Diabetes In Adults Research Articles

Association of birthweight with diabetes, hypertension, and ischemic heart disease in young adulthood: a retrospective cohort study.

Birthweight has been associated with diabetes in a reverse J-shape (highest risk at low birthweight and moderately high risk at high birthweight) and inversely associated with hypertension in adulthood with inconsistent evidence for cardiovascular disease. There is a lack of population-based studies examining the incidence of cardiometabolic outcomes in young adults born with low and high birthweights. To evaluate the association between birthweight and diabetes, hypertension, and ischemic heart disease (IHD) in young adulthood, we conducted a retrospective cohort study of 874,904 singletons born in Ontario, Canada, from 1994 to 2002, identified from population-based health administrative data. Separate Cox regression models examined birthweight in association with diabetes, hypertension, and IHD adjusting for confounders. Among adults 18-26 years, the diabetes incidence rate was 18.15 per 100,000 person-years, hypertension was 15.80 per 100,000 person-years, and IHD was 1.85 per 100,000 person-years. Adjusted hazard ratios (AHR) for the hazard of diabetes with low (<2500g) and high (>4000g), compared with normal (2500-4000g) birthweight, were 1.46 (95% CI 1.28, 1.68) and 1.09 (0.99, 1.21), respectively. AHR for hypertension with low and high birthweight were 1.34 (1.15, 1.56) and 0.86 (0.77, 0.97), respectively. AHR for IHD with low and high birthweight were 1.28 (0.80, 2.05) and 0.97 (0.71, 1.33), respectively. Overall, birthweight was associated with diabetes in young adults in a reverse J-shape and inversely with hypertension. There was insufficient evidence of an association with IHD. Further evidence is needed to understand the causal mechanisms between birthweight and cardiometabolic diseases in young adults.

Distinct Amino Acid Profile Characterizes Youth With or at Risk for Type 2 Diabetes.

Branched-chain amino acids (BCAA) and aromatic AAs (AAA) are associated with increased risk for type 2 diabetes in adults. Studies in youth show conflicting results. We hypothesized that an AA metabolomic signature can be defined to identify youth at risk for β-cell failure and the development of type 2 diabetes. We performed targeted AA metabolomics analysis on 127 adolescents (65 females, 15.5±1.9 years old, Tanner stage II-V) with normal weight or obesity across the spectrum of glycemia, with assessment of AA concentrations by mass spectrometry, at fasting and steady-state (SS) of a hyperinsulinemic-euglycemic clamp, with determination of insulin sensitivity (ISFFM). We measured insulin secretion during a 2-hour hyperglycemic clamp and calculated the disposition index (DIFFM), a measure of β-cell function. Our results showed that Gly and Gln/Glu were lower, whereas BCAA, Tyr and Lys concentrations were higher in the groups with obesity and dysglycemia compared with those with normal weight. Gly and Gln/Glu were positively related to IS and DIFFM, with opposite relationships observed for BCAA, AAA and Lys. We conclude that a metabolic signature of low Gly, low Gln/Glu and elevated BCAA, AAA and Lys may constitute a biomarker to identify youth at risk for β-cell failure.

The Effect of Resistance Exercises Using an Elastic Band on Balance and Fear of Falling in Older Adults With Diabetic Peripheral Neuropathy: A 16-week Randomized Controlled Trial

ObjectiveThe current study aimed to investigate the effect of resistance training using an elastic band on balance and fear of falling in older adults with diabetic peripheral neuropathy. DesignThe study was a clinical controlled trial with a repeated measure design. SettingIranian Diabetes Foundation of Mashhad. ParticipantsThe participants were 51 older adults with diabetic peripheral neuropathy and balance impairment (N=51). InterventionsParticipants were randomly assigned to 2 groups; 1 group received balance training using an elastic band and the other group just received balance training. Main Outcome MeasuresThe main outcomes were balance and fear of falling that were measured using Berg Balance Scale and a short version of the Fall Efficiency Scale-International, respectively. ResultsThe results showed that balance resistance training with and without using an elastic band significantly enhances balance and reduces fear of falling in diabetic older adults suffering from balance issues. However, balance resistance training using an elastic band had a significantly better effect on the balance and fear of falling in the participants. The best results were obtained after week 12 (48 sessions of balance training). ConclusionBalance rehabilitation programs may include an elastic band in balance resistance training for 12 weeks (3-4 sessions a week) for enhancing balance in diabetic older adults suffering from balance impairment.

Clinical Features for Detecting Diabetic Macular Edema using Artificial Intelligence

Background:Vision is a valuable part of life: influencing our perception of the world and of memories. Diabetes, and more specifically, Diabetic Retinopathy (DR) can affect our vision, taking away sight potentially permanently if left untreated. Currently, Diabetic Retinopathy is the leading cause for adult blindness and will continue to rise with increasing prevalence of adult diabetes. Diabetic Macular Edema (DME), a complication of DR, is diagnosed by ophthalmologists using optical coherence tomography (OCT); however, the sheer amount of DME-related imaging creates a time strain on ophthalmologists, creating a demand to further optimize the image reading process. In this study, we hypothesize that increasing the rate and ease of diagnosing DME by introducing artificial intelligence-based methods in primary medical clinics will increase the long-term preservation of ocular health in diabetic patients.&#x0D; Methods:Due to the nature of our retrospective cohort study, consent was not acquired and images were also de-identified. We categorized 676 patient files by HbA1c, non-proliferative diabetic retinopathy (NPDR) severity, and proliferative diabetic retinopathy (PDR). Retinal OCT images were annotated to identify central macular edema, a common feature of DME. Retinal fundus images were also annotated to identify microaneurysms and hemorrhages, two additional features commonly used for detecting either DR or DME.&#x0D; Results:A lesion features dataset was prepared to train our AI model. OCT and fundus imaging features were extracted and combined to train the AI model for DME detection. From annotations of the in-house Macular thickness dataset, it was seen that 167 patients had DME from the total 389 diabetic retinopathy patients.&#x0D; Conclusion:We will continue to prepare more datasets like the macular thickness dataset for our AI. We predict that after our AI receives substantial training with the datasets, the AI will potentially demonstrate some capability of diagnosing DME, supporting its use in medical diagnostics.

Retracted: Oxidative Stress and Its Related Factors in Latent Autoimmune Diabetes in Adults.

[This retracts the article DOI: 10.1155/2021/5676363.].

Trajectory of lung function in diabetic adults: A 16-year follow-up study of community-based prospective cohorts.

To investigate the difference in lung function according to diabetes status in a community-based prospective study. Individuals aged 40-69 years from two community-based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross-sectional and longitudinal analyses based on diabetes status. Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, -1.853; 95% confidence interval [CI] -2.715 to -0.990 for prediabetes and mean, -4.088; 95% CI -5.424 to -2.752 for diabetes) and forced vital capacity (FVC) (mean, -2.087; 95% CI -2.837 to -1.337 for prediabetes and mean, -4.622; 95% CI -5.784 to -3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, -0.227; 95% CI -0.366 to -0.089) and FVC % predicted (mean, -0.232; 95% CI -0.347 to -0.117) during follow-up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow-up. Diabetes is associated with a lower baseline lung function and a faster rate of deterioration.

My Blood Glucose Level Data for Detecting and Monitoring Type 2 Diabetes in Adult People

The data note shares the blood sugar level data stored in a depository and makes it findable, accessible, interoperable, and reusable to researchers who are interested in modelling Type 2 diabetes data. The researcher collected quantitative data at 8am for the selected 45 days using an SD Code free Blood Sugar Meter from 23 October 2020 to 20 May 2022, a total of 574 days. The blood sugar levels were measured in millimoles of sugar per litre (mmol/L). The research also analysed the 5 data points that were recorded during the diagnosis of Type 2 diabetes on 28 September 2018 at Mutare Health Gate pharmacy in Zimbabwe. The benchmarks used were 5.0 – 7.2 mmol/L before meals, less than 10 mmol/L after 1 – 2 hours of meals, and 5.0 – 8.3 at bedtime. The findings from the data show that the designed data analysis template detected the absence of Type 2 diabetes in the researcher’s blood. The average and the standard deviation of the blood sugar level data are5.964 mmol/L and 0.5335 mmol/L respectively. The maximum and minimum data points are 4.6 mmol/L and 7.0 mmol/L respectively. One lesson from the findings is that Type 2 diabetes can be managed to complete remission if the patient is assisted by health specialists such as pharmacists, family doctors, diabetologists, and dieticians. The findings from the blood sugar level data led to the suggestion of tips and hints on how to manage Type 2 diabetes in adults.

Elevated triglyceride-glucose index associated with increased risk of diabetes in non-obese young adults: a longitudinal retrospective cohort study from multiple Asian countries.

Previous studies have confirmed a positive correlation between the Triglyceride-Glucose (TyG) index and future risk of diabetes. However, evidence of this association in non-obese young populations remains limited. This study aims to investigate the relationship between the TyG index and the future risk of diabetes among non-obese young adults. This retrospective cohort study included 113,509 non-obese young adults from China and 9,549 from Japan. The mean age was 35.73 ± 6.38 years, and 56,469 participants (45.89%) were male. The median follow-up duration was 3.38 years. The association between baseline TyG index and risk of diabetes was examined using Cox proportional hazards regression models. Non-linear relationships between the TyG index and risk of diabetes were identified using cubic splines and smoothed curve fitting in the Cox models. Sensitivity and subgroup analyses were also conducted. After adjusting for covariates, the results indicated a positive correlation between the TyG index and risk of diabetes in non-obese young adults (HR=3.57, 95% CI: 2.92-4.36, P<0.0001). A non-linear relationship was observed with an inflection point at 7.3. The HR to the right of this inflection point was 3.70 (95% CI: 3.02-4.52, P<0.0001), while to the left, it was 0.34 (95% CI: 0.06-1.88, P=0.2161). The robustness of our findings was confirmed through a series of sensitivity analyses and subgroup analyses. This study reveals a positive and non-linear association between the TyG index and risk of diabetes among non-obese young adults. Interventions aimed at reducing the TyG index by lowering triglycerides or fasting glucose levels could substantially decrease the future likelihood of developing diabetes in this population.

Using electronic health records to enhance surveillance of diabetes in children, adolescents and young adults: a study protocol for the DiCAYA Network

IntroductionTraditional survey-based surveillance is costly, limited in its ability to distinguish diabetes types and time-consuming, resulting in reporting delays. The Diabetes in Children, Adolescents and Young Adults (DiCAYA) Network seeks...

Acute complications of diabetes in adults: diagnosis and management

Acute complications of diabetes in adults: diagnosis and management

Cumulative ADHD medication use and risk of type 2 diabetes in adults: a Swedish Register study

BackgroundLittle is known about the impact of cumulative attention-deficit/hyperactivity disorder (ADHD) medication use on the risk of type 2 diabetes (T2D).ObjectiveThe objective is to examine the association between cumulative use...

In latent autoimmune diabetes in adults, mortality was similar to T2DM but retinopathy was higher at 5.9 y.

Wei Y, Herzog K, Ahlqvist E, et al. All-cause mortality and cardiovascular and microvascular diseases in latent autoimmune diabetes in adults. Diabetes Care. 2023;46:1857-1865. 37635682.

Diabetes and chronic kidney disease in Chinese adults: a population-based cohort study

IntroductionCohort evidence of the association of diabetes mellitus (DM) with chronic kidney disease (CKD) is limited. Previous studies often describe patients with kidney disease and diabetes as diabetic kidney disease...

Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study.

The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

Duration of type 1 diabetes and subclinical target organ damage in young diabetic adults.

Duration of type 1 diabetes and subclinical target organ damage in young diabetic adults.

Knowledge, attitude, and practice of medical students on artificial sweeteners: A cross-sectional study at Medical College and Hospital, Kolkata

Background: With rising obesity, diabetes, and metabolic syndrome rates, artificial sweeteners (ASs) have gained popularity as a healthier sugar substitute. However, their long-term effects remain unknown. Studies link them to increased risk of Type 2 diabetes, cardiovascular diseases, and mortality in adults. On May 15, 2023, the World Health Organization issued a guideline discouraging non-sugar sweetener use for weight control and reducing non-communicable disease risk. Medical students are future doctors who will be responsible for the health of the society for 1 day. This study aims to raise awareness among medical students about the pros and cons of ASs through questionnaires based on the knowledge, beliefs, and behaviors regarding the same. Aims and Objectives: The aim of the study was to assess the knowledge, attitude, and practice of undergraduate medical students about the use of ASs. Materials and Methods: A predesigned, pre-validated questionnaire study was conducted among 600 medical undergraduates at Medical College, Kolkata, using Google Forms. The study included 18 questions with six questions in each section of knowledge, attitudes, and practices (KAP). The responses were analyzed as percentages, using Microsoft excel. Results: 55% of undergraduate medical students consider ASs to be different from natural sugar. About 82% acknowledge lower calorie content in ASs. While 27.2% support replacing daily sugar with sweeteners, only 5.1% actually used these sweeteners at home. About 67.8% preferred sugar-free items occasionally. Though medical students, only 59.9% occasionally checked ingredient labels while buying food items. Conclusion: Medical students have diverse knowledge, attitudes, and practices regarding ASs. While they recognize the caloric advantage and potential for weight reduction, opinions vary on their impact on insulin resistance, sensory perception, cancer risk, tooth decay, and suitability for pregnant diabetic women. More education and research are needed to improve understanding and establish evidence-based recommendations in clinical practice.

Ab. No. 72 Relationship Between Duration of Diabetes and Functional Balance in Adults – A Cross Sectional Study

Introduction: Diabetes is a major problem and Type-2 Diabetes(T2DM) is becoming more common in adults. Particularly in those with Diabetes and poorer glucose management, there was a higher prevalence of risk of falls. Hence this study has been designed to evaluate balance performance in adults and its correlation with Duration of Diabetes in T2DM. The purpose is to correlate duration of diabetes on functional balance in adults with T2DM.Very few research was done on determining balance with duration of diabetes. Literature shows balance is one of the impairment among diabetic individuals. Treating balance is a crucial role for a physiotherapist and thereby preventing falls and promoting functional independence to patients. Methods: A total 30 diabetic patients were recruited from Dhiraj General hospital, based on the inclusion criteria. Based on the duration of diabetes, Group 1(&lt;5-Year) and Group 2 (&gt;5-Year) were formed. Functional balance of both the groups was assessed though berg balance scale (BBS). Descriptive demographic and clinical data statistics were analysed by SPSS-26 software and quantitative comparison of Balance with Duration of Diabetes was made using two sample t-tests. Results: We evaluated 30 adults. After adjustment for age, sex, and HBA1C. longer duration (&gt;5 years) of T2DM was associated with a higher risk of fall shows lower scores on BBS (Mean 45.00 ± 4.93; P = 0.0663) compared with those with duration &lt;5 year (48.63 ± 5.40). Conclusion: In adults with T2DM, duration of diabetes impacts clinical, Balance, and functional status should be considered in development of management strategies for safety and quality of life. Implications: Altered balance can also lead to impaired function, which has a detrimental impact on patient’s quality of life. Physical exercise improves physical fitness, quality of life in patients with type T2DM.

Correlation between Dyslipedemia and Urine Albumin Excretion in Non Diabetic Obese Subjects: A Cross-sectional Study

Introduction: Obesity is a global health concern, and recent research has shown that it can cause kidney problems, especially in non diabetics. Obesity-related dyslipedemia, characterised by aberrant lipid profiles, may contribute to kidney damage. Aim: The purpose of the present cross-sectional study was to shed light on the complex interaction between dyslipedemia and renal health by examining the relationship between dyslipedemia and urine albumin excretion in non diabetic obese adults. Materials and Methods: The cross-sectional investigation was conducted in the Outpatient Obesity Clinic of the Endocrinology Department at a Tertiary Hospital in Kerala, India. A total of 144 non diabetic obese individuals between the ages of 18 and 65 years. All subjects provided informed consent, and ethical approval was obtained. The primary inclusion criteria were a Body Mass Index (BMI) of less than 25.0, the absence of Type 2 Diabetes Mellitus (T2DM), and the absence of proteinuria. Urine and blood samples were collected for laboratory testing, and statistical analysis was conducted using International Business Machines (IBM) Statistical Package for Social Sciences (SPSS) Statistics 20.0. Results: Dyslipedemia was found to be common, with low High-Density Lipoproteins (HDL) levels in 41.4% of participants, high Low-Density Lipoproteins (LDL) levels in 49.6%, high Triglycerides (TG) levels in 29.7%, and high Total Cholesterol (TC) levels in 43%. The study revealed that obese individuals with dyslipedemia excrete albumin at a significantly higher rate than obese individuals without dyslipedemia. Furthermore, a weak correlation between TG levels and the Urine Albumin Creatinine Ratio (UACR) was discovered. However, UACR did not significantly correlate with metabolic risk markers such as Fasting Plasma Glucose (FPG), serum insulin, blood pressure, HDL, LDL, TC, and systolic/Diastolic Blood Pressure (DBP). Conclusion: The results of the present study demonstrate that dyslipedemia significantly contributes to kidney damage in non diabetic obese individuals. The presence of dyslipedemia in obese then could serve as an early warning sign of potential renal problems. Further research is needed to fully understand the complex interactions between obesity, dyslipedemia, and renal health. These insights could be crucial for developing effective preventative and intervention methods in this context.

Supporting Adolescents and Young Adults through Digitally Mediated Type 1 Diabetes Transition Care: A Qualitative Descriptive Study

Objective. The time during which adolescents and young adults (AYAs) living with Type 1 Diabetes (T1D) transition from pediatric to adult care is associated with blood sugar levels outside of target ranges, care gaps, and an increased risk of acute diabetes complications. The aim of this study was to understand (1) the perspectives of AYAs and providers about the strengths, challenges, and opportunities of transition care and (2) the role of digital technologies in supporting the transition to adult care. Research Design and Methods. We conducted a qualitative descriptive study that involved 43 semistructured interviews in French or English with AYA living with T1D (aged 16–25; n = 22) and pediatric or adult diabetes health care providers (HCPs) (n = 21). Results. We identified three themes. First, transition care is not standardized and varies widely, and there is a lack of awareness of transition guidelines. Second, virtual care can simultaneously hinder and help relationship‐building between providers and AYA. Third, AYAs value a holistic approach to care; both HCPs and AYA highlighted the opportunity to better support overall mental wellbeing. Conclusions. The design of digital technologies to support T1D transition care should consider methods for standardizing holistic care delivery and integrating hybrid diabetes care visits to support access to transition care. These findings can inform future transition intervention development that leverages existing transition guidelines, targets holistic care model integration, and considers quantitative diabetes metrics in conjunction with broader life experiences of AYA when providing transition care.

Self-care practices and its associated factors among adult diabetes mellitus patients in public hospitals of Sidama region, Southern Ethiopia: a cross-sectional study.

poor adherence to diabetes self-care practices can result in adverse health outcomes. Thus, it is important to adapt self-care behaviors to reduce and prevent complications from diabetes mellitus. Therefore, this study aimed to determine the level of diabetes self-care practices and associated factors among adults with diabetes in Ethiopia. a health facility-based cross-sectional study was conducted from March to April 2021 in the Sidama region public hospitals. A systematic random sampling technique was used to select 437 diabetic patients. The data were entered using Epi data version 3.1 and analyzed using SPSS version 25. A binary logistic regression analysis was performed, and variables with a p-value <0.05 were considered statistically significant. in this study, a large number of diabetes patients had inadequate self-care practices. Therefore, it is important to strengthen and establish support systems, such as collaborating with healthcare providers, enlisting the support of family members, and providing health education to improve self-care practices. this study found that 48.9% of participants had a good level of self-care practice. College graduates and above [AOR: 4.4, 95% CI (1.87, 10.4)], those with strong social support [AOR: 4.6, 95% CI (2.3,10.5)], attendees of health education [AOR: 2.33, 95% CI (1.38,4.6)], those who were on oral hypoglycemic drug [AOR: 0.45, 95% CI (0.24, 0.83)], those who perceived the benefits of self-care [AOR: 0.46, 95% CI (0.25,0.84)], and those who perceived the severity of complications [AOR: 0.56, 95% CI (0.29, 0.77)] were predictors of diabetes self-care practices.