Diabetes Mellitus Family Research Articles

Evaluation of Systemic Risk Factors in Patients with Diabetes Mellitus for Detecting Diabetic Retinopathy with Random Forest Classification Model.

This study aims to assess systemic risk factors in diabetes mellitus (DM) patients and predict diabetic retinopathy (DR) using a Random Forest (RF) classification model. We included DM patients presenting to the retina clinic for first-time DR screening. Data on age, gender, diabetes type, treatment history, DM control status, family history, pregnancy history, and systemic comorbidities were collected. DR and sight-threatening DR (STDR) were diagnosed via a dilated fundus examination. The dataset was split 80:20 into training and testing sets. The RF model was trained to detect DR and STDR separately, and its performance was evaluated using misclassification rates, sensitivity, and specificity. Data from 1416 DM patients were analyzed. The RF model was trained on 1132 (80%) patients. The misclassification rates were 0% for DR and ~20% for STDR in the training set. External testing on 284 (20%) patients showed 100% accuracy, sensitivity, and specificity for DR detection. For STDR, the model achieved 76% (95% CI-70.7%-80.7%) accuracy, 53% (95% CI-39.2%-66.6%) sensitivity, and 80% (95% CI-74.6%-84.7%) specificity. The RF model effectively predicts DR in DM patients using systemic risk factors, potentially reducing unnecessary referrals for DR screening. However, further validation with diverse datasets is necessary to establish its reliability for clinical use.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

The Effect of Wetland Geography on the Prevalence of Diabetes Mellitus in South Kalimantan

Diabetes mellitus (DM) is a high-burden disease in Indonesia especially in South Kalimantan Province. South Kalimantan province lies in mostly wetlands areas. Identification of risk factors related to DM is necessary to prevent the disease. We conducted this study to assess the prevalence of DM in the South Kalimantan people, the impact of a wetlands area on DM prevalence, and other significant risk factors. A cross-sectional study approach was used to identify significant risk factors. We used adjusted multiple logistic regression to assess the association between risk factors and DM prevalence. There were 4612 subjects more than 18 years old in this study with 6.5% of them diagnosed as DM. Most of the subjects live in wetlands area (79.1%) and most of them >40 years old. Several important risk factors associated with DM were identified. Subjects in wetlands have a lower risk of DM compared to non-wetlands area (OR 0.73, CI 95%; 0.43-0.71, p<0.001). Age >40 years old increase the risk of DM (OR 2.24, CI 95 % 1.61-3.10, p<0.001), hypertension (OR 1.65, CI 95% 1.23-2.21, p<0,001), waist circumference >90 cm (OR 2.12, CI 95%. p<0.001), cholesterol level (>200 mg/dl) with DM prevalence (OR 1.38, CI 95% 1.02-1.87, p<0.04) and family history of DM (OR 10.28, CI 95% 7.67-13.76, p<0.001). This study found that wetlands areas may reduce the DM prevalence and other risk factors may increase the prevalence of DM. Further research is necessary to establish the relationship between wetlands area and DM.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background: Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results: A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions: Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity.

Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories

Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitusis characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs duringthe development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during thedevelopment of hypertension in patients with or without diabetes mellitus using data from the MCDS and in the FOSduring a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS,odds ratio, 3.14; 95% confidence interval, 2.17–4.54) independently of sex, age, body mass index, and familial diabetesmellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus. In comparisonwith the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype(hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall,results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitustrack each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BPvalues, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent ofprogression to 2 respective disease states.

Prevalence of diabetes mellitus among newly detected sputum positive pulmonary tuberculosis patients and associated risk factors: A cross-sectional study

Background: Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods: In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results: A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions: Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

Gradient association between pulmonary tuberculosis and diabetes mellitus among households with a tuberculosis case: a contact tracing-based study

Pulmonary tuberculosis (PTB) and diabetes mellitus (DM) remain high morbidity and mortality, especially when they are comorbid with each other. Screening for diabetes mellitus in tuberculosis is essential as the incidence and mortality of DM in the population with PTB are higher than in the general people. We aimed to examine the gradient association of tuberculosis on developing DM, the additional yield and the number needed to screen (NNS) to find a new diabetes case. A cross-sectional study was conducted on 801 tuberculosis cases and 972 household contacts in Guizhou, China, from April 2019 to October 2020. After screening for PTB among contacts, all participants were screened for DM and interviewed. Kendall’s tau-b test and proportional odds logistic regression analysis were applied to identify the gradient associations. Among the 1773 subjects, the additional yield of screening was 21.8%. The NNSs of the non-PTB group, the sputum-culture negative and positive groups were 50, 60 and 113, respectively. The gradient incremental establishment of DM and PTB were positively correlated. The general trend on the gradient of DM significantly increased with the gradient increase of PTB. Age 35 years and over, excessive edible oil intake and DM family history were identified as significant predictors of diabetes. Integrated screening for DM targeted to different gradients of PTB combined with associated factors is necessitated to achieve a higher additional yield.

Application of Early Diagnosis of Diabetes Mellitus (DM) Equipped with Calorie Needs for DM Sufferers using the Fuzzy Mamdani Method

Diabetes Mellitus (DM) is one of the deadliest degenerative diseases in the world. The prevalence of DM in Indonesia from year to year shows asignificant increase. The high number of these causes the need for appropriate action and anticipation for health workers, DM families and DM people themselves. In this study, a system application model was created by using informatics techniques in health for early diagnosis of DM and what calorie needs needed for DM sufferers. This system was created using a GUI application and the Mamdani fuzzy method. The purpose of creating this system is to help in making an initial decision for DM diagnosis. The results obtained, first a DM diagnosis system with 6 input variables, 3 output variables, and 155 rules with MAPE achieved 29.48%. The second is the calorie requirements system with 2 input variables, 2 output variables namely BMI with MAPE 10.57% BMR with MAPE 9.7% and 9 rules with the results achieved by 99%.

Personal History of Diabetes as Important as Family History of Colorectal Cancer for Risk of Colorectal Cancer: A Nationwide Cohort Study.

Diabetes mellitus (DM) and colorectal cancer (CRC) share some risk factors, including lifestyle and metabolic disturbances. We aimed to provide in-depth information on the association of CRC risk, especially early-onset CRC, with DM, family history of CRC, and age at DM diagnosis. A nationwide cohort study was conducted using Swedish family cancer data sets, inpatient, and outpatient registers (follow-up: 1964-2015), including all individuals born after 1931 and their parents (12,614,256 individuals; 559,375 diabetic patients; 162,226 CRC patients). DM diagnosis before the age of 50 years was associated with a 1.9-fold increased risk of CRC before the age of 50 years (95% CI for standardized incidence ratio: 1.6-2.3) vs 1.3-fold risk of CRC at/after the age of 50 years (1.2-1.4). DM diagnosis before the age of 50 years in those with a family history of CRC was associated with 6.9-fold risk of CRC before the age of 50 years (4.1-12) and 1.9-fold risk of CRC at/after the age of 50 years (1.4-2.5). Diabetic patients had a similar lifetime risk of CRC before the age of 50 years (0.4%, 95% CI: 0.3%-0.4%) to those with only a family history of CRC (0.5%, 0.5%-0.5%), double that of the population (0.2%, 0.2%-0.2%). Our large cohort with valid information on DM and family history of cancer showed that DM is associated with increased risk of CRC in a magnitude close to having family history of CRC. Associations of DM and CRC family history with increased CRC risk were most prominent in young adults. These findings warrant further studies on harms, benefits, and cost-effectiveness of CRC screening in patients with diabetes, especially type 2, at earlier ages than in the general population.

Retrospective Survey of Pediatric Diabetics at a Tertiary Healthcare Center in Uyo, South-South Nigeria

<i>Purpose</i>: Despite the high prevalence of diabetes mellitus (DM) reported among adult Uyo inhabitants in south-south Nigeria, no data exist on pediatric DM (PDM) to date. Hence, the current study aimed to evaluate pediatric subjects diagnosed with DM in Uyo, South-south Nigeria. <i>Methods</i>: This was a retrospective survey of incident/newly diagnosed PDM subjects diagnosed/managed over 15 years (2003-2018) at the University of Uyo Teaching Hospital (UUTH), South-south Nigeria. Patients’ demographic, clinical, and laboratory variables at PDM diagnosis were retrieved from medical records and analyzed using descriptive statistics. <i>Results</i>: 45,551 pediatric cases were managed during the studied period among them 9 PDM cases, all of type 1 DM, giving PDM prevalence of 0.20/1000. Age at diagnosis was 7.00±4.82 years (range 2-16) with a predominance of ≤5-year-olds (44.4%) and females (66.6%). Most (77.8%) presented via the pediatric outpatient clinic, during the rainy season (55.6%), were urban-dwellers (55.6%), of Ibibio ethnicity (55.6%), and lower socioeconomic status (44.4%). Three (33.3%) had DM family history, mostly in first-degree (n=2) relatives. Predominant symptoms were polyuria (100%), polydipsia (100%), weight loss (88.9%), and weakness (77.8%); polyuria being the most prolonged symptom. Three (33.3%) were underweight/stunted, and 2 (22.2%) were overweight. DKA complicated with AKI and dehydration-induced AKI was recorded in 2 respective cases. The default rate to follow-up was discouragingly high following diagnosis. <i>Conclusion</i>: The prevalence rate of PDM was relatively low, occurred mostly among the ≤5-year-olds, with a high rate of default to follow-up. These findings could serve as health policy targets by various stakeholders within the studied region.

Analysis of the Health Tasks of Families with Diabetes Mellitus (DM)

The family is the entry point in providing nursing services in the community, the involvement of all family members is needed in carrying out health tasks as an effort to prevent and treat DM. This aim of the study was to analyse personal and family factors towards family health tasks that have family members with DM patients. The study design used an analytic observational design with a cross sectional approach, a population of 184 DM families, a sample of 67 respondents using cluster random sampling. Analysis was conducted using the Spearman rho test. The results of the research of the patient factors influencing family tasks are age (p = 0.003), gender (p = 0.837), education (p = 0.013), work (p = 0.936), duration of suffering (p = 0.538). Family factors that affect family health tasks are family type (p = 0.137), family development (p = 0.097), income (p = 0.001), knowledge (p = 0.001). The average health assignment is 56.7 less. DM patients and families need to increase their knowledge about DM, complications, prevention, treatment therapy and be able to maximize health facilities in providing continuous care. © 2019, Indian Journal of Public Health Research and Development. All rights reserved.

The Association between Knowledge, Family Support, and Blood Sugar Level in Type 2 Diabetes Mellitus Patients

Background: Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia. The incidence of DM has increased due to lack of knowledge about DM and changes in lifestyle. The purpose of this study was to analyze the relationship of knowledge about DM, family support, and blood sugar levels in type 2 DM patients in Jebres health center, Surakarta.Subjects and Method: A cross sectional study was conducted at Sibela and Ngoresan Surakarta health center. The study subjects were 100 DM patients selected by purposive sampling. Socio-economic data, knowledge and family support were measured by questionnaires. Blood sugar levels were measured using a spectrophotometer. The data were analyzed using a multiple logistic regression.Results: A total of 66 DM patients had a high level of knowledge, 58 patients received strong family support, and 76 people had normal blood sugar levels. High knowledge about DM (OR= 0.87; p= 0.001) and strong family support (OR= 0.99; p= 0.017) lowered blood sugar levels in DM patients.Conclusions: High knowledge about DM and strong family support reduce blood sugar levels in DM patients.Keywords: knowledge about DM, family support, blood sugar level, type 2 diabetes mellitusCorrespondence:Ratna Herawati. Masters Program in Family Medicine, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java. Email: ratna_herawati_dokter@yahoo.co.id.Indonesian Journal of Medicine (2018), 3(1): 49-55https://doi.org/10.26911/theijmed.2018.03.01.07

Path Analysis on the Biopsychosocial Determinants of Type 2 Diabetes Mellitus and Depression at Dr. Moewardi Hospital, Surakarta

Background : Diabetes Mellitus (DM) is a a major disease that is threatening global population health. This disease ranks third by global public health priority. The incidence of type 2 DM in 2014 was 442 million patients worldwide. Indonesia is one of 10 countries with high DM incidence. The incidence of type 2 DM in Indonesia in 2014 was 10 million patients. This study aimed to examine the biopsychosocial determinants of type 2 Diabetes Melitus and depression at Dr. Moewardi Hospital, Surakarta, using path analysis. Subje cts and Met hod: This was an analytic and observational study with case control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, from August to October, 2017. Sample consisting of 100 patients type 2 DMÂ and 100 non DM patients were selected for this study by fixed disease sampling. The dependent variable was type 2 DM. The independent variables were body age, mass index, education level, occupation, stres, family income, comorbidity, activity, and family history of type 2 DM. The data were collected using medical record and questionnaire. The data were analyzed by path analysis. Results : The risk of type 2 DM increased with higher body mass index (b= 2.66; 95% CI= 1.41 to 3.91; p<0.001), higher income (b=-0.93; 95% CI= -1.90 to 0.045; p=0.062), older age (b= 2.88; 95% CI= 0.62 to 5.15; p= 0.013), presence of DM family history (b= 2.56; 95% CI= 1.45 to 3.68; p <0.001), and comorbidity (b= 3.25; 95% CI= 2.07 to 4.43; p<0.001). The risk of depression increased by type 2 DM (b= 1.032; 95% CI= 0.42 to 1.63; p= 0.001). Body mass index increased with higher physical activity (b= -1.41; 95% CI= -2.03 to -0.79; p<0.001). Income increased with high education level (b= 2.58; 95% CI= 1.83 to 3.33; p<0.001). High physical activity increased with occupation (b=0.96; 95% CI= 0.38 to 1.53;p= 0.001). Conclusion : The risk of type 2 DM increased with higher body mass index, higher income, older age, presence of DM family history, and comorbidity. Keyword : biopsychosocial determinants, type 2 DM, depression Correspondence:Â Esty Budiarti. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email:estybudiarti21@gmail.com. Journal of Epidemiology and Public Health (2018), 3(1): 1-14 https://doi.org/10.26911/jepublichealth.2018.03.01.01Â

Polymorphism of Transcription Factor 7-Like 2 Gene and HOMA-β Level of Individuals With and Without Type 2 Diabetes Mellitus Family History

Family history has considered as a risk factor of type 2 diabetes. Transcription factor-7 like 2 (TCF7L2) hasrole to regulates insulin secretion and blood glucose homeostasis. The aim of current study was to determine thers7903146 polymorphism of TCF7L2 gene and homeostatic model assessment-β (HOMA-β) level on individual withand without type 2 Diabetes Mellitus (DM) family history. This work is a case-control study. Thirty six subjectswith type 2 DM family history and 36 subjects without type 2 DM family history were recruited. HOMA-βmeasure to analyze the insulin secretion. Polymorphisms of TCF7L2 gene was analyzed by using PCR-RFLPmethod. Statistical analysis was performed by using T-test, Mann-Whitney and Chi-square with signifi cancelevel 0.05. The frequency of the T allele of the cases were 4.2% and the controls were 2.8% (p=0.500). The oddratio was 0.649 (CI;95%:0.106-4.055). The HOMA-β levels of the cases were signifi cant low (132.56±62.48)compared with the controls (266.09±1.68) with p=0.000. The subjects with type 2 DM family history have asimilar frequency of having T alleles and CT/TT genotypes. The subjects with type 2 DM family history hassignifi cantly lower HOMA-β levels than subject without DM family history.

The hereditary predisposition features of latent autoimmune diabetes of adults

There are the results of complex study of features formation of hereditary predisposition to latent autoimmune diabetes of adults (LADA).The aim of the study was the complex analysis of LADA hereditary predisposition with using of genealogical, genetic-demographic and molecular-genetic methods.Material and methods. Genetic and genetic-demographic research is spent at 1155 diabetes mellitus (DM) patients, the analysis of distribution of polymorphism С1858Т of gene PTPN22 is executed at 599 DM patients and 253 healthy ones; 49A/G gene CTLA4 — at 300 DM patients and 44 control group persons; Е23К gene KCNJ11 — at 231 DM patients and 44 healthy ones. Testing of polygene and genetic heterogeneity inheritance models are held; the interrelation of crossbreeding degree sick and DM family accumulation is studied; definition of single nucleotide polymorphisms were carried out with the help of polymerase chain reaction and restrict analysis.Results. It has been shown, that LADA is genetically independent DM form, is described by parameters of polygenic threshold model, in its inheritance the essential role belongs to hereditary factors (59,2%), are available nonlinear intraloci and interallelic (GD=1,2%) interactions and influence of some genes with the expressed effect in determination of this form of disease is possible. In LADA genetic control system has about identical quantity of the common genes with DM type 1 and 2 (65,3 and 66,1%, accordingly). Change of family accumulation type 1 and 2 DM among 1 and 2nd degree of relationship relatives at LADA patients with crossbreeding degree augmentation differs from that at patients both type 1, and 2 DM. It has been shown, that the Е23К of gene KCNJ11, 49A/G gene CTLA4 and С1858Т gene PTPN22 polymorphisms in the Kharkov population are associated with LADA, type 1 and 2 DM and raised the risk of their development. The homozygous carriage 23K/K gene KCNJ11, 49G/G gene and 1858T/T gene PTPN22 corresponds to the greatest risk of the LADA development.Conclusions. The carried out complex research has taped the LADA genetic independence what can form the establishment for specification of classification of this DM form.

Demographic distribution of diabetes–tuberculosis comorbidity in Eastern rural China

ObjectiveChina has the second highest burden of tuberculosis (TB) worldwide, and it is also facing a remarkable increase of Diabetes Mellitus (DM) in the population. DM patients are at high risk of contracting TB and patients with DM–TB comorbidity usually present a relatively poor disease progress. To achieve the goal of TB control on incidence and mortality, it is of great importance to understand the epidemiology of DM–TB comorbidity in the Chinese population. This study aims to understand the prevalence of DM–TB comorbidity in newly diagnosed active TB patients and its demographic distribution in eastern rural China. MethodsA population-based cross-sectional study was carried out in four counties in eastern rural China, two in Jiangsu Province (GDP per capita in 2013: 74699.37 yuan, prevalence of DM: 8.50%) and two in Jiangxi Province (GDP per capita in 2013: 31835.53 yuan, prevalence of DM: 7.63%). All newly diagnosed and registered active TB patients from April 2013 to March 2014 were investigated using a structured questionnaire. Fasting blood glucose levels were tested to screen potential DM patients. Confirmation of diagnosis was made by glycosylated hemoglobin A1c (HbA1C). ResultsIn total, 1406TB patients from four counties were recruited with 447 (33.8%) being smear-positive TB. The average age of patients was 41years, and the male to female ratio was 1019 (76.2%) to 319 (23.8%). Overall, 71 DM–TB comorbidity patients were detected; of them 52 (73.24%) were from Jiangsu and 19 (26.76%) from Jiangxi. The prevalence of DM–TB comorbidity was 5.05% of the 1406TB patients. The prevalence of DM–TB in Jiangsu (9.29%) was 4.13 times higher than Jiangxi Province (2.25%, p<0.01). It was found that ethnicity, family history of diabetes, diet habit and Province were associated with the prevalence of DM in TB patients. Compared to patients from Jiangxi Province and Han ethnicity patients, TB patients from Jiangsu Province (60.2% vs. 39.8%, OR: 24.17, 95% CI: 4.94–118.32) and minority patients (1.4% vs. 98.6%, OR: 24.29, 95% CI: 1.69–349.11) had a higher prevalence of DM–TB comorbidity. It was found that patients with a family history of DM had an increased possibility of DM–TB comorbidity (2.6% vs. 97.4%, OR: 6.46, 95% CI: 1.05–39.70), as well as those having a diet consisting of salty food (25.2% vs. 74.8%, OR: 3.41, 95% CI: 1.25–9.29). ConclusionDM–TB comorbidity is more prevalent in areas with better economic status and higher prevalence of DM. Patients with a DM family history might be at high risk of DM–TB comorbidity. A TB control program should be integrated with DM screening and management program in eastern rural China.

Diabetic retinopathy in acromegaly.

Introduction:Although growth hormone (GH) has been implicated in the pathogenesis of diabetic retinopathy (DR), DR is deemed to be rare in patients with GH excess. Our aim was to study its prevalence in subjects with acromegaly suffering from diabetes mellitus (DM), to analyze its characteristics, and to look for predictive factors such as age at diagnosis, GH concentration and duration, DM duration, DM control, and family background.Materials and Methods:Forty patients with acromegaly and DM (21 males, 19 females), median age = 50 years, underwent a systematic ophthalmological examination with dilated funduscopy to seek diabetic retinopathy.Results:Among this population, 05 (12.5%) had DR. It was at an early stage or background retinopathy in 3 cases and at a more advanced stage or proliferative retinopathy in 2 cases. We did not find any correlation with age at diagnosis, GH levels and duration, DM duration and family history of DM, but poor glycemic control seems to play a role although statistical analysis showed borderline significance.Conclusion:From this study, we conclude that prevalence of DR in patients with acromegaly is 12.5%, and it is slight or moderate. Among studied factors, only poor glycemic control seems to be implicated in its development.

Impaired glucose homeostasis in non-diabetic Greek hypertensives with diabetes family history. Effect of the obesity status

Arterial hypertension (AH) and diabetes mellitus (DM) are established cardiovascular risk factors. Impaired glucose homeostasis (IGH; impaired fasting glucose or/and impaired glucose tolerance) or pre-diabetes, obesity, and DM family history identify individuals at risk for type 2 DM in whom preventive interventions are necessary. The aim of this study was to determine the glycemic profile in non-diabetic Greek adult hypertensive men and women according to DM family history and the obesity status. Diabetes family history, obesity markers (waist-to-hip ratio, WHR; body mass index, BMI), glycemic parameters (fasting and 2-hour post-load plasma glucose, if necessary; glycated hemoglobin, HbA1c; fasting insulin), insulin resistance indices (homeostasis model assessment, HOMA; quantitative insulin sensitivity check index, QUICKI; Bennett; McAuley), and IGH prevalence were determined in a large cohort of 11,540 Greek hypertensives referred to our institutions. Positive DM family history was associated with elevated fasting glucose (98.6 ± 13.1 vs 96.5 ± 12.3 mg/dL), HbA1c (5.58% ± 0.49% vs 5.50% ± 0.46%), fasting insulin (9.74 ± 4.20 vs 9.21 ± 3.63 μU/mL) and HOMA (2.43 ± 1.19 vs 2.24 ± 1.01) values, lower QUICKI (0.342 ± 0.025 vs 0.345 ± 0.023), Bennett (0.285 ± 0.081 vs 0.292 ± 0.078) and McAuley (6.73 ± 3.43 vs 6.95 ± 3.44) values, and higher IGH prevalence (45.3% vs 38.7%); P < .01 for all comparisons. The difference in the prevalence of IGH according to DM family history was significant (P < .01) in both genders and every WHR and BMI subgroup (except for women with BMI <20 kg/m2). Non-diabetic hypertensives with positive DM family history present with higher IGH prevalence and worse glycemic indices levels compared with those with negative family history, especially in the higher WHR/BMI subgroups.

Low Physical Function as a Risk Factor for Incident Diabetes Mellitus and Insulin Resistance

Data from 1790 HIV-infected and uninfected men in the Multicenter AIDS Cohort Study (MACS) were analyzed to evaluate relationships between physical function, incident diabetes mellitus (DM) and insulin resistance among HIV-infected and -uninfected men. DM was defined in two ways, using less stringent and more stringent criteria. The 10-item Physical Functioning Scale from the Short Form-36 Health Survey measured baseline physical function. Cumulative DM incidence was highest among HIV-uninfected and HIV-infected men with low physical function. Physical function was a risk factor for DM in HIV-uninfected men and remained so after controlling for BMI, DM family history and race. Among HIV-infected men, physical function was an independent risk factor for DM using the less stringent diabetes definition. This study supports our previous findings that low physical function is an important risk factor for DM in the MACS cohort.