Clinical Characteristics Of Diabetes Mellitus Research Articles

The prevalence and clinical characteristics of diabetes mellitus in Chinese inpatients with chronic schizophrenia: a multicenter cross-sectional study.

BackgroundDiabetes mellitus (DM) is common among patients with schizophrenia. However, information on patients comorbid DM and schizophrenia is limited in China. The present study investigated the prevalence of DM and its clinical characteristics in Chinese inpatients with chronic schizophrenia.MethodsA cross-sectional study was performed in Chinese inpatients with chronic schizophrenia. Diagnosis of Diabetes was established using World Health Organization diagnostic criteria for diabetes mellitus (persistent fasting glucose levels ≥ 126 mg/dl or 2-h plasma glucose ≥ 200 mg/dL after a 75-g Oral Glucose Tolerance Test). Patients were also measured height, weight, waist circumference, hip circumference, triglyceride level, and cholesterol level. Patients’ psychiatric symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression analysis was performed to examine the associated demographic and clinical variables in chronic schizophrenia.ResultsA total of 988 inpatients (64.6% male, average age of 47.19 ± 12.55) was recruited. The prevalence of DM in Chinese patients with chronic schizophrenia was 13.8% (95% CI [11.6–15.9]%). Logistic regression analysis showed that overweight (OR = 1.90, 95% CI [1.20–3.03], p = 0.006), obesity (OR = 1.85, 95% CI [1.07–3.21], p = 0.028), comorbid hypertension (OR = 2.14, 95% CI [1.34–3.42], p = 0.002), and course of schizophrenia (OR = 1.03, 95% CI [1.01–1.06], p = 0.040) were significantly associated with the DM risk in patients with schizophrenia.ConclusionThe findings indicated that diabetes mellitus was non-negligible in patients with chronic schizophrenia. Patients with schizophrenia should be regularly monitored for DM. Overweight/obesity, long duration of schizophrenia, and comorbid hypertension possibly were risk factors for diabetes.

Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: time to contextualize the interventions? A cross-sectional study

BackgroundExisting prevention and treatment strategies target the classic types of diabetes yet this approach might not always be appropriate in some settings where atypical phenotypes exist. This study aims to assess the socio-demographic and clinical characteristics of people with diabetes in rural Rwanda compared to those of urban dwellers.MethodsA cross-sectional, clinic-based study was conducted in which individuals with diabetes mellitus were consecutively recruited from April 2015 to April 2016. Demographic and clinical data were collected from patient interviews, medical files and physical examinations. Chi-square tests and T-tests were used to compare proportions and means between rural and urban residents.ResultsA total of 472 participants were recruited (mean age 40.2 ± 19.1 years), including 295 women and 315 rural residents. Compared to urban residents, rural residents had lower levels of education, were more likely to be employed in low-income work and to have limited access to running water and electricity. Diabetes was diagnosed at a younger age in rural residents (mean ± SD 32 ± 18 vs 41 ± 17 years; p < 0.001). Physical inactivity, family history of diabetes and obesity were significantly less prevalent in rural than in urban individuals (44% vs 66, 14.9% vs 28.7 and 27.6% vs 54.1%, respectively; p < 0.001). The frequency of fruit and vegetable consumption was lower in rural than in urban participants. High waist circumference was more prevalent in urban than in rural women and men (75.3% vs 45.5 and 30% vs 6%, respectively; p < 0.001). History of childhood under-nutrition was more frequent in rural than in urban individuals (22.5% vs 6.4%; p < 0.001).ConclusionsCharacteristics of people with diabetes in rural Rwanda appear to differ from those of individuals with diabetes in urban settings, suggesting that sub-types of diabetes exist in Rwanda. Generic guidelines for diabetes prevention and management may not be appropriate in different populations.

New thoughts on material basis and mechanism of Yin-tonifying traditional Chinese medicine in treatment of diabetes mellitus and its complications

Diabetes mellitus is a serious chronic metabolic disease, and the patient's hyperglycemia is often accompanied by complications. In the circles of medical science, traditional Chinese medicine(TCM) has the earliest knowledge and research about diabetes. According to TCM, the clinical characteristics of diabetes mellitus were basically the same as &quot;Xiaoke&quot;. TCM also believes that &quot;Yin deficiency and dryness heat&quot; was the main pathogenesis of diabetes. Therefore, Yin-tonifying TCMs is widely used in clinical treatment of diabetes mellitus, including Dendrobii Caulis, Lilii Bulbus, Ophiopogonis Radix, Polygonati Rhizome. The effective component for treating diabetes in the above Chinese materia medica is polysaccharides, which is used to treat complications of diabetes mellitus, like vascular disease, nephropathy, retinopathy, peripheral neuropathy. According to literature reports, except for specific some Yin-tonifying TCMs with effective ingredients for preventing and treating diabetes, other Yin-tonifying TCMs only contain water, alcohol extracts or polysaccharides in the treatment of diabetes. However, due to unclear material basis, dose-effect relationship and mechanism target of hypoglycemic drugs, Yin-tonifying TCMs are restricted in clinical application, with certain difficulties in in-depth studies. In this paper, the literatures related to the treatment of diabetes mellitus and its complications with Yin-tonifying TCM are analyzed and summarized, the existing problems are analyzed, and the research ideas and methods based on chromatographic technology and metabonomics are put forward, in order to provide reference for the application and development of Yin-tonifying TCM.

Prevalence and clinical characteristics of diabetes mellitus in Lebanon: a national survey.

Diabetes mellitus in all its forms has been rapidly increasing worldwide, especially in the Eastern Mediterranean Region. This national study aimed to assess the prevalence and clinical aspects of diabetes mellitus in Lebanon with special focus on type 1 (T1DM). A national multistage, random household sample survey was conducted, using face-to-face interviews with 1 questionnaire per household. A total of 4500 households were selected from all areas based on a pre-existing sampling frame of the Lebanese population. The prevalence of previously diagnosed diabetes mellitus in the surveyed population of 17 832 persons (mean age ~36 years) was 7.95%. The prevalence of T1DM in particular was estimated at 0.1%, or almost 1% of all detected cases of diabetes mellitus. Most persons with diabetes mellitus reported obtaining their usual care from endocrinologists rather than primary healthcare physicians. Delayed performance of haemoglobin A1c test was reported in 25% of 1418 patients. Hypoglycaemic episodes recently occurred in 30% of patients; of whom, at least one third required medical attention, including hospital admission. Diagnosed complications were reported in 22% of cases, with retinopathy being the most common. Prevalence of T1DM in this population was lower than international estimates. Diabetes mellitus management appears to be deficient, based on delays in standard control testing, hypoglycaemic episodes and diabetes mellitus-related complications. Coordination of diabetic care management should be devolved to primary healthcare physicians, who can keep track of the need for referral to various types of diabetes mellitus care.

Prevalence and clinical characteristics of diabetes mellitus in Lebanon: A national survey

Introduction Diabetes Mellitus (DM) in all its forms has been rapidly increasing all over the world, especially in the Eastern-Mediterranean Region. This national study aimed to assess the prevalence and clinical aspects of DM in Lebanon with a special focus on type 1. Methods A national multi-stage, random household sample survey was conducted, using face-to-face interviews with one questionnaire per household. A total of 4500 households were selected from all areas based on a pre-existing sampling frame of the Lebanese population. Results The prevalence of previously diagnosed diabetes in the surveyed population of 17,832 persons (mean age≈36) was 7.95% (95% CI: 7.55–8.35). The prevalence of type 1 DM in particular, was estimated at 0.1%, or almost 1% of all detected diabetes cases. Most persons with diabetes reported obtaining their usual care from endocrinologists rather than primary healthcare (PHC) physicians. Delayed performance of HbA1c test was reported in 25% of 1418 patients. Hypoglycemic episodes recently occurred in 30%, of whom at least 1/3rd required medical attention, including hospital admission. Diagnosed complications were reported in 22%, with retinopathy being the most common one. Conclusions The prevalence of type 1 DM in this population is lower than international estimates. Diabetes management appears to be deficient based on delays in standard control testing, hypoglycemic episodes, and diabetes-related complications. Coordination of diabetic care management should be devolved to PHC physicians, who can keep track of the need for referral to various aspects of diabetes care.

Natural history and clinical characteristics of 50 patients with Wolfram syndrome.

To describe clinical characteristics of diabetes mellitus (DM) in a group of patients with Wolfram Syndrome (WS). Descriptive, cross-sectional observational design. The sample consisted of 50 patients diagnosed with WS. Clinical criteria contributing to WS diagnosis were analyzed: diabetes mellitus (DM), optic nerve atrophy (OA), sensorineural deafness, urological and neurological dysfunction, among others. These parameters were assessed according to their presence/absence, age of onset, and various clinical-analytical parameters. All the patients studied presented DM and OA, with a mean age of onset of 5.4 ± .9 (1-14) years and 9 ± .9 (1-16) years, respectively. The remaining criteria were present with a variable frequency: 77% had diabetes insipidus, 66.7% auditory alterations, 77.8% neurogenic bladder, 61.1% neurological involvement, and 27.8% hypogonadism. A 16.7% of the patients had positive albuminuria (urinary albumin/creatinine ratio > 30 mg/g) and 72.2% had hyporreflexia. There were no significant differences in the age of diagnosis nor of the presence of different pathologies according to sex. The early presence of a non-autoimmune insulin dependent DM, should alert us of an "infrequent" diabetes syndrome. Wolfram's presumptive diagnosis could be established if juvenile-onset DM occurs concomitantly with OA, and this visual impairment is not attributable to diabetic retinopathy. Despite the long period of evolution of DM and altered values of HbA1c, the prevalence of microvascular complications in the sample are low.

Clinical Characteristics of Diabetes Mellitus and Suicide Risk.

Diabetes mellitus (DM) is a chronic illness with impaired health-related quality of life and a high risk of psychiatric disorders. We carried out a systematic review analyzing the relationship between DM and suicide by providing a qualitative data synthesis of the studies. We conducted, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of the literature in PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. Search terms were "suicid*" combined with the Boolean "AND" operator with "diabetes." The initial search identified 568 citations. A total of 17 research reports met the predefined inclusion criteria and were analyzed. DM was found to be significantly associated with a marked increase in suicidal behaviors and suicidal ideation (SI), especially in patients with depressive symptoms. Insulin therapy, DM of long duration, and unsatisfactory glycemic control were identified as risk factors for SI in Type 1 (T1DM) and Type 2 (T2DM). Health-care professionals need to be aware of the higher suicidal risk in patient subgroups based on the clinical characteristics of DM; thus, patients with these characteristics warrant special attention. In this regard, clinical management should include efforts to manage emotional distress in DM care.

Comparison of the clinical characteristics of diabetes mellitus diagnosed using fasting plasma glucose and haemoglobin A1c: The 2011 Korea National Health and Nutrition Examination Survey

We compared the characteristics of a Korean adult population diagnosed with diabetes using only a fasting plasma glucose criterion or an HbA1c criterion. The single difference between these two groups was age. Further studies should be undertaken to clarify whether age-specific diagnostic criteria would be appropriate in Korean populations.

Clinical characteristics of diabetes mellitus in Morindawa Daur population

Total 967 patients with diabetes mellitus treated in Morindawa People's Hospital from June 2012 to June 2014 were included in the study, among them 425 (44.0%) were of Daur nationality and 542 (56.0%) were of Han nationality. The clinical data and laboratory tests were analyzed and compared between two groups. Compared with Han nationality, Daur patients presented a younger average age[(55±11)y vs.(58±10)y, P=0.000], an earlier age of onset[(50±10)y vs.(53±11)y, P=0.000], a higher percentage of males (54.8% vs. 46.9%, P=0.008), a higher percentage of rural residents (42.1% vs.36.2%, P=0.034), a lower level of fasting blood-glucose (FBG) [(9.25±3.37) mmol/L vs. (10.28±4.33) mmol/L, P=0.000], higher levels of HbA1c [(7.61±1.71)% vs. (7.29±1.63)%, P=0.008], triglyceride (TG)[(2.91±2.06) mmol/L vs. (2.36±2.13) mmol/L, P=0.008], low density lipoprotein cholesterol (LDL-C)[(3.22±1.06) mmol/L vs. (3.01±0.92)mmol/L, P=0.020], systolic blood pressure (SBP)[(139.48±21.58)mmHg (1 mmHg=0.133 kPa) vs. (136.37±23.44)mmHg, P=0.002], diastolic blood pressure (DBP)[(87.23±12.59) mmHg vs. (85.32±12.52) mmHg, P=0.019], blood uric acid [(324.97±106.45)μmol/L vs. (285.32±98.69)μmol/L, P=0.000] and the ratio of urine microalbumin to urine creatinine [(2.29±5.57)mg/g vs. (0.12±0.98) mg/g, P=0.000]. The results show that Daur diabetic patients are younger in age, with more severe disorders in HbA1c, blood pressure, blood uric acid and lipids levels, which increase the probability of renal damage or cardiovascular diseases in these patients. Key words: Diabetes; Daur

Autoantibody Positivity and Clinical Characteristics of Diabetes Mellitus in Childhood

The present research was conducted by the research fund of Dankook University in 2010. Received: 2 August, 2011, Revised: 12 August, 2011 Accepted: 25 August, 2011 Address for correspondence: Jeesuk Yu, M.D., Ph.D. Department of Pediatrics, Dankook University College of Medicine, Anseo-dong, dongnam-gu, Cheonan 330-714, Korea Tel: +82.41.550-3938, Fax: +82.41.565-6167 E-mail: dryujs@yahoo.co.kr 병이 형이었으나 최근소아에서의 형당뇨병또한늘어나 1 , 2

Anti-GAD Antibody in Patients with Adult-Onset Diabetes in Korea

Background: It is well known that the clinical characteristics of diabetes mellitus in Korean people are different from those of Western people. The purpose of this study was to investigate the prevalence of the anti-GAD antibody (GADA) in a large number of Korean patients with adult-onset diabetes. Methods: The GADA was measured by radioimmunoassay for 11,472 adult-onset diabetic patients who visited the Asan Medical Center from 1998 to 2007. According to the fasting C-peptide levels, we classified the patients into an insulin dependent diabetes mellitus group (IDDM; C-peptide < 0.6 ng/mL) and non-insulin dependent diabetes mellitus group (NIDDM; C-peptide ≥ 1.0 ng/mL). Other clinical and laboratory data were obtained from medical records. Results: Among the 11,147 diabetic patients, 9,250 patients were classified as NIDDM, 922 patients were classified as IDDM and 975 patients excluded. Within the latter group 472 patients were to absolute insulin deficient (C-peptide < 0.1 ng/mL). The prevalence of GADA was 2 2.0% in the IDDM group and 4.7% in the NIDDM group. GADA was more prevalent in younger-onset NIDDM patients (25~40 years of age; 12.4%) than in older-onset NIDDM patients (≥ 40 years of age; 3.8%). The GADA-positive NIDDM patients had lower C-peptide and BMI levels, and higher rates of typical diabetic symptoms and insulin treatment. Conclusion: The prevalence of GADA in Korean patients with IDDM and NIDDM was lower than that reported in Western populations. It is thus suggested that autoimmunity is a rarer cause of diabetes in Korean people. However, since over 10% of younger-onset NIDDM patients were positive for GADA, routine GADA measurement in such patients is recommended. (Korean Diabetes J 33:16-23, 2009)

Elevation of Cerebrospinal Fluid Protein in Patients with Diabetes Mellitus Is Associated with Duration of Diabetes

We investigated the relationships between total cerebrospinal fluid (CSF) protein in diabetic patients and the clinical characteristics of diabetes mellitus. The subjects comprised 16 diabetic patients (median age = 60.5 years, range = 47–71) who were studied retrospectively. Patients with diseases known to be associated with increases in total CSF protein were excluded as far as possible. The median total CSF protein and albumin quotient in the diabetic group were 52.5 mg/dl (range = 41–84) and 6.13 × 10^–3 (range = 4.0 × 10^–3 to 13.1 × 10^–3), respectively. These results were significantly higher than those in 28 age-matched nondiabetic patients (median = 59.0 years, range = 50–71) (p < 0.01). Duration of diabetes was associated with total CSF protein (r = 0.642, p < 0.01). If the CSF shows increased total protein in a diabetic patient who has not suffered from long-term diabetes (≧5 years), causes other than diabetes should be considered to explain increases in total CSF protein. We need to confirm the present results by studying a larger population of diabetic patients.

Diabetes mellitus and concomitant depressions

The fact that there is a high prevalence of depressions among patients with diabetes mellitus (DM) is well known. However, the relationships between the nosological entities of depressions and the clinical characteristics of DM are little studied. The study was undertaken to search for such relationships. A hundred and fifty outpatients with DM (out of them 38 males, Type 2 DM was diagnosed in 102 patients) the median age was 54.0 years (25 and 75 percentiles: 43.0-61.5), the median duration of diabetes was 7.2years (2.0-15.0); the median level of HbAlc was 8.6% (7.49.7%). Depression was revealed in 50 (33%) patients. Their comparison with patients without depression indicated that there was no association with the main clinical characteristics of MD (the type and duration of the disease, the prevalence of acute and chronic complications, insulin therapy). At the same time, a comparison of three groups of patients with the major clinical forms (nosogenic, cyclothymic, and dysthymic) of diagnosed depression by using x2 revealed the following associations: between DM-1 and cyclothymic depression and between DM-2 and nosogenic and dysthymic depression (р = 0.01). Cyclothymic and dysthymic depression showed no associations with clinical characteristics of DM. The prevalence of nosogenic depression was significantly higher in patients with a history of second-three grade diabetic retinopathy (p = 0.02), arterial hypertension (p = 0.001), proteinuria (p = 0.02), myocardial infarction (p = 0.04), and foot ulcerative defects (p = 0.04). The results show that nosogenic depression are mental responses to the severe course of DM, namely to the severity of micro- and macrovascular complications. The associations between the types of DM and the clinical types of depression -cyclothymia and dysthymia - await further study. Overall general predisposition may be discussed as a possible explanation.

Non‐insulin‐dependent Diabetes Mellitus (NIDDM) in Korea

The prevalence of diabetes mellitus in Korea has increased tremendously during the past several decades. In addition to the explosive increase of diabetes mellitus, the clinical characteristics of diabetes mellitus in Korea seems to be quite different from those of Western countries. Most patients with non-insulin-dependent diabetes mellitus (NIDDM) are non-obese and many of them lose weight significantly during the course of developing diabetes. The pathogenic mechanism(s) underlying this phenotype is still unclear. A subgroup of patients known as slow onset IDDM exists, but this could not explain the majority of non-obese NIDDM in Korea. In order to examine whether insulin resistance/hyperinsulinaemia is important in the development of NIDDM we conducted the following studies. Fasting plasma glucose and insulin concentration were measured in subjects with normal glucose tolerance, impaired glucose tolerance and diabetes mellitus. The peak plasma insulin level was much lower than that of Pima Indians or Caucasians. We also found that the insulin sensitivity index measured by euglycemic hyperinsulinaemic clamp in the first degree relatives of Korean NIDDM patients was not lower than that in a control group. This data suggests that insulin resistance, or hyperinsulinaemia, does not play a major role in the development of NIDDM in Korea. Taken together with the rarity of obese NIDDM in Korea, it maybe suggested that the insulin secretory capacity of Korean people being smaller than Western people they cannot compensate for the insulin resistance imposed by recent changes in life style.

Risk factors of ischemic brain stroke in Korean diabetic patients: a retrospective study

In order to investigate the risk factors of ischemic brain stroke (IBS) in diabetic patients, we analyzed 416 cases selected from 6239 diabetic patients admitted to Severance Hospital from Jan. 1983 to Dec 1987. Two hundred and eight cases had IBS. The other 208 cases without IBS were selected as a control group by a stratified random sampling method. The two groups were compared using various clinical characteristics of diabetes mellitus (DM) and known risk factors of IBS. In diabetics with IBS, the duration of DM was longer (9.2 +/- 7.1 years), hypertension was more frequently associated (68.2%) and the serum cholesterol level was higher (213.0 +/- 55.2 mg/dl) than in diabetics without IBS (7.6 +/- 7.1 years, 32.1% and 192.1 +/- 44.8 mg/dl, respectively). By means of Stepwise Logistic Regression Analysis (SLRA), it was found that the strong risk factors were hypertension and serum cholesterol level. The serum triglyceride level, type of DM and response to diabetes treatment were also thought to be risk factors of IBS by the retrial of SLRA of residuals after exclusion of hypertension and serum cholesterol level. IBS was not significantly related to the duration of DM, fasting blood glucose level, body weight, glycosylated hemoglobin value, and serum high-density lipoprotein-cholesterol level.