Development Of Diabetes Mellitus Research Articles

Colorectal Cancer and Subsequent Diabetes Risk: A Population-based Cohort Study in Taiwan.

The association between colorectal cancer (CRC) and new-onset diabetes mellitus remains unclear. To examine the association between CRC and the risk of subsequent diabetes mellitus and to further investigate the impact of chemotherapy on diabetes mellitus risk in CRC. A nationwide cohort study. Using the Taiwan Cancer Registry Database (2007-2018) linked with health databases, 86,268 patients with CRC and an equal propensity score-matched cohort from the general population were enrolled. Among them, 37,277 CRC patients from the Taiwan Cancer Registry (2007-2016) were analyzed for diabetes mellitus risk associated with chemotherapy. Chemotherapy exposure within 3 years of diagnosis was categorized as no chemotherapy, <90 days, 90-180 days, and >180 days. Differences in diabetes mellitus risk were assessed across these categories. Each group involved 86,268 participants after propensity score matching. The patients with CRC had a 14% higher risk of developing diabetes mellitus than the matched general population (hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 1.09-1.20). The highest risk was observed within the first year after diagnosis followed by a sustained elevated risk. Long-term chemotherapy (>180 days within 3 years) was associated with a 60-70% increased risk of subsequent diabetes mellitus (HR: 1.64, 95% CI: 1.07-2.49). Patients with CRC are associated with an elevated risk of diabetes mellitus, and long-term chemotherapy, particularly involving capecitabine, increases diabetes mellitus risk. Thus, monitoring blood glucose levels is crucial for patients with CRC, especially during extended chemotherapy.

COVID-19-Induced Diabetes Mellitus: Comprehensive Cellular and Molecular Mechanistic Insights.

Despite evidence demonstrating the risks of developing diabetes mellitus because of SARS-CoV-2, there is, however, insufficient scientific data available to elucidate the relationship between diabetes mellitus and COVID-19. Research indicates that SARS-CoV-2 infection is associated with persistent damage to organ systems due to the systemic inflammatory response. Since COVID-19 is known to induce these conditions, further investigation is necessary to fully understand its long-term effects on human health. Consequently, it is essential to consider the effect of the COVID-19 pandemic when predicting the prevalence of diabetes mellitus in the future, especially since the incidence of diabetes mellitus was already on the rise before the pandemic. Additional research is required to fully comprehend the impact of SARS-CoV-2 infection on glucose tolerance and insulin sensitivity. Therefore, this article delves deeper into the current literature and links the perceived relationship between SARS-CoV-2 and diabetes. In addition, the article highlights the necessity for further research to fully grasp the mechanisms that SARS-CoV-2 utilises to induce new-onset diabetes. Where understanding and consensus are reached, therapeutic interventions to prevent the onset of diabetes could be proposed. Lastly, we propose advocating for the regular screening of diabetes and pre-diabetes, particularly for the high-risk population with a history of COVID-19 infection.

IJCM_116A: Risk assessment of type II Diabetes mellitus using Indian Diabetic Risk Score among adults in a tertiary care hospital, Tamil Nadu - A cross sectional study

Background: Non-communicable diseases (NCD) kill 41 million people each year which accounts to 74% of all deaths globally. India ranks second with a diabetes population of 69.2 million and may rise to 123.5 million by 2040. Early detection of diabetes risk through periodic screening could be instrumental in controlling diabetes. Objectives: 1. To estimate the risk of type 2 diabetes mellitus among adults attending tertiary care hospital. 2. To assess correlation between INDIAN DIABETIC RISK SCORE(IDRS) and Random Capillary Blood Sugar (RBS). 1. To assess association between selected risk factors and risk of developing diabetes mellitus. Methodology: This study was done among 270 individuals aged 18 years and above attending NCD OPD in Madurai medical college, Tamil Nadu during November 2023. The sample size was calculated based on 40% global prevalence of moderate to high diabetic risk by Sarah Wild et al. Consecutive sampling was done. After obtaining informed consent, data was collected using semi structured questionnaire containing sociodemographic details, risk factors, and IDRS. Anthropometric measurements and RBS were done. The study excluded all known cases of Diabetes. Results: The mean age of the study participants was 42.25 years (SD 4.70). Majority (83.3%) were females. IDRS categorization showed 18.2%, 56.6% and 25.2% in the low, moderate and high-risk groups respectively. The study indicates moderate correlation (r=0.435) of IDRS and RBS values. Also, significant correlation (r=0.543) of IDRS with RBS in 18-30 age group. Age, waist circumference and body mass index (BMI) were significantly (P &lt; 0.05) higher in the high-risk group. Conclusion: Screening of young adults by simple cost-effective tools like IDRS helps in further evaluation by blood investigations for early detection of diabetes, thereby preventing or delaying complications.

Effect of Quercetin With Oral Hypoglycemics in Streptozotocin‐Induced Diabetes, and Its Effect on Ulcerogenic Activity

AbstractA diabetic‐induced ulcer is a complication of diabetes in which the formation of an ulcer increases and also causes a delay in ulcer healing. Diabetes adds a bonus to various factors like starvation and stress, imbalanced acid‐pepsin secretions, impaired mucosal resistance, acid‐back diffusion, and neuronal dysfunction. Feeding a high‐fat diet for 15 days after induction of STZ in rats develops diabetes mellitus simultaneously with growth, resulting in an acceleration of ulcers for any of the above reasons. The OGTT investigation included both normal and diabetic rats, and the researchers establish a consistently low dosage of conventional oral hypoglycemic agents for the treatment. Clinical studies in the literature highlight that effectively treating patients with diabetes complications has been demonstrated through glycemic control. Hence, effective palliative hypoglycemic agents are employed. Long‐term usage has revealed that they exert a drastic negative effect. Hence, herbal drug combinations with these standard drugs have proved to be effective in minimizing the side effects. QE, which has hypoglycemic, dyslipidemia, and antioxidant properties, has been effective when administered with Glipizide (5 mg kg−1). The monotherapy of this Glipizide and QE has not shown a beneficial effect in protecting the stomach from ulcers. The combination (G + QE) showed effective control of glucose without any hypoglycemia. QE as a single adjunct with Glipizide has proven promising in preventing and treating diabetic ulcers.

New-onset Diabetes Mellitus after EUS-guided Drainage with LAMS: A Pilot Study.

Walled-off necrosis (WON) is a serious complication of severe pancreatitis, patients with necrotizing pancreatitis having an increased risk of developing diabetes mellitus (DM). The aim of this study was to assess the frequency of new-onset diabetes (NOD) in patients with symptomatic WON after endoscopic ultrasound (EUS)-guided drainage with lumen-apposing metal stents (LAMS). We retrospectively analyzed a prospectively collected database of patients with symptomatic WON treated by EUS-guided drainage with LAMS in a tertiary referral center. The patients were followed-up for at least 12 months after stent removal. These patients were compared with age- and sex-matched asymptomatic WON controls without interventional treatment and healthy controls to assess the one-year occurrence of DM. Diabetes was defined according to the American Diabetes Association criteria. Of the 50 patients with symptomatic WON included in the study (male/female ratio, 33:17; median age, 60 years), 13 patients (26%) had pre-existing DM and were excluded. Ten of the remaining 37 patients (27%) without prior DM developed NOD within one year after stent removal, this frequency being higher than in asymptomatic WON controls (18.9%, p=0.581) and healthy controls (2%, p = 0.002). In the symptomatic WON group, NOD patients compared to non-DM patients were older (63.5 vs. 56 years old, p=0.042), had more frequent necrosis > 50% of the pancreatic parenchyma (p=0.002) and had a body-tail location of WON (p<0.001). On multivariate analysis, the number of direct endoscopic necrosectomy (DEN) sessions was the only significant factor for NOD occurrence (OR=7.05, p=0.010). NOD patients had poor glycemic control and required more DEN sessions to achieve WON resolution than patients with prior DM (p=0.017). In patients with symptomatic WON treated by EUS-guided drainage, DM occurred in 27% of previously non-diabetic patients within one year of follow-up. Patients with extensive pancreatic necrosis were more likely to develop NOD, a high number of DEN sessions being a significant risk factor for NOD occurrence.

Effectiveness of Foot Exercises together with the Hydrotherapy program on Blood Sugar Levels in Elderly People without Diabetes

Background: The elderly human population is susceptible to health problems due to decreased organ function. The risk of diabetes in old age also reduces quality of life. Preventing the risk of developing diabetes mellitus requires simple and simple exercise programs such as foot exercises and hydrotherapy. The effect of light leg exercise and hydrotherapy on carbohydrate metabolism is unknown. Objectives: To find out the impact of hydrotherapy alone or in combination with foot exercise on elderly's blood sugar levels. Methods: Parallel three-group pre and post-test designs for an experimental investigation. 21 elderly in RW 04 Karangwetan, Ungaran served as research participants, divided into control group (n=7), combination of foot exercises and hydrotherapy intervention group (n=7), and foot exercise intervention group (n=7). The intervention took place three times per week for five weeks. We used POCT to assess blood sugar levels. Results: There is no significant decrease in blood sugar levels from control group (p&gt;0.05). There is significant decrease in blood sugar levels from foot exercise and hydrotherapy intervention group (p&lt;0.05) and foot exercise intervention group (p&lt;0.05). The difference in blood sugar levels showed significant results between foot exercise and hydrotherapy intervention group and control group (p=0.000) and between foot exercise intervention group and control group (p=0.004). There is no significant differences in blood sugar levels between foot exercise and hydrotherapy intervention group and foot exercise intervention group (p=0.112). Conclusion: Simple exercise activities such as foot exercises together with hydrotherapy have been proven to reduce blood sugar levels in healthy elderly populations without diabetes

Abstract MP45: Beyond Pregnancy: Meta-Analysis of Lifestyle Intervention for Prevention of Diabetes Mellitus in Women With Prior Gestational Diabetes Mellitus

Introduction: Among parous women,1 in 3 have a pregnancy complication, increasing chances of developing Diabetes Mellitus(DM), Hypertension, or heart disease. Lifestyle intervention is recommended to reduce cardiovascular morbidity risk after complicated pregnancies. The effect of lifestyle intervention on the risk of type 2 DM in women with prior Gestational DM (GDM) is not widely studied. Our study highlights the impact of lifestyle intervention on risk of type 2 DM in women with prior GDM. Methods: We ran a systemic literature search of PubMed, EMBASE, Clinical Trials.gov, and Google Scholar from January 2000 to August 2023 for relevant articles comparing lifestyle intervention (diet and physical activity) with standard care in women with prior GDM. The relative risk (RR) of DM with 95% confidence interval (CI) and p-values were extracted with fixed effect model using RevMan v.5.4. Results: Of 3100 articles that were screened, 28 underwent full-text review, and 11 studies met the inclusion criteria. Of 11 studies, 1661 were evaluated in intervention group (IG) and 1671 in control group (CG). The mean age of participants was 26.1-39 years, with a baseline body mass index (BMI) range (R) of 23.4-31.4 kg/m2 and a follow-up duration with R of 4-36 months. On analysis, the incidence of type 2 DM was 7.6% in IG compared to CG (10.35%). IG showed a 27% reduction in DM incidence as compared to CG, RR of 0.73(CI: 0.59-0.91) (p &lt; 0.05) (Figure 1). On meta-regression analysis, duration of lifestyle intervention (R: 4-36 months) significantly impacted the observed reduction in incident type 2 DM (p &lt; 0.05) (positive relation) as compared to baseline BMI (p = 0.21) (Figure 1). Conclusion: Our analysis highlights that lifestyle intervention in women with prior GDM positively reduces risk of type 2 DM, and intervention duration significantly impacts the long-term risk of DM and cardiovascular diseases. Further data is warranted from larger studies for stronger evidence regarding the benefits of lifestyle intervention in prior GDM patients

Spontaneous hypoglycemia: should we mind the gap? Long-term follow-up of healthy people who met Whipple's triad criteria.

Patients discharged as "healthy" with the symptoms of spontaneous hypoglycemia, commonly known as Whipple's triad, need more attention. Characterization and long-term follow-up of symptom development in patients with spontaneous hypoglycemia discharged as "healthy". The objective was to ascertain whether any conditions related to the symptoms were diagnosed during the follow-up period. Retrospective analysis of patient data and evaluation of a specific questionnaire on the development of symptoms of spontaneous hypoglycemia. In addition, patient questionnaires were evaluated and primary care physicians were asked about possible diseases not recorded at baseline that occurred during the follow-up period. Center for Endocrinology, Diabetology, and Osteology at the University Hospital Marburg, Inpatient Department, Germany. All patients who presented to our center for the 72-hour fast between 2005 and 2018 and were discharged without an internal medicine diagnosis were included. Survey by questionnaire, via telephone interview. Patient-reported information on current symptoms compared to original symptoms, diagnosis of insulinoma or diabetes mellitus during follow-up, matched with primary care physician data, and metabolic and biometric data such as body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA IR), insulin sensitivity Matsuda Index (ISI-M), and area under the curve. A total of 41 datasets were evaluated at baseline and 38 patients were followed for an average of approximately 10 years. In total, 61% of respondents still reported the same symptoms as at baseline. No insulinoma was missed in these patients. Only two of the 38 patients developed diabetes mellitus. The high percentage of patients who are discharged as "healthy" and still have symptoms after many years is disturbing. It is possible that the symptoms are not due to low blood glucose. We urge caution with use of the term "healthy". We advocate a multidisciplinary therapeutic approach after an organic cause of hypoglycemia has been ruled out. Psychosomatic treatment seems to be useful. In addition, more research should be conducted on this topic.

The effect of level of injury on diabetes incidence and mortality after spinal cord injury - a longitudinal cohort study.

Retrospective longitudinal cohort study of veterans with SCI. Spinal cord injury (SCI) is associated with an increased risk of developing diabetes mellitus (DM), likely due to body composition alterations and autonomic nervous system dysfunction. These factors are more pronounced in persons with tetraplegia (TP) versus paraplegia (PP). However, the effect of level of injury (LOI) on DM incidence is largely unknown. Therefore, the objective is to examine the effect of LOI on DM incidence in persons with SCI. South Texas Veterans Health Care System. We obtained electronic record data on age, sex, race/ethnicity, LOI and HbA1c concentration from January 1st 2001 through December 31st 2021. Cox proportional hazard regression analyses were used to assess the association between LOI, DM and all-cause mortality. Among 728 non-diabetic veterans with SCI (350 TP/ 378 PP, 52 ± 15 years, 690 male/38 female) 243 developed DM, of which 116 with TP and 127 with PP. Despite chronological variations between TP and PP, DM risk over the entire follow-up did not differ between the groups (hazard ratio (HR): 1.06, 95% CI: 0.82-1.38). Mortality was higher in TP versus PP (HR: 1.40, 95% CI: 1.09-1.78). However, developing DM did not increase the risk of death, regardless of LOI (HR: 1.07, 95% CI: 0.83-1.37). Despite chronological variations between both groups, the level of injury had minimal effect on long-term DM development in this cohort of veterans with SCI. Sponsorship NIH (DK105379; MS), RR&D SPiRE (I21RX003724-01A1; MT and SH).

Prevalence of Non-diabetic Hyperglycemia in Young Adults and Its Impact on Periodontal Health.

Background Non-diabetic hyperglycemia is a transitional phase of hyperglycemia that poses a hidden risk for the development of diabetes mellitus and related complications, including periodontal destruction. The current study sought to determine the prevalence of non-diabetic hyperglycemia in young adults and any possible links to periodontal health. Methods A total of 400 participants in this cross-sectional study were evaluated for non-diabetic hyperglycemia between the ages of 18 and 35 years. Group I consisted of non-diabetic hyperglycemic participants. Group II comprised an equal number of matched, healthy subjects. The groups' hyperglycemic and clinical periodontal characteristics were contrasted. Using a one-sample t-test and logistic regression analysis, the acquired data were subjected to statistical analysis. Results The prevalence of non-diabetic hyperglycemia was 19%, with men (13%) having a higher prevalence than women (6%). The mean fasting plasma glucose and hemoglobin A1c (HbA1c) levels were 114.47 ± 6.40 mg/dL and 6.10 ± 0.21%, respectively, for group I, and 85.72 ± 7.24 mg/dL and 4.38 ± 0.70% for group II. When compared to healthy controls, all periodontal parameters, including plaque index, gingival index, bleeding on probing, probing depth, and clinical attachment loss, were significantly higher in group I non-diabetic hyperglycemic patients. The regression analysis revealed statistically significant links between hyperglycemic and periodontal parameters. Conclusion The prevalence of non-diabetic hyperglycemia among young adults is a serious concern similar to that of older adults with the risk for periodontal diseases. Non-diabetic hyperglycemic considerations in young adults should be emphasized in dental and medical clinics to reduce the risk of developing diabetes mellitus and to avoid irreversible periodontal tissue damage.

Impact of Preoperative Diabetes Mellitus on Postoperative Outcomes in Elective Pancreatic Surgery and Its Implications for Prehabilitation Practice.

Patients with pancreatic disease(s) have a high risk of developing diabetes mellitus (DM). Diabetes mellitus is associated with adverse postoperative outcomes. This study aimed to investigate the prevalence and effects of DM on postoperative outcomes in pancreatic surgery. Subgroup analysis of a prospective cohort study conducted at an academic hospital. Patients undergoing pancreatoduodenectomy between January 2019 and November 2022 were included and screened for DM preoperatively using glycated hemoglobin (HbA1c). New-onset DM was diagnosed based on HbA1c ≥ 6.5% (48 mmol/mol). Postoperative outcomes were compared between patients with and without DM. From 117 patients, 29 (24.8%) were given a diagnosis of DM, and of those, 5 (17.2%) were diagnosed with new-onset DM, and 15 (51.8%) displayed poorly controlled preoperative DM (HbA 1c ≥ 7% [53 mmol/mol]). The incidence of surgical site infections (48.3% vs 27.3% in the non-DM group; P = 0.04) was higher for patients with DM. This association remained significant after adjusting for confounders (odds ratio, 2.60 [95% confidence interval, 1.03-6.66]; P = 0.04). One-quarter of the patients scheduled for pancreatoduodenectomy had DM; over half of them had poor glycemic control. The association between DM status and surgical site infections revealed in this study emphasizes the importance of adequate preoperative glycemic control.

VKH disease in the elderly: Variations in clinical course as compared to VKH disease in adults.

To describe disease characteristics and outcomes of Vogt-Koyanagi-Harada (VKH) disease in elderly patients. Retrospective analysis of patients older than 50 years with VKH disease at two referral centers in India. Demographics, extraocular and ocular involvement, treatment, complications, and visual acuity outcomes were noted. In total, 69 patients (mean age at presentation: 56.4 ± 4.7 years) were analyzed; 6/69 patients had diabetes mellitus at presentation, and 10/69 had hypertension. Clinical signs included anterior chamber cells >2+ (29%), granulomatous keratic precipitates (23%), disc hyperemia (26%), neurosensory retinal detachment (34.7%), and "sunset-glow" fundus (52.1%). Patients were classified as probable (n = 50, 72.4%), incomplete (n = 18, 26%), and complete VKH (n = 1, 1.4%). The mean follow-up period was 20.2 ± 19.4 months. Improvement in mean BCVA of (0.63 LogMAR, 6 Snellen lines) was noted on the last follow-up. Patients receiving systemic steroids with immunosuppressants (P < 0.0001) had better visual outcomes at final follow-up compared to steroids alone (P = 0.103). Eight patients (11.6%) had complications due to systemic immunosuppressants, and 17 patients (24.6%) developed diabetes mellitus or had worsening of diabetes while on systemic corticosteroids. Few patients presented with systemic manifestations in our cohort. Those treated with steroids and concurrent immunosuppressants had better outcomes. However, therapy with immunosuppressants was encountered with major dose-limiting complications in a significant number of elderly patients with VKH syndrome.

The roles of NADPH oxidase and PKC pathways in the modulation of GLP-1 induced-vasorelaxation in diabetic rat aorta

A hormone of the incretin system known as glucagon-like peptide-1 (GLP-1) is important for a number of glucoregulatory functions. This study aimed to investigate the effect of inhibitors on the vasorelaxant response of GLP-1 in T1D rats. A single subcutaneous injection of 50 mg/kg of streptozotocin (STZ) was used to develop diabetes mellitus. Eighty aortic rings from twenty male albino rats were prepared. An Automatic Organ Bath was used. In our study, apocynin increased vascular response to GLP- 1 in the non-diabetic group with (Emax:72.40±0.350) and (pD2: -9.923±0.444). In induced diabetes, the NADPH oxidase inhibitor decreased GLP-1 vasodilatation property with (Emax; 68.91±2.002) and (pD2: -9.480±0.138). The results show that bisindolylmaleimide IX (RO31-8220) has an increased effect on GLP-1 vasodilation in non-diabetic groups with (Emax:88.45±38.18) and (pD2: -10.81±0.281). While in induced diabetic rat’s vascular relaxation of GLP-1 decreased with (Emax: 77.73±2.801) and (pD2: - 10.28±0.203). The data analysis demonstrated that rotenone with (Emax: 63.69±35.10) (pD2: - 9.612±0.246), and in diabetic rats with (Emax:69.98±22.94) and (pD2: -9.612±0.246). In our study oxypurinol with (Emax: 82.16±16.10) and (pD2: - 9.434±0.443), and in diabetic rats with (Emax: 58.03±8.350) and (pD2: -9.612±0.246). We concluded that inhibitors could increase the vasorelaxant response of GLP-1 in non-diabetic rats, while this vasorelaxant response of GLP-1 diminished in diabetic-induced rats.

Preeclampsia and diabetes mellitus.

The purpose of this paper is to provide a review of recent research on the relationship between preeclampsia and diabetes mellitus in pregnancy. A structured search for literary sources in PubMed and ScienceDirect databases using keywords, followed by a selection of papers based on solid methodology. Preeclampsia is a serious condition, which complicates 2-7% of pregnancies. It causes maternal complications (organ dysfunction) and fetal complications (pathological haemodynamic parameters of the uteroplacental unit and fetal growth restriction). Pregnant women with pregestational diabetes have a 2- and 4-times higher risk of developing preeclampsia and the ones with gestational diabetes have 1.3-times higher risk. The main identified risk factors are inadequate compensation of diabetes, diabetic nephropathy, retinopathy and the duration of diabetes. To minimalize the risk of developing preeclampsia, a composite screening has been implemented. With a positive result a preventive use of acetylsalicylic acid from at the latest 16 and up until the 36th week is advised. Preeclampsia is also a risk factor for developing diabetes mellitus and other cardiovascular diseases later in life. For that reason, a long-term dispensary of women who had preeclampsia in pregnancy is recommended.

Changes of Serum Angiotensin Peptides, Pro-Endothelin-1 Levels in Women One Year After Preeclampsia and their Association with Cardiovascular Risk Factors

Abstract Introduction Women who suffered preeclampsia (PE) have two to four times higher risk for development of cardiovascular disease (CVD) compared with women with a history of normotensive pregnancy. Microvascular and endothelial dysfunction, mediated by different vasoactive factors have been suggested as attainable pathophysiological pathways. The study aimed to: (1) determine changes in circulating levels of key vasoactive peptides in sera of women with history of PE and in women who had a normal pregnancy 1 year after delivery and (2) investigate whether an association exists between these molecules and cardiovascular risk factors. Materials and methods The current research examined 32 women one year after preeclampsia (mean age 25.3 ± 6.3 years) and control group of 20 women one year after normal pregnancy (mean age 25.6 ± 5.6 years). The enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of angiotensin II (AngII), angiotensin-(1-7) [Ang-(1-7)] and pro-endothelin-1 (Pro-ET-1). Results We found that at 1 year after delivery 38.46% of women who suffered PE have developed hypertension and 5.77% have developed diabetes mellitus. Women who had normal pregnancy developed neither hypertension, nor diabetes mellitus 1 year after delivery. Serum AngII levels in women one year after PE were statistically significantly lower than in women one year after normotensive pregnancy 0.9 (0.55÷1.7) vs. 2.3 pg/ml (2.0 ÷ 2.9) (KW = 20.849; p = 0.0001). Ang-(1-7) concentrations in women one year after PE were lower than in women one year after normal pregnancy, but not significantly 1.7 (0.3÷4.5) vs. 3.2 ng/ml (0.2÷8.0) (p&gt;0.05). Levels of serum Pro-ET-1 in women one year after PE were statistically significantly higher than in women one year after normal pregnancy 322.65 (261.75÷391.85) vs. 248.7 pmol/L (231.05÷282.15) (KW = 6.639; p = 0.009). AngII showed correlation with AH grade (r = -0.33; 0.02), Ang-(1-7) (r = 0.27; 0.05), DBP (r = -0.28; p = 0.04), mean arterial pressure (r = -0.43; p = 0.002), pulse pressure (r = -0.28; p = 0.04), BMI (r = -0.30; p = 0.03), TC (r = -0.31; p = 0.03) and LDL (r = -0.30; p = 0.03). Pro-ET-1 correlated with age (r = 0.30; p = 0.03), mean arterial pressure (r = -0.25; p = 0.05) and pulse pressure (r = 0.41; p = 0.003). Conclusion Our data showed an association between key vasoactive peptides and major CVD risk factors in women one year after PE. We suggest that imbalance between AngII, Ang-(1-7) and Pro-ET-1 could have a potential imply on the vascular wall after PE, reflecting persistent microvascular and endothelial injury/dysfunction postpartum. Further studies are warranted to clarify these vasoactive peptides’ role in the ongoing vascular endothelial function after delivery and the pathogenic mechanisms determining development of CVD in previously PE women.

A quantile regression approach to identify risk factors for high blood glucose levels among Bangladeshi individuals.

Diabetes mellitus, characterized by high blood glucose, is an overwhelming public health concern globally, including in Bangladesh. The implication of this trend may pose a significant challenge to the health systems due to the lack of awareness and improper management of this chronic disease. To formulate strategies for public health planning, this study aims to explore the potential risk factors for elevated blood glucose levels among Bangladeshi individuals using advanced statistical methods and a nationally representative data set. This study utilized data from the 2017-18 Bangladesh Demographic and Health Survey and included 11,863 individuals. A nonparametric Kruskal-Wallis test assessed the significant association between fasting plasma glucose levelsand various risk factors. Additionally, a robust quantile regression model was applied to examine the net effects of each risk factor at different quantiles of the distribution. The prevalence of diabetes is 8.1% among individuals in the study population, with variations observed across different administrative divisions in the country. Respondents from the Dhaka division respondents had a higher likelihood (24.1%) of having elevated plasma glucose and the Rangpur division had a lower risk (10.3%) of developing diabetes disease. This study identified several potential risk factors associated with elevated blood glucose levels, including hypertensive disease, overweight and obese body mass index, higher economic status, reduced physical activities, and older age, significantly contributing to develop diabetes mellitus. This study recommends promoting healthy lifestyles, increased physical activity, effective hypertension management, obesity reduction, and nationwide screening programs to control diabetes and noncommunicable diseases in Bangladesh. These preventive measures are crucial for reducing the existing prevalence of diabetes and working towardachieving the Sustainable Development Goals by 2030.

Investigating a Causal Relationship Between Diabetes Mellitus and Oropharyngeal Cancer: A Mendelian Randomization Study.

Previous observational studies reported an association of diabetes mellitus (DM) with oropharyngeal cancer (OPC), however, the potential causality of the association between them remains unclear. To explore this causal relationship in individuals of European descent, a two-sample Mendelian randomization (MR) study was conducted. A genome-wide association study (GWAS) of DM was used to represent the exposure factor (T1DM: n = 24,840; T2DM: n = 215,654), and GWAS of OPC represented the outcome (n = 3,448). Forty-one single nucleotide polymorphisms (SNPs) related to T1DM and fifty-four SNPs related to T2DM were identified as effective instrumental variables (IVs) in the two-sample MR analyses. In IVW estimates, neither T1DM nor T2DM significantly contributed to an increased risk of OPC [T1DM: OR 1.0322 (95% CI 0.9718, 1.0963), P = 0.3033; T2DM: OR 0.9998 (95% CI 0.9995, 1.0002), P = 0.2858]. Four other regression models produced similar results. MR-Egger regression results [Cochran's Q statistic was 47.1544 (P = 0.1466) in T1DM, and 35.5084 (P = 0.9512) in T2DM] suggested no horizontal pleiotropy between IVs and outcomes. Our findings suggest little evidence to support the genetic role of diabetes mellitus in OPC development in the European population.

Impact of Degree and Duration of Iron Overload on Incidence of Diabetes Mellitus, Cardiac Disease, and Death in Congenital Hemolytic Anemias

Introduction : Iron overload and its complications are recognized to be morbid and fatal in patients with congenital hemolytic anemias. Much of what is assumed regarding the long-term complications of iron overload in these patients is extrapolated from other patient populations, primarily those with hereditary hemochromatosis. In patients with iron overload caused by congenital hemolytic anemias, there has been no study evaluating the dose-response relationship between serum markers of iron overload and long-term health complications. Filling this critical gap was the aim of the present study. Methods :We evaluated outcomes in a 5-hospital observational cohort study of adults with congenital hemolytic anemias diagnosed with iron overload over a 40-year period (1983-2023). Patients were identified via electronic database query, and eligibility was confirmed and data collection performed via manual chart review. Multivariable logistic modeling was used to assess the associations between depth of iron overload (as measured by lifetime peak ferritin measurement) or duration of iron overload (as measured by years of ferritin &amp;gt;500 ng/mL and &amp;gt;1000/mL) and complications of iron overload, including diabetes mellitus, heart disease, malignancy, and bone density disorders (osteopenia and osteoporosis), as well as death. Results : Patients and Iron Overload Exposure: 184 patients with congenital hemolytic anemias developing iron overload were included. Median (range) age was 32 (2-75) years at iron overload diagnosis and 105 patients (57%) were female. The cohort included 94 patients with sickle cell disease (51%), 30 patients with beta-thalassemia major (16%), and 60 patients with another hemolytic anemia (including thalassemia intermedia, hemoglobin H disease, and others). The cohort included a total of 2,139 patient-years of iron overload exposure (mean 11.6 years per patient). Association of Degree and Duration of Iron Overload with Development of Complications: During the observation period, 47 patients (26%) developed diabetes mellitus, 39 patients (21%) developed cardiac disease, 50 patients (27%) developed a bone density disorder, and 16 patients (8.7%) developed malignancy. More years experienced of ferritin &amp;gt;500 ng/mL and &amp;gt;1000 ng/mL were associated with development of diabetes mellitus with adjusted odds ratios (OR) (95% confidence interval [CI]) of 2.65 (1.12-6.08) per 10-year increment, P=0.025 and 3.76 (1.38-9.33) per 10-year increment, P=0.010, respectively (FIGURE 1). Similarly, more years experienced of ferritin &amp;gt;1000 ng/mL were associated with development of cardiac disease (adjusted OR [95% CI] 3.88 [1.51-9.96] per 10-year increment, P=0.005 [FIGURE 2]). Peak lifetime ferritin of &amp;gt;10000 ng/mL was associated with over 7-fold odds of development of both diabetes and cardiac disease ( P=0.013 and P=0.011, respectively; FIGURES 1 &amp; 2). No associations were observed between duration or degree of iron overload and development of malignancy or bone density disease. Association of Degree and Duration of Iron Overload with Death: During the observation period, 33 patients (18%) died. Peak lifetime ferritin of &amp;gt;10000 ng/mL was associated with over 9-fold odds of death (adjusted OR [95% CI], 9.06 [1.85-44.39], P=0.007). More years experienced of ferritin &amp;gt;1000 ng/mL were associated with death (adjusted OR [95% CI], 2.66 [0.99-7.17] per 10-year increment, P=0.053). Conclusions :In models controlling for sex, years of iron overload exposure, and underlying congenital hemolytic anemia, both the degree (as measured by peak lifetime ferritin) and duration (as measured by years of ferritin above 500 or 1000 ng/mL) of iron overload were associated with markedly increased odds of diabetes mellitus and cardiac disease, but not bone density disease or malignancy, in iron overloaded patients with congenital hemolytic anemias. While greater severity of iron overload was in general required for development of heart disease, prolonged exposure to relatively modest iron overload (serum ferritin &amp;gt;500 ng/mL) was associated with 3-fold increased odds of diabetes. Our findings emphasize the need for aggressive iron chelation therapy in these patients, highlight potential differences in risk of complications between these patients and those with hereditary hemochromatosis, and provide novel and valuable prognostic data for clinicians as they counsel patients.

Excessive weight gain onset-age and risk of developing diabetes mellitus: a large, prospective Chinese cohort study.

Excessive weight gain and obesity are widely accepted as risk factors for diabetes mellitus, and the age at which obesity onsets may be related to the development of cardiovascular diseases and certain cancers. Here, we aimed to investigate associations between the onset-age of overweight/obesity and risk of developing diabetes mellitus in China. 42,144 people with the normal weight range and without diabetes at baseline, were enrolled from the Kailuan cohort which began on the 1st June 2006. All participants were followed-up, biennially, until 31st December 2017. During follow-up, 11,220 participants had become overweight/obese. For each case, one normal-weight control was matched according to age ( ± 1 year) and sex. Our final analysis included 10,858 case-control pairs. An age-scaled Cox model was implemented to estimate hazard ratios (HR) with corresponding 95% confidence intervals (CI) for diabetes mellitus incidence across age-groups. At a median follow-up of 5.46 years, 1,403 cases of diabetes mellitus were identified. After multivariate adjustments, age-scaled Cox modelling suggested that risk gradually attenuated with every 10 year increase in age of onset of overweight/obesity. Diabetes mellitus adjusted HRs (aHRs) for new-onset overweight/obesity at <45years, 45-54 years, and 55-64 years were 1.47 (95%CI, 1.12-1.93), 1.38 (95%CI, 1.13-1.68), 1.32 (95%CI, 1.09-1.59), respectively. However, new-onset of overweight/obesity at ≥65 years did not relate to diabetes mellitus (aHR, 1.20; 95%CI, 0.92-1.57). This trend was not observed in women or the new-onset obesity subgroup but was evident in men and the new overweight onset subgroup. Participants with early onset of excessive weight gain issues are at considerably higher risk of developing diabetes mellitus compared to those who maintain a normal weight.

High Incidence of Diabetes Mellitus After Distal Pancreatectomy and Its Predictors: A Long-term Follow-up Study.

Glucose tolerance worsens after distal pancreatectomy (DP); however, the long-term incidence and factors affecting interindividual variation in this worsening are unclear. To investigate the changes in diabetes-related traits before and after DP and to clarify the incidence of diabetes and its predictors. Among 493 registered patients, 117 underwent DP. Among these, 56 patients without diabetes before surgery were included in the study. Glucose and endocrine function were prospectively assessed using a 75-g oral glucose tolerance test preoperatively, 1 month after DP, and every 6 months thereafter for up to 36 months. Pancreatic volumetry was performed using multidetector row computed tomography before and after surgery. Insulin secretion decreased and blood glucose levels worsened after DP. Residual pancreatic volume was significantly associated with the reserve capacity of insulin secretion but not with blood glucose levels or the development of diabetes. Among 56 patients, 33 developed diabetes mellitus. The cumulative incidence of diabetes at 36 months after DP was 74.1%. Multivariate Cox regression analysis showed that impaired glucose tolerance as a preoperative factor as well as a decreased insulinogenic index and impaired glucose tolerance at 1 month postoperatively were identified as risk factors for diabetes following DP. Impaired glucose tolerance and reduced early-phase insulin response to glucose are involved in the development of new-onset diabetes after DP; the latter is an additional factor in the development of diabetes and becomes apparent when pancreatic beta cell mass is reduced after DP.