Characteristics Of Diabetic Patients Research Articles

The influence of diabetes on sleep-derived cardiorespiratory features of the finger pulse wave signal – The population-based SCAPIS study

Study objectivesAdvanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities. MethodsThis cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50–64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification. ResultsPulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (β = −0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (β = −0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis. ConclusionsPhotoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes.

Analyzing pancreatic characteristics in diabetic patients: A texture-based CT investigation with volume assessment

The current study aimed to analyze the texture feature of the pancreas in diabetic patients at King Faisal Medical Complex (KFMC) in Taif, KSA through Cutting-Edge Computed tomography (CT) image analysis and volume metrics. Material and method: 78 participants were involved, 39 patients with normal pancreas acted as a control group, while the remaining 39 were diagnosed with diabetes, out of which 20 had type 2 diabetes (T2D) and 19 had type 1 diabetes (T1D). These patients underwent CT scans using two specific CT scanners and were compared to normal subjects with the same age, gender and CT scanner. The entire pancreas was subjected to computerized texture analysis, which involved the extraction of 31 variable features. A multivariate logistic regression analysis was used to identify factors that could predict diabetes. A Receiver Operating Characteristic (ROC curve) was generated to determine the optimal cut-off values for statistically significant variables. Findings: Analysis of various pancreatic texture features revealed sphericity to be the most informative for diagnosing diabetes. Diabetic patients, in general, exhibited lower sphericity compared to healthy controls (p = 0.0246). For individuals with diabetes, the sphericity feature demonstrated a sensitivity of 74.36%, a specificity of 69.23%, and an Area Under the Curve (AUC) of 0.7538. Interestingly, subgroup analysis did not show any significant differences among patients with type 2 diabetes. ConclusionThis study demonstrates the potential of using computerized 3D CT texture analysis of the pancreas to assess diabetes mellitus through the measurement of quantitative parameters.

#771 Estimating glomerular filtration rate: does the diabetic status influence the performances of current equations?

Abstract Background and Aims Diabetes is the first cause of chronic kidney disease (CKD) worldwide. The estimation of glomerular filtration rate (GFR) is one main tool to detect CKD. The most used biomarker remains serum creatinine and the European Kidney Function Consortium (EKFCcrea) equations is the most validated in Europe. More recently, another renal biomarker, cystatin C, has been proposed. In the current analysis, we studied the performances of the EKFC equations in a large cohort of subjects according to their diabetic status. Method Four cohorts from the EKFC dataset were considered in which the diabetic status was available: Lund, Sweden (n = 2,780), Berlin, Germany (n = 654), Créteil, France (n = 466), and Paris, France (n = 2,258). Serum creatinine and cystatin C were measured with calibrated assays. GFR was measured by plasma clearances (mGFR) (iohexol in Lund, Berlin and Créteil and 51Cr-EDTA in Paris). The performance of the equations was assessed by calculating bias, precision (IQR) and P30 (percentage of eGFR-values within ±30% of mGFR). As the characteristics of diabetic patients were different, we matched diabetic and non-diabetic patients using the following matching criteria: age (±3 years), sex (equal), mGFR (±3 mL/min/1.73 m²), and BMI (±2.5 kg/m²). Results In the whole population (n = 6,158), median [IQR] age was 61 [47; 72] years, with 45.8% of women. Mean measured GFR (mGFR) was 60 [39; 82] mL/min/1.73 m². Compared to non-diabetic subjects (n = 5,124), diabetic patients (n = 1,034) were older, more frequently males, heavier, had lower mGFR (45 vs 64 mL/min/1.73 m²), and higher creatinine (1.44 vs 1.06 mg/dL; p < 0.0001) and cystatin C (1.67 vs 1.20 mg/L) concentrations. The performance of the EKFCcys equation was similar to EKFCcrea, but the EKFCcrea+cys had better P30 than single-biomarker equations. Globally, P30 were substantially lower in diabetic patients than in non-diabetic patients (Table). We could match data for 289 females and 546 males. The results in the matched cohorts were quite similar between diabetics and non-diabetics subjects, and this is true for every equation. Conclusion In conclusion, in a large dataset of patients including diabetics and non-diabetics, we showed that the EKFC equations are accurate in diabetic and non-diabetic patients. Combining the creatinine and cystatin C-based equations presents an added value. If accuracy of all equations seems better in non-diabetic than in diabetic subjects, it is probably more due to differences in age and (still more) in GFR levels than to the diabetic status.

Unveiling the Effects of Diabetes on Coronary Artery Disease Through Angiography

Background: Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, particularly among patients with Type 2 Diabetes Mellitus (T2DM). Diabetic patients are at a higher risk of developing CAD due to factors such as poor glycemic control, lipid metabolism abnormalities, and endothelial dysfunction. Prior studies have demonstrated that diabetic patients tend to present with more extensive coronary artery involvement and worse outcomes following cardiovascular interventions. Objective: This study aimed to assess the impact of T2DM on coronary angiography outcomes, specifically focusing on the incidence of multi-vessel disease and the severity of coronary artery stenosis. Methods: This observational cohort study was conducted at Lady Reding Hospital, a tertiary care center specializing in cardiovascular diseases. Participants were recruited from the outpatient cardiology clinic between January 2020 and January 2022. Inclusion criteria included patients aged 40 to 80 years undergoing coronary angiography for the first time due to suspected CAD. Exclusion criteria were previous coronary artery interventions, congenital heart disease, active infections, and renal insufficiency (creatinine > 2.0 mg/dL). Baseline characteristics such as age, gender, BMI, hypertension status, and smoking history were collected. Diabetes status was confirmed via HbA1c levels (≥6.5%). Coronary angiography was performed using standard techniques, with angiograms analyzed by two blinded cardiologists. Primary outcomes included the presence of multi-vessel disease (≥70% stenosis in two or more major coronary arteries) and the severity of stenosis (>70% blockage). Additional assessments using Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) evaluated plaque characteristics and vessel sizes in a subset of patients. Statistical analysis was performed using SPSS version 25.0, employing Chi-square tests for categorical variables, independent t-tests for continuous variables, and multivariable logistic regression to adjust for confounders. Results: The study included 300 participants, with 150 diabetic and 150 non-diabetic patients. Diabetic patients had a mean age of 62.3 ± 10.4 years, while non-diabetic patients had a mean age of 58.2 ± 9.8 years. The prevalence of hypertension was higher among diabetic patients (60%) compared to non-diabetic patients (40%). The incidence of multi-vessel disease was significantly higher in diabetic patients (70%) compared to non-diabetic patients (50%) (p < 0.05). Severe stenosis was observed in 65% of diabetic patients versus 45% of non-diabetic patients (p < 0.01). IVUS and OCT analyses showed a higher prevalence of lipid-rich plaques in diabetic patients (55% vs. 30%) and a smaller mean luminal diameter (2.8 ± 0.6 mm vs. 3.4 ± 0.5 mm). Conclusion: Diabetes significantly impacts the severity and extent of coronary artery disease, with diabetic patients exhibiting higher rates of multi-vessel disease and severe stenosis. Advanced imaging techniques highlighted distinct plaque characteristics in diabetic patients, underscoring the need for aggressive and personalized management strategies. These findings emphasize the importance of integrating advanced imaging and comprehensive management to mitigate cardiovascular risks in diabetic patients.

Determinants of poor glycaemic control and proteinuria in patients with type 2 diabetes: a retrospective analysis of general practice records in Ireland

BackgroundAnalysis of general practice records can address the information gap on the epidemiology of type 2 diabetes (T2DM) in Ireland, informing practice and the development of interventions in primary care. The aim of this study was to identify patients with poor glycaemic control, risk factors for complications and evidence of end organ damage in a large multi-practice study and to profile their characteristics.MethodsPatients with T2DM were identified using disease coding in Health One practice management software in 41 general practices. Patients’ demographics and clinical data were extracted. Rates of poor glycaemic control (glycated haemoglobin > 58 mmol/mol) and albumin creatinine ratio > 3 mg/mmol were calculated. A multilevel logistic regression analysis using both patient and practice variables was conducted.ResultsData was collected from 3188 patients of whom 29% (95% CI 28 to 31%) had poor glycaemic control, which was associated with younger age, higher BMI and higher total cholesterol. Only 42% of patients (n = 1332) had albumin creatinine ratio measured with 42% (95% CI 40 to 45%) of these having values > 3 mg/mmol. Older age groups, men, those with hypertension, eGFR < 60 ml/min/1.73m2 and poor glycaemic control were most associated with higher values of albumin creatinine ratio.ConclusionsAnalysing this large multi-practice dataset gives important information on the prevalence and characteristics of diabetic patients who are most at risk of poor outcomes. It highlights that recording of some data could be improved.

The prevalence and associated risk factors of infertility among type 2 diabetes patients in Qassim region 2022: A cross-sectional study

Background: Diabetes Mellitus has a significant effect on reproductive health, including hypogonadism, hypoactive sexual desire disorder, menstrual dysfunction, and polycystic ovarian syndrome. However, the prevalence and the associations of infertility among type 2 diabetes have not been widely estimated and investigated. Aim: This study aimed to estimate the prevalence of infertility and its associated risk factors among type 2 diabetic patients. Patient and methods: This community-based cross-sectional (prevalence) study was conducted among type 2 diabetic patients in the Qassim Region, Saudi Arabia. A self-administered questionnaire was given to diabetic patients who visited Primary Healthcare Centers. The questionnaire included socio-demographic data (i.e., age, gender, residency, etc.), characteristics of diabetic patients, and a set of questions to assess infertility among patients. Results: Of the 201 type 2 DM patients, 65.7% were males, and 46.8% were aged between 41 to 50 years. Diabetic patients who were smokers constituted 12.4%. A family history of diabetes has been reported by 75.1% and 20.9% reported having difficulties getting pregnant. The prevalence of the patients who had been previously evaluated or treated with infertility was 4.5%. Younger age, being employed, difficulties in getting pregnant, having less than 4 children, and a family history of infertility were the factors that influence patients&amp;apos; infertility. Conclusion: The prevalence of infertility among diabetic type 2 patients is low. Younger patients who were employees, having difficulties getting pregnant, having fewer children, and having a family history of infertility were more likely to exhibit infertility than other diabetic patients. Further investigations are required to determine the associated factors of infertility among patients with type 2 diabetes.

A Cross Sectional Study of Coagulation Profile in Type 2 Diabetes Mellitus Patients in Correlation with HbA1c

Introduction: Diabetes mellitus is a prevalent global health concern associated with increased cardiovascular risk. Hypercoagulability is a prominent feature in diabetic patients, contributing to thrombotic complications. This study explores the coagulation profile in Type 2 diabetes mellitus (T2DM) patients, focusing on the correlation with glycated hemoglobin (HbA1c). Aim: The study aims to assess coagulation impairment in T2DM through routine prothrombin time (PT) and activated partial thromboplastin time (APTT) measurements, thereby preventing thromboembolic cardiovascular disease (CVD). It further examines the relationship between coagulation parameters, HbA1c, and diabetes duration.

Associations of High-Density Lipoprotein Functionality with Coronary Plaque Characteristics in Diabetic Patients with Coronary Artery Disease: Integrated Backscatter Intravascular Ultrasound Analysis.

High-density lipoprotein (HDL) functionality has been reported to be associated with coronary artery disease (CAD). However, little is known about the impact of HDL functionality on coronary atherosclerosis. Thirty-eight type 2 diabetic patients with CAD who underwent percutaneous coronary intervention were examined. Coronary atheroma burden and plaque composition of the culprit lesions were assessed using conventional gray-scale and integrated backscatter intravascular ultrasound. HDL-mediated cholesterol efflux capacity (HDL-CEC) and HDL antioxidant capacity, estimated as HDL inflammatory index (HII), were examined. The associations between HDL functionality and coronary plaques were analyzed using multivariate data analysis, including principal components analysis and orthogonal partial least squares (OPLS) models. Percent atheroma volume was correlated with HDL-CEC (r = 0.34, p = 0.04) but not with HII (p = 0.65). The OPLS model demonstrated that the percentage lipid volume was significantly associated with HDL functionality [coefficient (95% confidence interval); HDL-CEC: -0.26 (-0.49, -0.04); HII: 0.34 (0.08, 2.60), respectively]. HII exhibited the highest variable importance in projection score, indicating the greatest contribution. HDL functionality was associated with coronary plaque composition, a key component of plaque vulnerability. Our findings highlight the potential importance of HDL functionality for coronary plaque stabilization.

Analisis Klaster Data Pasien Diabetes untuk Identifikasi Pola dan Karakteristik Pasien

Diabetes is a significant health problem in Indonesia and the world. To understand the patterns and characteristics of diabetic patients, research was conducted by clustering the data of diabetic patients using the K-Means algorithm. The results of the analysis showed that there were two clusters, with cluster 1 consisting of 755 female patients aged 20-80 years and cluster 2 consisting of 404 male patients aged 40-90 years. The diagnosis of Non-insulin-dependent diabetes mellitus was the most common diagnosis in both clusters, followed by Rheumatoid arthritis in cluster 1 and Respiratory tuberculosis in cluster 2. BMI results in the "ideal" category had the highest frequency in both clusters, but the "less" category was more found in cluster 2. The unique variables in cluster 1 are M13.9 and I15, while the unique variables in cluster 2 are A15 and E11.6. In addition, the analysis of the two clusters shows that the Modopuro and Kebondalem sub-districts appear as the most sub-districts in the two clusters.

COVID -19 CHEZ LES PATIENTS DIABETIQUES : PRISE EN CHARGE EN UNITE DE SOINS INTENSIFS

Context :The presence of diabetes has been identified as a factor associated with severe forms and increased mortality during SARS-COV 2 infection. On the other hand, it has been suggested that infection with COVID 19 would be susceptible to induce Novo diabetes. Managing diabetes during COVID 19 infection is an important part of managing this infection. Goal :The aim of this work is to describe the characteristics of diabetic patients infected with COVID -19 and to share our experience in their management. Materials and methods: retrospective study of 104 patients admitted to the intensive care unit at Ibn Tofails company hospital. Results: The mean age of our patients was 64.47 years. Diabetes was discovered during infection in 22% of patients, while 78% of patients were known to have diabetes. Ketosis decompensation was demonstrated in 16.3% of patients. On admission, 32% were on oral antidiabetics and 38% patients were on insulin. Thoracic CT showed more than 50% of the pulmonary parenchyma in 43% of patients. 12.5% ​​of our patients were hemodynamically and respiratory unstable and were transferred to medical intensive care. Conclusion: our study had shown that diabetes was associated with severe forms of COVID 19 with significant inflammatory syndrome and extensive lung damage.

Genetic Polymorphisms and Clinical Features in Diabetic Patients With Fatty Liver: Results From a Single-Center Experience in Southern Italy.

Genetic background may be involved in the promotion and progression of non-alcoholic fatty liver disease (NAFLD). Previous studies have suggested that the single nucleotide polymorphisms (SNPs) may be associated with the specific clinical features in the patients with hepatic steatosis; however, data on the patients with diabetes from Southern Italy are lacking. We enrolled 454 patients and 260 of them had type 2 diabetes. We studied the PNPLA3 rs738409, LPIN1 rs13412852, KLF6 rs3750861, SOD2 rs4880, TM6SF2 rs58542926, and ZNF624 rs12603226 SNPs and their distribution in the study population. Lipid profile, liver stiffness, and kidney function were also studied to understand the potential role of the SNPs in the development of clinical phenotypes. No differences were observed in the distribution of polymorphisms between the diabetic and non-diabetic subjects. Carriers of risk allele G for PNPLA3 rs738409 SNP showed a lower mean value of serum triglycerides and a higher liver stiffness. Risk allele for KLF6 rs3750861 and SOD2 rs4880 polymorphism had a lower estimated glomerular filtration rate (eGFR) value, whereas no differences in the glucose and glycated hemoglobin level were observed in the subgroups by the different genotypes. Genetic polymorphisms are useful to identify the patients at higher risk of development of liver fibrosis and lower eGFR values in the patients with diabetes and NAFLD. Their use in clinical practice may help the clinicians to identify the patients who require a more strict follow-up program.

Optical Coherence Tomography Angiography Features In Diabetic Patients With Unexplained Visual Loss

Abstract Background Diabetic macular ischemia (DMI) has a conflicting impact on visual loss in diabetics. OCTA used as a new non-invasive technique allows for identification of several anatomical and vascular abnormalities of diabetic maculopathy. Aim This study aimed to detect quantitative and qualitative OCTA data of Foveal area in diabetic patients with unexplained visual loss. Methods and Material This cross-sectional study enrolled fifteen diabetic patients with unexplained visual loss. They underwent comprehensive ophthalmological assessment, Measurement Best-Corrected Visual acuity (BCVA) using a Snellen chart converted to LogMAR for statistical analysis. And OCTA imaging of the foveal area using AngioVue OCTA. Quantitative data analysed was Foveal Avascular Zone (FAZ) area. Statistical analysis used Descriptive statistics and Pearson correlation were performed. Results A positive significant correlation was noted between LogMAR BCVA and FAZ area (p = 0.004). DMI grade showed significant positive correlation with LogMAR BCVA (p = 0.011). Conclusions The current study demonstrated the significant correlation between FAZ area measured by AngioVue OCTA and BCVA in diabetic patients with unexplained visual loss. In addition, we elucidated Diabetic Macular Ischemia (DMI) as a leading reason for visual loss in diabetic patients by itself.

A retrospective cross-sectional analysis of re-contact rates and clinical characteristics in diabetic patients referred by paramedics to a community diabetes service following a hypoglycaemic episode.

Aims:To report the re-contact rates and clinical characteristics of individuals referred to community diabetic teams following non-conveyance by HCPC paramedics.Methods:A retrospective cross-sectional study of routinely collected data by the Northern Ireland Ambulance Service HSC Trust of individuals referred to a community diabetic service following ambulance attendance and non-conveyance. Data were collected over a 3-month period with ambulance service re-contact and clinical data analysed.Results:418 emergency calls were identified as relating to hypoglycaemia with 169 referrals being made, a referral rate of 40.4%. Patients treated with insulin represented the majority of calls and tended to have a lower Glasgow Coma Scale score, but demonstrated many successful referrals. Increased age and multimorbidity were associated with repeat hypoglycaemic episodes and EMS attendance while other subgroups traditionally considered higher risk, such as patients with infections or under the influence of alcohol, showed potential for safe community management.Conclusion:The majority of paramedic referrals to community diabetic teams were successful, with less than 5% re-contacting the ambulance service within 3 days. This study, although demonstrating a lower referral rate than previous research, reinforces the safety of paramedic management and community referral for hypoglycaemia.

Determinants of diabetes ketoacidosis among diabetes mellitus patients at North Wollo and Waghimra zone public hospitals, Amhara region, Northern Ethiopia

BackgroundDiabetes Mellitus (DM) is a metabolic disorder associated with acute and chronic complications. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus. It is the leading cause of mortality in children and young adults. Even though the burden of DKA has increased, no research has been conducted on the determinants of Diabetes ketoacidosis in Ethiopia, particularly in the Amhara region. Thus, this study aimed to identify the determinants of diabetes Ketoacidosis among Diabetes Mellitus patients at North Wollo and Waghimra Zone public Hospitals.MethodsAn institution-based unmatched case-control study design was employed among 408 patients at North Wollo and Waghimra Zone Public Hospitals from March 1st to April 30th, 2020. A consecutive sampling method was used to select study participants. The data were collected using structured interviewer-administered questioners and reviewing of patient charts. The analysis was done using a binary logistic regression model. Then, P-value < 0.05 was considered statistically significant.ResultThe mean (±SD) age of the study participants was 46.96 (± 15.175 SD) years. Irregular follow-up in diabetes clinic (AOR:4.19, 95% CI: 2.28–7.71), not received diabetic education (AOR: 2.87, 95% CI:1.44–5.72), alcohol drinking (AOR:2.99, 95% CI: 1.46–6.12), discontinuation of medications (AOR: 4.31, 95% CI:1.92–9.68), presence of comorbidity (AOR:2.57, 95% CI: 1.37–4.84), and being type one of diabetes mellitus (AOR: 2.01, 95% CI:1.11–3.63) were determinant factors of diabetic ketoacidosis .ConclusionsThis study showed that the behavioral and clinical characteristics of diabetic patients were determinant factors of DKA. Follow-up in the diabetic clinic, diabetic education, discontinuation of medications, alcohol drinking, presence of comorbidities, and type of diabetes mellitus were independent determinants of diabetic ketoacidosis.

Optical coherence tomography angiography features in diabetic patients with unexplained visual loss

Background Diabetic macular ischemia (DMI) has a known effect on visual loss in diabetics. Optical coherence tomography angiography (OCTA) allows identification of the vascular abnormalities of diabetic maculopathy.Aim This study aimed to detect the quantitative and qualitative OCTA features of foveal and macular areas in diabetic patients with unexplained visual loss.Settings and design This was a cross-sectional study.Patients and methods This cross-sectional study enrolled 15 diabetic patients with unexplained visual loss. They underwent comprehensive ophthalmological assessment, including measurement of best-corrected visual acuity (BCVA) converted to LogMAR for statistical analysis and macular OCTA imaging (AngioVue OCTA). Quantitative data analyzed were foveal avascular zone (FAZ) area, FAZ perimeter, and acircularity index (AI). Vessel density (VD) parameters included full-retinal VD in a 300-µm circle around the FAZ (FD-300) plus foveal and parafoveal VD in superficial and deep capillary plexuses.Results A positive significant correlation was found between LogMAR BCVA and FAZ area (r=0.701, P=0.004), FAZ perimeter (r=0.732, P=0.002), and AI (r=0.540, P=0.038). However, there was no significant correlation between BCVA and either FD-300 (P=0.144), or superficial and deep parafoveal VD (P=0.187 and 0.764, respectively), or superficial and deep foveal VD (P=0.34 and 0.187, respectively). In addition, DMI grade showed a significant positive correlation with LogMAR BCVA (P=0.011).Conclusion FAZ parameters (perimeter, area, and AI) measured by OCTA macula can precisely depict DMI in diabetic patients with unexplained visual loss and are closely correlated to BCVA. It is recommended to perform OCTA macula for those patients before making treatment decisions.

Abstract 13570: Diabetes is Probably Associated With Larger Fluid Retention in Patients With Heart Failure With Preserved Ejection Fraction

Introduction: Diabetes is observed in about third of patients with heart failure with preserved ejection fraction (HFpEF), and it is not well elucidated how it would affect the clinical conditions of HFpEF. We investigated the physical and echocardiographic characteristics of diabetes patients in a large-scale, registration study of HFpEF. Methods: We analyzed clinical and echocardiography data obtained at admission and just before hospital discharge in the PURSUIT-HFpEF (Prospective, Multicenter, Observational Study of Patients with Heart Failure with Preserved Ejection Fraction), which is a multicenter registration study of patients who were hospitalized for HFpEF. Results: We enrolled 862 patients who were hospitalized for HFpEF between June, 2016 and December, 2019 (Age 81±9 years, male gender 44.5%) for the present study. Diabetes was observed in 287 patients (33.3%), and their age was higher (82±8 years vs. 80±9 years, p=0.003) and body mass index before discharge was larger (23.2±4.7 kg/m2 vs. 21.1±4.6 kg/m2, p&lt;0.0001) than those without diabetes. Diabetic patients had higher body weight at admission (63.2±14.9 kg vs. 55.9±13.4 kg, p&lt;0.0001) and before discharge (56.8±13.3 vs. 50.7±12.1 kg, p&lt;0.0001) than non-diabetic patients. Reduction of body weight during hospital stay was higher in diabetic patients (6.4±4.5 kg) than in non-diabetic patients (5.2±4.0 kg) even after correction of body weight discharge or estimated GFR (p&lt;0.001 by ANCOVA). Body weight reduction was significantly associated with HbA1c (p=0.01). There was no difference in use of intravenous diuretics (69.3% vs. 66.6%, p=0.44) and in hospital stay (21.4±15.3 days vs. 19.9±13.7 days, p=0.14) between diabetic- and non-diabetic patients. Whereas no differences were observed in echocardiographic parameters at admission and before discharge between two arms, the diabetic arm showed significantly higher reduction in septal E/e’ ratio during hospital stay (19.0±8.7 to 17.1±7.6) than non-diabetic arm (16.6±8.3 to 16.4±8.2)(p=0.01 by repeated measure ANOVA). Conclusions: The present study implied that diabetic patients with HFpEF have more fluid retention before hospitalization than non-diabetic ones, which could affect the changes in diastolic pressure.

Clinical, biological and radiological characteristics of diabetic patients hospitalized for COVID-19 in a Belgian tertiary care center

Clinical, biological and radiological characteristics of diabetic patients hospitalized for COVID-19 in a Belgian tertiary care center

Sleep Characteristics in Diabetic Patients Depending on the Occurrence of Neuropathic Pain and Related Factors.

This study aims to compare the sleep characteristics (structure and quality) in patients with type-2 diabetes mellitus with and without diabetic neuropathic pain (DNP), and to investigate the relationship of sensory phenotypes, anxiety, and depression with sleep quality in DNP patients. A cross-sectional study was performed in patients with type-2 diabetes mellitus and neuropathy. Patients were classified into two groups—with or without neuropathic pain—according to the “Douleur Neuropathique-4 (DN4)” scale. Sleep characteristics and quality (Medical Outcomes Study—MOS-sleep), pain phenotype (Neuropathic Pain Symptom Inventory—NPSI), mood status (Hospital Anxiety and Depression scale—HADS), pain intensity (Visual Analogue Scale—VAS), and quality of life (SF-12v2) were measured. The sample included 130 patients (65 with DNP). The mean scores in all the dimensions of the MOS-sleep scale were higher (more disturbances) in the DNP patients. Higher scores in anxiety or depression, greater intensity of pain or a higher score in the paroxysmal pain phenotype were associated with lower sleep quality in DNP patients. A shorter duration of the diabetes and lower levels of glycated hemoglobin were also associated with lower sleep quality. The results show the relationship between DNP and sleep quality, and the importance of assessing sensory phenotypes and mental comorbidities in these patients. Taking these factors into consideration, to adopt a multimodal approach is necessary to achieve better clinical results.

مراجعة/ جائحة كوفيد- 19: الآثار المترتبة على رعاية مرضى السكري والمعالجة الخاصة

خلفية: برزت جائحة كرونا لعام 2019 (كوفيد- 19) كواحد من أكبر التحديات التي واجهتها البشرية في الماضي القريب. الأشخاص المصابون بداء السكري والأمراض المصاحبة ذات الصلة معرضون بشكل متزايد لخطر الإصابة بمضاعفاته والوفيات المرتبطة به. الشيخوخة، والأمراض المتعددة، وفرط سكر الدم، وإصابة القلب والاستجابة الالتهابية الشديدة هي مؤشرات على نتائج سيئة على مرضى السكري أثناء جائحة كوفيد- 19. الأهداف: تلخص هذه المقالة البيانات الحالية عن العرض السريري ومخاطر كوفيد- 19 على مرضى السكري. كما نقدم بعض التوصيات لإدارة مرضى السكري أثناء كوفيد- 19 النتائج: وفقًا للبيانات الحالية، لا يبدو أن مرضى السكري معرضون بشكل متزايد لخطر الإصابة بالسارس مقارنة بعامة السكان. من ناحية أخرى فإن مرض السكري هو عامل خطر لتطور الأشكال الحاسمة والخطيرة من كوفيد- 19، وهذا الأخير يتطلب القبول في وحدة العناية المركزة و/ أو استخدام التهوية الميكانيكية الغازية، مع معدلات وفيات عالية. تخضع خصائص مرضى السكري للكشف عن أشكال حادة وحرجة من كوفيد- 19، بالإضافة إلى التأثير النذري لمرض السكري على مسار كوفيد- 19، قيد التحقيق الحالي. السمنة عامل الخطر الرئيسي لمرض السكري من النوع 2، أكثر شيوعًا في المرضى الذين يعانون من أشكال حرجة من كوفيد- 19 التي تتطلب تمدد الوريد الميكانيكي الغزوي. من ناحية أخرى، عادة ما يرتبط كوفيد- 19 بسوء التحكم في نسبة السكر في الدم وارتفاع خطر الإصابة بالحماض الكيتوني لدى مرضى السكري. لا توجد حاليًا توصيات لصالح التوقف عن تناول الأدوية الخافضة للضغط التي تتفاعل مع نظام الرينين- أنجيوتنسين- الألدوستيرون. يجب التوقف عن مثبطات الميتفورمين والبروتين الناقل للصوديوم- جلوكوز في المرضى الذين يعانون من أشكال حادة من كوفيد- 19 بسبب علاجات الحماض اللبني والحماض الكيتوني. الخلاصة: لا توجد بيانات حاليًا تظهر زيادة خطر الإصابة بـ كوفيد- 19 في مرضى السكري. من ناحية أخرى، يحتاج مرضى السكري إلى عناية خاصة، لأن مرض السكري مرتبط بخطر أعلى من الأشكال الحادة والخطيرة والمميتة لـ كوفيد- 19. تتطور معرفتنا بهذا الفيروس التاجي الجديد يومًا بعد يوم، وستتيح الدراسات المستمرة تحديد أفضل لتعريف مرضى السكري المعرضين لخطر متزايد من سوء التشخيص. على أي حال، يجب التأكيد على أهمية مراقبة جلوكوز الدم والسيطرة على مسار العدوى، بالإضافة إلى فحص مرض السكري (قبل) في جميع المرضى الذين يعانون من الإصابة المؤكدة بـ كوفيد- 19.

Clinical Characteristics, Prognosis and Death-related Factors of Diabetic Patients With COVID-19: A Systematic Review and Meta-analysis

BACKGROUND: Most studies have shown that diabetic patients with COVID-19 have a higher proportion of mortality and poor prognosis. However, there are still many controversial issue about the relationship between diabetes and COVID-19. PURPOSE: The purpose of this study is to summarize the clinical characteristics, disease prognosis and the risk factors for death of COVID-19 patients with diabetes. DATA SOURCES: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched for relevant articles. STUDY SELECTION: We included retrospective or prospective original articles comparing the characteristics of diabetic and non-diabetic patients with COVID-19. DATA EXTRACTION: We collected data on demographic characteristics, clinical symptoms and signs, treatments and prognosis, etc. DATA SYNTHESIS: A total of 17 articles met the conditions of this systematic review and meta-analysis, including 1310 diabetic patients. Our research found that elderly male diabetic patients with high body mass index were more susceptible to COVID-19 infection than non-diabetic patients. Besides, COVID-19 patients with diabetes had more underlying comorbidities, were more likely to have various complications and usually need more treatments of mechanical ventilation and intensive care. In addition, male and dyspnea may be risk factors for in-hospital death. LIMITATIONS: There are still a lack of articles on the characteristics of diabetic patients with COVID-19, and further research is needed in a large sample. CONCLUSIONS: Diabetes was associated with poor outcomes and mortality in patients with COVID-19. More closely attention should be paid to the treatment and prevention for diabetic patients. Funding Statement: None. Declaration of Interests: The authors declare that they have no conflicts of interest for this work. Ethics Approval Statement: Since the study is a systematic review of the literature, informed consent and institutional review board approval were not obtained.