Diabetes Mellitus Patients Research Articles

Insulin injection rotation and Diabetes Mellitus nutritional management education

The management of Diabetes Mellitus (DM) involves implementing a healthy lifestyle and pharmacological interventions through the administration of anti-hyperglycemia drugs. An essential aspect of treating DM patients is insulin administration, which facilitates glucose transportation into cells. This study evaluated the effectiveness of insulin injection rotation and nutritional management education for DM.The literature search utilized the keywords "education,"AND "insulin injection," AND "nutritional management," AND "DM", ranged 2021-2023 Searches were conducted on various databases, including Proquest, NCBI, BMC, ScienceDirect, and other relevant platforms such as Google Scholar.Ten journal articles pertinent to the subject matter were identified in the study. Findings indicate that nutritional education facilitates overall health improvement in individuals with DM, contributing to maintaining average body weight and near-normal blood glucose levels. It also enhances lipid profile and insulin receptor sensitivity while being a preventive measure against acute or chronic complications such as hyperglycemia. It is noted that selecting the appropriate injection site can significantly impact patients' blood glucose levels. While it is recommended to administer injections at consistent locations, repetitive use of the same site may pose risks of side effects, such as lipodystrophy.After conducting a comprehensive review of ten journal articles, it has been concluded that insulin injection rotation and nutritional management education are effective for managing DM.

Differences in the effects of contrast agents on kidney injury and inflammatory response between diabetic and non-diabetic patients and their clinical significance.

With the increasing incidence of coronary heart disease (CHD), contrast-associated nephropathy (CAN) caused by contrast agents required in coronary angiography has gradually become a clinical concern that needs to be solved urgently. At present, CAN has become one of the most common causes of hospital-acquired acute kidney injury, which seriously affects the prognosis and health of patients. How to effectively identify high-risk CAN patients and prevent the occurrence of CAN has become a hotspot of clinical research. In this study, we attempted to evaluate the effect of contrast agents on renal injury in diabetes mellitus (DM) and non-DM patients by observing some indexes of early renal injury and inflammatory factors, so as to provide a more comprehensive reference for early identification of CAN in the future. The results showed that compared with non-DM patients, contrast agents caused more obvious renal damage in DM patients and more significantly activated inflammatory responses, increasing the risk of CAN. Cystatin C (CysC), neutrophil gelatinase-associated lipocalin (NGAL), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR)all showed excellent predictive effects for the occurrence of CAN after coronary angiography in both DM and non-DM patients.

Influence of remnant cholesterol levels on carotid intima thickness in type 2 diabetes patients

Investigate the impact of remnant cholesterol (RC) levels on carotid artery intima thickness (CIT) in type 2 diabetes mellitus (T2DM) patients. From September 2021 to September 2023, a prospective multicenter study involved 158 T2DM patients. They were divided into a higher RC group (n = 80) and a lower RC group (n = 78) based on median RC levels. Additionally, 92 healthy volunteers served as the control group. CIT, carotid media thickness (CMT), and carotid intima-media thickness (CIMT) were measured. General clinical data, lab results, CIMT, CIT, and CMT differences among the three groups were compared. Multiple regression analysis explored CIT factors in T2DM patients. 1. No significant sex, age, BMI, high-density lipoprotein cholesterol (HDL-C), T2DM duration, fasting blood glucose, or glycated hemoglobin differences were found among the groups (p > 0.05). 2. CIMT and CIT were significantly higher in T2DM than the control group (p < 0.05). 3. The higher RC group had thicker CIT than the lower RC group (p < 0.05), while CIMT differences were not significant (p > 0.05). Multiple linear regression analysis showed RC as an influencing CIT factor in T2DM patients (β = 0.473, p = 0.005). CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC, and RC is the influence factor of CIT, which suggests that more attention should be paid to the detection of RC in T2DM patients.

The beneficial effect of fermented Spirulina platensis on reducing oxidative stress in patients with type 2 diabetes mellitus.

Oxidative stress caused by hyperglycemia can lead to the intensification of hyperglycemia and an increased risk of diabetes complications. Spirulina platensis is a potent free-radical scavenger; it has the potential to be used as a substrate for fermentation by lactic acid bacteria. This study aimed to formulate two functional foods with antioxidant capacity (yogurt containing S. platensis powder / fermented S. platensis powder) for Type 2 Diabetes Mellitus (T2DM) patients and compare the antioxidant effects in diabetic subjects. In this article, for the first time, the antioxidant effect of fermented and non-fermented Spirulina was compared in a clinical study in 'T2DM' patients. By blood sampling, clinical parameters such as FBS, GSH, FRAP, MDA, and CRP before and after each treatment were measured and results were compared between two groups of intervention. Both products as functional foods have a positive effect on the health of diabetic patients by reducing FBS and increasing total antioxidant capacity, and this positive effect is more obvious when yogurt contains fermented lactic acid S. platensis is consumed by T2DM patients.

Empagliflozin add‐on therapy is superior to metformin monotherapy in diabetic patients with NAFLD: An open‐label, single‐center, pilot clinical trial

AbstractBackgroundThe prevalence of non‐alcoholic fatty liver disease (NAFLD), which is characterized by hepatic steatosis, inflammation, and advanced fibrosis, is high among type‐2 diabetes mellitus (T2DM) patients. Empagliflozin (EMPA), a sodium‐glucose cotransporter‐2 inhibitor, has been well established to improve glycemic status in T2DM. However, evidence of the desirable effects of EMPA, when added to the standard treatment in diabetics with coexisting NAFLD, has yet to be determined.ObjectiveThe main objective of the current study is to explore the benefits of EMPA on hepatic fat content in patients with T2DM and NAFLD, who received metformin (MET) monotherapy.MethodsIn this open‐label clinical trial study, 60 patients with T2DM and NAFLD were assigned to either the MET + EMPA or MET group in an up‐titrated manner for 24 weeks. Anthropometric characteristics, blood glucose indices, lipid profile, liver enzymes, and steatosis grades were measured at baseline and 24 weeks after the intervention.ResultsThe results showed that in patients with a mean age of 53.26 ± 7.64 who received MET+ EMPA, all the parameters had a greater decrease than the MET group. In addition, the reduction of FBS, BS, HbA1C, TG, and ALT had a statistically significant difference between the two groups after 24 weeks follow‐up (p &lt; 0.05). Notably, in the MET+ EMPA group, there was a substantial improvement in steatosis grades based on the fibroscan and ultrasound modality results.ConclusionThe EMPA add‐on therapeutic schedule in uncontrolled T2DM patients with NAFLD significantly ameliorated steatosis stages, liver function, anthropometric features, and biochemical parameters.

Effectiveness and Tolerability of Topical Curcumin for Management of Diabetic Foot Ulcer: A Pilot Clinical Study

Background: Diabetic foot ulcers (DFUs) affect 9.1 to 26.1 million individuals globally each year, with 15-25% of those with diabetes mellitus (DM) experiencing them during their lives. DFUs are a major cause of amputations, accounting for 85% of such cases in diabetic patients. Curcumin, a compound from Curcuma longa, shows potential in wound healing through mechanisms such as inhibiting the NLRP3 inflammasome pathway, promoting autophagy, and regulating microRNA expression. This study evaluated the efficacy and safety of C3-DiagardTM Cream in treating DFUs. Methods: This open-label, prospective clinical study assessed the efficacy and safety of C3-DiagardTM cream, containing 0.05mg of Harida (Curcuma longa) extract, in treating and preventing DFUs. The cream was applied twice daily for 12 weeks. Key outcomes were assessed through wound size reduction, pain (VAS score), and any adverse reactions during the treatment. Results: Fifty DM patients (36 males, 14 females; mean age 57.58±12.67 years) were enrolled. Among the patients, 75% (38 individuals) showed a wound healing response between 70% and 99%. The average wound size decreased significantly from 6.63 cm&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt; at baseline to 1.83 cm&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt; after 12 weeks, with a mean reduction of 4.8 cm&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt; (p &amp;lt; 0.05). Pain levels, measured by VAS score, significantly dropped from an average of 8 to 3 (p &amp;lt; 0.05). No adverse reactions were reported, highlighting the cream’s safety. Conclusion: C3-DiagardTM cream is effective in reducing the size of diabetic foot ulcers and alleviating pain, with a favourable safety profile. This study supports the clinical use of C3-DiagardTM as a well-tolerated treatment option for patients with DFUs.

Lipid Profile in Type 2 Diabetes Mellitus Patients with and without Diabetic Retinopathy

Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to abnormalities in insulin secretion, insulin action, or both. Diabetic retinopathy is the most common microangiopathic complication of DM and one of the leading causes of blindness in the world. Poor lipid profile levels are one of the risk factors for diabetic retinopathy. Objective: To analyze differences in the proportion of lipid profile categories in type 2 DM patients with and without diabetic retinopathy. Methods: This was a hospital-based cross-sectional study with 45 samples. The independent variables assessed were the lipid profile, including LDL, HDL, triglycerides, and total cholesterol levels. The dependent variable assessed was the incidence of diabetic retinopathy. The analysis used were univariate and bivariate (Chi-square and Fisher exact). Results: The prevalence of diabetic retinopathy was 37.8%, consist of 17.8% of NPDR and 20% of PDR. There were significant differences in the proportion of LDL categories (p=0.007) and total cholesterol (p=0.038) in type 2 DM patients with and without diabetic retinopathy, and there were no significant differences in the proportion of HDL categories (p=0.719) and triglycerides (p=1) in type 2 DM patients with and without diabetic retinopathy. Conclusion: There were significant differences in the proportion of LDL categories and total cholesterol in type 2 DM patients with and without diabetic retinopathy.

Study of Differences in Blood Sugar Levels of Diabetes Mellitus Patients Who Consume Rice Cooked with the Rice Cooker Method and The Steaming Method

The 2023 Indonesian Health Survey Report issued by the Ministry of Health revealed that there was an increase in the prevalence of diabetes mellitus (DM) in the population aged over 15 years based on the results of blood sugar level measurements. In the 2018 Basic Health Research, it was recorded that the prevalence of diabetes in Indonesia reached 10.9%. Now, the prevalence has reached 11.7% in 2023. The Aceh Health Office recorded that sufferers of Diabetes Mellitus until early 2023 reached 154,889 cases. The purpose of this study is to find out the difference in blood sugar levels in people with diabetes mellitus who consume rice after cooking with the rice cooker method and with the steaming method. This quantitative analytical research uses a cross-sectional study design. The population of the study was all people with diabetes mellitus at the Calang Health Center, Aceh Jaya Regency, totaling 50 people. Data collection was carried out from January 15 to March 15, 2024 using nonprobability sampling techniques. This study also took direct data by looking at the sugar content of the respondents by eating rice cooked by the rice cooker method and 1 month later by measuring the sugar content of the respondents consuming rice by cooking the rice by steaming. Data were analyzed using univariate, bivariate and multivariate statistical tests. The results of the study showed that factors related to blood sugar levels in DM patients were gender, age, education, occupation, income, physical activity, nutritional status, smoking behavior, and family history of diabetes. The factors most related to increased blood sugar levels in diabetes mellitus patients were steaming with OR=7.47, use of a rice cooker of 11.2 and family history of diabetes mellitus of 7.50. It is expected that respondents will control their blood sugar levels, so that DM sufferers and their families will cook rice using the steaming method, and control other risk factors that can cause high blood sugar levels.

Comparison of Machine Learning Algorithms and Nomogram Construction for Diabetic Retinopathy Prediction in Type 2 Diabetes Mellitus Patients

Introduction: The aim of this study was to compare various machine learning algorithms for constructing a diabetic retinopathy (DR) prediction model among type 2 diabetes mellitus (DM) patients and to develop a nomogram based on the best model. Methods: This cross-sectional study included DM patients receiving routine DR screening. Patients were randomly divided into training (244) and validation (105) sets. Least absolute shrinkage and selection operator regression was used for the selection of clinical characteristics. Six machine learning algorithms were compared: decision tree (DT), k-nearest neighbours (KNN), logistic regression model (LM), random forest (RF), support vector machine (SVM), and XGBoost (XGB). Model performance was assessed via receiver-operating characteristic (ROC), calibration, and decision curve analyses (DCAs). A nomogram was then developed on the basis of the best model. Results: Compared with the five other machine learning algorithms (DT, KNN, RF, SVM, and XGB), the LM demonstrated the highest area under the ROC curve (AUC, 0.894) and recall (0.92) in the validation set. Additionally, the calibration curves and DCA results were relatively favourable. Disease duration, DPN, insulin dosage, urinary protein, and ALB were included in the LM. The nomogram exhibited robust discrimination (AUC: 0.856 in the training set and 0.868 in the validation set), calibration, and clinical applicability across the two datasets after 1,000 bootstraps. Conclusion: Among the six different machine learning algorithms, the LM algorithm demonstrated the best performance. A logistic regression-based nomogram for predicting DR in type 2 DM patients was established. This nomogram may serve as a valuable tool for DR detection, facilitating timely treatment.

The Potential Diagnostic Utility of SMAD4 and ACCS in the Context of Inflammation in Type 2 Diabetes Mellitus Patients.

The search for new parameters for the prediction of type 2 diabetes mellitus (T2DM) or its harmful consequences remains an important field of study. Depending on the low-grade inflammatory nature of diabetes, we investigated three proteins in T2DM patients: 1-aminocyclopropane-1-carboxylate synthase (ACCS), granulocyte-colony-stimulating factor (G-CSF), and Sma Mothers Against Decapentaplegic homolog-4 (SMAD4). In brief, sixty T2DM and thirty healthy controls had their serum levels of ACCS, G-CSF, SMAD4, and insulin tested using the ELISA method. The insulin resistance (IR) parameter (HOMA2IR), beta-cell function percentage (HOMA2%B), and insulin sensitivity (HOMA2%S) were all determined by the Homeostasis Model Assessment-2 (HOMA2) calculator. The predictability of these protein levels was investigated by neural network (NN) analysis and was associated with measures of IR. Based on the results, ACCS, G-CSF, and SMAD4 increased significantly in the T2DM group compared with the controls. Their levels depend on IR status and inflammation. The multivariate GLM indicated the independence of the levels of these proteins on the covariates or drugs taken. The receiver operating characteristic area under the curve (AUC) for the prediction of T2DM using NN analysis is 0.902, with a sensitivity of 71.4% and a specificity of 93.8%. The network predicts T2DM well with predicted pseudoprobabilities over 0.5. The model's predictive capability (normalized importance) revealed that ACCS is the best model (100%) for the prediction of T2DM, followed by G-CSF (75.5%) and SMAD4 (69.6%). It can be concluded that ACCS, G-CSF, and SMAD4 are important proteins in T2DM prediction, and their increase is associated with the presence of inflammation.

Macular vascular and photoreceptor changes for diabetic macular edema at early stage

This study was intended to investigate the macular vascular and photoreceptor changes for diabetic macular edema (DME) at the early stage. A total of 255 eyes of 134 diabetes mellitus patients were enrolled and underwent an ophthalmological and systemic evaluation in this cross-sectional study. Early DME was characterized by central subfoveal thickness (CST) value between 250 and 325 μm, intact ellipsoid zone, and an external limiting membrane. While non-DME was characterized by CST < 250 μm with normal retinal morphology and structure. Foveal avascular zone (FAZ) area ≤ 0.3 mm2 (P < 0.001, OR = 0.41, 95% CI 0.26–0.67 in the multivariate analysis) and HbA1c level ≤ 8% (P = 0.005, OR = 0.37, 95% CI 0.19–0.74 in multivariate analysis) were significantly associated with a higher risk of early DME. Meanwhile, no significant differences exist in cone parameters between non-DME and early DME eyes. Compared with non-DME eyes, vessel diameter, vessel wall thickness, wall-to-lumen ratio, the cross-sectional area of the vascular wall in the upper side were significantly decreased in the early DME eyes (P = 0.001, P < 0.001, P = 0.005, P = 0.003 respectively). This study suggested a vasospasm or vasoconstriction with limited further photoreceptor impairment at the early stage of DME formation. CST ≥ 250 μm and FAZ ≤ 0.3 mm2 may be the indicator for early DME detection.

The Analysis Study of Prevalence of Gastrointestinal Complication in Patients with Type 2 Diabetes Mellitus : A Comprehensive Systematic Review

Background: Diabetes, a chronic metabolic disorder, has a high prevalence worldwide due to changing lifestyles and urbanization. It is associated with life-threatening hazards and disabling complications, decreasing life expectancy. Gastroparesis, a well-known manifestation, is more prevalent in women. Understanding the prevalence of gastrointestinal complications in type 2 diabetes mellitus patients is crucial for creating effective treatment regimens. Methods: Adhering to the PRISMA 2020 principles, this systematic study focused on analyzing complete English literature texts published from 2011 to 2024. Several websites, such as ScienceDirect, PubMed, and SagePub, were used to collect the literature. Result: The study examined over 4000 publications sourced from recognized platforms such as Science Direct, SagePub, and PubMed. Following the decision to subject eight publications to further scrutiny, a comprehensive examination of the complete body of literature was conducted. Conclusion: Diabetes often leads to gastroparesis, a condition affecting the upper gastrointestinal tract, associated with metabolic imbalance, high blood sugar levels, low insulin, hormone release, and H. pylori infection. This condition is linked to the contractile activity of the duodenum, and is associated with various liver conditions, including diabetic fibrosis and cirrhosis.

Retinal and Choroidal Phenotypes Across Novel Subtypes of Type 2 Diabetes Mellitus

PurposeThis study aimed to investigate longitudinal changes in choroidal thickness (CT) and ganglion cell-inner plexiform layer thickness (GC-IPLT) across distinct phenotypes of type 2 diabetes mellitus (T2DM) patients. DesignProspective observational cohort study. MethodsT2DM patients were categorized into five groups (SAID, SIDD, SIRD, MOD, and MARD) using K-means clustering based on β-cell function and insulin resistance. Swept-source optical coherence tomography measured baseline and 4-year follow-up CT and GC-IPLT. Linear mixed-effects models assessed absolute and relative changes in CT and GC-IPLT across subtypes. ResultsOver a median 4.11-year follow-up, CT and GC-IPLT decreased significantly across all groups. Choroidal thinning rates were most pronounced in SIDD (-6.5±0.53 µm/year and -3.5±0.24%/year) and SAID (-6.27±0.8 µm/year and -3.19±0.37%/year), while MARD showed the slowest thinning (-3.63±0.34 µm/year and -1.98±0.25%/year). SIRD exhibited the greatest GC-IPLT loss (-0.66±0.05 µm/year and -0.91±0.07%/year), with the least in SIDD (-0.36±0.05 µm/year and -0.49±0.07%/year), all statistically significant (Ps < 0.001). Adjusted for variables, SIDD and SAID groups showed faster CT thinning than MARD [-2.57 µm/year (95% CI: -4.16 to -0.97; P=0.002) and -2.89 µm/year (95% CI: -4.12 to -1.66; P<0.001), respectively]. GC-IPLT thinning was notably accelerated in SIRD versus MARD, but slowed in SIDD relative to MARD [differences of -0.16 µm/year (95% CI: -0.3 to -0.03; P=0.015) and 0.15 µm/year (95% CI: 0.03 to 0.27; P=0.015), respectively]. Stratified analysis revealed significant differences among non-DR groups. ConclusionsMicrovascular damage in the choroid is associated with SIDD patients, whereas early signs of retinal neurodegeneration are evident in SIRD patients. All these changes may precede the onset of DR.

Machine Learning-Based Plasma Metabolomics in Liraglutide-Treated Type 2 Diabetes Mellitus Patients and Diet-Induced Obese Mice.

Liraglutide, a glucagon-like peptide-1 receptor agonist, is effective in the treatment of type 2 diabetes mellitus (T2DM) and obesity. Despite its benefits, including improved glycemic control and weight loss, the common metabolic changes induced by liraglutide and correlations between those in rodents and humans remain unknown. Here, we used advanced machine learning techniques to analyze the plasma metabolomic data in diet-induced obese (DIO) mice and patients with T2DM treated with liraglutide. Among the machine learning models, Support Vector Machine was the most suitable for DIO mice, and Gradient Boosting was the most suitable for patients with T2DM. Through the cross-evaluation of machine learning models, we found that liraglutide promotes metabolic shifts and interspecies correlations in these shifts between DIO mice and patients with T2DM. Our comparative analysis helped identify metabolic correlations influenced by liraglutide between humans and rodents and may guide future therapeutic strategies for T2DM and obesity.

The Mindfulness-Based on Spiritual Intervention on Psychological Well-Being and Blood Sugar Levels in Type 2 Diabetes Mellitus Patients

Blood sugar levels are influenced by psychological well-being, which is affected by diabetics who go from being healthy to sick. This study examined the effect of spiritually situated mindfulness interventions on the psychological health and blood sugar levels of individuals with type 2 diabetes mellitus. Method: A quasi-explore different avenues regarding an untreated benchmark group and ward pre-and post-test samples was the research strategy utilized. All type 2 DM patients at the Surabaya Islamic Hospital Outpatient Clinic made up the study's populace. Using a basic random sampling strategy, 130 samples in totally were selected based on the inclusion and exclusion rules. Also, the sample was split fifty, with 60 respondents each in the control and treatment groups. The Glucometer and the Ryff Psychological Well-Being Scale were the instruments utilized in this investigation. Matched sample t-test and independent sample t-test data analysis. Result: The results showed that the psychological well-being of the intervention bunch was 147.68 before the intervention and 171.32 after it. The mean blood sugar level in the gathering before the intervention was executed was 302.64, however after it was carried out, it was 189.11. In addition, the mean blood sugar levels in the benchmark group were 289.21 and 283.87 when the intervention, and the mean psychological well-being levels were 146.84 and 146.02, respectively. Furthermore, the data analysis demonstrated a negative relationship between type 2 diabetes patients' blood sugar levels and psychological well-being and mindfullnes based on spiritual intervention (p = 0.00). Discuss: Individuals with type 2 diabetes can encounter improvements in their psychological well-being by lowering their blood sugar levels through the often used mindfullnes based on spiritual intervention.

Prevalence and Risk Factors of Psychiatric Symptoms among Type 2 Diabetes Mellitus Patients in South India: A Cross-Sectional Study.

Background: Type 2 diabetes mellitus poses a momentous challenge when accompanied by psychiatric symptoms like depression, anxiety, and stress, adding to the complaint's threat. Research on these factors in patients with uncontrolled chronic illnesses in India, particularly in Tamil Nadu, is limited. Hence, this study aims to determine the prevalence and risk factors of these psychiatric symptoms among Type 2 diabetes patients.  Methods: A cross-sectional study was conducted in Alpha Hospital and Research Center in Madurai, South India, from April 2020 to March 2021, enrolling 614 participants (307 with Type 2 diabetes mellitus and 307 general population). Data were collected using Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Perceived Stress Scale. The IBM SPSS version 23 was used for statistical analysis.  Results: Two-thirds of youth women with type 2 diabetes have higher fasting blood sugar levels than men when compared to general population. 82.61% of patients with uncontrolled diabetes developed severe stress, surpassing those with well-controlled and pre-diabetes. Severe depression is most prevalent among patients with neuropathic foot ulcers (54.76%) and nephropathy (61.54%). Predominant mental health risk factors include being single, high school education, poor glycemic control, comorbid hypertension, and family history. Interestingly, lifestyle factors like alcohol use and smoking positively impact mental health outcomes.  Conclusion: This study shows the intricate connection between Type 2 diabetes and mental health problems in Madurai, emphasizing the necessity for a multidisciplinary strategy to enhance outcomes and reduce financial burden. Future research in nursing has to focus on implementing and assessing therapies aimed at reducing patients' stress, anxiety and depression.

Spiritual Diabetes Self-Management Health Coaching Against Psychological Well-Being and Self-Management Compliance in Diabetes Mellitus Patients

Introduction: For patients with diabetes to keep being consistent with self-management, they should build their psychological well-being and feeling of direction in life through a progression of intricate and tedious errands. Aim: This examination looked to inspect the impacts of Spiritual Diabetes Self-Management Health Coaching on psychological health and self-management conduct. Methode: The study utilized a quasi-trial research design, using a basic irregular sampling method to decide the sample based on inclusion and exclusion rules. A sum of 126 respondents were remembered for the sample, with 63 respondents each in the intervention and control groups. Ryff's Psychological Well-Being (RPWB) and a Questionnaire on Compliance with Diabetes Self-Management (QCDSM) were the instruments utilized in this study. A t-test with p&lt;0.5 was used in the statistical analysis. Results: The findings demonstrated that the normal psychological well-being in the intervention bunch was 174.22 both when the intervention, and the typical compliance with self-management was 47.56. Pre-and post-intervention averages for psychological well-being and self-management compliance in the control bunch were 144.62 and 19.32, respectively. A p-worth of 0.000 between spiritual diabetes self-management compliance and psychological well-being is uncovered by information analysis. Conclusion: Spiritual Guidelines for Overseeing Diabetes Patients with diabetes mellitus can profit from long-term health coaching to upgrade their psychological health and compliance with self-management.

Metabolic-Associated Fatty Liver Disease and Cognitive Performance in Type 2 Diabetes: Basal Data from the Phytate, Neurodegeneration and Diabetes (PHYND) Study.

The effect of liver fibrosis on mild cognitive impairment (MCI) and dementia risk in type 2 diabetes mellitus (T2DM) patients is unclear. Therefore, we performed a prospective cross-sectional study on 219 patients with T2DM and older than 60 years to evaluate the association between liver fibrosis, liver steatosis, and cognitive impairment. The Montreal Cognitive Assessment (MoCA) was used to screen for MCI or dementia. Liver fibrosis was estimated using the non-invasive Fibrosis-4 (FIB-4) score, and liver steatosis was assessed with the hepatic steatosis index. The mean age was 71 ± 6 years, 47% were women and according to MoCA cut-off values, 53.88% had MCI and 16.43% had dementia. A moderate or high risk of advanced fibrosis was significantly higher in patients with MCI or dementia compared to those with normal cognition (p < 0.001). After adjusting for confounders, a FIB-4 score greater than 1.54 was associated with MCI or dementia (p = 0.039). Multivariate analysis identified age over 70.5 years, antiplatelet medication use, and a FIB-4 score above 1.54 as the most relevant risk factors. Liver fibrosis, but not liver steatosis, is associated with MCI or dementia in older T2DM patients, suggesting that FIB-4 score might be a simple biomarker for the detection of cognitive impairment.

Causes of Excess Mortality in Diabetes Patients Without Coronary Artery Disease: A Cohort Study Revealing Endocrinologic Contributions.

Diabetes mellitus (DM) patients without coronary artery disease (CAD) have a higher all-cause mortality rate than patients with neither DM nor CAD. We examined cause-specific death of DM patients with and without CAD. We conducted a cohort study of all patients who underwent CAG in Western Denmark between 2003 and 2016. Using Danish health registries, patients were followed for a maximum of 10 years and stratified according to their DM and CAD status. Outcomes included all-cause-, cancer-, circulatory-, and endocrinologic death. Ten-year cumulative risks were computed as well as adjusted and unadjusted hazard ratios (aHR and HR). A total of 132,432 patients (28,524 deaths, median follow-up of 6.2 years) were included. Compared to patients with neither DM nor CAD, DM patients without CAD had a higher 10-year risk of all-cause death (27.9% versus 19.7%, aHR 1.43 [95% CI 1.35-1.52]), cancer death (7.2% versus 5.4%, aHR 1.29 [95% CI 1.15-1.46]), circulatory death (9.1% versus 6.9%, aHR 1.35 [95% CI 1.22-1.49]), and endocrinologic death (3.9% versus 0.3%, aHR 14.02 [95% CI 10.95-17.95]). Among endocrinologic deaths, 87% were due to classical complications of DM, such as diabetic nephropathy and ketoacidosis, in DM patients without CAD. Diabetes patients without CAD exhibit a higher risk of all-cause mortality, driven primarily by elevated rates of cancer, circulatory, and endocrinologic deaths, particularly related to diabetic microvascular complications.

Association of plasma endothelin-1 levels with revascularization strategies and short-term clinical outcomes: Role of diabetes

Mortality rate due to coronary artery disease (CAD) is elevated among diabetes mellitus (DM) compared to non-DM patients. Endothelin 1 (ET-1), a potent vasoconstrictor, is implicated in the pathophysiology of both CAD and DM. The impact of ET-1 on the short-term clinical outcomes following revascularization by percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) remains unclear. We investigated the impact of ET-1 on clinical outcomes and revascularization strategies in CAD patients, exploring the role of DM on modifying these relationships. In a prospective observational study, patients presenting to cardiac catheterization lab for CAD evaluation at a Jordanian hospital were enrolled and stratified by status of CAD and DM. Plasma levels of ET-1 were measured before catheterization. Short-term clinical outcomes and prognosis were compared.Among 815 enrolled patients (603 CAD and 212 controls), DM prevalence was higher among CAD patients than non-CAD. Plasma ET-1 levels were measured in 490 random patients and were associated with CAD and the need for revascularization. Multivariate analysis independently revealed higher plasma ET-1 levels in DM patients requiring revascularization. Short-term follow-up for 366 patients (median of 4 months) showed that 132 developed one cerebro/cardiovascular event, predominantly among DM patients. Baseline ET-1 was not associated with higher risk of the first event. Notably, revascularization by PCI was associated with lower event risk in DM patients.Our study indicates that plasma ET-1 levels are associated with the need for revascularization in DM patients, with those undergoing PCI having a lower risk of initial cerebro/cardiovascular events.