Diabetes Risk Factors Research Articles

Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.

Diabetes mellitus is a significant risk factor for both ischaemic and haemorrhagic stroke, affecting up to a third of individuals with cerebrovascular diseases. Beyond being a risk factor for stroke, diabetes and hyperglycaemia have a negative impact on outcomes after ischaemic and haemorrhagic stroke. Hyperglycaemia during the acute ischaemic stroke phase is associated with a higher risk of haemorrhagic transformation and poor functional outcome, with evidence in favour of early intervention to limit and manage severe hyperglycaemia. Similarly, intensive glucose control nested in a broader bundle of care, including blood pressure, coagulation and temperature control, can provide substantial benefit for clinical outcomes after haemorrhagic stroke. As micro- and macrovascular complications are frequent in people with diabetes, cardiovascular prevention strategies also need to consider tailored treatment. In this regard, the broader availability of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists can allow tailored treatments, particularly for those with heart failure and chronic kidney disease as comorbidities. Here, we review the main concepts of hyperacute stroke management and CVD prevention among people with diabetes, capitalising on results from large studies and RCTs to inform clinicians on preferred treatments.

Yogurt, in the context of a healthy diet, for the prevention and management of diabetes and obesity: a perspective from Argentina

Diabetes is a non-communicable chronic, but preventable, disease whose occurrence is related to unhealthy lifestyles, including inadequate diet. Obesity is a risk factor for diabetes. In Argentina, 12.7% of the population is living with diabetes. In this work, we aimed at giving a perspective on the role of yogurt, as part of a healthy lifestyle, for the prevention and management of obesity and diabetes. The intake of yogurt declined in the last decade in Argentina. In the context of the global diet, the contribution of a moderate increase of yogurt consumption has the potential to improve up to 10% the nutritional density of the Argentine population’s diet, given its present low diversity and wide gaps in nutritive foods. The consumption of yogurt can be beneficial in the prevention and management of obesity and T2DM. The ready availability of yogurt and its easy introduction to diverse diets suggests that educating the general public to incorporate this fermented milk as part of a healthy diet may potentially contribute to improved public health through prevention of NCDs and the costs associated with them.

Assessing Priorities in a Statewide Cardiovascular and Diabetes Health Collaborative Based on the Results of a Needs Assessment: Cross-Sectional Survey Study.

The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites general and subspecialty medical staff at the 7 medical schools in Ohio with community and public health partnerships to improve cardiovascular and diabetes health outcomes and eliminate disparities in Ohio's Medicaid population. Although statewide collaboratives exist to address health improvements, few deploy needs assessments to inform their work. Cardi-OH conducts an annual needs assessment to identify high-priority clinical topics, screening practices, policy changes for home monitoring devices and referrals, and preferences for the dissemination and implementation of evidence-based best practices. The results of the statewide needs assessment could also be used by others interested in disseminating best practices to primary care teams. A cross-sectional survey was distributed electronically via REDCap (Research Electronic Data Capture; Vanderbilt University) to both Cardi-OH grant-funded and non-grant-funded members (ie, people who have engaged with Cardi-OH but are not funded by the grant). In total, 88% (103/117) of Cardi-OH grant-funded members and 8.14% (98/1204) of non-grant-funded members completed the needs assessment survey. Of these, 51.5% (53/103) of Cardi-OH grant-funded members and 47% (46/98) of non-grant-funded members provided direct clinical care. The top cardiovascular medicine and diabetes clinical topics for Cardi-OH grant-funded members (clinical and nonclinical) were lifestyle prescriptions (50/103, 48.5%), atypical diabetes (38/103, 36.9%), COVID-19 and cardiovascular disease (CVD; 38/103, 36.9%), and mental health and CVD (38/103, 36.9%). For non-grant-funded members, the top topics were lifestyle prescriptions (53/98, 54%), mental health and CVD (39/98, 40%), alcohol and CVD (27/98, 28%), and cardiovascular complications (27/98, 28%). Regarding social determinants of health, Cardi-OH grant-funded members prioritized 3 topics: weight bias and stigma (44/103, 42.7%), family-focused interventions (40/103, 38.8%), and adverse childhood events (37/103, 35.9%). Non-grant-funded members' choices were family-focused interventions (51/98, 52%), implicit bias (43/98, 44%), and adverse childhood events (39/98, 40%). Assessment of other risk factors for CVD and diabetes across grant- and non-grant-funded members revealed screening for social determinants of health in approximately 50% of patients in each practice, whereas some frequency of depression and substance abuse screening occurred in 80% to 90% of the patients. Access to best practice home monitoring devices was challenging, with 30% (16/53) and 41% (19/46) of clinical grant-funded and non-grant-funded members reporting challenges in obtaining home blood pressure monitoring devices and 68% (36/53) and 43% (20/46) reporting challenges with continuous glucose monitors. Cardi-OH grant- and non-grant-funded members shared the following high-priority topics: lifestyle prescriptions, CVD and mental health, family-focused interventions, alcohol and CVD, and adverse childhood experiences. Identifying high-priority educational topics and preferred delivery modalities for evidence-based materials is essential for ensuring that the dissemination of resources is practical and useful for providers.

The use of artificial intelligence in the diagnosis and detection of complications of diabetes

Introduction: Diabetes poses a significant global health challenge, impacting patient well-being and longevity. Despite advances in diagnosis and treatment, the prevalence of diabetes continues to rise, with projections indicating a substantial increase in affected individuals in the coming years. The complications of diabetes, including cardiovascular disease, retinopathy, nephropathy, and neuropathy, underscore the importance of early detection and management. In this context, artificial intelligence (AI) offers promising opportunities to revolutionize diabetes care, enabling faster diagnostics, more effective treatment strategies.
 Description of the State of Knowledge: Artificial intelligence (AI) has emerged as a transformative force in healthcare, leveraging machine learning and deep learning algorithms to analyze vast amounts of medical data. These algorithms enable more accurate diagnosis, prediction of disease onset, and early detection of complications associated with diabetes. Machine learning models, including support vector machines and neural networks, have shown promise in identifying diabetes risk factors and predicting disease progression. Deep learning techniques, with their ability to analyze complex data patterns, offer further insights into diabetes diagnosis. Additionally, fuzzy cognitive maps provide a framework for decision-making based on patient data, enhancing early detection efforts.
 Summary: Artificial intelligence holds immense potential to transform diabetes care, offering solutions for early detection, personalized treatment, and improved patient outcomes. By harnessing the power of AI algorithms, healthcare providers can enhance diagnostic accuracy, predict disease progression, and implement targeted interventions.

Health Status of Working Women in a Tertiary Care Center, North Kerala, India: During the COVID-19 Pandemic

Introduction: Women constitute about one-half of the workforces in most countries and spend a significant proportion of their time at the workplace, contributing to a lot of physical and mental stress. The health-care professional in the workforce was the most affected during the COVID-19 pandemic. COVID-19 and noncommunicable diseases (NCDs) and associated risk factors have a substantial correlation. According to numerous studies from around the world, people who already have established risk factors such as diabetes, hypertension, obesity, or other vascular risk factors, are more likely to contract COVID-19 and experience complications or even pass away from it. Objectives: The objective is to assess the health status of working women in a tertiary health-care center in Kerala during the COVID-19 pandemic. Methodology: The study was done in a tertiary health-care center in Kozhikode district, Kerala, South India. This center comprises medical, paramedical and nursing institutes. A total of 262 women were included in the study, and data were collected using a semi-structured questionnaire. Results: This study demonstrated that working women’s stress was prevalent. It reveals that 94 (99.4%) women experience stress, 60.7% experience depression, 72.5% do not engage in daily physical activity and 80.8% of women were at risk of having NCDs. Conclusion: This study was an attempt to explore the health status of the women’s working health status during COVID-19 time. It found that some women are hypertensive, depressed and have stress-related disorders such as anxiety and worries. Mental health is directly linked with physical activity. The stress levels were controlled for those who were involved in physical activity on regular basis. Hence, we should work on this area to help improve these conditions.

Trend and projection of non-communicable diseases risk factors in Iran from 2001 to 2030

This study aims to investigate the trends and project the major risk factors of Non-communicable Diseases (NCDs) in Iran. We obtained the trend of prevalence of main risk factors related to NCDs in 30 to 70-year-old-individuals. The data were extracted from WHO STEP wise approach to NCDs risk factor surveillance (STEPS) survey. Also,the previous studies conducted at national and subnational levels from 2001 to 2016 were employed. The prevalence of risk factors was projected by 2030 using Bayesian Model Averaging (BMA) and Spatio-temporal model stratified by sex and province. The percent change for the age-standardized prevalence of smoking in men between 2001 and 2016 was calculated to be − 27.0. Also, the corresponding values for the risk factors of diabetes, hypertension, obesity and overweight, physical inactivity (PI), and mean of salt intake were − 26.1, 29.0, 70.0, 96.8, 116.6, and 7.5, respectively. It is predicted that smoking and these risk factors will undergo a change to show values of − 1.26, 38.7, 43.7, 2.36, and 15.3 by 2030, respectively. The corresponding values in women for the time interval of 2001–2016 were − 27.3, 26.3, 82.8, 1.88, 75.2, and 4.2, respectively. Plus, projections indicate that the 2030 variation values are expected to be − 25.0, 16.7, 37.5, 28.7, 26.7, and 10.9 respectively. This study showed that the prevalence of four risk factors of PI, overweight and obesity, hypertension, and diabetes is increasing in Iran. Therefor, it is necessary to carry out effective interventions to adopt a healthy lifestyle and reduce the risk factors.

Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa.

The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon. A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs. Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level. The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.

Association between dental scaling and metabolic syndrome and lifestyle.

Periodontal disease is a risk factor for diabetes and metabolic syndrome, and non-surgical periodontal treatment has been shown to help maintain stable blood sugar in diabetic patients. Determining the level of preventive scaling in patients with metabolic syndrome will help manage the disease. The purpose of this study was to investigate the extent to which people with metabolic syndrome or bad lifestyle performed scaling and the association between preventive scaling and metabolic syndrome or lifestyle in a large population. This study was conducted on adults aged 20 years or older from January 2014 to December 2017 in the National Health Insurance System (NHIS) database. Among 558,067 people who underwent health checkups, 555,929 people were included. A total of 543,791 people were investigated for preventive scaling. Metabolic syndrome components were abdominal obesity, lower high density lipoprotein cholesterol (HDL)-C, high triglycerides, high blood pressure and hyperglycemia. Unhealthy lifestyle score was calculated by assigning 1 point each for current smokers, drinkers, and no performing regular exercise. When multiple logistic regression analysis was performed after adjusting for age, sex, income, body mass index (BMI), smoking, drinking and regular exercise, the Odds ratios (OR) and 95% confidence intervals (CI) of the group with 5 metabolic syndrome components were 0.741 (0.710, 0.773) (p<0.0001). After adjustment for age, sex, income, BMI, smoking, drinking, regular exercise, diabetes, hypertension and dyslipidemia, the OR (95% CI) of the group with unhealthy lifestyle score = 3 was 0.612 (0.586, 0.640) (p<0.0001). The more metabolic syndrome components, and the higher unhealthy lifestyle score, the less scaling was performed.

230 Assessing the Role of Youth Sports in Diabetes Prevention and Perceived Discrimination

OBJECTIVES/GOALS: Our study aims to 1) examine the link between engagement in CLR Academy and youth diabetes risk factors—physical activity, nutrition, mental health, and weight status; 2) examine CLR’s role in moderating the relationship between perceived discrimination and these risk factors. Includes a program evaluation of CLR &amp; interviews of members. METHODS/STUDY POPULATION: Youth-onset diabetes is rising in American minority communities. Youth sports programs like the Community Leadership Revolution (CLR) Academy in Washtenaw County, MI are emerging responses to this issue. CLR targets diabetes risk factors through team sports by promoting mindfulness and healthy habits. Employing a mixed-methods, pretest-posttest approach, our study focuses on how the frequency of engagement in CLR impacts CLR’s effect on youth’s diabetes risk factors. Considering the discrimination minority youth experience, we also aim to see if CLR potentially buffers the impact of perceived discrimination on diabetes risk factors. A posttest program evaluation of CLR will also include semi-structured interviews with CLR staff and participants. RESULTS/ANTICIPATED RESULTS: There is potential that youth with high engagement in CLR Academy may see enhanced benefits in managing diabetes risk factors compared to less active participants. This may be particularly true for youth experiencing high perceived discrimination, with potential marked improvements in mental health, like reduced anxiety and depression. Additionally, through a program evaluation and semi-structured interviews, our study aims to uncover the factors contributing to CLR’s success as a community-led intervention while also identifying areas for enhancement. Post-study, CLR will receive financial support to integrate these insights into their program, furthering their effectiveness in youth diabetes prevention and overall well-being. DISCUSSION/SIGNIFICANCE: This study may provide significant insights into the relationship between sports participation, diabetes risk factors, and perceived discrimination. The findings could help CLR improve its program and guide more effective diabetes prevention strategies in minority youth through other youth sports programs.

Diagnosis and Risk Factors of Prediabetes and Diabetes in People Living with HIV- Evaluation of Clinical and Microbiome Parameters.

Diabetes is more common among people living with HIV (PLWH), as compared with healthy individuals. In a prospective multicenter study (N = 248), we identified normoglycemic (48.7%), prediabetic (44.4%) and diabetic (6.9%) PLWH. HbA1c and fasting blood glucose (FBG) sensitivity in defining dysglycemia was 96.8%, while addition of oral glucose tolerance test led to reclassification of only 4 patients. Inclusion of 93 additional PLWH with known DM enabled identification of multiple independent predictors of dysglycemia or diabetes: older age, higher BMI, Ethiopian origin, HIV duration, lower integrase inhibitor exposure and advanced disease at diagnosis. Shotgun metagenomic microbiome analysis revealed 4 species that were significantly expanded with hyperglycemia/hyperinsulinemia, and 2 species that were differentially more prevalent in prediabetic/diabetic PLWH. Collectively, we uncover multiple potential host and microbiome predictors of altered glycemic status in PLWH, while demonstrating that FBG and HbA1C likely suffice for diabetes screening. These potential diabetic predictors merit future prospective validation.

Correlation Between HbA1c and Body Mass Index Among Patients with High Lipid Profile Attending Johns Hopkins Aramco Healthcare Hospital in Saudi Arabia

BACKGROUND AND OBJECTIVES: Dyslipidemia is a modifiable risk factor for cardiovascular diseases, diabetes, and stroke. Obesity and elevated HbA1c levels are both risk factors for cardiovascular disease. The primary objective of this study was to examine the relationship between HbA1C and body mass index (BMI) among patients with high lipid profiles. METHODS: This retrospective, hospital-based study was conducted at Johns Hopkins Aramco Healthcare Facilities. Data were extracted from medical health records and included demographics, lipid profiles, and HBA1c measurements. The study included 2368 non-diabetic participants, and DATAtab was used to analyze the data. RESULTS: The participants were 57.05% male and 78.42% Saudi. The mean age was 41.48±12.1 years, and the mean body mass index (BMI) was 28.44±5.53. There was a statistically significant relationship between the use of lipid lowering medicine and HbA1c (P&lt;0.001). There was a very weak positive but statistically significant relationship between HbA1c and BMI (r = 0.18, P&lt;0.001). HbA1c and systolic blood pressure appeared to have a statistically significant positive association (r = 0.16, P&lt; 0.001). There was no correlation between HbA1c and low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or diastolic blood pressure. There was an inverse correlation between HbA1c and high-density lipoprotein cholesterol (HDL-C) (r = -0.11, P&lt; 0.001). Regression was performed using a linear multivariable analysis with HbA1c as the dependent variable and age (B 0.192, P&lt;0.001), BMI (B 0.119, P&lt;0.001), HDL (B -0.058, P&lt;0.005), triglyceride (B 0.093, P&lt;0.001), lipid-lowering medication (B 0.104, P&lt;0.001), and systolic BP (B 0.060, P&lt; 0.003) as independent variables.  CONCLUSION: The results indicated that HbA1c is linked to BMI, age, systolic blood pressure, triglycerides, and HDL-C levels. There was no correlation between HbA1c and LDL-C, TC, and diastolic blood pressure.

Camel milk; A potent superfood for diabetes complications

Currently, camel milk has been considered around the world due to awareness of its unique health benefits. Camel milk is considered a superfood with special nutrients and therapeutic values. In diabetes or hyperglycemia, the cells may not respond properly to insulin or defects in insulin secretion by the pancreas, therefore glucose level of blood is excessive. Chronic hyperglycemia is associated with dysfunction in the eyes, heart, nerves, kidneys, liver, and blood vessels. Insulin and oral hypoglycemic drugs are used for diabetes, but a high percentage of patients cannot use allopathic drugs and rely on natural alternative healings. Furthermore, coagulation of oral insulin in an acidic environment neutralizes and decreases the efficacy of insulin. Camel milk contains insulin-like proteins and may be an effective alternative for insulin to treat type 1 and 2 and gestational diabetes. Camel milk may prepare about 60% of the insulin in diabetic patients and reduce blood sugar and required insulin doses of about 30% - 35% in type 1 diabetes patients. This milk is believed to be a suitable hypoglycemic agent in improving long-term glycemic control in experimental animals and diabetic patients, as well as improving diabetes risk factors such as liver and kidney failures and cardiovascular challenges. It appears that more scientific studies are needed to confirm the efficacy of processed camel milk on diabetes. This review represents scientific studies on how camel milk as a superfood can be effective in diabetes.

Abstract 3427: Serum metabolites and pancreatic ductal adenocarcinoma in two prospective cohorts

Abstract Objective: Metabolomics may provide insight to understand the etiology and potential mechanisms for pancreatic ductal adenocarcinoma (PDAC) development beyond established risk factors of smoking, diabetes, and adiposity. We extended our previous metabolomic study by including additional participants from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) with the aim to examine prospective associations between serum metabolites and incident PDAC. Method: We measured 1483 known metabolites in pre-diagnostic serum (up to 24 years) in two PDAC nested case-control studies within the PLCO (360 cases-control pairs) of mostly non-smoker men and women and Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC, 372 cases-control pairs) male smokers using liquid chromatography, high resolution/accurate mass spectrometry. Controls were incidence-density sampled and matched to cases by age, blood draw date, sex, race/ethnicity, and cohort. We used conditional logistic regression to calculate odds ratios and 95% confidence intervals for PDAC per standard deviation increase in log10-metabolite levels in each cohort and combined using fixed-effect meta-analyses and stratified by follow-up time. We also performed ElasticNet regression in each cohort to identify metabolites. We assessed associations of 72 predefined metabolic pathways with PDAC by comparing Fisher’s statistic of metabolite p-values per pathway with a null distribution based on 500,000 permutations. Results: Sixty-six metabolites were associated with PDAC at a false discovery rate (FDR)&amp;lt;0.05 with 26 below the Bonferroni threshold (P&amp;lt;3.4 × 10−5). Among the 66 metabolites, 14 and 15 were selected in ElasticNet regressions in ATBC and PLCO, respectively, with two in both cohorts. Notable findings include: fibrinopeptide B(1-9); seven modified, di- or poly-peptides; eight xenobiotics related to tobacco smoke; amino acids, carbohydrates, and TCA cycle metabolites known to be regulated by mutant KRAS (aspartate, glutamate, lactate, pyruvate, and α-ketoglutarate); four secondary bile acids and three aromatic amino acids (tryptophan, phenylalanine, and tyrosine) that were positively, while four fibrinogen cleavage peptides were inversely associated with PDAC. Among the top identified metabolites, aspartate, α-glutamyltyrosine, pyroglutamylglutamine, and Glu-Gly-Asn-Val showed time-varying associations overall (P≤0.05) with greater magnitudes within the first 5 years after blood draw. Thirteen metabolic pathways were associated with PDAC (Bonferroni P≤0.05). Conclusion: Our study suggests pre-diagnostic circulating metabolites, particularly those potentially related to subclinical disease, microbiome, and tobacco metabolism are associated with PDAC. The identified metabolites along with other known risk factors might be useful in algorithms to model disease risk and progression. Citation Format: Ting Zhang, Steven C. Moore, Sheng Fu, Kevin Wang, Demetrius Albanes, Stephanie J. Weinstein, Kai Yu, Rachael Z. Stolzenberg-Solomon. Serum metabolites and pancreatic ductal adenocarcinoma in two prospective cohorts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3427.

Associations of muscle mass and strength with new-onset diabetes among middle-aged and older adults: evidence from the China health and retirement longitudinal study (CHARLS).

The associations of muscle mass and strength with new-onset Type 2 diabetes mellitus (T2DM) remain controversial. We aimed to longitudinally evaluate muscle mass and strength in predicting T2DM among Chinese middle-aged and older adults. We enrolled 6033 participants aged ≥ 45years from the China Health and Retirement Longitudinal Study (CHARLS), a cohort survey, between 2011 and 2012. The appendicular skeletal muscle mass (normalized by weight, ASM/BW%), relative hand grip strength (normalized by weight, HGS/BW), and five-repetition chair stand test (5CST). were all categorized into tertiles (lowest, middle, and highest groups) at baseline, respectively. Individuals were followed up until the occurrence of diabetes or the end of CHARLS 2018, whichever happened first. Cox proportional hazards models to calculate hazard ratios with 95% confidence intervals (CI) and mediation analysis were used. During follow-up, 815 (13.5%) participants developed T2DM. After adjusting for covariates, lower ASW/BW% was not associated with a higher risk of diabetes. Compared with individuals in the highest tertile of HGS/BW, those in the lowest tertile had 1.296 (95%CI 1.073-1.567) higher risk of diabetes. Compared with individuals in the lowest tertile of 5CST, those in the highest tertile had 1.329 times (95%CI 1.106-1.596) higher risk of diabetes. Bysubgroup,both the lowest HGS/BW and highest 5CST were risk factors for diabetes among obesity. The mediation analysis revealed that the effect of HGS/BW on therisk of diabetes is mainly mediated by insulin resistance. Lower muscle strength is associated withan increased risk of diabetes, especially in obese populations.

Diabetes mellitus and associated risk factors among HIV infected patients on HAART

BackgroundUnderstanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors especially to patients with family history of confirmed diabetes cases. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Understanding the correlates of HIV and diabetes is crucial to inform management and prevention strategies of the twin infections. We therefore aimed to determine the prevalence of diabetes mellitus and risk factors in a population of HIV infected patients on HAART. This study determined the association of diabetes/impaired glucose regulation in the context of HIV-1. A cross-sectional study was conducted at a comprehensive care clinic in Nairobi (Kenya). Participants were screened for diabetes and impaired glucose regulation using random blood glucose and glycated haemoglobin (HbA1c) This paper describes the prevalence of diabetes mellitus in Human Immunodeficiency Virus positive individuals and the associated risk factors. We have demonstrated that family history is a risk factor for diabetes. While age and BMI are known risk factors, they were not associated with diabetes in this study.

Knowledge, attitude, and practice of pre-diabetic older people regarding pre-diabetes.

One of the risk factors of diabetes is the pre-diabetes stage which is significantly prevalent in older people. Knowledge, attitude, and practice of the pre-diabetic stage are of great importance and can decrease complications. The present study aimed to determine the knowledge, attitude, and practice of the pre-diabetic older people. This cross-sectional study was conducted from April 2022 to August 2022 on 219 pre-diabetic older people referring to Sina Hospital in Tabriz, one of the most populated cities in the northwest of Iran. Data were collected using questionnaires of Knowledge, Attitude, Practice-Prediabetes Assessment Questionnaire (KAP-PAQ). The data were analyzed by SPSS 21. The mean scores of knowledge (in the range of 0-17), attitude (in the range of -10, + 10), and practice (in the range of 0-26) were 1.72 ± 1.0, 2.24 ± 1.92, and 5.76 ± 2.61, respectively. The older people's knowledge and practice levels in the pre-diabetes stage were low and about 50% of them had negative views. According to the Spearman correlation test, there was a positive significant relationship between the older people's knowledge and practice (p < 0.001, r = 0.234). The older people in the pre-diabetes stage had low knowledge and attitude and a negative viewpoint towards correcting lifestyle on diet, exercising and physical activity, weight control, diagnostic and screening methods. Increased knowledge about pre-diabetes and strengthened positive attitude towards correcting lifestyle through counseling as well as empowering the pre-diabetic older people can increase the efficiency of pre-diabetes prevention and control programs and prevent its progression to the diabetes stage.

Effectiveness of Online Learning to Improve Knowledge About Metabolic Syndrome in Pregnancy

Background: Metabolic syndrome is a persistent global health problem and a risk factor for diabetes and heart disease. A metabolic syndrome that occurs during pregnancy will pose a threat to maternal and fetal health. The incidence of metabolic syndrome during pregnancy, especially in developing countries, will become a serious public health problem in the future. This study aims to assess the effectiveness of online learning in improving the knowledge of online learning participants on metabolic syndrome cases in pregnancy. Subjects and Method: This was a cross-sectional study conducted in July through Zoom online learning on Metabolic Syndrome in Pregnancy attended by 125 participants. The dependent variable was knowledge about metabolic syndrome in pregnancy. The independent variable was online learning. The data obtained from this study were in the form of pretest and post-test scores. The data were analyzed by t-test. Results: The mean score of knowledge about metabolic syndrome in pregnancy after online learning was higher (Mean= 90.8; SD= 14.05) than before (Mean= 60.08; SD= 6.94), and this was statistically significant (p= &lt;0.001). Conclusion: Online learning is effective to improve knowledge about metabolic syndrome in pregnancy among Indonesian Obstetrics and Gynecology Association (POGI) members and young POGI members. Keywords: metabolic syndrome, pregnancy, online learning. Correspondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia. Mobile: +62 812-2651-819. E-mail: nutria_dr@staff.uns.ac.id

The association between variability of risk factors and complications in type 2 diabetes mellitus: a retrospective study.

The variability in diabetes risk factors, such as uric acid and lipids, may influence the development of complications. This study aimed to investigate the influence of such variability on the occurrence of diabetic complications. A retrospective analysis of electronic medical records was conducted with type 2 diabetic patients who received treatment at a tertiary care hospital in Chengdu, Sichuan Province, between 2013 and 2022. The risk factor variability is presented as the standard deviation (SD). The associations between the variability and complications were examined using a binary logistic regression model. The study included 369 patients with type 2 diabetes. The findings revealed that outpatient special disease management served as a protective factor against the development of complications [OR = 0.53, 95% confidence interval (CI) (0.29-0.10)], particularly for the prevention of diabetic peripheral neuropathy [OR = 0.51, 95% CI (0.30-0.86)]. Variability in total cholesterol (TC-SD) was found to be a risk factor for the development of complications [OR = 2.42, 95% CI (1.18-4.97)] and acted as a risk factor for diabetic peripheral vasculopathy [OR = 2.50, 95% CI (1.25-5.02)]. TC-SD is a risk factor for the occurrence of diabetic peripheral neuropathy and diabetic peripheral vasculopathy, whereas outpatient special disease management functions as a protective factor against complications and diabetic peripheral neuropathy. Thus, in addition to glycaemic control, the regulation of lipid levels should be emphasized, particularly among patients without outpatient special disease management, to delay the onset of complications.

Effects of vitamin family members on insulin resistance and diabetes complications.

The following letter to the editor highlights the article "Effects of vitamin D supplementation on glucose and lipid metabolism in patients with type 2 diabetes mellitus and risk factors for insulin resistance" in World J Diabetes 2023 Oct 15; 14 (10): 1514-1523. It is necessary to explore the role of vitamin family members in insulin resistance and diabetes complications.

Prevalence and Risk Factors for Renal Insufficiency among Adults Living with HIV in Tanzania: Results from a Cross-Sectional Study in 2020-2021.

With improved survival, adults living with HIV (ALHIV) are increasingly likely to experience age-related and HIV-related comorbidities, including renal insufficiency. Other risk factors for renal insufficiency (high blood pressure (BP), obesity, diabetes, and dyslipidemia) are also growing more common among ALHIV. To determine the prevalence of renal insufficiency (defined as an eGFR < 60 mL/min/1.73 m2) and factors associated with reduced eGFR, we conducted a cross-sectional study at six HIV clinics in Dar-es-Salaam, Tanzania. We applied multivariable (MV) ordinal logistic regression models to identify factors associated with reduced eGFR and examined the interaction of age with BP levels. Among the 450 ALHIV on ART analyzed [26% males; median age 43 (IQR: 18-72) years; 89% on tenofovir-containing ART; 88% HIV viral load ≤50 copies/mL], 34 (7.5%) had renal insufficiency. Prevalence was higher among males (12%) vs. females (6%), p = 0.03; ALHIV ≥50 (21%) vs. <50 years (2.5%), p < 0.001; those with high [≥130/80 mmHg (15%)] vs. normal [<120/80 mmHg (4%)] BP, p < 0.01 and those with dyslipidemia (10%) vs. those without (4.5%), p < 0.03. After adjusting for covariates, age (in years) was the only covariate with a statistically significant association with reduced eGFR (OR = 1.09 (1.07-1.12), p < 0.001). No significant interaction between age and BP was found. Interventions to increase routine screening for renal insufficiency, especially among older ALHIV, and improve BP control are critical to reducing kidney disease-related morbidity and mortality.