Diagnosis Of DM2 Research Articles

Balance, Gait, Functionality and Fall Occurrence in Adults and Older Adults with Type 2 Diabetes Mellitus and Associated Peripheral Neuropathy.

Body balance is regulated by sensory information from the vestibular, visual and somatosensory systems, and changes in one or more of these sensory systems can trigger balance disorders. Individuals with type 2 Diabetes Mellitus (DM2) often present peripheral neuropathy, a condition that alters foot sensory information and can negatively influence balance and gait performance of these subjects. To evaluate and compare balance, gait, functionality and the occurrence of falls between individuals with and without a clinical diagnosis of DM2 with associated peripheral neuropathy. Cross-sectional study, which evaluated seventy individuals, thirty-five with and thirty-five without a clinical diagnosis of DM2, of both sexes and age range between 50 and 85 years, who were recruited from Basic Health Units of Serra Talhada, Pernambuco state, Brazil. The volunteers' balance was analyzed using the Berg Balance Scale, gait-related functional tasks were measured using the Dynamic Gait Index, functional mobility was assessed using the Timed Up and Go test and functionality was assessed using the Katz Index. The occurrence of falls was recorded by the volunteers' self-report. Individuals with DM2 demonstrated the worst performance in balance (p = 0.000) and in gait-related functional tasks (p = 0.000), slower functional mobility (p = 0.000) and worse functionality (p = 0.016) compared to the group without DM2, demonstrating significant differences for all analyzed outcomes. A greater occurrence of falls was observed in individuals with DM2, compared to those without the disease (p = 0.019). Individuals with DM2 demonstrated worse performance on balance, gait-related functional tasks, slower functional mobility and worse functionality compared to those without the disease. Individuals with DM2 had the highest occurrence of falls in this study.

Abstract TP51: Improving Prescriptions of Cardiovascular-Effective Anti-Diabetic Medications in Patients With Stroke and Type 2 Diabetes

Background and Issue: Type 2 diabetes (DM2) and cardiovascular (CV) disease pose significant risks for ischemic stroke, with a heightened impact on marginalized and under-resourced communities. Despite known CV benefits of newer anti-diabetic medications like glucagonlike peptide 1 receptor agonists (GLP-1 RA) and sodium-glucose co-transporter-2 (SGLT2) inhibitors, these medications are under prescribed. To improve utilization, we conducted a quality improvement (QI) project to enhance prescription rates for these medications. The QI initiative focused on improving diabetes education and ensuring appropriate hypoglycemic medications were provided at discharge, with an aim of reducing the incidence of recurrent strokes. Purpose: The goal of this QI initiative was to improve prescription rates of GLP-1 R or SGLT2 inhibitors in eligible patients with stroke. Method: An assessment of current diabetic referral practices and medical therapy management were conducted, and an algorithm aimed at streamlining referrals for diabetic consults for patients with stroke developed. A diabetic educator or advanced practice nurse was consulted for patients with stroke and elevated A1c. Patients were then evaluated for qualification and use of GLP-1 RA or SGLT2 inhibitors, and discharge recommendations provided. A stroke registry was used to conduct a retrospective analysis of cases with stroke and DM2 for discharged prescriptions of GLP-1 R or SGLT2 inhibitors. Pre-implementation data from October 2021 to March 2022 were compared to post-implementation data from October 2022 to March 2023. Results: A review of 273 cases was completed. Prior to the QI implementation, 14.2% (19 of 134) of cases admitted for stroke with a secondary diagnosis of DM2 and elevated A1c were discharged home on a GLP-1 RA or SGLT2 inhibitor compared with 28.8% (40 of 139) of cases post implementation. Conclusion: Implementation of a QI process aimed at increasing the number of written discharge prescriptions for DM2 medications with proven CV benefits demonstrated a substantial increase in the number of written prescriptions for these medications at discharge.

Type 2 diabetes mellitus is associated with food addiction in Brazilian women living in poverty.

Food addiction (FA) has been widely investigated. For the first time, two studies reported its association with type 2 diabetes mellitus (DM2) in the general population and populations with mental disorders and undergoing bariatric surgery. However, the relationship between FA and DM2 needs to be better explored in different social contexts and population groups. Given this, the present study aims to evaluate whether DM2 diagnosis is associated with FA diagnosis in women living in poverty. This is a cross-sectional, population-based study conducted in a Brazilian capital city. FA was assessed by the modified Yale Food Addiction Scale (mYFAS) 2.0, and DM2 diagnosis was assessed by self-reporting of previous medical diagnosis. The association was assessed by multivariable Poisson regression with robust variance estimation adjusted for age, poverty situation, race/skin colour, physical activity and BMI. A total of 1878 women were included, of whom 15·1 % had FA and 3·2 % had a medical diagnosis of DM2. In the multivariable analysis, the medical diagnosis of DM2 was associated with FA (prevalence ratio, PR: 2·18; 95 % CI (1·26, 3·76)). The DM2 diagnosis was also identified to be associated with role interference (PR: 1·93; 95 % CI (1·01, 3·67)) symptom of FA. In conclusion, a positive association between FA and DM2 in women living in poverty was observed, information that adds to the current evidence already available in the literature, pointing to a new line of research and integrated care.

Myalgia in a Patient with Adult-Onset Asthma with Periocular Xanthogranuloma (AAPOX) due to Myotonic Dystrophy type 2 (P6-8.013)

<h3>Objective:</h3> To report a patient with myotonic dystrophy type 2 (DM2) and an adult-onset asthma with periocular xanthogranuloma (AAPOX). <h3>Background:</h3> AAPOX is a rare systemic non-Langerhans histiocytosis, clinically characterized by periocular yellowish plaques, adult-onset asthma, and lymphadenopathy, and pathologically characterized by non-caseating granulomas consisting of foamy histiocytes and Touton giant cells. The etiology of AAPOX is unknown, but recent studies suggested a possible link to IgG4-related disease. Autoimmune diseases occur in up to 30% of myotonic dystrophy type 2 (DM2) patients but concomitant AAPOX and DM2 have never been reported. <h3>Design/Methods:</h3> Case report. <h3>Results:</h3> A 38-year-old man with hyperlipidemia presented with 1.5-year history of progressive bilateral periorbital swelling and periocular yellowish plaques, 1-year history of asthma and exercise intolerance, and 4-month history of rosuvastatin-associated myalgias and difficulty climbing stairs. Periorbital soft tissue biopsy revealed characteristic pathological features of AAPOX. Neurologic examination revealed neither weakness nor clinical myotonia. Family history was significant for bradyarrhythmia requiring pacemaker in his mother and maternal grandfather. The patient’s creatine kinase was elevated at 606 U/L (normal &lt; 308 U/L). HMGCR-IgG was negative. IgG4 level was normal. Electromyography revealed diffuse myotonic discharges and a mild proximal myopathy without fibrillation potentials. A triceps brachii biopsy showed a marked increase of fibers harboring internal nuclei, scattered pyknotic nuclear clumps, and type 1 fiber smallness without granulomas. Genetic testing revealed a heterozygous CCTG repeat expansion &gt; 15,600 base pairs in intron 1 of <i>CNBP</i>, consistent with a diagnosis of DM2. His cardiac evaluation was unrevealing. The patient was treated with prednisone and methotrexate with improvement of his periocular disease. Myalgias persisted despite discontinuation of rosuvastati <h3>Conclusions:</h3> We first report the cooccurrence of AAPOX and DM2. Our finding supports the increased risk of autoimmune diseases in DM2 patients. <b>Disclosure:</b> Dr. Skolka has nothing to disclose. The institution of Shreyasee Amin has received research support from NIH. Dr. Liewluck has nothing to disclose.

473. Diabetes Mellitus as a Risk Factor for Cryptococcosis — a Multicenter Research Network Study

Abstract Background Diabetes mellitus type 2 (DM2) is a common medical condition that increases the risk of bacterial infections, and is often present in patients with cryptococcosis. The role of DM2 as an independent risk factor for cryptococcosis is debatable. We aim to better characterize the natural history of cryptococcosis in patients with DM2 as their only comorbidity. Methods We utilized TrinetX, a federal national network, to identify HIV-negative patients who had cryptococcosis without known risk factors. Demographic characteristics and outcomes were compared between patients with DM2 and those without DM2, who tested positive or had ICD based diagnoses of Cryptococcus infection within five years of diagnosis of DM2. Results Sixty patients with DM2 (as the sole risk factor) and 707 patients without DM2 had cryptococcosis. Patients with DM2 and cryptococcosis were older (61 ± 13.6 years vs. 55.8 ± 16.2 years, p=0.0219), and more likely to be Hispanic or Latino (18% vs. 9%, p=0.023). They had higher rates of hypertension (77% vs 44%, p&amp;lt; 0.0001), cystic fibrosis (18% vs 1%, p&amp;lt; 0.0001), tuberculosis (18% vs 1%, p&amp;lt; 0.0001), and chronic kidney disease (33% vs 18%, p=0.0026). The mean HbA1c among patients with DM2 who developed cryptococcosis was 8.16 (SD 2.62). The most common sites of cryptococcus infection were pulmonary (56% vs 55%, p=0.8930) and cerebral (36% vs 40%, p=0.5589), in both groups. The two groups had similar mortality (20% vs 25.47%, p=0.3676) (Figure 1), and hospitalization rates (20% vs 31.3%, p=0.08). The overall annual cryptococcosis risk among HIV-negative patients with DM2 without any additional risk factors was 0.001%. Conclusion Cryptococcosis occurs rarely in HIV-negative patients with DM2 and without additional risk factors. Hispanic or Latino ethnicity, uncontrolled hyperglycemia, and chronic kidney disease may increase the risk of cryptococcosis among patients with DM2. Cryptococcosis in patients whose only comorbidity is DM2 have as high of mortality as that seen with more established comorbitidies. Disclosures All Authors: No reported disclosures.

Clinical score for early diagnosis of myotonic dystrophy type 2

IntroductionMyotonic dystrophy type 2 (DM2) is a rare, multisystemic, autosomal dominant disease with highly variable clinical presentation. DM2 is considered to be highly underdiagnosed.ObjectiveThe aim of this study was to determine which symptoms, signs, and diagnostic findings in patients referred to neurological outpatient units are the most indicative to arouse suspicion of DM2. We tried to make a useful and easy-to-administer clinical scoring system for early diagnosis of DM2-DM2 early diagnosis score (DM2-EDS).Patients and methodsTwo hundred ninety-one patients with a clinical suspicion of DM2 were included: 69 were genetically confirmed to have DM2, and 222 patients were DM2 negative. Relevant history, neurological, and paraclinical data were obtained from the electronic medical records.ResultsThe following parameters appeared as significant predictors of DM2 diagnosis: cataracts (beta = 0.410, p < 0.001), myotonia on needle EMG (beta = 0.298, p < 0.001), hand tremor (beta = 0.211, p = 0.001), positive family history (beta = 0.171, p = 0.012), and calf hypertrophy (beta = 0.120, p = 0.043). In the final DM2-EDS, based on the beta values, symptoms were associated with the following values: cataracts (present 3.4, absent 0), myotonia (present 2.5, absent 0), tremor (present 1.7, absent 0), family history (positive 1.4, negative 0), and calf hypertrophy (present 1.0, absent 0). A cut-off value on DM2-EDS of 3.25 of maximum 10 points had a sensitivity of 84% and specificity of 81% to diagnose DM2.ConclusionSignificant predictors of DM2 diagnosis in the neurology outpatient unit were identified. We made an easy-to-administer DM2-EDS score for early diagnosis of DM2.

DSVRI: A PPG-Based Novel Feature for Early Diagnosis of Type-II Diabetes Mellitus

Diabetes is a group of metabolic disorders characterized by hyperglycemia caused by a deficiency in insulin production, insulin action, or both. Type-II diabetes mellitus (DM-2) complications include retinopathy, cardiovascular disorder, and diabetic neuropathy. The existing works for the diagnosis of DM-2 using photoplethysmogram (PPG) utilize several time-domain features and demographic parameters of the individuals. However, the current features do not indicate a clinical correlation between DM-2 and its functional influence on cardiovascular regulation. This work proposes a novel index, called dynamic systemic vascular resistance index (dSVRI), as a feature based on systemic vascular resistance pathology to discriminate between a healthy and diabetic subject. The discrimination ability and the diagnostic performance of the proposed dSVRI were compared with the existing time-domain PPG features and its higher derivatives. In experiments with a publicly available dataset (having 219 subjects including healthy and DM-2 individuals), an accuracy of 98.52% is obtained using grid search random forest, which is significantly higher than the existing methods.

Characterization of full-length CNBP expanded alleles in myotonic dystrophy type 2 patients by Cas9-mediated enrichment and nanopore sequencing.

Myotonic dystrophy type 2 (DM2) is caused by CCTG repeat expansions in the CNBP gene, comprising 75 to >11,000 units and featuring extensive mosaicism, making it challenging to sequence fully expanded alleles. To overcome these limitations, we used PCR-free Cas9-mediated nanopore sequencing to characterize CNBP repeat expansions at the single-nucleotide level in nine DM2 patients. The length of normal and expanded alleles can be assessed precisely using this strategy, agreeing with traditional methods, and revealing the degree of mosaicism. We also sequenced an entire ~50 kbp expansion, which has not been achieved previously for DM2 or any other repeat-expansion disorders. Our approach precisely counted the repeats and identified the repeat pattern for both short interrupted and uninterrupted alleles. Interestingly, in the expanded alleles, only two DM2 samples featured the expected pure CCTG repeat pattern, while the other seven presented also TCTG blocks at the 3' end, which have not been reported before in DM2 patients, but confirmed hereby with orthogonal methods. The demonstrated approach simultaneously determines repeat length, structure/motif, and the extent of somatic mosaicism, promising to improve the molecular diagnosis of DM2 and achieve more accurate genotype-phenotype correlations for the better stratification of DM2 patients in clinical trials.

Predictors of Early Onset Glaucoma.

Purpose/RelevanceTo determine the influence of hypertension (HTN), type 2 diabetes (DM2), migraine, and obstructive sleep apnea (OSA) on the onset of primary open-angle glaucoma (POAG) to enhance predictive accuracy.MethodsIn this cross-sectional study, data for 389 eligible patients with POAG were collected through medical records review and phone surveys. All data were assessed collectively using stepwise multiple regression analysis to determine the relative contribution to age at POAG diagnosis. We used the following groups, based on age at diagnosis, HTN for patients with or without DM2 (model 1), HTN for patients with DM2 (model 2), DM2 for patients with or without HTN (model 3), and DM2 for patients with HTN (model 4).ResultsIn model 1, age at HTN diagnosis was associated with age at POAG diagnosis (β = 0.14; 95% CI, 0.01–0.26, p = 0.04). In model 2, age at HTN diagnosis was not associated with age at POAG diagnosis (p > 0.05). In model 3, age at DM2 diagnosis was associated with age at POAG diagnosis (β = 0.37; 95% CI 0.16–0.58, p = 0.001). In model 4, age at DM2 diagnosis was associated with age at POAG diagnosis (β = 0.40; 95% CI 0.00–0.15, p = 0.003). Asian race/ethnicity was associated with early onset of POAG in model 3 (β = −6.44; 95% CI −12.34–0.54, p = 0.033). OSA and migraine did not influence the onset of POAG.ConclusionOur study found that the diagnosis of DM2 and HTN at an earlier age is associated with the early onset of POAG.

IDF21-0377 Evaluation of the glycemic profile during 6 months after hospital discharge of patients with severe COVID-19

Background: COVID-19, caused by the novel coronavirus SARS-CoV-2, has resulted in more than 206 million infections and over 4 million deaths worldwide. Among the risk factors associated with the mortality of patients with the severe form of the disease, type 2 diabetes mellitus (DM2) is included. In addition, recent-onset hyperglycemia and complications of preexisting DM2 were observed in post-infection patients, establishing a bidirectional relationship between COVID-19 and diabetes, which is not sufficiently described. Aim: To describe the clinical and glycemic evolution of patients hospitalized due to severe COVID-19 during 6 months after discharge. Method: From July to October 2020, patients of both sexes, aged between 18 and 70 years, hospitalized with COVID-19, were recruited after the end of hospitalization. A questionnaire was applied on the 30th day after discharge to assess the profile of the patients. Blood samples were taken on the 30th, 90th, and 180th days after hospital discharge and, on the 180th day, an oral glucose tolerance test (OGTT) was performed for non-diabetics in order to assess their glycemic profile. Results: 44 patients were included, with 32 (73%) men (mean age: 49 years) and 12 (27%) women (mean age: 58 years). 30 (68%) had no previous history of DM2 and 14 (32%) had this diagnosis confirmed. Assessing only the 24 patients who completed the 6-months follow-up, the mean fasting glucose (FG, mmol/L) verified on the 30th day was 6.83 and glycated hemoglobin (HbA1c) was 7.5%, while on the 90th day the FG average was 6.44 and the HbA1c was 6.8% and, finally, on the 180th day, the FG average was 6.94 and the HbA1c was 6.7%. Considering those without a previous diagnosis of DM2, 12/28 (43%) had hyperglycemia on the 30th day after hospital discharge, 7/25 (28%) on the 90th day, and 9/20 (45%) on the 180th day. Among the 16 patients who underwent OGTT, 1 (6%) had a result compatible with DM2, 4 (25%) were intolerant to insulin and 11 (69%) had normal blood glucose 2 hours after drinking the 75g glucose solution. Discussion: The prevalence of DM2 in patients with severe COVID-19 (32%) was higher than in the global population (9.3%) [4], corroborating literature data. Severe post-COVID-19 patients have hyperglycemia for more than 4 weeks, but transient, as demonstrated by the drop in HbA1c levels at 3 and 6 months and by the normal OGTT found in more than 50% of non-diabetic patients. The increase in the mean FG on the 180th day may be a result of the small number of patients at the end of the study.

Evaluation of microvascular density and retinal vessel diameter in gestational and type 2 diabetes using swept-source OCT-A technology

To assess foveal and parafoveal retinal and choroidal microvascular changes using optical coherence tomography angiography (OCTA) and changes in retinal vessel caliber in pregnant women with gestational diabetes mellitus (GDM), non-pregnant female patients with type 2 diabetes mellitus (DM2), and healthy pregnant female subjects. The study was conducted cross-sectionally and composed of three age-matched groups: 32 near-term pregnant women with GDM (GDM group), 32 non-pregnant female patients with a recent diagnosis of DM2 (DM2 group), and 32 healthy near-term pregnant female subjects. Vessel density (VD) and vessel diameter were the main outcomes. Detailed ophthalmic examinations were performed for each participant, including swept-sourceOCTA measurements consisting of superficial, deep, outer retinal and choroidal vessel density. The average VD values in the central fovea of the superficial and deep retina were significantly lower in the GDM group (P=0.001 for both, between the three groups), whereas the mean VD in the parafoveal nasal sector of the deep retina was significantly lower in the DM2 group (P=0.008, between the three groups). There were no significant differences in the foveal or parafoveal VD measurements of the outer retina and choriocapillaris (P>0.05 for all). There were statistically significant differences in the retinal venous diameter and arterial vein ratio in the GDM and DM2 groups compared to the control group (P=0.001 for all). The microvascular density changes seen on OCTA images of pregnant women with GDM are remarkable. These changes in retinal vessels appeared to occur rapidly after the onset of the metabolic impairment or might be the reflection of previous insulin resistance as well, as in recent diabetes. Our results also suggest that these changes may be more significant in a GDM pregnant woman than in a pregnant, established diabetic patient.

Screening for diabetes and prediabetes: the newest communication opportunities

Type 2 diabetes mellitus (DM-2) and prediabetes are serious diseases that can lead to early disability and death. DM-2 can remain undiagnosed for many years; therefore, screening is one of the main assistants of a doctor in establishing a diagnosis, allowing to start treatment as early as possible.Research objective: early identification of patients with prediabetes and DM-2 using an online questionnaire.Materials and methods. The study was carried out online using the Google Forms platform, where a questionnaire was created based on Appendix 3 “Form of risk assessment of diabetes mellitus-2” of the Unified clinical protocol of primary and secondary (specialized) medical care “Type 2 diabetes mellitus”, approved by order of the Ministry of Health of Ukraine No. 1118 dated 12.21.2012, as well as additional questions on nutrition and physical activity. As of June 2021, the study involved 209 patients (151 women and 58 men) who did not have a documented diagnosis of DM-2 or prediabetes.Results. Most of the respondents (89 people) were overweight. 51 respondents had grade I obesity, 31 respondents had grade II, and 7 patients had a body mass index &gt; 40 kg/m2, which corresponds to grade III obesity. Only 49 respondents had a healthy weight, which corresponds to a body mass index 18.5–24.9 kg/m2. 29 (19.21%) women had a history of childbirth with a child weighing more than 4 kg. The diagnosis of polycystic ovary disease (a risk factor for the DM-2) was in 34 (22.52%) women. Upon receipt of laboratory tests, we established a diagnosis of prediabetes in 28 (13.40%) patients, and a diagnosis of DM-2 in 17 (8.13%) people.Conclusions. It is necessary to search for new opportunities in communicating with patients during the COVID-19 pandemic, one of which is online questionnaires based on regulatory documents.

Type 2 diabetes mellitus in children and adolescents in the world and in Ukraine

Introduction. Recently, many studies have been devoted to the study of type 2 diabetes mellitus (DM2) worldwide. In most countries of the world, the increase in the prevalence of DM2 among children and adolescents is accompanied by an increase in childhood obesity. The presence of obesity or overweight in children can complicate the diagnosis of various types of DM. Detection and treatment of DM2 is extremely important for the society due to the wide range of severe diabetes complications.The aim of this work was to analyze the frequency of DM2 according to the Register of patients with DM, and to determine the state of glycemic control in children with DM2. Materials and methods. An analysis of glycemic control in children with DM2 who received various treatment regimens: with diet and lifestyle modifications, or with additional oral hypoglycemic agents (metformin monotherapy, or combination with insulin therapy). The glycemic control was assessed by measurement of glycated hemoglobin (HbA1c) level. Results. According to the data Register in Ukraine, the prevalence of DM among children has a tendency to rise — from 8.6 per 10 thousand children in 2005, to 13.14 — in 2019 year. The prevalence of DM2 in 2019 was 0.47 % of all cases of DM, and its prevalence contained 0.062 per 10 thousand children under 19 years of age with significant differences in the frequency of its diagnosis in different regions of Ukraine. We analyzed the state of glycemic control in children with DM2 aged from 9 up to 19 years old (Me 16.2 [15.5; 18.0]), with a disease duration 0.5—12 years (Me 4.5 [1.0] ; 7.5]). The age of diagnosis of DM2 was 2-17 years old (Me 11.7 [8.5; 15.0]), and 91.3 % of patients had obesity. Diet and lifestyle modifications were used in 34.8 % of patients, metformin monotherapy in 52.2 %, and metformin and insulin combination therapy in 13 % of patients. HbA1c values ​​ranged from 5.0 to 11.4 % (Me 7.2 % [5,8; 8,0]). The proportion of children who had ideal or optimal glycemic control (HbA1c 7.0—7.5 %) was 52.2 %, suboptimal (HbA1c 7.6—9.0 %) — 39.1 %, high-risk glycemic control (HbA1c&gt; 9.1 %) — 8.7 % of children. The most unsatisfactory HbA1c levels ​​were registered in children who received metformin in combination with insulin (Me 10.6 % [10,15; 11,4]). Chronic complications of DM2 have not been reported.Conclusions. We found a low prevalence of DM2 among the pediatric population in Ukraine, more likely due to the low quality of its detection among children diagnosed with DM, as well as among children among high risk groups. Most children with DM 2 were obese. The majority of patients with DM2 (52.2 %) received metformin monotherapy, more than a third did not receive oral hypoglycemic agents. In most children with DM2 (52,2 %), the state of glycemic control corresponded to the optimal (&lt; 7.5 %), but higher levels of HbA1c were found children who received metformin in combination with insulin.

Экономический эффективная модель скрининга сахарного диабета 2-го типа В Республике Узбекистан

Epidemiological studies revealed up to 5-6 undiagnosed cases of type 2 diabetes mellitus (DM2) per 1 registered patient. The late diagnosis of DM2 presents a medical and socio-economic problem. Aim. To identify the most cost-effective, easy-to-use method for regular screening for DM2 in primary care settings in the Republic of Uzbekistan. Material and methods. 4 diabetes screening scenarios differing in the inclusion criteria (age 45 vs age 45 plus arterial hypertension plus obesity), and screening methods (testing for glycemia and/or HbA1c) were studied in urban and rural primary care polyclinics among 2430 people. Results. In primary health care real clinical practice, the most cost-effective and easy-to-follow strategy for active screening for DM2 is testing for random glycemia using a certified glucometer, in any resident aged 45 or older visiting his/her GP for any reason. If test results are intermediate, the person is called again the next day for fasting glycemia testing to confirm the diagnosis. If the test results are normal, the person is given recommendations of healthy lifestyle and re-testing in 1 year. If the test result corresponds to DM, the person is referred to a local endocrinologist.

Clinical Characteristics and Outcomes Among COVID 19 Hospitalized Patients in a Community Hospital in New York City

Background: COVID-19 has disproportionally affected communities of color in the US. These communities exhibit higher prevalence of chronic preventable disease including type 2 diabetes mellitus (DM2) and obesity. DM2 and obesity have been linked to higher morbidity and mortality in the setting of COVID-19 infection (1). Methods: We query data collected from 521 patients with laboratory-confirmed Covid-19 infection admitted to an inner-city community hospital in Brooklyn, New York between March 20 2020 and May 15 2020. Demographics, pre-infection medical comorbidities, laboratory data at admission and clinical outcomes including in-hospital mortality were analyzed. Results: Patients were 61 years on average (+/-17.2), 42.8% were female, 53.9% were Hispanic and 33% were African-American. Most common comorbidities included: hypertension (62%), chronic kidney disease (20.8%), diabetes (45 %). Mean BMI was 29.9 (+/- 8.2). Among patients with no prior diagnosis of diabetes mean A1c was 5.8% (+/-1.2) and 8.7 (+/-2.5) amongst those with a previous diagnosis of diabetes. Patients hospitalized with moderate to severe COVID-19 infection and a previous diagnosis of DM2 had significantly higher prevalence of CKD and HTN. Amongst those with T2DM, 19.1% presented with DKA. After adjustment for age, gender, race, BMI and creatinine obese patients, compared with normal-weight patients had significantly higher mortality rate (BMI > 30 kg/m2 [OR: 2.29, CI: 95%, P-value: <0.002]) however this association was not observed for DM2 ([OR: 1.25, CI: 95%, P-value: <0.002]). Conclusion: Our cohort represents a particular population affected by the first wave of Covid-19 infection in an urban inner-city community in NYC. The population studied had a larger proportion of African-American, Hispanic and younger patients compared to national averages; these differences are related to the demographics of the communities served by our hospital. Obesity is a negative prognostic factor in the course of Covid-19 infection in comparison to normal-weight patients. Obesity is a proinflammatory condition, associated with high levels of prothrombotic factors including angiotensin-II, also elevated in COVID-19. Understanding that link may yield valuable knowledge on the role obesity plays in numerous disease states beyond COVID-19.

Comparación de parámetros metabólicos en pacientes adultos y ancianos sometidos a cirugía bariátrica: Una cohorte prospectiva

Introducción: El Objetivo fue evaluar los parámetros metabólicos en pacientes adultos ≥ 65 años en comparación con adultos &lt; 65 años sometidos a CB pre y post intervención.Materiales y métodos: Estudio analítico de cohorte prospectiva en 40 pacientes sometidos a CB durante el periodo julio de 2015 y marzo de 2018. Los pacientes fueron divididos en dos grupos (A: ≥65 años; B: &lt; 65 años) y se evaluaron previo a la cirugía (basal), y a los 3 y 6 meses posteriores al acto quirúrgico parámetros antropométricos y parámetros bioquímicos. Se calculó el porcentaje de peso perdido (PEPP) y se evaluó el índice Triglicéridos/HDLc (TAG/HDLc) como marcador de insulinorresistencia.Resultados: De los 40 pacientes sometidos a la CB, se incluyeron 36: 21 pacientes eran del grupo A (mediana de edad: 59, RIQ: 48-61 años) y 15 pacientes del grupo B (mediana de edad: 67, RIQ: 66-69 años), el porcentaje de pacientes con diabetes mellitus tipo 2 era de 53%(n=8) en B vs 43% (n=9) en A. Luego de 3 y 6 meses post CB se observó en el grupo B un descenso en el peso, índice de masa corporal y porcentaje de exceso de peso perdido (PEPP) no significativo, disminución en los niveles de glucemia y HbA1c sumado a un aumento significativo en los niveles de HDLc, además de un descenso significativo del índice TAG/HDLc en el grupo B. Se encontró una correlación positiva entre los niveles de HbA1c y PEPP, HDLc y el índice TAG/HDLc así como el descenso del uso de antidiabéticos e hipolipemiantes en el grupo B. Conclusiones: la CB logró similares resultados antropométricos en el grupo de pacientes ≥ de 65 años presentando una mejoría significativa en los paramétricos metabólicos a los 3 y 6 meses, principalmente en la insulinorresistencia, lo cual apoyaría el beneficio de la CB en este grupo etario.

Genetic and pathophysiological substantiation of polyphenolic grape processing products’ application in the treatment of metabolic syndrome in the population of the Republic of Crimea

Adipose tissue in abdominal obesity produces various cytokines, the most important of which is adiponectin (AN). Polymorphism of the AN receptor genes is associated with the risk of metabolic syndrome (MS) and type 2 diabetes mellitus (DM2) development. The aim of the study was to investigate the association of AN genes receptors’ polymorphism with the development of MS and DM2 in the Republic of Crimea as well as the possibility of named pathology correction with polyphenolic functional foods. The study included 100 patients with confirmed diagnosis of DM2 and MS. Genomic DNA was isolated from the whole blood of patients. Gene polymorphism amplification was performed by PCR real-time. The most common genotype of the ADIPOQ gene (rs1501299) among patients with DM2 and MS was GT polymorphism G276T. The most frequent genotypes of the ADIPOR1 gene were AC (rs2275737) – 53.3% and CT (rs2275738) - 50.0%. The most frequent combinations between ADIPOR1 and ADIPOQ genes were AC (rs2275737) /CT (rs2275738) and GT (rs1501299) – 28.6%, as well as AC (rs2275737)/CT (rs2275738) and GG (rs1501299) – 19.7%. Thus, in patients with MS and DM2 in the Republic of Crimea, associations of polymorphism of the genes of the AN receptors with the development of this pathology have been established. It is known that polyphenols of red grape varieties are epigenetic modifiers. Therefore, these products can be included in individual nutrition programs in population groups genetically predisposed to MS and DM2.

Распространенность сахарного диабета 2 типа среди взрослого населения Цхинвала

Summary: аssessment of the prevalence of type 2 diabetes mellitus (DM2) in the adult population of Tskhinval, Republic of South Ossetia. Material and methods. The outpatient records of 811 patients registered with the endocrinologist of the municipal polyclinic with a diagnosis of DM2 were analyzed. The study took into account outpatient records of 478 women and 333 men. To obtain a representative sample, patients (aged 38 to 93 years) were stratified by age, gender, and body mass index. The level of glycemia and the year of occurrence in the initial setting of DM2 were also taken into account. Results. The average age at the diagnosis of DM2 in women was higher than in men (62 and 57 years, respectively). The prevalence of DM2 in relation to gender was higher in women than in men (59 and 41%). At the age of 51–58 years, the largest number of newly detected cases of DM2 was observed. Conclusions. The prevalence of DM2 among the population of Tskhinval is 4.4%. Given the data from the NATION study that only 54% of cases of DM2 are diagnosed, the number of patients with DM2 in Tskhinval may be about 2.5 thousand people (about 8.1% of the urban population). The obtained data should form the basis of the service for medical examination of the population, prevention and treatment of DM2 in the Republic of South Ossetia

Blood Biochemical Parameters In Yakut Women With Type 2 Diabetes Mellitus Versus Their Somatotypes

Objective — Investigating the features of blood biochemical parameters in patients with type 2 diabetes mellitus (DM2), depending on the somatotype sensu the Rees-Eysenck body index. Material and methods — We examined 88 women of Yakut nationality (39-74 years old) with an established diagnosis of DM2. An anthropometric examination with consequent somatotyping according to the Rees-Eysenck body index, along with determination of BMI were carried out. The biochemical blood test results were copied from the anamneses of female subjects. Statistical analysis was performed using the SPSS Statistics software package for Windows (version 17). Methods of parametric and nonparametric statistics were used. Results — We established that the anthropometric parameters and BMI of women with DM2 were significantly higher. According to the BMI gradation, obesity was more common in people with DM2. The results of somatotyping implied that 11.4%, 50.0% and 38.6%of the examined women belonged to the asthenic, normosthenic and pyknic somatotypes, correspondingly. The distribution of somatotypes among women with DM2 differed from the general population distribution in a smaller fraction of individuals with asthenic somatotype. Blood biochemical parameters in subjects with asthenic body type were within the reference limits (except for glucose), in contrast to those of women with other somatotypes. Conclusion — Women with asthenic somatotype are less at risk of developing DM2. Even if the ailment develops, their blood biochemical parameters remain within reference limits, with the exception of glucose.

SYSTEMATIZATION OF NURSING ASSISTANCE TO PATIENTS WITH DIABETES MELLITUS TYPE 2: EXPERIENCE REPORT

Introduction Type 2 Diabetes Mellitus (DM2) is the form found in 90 to 95% of diabetes cases characterized by defects in the action and secretion of insulin and in the regulation of hepatic glucose production. Insulin resistance and functional defect of beta cells appear early in the preclinical phase of the disease. Obesity is the main risk factor for triggering this pathology, considering that, in these cases, insulin resistance is usually the consequence. From this perspective, Systematization of Nursing Assistance (SNA) is essential for the care of patients with a diagnosis of DM2, as it ensures the promotion of systematic and continuous assistance, thus constituting a basis for selection for care interventions. Objective To analyze the importance of Systematization of Nursing Assistance in health promotion for patients with Diabetes Mellitus Type 2. Methodology Descriptive study of the experience report type, conducted from the academic experience in supervised curricular internship, from the Adult and Elderly Health discipline in Primary Care, with home visits together with the Family Health Strategy Team in municipality of Recife – PE, in June 2019. Results With the practice of care planning from SNA, in DM2, it was possible to reach the following Nursing Process implementations: NANDA: Impaired skin integrity related to injury in the left lower limb evidenced by pain and loss of skin continuity after debridement. Nursing Outcomes Classification (NOC): Will have wound healing in a timely manner without complications. Nursing Interventions Classification (NIC): Check for general weakness associated with chronic disease. NANDA – Risk of falls related to visual impairment and difficulty walking. NOC – Verbalizes that understands the personal risk factors that contribute to the risk of falling. NIC – Assess the general health status of the individual, paying attention to factors that may compromise safety, including chronic disorders. Conclusions/Considerations: In this context, the importance of Nursing Systematization is noteworthy, since it can be applied in various areas of nursing practice, concretizing nursing care through scientific bases, granting greater credibility and autonomy to the professional. It also provides the patient with holistic care through various pathological contexts.