Type 2 Diabetes Mellitus Research Articles

Use of Technology in the Management and Treatment of Prediabetes, A New Era: A Case Report Series

Introduction: The escalating prevalence of prediabetes has positioned it as a silent precursor to a looming public health crisis, particularly as it paves the way for type 2 diabetes mellitus (T2DM). This case series report explores the transformative role of technology, specifically the Sugar Fit’s Diabetes Reversal and Management Program (SDRMP), in the treatment and management of prediabetic patients. Methods: The case series follows the progress of two patients aged 31-44 with prediabetes utilizing the SDRMP to prevent the progression to diabetes. The interventions for both patients involved continuous glucose monitoring, personalized nutrition plans, fitness strategies, and behavioral modifications. The patients also engaged in regular communication with their life coaches through the Sugar Fit application, ensuring ongoing support and adherence to the program. Results: The results revealed significant improvements in glycemic control, lipid profiles, and overall well-being. The first patient, a 44-year-old male, demonstrated a successful return to normal glycemic control in 177 days through a comprehensive approach involving dietary changes, exercise, and lifestyle modifications. The second patient, a 31-year-old male, achieved normal glycemic control in a comparable timeframe, showcasing the effectiveness of the SDRMP. Discussion and Conclusion: These cases demonstrate that patients were able to adhere to the goals of care, preventing the progression of prediabetes to diabetes and improving insulin resistance. The study also underscores the potential impact of technology on public health outcomes, bridging the gap between traditional interventions and the evolving needs of a tech-savvy population. The synergy between healthcare expertise and technological innovation not only arrests the progression of prediabetes but also contributes to a broader societal shift towards metabolic well-being, paving the way for a healthier future. Future monitoring is essential to ensure the maintenance of lifestyle modifications and continued success in preventing diabetes.

Efficacy of Myricetin Supplementation on Glucose and Lipid Metabolism: A Systematic Review and Meta-Analysis of In Vivo Mice Studies.

Type 2 diabetes mellitus (T2DM) is a disorder characterized by insulin resistance, hyperglycemia, and dyslipidemia. Myricetin, a flavonoid found in various plants, has shown potential anti-diabetic effects in murine studies. This meta-analysis aimed to evaluate the impact of myricetin supplementation on glucose metabolism and lipid profiles in mouse models of metabolic diseases. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPERO: CRD42024591569). Studies involving mice with metabolic disease models and exclusively using myricetin supplementation were checked across four databases (Embase, Scopus, PubMed, and WoS) until 23rd September 2024. The primary outcomes assessed were blood glucose (BG), insulin levels, triacylglycerol (TAG), total cholesterol (TC), HDL, and LDL. A random-effects model was applied to estimate standardized mean differences (SMD), and SYRCLE's risk-of-bias tool for animal studies was used. Twenty-one studies with 514 mice met the inclusion criteria. Myricetin supplementation significantly reduced BG (SMD = -1.45, CI: -1.91 to -0.99, p < 0.00001, I2 = 74%), insulin (SMD = -1.78, CI: -2.89 to -0.68, p = 0.002, I2 = 86%), TAG (SMD = -2.60, CI: -3.24 to -1.96, p < 0.00001, I2 = 81%), TC (SMD = -1.86, CI: -2.29 to -1.44, p < 0.00001, I2 = 62%), and LDL (SMD = -2.95, CI: -3.75 to -2.14, p < 0.00001, I2 = 74%). However, the effect on HDL was not statistically significant (SMD = 0.71, CI: -0.01 to 1.43, p = 0.05, I2 = 83%). Myricetin supplementation improved glucose metabolism and lipid profiles in mouse models, suggesting its potential as a therapeutic agent for managing T2DM. However, further research is needed to confirm these findings in human studies.

Post-COVID syndrome and type 2 diabetes mellitus in Kazakhstan: clinical manifestations and vaccine efficacy.

In this article, we report the results of a survey investigating post-coronavirus disease 2019 (COVID-19) syndrome in patients with type 2 diabetes mellitus and the impacts of vaccination on long-term manifestations. From February 2022 to April 2023, a survey of patients with type 2 diabetes and people without diabetes who were treated for a coronavirus infection was conducted in Kazakhstan. Participants were invited via social media to voluntarily participate in this study. A total of 417 surveys were included in this study, comprising 212 patients with type 2 diabetes and 205 without diabetes. We compared persistent complaints after recovery in patients with and without diabetes mellitus (DM), as well as vaccination status. The results of this study on self-reported symptoms of prolonged COVID show that more than half of those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Kazakhstan have at least one persistent symptom after recovery. Based on the list of prolonged COVID-19 symptoms reported by patients with type 2 DM (T2DM), exertional dyspnoea, fatigue, respiratory discomfort, headaches, and sleep disturbances are among the most common ongoing conditions, and in many cases last more than 3 months after COVID-19. Patients with T2DM experience more severe and prolonged symptoms than those without diabetes. Additionally, vaccination lowers COVID-19 hospitalization risk and decreases the need for adjusting hypoglycemic therapy, such as insulin treatment, after recovering from SARS-CoV-2 infection.

CASE REPORT: HEMICHOREA-HEMIBALLISMUS IN NONKETOTIC HYPERGLYCEMIC FEMALE PATIENT: PUTAMINAL HIGH INTENSITY LESION ON MRI T1-WEIGHTED IMAGES

A 65-year-old female known case of diabetes mellitus type 2, hypertension, chronic heart failure and chronic renal failure was admitted to our hospital with fever, diarrhea, and sudden onset of hemichorea-hemiballismus in right upper limb and lower limb. On admission blood glucose level was 175mg/dl, hemoglobin A1c was 11% and the serum osmolality was 292 mOsm/l. Urine analysis was negative for glucose and ketone bodies. After correction of blood glucose to normal level choreiform and ballistic movements disappeared. MRI showed high intensity on T1-weighted images in the left putamen, which disappeared 4 months after onset. The putaminal abnormality was the cause of her involuntary movements. The cause of high intensity in the putamen might be the multiple petechial hemorrhages which can occur in association with nonketotic hyperglycemia. We report an occurrence of hemichorea-hemiballismus in a female patient with diabetes mellitus type 2.

Effectiveness of nutrition counseling on blood sugar levels and adherence to dietary practices in patients with type 2 diabetes mellitus

One of the management strategies for Diabetes Mellitus (DM) is through nutrition counseling to increase patients' knowledge and ability to prepare food and manage their diet to achieve optimal health. This study aims to determine the effectiveness of nutrition counseling on blood sugar levels and patient adherence to the DM type 2 diet. Quasi-experimental research design using a Non-Equivalent Control Group Design. Respondents were selected using purposive sampling, resulting in 35 respondents who met the criteria. Diet adherence is assessed based on compliance with the 3Js (quantity, type, and schedule), and blood sugar levels are measured using a glucometer. Data analysis was conducted using the Wilcoxon test. The study results showed that before nutrition counseling, the intake of nutrients was as follows: carbohydrates 268.77±96.1 grams, protein 60.69±11.97 grams, fat 61.61±20.53 grams, carbohydrates 268.77±96.1 grams, and fiber 11.40±4.57 grams. After nutrition counseling, the intake was: energy 1621.17±409.01 kcal, protein 61.36±11.61 grams, fat 56.78±25.41 grams, carbohydrates 268.77±96.12 grams, and fiber 12.92±13.82 grams. The mean adherence to food type before nutrition counseling was 0.57±0.502 and after nutrition counseling was 0.91±0.284. The mean adherence to meal schedules before nutrition counseling was 0.60±0.497 and after nutrition counseling was 0.83±0.382. The mean blood sugar level before nutrition counseling was 151.20±26.787, and after nutrition counseling, it was 136.57±26.947. The conclusion is that nutrition counseling is effective in changing blood sugar levels and adherence to the diet in patients.

Acceptability and Scalability of a Meditation App Among Adolescents With Type 1 Diabetes Mellitus.

Background Adolescents with type 1 diabetes mellitus (T1DM) experience stress from general life stressors and diabetes-specific stressors. This stress manifests in a range of ways, such as mood swings, heightened frustration, strained familial relationships, and difficulties in T1DM self-management, which then leads to worse health outcomes. There is small to moderate evidence that frequent use of mental health applications (MHapps) improves mental and physical health outcomes. Meditation apps may help reduce some of the stress associated with living with T1DM. This study explores the acceptability and scalability of a self-guided, smartphone-based meditation app, the Healthy Minds Program (HMP) app, among adolescents with T1DM using the Unified Theory of Acceptance and Use of Technology. Methods Eight adolescents ages 15-19 were recruited from a pediatric clinic in a Midwestern state and introduced to the HMP app. After using the HMP app for one week, they were invited to participate in three successive focus group meetings. During the meetings, they shared their perspectives on the content, navigation, and acceptability of the HMP app and strategies to introduce and scale app utilization among adolescents with T1DM. Researchers conducted conventional content analysis using a hybrid coding approach. Data was managed and analyzed using NVivo 10 (Lumivero, Denver, Colorado, USA). Findings Participants believed that the HMP app has the potential to enhance their stress management, mood, and coping abilities when dealing with the challenges of T1DM management. They found the app enjoyable and easy to use but expressed concerns about time constraints as a potential barrier. To address this, they shared recommendations for facilitating app uptake and usage. Conclusions This study's results provide an in-depth understanding of how positively this subset of adolescents with T1DM viewed the HMP app. The participants also offered valuable suggestions that can promote the adoption and sustained use of MHapps by adolescents living with T1DM.

Effects of cholecalciferol supplementation on depressive symptoms, C-peptide, serotonin, and neurotrophin-3 in type 2 diabetes mellitus: A double-blind, randomized, placebo-controlled trial

The coexistence of depression and type 2 diabetes mellitus (T2DM) can significantly worsen disease prognosis and lower quality of life. Emerging evidence suggests that vitamin D deficiency contributes to the progression of T2DM and is closely associated with the development of depression. The aim of this study was to investigate the effects of cholecalciferol on depression in patients with T2DM, exploring its mechanisms by analyzing its impact on C-peptide, serotonin, and neurotrophin-3 levels. A double-blind, randomized, placebo-controlled clinical trial was conducted at Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from April 2021 to September 2022. Patients with T2DM and depressive symptoms were randomly assigned to two groups: received 4000 IU of cholecalciferol daily and received a placebo for 12 weeks. Depression was assessed using the Beck Depression Inventory-II (BDI-II) before and 12 weeks after the intervention. The levels of C-peptide, serotonin, and neurotrophin-3 were measured at the end of the fourth week of intervention using the enzyme-linked immunosorbent assay (ELISA) method. Between-group comparisons were made using independent Student t-tests and Mann-Whitney U tests. Paired Student t-tests or Wilcoxon tests were applied for within-group comparisons between pre- and post-intervention. A total of 70 T2DM patients with depression were included in this study, comprising 38 patients in the cholecalciferol group and 32 in the placebo group. C-peptide levels increased significantly in the cholecalciferol group compared to the placebo group (p=0.006). No significant differences were observed in serotonin and NT-3 levels between the cholecalciferol group compared to the placebo group. The cholecalciferol group had a significantly greater reduction in BDI-II scores compared to the placebo group (p&lt;0.001). This trial highlights that taking cholecalciferol might help ease mild to moderate depression symptoms in patients with T2DM by enhancing c-peptide levels, though its effects on serotonin and neurotrophin-3 are still unclear.

The correlation between S-nitrosylation and type 2 diabetes mellitus: a review.

Type 2 diabetes mellitus (T2DM) represents a chronic metabolic disorder, constituting over 90% of all diabetes cases. Its primary characteristics include insulin deficiency and insulin resistance. The aetiology of T2DM is complex, which is attributed to a convergence of genetic and environmental factors. Moreover, it can engender various complications such as diabetes retinopathy, diabetes nephropathy, and diabetes neuropathy. T2DM cannot be cured fundamentally, it can only delay the development of the disease by controlling the blood sugar level. If the blood sugar is at a high level for a long time, it will aggravate the disease progress, and even lead to death in serious cases. Therefore, understanding the pathogenesis of diabetes, early detection, and intervention are the main means of treatment. S-nitrosylation (SNO), a post-translational modification of proteins based on redox, possesses the capacity to regulate a variety of physiological and pathological processes, and it is also involved in the occurrence and development of T2DM. However, the relationship between the dysregulation of SNO homeostasis and the occurrence of diabetes is not fully understood. This article reviews the correlation between SNO and T2DM, elucidating the mechanism by which SNO contributes to T2DM, encompassing diminishing insulin secretion, inducing insulin resistance, and affecting glucokinase activity. Understanding the correlation between SNO and T2DM provides a new research direction for the pathogenesis and treatment targets of diabetes.

Is alcohol use disorder associated with higher rates of depression and anxiety among people with new onset type 2 diabetes? A cohort study using linked primary care data in England

IntroductionDepression and alcohol use disorder (AUD) in people living with Type 2 diabetes mellitus (T2DM) are associated with worse health outcomes. AUD is strongly associated with depression and anxiety, but it is not known how these conditions cluster in people with T2DM. We investigated rates of new episodes of depression and anxiety following T2DM diagnosis in people with and without prior AUD among an English primary care population.MethodsThe study population was people diagnosed with T2DM between 2004 and 2019. We used the Clinical Practice Research Datalink (CPRD) Aurum database and linked Hospital Episode Statistics Admitted Patient Care (HES APC) and Office for National Statistics (ONS) mortality data. We examined incidence of new episodes of anxiety or depression in people with T2DM with and without AUD. AUD was defined as any of i) clinical diagnosis; ii) alcohol withdrawal; or iii) chronic alcohol-related harm (physical or mental) using SNOMED-CT or ICD-10 codes. People were excluded if they had codes for depression/anxiety 12 months prior to T2DM diagnosis. Poisson regression models were fitted adjusting sequentially for a) age, gender, calendar time; b) region, Index of Multiple Deprivation, ethnicity, body mass index, smoking status, Charlson co-morbidity index; and c) history of a mental health condition.ResultsOur study population was 479,447 people of whom 10,983 (2.3%) had an AUD code prior to T2DM diagnosis.After adjusting for all measured confounders except history of a mental health condition, IRR for depression was 2.00 (95% CI 1.93, 2.06) for people with AUD compared to without AUD. This reduced to 1.45 (95% CI 1.41, 1.50) after further adjustment for history of a mental health condition.Findings for anxiety were substantially similar to those for depression (adjusted for all measured confounders except history of a mental health condition, IRR 2.08 95% CI 1.99, 2.18 fully adjusted IRR 1.48 95% CI 1.41, 1.55).ConclusionsPeople with AUD have over double the rates of depression and anxiety following T2DM diagnosis than those without AUD. This was only partially explained by pre-existing diagnoses of mental health conditions. A holistic approach incorporating mental health support is needed to improve health outcomes for people with AUD who develop T2DM.Trial registrationNot applicable.

Mortality from type 2 diabetes mellitus across municipalities in Mexico

BackgroundOne in six Mexican adults’ lives with type 2 diabetes mellitus (T2DM), which is the third leading cause of death in the country. Analyzing the geographic distribution of T2DM mortality helps identify regions with higher mortality rates. This study aimed to examine the spatial patterns of mortality from type 2 diabetes mellitus (T2DM) across municipalities in Mexico and to analyze the main contextual factors linked to this cause of death in 2020.MethodsWe employed a spatial Bayesian hierarchical regression model to estimate the risk and probability of death from type 2 diabetes mellitus (T2DM) across Mexico’s municipalities.ResultsThe SMR results revealed geographic and age-specific patterns. Central Mexico and the Yucatán Peninsula exhibited the highest excess mortality rates. For the population under 50 years of age, municipalities in Oaxaca had the highest T2DM mortality rates, whereas those aged 50 years old and older had the highest rates in Tlaxcala and Puebla. Socioeconomic factors such as low levels of educational attainment, lack of health services, dietary deficiency, and marginalization were positively associated with increased T2DM mortality risk. By contrast, GDP per capita showed a negative association. High-risk areas for T2DM mortality were prominent along the south of the Pacific Coast, the Bajío, Central Mexico, and southern Yucatán for those under 50, and along a central strip extending to the Yucatán Peninsula for the older population. Significant uncertainties in mortality risk were identified, with Central Mexico, Oaxaca, Chiapas, and Tabasco showing high probabilities of excess risk for those under 50 years of age and extended risk areas along the Gulf of Mexico for those 50 years old and older.ConclusionsThe assessment and identification of spatial distribution patterns associated with T2DM mortality, and its main contextual factors, are crucial for informing effective public health policies aimed at reducing the impact of this chronic disease in Mexico.

Effect of Iron Deficiency Anemia on HbA1c Levels in a cohort of patients with Type 2 diabetes mellitus in a tertiary care hospital

Introduction: Studies have reported that HbA1c levels can be changed by iron deficiency (ID) which is the commonest nutritional anaemia globally. This study was aimed at determining the effect of iron deficiency anaemia (IDA) on HbA1c levels in a cohort of type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Sri Lanka. Methods: A retrospective analytical study was performed for a period of six months from January 2021. Laboratory records of 281 adult T2DM patients both, anaemic (n=135) with Hb &lt;12g/dL in females and &lt;13g/dL males and transferrin saturation &lt;16%, and nonanaemic (n=146) with Hb &gt;12g/dL in females and &gt;13g/dL in males were analyzed. Data were analyzed using (SPSS) version 20, descriptive statistical methods, Pearson’s Correlation test, independent sample t-test, one-way analysis of variance (ANOVA) and Chi-Square test were used. P&lt;0.05 was considered significant. Results: Out of the total 281 patients diagnosed with T2DM, 150 were female, and 131 were male, spanning an age range of 22 to 96 years. The mean ± standard deviation (SD) values for HbA1c in both anaemic and non-anemic groups were 7.4±2.2% g/dL and 7.3±2.36% g/dL, respectively. Importantly, no statistically significant relationship was observed between the two groups (p=0.889). Furthermore, there was no significant correlation between HbA1c levels with serum iron (p=0.617), total Iron Binding Capacity (TIBC) (p=0.340), and transferrin saturation (p=0.168). Conclusion: The study reveals, HbA1c in T2DM patients with and without IDA show no significant difference. Therefore, HbA1c could be reliably used in monitoring patients with T2DM and IDA. Keywords: T2DM, HbA1c, iron deficiency anaemia, red blood cell indices

High Stress Hyperglycemia Ratio Versus Absolute Hyperglycemia as a Predictor of Poor Outcome Among Patients With Type 2 Diabetes Mellitus and Moderate to Critical Covid-19 Infection Admitted at a Tertiary Hospital from 2020-21: A Retrospective Study

Background: Patients with diabetes are vulnerable and highly susceptible to contracting COVID-19. Stress hyperglycemia ratio (SHR) may provide prognostic information in hospitalized patients. It is debatable whether stress hyperglycemia directly leads to poor outcomes, or is simply a marker of increased stress and inflammation. Objective: This study investigates whether high SHR is associated with poor clinical outcomes among patients with type 2 diabetes mellitus (T2DM) and moderate to critical COVID-19 infection. Moreover, this study aims to compare high SHR versus absolute hyperglycemia as a predictor of poor outcomes. Methodology: A chart review was conducted on 146 COVID-19 patients with T2DM from March 2020 to December 2021. The area under the receiver operating curve was conducted to categorize SHR into low and high levels. The association of high SHR levels and absolute hyperglycemia with outcomes was analyzed using the regression analysis. Survival analysis was also utilized to allow differences in the time when in-hospital mortality occurred. Result: Patients with high SHR had a significantly higher proportion of mortality and invasive ventilation compared to those with low SHR. High SHR significantly increased the likelihood of invasive ventilation by 16.49 times and mortality hazards by 5.70 times compared to low SHR. Kaplan-Meier survival curves showed that those with high SHR had significantly lower survival rates than those with low SHR. In contrast, the survival estimates between those with and without absolute hyperglycemia were not statistically significant. Conclusion: High SHR (&gt;1.082) was associated with poorer outcomes, increased invasive mechanical ventilatory support and increased mortality. Keywords: Stress Hyperglycemia Ratio, Absolute Hyperglycemia, Type 2 Diabetes Mellitus, COVID-19, Poor outcome

Comparing ischemic cardiovascular effectiveness and safety between individual SGLT-2 inhibitors and DPP-4 inhibitors in patients with type 2 diabetes: a nationwide population-based cohort study.

This study compared the ischemic cardiovascular events (iCVEs) effectiveness and safety of initiating empagliflozin or dapagliflozin with those of dipeptidyl peptidase-4 inhibitors (DPP-4is), as well as the comparative effects between empagliflozin and dapagliflozin. Using data from the National Health Insurance Service in Korea, patients with type 2 diabetes mellitus (T2DM) who were newly prescribed empagliflozin, dapagliflozin, or DPP-4is from 2016 to 2019 and who did not have a recent CVE history were included. A Cox proportional hazards regression model was used to estimate the adjusted hazard ratio (aHR) with 95% confidence intervals (CIs) for iCVEs and safety events. Empagliflozin and dapagliflozin significantly reduced the risks of ischemic stroke (aHR 0.568, 95% CI 0.408-0.791; aHR 0.612, 95% CI 0.476-0.786, respectively) and all-cause mortality (aHR 0.590, 95% CI 0.442-0.788; aHR 0.730, 95% CI 0.603-0.884, respectively) compared with DPP-4is. Initiating dapagliflozin or empagliflozin was associated with significantly lower incidence of severe hypoglycemia, bone fracture, urinary tract infection, and acute kidney injury than that of DPP-4is. No significant differences were observed between empagliflozin and dapagliflozin in iCVEs and most safety outcomes. Empagliflozin and dapagliflozin showed significant preventive effects on ischemic stroke and all-cause mortality compared with DPP-4is in patients with T2DM, and their protective effects were similar. Both empagliflozin and dapagliflozin were not related to the harmful effects on most safety events. These results suggest that it may be beneficial to initiate empagliflozin or dapagliflozin for ischemic stroke prevention in patients with T2DM. However, further validation studies, such as randomized controlled trials, are needed to generalize these results.

Characteristics of blood lipid and metabolic indicators in subclinical hypothyroidism patients: a retrospective study.

The characteristics of blood lipid and metabolic indicators were analyzed in patients with subclinical hypothyroidism (SCH), and the effect of type 2 diabetes mellitus (T2DM) on SCH patients was determined. The physical examination data of 2,119 residents in a university community were retrospectively divided into 2 groups (SCH and non-SCH groups). Furthermore, the SCH group was divided into SCH-T2DM and SCH-non-T2DM subgroups, and the data between the groups were analyzed. The SCH group had significantly higher levels of triglycerides (p = 0.044), total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.019), very low-density lipoprotein cholesterol (p = 0.044), 2-h plasma glucose (p = 0.023), and globulin (p = 0.000) compared to the non-SCH group. The SCH-T2DM group was older (p < 0.001), had a greater BMI (p = 0.028), a more rapid heart rate (p = 0.025), and a greater waist circumference (p < 0.001) than the SCH-non-T2DM group based on the subgroup analysis. The SCH-T2DM group had significantly higher dyslipidemia and dysglycemia levels than the SCH-non-T2DM group. Patients with SCH with or without T2DM may have dyslipidemia and dysglycemia and should be evaluated accordingly.

Burden of diabetes mellitus in Weifang: Changing trends in prevalence and deaths from 2010 to 2021.

The objective of this study is to analyze the death characteristics and burden of disease (BOD) in diabetes mellitus (DM) patients in Weifang from 2010 to 2021. The findings will serve as a foundational data source and theoretical framework for public health administrative departments in the formulation of DM-related policies. The annual percent change (APC) and average annual percent change (AAPC) of the disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) in DM residents from 2010 to 2021 were analyzed using the Joinpoint software to reflect the changing trend of the BOD in DM patients. Additionally, we conducted an analysis of the various causes of death among these patients and compared BOD in diabetic patients with different backgrounds. From 2010 to 2021, the burden of disease, which includes DALY, YL, and YLD, has been increasing among patients with DM in Weifang. It is noteworthy that the burden of disease is particularly pronounced among male patients and those aged 75 or above. Additionally, it is observed that widowed and illiterate DM patients have comparatively longer survival times. Furthermore, among the DM patients who have unfortunately passed away, it has been identified that unspecified DM with ketoacidosis accounts for 10.03% of the deaths as a direct cause of death. In contrast, type 2 diabetes mellitus (T2DM) with kidney complications contributes to 10.23% of the deaths as the fundamental cause of death. The city is faced with a significant challenge of diabetes, which is influenced by factors such as gender, age, cultural background, and marital status. Unspecified diabetes mellitus (DM) with ketoacidosis (10.03%) and T2DM with renal complications (0.23%) are identified as the primary direct and underlying causes of death among diabetic patients, respectively. This study serves as a valuable reference for other regions in terms of diabetes prevention, control, and the management of chronic diseases.

Characterization of Telecare Conversations on Lifestyle Management and Their Relation to Health Care Utilization for Patients with Heart Failure: Mixed Methods Study.

Telehealth interventions where providers offer support and coaching to patients with chronic conditions such as heart failure (HF) and type 2 diabetes mellitus (T2DM) are effective in improving health outcomes. However, the understanding of the content and structure of these interactions and how they relate to health care utilization remains incomplete. This study aimed to characterize the content and structure of telecare conversations on lifestyle management for patients with HF and investigate how these conversations relate to health care utilization. We leveraged real-world data from 50 patients with HF enrolled in a postdischarge telehealth program, with the primary intervention comprising a series of telephone calls from nurse telecarers over a 12-month period. For the full cohort, we transcribed 729 English-language calls and annotated conversation topics. For a subcohort (25 patients with both HF and T2DM), we annotated lifestyle management content with fine-grained dialogue acts describing typical conversational structures. For each patient, we identified calls with unusually high ratios of utterances on lifestyle management as lifestyle-focused calls. We further extracted structured data for inpatient admissions from 6 months before to 6 months after the intervention period. First, to understand conversational structures and content of lifestyle-focused calls, we compared the number of utterances, dialogue acts, and symptom attributes in lifestyle-focused calls to those in calls containing but not focused on lifestyle management. Second, to understand the perspectives of nurse telecarers on these calls, we conducted an expert evaluation where 2 nurse telecarers judged levels of concern and follow-up actions for lifestyle-focused and other calls (not focused on lifestyle management content). Finally, we assessed how the number of lifestyle-focused calls relates to the number of admissions, and to the average length of stay per admission. In comparative analyses, lifestyle-focused calls had significantly fewer utterances (P=.01) and more dialogue acts (Padj=.005) than calls containing but not focused on lifestyle management. Lifestyle-focused calls did not contain deeper discussions on clinical symptoms. These findings indicate that lifestyle-focused calls entail short, intense discussions with greater emphasis on understanding patient experience and coaching than on clinical content. In the expert evaluation, nurse telecarers identified 24.2% (29/120) of calls assessed as concerning enough for follow-up. For these 29 calls, nurse telecarers were more attuned to concerns about symptoms and vitals (19/29, 65.5%) than lifestyle management concerns (4/29, 13.8%). The number of lifestyle-focused calls a patient had was modestly (but not significantly) associated with a lower average length of stay for inpatient admissions (Spearman ρ=-0.30; Padj=.06), but not with the number of admissions (Spearman ρ=-0.03; Padj=.84). Our approach and findings offer novel perspectives on the content, structure, and clinical associations of telehealth conversations on lifestyle management for patients with HF. Hence, our study could inform ways to enhance telehealth programs for self-care management in chronic conditions.

Perspective on the health effects of unsaturated fatty acids and commonly consumed plant oils high in unsaturated fat.

Epidemiological and clinical trial evidence indicates that n-6 polyunsaturated fatty acid (PUFA) intake is cardioprotective. Nevertheless, claims that n-6 PUFA intake promotes inflammation and oxidative stress prevail. This narrative review aims to provide health professionals with an up-to-date evidence overview to provide the requisite background to address patient/client concerns about oils containing predominantly unsaturated fatty acids (UFA), including MUFA and PUFA. Edible plant oils, commonly termed vegetable oils, are derived from vegetables, nuts, seeds, fruits and cereal grains. Substantial variation exists in the fatty acid composition of these oils; however, all are high in UFA, while being relatively low in saturated fatty acids (SFA), except for tropical oils. Epidemiological evidence indicates that higher PUFA intake is associated with lower risk of incident CVD and type 2 diabetes mellitus (T2DM). Additionally, replacement of SFA with PUFA is associated with reduced risk of CVD and T2DM. Clinical trials show higher intake of UFA from plant sources improves major CVD risk factors, including reducing levels of atherogenic lipids and lipoproteins. Importantly, clinical trials show that increased n-6 PUFA (linoleic acid) intake does not increase markers of inflammation or oxidative stress. Evidence-based guidelines from authoritative health and scientific organisations recommend intake of non-tropical vegetable oils, which contain MUFA and n-6 PUFA, as part of healthful dietary patterns. Specifically, vegetable oils rich in UFA should be consumed instead of rich sources of SFA, including butter, tallow, lard, palm and coconut oils.

Evaluation of HbA1c, C-peptide and Rf in DM patients related to COVID-19, ABO group and BMI in Babylon, Iraq

Background: A total of 30(100%) cases of diabetes mellitus DM were collected from a private laboratory during the period from October 2023 to February 2024, compared with 30 control to evaluate several parameters in a case-control study. The demographic information of sex distribution for DM cases appear 16(53%) male and 14(47%) and the mean±SD of the age was 45.6±14.7 compared to the control 33.6±10.5 which reveals a significant at P = 0.0006. The mean±SD of the BMI was 29±6.4 in DM cases compared to the control 25.8±3.4 which reveals a significant difference at P = 0.0187. Distribution of DM types appears in 16(53%), and 14(47%) cases of DM type 1 and 2 respectively with no significant difference between the two study groups. The mean±SD of HbA1c Level with DM Patients and was 9.2±2.8 compared to the control 5.6±0.9 which appeared a significant at P = 0.0002. Methods: Evaluation of C-peptide Level appears the mean±SD of the C-peptide for DM cases was 5.7±4.5 compared to the control 3.3±2.4. this case-control study appeared a significant difference at P = 0.0125. RBS Level mean±SD of DM cases was 275.7±121.5 compared to the control 103.7±16.6. this case-control study appeared significant at P = 0.0001. The distribution of DM cases in blood groups O+, A+, B+, AB+, AB-, and O- was 10(33.3%), 8(26.7%), 5(16.7%), 3(10%), 3(10%), 1(3.3%), respectively. Results: All the cases in the present study show negative results for rheumatoid factor and there is no correlation between RF and DM. 2(7%) DM cases have a cardiac problem while the other 28(93%) don’t suffer from any cardiac problem. Relationship between COVID-19 and DM Type-1 Patients appears 15(50%) have positive COVID-19, 12(40%) has DM type 1 and 3(10%) has DM type-2. Conclusion: The study was concluded an appositive relationship between age, HbA1c, C-peptide, RBS, O+ and A+ blood groups and developments of diabetes mellitus.

Advances in Research on the Anticancer Properties and Mechanisms of Metformin in Lung Cancer.

Lung cancer is a leading cause of death globally with high mortality and morbidity. Patients are often diagnosed at an advanced stage. Metformin has become a primary medication used in the clinical management of type 2 diabetes mellitus (T2DM) due to its relative safety, low cost, and effectiveness, mainly exerting its hypoglycemic effect by inhibiting hepatic gluconeogenesis and insulin resistance. Research data indicate that metformin extends the distant metastasis-free survival (DMFS) and progression-free survival (PFS) of diabetic patients with lung cancer, improving overall survival rates. Metformin lowers the risk of tumour development through various mechanisms, including the adenosine 5'-monophosphate-activated protein kinase/liver kinase B1/mechanistic target of rapamycin (AMPK/LKB1/mTOR) pathway, insulin-like growth factor-1 receptor pathway, apoptosis, and autophagy. However, research findings are not entirely consistent. This article reviews the research progress of metformin in terms of lung cancer treatment within the past few years, aiming to provide a more comprehensive understanding of how metformin exerts its anti-cancer impact and how it can be clinically applied, as well as provide new insights for lung cancer treatment.

Exploring diabesity pathophysiology through proteomic analysis using Caenorhabditis elegans.

Diabesity, characterized by obesity-driven Type 2 diabetes mellitus (T2DM), arises from intricate genetic and environmental interplays that induce various metabolic disorders. The systemic lipid and glucose homeostasis is controlled by an intricate cross-talk of internal glucose/insulin and fatty acid molecules to maintain a steady state of internal environment. In this study, Caenorhabditis elegans were maintained to achieve glucose concentrations resembling the hyperglycemic conditions in diabetic patients to delve into the mechanistic foundations of diabesity. Various assays were conducted to measure intracellular triglyceride levels, lifespan, pharyngeal pumping rate, oxidative stress indicators, locomotor behavior, and dopamine signaling. Proteomic analysis was also performed to identify differentially regulated proteins and dysregulated KEGG pathways, and microscopy and immunofluorescence staining were employed to assess collagen production and anatomical integrity. Worms raised on diets high in glucose and cholesterol exhibited notably increased intracellular triglyceride levels, a decrease in both mean and maximum lifespan, and reduced pharyngeal pumping. The diabesity condition induced oxidative stress, evident from heightened ROS levels and distinct FT-IR spectroscopy patterns revealing lipid and protein alterations. Furthermore, impaired dopamine signaling and diminished locomotors behavior in diabesity-afflicted worms correlated with reduced motility. Through proteomic analysis, differentially regulated proteins encompassing dysregulated KEGG pathways included insulin signaling, Alzheimer's disease, and nicotinic acetylcholine receptor signaling pathways were observed. Moreover, diabesity led to decreased collagen production, resulting in anatomical disruptions validated through microscopy and immunofluorescence staining. This underscores the impact of diabesity on cellular components and structural integrity in C. elegans, providing insights into diabesity-associated mechanisms.