Global Prevalence Of Diabetes Research Articles

Computational Simulation Studies, Synthesis, In Vitro, and In Vivo Evaluation of Heterocyclically Substituted Glycinamide Derivatives as DPP 4 Inhibitors

AbstractAccording to the International Diabetes Federation, the global prevalence of diabetes is projected to increase to 643 million individuals by 2030 and 783 million by 2045. DPP 4 inhibitors approved by regulatory authorities worldwide, efficiently to regulate high blood sugar levels by impeding the degradation of glucagon like peptide‐1 (GLP‐1), an incretin hormone, prolonging the physiological effects of GLP‐1. In the present research work, a total of 12 glycinamide‐based compounds with aromatic substituents on the N‐terminus and heterocycles like piperidine, 4‐phenylpiperazine, and 6‐fluorobenzo[d]isoxazol‐3‐piperidine on the C‐terminus were synthesized and characterized. The synthesized compounds were subjected to in vitro DPP 4 inhibition assay. The promising compound JAG‐D2 was evaluated in vivo using OGTT assay in streptozotocin‐induced diabetic rats. JAG‐D2 produced a significant reduction in blood glucose levels at 20 mg/kg and 40 mg/kg doses when compared with a 1 mg/kg dose of the reference standard sitagliptin. The synthesized compounds occupied the active site of DPP 4 as demonstrated in molecular docking and MM‐GBSA analysis for rescoring on the basis of binding free energy. Molecular dynamics studies displayed the stability of the docked pose of JAG‐D2 in the catalytic site of DPP 4. All compounds exhibited compliance with Lipinski's rule of five, suggesting drug‐like properties.

The role of microRNAs in pregnancies complicated by maternal diabetes.

With the global prevalence of diabetes increasing, more people of reproductive age are experiencing hyperglycaemic pregnancies. Maternal Type 1 (T1DM) or Type 2 (T2DM) diabetes mellitus, and gestational diabetes mellitus (GDM) are associated with maternal cardiovascular and metabolic complications. Pregnancies complicated by maternal diabetes also increase the risk of short- and long-term health complications for the offspring, including altered fetal growth and the onset of T2DM and cardiometabolic diseases throughout life. Despite advanced methods for improving maternal glucose control, the prevalence of adverse maternal and offspring outcomes associated with maternal diabetes remains high. The placenta is a key organ at the maternal-fetal interface that regulates fetal growth and development. In pregnancies complicated by maternal diabetes, altered placental development and function has been linked to adverse outcomes in both mother and fetus. Emerging evidence suggests that microRNAs (miRNAs) are key molecules involved in mediating these changes. In this review, we describe the role of miRNAs in normal pregnancy and discuss how miRNA dysregulation in the placenta and maternal circulation is associated with suboptimal placental development and pregnancy outcomes in individuals with maternal diabetes. We also discuss evidence demonstrating that miRNA dysregulation may affect the long-term health of mothers and their offspring. As such, miRNAs are potential candidates as biomarkers and therapeutic targets in diabetic pregnancies at risk of adverse outcomes.

A wireless, battery-free microneedle patch with light-cured swellable hydrogel for minimally-invasive glucose detection

The escalating global prevalence of diabetes necessitates the development of advanced diagnostic methodologies that are both minimally invasive and devoid of discomfort. This study introduces a wireless battery-free passive microneedle patch with CMC-pHEA GelMA-GOx (CMC: sodium carboxymethyl cellulose; pHEA: polyethylene glycol diacrylate, 2-hydroxyethyl acrylate; GelMA: gelatin methacryloyl; GOx: glucose oxidase) light-cured swellable hydrogel for minimally-invasive glucose detection. The core of this technology combines microneedle with Radio-Frequency (RF) coupling detection, achieving extraction capacity; the microneedle lies in the use of composite hydrogel composed of a freeze-dried CMC-pHEA nanogel and GelMA-GOx, specifically fabricated to be selectively glucose-responsive through cross-linking with glucose oxidase. Upon exposure to interstitial fluid, the hydrogel microneedles swell in proportion to the glucose concentration, enabling glucose binding and facilitating the detection process. A flexible antenna, which is integral to the microneedle substrate as a passive sensing component, detects changes in the swelling of the hydrogel; these are reflected in the RF parameters (frequency, magnitude) variations, which are directly correlated with glucose levels. Furthermore, the results are near field wirelessly detected through a readout coil, simplifying sensing patch configurations. This method not only integrates the glucose monitoring process by combining extraction and detection into a single step but also enhances patient comfort. The platform’s sensitivity, specificity, and minimal invasiveness make it a promising tool for diabetes management and continuous glucose monitoring. By demonstrating the successful application of RF technology in wireless sensing applications, this study paves the way for advanced, user-friendly glucose monitoring solutions.

Extracellular signal-regulated kinase is activated in podocytes from patients with diabetic nephropathy.

In the past few decades, the global prevalence of diabetes has provided us with a warning about future chronic complications. Diabetic nephropathy (DN) is the main cause of end-stage kidney disease. Podocytes in the glomerulus play a critical role in regulating glomerular permeability, and podocyte injury is one of the main causes of DN. Extracellular signal-regulated kinase (ERK) is a member of the mitogen-activated protein kinase family that plays critical roles in intracellular signal transduction. In human patients with DN, phosphorylated ERK (pERK), the active form of ERK, is increased in the glomeruli. However, information on the expression of pERK, specifically in podocytes in DN, is limited. Meanwhile, high glucose induces ERK activation in immortalized podocyte cell lines, suggesting the involvement of podocytic ERK in DN. We performed an immunohistochemical study using Wilms' tumor-1 (WT-1) as a podocyte-specific marker to investigate whether podocytic pERK levels are increased in patients with DN. In the glomeruli of the DN group, we observed remarkable co-staining for WT-1 and pERK. In contrast, the glomeruli of the control group contained only a few pERK-positive podocytes. Statistical analyses revealed that, relative to healthy controls, patients with DN showed significantly increased pERK expression levels in cells that were positive for WT-1 (DN: 51.3 ± 13.1% vs. control: 7.3 ± 1.6%, p = 0.0158, t-test, n = 4 for each group). This suggests that ERK activation in podocytes is involved in the pathogenesis of DN.

Preclinical Evaluation of Sigma 1 Receptor Antagonists as a Novel Treatment for Painful Diabetic Neuropathy.

The global prevalence of diabetes is steadily rising, with an estimated 537 million adults affected by diabetes in 2021, projected to reach 783 million by 2045. A severe consequence of diabetes is the development of painful diabetic neuropathy (PDN), afflicting approximately one in every three diabetic patients and significantly compromising their quality of life. Current pharmacotherapies for PDN provide inadequate pain relief for many patients, underscoring the need for novel treatments that are both safe and effective. The Sigma 1 Receptor (S1R) is a ligand-operated chaperone protein that resides at the mitochondria-associated membrane of the endoplasmic reticulum. The S1R has been shown to play crucial roles in regulating cellular processes implicated in pain modulation. This study explores the potential of PW507, a novel S1R antagonist, as a therapeutic candidate for PDN. PW507 exhibited promising in vitro and in vivo properties in terms of ADME, toxicity, pharmacokinetics, and safety. In preclinical rat models of Streptozotocin-induced diabetic neuropathy, PW507 demonstrated significant efficacy in alleviating mechanical allodynia and thermal hyperalgesia following both acute and chronic (2-week) administration, without inducing tolerance and visual evidence of toxicity. To the best of our knowledge, this is the first report to evaluate an S1R antagonist in STZ-induced diabetic rats following both acute and 2-week chronic administration, offering compelling preclinical evidence for the potential use of PW507 as a promising therapeutic option for PDN.

Contextual awareness, response and evaluation (CARE) of diabetes in poor urban communities in Ghana: the CARE diabetes project qualitative study protocol

ABSTRACT Diabetes remains a major, global clinical and public health threat with consistent rises in prevalence around the world over the past four decades. Two-thirds of the projected increases in global diabetes prevalence to 2045 are expected to come from low- and middle-income countries, including those in sub-Saharan Africa. Ghana is typical of this trend. However, there are gaps in evidence regarding the appropriate development of interventions and well-targeted policies for diabetes prevention and treatment that pay due attention to relevant local conditions and influences. Due consideration to community perspectives of environmental influences on the causes of diabetes, access to appropriate health services and care seeking for diabetes prevention and management is warranted, especially in urban settings. The ‘Contextual Awareness, Response and Evaluation (CARE): Diabetes in Ghana’ project is a mixed methods study in Ga Mashie, Accra. An epidemiological survey is described elsewhere. Six qualitative studies utilising a range of methodologies are proposed in this protocol to generate a contextual understanding of type 2 diabetes mellitus in an urban poor population. They focus on community, care provider, and policy stakeholder perspectives with a focus on food markets and environmental influences, the demand and supply of health services, and the history of the Ga Mashie community and its inhabitants. The results will be shared with the community in Ga Mashie and with health policy stakeholders in Ghana and other settings where the findings may be usefully transferable for the development of community-based interventions for diabetes prevention and control.

Advances in Nanomedicine for Precision Insulin Delivery.

Diabetes mellitus, which comprises a group of metabolic disorders affecting carbohydrate metabolism, is characterized by improper glucose utilization and excessive production, leading to hyperglycemia. The global prevalence of diabetes is rising, with projections indicating it will affect 783.2 million people by 2045. Insulin treatment is crucial, especially for type 1 diabetes, due to the lack of β-cell function. Intensive insulin therapy, involving multiple daily injections or continuous subcutaneous insulin infusion, has proven effective in reducing microvascular complications but poses a higher risk of severe hypoglycemia. Recent advancements in insulin formulations and delivery methods, such as ultra-rapid-acting analogs and inhaled insulin, offer potential benefits in terms of reducing hypoglycemia and improving glycemic control. However, the traditional subcutaneous injection method has drawbacks, including patient compliance issues and associated complications. Nanomedicine presents innovative solutions to these challenges, offering promising avenues for overcoming current drug limitations, enhancing cellular uptake, and improving pharmacokinetics and pharmacodynamics. Various nanocarriers, including liposomes, chitosan, and PLGA, provide protection against enzymatic degradation, improving drug stability and controlled release. These nanocarriers offer unique advantages, ranging from enhanced bioavailability and sustained release to specific targeting capabilities. While oral insulin delivery is being explored for better patient adherence and cost-effectiveness, other nanomedicine-based methods also show promise in improving delivery efficiency and patient outcomes. Safety concerns, including potential toxicity and immunogenicity issues, must be addressed, with the FDA providing guidance for the safe development of nanotechnology-based products. Future directions in nanomedicine will focus on creating next-generation nanocarriers with precise targeting, real-time monitoring, and stimuli-responsive features to optimize diabetes treatment outcomes and patient safety. This review delves into the current state of nanomedicine for insulin delivery, examining various types of nanocarriers and their mechanisms of action, and discussing the challenges and future directions in developing safe and effective nanomedicine-based therapies for diabetes management.

Sex differences in risk of incident microvascular and macrovascular complications: a population-based data-linkage study among 25 713 people with diabetes

BackgroundThe global prevalence of diabetes is similar in men and women; however, there is conflicting evidence regarding sex differences in diabetes-related complications. The aim of this study was to investigate...

Preclinical pharmacokinetics, pharmacodynamics, and toxicity of novel small-molecule GPR119 agonists to treat type-2 diabetes and obesity

The escalating global prevalence of type-2 diabetes (T2D) and obesity necessitates the development of novel oral medications. Agonism at G-protein coupled receptor-119 (GPR119) has been recognized for modulation of metabolic homeostasis in T2D, obesity, and fatty liver disease. However, off-target effects have impeded the advancement of synthetic GPR119 agonist drug candidates. Non-systemic, gut-restricted GPR119 agonism is suggested as an alternative strategy that may locally stimulate intestinal enteroendocrine cells (EEC) for incretin secretion, without the need for systemic drug availability, consequently alleviating conventional class-related side effects. Herein, we report the preclinical acute safety, efficacy, and pharmacokinetics (PK) of novel GPR119 agonist compounds ps297 and ps318 that potentially target gut EEC for incretin secretion. In a proof-of-efficacy study, both compounds demonstrated glucagon-like peptide-1 (GLP-1) secretion capability during glucose and mixed-meal tolerance tests in healthy mice. Furthermore, co-administration of sitagliptin with investigational compounds in diabetic db/db mice resulted in synergism, with GLP-1 concentrations rising by three-fold. Both ps297 and ps318 exhibited low gut permeability assessed in the in-vitro Caco-2 cell model. A single oral dose PK study conducted on healthy mice demonstrated poor systemic bioavailability of both agents. PK measures (mean ± SD) for compound ps297 (Cmax 23 ± 19 ng/mL, Tmax range 0.5 – 1 h, AUC0–24 h 19.6 ± 21 h*ng/mL) and ps318 (Cmax 75 ± 22 ng/mL, Tmax range 0.25 – 0.5 h, AUC0–24 h 35 ± 23 h*ng/mL) suggest poor oral absorption. Additionally, examinations of drug excretion patterns in mice revealed that around 25 % (ps297) and 4 % (ps318) of the drugs were excreted through faeces as an unchanged form, while negligible drug concentrations (<0.005 %) were excreted in the urine. These acute PK/PD assessments suggest the gut is a primary site of action for both agents. Toxicity assessments conducted in the zebrafish and healthy mice models confirmed the safety and tolerability of both compounds. Future chronic in-vivo studies in relevant disease models will be essential to confirm the long-term safety and efficacy of these novel compounds.

Diabetic Retinopathy: New Treatment Approaches Targeting Redox and Immune Mechanisms.

Diabetic retinopathy (DR) represents a severe complication of diabetes mellitus, characterized by irreversible visual impairment resulting from microvascular abnormalities. Since the global prevalence of diabetes continues to escalate, DR has emerged as a prominent area of research interest. The development and progression of DR encompass a complex interplay of pathological and physiological mechanisms, such as high glucose-induced oxidative stress, immune responses, vascular endothelial dysfunction, as well as damage to retinal neurons. Recent years have unveiled the involvement of genomic and epigenetic factors in the formation of DR mechanisms. At present, extensive research explores the potential of biomarkers such as cytokines, molecular and cell therapies, antioxidant interventions, and gene therapy for DR treatment. Notably, certain drugs, such as anti-VEGF agents, antioxidants, inhibitors of inflammatory responses, and protein kinase C (PKC)-β inhibitors, have demonstrated promising outcomes in clinical trials. Within this context, this review article aims to introduce the recent molecular research on DR and highlight the current progress in the field, with a particular focus on the emerging and experimental treatment strategies targeting the immune and redox signaling pathways.

Exploratory insights into prefrontal cortex activity in continuous glucose monitoring: findings from a portable wearable functional near-infrared spectroscopy system.

The escalating global prevalence of diabetes highlights an urgent need for advancements in continuous glucose monitoring (CGM) technologies that are non-invasive, accurate, and user-friendly. Here, we introduce a groundbreaking portable wearable functional near-infrared spectroscopy (fNIRS) system designed to monitor glucose levels by assessing prefrontal cortex (PFC) activity. Our study delineates the development and application of this novel fNIRS system, emphasizing its potential to revolutionize diabetes management by providing a non-invasive, real-time monitoring solution. Fifteen healthy university students participated in a controlled study, where we monitored their PFC activity and blood glucose levels under fasting and glucose-loaded conditions. Our findings reveal a significant correlation between PFC activity, as measured by our fNIRS system, and blood glucose levels, suggesting the feasibility of fNIRS technology for CGM. The portable nature of our system overcomes the mobility limitations of traditional setups, enabling continuous, real-time monitoring in everyday settings. We identified 10 critical features related to blood glucose levels from extensive fNIRS data and successfully correlated PFC function with blood glucose levels by constructing predictive models. Results show a positive association between fNIRS data and blood glucose levels, with the PFC exhibiting a clear response to blood glucose. Furthermore, the improved regressive rule principal component analysis (PCA) method outperforms traditional PCA in model prediction. We propose a model validation approach based on leave-one-out cross-validation, demonstrating the unique advantages of K-nearest neighbor (KNN) models. Comparative analysis with existing CGM methods reveals that our paper's KNN model exhibits lower RMSE and MARD at 0.11 and 8.96%, respectively, and the fNIRS data were highly significant positive correlation with actual blood glucose levels (r = 0.995, p < 0.000). This study provides valuable insights into the relationship between metabolic states and brain activity, laying the foundation for innovative CGM solutions. Our portable wearable fNIRS system represents a significant advancement in effective diabetes management, offering a promising alternative to current technologies and paving the way for future advancements in health monitoring and personalized medicine.

FACTORS ASSOCIATED WITH INCIDENCE OF DIABETES MELLITUS IN INTERNAL DISEASE POLY BUDI LESTARI BEKASI HOSPITAL

Introduction: The World Health Organization (WHO) states, the number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years has increased from (4.7%) in in 1980 to (8.5%) in 2014. Diabetes prevalence is increasing faster in middle and low income countries. In 2015, an estimated 1.6 million deaths were directly caused by Diabetes. 2.2 million other deaths were caused by high blood glucose in 2012. Nearly half of all deaths due to high blood glucose occurred before the age of 70 years. Research Objectives : To determine the factors related to the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Bekasi Hospital in 2019. Research Methods : This research method uses Analytical Quantitative Design with Cross Sectional Approach, with Independent Variables, Heredity, Diet and Sports Habits while the Dependent Variable is Diabetes Mellitus, with a population of 300 patients during the last 6 months July-December 2019, for sampling using accidental sampling as many as 35 respondents, the type of statistical test used is chi square. Research Results : The results showed that there was a significant relationship between heredity, diet, exercise habits with the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Hospital in Bekasi with a P.Value value of 0.014 or P.Value ≤  (0.05) with OR (Odds Ratio) = 0.050. Suggestion : It is expected that hospitals can provide maximum health services for patients seeking treatment and input for nurses in providing health education to patients with Diabetes Mellitus about Factors Related to Diabetes Mellitus.

Combination therapy for kidney disease in people with diabetes mellitus.

Diabetic kidney disease (DKD), defined as co-existing diabetes and chronic kidney disease in the absence of other clear causes of kidney injury, occurs in approximately 20-40% of patients with diabetes mellitus. As the global prevalence of diabetes has increased, DKD has become highly prevalent and a leading cause of kidney failure, accelerated cardiovascular disease, premature mortality and global health care expenditure. Multiple pathophysiological mechanisms contribute to DKD, and single lifestyle or pharmacological interventions have shown limited efficacy at preserving kidney function. For nearly two decades, renin-angiotensin system inhibitors were the only available kidney-protective drugs. However, several new drug classes, including sodium glucose cotransporter-2 inhibitors, a non-steroidal mineralocorticoid antagonist and a selective endothelin receptor antagonist, have now been demonstrated to improve kidney outcomes in people with type 2 diabetes mellitus. In addition, emerging preclinical and clinical evidence of the kidney-protective effects of glucagon-like-peptide-1 receptor agonists has led to the prospective testing of these agents for DKD. Research and clinical efforts are geared towards using therapies with potentially complementary efficacy in combination to safely halt kidney disease progression. As more kidney-protective drugs become available, the outlook for people living with DKD should improve in the next few decades.

Global Prevalence and Mortality of Type-2 Diabetes from 1990 to 2019, with Future Projections to 2023 and 2050: a Systematic Review

Type-2 diabetes (T2DM) is a key public health issue due to its high prevalence and mortality rate. This review estimates future global trends in T2DM prevalence and mortality using the Forecast exponential smoothing (ETS) model. By 2050, estimated prevalence and mortality for all ages are 10.23% and 2.05 million, respectively, and for adults (&gt;20 years) are 11.97% and 1.9 million. Obesity and high BMI are key risk factors. Mortality is higher in adults due to polypharmacy and complications. T2DM prevalence and mortality will continue to rise alarmingly. Urgent international and national measures are needed to address this burden. Collaboration between researchers, clinicians, and policymakers is crucial for optimal health planning and mitigating the impact of T2DM

Protective Effect of Pemafibrate Treatment against Diabetic Retinopathy in Spontaneously Diabetic Torii Fatty Rats.

Diabetic retinopathy (DR) can cause visual impairment and blindness, and the increasing global prevalence of diabetes underscores the need for effective therapies to prevent and treat DR. Therefore, this study aimed to evaluate the protective effect of pemafibrate treatment against DR, using a Spontaneously Diabetic Torii (SDT) fatty rat model of obese type 2 diabetes. SDT fatty rats were fed either a diet supplemented with pemafibrate (0.3 mg/kg/day) for 16 weeks, starting at 8 weeks of age (Pf SDT fatty: study group), or normal chow (SDT fatty: controls). Normal chow was provided to Sprague-Dawley (SD) rats (SD: normal controls). Electroretinography (ERG) was performed at 8 and 24 weeks of age to evaluate the retinal neural function. After sacrifice, retinal thickness, number of retinal folds, and choroidal thickness were evaluated, and immunostaining was performed for aquaporin-4 (AQP4). No significant differences were noted in food consumption, body weight, or blood glucose level after pemafibrate administration. Triglyceride levels were reduced, and high-density lipoprotein cholesterol levels were increased. Extension of oscillatory potential (OP)1 and OP3 waves on ERG was suppressed in the Pf SDT fatty group. Retinal thickness at 1,500 microns from the optic disc improved in the Pf SDT fatty group. No significant improvements were noted in choroidal thickness or number of retinal folds. Quantitative analyses showed that AQP4-positive regions in the retinas were significantly larger in the Pf SDT fatty group than in the SDT fatty group. The findings suggest that pemafibrate treatment can exert protective effects against DR.

A Review on Some Potential Traditional Phytomedicine with Antidiabetic Properties

Diabetes is a chronic carbohydrate, lipid, and proteinmetabolic condition characterised by elevated fasting andpostprandial blood sugar levels. The global prevalence of diabetes isexpected to rise from 4% in 1995 to 5.4% by 2025. According toWHO, the majority of the burden will fall on underdevelopedcountries. Plants have been used as a source of medicine sinceprehistoric times. Plants are mentioned in Ayurveda and other Indianliterature as being used in the treatment of many human illnesses.There are over 45000 plant species in India, and thousands of themhave been claimed to have therapeutic characteristics. In recentdecades, research on plants described in ancient literature or usedhistorically for diabetes has revealed anti-diabetic properties.

A COMPARATIVE STUDY ON THE EFFECT OF GENERAL ANAESTHESIA ON BLOOD GLUCOSE LEVELS IN NON-DIABETIC AND CONTROLLED DIABETIC PATIENTS: AN OBSERVATIONAL STUDY AT S. M. S. MEDICAL COLLEGE, JAIPUR

Objective: Diabetes, a complex metabolic disorder, poses significant challenges during surgery due to its association with chronic hyperglycemia. Surgical stress triggers hormonal changes, impacting glucose homeostasis. With an increasing global prevalence of diabetes, understanding the interplay between surgery, stress, and diabetes becomes crucial for perioperative management.&#x0D; Methods: This hospital-based cross-sectional observational study included 222 patients (111 non-diabetic and 111 controlled diabetic) undergoing elective surgery. Demographic data, hemodynamic parameters, and blood glucose levels were assessed at various intervals. Statistical analyses compared age, gender, blood glucose levels, and hemodynamic responses between the two groups.&#x0D; Results: Demographic parameters were comparable between non-diabetic and controlled diabetic groups. Hemodynamic responses, including heart rate and blood pressure, showed no significant differences during the surgery. Blood glucose levels were similar preoperatively and up to 30 min post-intubation. However, a significant difference was observed after 5 min of extubation, with controlled diabetic patients exhibiting higher levels. Variations in blood glucose levels after extubation were statistically significant, emphasizing the importance of postoperative monitoring.&#x0D; Conclusion: This study highlights the intricate relationship between surgery, stress, and diabetes, emphasizing the need for tailored perioperative management. Close monitoring, especially during critical moments, is essential to ensure optimal glucose control and mitigate complications. The findings align with existing literature, reinforcing the importance of individualized approaches for diabetic patients undergoing surgery.

Social support via Internet communication technology for diabetes self-management: a scoping review.

The global prevalence of diabetes has been increasing over the past 30 years, leading to a rise in complications; diabetes is the leading cause of amputations, blindness, and kidney failure in developed countries. Diabetes self-management is challenging due to the complex lifestyle changes required. Social support from family and friends plays a crucial role in overcoming barriers to healthy behavior choices. Integrating Internet and communication technologies with social support interventions has the potential to improve diabetes self-management. A scoping review was conducted by searching PubMed, Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Association for Computing Machinery (ACM) Digital Library databases for studies combining diabetes, Internet and communication technologies, and social support interventions. Inclusion criteria focused on adult patients with diabetes and primarily Internet and communication technologies-based strategies to initiate and enhance social support. Data abstraction included study population, design, outcomes, social support domains emphasized, support relationship intervention strategy, and Internet and communication technologies modality. The review identified 39 articles and 33 unique studies representing 27 unique interventions utilizing peer web forums, interactive voice recordings, messaging-based interventions (including Short Message Service and instant messaging), and email as Internet and communication technologies modalities. Various outcomes were reported, including improvements in perception of social support, psychosocial well-being, behavior changes, and clinical outcomes. Existing support relationships may be more effective in promoting behavior change and clinical outcomes compared to developing new relationships. Studies that explicitly measured patients' perception of support consistently showed improvements in psycho-social, behavioral, and clinical outcomes. This scoping review highlights the pivotal role of social support in diabetes self-management. By integrating Internet and communication technologies into interventions, diverse modalities such as web forums and text messaging have shown promise in enhancing patients' perception of support and improving psychosocial well-being, behavior changes, and clinical outcomes. The emphasis on leveraging existing support relationships, rather than establishing new ones, underscores the effectiveness of personalized, patient-centered approaches. These findings provide essential insights for healthcare strategies, emphasizing the need to harness technology and existing social networks to empower individuals in managing diabetes effectively.

A hybrid Transformer-LSTM model apply to glucose prediction.

The global prevalence of diabetes is escalating, with estimates indicating that over 536.6 million individuals were afflicted by 2021, accounting for approximately 10.5% of the world's population. Effective management of diabetes, particularly monitoring and prediction of blood glucose levels, remains a significant challenge due to the severe health risks associated with inaccuracies, such as hypoglycemia and hyperglycemia. This study addresses this critical issue by employing a hybrid Transformer-LSTM (Long Short-Term Memory) model designed to enhance the accuracy of future glucose level predictions based on data from Continuous Glucose Monitoring (CGM) systems. This innovative approach aims to reduce the risk of diabetic complications and improve patient outcomes. We utilized a dataset which contain more than 32000 data points comprising CGM data from eight patients collected by Suzhou Municipal Hospital in Jiangsu Province, China. This dataset includes historical glucose readings and equipment calibration values, making it highly suitable for developing predictive models due to its richness and real-time applicability. Our findings demonstrate that the hybrid Transformer-LSTM model significantly outperforms the standard LSTM model, achieving Mean Square Error (MSE) values of 1.18, 1.70, and 2.00 at forecasting intervals of 15, 30, and 45 minutes, respectively. This research underscores the potential of advanced machine learning techniques in the proactive management of diabetes, a critical step toward mitigating its impact.

Sugar Substitute: The Safety and Function of Artificial and Natural Sweeteners

As the global prevalence of obesity, diabetes, and other non-communicable diseases continues to rise, there is growing attention to the importance of a proper diet and managing energy intake. There is a growing desire for sugar alternatives as the harmful consequences of excessive sugar consumption on human health become more and more obvious. This article aims to consolidate current knowledge and research findings on sugar substitutes, with a focus on their digestive processes, taste characteristics, and potential health risks within the human body. The paper provides an examination of various sugar substitutes, including four artificial sweeteners which is aspartame, saccharin, Ace-K, and sucralose, as well as natural sweeteners like stevia and erythritol. Each category is assessed for its suitability in different food applications and associated toxicity studies, drawing comparisons to sucrose. The regulatory framework and safety assessment surrounding sugar substitutes are also discussed, underscoring the importance of understanding their potential health effects. Furthermore, this study explored the benefits of sugar substitutes in terms of calorie control and their potential to improve dietary choices for specific patient groups. The potential impact of sugar substitutes on environmental pollution, gut microbiota, and metabolic syndrome is also examined, highlighting areas that warrant further research. The conflicting results from some studies on the toxicity of sugar substitutes are also addressed, contributing to solve the ongoing controversy surrounding their use.