Onset Of Diabetes Mellitus Research Articles

Incidence of Postoperative Diabetes Mellitus After Roux-en-Y Reconstruction for Gastric Cancer: Retrospective Single-Center Cohort Study.

Sleeve gastrectomy is an effective surgical option for morbid obesity, and it improves glucose homeostasis. In patients with gastric cancer and type 2 diabetes mellitus (DM), gastrectomy, including total gastrectomy, is beneficial for glycemic control. This study aims to clarify the effects of gastrectomy and different reconstructive techniques on the incidence of postoperative DM in patients with gastric cancer. This retrospective, single-center, cohort study included 715 patients without DM who underwent total gastrectomy at the Tokyo Metropolitan Bokutoh Hospital between August 2005 and March 2019. Patients underwent reconstruction by Roux-en-Y (RY) gastric bypass or other surgical techniques (OT), with DM onset determined by hemoglobin A1c levels or medical records. Analyses included 2-sample, 2-tailed t tests; χ2 tests; and the Kaplan-Meier method with log-rank tests to compare the onset curves between the RY and OT groups, along with additional curves stratified by sex. A Swimmer plot for censoring and new-onset DM was implemented. Stratified data analysis compared the RY and OT reconstruction methods. The hazard ratio was 1.52 (95% CI 1.06-2.18; P=.02), which indicated a statistically significant difference in the incidence of new-onset diabetes between the RY and OT groups in patients with gastric cancer. The hazard ratio after propensity score matching was 1.42 (95% CI 1.09-1.86; P=.009). This first-of-its-kind study provides insight into how different methods of gastric reconstruction affect postoperative diabetes. The results suggest significant differences in new-onset DM after surgery based on the reconstruction method. This research highlights the need for careful surgical planning to consider potential postoperative DM, particularly in patients with a family history of DM. Future studies should investigate the role of gut microbiota and other reconstructive techniques, such as laparoscopic jejunal interposition, in developing postoperative DM.

CONSUMPTION PATTERNS AND NUTRITIONAL STATUS OF ADOLESCENTS AND PARENTS WITH DIABETES MELLITUS (DM)

Teenagers more often consume foods that are high in fat and glucose than vegetable and fruit consumption. This can trigger the onset of diabetes mellitus, especially in adolescents who have Diabetes Mellitus (DM) parents. The purpose of this study was to determine the differences in consumption patterns and status between adolescents and parents of DM and not DM. This cross sectional study involved 42 adolescents as samples, consisting of 21 adolescents with DM parents and 21 adolescents who were not DM parents, randomly using simle rendom sampling technique, the differences between variables were analyzed using the Independent T-test and Mann Whitney test (α=0.05). The results showed that there were no differences in the consumption patterns of high Glycaemic Index (GI) foods (p = 0.229) and fruit and vegetables (p = 0.14) between adolescents with DM parents and non-DM parents, but adolescents with DM parents tended to consume more high GI foods than adolescents with non-DM parents. There were differences in nutritional status between adolescents with DM parents and non-DM parents (p = 0.036). The conclusion of this study is that most adolescents with DM parents are very overweight at the time of nutritional status. In adolescents, it is necessary to reduce the frequency of consumption of foods with high IG and to increase the consumption of fruit and vegetables and physical activity, especially in adolescents with DM parents.

Glycemic Risk Index in a Cohort of Patients with Type 1 Diabetes Mellitus Stratified by the Coefficient of Variation: A Real-Life Study.

Objective: To analyze the Glycemic Risk Index (GRI) and assess their possible differences according to coefficient of variation (CV) in a cohort of real-life type 1 diabetes mellitus (DM) patient users of intermittently scanned continuous glucose monitoring (isCGM). Patients and Methods: In total, 447 adult users of isCGM with an adherence ≥70% were included in a cross-sectional study. GRI was calculated with its hypoglycemia (CHypo) and hyperglycemia (CHyper) components. Multivariate linear regression analysis was performed to evaluate the factors associated with GRI. Results: Mean age was 44.6 years (standard deviation [SD] 13.7), 57.7% being male; age of DM onset was 24.5 years (SD 14.3) and time of evolution was 20.6 years (SD 12.3). In patients with CV >36% (52.8%) versus CV ≤36% (47.2%), differences were observed in relation to GRI (18.8% [SD 1.9]; P < 0.001), CHypo (2.9% [SD 0.3]; P < 0.001), CHyper (6.3% [SD 1.4]; P < 0.001), and all classical glucometric parameters except time above range level 1. The variables that were independently associated with GRI in patient with CV >36% were time in range (TIR) (β = -1.49; confidence interval [CI:] 95% -1.63 to -1.37; P < 0.001), glucose management indicator (GMI) (β = -7.22; CI: 95% -9.53 to -4.91; P < 0.001), and CV (β = 0.85; CI: 95% 0.69 to 1.02; P < 0.001). However, in patients with CV ≤36%, the variables were age (β = 0.15; CI: 95% 0.03 to 0.28; P = 0.019), age of onset (β = -0.15; CI: 95% -0.28 to -0.02; P = 0.023), TIR (β = -1.35; CI: 95% -1.46 to -1.23; P < 0.001), GMI (β = -6.67; CI: 95% -9.18 to -4.15; P < 0.001), and CV (β = 0.33; CI: 95% 0.11 to 0.56; P = 0.004). Conclusions: In this study, the factors independently associated with metabolic control according to GRI are modified by glycemic variability.

The incidence of diabetes mellitus and its determining factors in a Kurdish population: insights from a cohort study in western Iran

Diabetes mellitus (DM) is among the most widespread non-communicable diseases and poses a substantial global health challenge. The aim of this study was to examine the incidence of DM and its nutritional, anthropometric, laboratory, demographic, and behavioral determinants, as well as comorbidities, within a Kurdish population residing in western Iran. This research was conducted in the Ravansar Non-Communicable Disease (RaNCD) cohort study, followed 9170 participants aged 35–65 years, for an average ± SD of 7.11 ± 1.26 years, from 2015 until 2023. A hierarchical Cox regression model was used to estimates the adjusted hazard ratios (HRs). The incidence of DM was 4.45 (95% CI 3.96, 4.99) per 1000 person-years. We found several significant predictors for DM incidence, including prediabetes, comorbidity, urban residence, total antioxidant capacity (TAC), and the interaction between gender and body mass index (BMI). Prediabetes emerged as the strongest predictor of DM incidence, with a hazard ratio of 10.13 (CI 7.84, 13.09). Additionally, having two diseases (HR = 2.18; 95% CI 1.44, 3.29) or three and more diseases (HR = 3.17; 95% CI 2.06, 4.90) increased the risk of developing DM. Also, the hazard ratios for the effects of gender on DM incidence in the normal, overweight, and obese BMI groups were 0.24, 0.81, and 1.01, respectively. The presence of prediabetes and obesity serve as the crucial indicators for the onset of DM, emphasizing the pressing need for interventions to prevent DM in these circumstances. Furthermore, there are notable disparities between urban and rural populations in this study, warranting further investigations to ascertain the underlying causes of such variations.

The interaction effect between BMI, diabetes and age at diabetes onset on the risk of thyroid cancer: A population-based cohort study in Shanghai, China.

To determine the association of the presence of diabetes and, among persons with diabetes, the age at type 2 diabetes mellitus (T2DM) onset, BMI and the interactive effect with the subsequent thyroid cancer risk. We conducted a population register-based longitudinal cohort study in Shanghai, including 428 568 persons with new-onset T2DM matched with the general population. The risk of thyroid cancer among subgroups was calculated based on standardized incidence ratio (SIR), hazard ratio (HR) and Cox proportional hazards models. In total, 1142 thyroid cancer cases were identified during 8 years of follow-up, with an incidence rate of 59.01/100 000 person-years and a higher risk (SIR = 1.21) compared with the general population. The earlier age at T2DM onset and higher BMI were associated with an increasing risk of thyroid cancer independently (onset age <50, SIR: 1.46; BMI ≥30.0 kg/m2, SIR: 1.93), with the highest risk in patients with both BMI ≥30.0 kg/m2 and onset age <50 years (SIR = 3.91, HR = 3.04). Among patients with T2DM onset age <60 years, SIR increased with higher BMI, while there were no trends when onset age ≥60 years. Among patients with BMI ≥25.0 kg/m2, SIR increased with an earlier onset age, whereas no trends were shown in the BMI <24.9 kg/m2 groups. Obese (BMI ≥30.0 kg/m2) patients had a significantly higher HR of thyroid cancer only when T2DM onset age <60 years. Both earlier age of T2DM onset (<50 years) and higher BMI (≥30 kg/m2) contributed to the higher risk of thyroid cancer. Patients with young-onset T2DM and obesity are considered more vulnerable to thyroid cancer development.

Early-onset and uncontrolled diabetes mellitus factors correlate with complications of Peyronie's disease.

Peyronie's disease (PD) is a connective tissue disorder that affects the penis and is characterized by abnormal collagen structure in the penile tunica albuginea, resulting in plaque formation and penile deformity. PD's overall prevalence is estimated at 3.2% to 8.9%, with rates as high as 20.3% among men with type 2 diabetes mellitus (DM). However, the characteristics of DM associated with PD complications remain unclear. To explore clinical associations between DM characteristics and PD complications. We conducted a retrospective analysis of patients with DM and PD who presented at our institution between 2007 and 2022. We examined patients' clinical histories, DM- and PD-related clinical parameters, and complications. Penile deformities were assessed through physical examination, photographs, and penile Doppler ultrasound. Patients were categorized into subgroups based on age of DM onset: early (<45years), average (45-65years), and late (>65years). Outcomes included effects of DM characteristics on PD development, progression, and severity. In total, 197 patients were included in the evaluation. Early-onset diabetes and elevated hemoglobin A1c (HbA1c) levels exhibited significant correlations with the early development of PD (ρ = 0.66, P < .001, and ρ = -0.24, P < .001, respectively). Furthermore, having DM at an early age was associated with the occurrence of penile plaque (ρ = -0.18, P = .03), and there were no significant differences in plaque dimensions (ρ = -0.29, P = .053). A rise in HbA1c levels after the initial PD diagnosis displayed positive correlations with the formation of penile plaque (ρ = 0.22, P < .006). These findings emphasize the need for comprehensive assessments and personalized treatment strategies for individuals with DM and PD. Enhanced management approaches can improve outcomes for those facing both challenges. Limitations include the single-site retrospective design with potential selection bias, inaccuracies in medical record data, and challenges in controlling confounding variables. This study highlights that early-onset diabetes and poor diabetes control, as indicated by a subsequent rise in HbA1c levels following PD diagnosis, are significantly correlated with the onset and severity of PD. Revealing the mechanisms behind these findings will help us develop better management strategies for individuals with DM and PD.

Management of Diabetes Mellitus in Acromegaly and Cushing's Disease with Focus on Pasireotide Therapy: A Narrative Review.

Patients suffering from acromegaly and Cushing's Disease (CD) face the risk of several clinical complications. The onset of diabetes mellitus (DM) is among the most important: exposure to elevated growth hormone or cortisol levels is associated with insulin resistance (IR). DM contributes to increasing cardiovascular risk for these subjects, which is higher compared to healthy individuals. Hyperglycemia may also be caused by pasireotide, a second-generation somatostatin receptor ligand (SRLs), currently used for the treatment of these diseases. Accordingly, with 2014 medical expert recommendations, the management of hyperglycemia in patients with CD and treated with pasireotide is based on lifestyle changes, metformin, DPP-4 inhibitors (DPP-4i) and, subsequently, GLP-1 Receptor Agonists (GLP-1 RAs). There is no position for SGLT2-inhibitors (SGLT2-i). However, a very recent experts' consensus regarding the management of pasireotide-induced hyperglycemia in patients with acromegaly suggests the use of GLP-1 RAs as first line treatment (in suitable patients) and the use of SGLT2-i as second line treatment in patients with high cardiovascular risk or renal disease. As a matter of fact, beyond the hypoglycemic effect of GLP1-RAs and SGLT2-i, there is increasing evidence regarding their role in the reduction of cardiovascular risk, commonly very high in acromegaly and CD and often tough to improve despite biochemical remission. So, an increasing use of GLP1-RAs and SGLT2-i to control hyperglycemia is desirable in these diseases. Obviously, all of that must be done with due attention in order to minimize the occurrence of adverse events. For this reason, large studies are needed to analyze the presence of potential limitations.

A study on the new onset of diabetes mellitus in patients with dengue fever

A study on the new onset of diabetes mellitus in patients with dengue fever

Prediabetes in Children: A Single Center Experience from Qatar

Background: Prediabetes is a state of hyperglycemia before the onset of frank diabetes mellitus. The prevalence of prediabetes is on the increase due to the obesity epidemic. No previous studies have described the clinical, biochemical, and immunological features of children and adolescents with prediabetes from the State of Qatar. Aim: To describe our single-center experience of children with prediabetes. Method: From 2018 to 2022, we enrolled patients below 18 years of age diagnosed with prediabetes. Clinical parameters were meticulously collected, encompassing age of onset, familial history, anthropometric measurements including weight and body mass index (BMI), HbA1C levels, diabetes-associated autoantibodies (GAD65, IAA, IA2, and ZnT8), as well as Insulin and C-peptide concentrations. Prediabetes diagnosis was established using HbA1C, with a diagnostic threshold set at 5.8% Results: Our study examined the prevalence of prediabetes among 1325 diabetes patients in Qatar, revealing a 1.6% prevalence rate. Among the cohort, 60% were Qatari nationals, and a significant 95% were overweight or obese (BMI 25-40 kg/m²), emphasizing the connection between prediabetes and obesity. Obesity-related complications, such as obstructive sleep apnea and non-alcoholic fatty liver disease, were common. Approximately 22.7% of patients exhibited positive antibodies, with two later developing Type 1 Diabetes. These findings stress the need for tailored interventions and monitoring for high-risk individuals to curb diabetes progression and complications. Conclusions: The primary risk factors identified for the development of Prediabetes were obesity and a familial history of diabetes. The majority of patients had grandparents affected by Type 2 Diabetes Mellitus (T2DM), with fewer having affected parents. Notably, 70% of patients were categorized as obese. Promoting healthy lifestyle modifications to manage obesity emerges as a pivotal strategy to mitigate the progression of Prediabetes towards full-blown diabetes in the future.

Hormone imbalances detected in study participants with pre-diabetes in a Durban-based clinical setting, South Africa

Abstract Background Type II diabetes mellitus onset is linked with hormonal imbalances. However, the knowledge about hormonal alterations in pre-diabetes is limited. Objective The study aimed to examine type II diabetes mellitus-associated hormone levels during the pre-diabetes phase in participants aged 25–45 in a Durban-based clinical setting in South Africa. Methods Stored plasma samples from a retrospective study collected 364 samples that were divided into pre-diabetes and non-pre-diabetes groups. From the 364, 38 samples from the group of persons without pre-diabetes and 38 from persons with glycated haemoglobin determined pre-diabetes were blindly selected. The hormone concentrations (C-peptide, cortisol, adipokines, thyroids, incretins, and sex steroids) of the study participants were measured using the BIO-RAD Bio-Plex MAGPIX instrument. Results Hormone imbalances in several hormones were detected in study participants with pre-diabetes. Most of the hormone dysregulation associated with T2DM begins in pre-diabetes but at a moderate level. Conclusion The findings reveal new possible hormone therapy targets for pre-diabetes and contribute to the growing support for targeting pre-diabetes as a preventative measure for T2DM prevention.

Predictive factors of diabetic ketoacidosis in patients with newly onset type 1 diabetes: A single center study

BackgroundDiabetic ketoacidosis is a severe metabolic emergency often associated with the onset of Type 1 Diabetes Mellitus, with significant morbidity and mortality. Its incidence as the initial presentation of Type 1 Diabetes Mellitus varies widely by country. In Morocco, there is a lack of comprehensive research on the prevalence and risk factors of diabetic ketoacidosis in children with newly diagnosed Type 1 Diabetes Mellitus, highlighting the need for this study. ObjectivesThe aim of our study was to analyze the predictive factors of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus in children and adolescents at a single medical center in Morocco to develop prevention and management strategies. MethodsA retrospective, single-center study including 200 patients aged between 1 and 18 years at Type 1 Diabetes Mellitus onset, between September 2019 and September 2023. The population was divided into two groups according to the presence or absence of diabetic ketoacidosis. Medical records provided data for analysis with SPSS v21, employing Chi-square and Student's t-tests, followed by logistic regression to identify predictors of diabetic ketoacidosis. ResultsMultivariate regression identified several factors that were significantly associated with diabetic ketoacidosis at presentation, including age below 5 years (OR: 3.98; p = 0.021 compared to 6–10 years and OR: 5.07; P = 0.003 compared to 11–18 years), rural living (OR: 2.95; p = 0.032), low family income (OR: 9.22; p < 0.001), delayed diagnosis (OR: 21.27; p < 0.001), longer symptom duration before diagnosis (OR: 1.02; p = 0.010), preceding infections (OR: 2.72; p = 0.019), and lower vitamin D levels (OR: 0.90; p = 0.011). ConclusionOur findings underscore the critical need for increased awareness, education, use of point-of-care glucose testing, and targeted interventions in rural areas, in order to reduce the incidence of diabetic ketoacidosis. We also highlight the potential role of vitamin D in increasing the risk of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus. This study provides important information on the present state of pediatric diabetes care in our country, and suggests target points for future interventions and research.

Safety profile of proprotein convertase subtilisin/kexin type 9 inhibitors alirocumab and evolocumab: an updated meta-analysis and meta-regression

Background The use of alirocumab and evolocumab is generally safe and well-tolerated. However, concerns remain about their long-term safety, especially with regard to new-onset or worsening diabetes mellitus (DM). We aim to assess the safety profile of alirocumab and evolocumab compared to comparator. Methods Studies were retrieved comparing the safety of PCSK9i vs. comparator (placebo or statin with or without ezetimibe). The primary outcome was adverse events leading to death. Secondary outcomes included serious adverse events, new onset diabetes mellitus (DM), worsening of DM, neurocognitive dysfunction, creatine kinase (CK) elevation, elevation of liver enzymes and local injection site reaction. Factors associated with the treatment effect were determined by meta-regression analysis. Subgroup analyses were done to explore potential treatment effect differences based on PCSK9i type and treatment duration. Results We identified 56 studies with 85,123 adults (29.14% females). PCSK9i was not associated with adverse events that lead to death (OR 0.94, 95% CI 0.84 to 1.04, p = 0.22). Between the two PCSK9i, alirocumab decreased adverse events leading to death (OR 0.79, 95% CI, 0.67 to 0.94, p = 0.008). PCSK9i was associated with less serious events compared to the comparator (OR 0.93, 95% CI 0.89 to 0.98, p < 0.001). This reduction was driven mainly by alirocumab (OR 0.89, 95% CI, 0.85 to 0.93, p < 0.001). Evolocumab worsened DM (OR 2.3, 95% CI 1.26 to 4.2, p = 0.041). Subgroup analysis showed worsening of DM in the first 24 weeks of treatment with odds being highest in the first 12 weeks of treatment (<12 weeks: OR 3.82, 95% CI 1.13 to 12.99, p = 0.03; 12–24 weeks OR 2.12, 95% CI 1.20 to 3.73, p = 0.01. On the other hand, therapy >24 weeks reduced the odds of worsening DM (OR 0.89, 95% CI 0.79 to 0.99, p = 0.04). PCSK9i did not increase cognitive dysfunction, (OR 1.02, 95% CI 0.88 to 1.18, p = 0.76), or cause elevations in liver enzyme (OR 0.91, 95% CI 0.81 to 1.03, p = 0.14), or CK (OR 0.82, 95% CI 0.65 to 1.04, p = 0.10). However, PCSK9i was associated with local injection site reaction (OR 1.54, 95% CI 1.37 to 1.73, p < 0.01). Conclusion Alirocumab decreased adverse events leading to death. Alirocumab and Evolocumab both decreased serious adverse events. PCSK9i did not increase new onset DM however evolocumab worsened DM in the first 24 weeks of treatment. PCSK9i did not increase neurologic dysfunction, and did not elevate liver enzymes and CK, however it was associated with local injection site reaction.

A Pharmacovigilance Study on Clozapine in the Food and Drug Administration Adverse Event Reporting System: A Regional Comparative Analysis.

This pharmacovigilance study evaluated the profile of clozapine-related adverse events by region using the Food and Drug Administration Adverse Event Reporting System (FAERS). We categorized each case into five regions (America, Europe/West Asia, Oceania, Asia, and Africa) based on the reporting country information in the FAERS database. The number of clozapine-related adverse events reported in each region was aggregated according to the preferred term (PT) and the Standardized Medical Dictionary for Regulatory Activities (MedDRA) Query (SMQ). A total of 101,872 clozapine-related adverse events were registered in the FAERS database. In America and Europe, leukocyte or neutrophil count abnormalities accounted for half of the top 10 PTs by relative reporting rate. However, Asia had higher relative reporting rates of pyrexia and salivary hypersecretion (13.91% and 10.85%, respectively). Regarding the SMQ, the relative reporting rates of infective pneumonia, convulsions, extrapyramidal syndrome, gastrointestinal obstruction, and hyperglycaemia/new onset diabetes mellitus were higher in Asia than in other regions (5.26%, 9.72%, 12.65%, 5.13%, and 8.26%, respectively), with significant differences even after adjusting for confounding factors using multivariate logistic regression analysis. Spontaneous reports of adverse events associated with clozapine show regional disparities, particularly in Asia, where concentration-dependent adverse events are more frequently reported. However, the spontaneous reporting system has several limitations, requiring further research for validation.

Editor's Choice – Glycaemic Status and Risk of Abdominal Aortic Aneurysm: A Nationwide Cohort Study of Four Million Adults using Korean National Health Screening Data

This retrospective cohort study aimed to confirm the previously reported inverse association between diabetes mellitus (DM) and abdominal aortic aneurysm (AAA) using large population based data. It also investigated the associations between AAA and impaired fasting glucose (IFG) and new onset DM (not yet treated). A representative dataset was obtained from the Korean National Health Insurance Service. Participants who were aged ≥ 50 years and received a national health examination in 2009 were included and followed until 31 December 2019. Glycaemic status was defined based on fasting plasma glucose level and the relevant diagnostic codes. AAA was ascertained using medical facility use records with relevant diagnostic codes or aneurysm repair surgery. A Cox proportional hazards model was used to examine the association between glycaemic status and AAA, with adjustment for confounders. Additionally, the interactions between glycaemic status and subgroups based on baseline characteristics were examined. The study population comprised 4 162 640 participants. Participants with IFG or DM were significantly more likely to be male, older, and have comorbidities compared with normoglycaemic participants at baseline. The incidence of AAA was lower in participants with IFG or DM compared with normoglycaemic participants. The AAA risk was lower in patients with DM than in patients with IFG, and decreased linearly according to glycaemic status: the adjusted hazard ratio was 0.88 (95% confidence interval [CI] 0.85- 0.91) for IFG, 0.72 (95% CI 0.67- 0.78) for newly diagnosed DM, 0.65 (95% CI 0.61- 0.69) for DM duration < 5 years, and 0.47 (95% CI 0.44- 0.51) for DM duration ≥ 5 years compared with the normoglycaemia group. Both IFG and DM were related to reduced AAA risk in all subgroups, suggesting an independent association. Both IFG and DM, even when not treated with antihyperglycaemic medication, were associated with a lower incidence of AAA. The AAA risk decreased linearly according to DM duration.

Immune checkpoint inhibitors and immune mediated diabetes mellitus: Meta-review of case reports.

e14606 Background: Use of Immune checkpoint inhibitors (ICIs) is an increasingly popular antitumor immunotherapy targeting immunoreceptors on T lymphocytes, enhancing the anti-neoplastic immune response. ICIs are becoming first line therapy options for non-small cell lung cancer and gastric adenocarcinoma and can be used as second line for variety of others. Various endocrinologic adverse events have been reported with use of ICIs. Of these, new onset Type-1 diabetes mellitus (T1DM) is of particular interest given its significant morbidity and noted frequency of 1-5% of patients who receive ICIs. There is limited consolidated information about symptomatic presentations, risk factors, and demographics of patients developing Type 1 DM in relation to ICI use. We performed a systematic review of published case reports to identify commonalities between patient disease presentation, ICI use, and development of immune-mediated diabetes mellitus. Methods: A comprehensive systemic literature search from PubMed Web Science, CINAHL, and Google Scholars was performed identifying case reports showing development of new onset diabetes mellitus in patients using immune checkpoint inhibitors. Descriptive analysis was performed to better identify characteristics and presentation of patients. Results: Based on our parameters, 130 reports with 149 cases were included. Primary tumors among the patients comprised lung cancer (34.9%) and melanoma (31.5%). Amongst all the cases, about 88% of the patients were treated with anti-PD-1 (program cell death) receptor, with nivolumab alone (34.9%) and pembrolizumab alone (26.2%) being the most common agents. Cases were more commonly found to be males (61.7%) and of Asian (36.6%) or North American (35.6%) background. Patient ages ranged from 14-95 with a mean of 62.3. Presentation most commonly started after the third cycle (13.4%) and was noted to occur between 1-50 doses. Diabetic Ketoacidosis was diagnosed in 69.8% of individuals, and the average presenting blood glucose was 611 mg/dl with an HbA1c of 8.2%. Autoantibody data was largely missing; however, anti-GAD antibodies were noted to be present in 29.5% of cases. 34.2% of patients had coexisting endocrinopathies with thyroiditis being the most common, occurring in 20% of patients. 1.3% of patients did not survive the initial hospitalizations, with the vast majority (95.3%) remaining on insulin and a select few (2%) were eventually able to discontinue insulin. Conclusions: New onset diabetes is a rare but a potential life-threatening metabolic urgency. Thus, it is paramount that clinicians maintain close monitor of blood glucose and endocrine function when a cancer patient who recently started ICIs gets admitted for hyperglycemia. Further research is warranted to understand onset of diabetes mellitus at molecular level.

Bone mineral density and osteoporosis related risk factors in type 2 diabetes mellitus

Diabetes mellitus negatively affects bone tissue and unfavourably impacts bone mineral density (BMD), therfore increasing the probability of fractures through pathological mechanisms. This study aimed to explore the factors associated with BMD and osteoporosis risk in individuals with a diagnosis of type 2 diabetes mellitus (T2DM). An investigation was undertaken involving 49 patients diagnosed with T2DM who fulfilled the specified criteria. These individuals underwent BMD assessment as part of a cross-sectional study. The analysis encompassed both univariate and bivariate approaches, utilizing the Chi-square test (X2) and binary logistic regression methods. A total of 30 participants (61%) have decreased BMD. Among the participants aged 60 years and above, 83.4% exhibited a decreased BMD status (osteopenia and osteoporosis), in contrast to the under 60 years age group, in which 40% displayed decreased BMD status. Older age (&amp;gt;60 years) is a risk factor for decreasing bone density onset of diabetes mellitus (DM) diagnosis, duration of DM, glycemic control, body mass index (BMI), use of thiazolidinediones (TZD) drugs, kidney function, were not associated with lower BMD in T2DM patients.

Decreased antioxidant capacity in children with diabetic ketoacidosis

Objective. To analyze the levels of antioxidant enzyme superoxide dismutase (SOD) and glutathione peroxidase (GP) against the background of diabetic ketoacidosis (DKA) in type 1 diabetes mellitus (DM) children and adolescents. Materials and methods. The study involved examination of 74 children: 50 DKA children (study group) and 24 relatively healthy children (control group). The study group children were divided into two subgroups: subgroup 1 included children with DKA against the background of type 1 DM onset (n=27), subgroup 2 consisted of children with DKA against the background of chronic type 1 DM (n=23). SOD and GP concentrations in blood plasma were determined in all children by enzyme immunoassay. The reliability between the data was estimated using the Mann-Whitney test, Kruskal-Wallis test and Spearman coefficient. Results. A significant decrease in SOD and GP in children with DKA was revealed as follows: 13130 [13005–18255] Pg/ml and 50.085 [42.02–70.325] Ng/ml, compared to controls: 16415 [13370–19935] Pg/ml and 84.695 [52.49–144.5] Ng/ml, respectively. Minimal SOD and GP were noted in patients with DKA at the background of chronic type 1 DM, compared to DM onset children. The study indicates a reliable correlation between age, duration of the disease, number of DKA in the history and low values of SOD and GP. Conclusion. Decreased antioxidant capacity was found in children with DKA in type 1 DM. SOD and GP can be considered in pediatric practice as markers of oxidative stress in DKA. In addition, an early detection of SOD and GP contributes to the efficient therapy of DKA in children and adolescents.

Genetic markers of cardiac autonomic neuropathy in the Kazakh population

BackgroundCardiac autonomic neuropathy (CAN) is a complication of diabetes mellitus (DM) that increases the risk of morbidity and mortality by disrupting cardiac innervation. Recent evidence suggests that CAN may manifest even before the onset of DM, with prediabetes and metabolic syndrome potentially serving as precursors. This study aims to identify genetic markers associated with CAN development in the Kazakh population by investigating the SNPs of specific genes.Materials and methodsA case-control study involved 82 patients with CAN (cases) and 100 patients without CAN (controls). A total of 182 individuals of Kazakh nationality were enrolled from a hospital affiliated with the RSE “Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan”. 7 SNPs of genes FTO, PPARG, SNCA, XRCC1, FLACC1/CASP8 were studied. Statistical analysis was performed using Chi-square methods, calculation of odds ratios (OR) with 95% confidence intervals (CI), and logistic regression in SPSS 26.0. Results: Among the SNCA gene polymorphisms, rs2737029 was significantly associated with CAN, almost doubling the risk of CAN (OR 2.03(1.09–3.77), p = 0.03). However, no statistically significant association with CAN was detected with the rs2736990 of the SNCA gene (OR 1.00 CI (0.63–1.59), p = 0.99). rs12149832 of the FTO gene increased the risk of CAN threefold (OR 3.22(1.04–9.95), p = 0.04), while rs1801282 of the PPARG gene and rs13016963 of the FLACC1 gene increased the risk twofold (OR 2.56(1.19–5.49), p = 0.02) and (OR 2.34(1.00-5.46), p = 0.05) respectively. rs1108775 and rs1799782 of the XRCC1 gene were associated with reduced chances of developing CAN both before and after adjustment (OR 0.24, CI (0.09–0.68), p = 0.007, and OR 0.43, CI (0.22–0.84), p = 0.02, respectively). Conclusion: The study suggests that rs2737029 (SNCA gene), rs12149832 (FTO gene), rs1801282 (PPARG gene), and rs13016963 (FLACC1 gene) may be predisposing factors for CAN development. Additionally, SNPs rs1108775 and rs1799782 (XRCC1 gene) may confer resistance to CAN. Only one polymorphism rs2736990 of the SNCA gene was not associated with CAN.

THE UTILITY OF BODY INDICES FOR DIABETES PREDICTION IN PATIENTS WITH FASTING HYPERGLYCEMIA: A 10-YEAR FOLLOW-UP STUDY

Objective: We aimed to compare the new body indices against traditional body mass index in their ability to predict diabetes development in patients with fasting hyperglycemia. Design and method: Baseline examination of population-based cohort was performed 2012-2013 in the framework of epidemiological study ESSE-RF which included questionnaires, anthropometry (weight, height, waist and hip circumference), laboratory tests (fasting glucose, glycated hemoglobin, lipids) and target organ damage assessment. In 2022-2023 patients with fasting hyperglycemia at baseline visit were re-examined to register onset of diabetes mellitus (DM), glucose and glycated hemoglobin levels. Several anthropometric indices were calculated: body mass index (BMI), waist-to-height ratio (WHtR), body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), and lipid accumulation product (LAP). Results: In total 72 participants were re-examined - 35 men and 37 women (mean age 43,6 years and 50,5 years, respectively). New onset of DM was confirmed in 15 patients (20,8%), in 6 men and 9 women. According to multiple regression analysis the most significant predictors of DM development were BRI (p=0,04, beta=-2,2) and WHTR (p=0,04, beta=2,94), but not BMI (p=0,42, beta=-0,22), model (R2 = 0.32; p=0,0014). After adjustment for traditional risk factors (sex, triglycerides, age, insulin, high density lipoproteins, waist circumference, glucose), the most significant diabetes predictors were the WHTR (p=0,01, beta=4,23) and VAI indices (p=0,04, beta=0,732), model (R2 = 0.547; p=1x10-4). We used individual body indices as predictors for the DM and estimated the area under the ROC curve (AUC). The AUC ROC for BRI, WHTR, CVAI and ABSI was greater than for traditional BMI, while for VAI and LAP indices performed worse than BMI (Table 1). Conclusions: New body composition indices involving advanced mathematical framework and including extended set of parameters - BRI, WHTR, CVAI and ABSI, are more reliable diabetes predictors than BMI in patients with fasting hyperglycemia after 10 years of follow-up. This work was supported by the Ministry of Science and Higher Education of the Russian Federation (Agreement # 075-15-2022-301) to A.Konradi.

IMPACT OF DIFFERENT TYPES OF HYPERTENSIVE DISORDERS OF PREGNANCY AND THEIR DURATION ON INCIDENT POST-PARTUM RISK OF DIABETES MELLITUS; RESULTS FROM A FRENCH NATIONWIDE STUDY

Objective: The reasons for the association between hypertensive disorders of pregnancy (HDP) and diabetes mellitus (DM) are poorly understood. Several studies have suggested an association between HDP and long-term onset of incident type 2 DM, irrespective of gestational diabetes status during pregnancy. The present study aimed to evaluate the impact of various types of HDP on the risk of incident DM. Design and method: We used data from the ongoing French nationwide prospective cohort study CONCEPTION which investigates the impact of HDP on women's health. For the present analysis, we included all primiparous women in CONCEPTION who had no personal history of DM prior to giving birth and who delivered between 2010 and 2018 (n=2,815,057 women). Follow-up spanned from childbirth to 31 December, 2021. HDP and incident DM onset during follow-up were identified using algorithms combining ICD-10 coded diagnoses during hospitalization and/or medication dispensing. We used Cox models Results: Pre-eclampsia and GH occurred in 2.6% and 4.6% of the study sample, respectively. During follow-up, 16 670 women had incident DM. The cumulative incidences of DM were 17.5% and 2.1% in women who had pre-eclampsia during pregnancy with and without concomitant gestational diabetes, respectively. The risk of DM was higher after HDP (all types) irrespective of gestational diabetes status during pregnancy. In women without gestational diabetes, compared with those who had no HDP, the risk of incident DM was higher in women who had GH (adjusted hazard ratio, aHR= 1.97 [1.81-2.16]), pre-eclampsia (aHR=2.42 [2.21-2.65]), and preexisting chronic hypertension prior to pregnancy (aHR=3.35 [3.03-3.70]). Early onset and severe pre-eclampsia were associated with a higher risk of DM. Finally, pre-eclampsia duration was significantly and positively associated with a higher risk of DM. Conclusions: Women who experienced an HDP had twice the risk of developing DM, even in the absence of gestational diabetes. Taking into account the phenotype and duration of pre-eclampsia could improve HDP risk stratification of pregnant women with a history of these disorders. Early concurrent blood glucose assessment and blood pressure monitoring should be more widely recommended after HDP diagnosis.