Development Of Diabetes Mellitus Research Articles

Atopic dermatitis and diabetes mellitus-is there alink?

Atopic dermatitis and diabetes mellitus are chronic, immune-mediated, inflammatory diseases that significantly affect patients' quality of life and also represent a considerable socioeconomic burden. Despite intensive research in recent decades, the possible link between these two medical conditions remains a controversial topic due to sparse and sometimes contradictory data. Nevertheless, the potential link between them is based on some recognized common pathophysiological features. To summarize and evaluate a possible association between atopic dermatitis and diabetes mellitus. A literature review on the potential association between atopic dermatitis and diabetes mellitus was conducted. Several studies have reported a correlation between atopic dermatitis and type1 or type2 diabetes mellitus. However, other studies have shown no association between these two conditions or even suggested that atopic dermatitis could reduce the risk of developing diabetes mellitus in certain patients. In addition, these two chronic diseases also have certain clinical features that suggest a possible correlation. However, there is currently no clear scientific evidence of a significant positive association between atopic dermatitis and diabetes mellitus, mainly due to the lack of large and diverse demographic studies. Clinicians should be aware of this potential correlation in both adult and pediatric patients and consider the importance of an interdisciplinary approach for the management of atopic dermatitis. Further research is needed to determine possible associations between atopic dermatitis and diabetes mellitus in specific populations.

Skin as a mirror of metabolic syndrome: Do some dermatoses alarm internal metabolic sinister?

Metabolic syndrome is a group of abnormalities in metabolism including hypertension, central obesity, insulin resistance and dyslipidaemia. Etiopathogenesis is multifactorial including genetic and environmental factors. It is more prevalent in recent decade due to sedentary lifestyle with unhygienic food habits and cause increased prevalence in younger age group. This abnormal metabolism leads to oxidative stress in body involving multiple inflammatory pathways. There are so many dermatoses which are associated with metabolic syndrome due to common factors are involved in etiopathogenesis. These includes psoriasis, acne vulgaris, acanthosis nigricans, hidradenitis suppurativa, atopic dermatitis, androgenetic alopecia, lichen planus. There is increased risk of developing diabetes mellitus and damage to cardiovascular system. Early diagnosis and management are required to reduce risk of complications. These includes active lifestyle, dietary changes and medications.

Individuation of a cut-off value of triglyceride-glucose index for incident diabetes mellitus in patients with essential hypertension.

The prevalence of obesity and diabetes, risk factors for atherosclerotic vascular diseases, is increasing worldwide; therefore, it is desirable to early identify them to reduce cardiovascular events. Thus, we investigated whether the triglyceride-glucose index (TyG index), a new marker of insulin resistance, is associated with incident diabetes in patients with newly diagnosed arterial hypertension. We selected 585 patients with newly diagnosed arterial hypertension referred to our tertiary Clinic of Catanzaro University Hospital for the evaluation of their cardiometabolic risk profile. None of the patients had diabetes mellitus at enrollment and took any drug known to affect glucose metabolism. Patients underwent medical history collection, clinical examination and laboratory tests. The TyG index was calculated as the ln [fasting TG (mg/dl) × FPG (mg/dl)/2], as previously suggested. During the follow-up [mean 8.5years (range 3.1-10.7)], there were 78 new cases of incident diabetes (1.57% patient-year). Patients who developed diabetes mellitus were older and had a higher body mass index (BMI), baseline blood pressure, fasting glucose, insulin, homeostatis model sssessment (HOMA) index, triglyceride, creatinine and hs-CRP mean values, while estimated glomerular filtration rate values were lower. At the Cox regression analysis, covariates significantly associated with incident diabetes were: BMI (HR = 2.842, 95%CI = 2.299-3.514), TyG index (HR = 2.392, 95%CI = 1.745-3.192), age (HR = 1.944, 95%CI = 1.527-2.474), hs-CRP (HR = 1.409, 95%CI = 1.153-1.722), and HOMA (HR = 1.325, 95%CI = 1,079-1.756). The best estimated cut-off value of TyG index in predicting diabetes was 4.71. In addition, we documented a significant relationship between TyG index and HOMA (r = 0.575; p < 0.0001). Present data demonstrate that TyG index, a simple and cost-effective marker of insulin resistance, is useful in predicting incident diabetes in patients with arterial hypertension.

Assessment of risk of developing diabetes mellitus using Indian diabetes risk score (IDRS) among adult population living in an urban field practice area

ABSTRACT Background: The Indian Diabetes Risk Score (IDRS) is a simple and cost-effective tool for the early detection of undiagnosed cases in the community and is most suited for the Indian population to assess the risk of developing diabetes. Aim and Objectives: To assess the risk of Type 2 Diabetes Mellitus among the adult population living in an urban area by using the Indian Diabetes Risk Score (IDRS). To determine associated risk factors among the study population. Materials and Methods: A community-based cross-sectional study was done among 145 adults in an Urban field practice area under the Department of Community Medicine, Andhra, Medical College, Visakhapatnam. All males and females aged between 20 and 60 years living in the urban field practice area for the past year or more. The known diabetics and severely ill patients were excluded. Ethical permission was obtained and informed consent was taken from all the study participants. Results: Out of 145 study population, 66 people (45.5%) were found to be at the low-risk category, 41 people (28.3%) were in the medium-risk category and 38 people (26.2%) were at high risk based on their IDRS scores. Conclusion: The study showed a statistically significant relationship between factors such as gender, age, increased waist circumference, family history of diabetes mellitus, physical activity, and increased risk score.

Regional and ethnic factors of obesity and diabetes mellitus in women of re-productive age in the Pribaikal region

Introduction. Overweight is currently one of the leading global medical problems. Overweight and obesity contribute significantly to the development of diseases such as diabetes, cardiovascular disorder and can also cause premature death. Obesity has a negative impact on reproductive function; almost a quarter of women of childbearing age are overweight and about a third of them are obese.Aim. To study the characteristics of carbohydrate metabolism, hormonal indicators, and clinical-metabolic profiles, as well as to assess the potential risk of developing diabetes mellitus in women of fertile age with overweight and obesity residing in the Baikal region.Materials and methods. The study involved 60 overweight and obese women of reproductive age in the Pribaikalye region, including 33 women of Russian nationality (group 1) and 27 women of Buryat nationality (group 2). Anthropo-metric, sociodemographic and behavioural criteria were analysed, as well as questionnaires using the FINDRISC Scale. General clinical analyses of blood and urine were performed, lipid profile parameters, glucose, insulin, creatinine, transaminases, estradiol, thyroid hormone, leptin levels in blood plasma were studied. In addition, an oral glucose tolerance test was performed and the insulin resistance index (HOMA-IR) was calculated.Results. In the group of Buryat women with lower body weight as compared to Russians, higher levels of leptin, HOMA- IR index, and larger waist circumference are observed. In Buryat women, low physical activity makes a significant contribution to the development of overweight and obesity, while for Russian women, excessive caloric intake is more important. In accordance with the results of the FINDRISC scale survey, the greatest contribution to the potential development of diabetes mellitus in the Russian group is body mass index (weight), and in the Buryat group, in addition to these indicators, waist circumference and reduced physical activity.Conclusions. The results of the study will be of great help in the development of pro-grammes for the prevention of diabetes and obesity, taking into account regional and ethnic differences among the population.

Exploring Therapeutic Strategies: The Relationship between Metabolic Disorders and FOXO Signalling in Alzheimer's Disease.

Alzheimer's disease is an ailment that is linked with the degeneration of the brain cells, and this illness is the main cause of dementia. Metabolic stress affects the activity of the brain in AD via FOXO signaling. The occurrence of AD will significantly surge as the world's population ages, along with lifestyle changes perceived in current decades, indicating a main contributor to such augmented prevalence. Similarly, metabolic disorders of current adulthood, such as obesity, stroke, and diabetes mellitus, have been observed as the risk-causing factors of AD. Environmental influences induce genetic mutations that result in the development of several diseases. Metabolic disorders develop when individuals are exposed to an environment where food is easily accessible and requires minimal energy expenditure. Obesity and diabetes are among the most significant worldwide health concerns. Obesity arises because of an imbalance between the amount of energy consumed and the amount of energy expended, which is caused by both behavioral and physiological factors. Obesity, insulin resistance syndrome, hypertension, and inflammation are factors that contribute to the worldwide risk of developing diabetes mellitus and neurodegenerative diseases. FOXO transcription factors are preserved molecules that play an important part in assorted biological progressions, precisely in aging as well as metabolism. Apoptosis, cell division and differentiation, oxidative stress, metabolism, and lifespan are among the physiological processes that the FOXO proteins are adept at controlling. In this review, we explored the correlation between signaling pathways and the cellular functions of FOXO proteins. We have also summarized the intricate role of FOXO in AD, with a focus on metabolic stress, and discussed the prospect of FOXO as a molecular link between AD and metabolic disorders.

Pancreaticogastrostomy: A Safe and Effective Reconstruction Method After Pancreaticoduodenectomy: A Short Observational Study

Background: Pancreaticoduodenal resection is usually performed in patients with a localised small carcinoma in the head of the pancreas, at the lower end of the common bile duct or at the ampulla and occasionally for chronic pancreatitis.The mortality following pancreaticoduodenal resection has fallen and is now below 5% 1-6 .However, leakage from the anastomosis between pancreas and the jejunum has been and remains, one of the most worrying complications of the operation. The data from papers published in the last 8 years show that the incidence of pancreatic leak is 14% and the mortality of this complication 24%3,4,6-16 .Pancreaticogastrostomy is a potentially safer alternative to pancreaticojejunostomy in the reconstruction following Whipple's operation. Aim: The aim of the study was to observe pancreaticogastrostomy is a potentially safer alternative to pancreaticojejunostomy after pancreaticoduodenectomy. Methods: This prospective observational study was conducted at the Department of Surgery in Shaheed Suhrawardy Medical College Hospital, for One year (August 2021 to July 2022). Patients with a localised small carcinoma in the head of the pancreas, at the lower end of the common bile duct or at the ampulla, and occasionally for chronic pancreatitis admitted in the department of surgery were approached for inclusion in the study. Total 41 patients were selected according to inclusion and exclusion criteria. Informed written consent was taken from each patient. All patients underwent pancreaticogastrostomy. Detail clinical and demographic history was taken along with thorough physical examination relevant investigations. All patients were evaluated preoperatively and post operatively at discharge, 1 month and 3 months. Outcome was assessed post operatively. Collected data were checked and analysed in SPSS 23. Results: Two patients died within 30 days of the operation (mortality 4.9%), one from perioperative haemorrhage and another from septicaemia due to a biliary infection, which may have resulted from preoperative transhepatic biliary drainage. Both operations were carried out for carcinoma of the head of the pancreas. One patient developed a biliary leak which closed in 6 days. A postoperative pancreatic leak occurred in one patient with carcinoma of the ampulla; the fistula closed after 5 mdays, and did not delay his discharge from hospital. This patient remains well 36 months after operation, although he has now developed mild diabetes.One other patient developed diabetes mellitus postoperatively. This woman had evidence of obstructive pancreatitis at operation. She died 6 months later of recurrent carcinoma of the head of the pancreas. One patient with chronic pancreatitis has uncontrolled steatorrhoea, with up to four bowel movements a day. Four other patients take regular pancreatic supplements together with H2 receptor antagonists in order to maintain normal defaecation. There has been no case of stomal ulceration. None of the patients were lost to follow-up. The median survival for patients operated on for carcinoma of the head of the pancreas was 13 months, and for patients with carcinoma of the bile duct, 14 months. Median survival of patients with ampullary carcinoma was 38 months. Conclusion: Seventy two percent of patients had good outcome after Pancreaticogastrostomy(PG). Significant relief in symptoms of pain were noted after PG. Further larger study is recommended to validate this findings. J Shaheed Suhrawardy Med Coll 2023; 15(1): 66-72

8283 Diabetes Mellitus in Patients with Hemochromatosis- A Diagnostic and Therapeutic Challenge

Abstract Disclosure: U. Rafat: None. M. Siddiqui: None. J.L. Gilden: Other; Self; Novartis Pharmaceuticals. A. Moid: Other; Self; Novartis Pharmaceuticals. Background: Primary Hemochromatosis is a genetic condition most commonly due to two sets of mutations in the Human homeostatic iron regular Protein (HFE) gene. HFE modulates the expression of hepcidin, which regulates intestinal iron absorption, plasma iron concentration and distribution of iron in tissues. Hemochromatosis patients are at high risk for developing diabetes mellitus (DM) due to iron overload in the pancreas with damage to Beta cells and impaired insulin secretory capacity. Hemochromatosis is often called Bronze Diabetes due to brown discoloration of the skin from accumulation of iron, and is characterized by hepatic fibrosis, fatigue, arthralgias, cirrhosis, DM, arthropathy, pigmentation and cardiomyopathy. Case: We present a Caucasian male with homozygous hereditary hemochromatosis, diagnosed by liver biopsy at age 40 due to transaminitis and Ferritin level of 1500 ng/mL and Genetic testing- 2 copies of HFE gene pathogenic variant (C282Y). He was later diagnosed with DM age 51, started on Metformin and referred to Endocrine clinic with abdominal bloating, and polyarticular arthralgias. Physical exam=Vital Signs normal (WT. 231lbs, BMI 34), with splenomegaly, but normal musculoskeletal exam and skin without bronze discoloration. Both parents had T2DM. Lab- Hb a1c 8.7% (0.0-5.6), Iron saturation 71% (10-50), Ferritin 66.3 ng/mL (26-388), C-Peptide 3.30 ng/ml (0.81-3.85), with glucose level of 119 mg/dL, and negative IA-2 &amp;lt;5.4 U/mL, negative Islet cell antibody, GAD 65 &amp;lt;5 IU/mL (nl &amp;lt;5), Insulin Autoantibody &amp;lt;0.4 U/mL (nl &amp;lt;0.4), and Zinc Transporter 8 antibodies &amp;lt;10 U/mL (nl &amp;lt;15). Liver tests- AST 39 U/L(10-37), ALT 77 U/L (10-65), ALP 89 U/L (45-117), total bilirubin 1.1 mg/dL(0.2-1.2). Hormonal evaluation included TSH 1.2 uIU/mL (0.55-4.78), ACTH 19 pg/mL (0-47), AM Cortisol 16.28 ug/d (5.30-22.50) IGF1 158 ng/mL (50-317) FSH 9.6 mIU/mL(l.40-18.10), LH 5.09 mIU/mL (1.50-9.30), Prolactin 7.40 ng/mL(2.10-17.70), total testosterone 374 ng/dL(250-1100), free testosterone 66.2 pg/mL (35.0-155.0). Echocardiogram-left ventricular hypertrophy and thick right ventricular wall with concerns for iron overload. Hba1c improved to 6.6% on Metformin. Fructosamine 351umol/L (151-300). In the absence of advanced cardiac, hepatic and other organ involvement, and presence of elevated C-peptide and high BMI, this patient is being managed as T2DM, with low threshold to initiate insulin therapy considering possibility of concomitant Bronze DM. Conclusion: It is important to determine type of DM, so appropriate management options can be devised. While insulin is recommended for management in Bronze Diabetes, insulin sensitizers, such as metformin and/or GLP 1 agonists can be used in type 2 DM. One must also consider therapy based upon the risk of cancer and acute pancreatitis in the setting of pancreatic iron overload, when considering antihyperglycemic therapies. Presentation: 6/2/2024

Cutoff Values for Glycated Albumin, 1,5-Anhydroglucitol, and Fructosamine as Alternative Markers for Hyperglycemia.

Glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), and fructosamine have attracted considerable interest as markers of hyperglycemia. This study aimed to evaluate the optimal cutoff values for GA, 1,5-AG, and fructosamine and to determine their respective diagnostic efficacies in relation to hyperglycemia. We enrolled 6012 individuals who had undergone fasting blood glucose (FBG) and Hemoglobin A1c (HbA1c) tests along with at least one alternative glycemic marker. Receiver operating characteristic (ROC) curves and the upper or lower limit of the reference range (97.5 or 2.5 percentiles) were used to ascertain the optimal cutoff values. Follow-up data from healthy individuals were used to identify patients who developed diabetes mellitus (DM). The ROC cutoff values for GA, 1,5-AG, and fructosamine were 13.9%, 13.3 μg/mL, and 278 μmol/L, respectively, with corresponding area under the curve (AUC) values of 0.860, 0.879, and 0.834. The upper limits of the reference intervals for GA and fructosamine were 15.1% and 279 μmol/L, respectively, and the lower limit for 1,5-AG was 5.3 μg/mL. Among the GA cutoff values, the ROC cutoff had the highest sensitivity. Analyzing the follow-up data showed that lowering the GA cutoff from 16.0% to 13.9% identified an additional 40 people with DM progression. Lowering the GA cutoff values significantly increased the sensitivity of DM diagnosis and enhanced its potential as a screening marker by identifying more individuals with diabetes progression. Conversely, modifications to the cutoff values for 1,5-AG and fructosamine did not confer any discernible diagnostic or predictive advantages.

Obstructive sleep apnea mediates genetic risk of Diabetes Mellitus: The Hispanic Community Health Study/Study of Latinos.

We sought to evaluate whether obstructive sleep apnea (OSA), and other sleep disorders, increase genetic risk of developing diabetes mellitus (DM). Using GWAS summary statistics from the DIAGRAM consortium and Million Veteran Program, we developed multi-ancestry Type 2 Diabetes (T2D) polygenic risk scores (T2D-PRSs) useful in admixed Hispanic/Latino individuals. We estimated the association of the T2D-PRS with cross-sectional and incident DM in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We conducted a mediation analysis with T2D-PRSs as an exposure, incident DM as an outcome, and OSA as a mediator. Additionally, we performed Mendelian randomization (MR) analysis to assess the causal relationship between T2D and OSA. Of 12,342 HCHS/SOL participants, at baseline, 48.4% were normoglycemic, 36.6% were hyperglycemic, and 15% had diabetes, and 50.9% identified as female. Mean age was 41.5, and mean BMI was 29.4. T2D-PRSs was strongly associated with baseline DM and with incident DM. At baseline, a 1 SD increase in the primary T2D-PRS had DM adjusted odds ratio (OR) = 2.67, 95% CI [2.40; 2.97] and a higher incident DM rate (incident rate ratio (IRR) = 2.02, 95% CI [1.75; 2.33]). In a stratified analysis based on OSA severity categories the associations were stronger in individuals with mild OSA compared to those with moderate to severe OSA. Mediation analysis suggested that OSA mediates the T2D-PRS association with DM. In two-sample MR analysis, T2D-PRS had a causal effect on OSA, OR = 1.03, 95% CI [1.01; 1.05], and OSA had a causal effect on T2D, with OR = 2.34, 95% CI [1.59; 3.44]. OSA likely mediates genetic effects on T2D.

ANALYSIS OF CLUSTERING METHODS ON THE CAUSAL FACTORS OF DIABETES MELLITUS WITH FUZZY C MEANS METHOD

This study focuses on the effectiveness of clustering algorithms, namely Fuzzy C-Means by using k-Means algorithm as a supporting method, in the factors that cause Diabetes Mellitus. Diabetes mellitus is a chronic disease characterized by high levels of sugar (glucose) in the blood. Indonesia ranks 5th with the highest diabetes Mellitus patients in the world. This study aims to understand the pattern of factors causing Diabetes Mellitus and test the effectiveness of the clustering algorithm used. The data analysis methods include data collection, data pre-processing, distribution of cluster numbers, algorithm implementation, model adjustment, model training, model evaluation, and analysis of results. The results showed that the Fuzzy C-Means algorithm gets a coefficient of Fuzzynes score of 0.23 with a validation score of 0.40, while for supporting methods used K-Means algorithm gets a validation score of 0.32. This result shows that Fuzzy C-Means algorithm is superior in clastering the factors that cause Diabetes mellitus. The results of what variables have the most effect on cluster values 0 and 1. Where cluster 0 is a cluster that shows which variables are more at risk of diabetes, while cluster 1 is a cluster whose value shows what variables are far from the risk of causing diabetes mellitus. Then based on the results of the cluster that has been done, random blood sugar variables become the most influential variable on the risk of developing diabetes mellitus, followed by blood sugar variables 2 hours PP, and fasting blood sugar

Study of the Relationship between Platelet Distribution Width, Red Blood Cell Distribution Width and Insulin Resistance in Type 2 Diabetic Patients with Non-Alcoholic Fatty Liver Disease

Abstract Background Insulin resistance is identified as an impaired biological response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue. The metabolic consequences of insulin resistance can result in hyperglycaemia, hypertension, dyslipidaemia, visceral adiposity, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombotic state. Progression of insulin resistance can lead to metabolic syndrome, non- alcoholic fatty liver disease, and type 2 diabetes mellitus. Aim of the Work We aimed by our study to assess the relationship of platelet distribution width and red blood cell distribution width with insulin resistance in patients with type 2 diabetes with and without non-alcoholic fatty liver disease (NAFLD) and to check if platelet distribution width or red blood cell distribution width could be easy predictors of insulin resistance. Patients and Methods The present study is a Case Control Study was conducted in Ain Shams University Hospital. This study includes 80 subjects with matched age and sex. Results The present study results confirmed that low RDW was associated with increased risk of developing diabetes mellitus. Their study found that RDW is negatively correlated with waist and FG, insulin and TG concentrations. We also found that the group with the lowest quartile of RDW had the highest glucose, insulin and HOMA levels. Moreover, our results were found that there is a significant negative correlation of RDW with poor glycemic control. Our results also found that decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin. Our study was documented a negative correlation between HbA1c and the platelet index PDW. Conclusion In our study, we found a relation between insulin resistance and red blood cell distribution width. RDW (fl) could be used to discriminate between patients with type II diabetes and controls.

Sidonia and Nicu de Barcsy: a famous mother with post-partum hirsutism after giving birth to a famous son with idiopathic short stature.

At the end of the 19th century, an 18-year-old lady gave birth to a well-proportioned, though very small, son. After delivery, the mother developed a full-grown beard, whereas the son always remained of small stature. The mother developed diabetes mellitus and died, aged 59, from a complicated severe cold. The son died at the age of 91 because of chronic kidney disease. The differential diagnosis in the son is isolated growth hormone deficiency. The mother might have suffered luteoma of pregnancy, polycystic ovary syndrome (PCOS), or Sertoli-Leydig cell tumor(s). The two cases are apparently coincidental/not related in pathophysiology. Hirsutism occurring directly postpartum can have several causes. Patients with isolated growth hormone deficiency can live a long life without the substitution of growth hormone. Coincidence does not necessarily imply correlation. In the past, patients with endocrine disorders like severe hirsutism or small stature were employed at circuses and fairs to entertain the audience as curiosities.

“Diabetes Mellitus”, the Then and Now

Study’s Novelty/Excerpt This study provides comprehensive historical analysis of diabetes mellitus, tracing its evolution from ancient times to the modern era, which provides a unique chronological perspective on the disease's development. It distinguishes itself by detailing key events, such as insights from the Ebers Papyrus and the discovery of insulin, and their impact on our understanding and treatment of diabetes. Additionally, the manuscript offers a thorough exploration of how scientific endeavors over centuries have shaped the current medical landscape for diabetes mellitus, emphasizing the persistent challenge it poses despite significant medical advancements. Full Abstract Diabetes mellitus is a type of metabolic illness characterized by protein, lipid, and glucose metabolism difficulties. It is distinguished by chronic hyperglycemia, which defects in either insulin action or secretion can cause. Diabetes mellitus has been recognized since ancient times, and despite medical advances, it remains an incurable chronic illness. Our historical article presents major events in the evolution of diabetes mellitus from ancient times to the present day. Articles, as well as book chapters were used in citing. The key events in the development of diabetes mellitus from ancient times to the present were explored. An understanding of the key moments leading up to the identification of diabetes mellitus was provided in this study. Events from the Ebers Papyrus, the nineteenth and early twentieth centuries, and the discovery of diabetes are covered in this article. It can be deduced that scientists tried to discover the presence and existence of these illnesses. The discovery of insulin has played a significant role in the history of diabetes mellitus.

Metformin in diabetes management: expanding benefits. Review

We have conducted a narrative review based on a structured search strategy, focusing on the effects of metformin on the progression of non‑diabetic hyperglycemia to clinical type 2 diabetes mellitus. The principal trials that demonstrated a significantly lower incidence of diabetes in at‑risk populations randomized to metformin (mostly with impaired glucose tolerance) were published mainly from 1999 to 2012. Metformin reduced the 3‑year risk of diabetes by ‑31% in the randomized phase of the Diabetes Prevention Program (DPP), vs.‑ 58% for intensive lifestyle intervention. Metformin was most effective in younger, heavier subjects. Diminishing but still significant reductions in diabetes risk for subjects originally randomized to these groups were present in the trial’s epidemiological follow‑up, the DPP Outcomes Study (DPPOS) at 10 years (‑18 and ‑34%, respectively), 15 years (‑18 and ‑27%), and 22 years (‑18 and ‑25%). Long‑term weight loss was also seen in both groups, with better maintenance under metformin. Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect. Improvements in long‑term clinical outcomes with metformin in people with non‑diabetic hyperglycemia («prediabetes») have yet to be demonstrated, but cardiovascular and microvascular benefits were seen for those in the DPPOS who did not vs. did develop diabetes mellitus. Multiple health economic analyses suggest that either metformin or intensive lifestyle intervention is cost‑effective in a community setting. Long‑term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects. Future research will demonstrate whether intervention with metformin in people with non‑diabetic hyperglycemia will improve long‑term clinical outcomes.

Assessment of Risk of Type 2 Diabetes using Indian Diabetes Risk Score: A Community-Based Cross-Sectional Study in Marathwada region of Maharashtra

Background: Diabetes mellitus is one of the non-communicable diseases which have become a major global health problem whose prevalence is increasing worldwide and will reach to 12.2% (783 million) by 2045. The risk of diabetes escalates with increase in the number of risk factors and their duration as well. The Indian Diabetic Risk Score (IDRS) is a simple, low cost, feasible tool for mass screening programme for diabetes at the community level. Hence the present study was carried out to assess the level of risk of developing type 2 diabetes using IDRS. Methods: A cross-sectional study was carried out amongst 380 participants aged 20 years and above during the period of July 2018 to June 2019 in the field practice area of Rural Health Training Centre of IIMSR Medical College in Jalna, Maharashtra. A semi-structured interview schedule consisting of socio-demographic characteristics, risk factor profile and Indian Diabetes Risk Score was used. Data was analysed by using appropriate statistical test whenever necessary. Results: In our study, 52% are moderately at risk and 2% are at high risk for developing diabetes mellitus. About 62.1% participants belonged to nuclear family, 42.6% had family history of diabetes mellitus, 76.3% carried out moderate physical activity and 50.3% were overweight / obese. Family history of diabetes, lack of physical activity and overweight / obesity were found to be potential risk factors for developing diabetes mellitus. Conclusion: More than half i.e. 52% of the study subjects were at risk of having diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage.

Analysis of Determinants of NCD Diabetes Mellitus in Tilango Health Centre

The incidence and prevalence of type 2 diabetes in adolescents varies according to ethnicity and other factors. Populations with a high incidence and prevalence of type 2 diabetes in young people also have a higher risk of developing type 2 diabetes in adults. This research aims to analyze the determinants of PTM Diabetes Mellitus at the Tilango Community Health Center. Analytical survey research method with a cross-sectional study design. The population is all Prolanis patients at the Tilango Community Health Center in 2023 totaling 104 people. Sampling used total sampling, so the total sample was 104 people. Analysis was carried out using the chi-square test and multiple logistic regression test. The research results of the multiple logistic regression test obtained the variables diet (0.016) and hypertension (0.003). The largest OR value was obtained for the diet variable (11.075). This research concludes that there is a relationship between diet, obesity, genetic history, hypertension, physical activity, and the incidence of PTM diabetes mellitus at the Tilango Health Center. Diet is the variable most related to the incidence of PTM Diabetes Mellitus at the Tilango Community Health Center, excessive eating patterns have an 11.075 times greater chance of developing diabetes mellitus.

Menopausal hormone therapy decreases the likelihood of diabetes development in peri‑menopausal individuals with prediabetes

BackgroundThe influence of menopausal hormone therapy (MHT) on the probability of developing diabetes mellitus in individuals with prediabetes remains uncertain. MethodsThis retrospective cohort study, utilizing the TriNetX U.S. Collaborative Network, investigated cohorts, implemented propensity score matching, and analyzed outcomes associated with diabetes mellitus. The study focused on individuals aged 46–60 with prediabetes prior to menopause, categorizing them into MHT and non-MHT groups. Further stratified analyses, including variables such as age and race, were conducted to thoroughly examine potential variations in outcomes. ResultsThe study involved 6566 individuals (MHT and non-MHT), with propensity score matching ensuring balanced cohorts. Over a 20-year follow-up, the MHT group demonstrated a lower incidence of diabetes mellitus compared to the non- MHT group, with a Hazard Ratio of 0.693 (95 % CI: 0.577, 0.832). Stratified analyses revealed age-specific nuances, with significant protective effects in individuals aged 46–50 and 55–60. Additionally, ethnicity played a role, with MHT demonstrating significant benefits in White individuals but not in the Black or Asian populations. BMI analysis indicated a significant risk reduction with MHT in individuals with BMI less than or equal to 24.9 and 25–29.9 kg/m 2, but not in those with BMI greater than or equal to 30 kg/m 2. ConclusionIn our study, we demonstrate a sustained 20-year decrease in the risk of diabetes among premenopausal individuals with prediabetes who undergo menopausal hormone therapy.

Diabetes Mellitus: Preconception management in primary care

Women with diabetes experience adverse risks to their health and the health of their foetuses during pregnancy. This article draws upon research to help primary care nurses advise and care for patients who fall into this category Diabetes mellitus is associated with adverse risks to both pregnant women and their foetuses. These risks include; congenital malformations, stillbirth and miscarriage. The infant is also at risk of developing diabetes mellitus and other health issues in the future. This article provides an overview of diabetes mellitus and pregnancy. Addressing the importance of preconception management and the role general practice nurses have in increasing favourable outcomes, through improving preconception management in primary care. Discussing integrating primary and secondary care to enable continuity of care. Analysing the research on the impact health care professionals conducting educational interventions has on patient's pregnancy outcomes. As well as the use of conventional and digital methods to provide health education on preconception care.

PENYULUHAN KESEHATAN DAN PEMERIKSAAN KADAR GULA DARAH SEBAGAI UPAYA PENCEGAHAN DIABETES MELITUS DI DESA CURAH COTTOK, SITUBONDO

Diabetes mellitus is a disease whose population is increasing and can occur at all ages. This disease generally appears in the elderly. Diabetes mellitus is characterized by increased glucose levels in the blood. In rural communities, knowledge about this disease is still minimal, so hyperglycemia is usually only discovered when the condition gets worse. Blood sugar levels can be determined through blood sugar checks. The people in Curah Cottok Village have a pattern of consuming quite a lot of sugar. Drinks tend to taste very sweet when consumed. Apart from that, this village also produces crackers where the basic ingredient for making crackers is flour which is another source of carbohydrates. This needs to be watched out for because it can be a factor in increasing blood sugar levels. Increasing community knowledge in rural areas is carried out through health education activities and health consultations. Early detection of diabetes mellitus is carried out through random blood sugar level checks. This community service activity was carried out in Curah Cottok Village, Situbondo. Participants in this activity were 26 people aged 50-80 years. The result of this community service activity is a change in the village community's knowledge from knowing to knowing about diabetes mellitus and the prevention that needs to be done. Another result is data reports on residents who are at risk of developing diabetes mellitus. This data can be used by village officials or village midwives to plan referrals to health facilities or programs to prevent diabetes mellitus complications