Diabetes Mellitus In Asia Research Articles

Prevalence and risk factors of gestational diabetes mellitus in Asia: a review

Introduction. Gestational diabetes mellitus (GDM) is a global problem that occurs in the world. This case occurred in pregnant women at 24-28 weeks of gestation. The global prevalence of GDM varies widely from 1% to 28%. Objective. The purpose of this study is to describe the prevalence of GDM in Asia and the risk factors for GDM. Materials and Methods. This research method used a systematic review for observational studies. The research inclusion criteria were original English papers, with full text published in peerreviewed journals. Method of 23 international articles in 2012-2022, which have articles that meet the requirements to be researched subjects regarding the description of the average prevalence of GDM cases in Asia and the risk factors for GDM. Results. The results of the study found that the lowest prevalence of GDM was in India at 1.9%, and the highest prevalence was found in Australia at 30%. The average risk factors for GDM are a family history of DM, BMI > 25 kg/m2, multiparity and history of GDM in previous pregnancies, and history of abortion. The results of a journal review also show that mothers who give birth to GDM have a 48% risk of developing DM in the future. Conclusion. Based on the conclusion in this study, with the wide variation in GDM prevalence rates, it is better to set a GDM risk factor score so that other health services can use these indicators as the gold standard for screening GDM.

Impact of diet and physical activities in preventing type II diabetes mellitus in Asia

Diabetes is a major lifestyle disorder, the prevalence of which is increasing globally. Asian countries contribute to more than 60% of the world’s diabetic population as the prevalence of diabetes is increasing in these countries. Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors. As a result, they develop diabetes at a younger age and at a lower body mass index and waist circumference when compared with the Western population. The .review aims to explore impact of Diet and Physical activities in preventing Type II Diabetes Mellitus in Asia. The study involved a systematic review from internet databases such as Pubmed and CINHAL. Following that, databases were accessed to conduct a more detailed search of the literature using key phrases and Boolean operators to create articles pertinent to the issue. 1740 records identified. The duplicates and those not matching with the criteria were excluded. 8 articles were filtered using an inclusion/exclusion criterion. Dietary and physical activity components, and effects on T2D incidence, glycemic status and adiposity measures, were summarized in tabular format and evaluated narratively. Results showed that the interventions have positive impacts on the reduction of levels of parameters.

Economic Evaluation of Health Behavior Interventions to Prevent and Manage Type 2 Diabetes Mellitus in Asia: A Systematic Review of Randomized Controlled Trials.

Health behavior interventions implemented in Asian countries often lack economic evaluations that effectively address the problems of type 2 diabetes mellitus. This review systematically assessed the existing literature on economic evaluation of health behavior interventions to prevent and manage type 2 diabetes mellitus for people living in Asian countries. Eligible studies were identified through a search of six bibliographic databases, namely, PubMed, Scopus, Public Health Database by ProQuest, Cumulative Index to Nursing and Allied Health Literature Complete, Web of Science, and Google Scholar. Randomized controlled trials of health behavior interventions and studies published in the English language from January 2000 to May 2022 were included in the review. The search yielded 3867 records, of which 11 studies were included in the review. All included studies concluded that health behavior interventions were cost-effective. Eight of these studies undertook an evaluation from a health system perspective, two studies used both societal and health system perspectives, and one study utilized a societal and multi-payer perspective. This review identified the time horizon, direct and indirect medical costs, and discount rates as the most important considerations in determining cost effectiveness. These findings have implications in extending health behavior interventions to prevent and manage type 2 diabetes mellitus in low-resource settings, and are likely to yield the most promising outcomes for people with type 2 diabetes mellitus.

Use of sodium-glucose co-transporter-2 inhibitors in patients with type 2 diabetes mellitus and multiple cardiovascular risk factors: An Asian perspective and expert recommendations.

Diabetes mellitus in Asia accounts for more than half of the global prevalence. There is a high prevalence of cardiovascular disease (CVD) in the region among people with type 2 diabetes mellitus (T2DM) and it is often associated with multiple risk factors including hypertension, renal disease and obesity. The early onset of T2DM and the eventual long disease duration portends an increasing proportion of the population to premature CVD. In addition to lowering blood glucose, sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors exert favourable effects on multiple risk factors (including blood pressure, body weight and renal function) and provide an opportunity to reduce the risk of CVD in patients with T2DM. In this article, we consolidated the existing literature on SGLT‐2 inhibitor use in Asian patients with T2DM and established contemporary guidance for clinicians. We extensively reviewed recommendations from international and regional guidelines, published data from clinical trials in the Asian population (dapagliflozin, canagliflozin, empagliflozin, ipragliflozin, luseogliflozin and tofogliflozin), CVD outcomes trials (EMPAREG‐OUTCOME, CANVAS and DECLARE‐TIMI 58) and real‐world evidence studies (CVD‐REAL, EASEL, CVD‐REAL 2 and OBSERVE‐4D). A series of clinical recommendations on the use of SGLT‐2 inhibitors in Asian patients with T2DM was deliberated among experts with multiple rounds of review and voting. Based on the available evidence, we conclude that SGLT‐2 inhibitors represent an evidence‐based therapeutic option for the primary prevention of heart failure hospitalization and secondary prevention of CVD in patients with T2DM, and should be considered early on in the treatment algorithm for patients with multiple risk factors, or those with established CVD.

The Validity of One Step 75 Grams Oral Glucose Challenge Test for Universal Screening of Gestational Diabetes Mellitus: A Prospective Study

Background- Diabetes mellitus (GDM) is the most common metabolic disorder in pregnant women and is characterized by carbohydrate intolerance of variable severity with onset or first recognition during pregnancy regardless of glycemic status after delivery .There has been a recent trend in increase in Type 2 diabetes mellitus in Asia which is well documented. The increase seems to be greater in South Asian region as compared to East and South East Asia. The validity of 75 gram 2 hours Glucose Challenge Test as a diagnostic tool is not well established. Therefore, present study was undertaken to evaluate the validity of 75 gram 2 hours Glucose Challenge Test as a diagnostic test.Methodology- This study included 100 women with gestational age between 24th and 28th weeks, attending antenatal care (ANC) clinic at a tertiary care hospital in Delhi. Women who had given the consent to participate were given a standardized 2-h 75 g oral glucose tolerance test (OGTT). Then they were asked to come after a week on an empty stomach for 100g oral glucose tolerance test recommended by Carpenter Couston. Venous blood will be drawn in the fasting state, 1hr, 2hr & 3hr.Results- Prevalence of GDM was found 19% and 75 gram Glucose Challenge Test is a highly sensitive (100%) and specific (98.7%) test which has a very high positive (95%) and negative (100%) predictive value.Conclusion- Country like India, where antenatal visits and follow-ups are not very regular, this test is an important single step screening for gestational diabetes mellitus (GDM). The present study concludes that 75-gms GCT is an easy, economical as well as less cumbersome procedure. It is a patient-friendly approach because it is performed irrespective of the last meal and patient need not to come fasting. Patient needs to come once for this test. So this test can be utilized for screening purpose.

Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis

BackgroundGestational diabetes mellitus (GDM) is a of the major public health issues in Asia. The present study aimed to determine the prevalence of, and risk factors for GDM in Asia via a systematic review and meta-analysis.MethodsWe systematically searched PubMed, Ovid, Scopus and ScienceDirect for observational studies in Asia from inception to August 2017. We selected cross sectional studies reporting the prevalence and risk factors for GDM. A random effects model was used to estimate the pooled prevalence of GDM and odds ratio (OR) with 95% confidence interval (CI).ResultsEighty-four studies with STROBE score ≥ 14 were included in our analysis. The pooled prevalence of GDM in Asia was 11.5% (95% CI 10.9–12.1). There was considerable heterogeneity (I2 > 95%) in the prevalence of GDM in Asia, which is likely due to differences in diagnostic criteria, screening methods and study setting. Meta-analysis demonstrated that the risk factors of GDM include history of previous GDM (OR 8.42, 95% CI 5.35–13.23); macrosomia (OR 4.41, 95% CI 3.09–6.31); and congenital anomalies (OR 4.25, 95% CI 1.52–11.88). Other risk factors include a BMI ≥25 kg/m2 (OR 3.27, 95% CI 2.81–3.80); pregnancy-induced hypertension (OR 3.20, 95% CI 2.19–4.68); family history of diabetes (OR 2.77, 2.22–3.47); history of stillbirth (OR 2.39, 95% CI 1.68–3.40); polycystic ovary syndrome (OR 2.33, 95% CI1.72–3.17); history of abortion (OR 2.25, 95% CI 1.54–3.29); age ≥ 25 (OR 2.17, 95% CI 1.96–2.41); multiparity ≥2 (OR 1.37, 95% CI 1.24–1.52); and history of preterm delivery (OR 1.93, 95% CI 1.21–3.07).ConclusionWe found a high prevalence of GDM among the Asian population. Asian women with common risk factors especially among those with history of previous GDM, congenital anomalies or macrosomia should receive additional attention from physician as high-risk cases for GDM in pregnancy.Trial registrationPROSPERO (2017: CRD42017070104).

Prevalence and risk factors of gestational diabetes mellitus in Asia: A systematic review and meta-analysis

Prevalence and risk factors of gestational diabetes mellitus in Asia: A systematic review and meta-analysis

Abstract #1119: Academic Challenges Faced by Children with Type 1 Diabetes Mellitus in Asia - The Problem and Solution.

Abstract #1119: Academic Challenges Faced by Children with Type 1 Diabetes Mellitus in Asia - The Problem and Solution.

DDT and its metabolites are linked to increased risk of type 2 diabetes among Saudi adults: a cross-sectional study.

Organochlorine (OC) pesticides have recently been associated with type 2 diabetes in several non-Asian general populations. As there is currently an epidemic of type 2 diabetes mellitus in Asia. The prevalence and incidence of diabetes is increasing rapidly worldwide including many Arab Gulf countries. According to a community-based national epidemiological health survey, the overall prevalence of diabetes mellitus in Saudi adults (age group of 30-50 years) is 23.7%. A recent study by Al-Daghri et al. (BMC Med 9:76, 2011) reported that the prevalence of diabetes mellitus in the Kingdom of Saudi Arabia (KSA) is 31.6%. We investigated the associations between OC pesticides and type 2 diabetes in Saudi Arabia using a simple, sensitive, rapid, and selective gas chromatography coupled with mass spectrometry (GC-MS) method that has been recently developed. A total of 280 Saudi adults (136 diabetes mellitus (DM) patients and 144 non-DM controls) were randomly selected from the Riyadh Cohort Study for inclusion. The diagnosis of diabetes was based on established diagnosis and medications taken. Blood dichlorodiphenyltrichloroethane (DDT) and its derivatives were quantified using GC-MS. Residues of DDT and its derivatives were analyzed in serum by means of gas chromatography with a mass spectrometry detector. Associations between DDT exposure and T2DM were analyzed by logistic regression. DDT and its derivatives and serum concentrations of DDT and its derivative DDE showed the strongest and most significant association to type 2 diabetes in both cross-sectional and prospective studies. Associations of DDT and its derivatives varied across different diabetes-related components of the metabolic syndrome. It positively and significantly associated with four of the five of these components especially elevated triacylglycerol, high fasting glucose, high blood pressure, and HOMA-IR but negatively and significantly with HDL. Possible biological mechanisms are discussed. This study confirms previous reports relating organochlorine pesticide (OCP) exposure to diabetes and suggests possible hormonal pathways deserving further exploration. The study will be one of the first to shed light on the associations of serum levels of total DDTs and DDT derivatives among the Saudi Arab ethnicity, and diabetes type 2 chronic noncommunicable diseases are highly prevalent.

ニガウリ抽出物の血糖降下作用に関する文献的考察

Diabetes mellitus (DM) represents a global health and economical problem. Many patients with DM in Asia, South America, India and East Africa have traditionally used the water extract of unripe fruits of Momordica charantia (bitter melon) as some form of complementary and alternative medicine. Studies of laboratory animals have shown the beneficial blood-glucose lowering and anti-diabetic effects of this remedy. Some oral components that bring lower blood glucose level have been isolated : charantin (sterol glycosides), charantin (polypeptide) and cucurbine-type triterpenes. Part of their actions are related to AMP-activated kinase and repression of the oxidative stress that is increased in DM. Most clinical reports are not fully convincing due to the lack of randomized control studies. The present article reviews the pharmacological and clinical effects of bitter melon with special emphasis on the anti-diabetic effects, and some effects that would require caution in the context of human trials.

Titration of Insulin Glargine in Patients with Type 2 Diabetes Mellitus in Asia: Physician- Versus Patient-Led? Rationale of the Asian Treat to Target Lantus Study (ATLAS)

the AT-LANTUS Study demonstrated that a simple subject-administered titration algorithm significantly improved glycemic control with a low incidence of severe hypoglycemia compared with a physician-managed titration. However, in the AT-LANTUS Study Asian patients were under-represented, and more than 70% of the patients were already treated with insulin. The Asian Treat to Target Lantus Study (ATLAS) will compare the effectiveness of a patient- versus physician-led initiation of insulin glargine-based basal management in the specific setting of Asia and Russia (as is routinely used in Western countries). This report presents the study design of ATLAS. subjects are 40-75 years old (body mass index ≥ 20 and ≤ 40 kg/m(2)) with type 2 diabetes mellitus (T2DM) of >2 years in duration, suboptimally controlled (hemoglobin A1c [HbA1c] ≥ 7.0% and ≤ 11%) with stable doses of two oral antidiabetes drugs (OADs) (sulfonylureas, biguanides, α-glucosidase inhibitors, dipeptidyl peptidase-IV inhibitors, and glinides) for more than 3 months, and not using insulin. The subjects will be randomized to either the patient-led or the physician-led titration arm, where the insulin dose will be adjusted to achieve a target fasting plasma glucose (FPG) value of 110 mg/dL (6.1 mmol/L). the primary outcome will be change in mean HbA1c at 6 months from baseline. The analysis plan prespecifies a hierarchical testing procedure for the primary outcome. If noninferiority is achieved using a 0.3% HbA1c boundary, we will go on to undertake a test for superiority. Secondary outcomes will also include number of patients reaching American Diabetes Association target HbA1c with or without hypoglycemia and analysis of FPG profiles in the two groups. ATLAS will provide information on the relative safety and efficacy of a patient- versus physician-led titration strategy for insulin glargine-based basal insulin initiation in patients who are not controlled with two OADs in Asia and Russia. The results of the study may guide policymakers to translate data into clinical practice.

Altered expression of serum protein in ginsenoside Re-treated diabetic rats detected by SELDI-TOF MS

Diabetes mellitus (DM) is now a global health problem, however, its pathogenesis has not yet been fully deciphered. Even though modern medicine has great contribution to the control and treatment of DM, it is still far from success to completely cure the disease. Panax ginseng C.A. Meyer (ginseng) is a well-recognized traditional Chinese medicine for treating DM in Asia. In this study, high throughput proteomic approach has been adopted to investigate the antidiabetic action of 2 weeks’ ginsenoside Re (Re, a major component of ginseng) administration to streptozotocin-induced diabetic rats. Employing surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) and bioinformatics, 432 cluster peaks were detected in the samples, among them 293 potential biomarkers were found to have significant differentiations between the DM and control normal rats. When the Re-treated diabetic rats were compared to the untreated ones, a protein peak was detected to have significant alteration corresponding to Re treatment. This specific protein was found to match with C-reactive protein (CRP) in the protein database, and was subsequently validated by ELISA. This is the first study demonstrated that CRP could be altered by Re treatment, indicating that Re may improve diabetes and its complications by alleviation of inflammation.

Protective effect of Coptidis Rhizoma on S-nitroso-N-acetylpenicillamine (SNAP)-induced apoptosis and necrosis in pancreatic RINm5F cells

Coptidis rhizoma (CR) is a herb used in many traditional prescriptions against diabetes mellitus in Asia for centuries. Our purpose was to determine the protective effect and its action mechanism of CR on the cytotoxicity of pancreatic β-cells. Nitric oxide (NO) is believed to play a key role in the process of pancreatic β-cell destruction leading to insulin-dependent diabetes mellitus (IDDM). Exposure of RINm5F cells to chemical NO donor such as S-nitroso-N-acetylpenicillamine (SNAP) induced apoptotic events such as the disruption of mitochondrial membrane potential (Δψ m), cytochrome c release from mitochondria, activation of caspase-3, poly (ADP-ribose) polymerase cleavage and DNA fragmentation. Also, exposure of SNAP led to LDH release into medium, one of the necrotic events. However, pretreatment of RINm5F cells with CR extract protected both apoptosis and necrosis through the inhibition of Δψ m disruption in SNAP-treated RINm5F cells. In addition, rat islets pretreated with CR extract retained the insulin-secretion capacity even after the treatment with IL-1β. These results suggest that CR may be a candidate for a therapeutic or preventing agent against IDDM.

Clinical features of diabetes mellitus in Japan.

The first Symposium on Diabetes Mellitus in Asia was held in Kobe, Japan, in 1970 and the second symposium in Kyoto, Japan, in 1975. These two symposia raised many questions. Participants from various countries compared their findings on the frequency of diabetes and its complications. Such comparisons are usually complicated because of the differences in diagnostic criteria used, the age groups compared, and duration of diabetes observed, etc. In spite of these problems, careful analysis and close comparisons may offer important clues as to the pathogenesis of diabetes and the factors related to its complications. Japanese and Caucasian diabetes have some differences resulting from the Japanese diabetic pathophysiologic, ethologic, and ecologic factors. In this paper, diabetes is discussed from an ecologic viewpoint, especially characteristics of the disease and its prognosis in relation to the complications and food habits in Japan.