towards those populations, aiming to reduce disparities and public health expenditures.

Hypertension (HTN) and type 2 diabetes mellitus (DM) are risk factors for cardiovascular disease (CVD), which is increasing in rural China. Little data is available about their prevalence among ethnic minorities in rural China. Eleven villages were randomly selected from Yunnan province, China. Six hundred thirty-four randomly selected subjects from six ethnic minorities and the Han ethnic majority participated in a cross-sectional survey, which included blood pressure (BP) and HbA1c measurements. From each village, 70–90 men and women between the ages of 50 and 70 years were randomly selected. The prevalence and self-reported history of HTN and DM were evaluated in these seven ethnic groups. The prevalence of DM was 6.3 %, with variability between ethnic groups, ranging from 2.7 % in the Tibetan group to 9.8 % in the Han group (P = 0.09). HTN prevalence also varied from 30.5 % in the Lisu group to 54.7 % in the Tibetan group (P = 0.003). Only 22.5 % (9/40) and 47.7 % (112/235) of those diagnosed with DM and HTN, respectively, had reported a known history of their condition. The prevalence of DM varied across ethnic groups, with Han people having a greater prevalence than the ethnic minorities. As most subjects with DM or HTN were not actually aware of their condition, there is need for increased screening and education promotion in this region.

This study was conducted in Riyadh to determine the prevalence of diabetes mellitus and impaired glucose tolerance. Blood samples (3981) were collected from Saudi male and female adults (2402) and children (1579) during a household screening program conducted over a period of two years from September 1991 to September 1993. Fasting blood samples were collected and each individual was given an oral glucose load. Two-hour postprandial blood glucose was estimated and the World Health Organization (WHO) criteria were used to diagnose diabetes and impaired glucose tolerance. The diabetic patients were further grouped into noninsulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM) depending on the age of onset and mode of treatment. The overall prevalence of diabetes mellitus (IDDM and NIDDM) was 4.76% in males and 4.10% in the females in the two-to 70-year age group. Ten individuals of the 3981 were suffering from IDDM, giving an incidence of two to three per 1000. When the children <14 years were removed, the prevalence increased to 8.235% and 6.476% in the males and females respectively, while in the >30 year old group, the prevalence increased to 16.0% and 12.34% in the males and females. Further significant increase in NIDDM and impaired glucose tolerance (IGT) was observed with age (P<0.05). NIDDM was more frequent in males while IGT was more frequent in females. This paper presents the results of screening in Riyadh and stresses the need for diabetes mellitus awareness programs in the Saudi population.

A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent. Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression. MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD. A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 -12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26-1.43 p < 0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12-0.60; p < 0.001) and higher UPDRS (SMD 0.60 95%CI 0.28-0.92; p < 0.001) compared with PD patients without DM. Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.