Glycemic Status Research Articles

Evaluating HbA1c-to-average glucose conversion with patient-specific kinetic models for diverse populations.

The discrepancy between estimated glycemia from HbA1c values and actual average glucose (AG) levels has significant implications for treatment decisions and patient understanding. Factors contributing to the gap include red blood cell (RBC) lifespan and glucose uptake into the RBC. Personalized models have been proposed to enhance AG prediction accuracy by considering interpersonal variation. This study contributes to our understanding of personalized models for estimating AG from HbA1c. Utilizing data from seven studies (340 participants), including Hispanic/Latino populations with or at risk of non-insulin-treated type 2 diabetes (T2D), we examined kinetic features across cohorts. Additionally, the study simulated scenarios to understand data requirements for improving accuracy. Personalized approaches improved agreement between AG estimations and CGM-AG, particularly with four or more weeks of training CGM data. A multiple linear regression model using kinetic parameters and added clinical features was shown to improve the accuracy of personalized models further. As CGM usage extends beyond type 1 diabetes, there is growing interest in leveraging CGM data for clinical decision-making. Patient-specific models offer a valuable tool for managing glycemic status in patients with discordant HbA1c and AG values.

Dairy consumption and risk of prediabetes and type 2 diabetes in the Fenland study

Background & AimsLimited observational evidence suggests that a higher intake of high-fat dairy may be associated with lower prediabetes risk, while opposite associations have been observed for low-fat milk intake. This study aimed to examine associations between baseline and changes in dairy consumption, risk of prediabetes, and glycaemic status. Methods7,521 participants from the prospective UK Fenland study were included (mean age 48.7±2.0 years, 51.9% female). Dairy intake was measured using self-reported food frequency questionnaires. Associations with prediabetes risk and glycaemic status were analysed using Poisson regression models adjusted for social demographics, health behaviours, family history of diabetes and food group intake. ResultsAt a mean follow-up of 6.7±2.0 years, 290 participants developed prediabetes (4.3%). Most dairy products were not significantly associated with prediabetes risk. A higher baseline intake of high-fat dairy (RRservings/day 1.20, 95%CI 1.03-1.39) and high-fat milk (RRservings/day 1.22, 1.01-1.47) were associated with higher prediabetes risk. Conversely, low-fat milk was associated with lower prediabetes risk (RRservings/day 0.86, 0.75-0.98). In the analyses evaluating dietary changes over time, increases in high-fat milk were inversely associated with risk of progressing from normoglycaemia to prediabetes or type 2 diabetes. ConclusionsThis population-based study showed that most dairy products not associated with prediabetes risk or progression in glycaemic status. Positive associations of high-fat dairy, high-fat milk, and the inverse association of low-fat milk with prediabetes risk found were inconsistent with prior literature and suggestive of the need for future research on environmental, behavioural, and biological factors that explain the available evidence.

Improved Glycemic Control using Oral Semaglutide in a Patient with Type 2 Diabetes with Insulin Allergy

AbstractWe present a unique clinical scenario of a patient with type 2 diabetes mellitus (T2DM) who exhibited an allergic reaction to all forms of insulin. The patient had previously maintained good glycemic control with maximum-dose metformin. However, her glycemic control deteriorated once she became pregnant. Trials with various types of insulin resulted in allergic reactions, but this was managed successfully using insulin pump therapy, which was discontinued postpartum. Upon reassessment, her HbA1c had deteriorated to 80 mmol/mol. After re-attempting various insulin formulations without success, she was trialed again using the closed-loop Omnipod system. Initial management with the closed-loop system failed to achieve optimal glycemic control. Therefore, oral semaglutide was added. The introduction of oral semaglutide to her treatment regimen led to a significant improvement in her glycemic status. This report compares the patient's glycemic control while on the closed-loop Omnipod system alone versus in combination with oral semaglutide. The findings suggest that oral semaglutide, in conjunction with a closed-loop system, may offer a viable alternative for patients with insulin-dependent type 2 diabetes who cannot tolerate insulin.

Glycaemic status, length of stay and mortality in acute pancreatitis patients admitted to intensive care

Glycaemic status, length of stay and mortality in acute pancreatitis patients admitted to intensive care

Patterns of Lipid Abnormalities in Obesity: A Comparative Analysis in Normoglycemic and Prediabetic Obese Individuals.

Background: Obesity is a growing global health concern, often accompanied by dyslipidemia, contributing to cardiovascular risk. Understanding the patterns of dyslipidemia in different glycemic states is crucial for targeted interventions. This study compares dyslipidemia patterns in normoglycemic and prediabetic obesity to improve clinical management strategies. Methods: The study analyzed the complete lipid profiles of 138 subjects, comparing the medians, prevalence, diagnostic performance, and risk assessment of each lipid parameter across 54 non-obese (NO), 44 normoglycemic obese (NG-OB), and 40 pre-diabetic obese (PreDM-OB) groups. Results: Elevated total cholesterol (TC) and low-density lipoprotein (LDL) were the most prevalent forms of dyslipidemia observed in obesity (45.35% and 43.53%, respectively). Stratification by glycemic status revealed that triglyceride (TG) levels were elevated in both the NG-OB and PreDM-OB groups, with a more marked increase in the latter group (73.07 mg/dL vs. 97.87 mg/dL vs. 121.8 mg/dL, respectively). Elevated LDL showed better diagnostic performance and higher odds ratios (OR) in the NG-OB group (AUC = 0.660, p = 0.006; OR = 2.78, p = 0.022). Conversely, low high-density lipoprotein (HDL) was more common and exhibited significant diagnostic performance, with higher OR values in the PreDM-OB group (AUC = 0.687, p = 0.002; OR = 3.69, p = 0.018). Importantly, all lipid ratios were elevated in obesity, with TC/HDL showing the highest predictive ability for prediabetes (AUC = 0.7491, p < 0.001). Conclusions: These findings revealed unique and common lipid abnormalities in normoglycemic and prediabetic obesity. Future research should explore the effects of targeted lipid management on obesity-associated complications.

Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia.

Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited. To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022. A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The χ 2 test, Mann-Whitney U test, Kruskal-Wallis test, post hoc test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A P value < 0.05 was considered statistically significant. The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals (P < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus. The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

Defining continuous glucose monitor time in range in a large community-based cohort without diabetes.

Continuous glucose monitor (CGM) companies are beginning to market these sensors to populations without diabetes, but the range of CGM values clinicians should expect to see for this population is unclear because there have been no large studies reporting these ranges. To report the physiological range of continuous glucose monitor (CGM) time in range values observed across glycemic status, including individuals without diabetes, to serve as a reference for clinicians. The Framingham Heart Study, a prospective cohort study. Community-dwelling individuals. Adults with normoglycemia (n=560), prediabetes (n=463), and diabetes (n=152). We conducted a cross-sectional investigation in participants who wore a Dexcom G6 Pro CGM for ≥7 complete days. CGM metrics including mean glucose and time spent in glucose ranges. Normoglycemic participants (mean age 58.5y, 64.5% women, 93.3% non-Hispanic white) spent 87.0% time in the 70-140mg/dL CGM range, and, on average, >15min/day (1.2% time) >180mg/dL. Furthermore, normoglycemic participants spent ∼3 hours/day (12.1% time) with CGM glucose >140mg/dL. On average, participants with prediabetes and diabetes spent 77.1% and 46.2% time in 70-140mg/dL, respectively. Our results contribute to the understanding of the physiological CGM range in >1000 participants without diabetes. These results are also important for clinicians to reference as CGM sensors become more widely accessible to people without known diabetes.

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

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

Uncovering novel regulatory variants in carbohydrate metabolism: a comprehensive multi-omics study of glycemic traits in the Indian population.

Clinical biomarkers such as fasting glucose, HbA1c, and fasting insulin, which gauge glycemic status in the body, are highly influenced by diet. Indians are genetically predisposed to type 2 diabetes and their carbohydrate-centric diet further elevates the disease risk. Despite the combined influence of genetic and environmental risk factors, Indians have been inadequately explored in the studies of glycemic traits. Addressing this gap, we investigate the genetic architecture of glycemic traits at genome-wide level in 4927 Indians (without diabetes). Our analysis revealed numerous variants of sub-genome-wide significance, and their credibility was thoroughly assessed by integrating data from various levels. This identified key effector genes, ZNF470, DPP6, GXYLT2, PITPNM3, BEND7, and LORICRIN-PGLYRP3. While these genes were weakly linked with carbohydrate intake or glycemia earlier in other populations, our findings demonstrated a much stronger association in the Indian population. Associated genetic variants within these genes served as expression quantitative trait loci (eQTLs) in various gut tissues essential for digestion. Additionally, majority of these gut eQTLs functioned as methylation quantitative trait loci (meth-QTLs) observed in peripheral blood samples from 223 Indians, elucidating the underlying mechanism of their regulation of target gene expression. Specific co-localized eQTLs-meth-QTLs altered the binding affinity of transcription factors targeting crucial genes involved in glucose metabolism. Our study identifies previously unreported genetic variants that strongly influence the diet-glycemia relationship. These findings set the stage for future research into personalized lifestyle interventions integrating genetic insights with tailored dietary strategies to mitigate disease risk based on individual genetic profiles.

Glycemic status and effect on mortality: Multifactorial prevention programme for cardiovascular disease in Finnish primary care

AimsTo compare 13-year mortality rates in normoglycemic, prediabetic and diabetic subjects attending a community-based screening and intervention programme. MethodsPopulation survey identified 2569 cardiovascular disease (CVD) white risk subjects aged 45–70 years and without manifested CVD or diabetes. Oral glucose tolerance test was performed, and multifactorial intervention was provided. Effect of glycemic status on mortality was estimated in models adjusted for age, gender, education years, smoking, body mass index, mean arterial pressure, total cholesterol, and physical activity. ResultsOf the subjects, 2055 (77 %) were normoglycemic, 380 (14 %) had prediabetes and 224 (9 %) diabetes. Compared to the normoglycemic group, the fully adjusted hazard ratios (HR) for all-cause mortality were 1.34 (95 % CI: 0.98–1.83) in the prediabetes group and 2.31 (95 % CI: 1.62–3.31) in the diabetes group. Standardized mortality rates were 0.63 (95 % CI: 0.54–0.73), 0.91 (95 % CI: 0.69–1.18), and 1.55 (95 % CI: 1.19–2.02) in the normoglycemic, prediabetes, and diabetes groups, respectively. The most common cause of death was cancer (42 % of all deaths), followed by CVD (28 %). Conclusions/interpretationScreen-detected diabetes carries a substantial risk of death even after primary care intervention. The pattern of excess mortality has shifted towards cancer deaths.

Determination of SRPA and adiposity measures and its association with glycemic status in type 2 diabetics having high mean HbA1c in a private clinic of a city in west India.

Indian type 2 diabetics (T2D) is known for poor disease control on which self-reported physical activity (SRPA) and optimum body composition have positive impact. We determined prevalence of SRPA and general/visceral obesity and its impact on HbA1c-based glycemia. By a cross-sectional study conducted on 200 T2Ds in a private clinic, HbA1c-based glycemic status, WHO questionnaire-based SRPA, BMI-based general obesity, and bipolar bioelectrical impedance-based visceral obesity were evaluated. SRPA and obesity were compared and associated with glycaemic status keeping mean HbA1c as cutoff. Mean age, male%, mean duration of T2D, mean BMI, mean HbA1c, and SRPA prevalence were 54 years, 42.5%, 4.82 years, 25.49, 8.69%, and 61.5%, respectively. Comparison of groups based on either SRPA or BMI (cutoff 25) showed better HbA1c with the presence of SRPA and BMI <25. Physical inactivity imposed odds risk of 3.44 for visceral fat (VF) ≥10% and odds risk of 2.6 for more than mean HbA1c with statistical significances. VF ≥10% imposed odds risk of 4 for higher than mean HbA1c. Physical inactivity and visceral obesity together imposed ⅓rd prevalence of better glycaemic value, while physical activity and controlled visceral obesity yielded ¾th prevalence of good glycaemic value. In T2D with poor glycaemic status and moderately prevalent physical activity, we found strongly significant association of SRPA and controlled body adiposity with HbA1c-based glycaemic status. It reaffirms physical activity and control of central obesity as forerunners of better glycaemic status and calls for further studies having vertical follow-up.

К вопросу об осложнениях сахарного диабета: систематический обзор литературы

INTRODUCTION. The article presents an overview of the trigger role of diabetes mellitus in the development of periodontal pathology in patients aged 40-70 years. During the analytical systematic review, the emphasis was placed on the currently studied issues related to the characteristics of the clinic, glycemic status and risks of a complicated course, including with regard to microvascular, neurological and other disorders. The focus is on the dental status and glycemic profile of patients with diabetes mellitus and its role in regulating the adaptive potential of patients with diabetes mellitus. AIM. To assess the risks of diabetes in the regulation of periodontal pathology and other most significant complications. MATERIAL AND METHODS. the search was conducted in the database on evidence-based physiotherapy (PEDro), by keywords: "diabetes mellitus", "rehabilitation", "microvascular and other complications", "periodontal pathology" from 2000 to 2024. A total of 284 sources were selected as of March 2024, of which 26 were systematic reviews, 9 were Cochrane reviews, 17 – Clinical recommendations (American Association for Diabetes Mellitus), as well as Clinical recommendations for diabetes mellitus (70.5%). The search was conducted in the sources Web of Science, PubMed and Scopus in accordance with the principles of PRISMA and initially revealed 185 entries. Of these, 40 articles were included in the 2013-2024 publication study. Keywords were used: "periodontal pathology", "diabetes mellitus", "rehabilitation", "microvascular and other complications". RESULTS: the analysis of the collected Russian and foreign literature allowed us to summarize that in the treatment of patients with type 2 diabetes with periodontal pathology, the participation of specialists (endocrinologist, dentist, rehabilitologist, hygienist, neurologist) of a multidisciplinary team is necessary to compile an optimal rehabilitation program aimed at preventing the occurrence of complications and their progression, to achieve a speedy and complete restoration of lost dental functions and reduce glycemic risks. CONCLUSION. A personalized approach, individually selected therapies with an assessment of the dental status and glycemic profile in patients with diabetes mellitus and periodontal pathology will help to achieve the best results in recovery and elimination of complications. KEYWORDS: diabetes mellitus patients, dental status, glycemic profile, microvascular, neurological disorders

P191 CO-EXISTING HYPERTENSION: AN INDEPENDENT RISK FACTOR FOR DIABETIC RETINOPATHY IN TYPE-2 DIABETES

Background and Objectives: Hypertension has plausible reason to be show the interaction due to its independent effect on retina. Epidemiological studies also provide clue that for hypertension as a possible effect modifier in the risk development of retinopathy in diabetic patients. It is worth exploring whether subgroup in diabetic population with Hypertension have different risk potential of developing retinopathy. The present study aimed to assess the association of hypertension as a risk factor for diabetic retinopathy (DR) in type 2 diabetes mellitus. Methods: A total of 977 type-2 diabetic patients recruited retrospectively in 2008 from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) based on hospital records for determining the incidence of diabetic retinopathy (DR), who were naı̈ve type-2 diabetes during 1993. At the end of 15 year follow-up 495 patients were diagnosed as DR by retinal colour photography. Data on diabetes and lipid profile with serum creatinine, blood pressure and biophysical measures were obtained at baseline, 5, 10 and 15 years follow-up. Binary logistic regression model was used to assess the associations of co-existing hypertension with retinopathy risk adjusting for clinical, biochemical and anthropometric variables. Results: In all three follow-up points, including at baseline, mean systolic and diastolic blood pressure were found to significantly higher among patients who developed DR (P&lt;.001). Binary logistic regression model confirmed coexisting hypertension (OR 3.2; 95% CI 2.2 -4.7) as a significant risk factor of DR adjusting for possible confounders; serum creatinine (OR 21.9; 95% CI 14.0 -35.4) and glycemic control status (OR 17.2; 95% CI 9.4 -31.4). Interaction between hypertension, glycemic control and raised serum creatinine did not appear to be statistically significant (P&gt;0.05). Conclusions: Co-existing hypertension is a significant risk factor of DR irrespective of nephropathy or glycolic control status among Type 2 diabetes mellitus.

The Impact of Empagliflozin on Renal Function and Kidney Injury Markers in Patients with Diabetic Nephropathy

Background: Diabetic nephropathy affects approximately 50% of type 2 diabetes patients. Early detection of kidney disease is crucial to reducing the deterioration of renal function. Reversing microalbuminuria towards normal showed beneficial effects in delaying the onset of renal impairment or even reversing the progression of the disease. Recently, empagliflozin, a sodium/glucose cotransporter-2 inhibitor, has received attention for its anti-inflammatory and reno-cardioprotective effects. Objective: This interventional open-label randomized clinical trial aimed to evaluate the clinical outcome of empagliflozin as an add-on therapy for renal function parameters and other injury markers in type 2 diabetic nephropathy patients. Methods: The study enrolled twenty-one type 2 diabetic patients with nephropathy and nineteen without nephropathy. Each group received empagliflozin 10 mg/day for 16 weeks as an add-on to the traditional treatment. Blood and urine samples were collected at baseline and at week 16 to evaluate the glycemic status, renal function, tubular injury markers, and inflammatory and oxidative stress markers. Results: After 16 weeks, empagliflozin significantly reduced glycated hemoglobin A1c and urinary albumin/creatinine ratios in the nephropathy group. Compared with the non-nephropathy group, empagliflozin showed a significant increase in serum creatinine and a significant decrease in eGFRcr. Empagliflozin significantly reduced serum kidney injury molecule-1, cystatin C, interleukin-18, c-reactive protein, and malondialdehyde in both groups. Conclusions: Adding empagliflozin to the traditional oral antidiabetic drugs in diabetic nephropathy improved albuminuria with a mild increment in serum creatinine. Empagliflozin also effectively reduced renal injury markers, as well as inflammatory and oxidative stress markers.

Assessment of glycemic control and correlation of HbA1c level with lipid profile and duration of diabetes in type 2 diabetes mellitus patients

Background &amp; Objectives: The prevalence of Type 2 diabetes mellitus, or Type 2 DM, is rising globally. A periodic estimation of HbA1c has been recommended to track the state of glycemic control of Type 2 DM patients, in order to control the diabetes associated disorders. The main consequence and cause of death in Type 2 diabetes has been identified as cardiovascular disease (CVD).Optimization of glycemic status along with decreasing CVD risk factors are critical to preventing morbidity and mortality in patients with Type 2 DM. Since there is a lack of data on these CVD risk factors, in Madhesh Province, Nepal, we aimed to evaluate the glycemic status, estimate the lipid profile, and ascertain their correlation, including duration of Type 2 DM among patients in tertiary care hospitals in Madhesh Province, Nepal. Materials and Methods: The tertiary care hospital based cross-sectional study was conducted on 139 Type 2 DM patients, in Madhesh Province, Nepal. In order to gather information of the participants, a systematic questionnaire was introduced. A physical and clinical examination was performed, and an appropriate volume of blood was drawn with prior written consent. The lipid profile parameters, HbA1C, Fasting and post prandial serum glucose were estimated. Results: In 84 (60.3%) and 106 (76.3%) cases, there was an increased fasting and postprandial blood sugar. The mean±SD HbA1c level was 8.40±0.8%. More than half (52.5%) of the patients had poor glycemic control, while 22.3% had inadequate glycemic control, in reference to HbA1c &gt;8% and 7 to 8%, respectively. A substantial increased level of LDL-C, triglycerides and total cholesterol was observed in 122 patients and 85.6% had reduced HDL-C. A significant strong positive association was found between HbA1c level and total cholesterol and triglycerides, in contrast, no discernible association with duration of disease observed. Conclusion: Glycemic control was inadequate. Triglycerides and total cholesterol were significantly positively correlated with HbA1c, but not with HDL-C, LDL-C, or the course of diabetes.

New Onset Diabetes After COVID 19 (NODAC) is predominantly due to exacerbated Insulin Resistance (IR) rather than beta cell dysfunction: Lessons from tertiary care hospital data during confluence of two epidemics.

To investigate determinants of new onset diabetes after COVID-19 (NODAC) and its recovery at 6 months. This was an observational follow up study conducted from August, 2020 to July, 2023, recruiting patients with preexisting DM and COVID 19 patients with no history of DM. Multivariate regression analysis was used to determine the factors responsible for severity of COVID 19 infection in preexisting DM group. Clinical, laboratory and glycometabolic parameters were estimated at baseline and 6 months in NODAC and euglycemic group to determine the factors responsible for NODAC and its persistence at 6 months. Of 1310 patients, 855 (65.3%) COVID 19 patients were further divided based on their glycemic status: preexisting DM (19%), NODAC (8.5%) and euglycemia (72.5%). Older age and male gender were independent risk factors for severe COVID 19 disease in patients with preexisting diabetes. Prevalence of NODAC in present study was 8.5%. Patients with NODAC had higher mean fasting blood glucose (FBG), random blood glucose (RBG) and HbA1c at baseline as compared to COVID with euglycemic group with no difference in serum C-peptide levels. Female gender, family history of DM, signs of insulin resistance, higher BMI, WHR, HbA1c, serum insulin levels, FBG and RBG predicted persistence of NODAC at 6 months. Preexisting DM is a risk factor for severe COVID 19 disease. Patients with NODAC have evidence of persistence insulin resistance on follow up, underscoring the need for long term glycemic monitoring.

Association between glycemic status and all-cause mortality among individuals with dementia: a nationwide cohort study

BackgroundTo examine the association between glycemic status and all-cause mortality risk among individuals with dementia.MethodsWe enrolled 146,832 individuals aged 40 and older with dementia as identified through the Korean National Health Insurance Service health screening test between 2008 and 2016. Mortality status was evaluated at the end of 2019. Participants were classified into normoglycemia, prediabetes, or diabetes mellitus (DM) categories. The duration of diabetes was noted in those with DM. This study focused on the association between glycemic status and all-cause mortality.ResultsThe cohort, which was predominantly elderly (average age 75.1 years; 35.5% male), had a 35.2% mortality rate over an average 3.7-year follow-up. DM was linked with increased all-cause mortality risk (hazard ratio [HR] 1.34; 95% confidence interval [CI]: 1.32–1.37) compared to non-DM counterparts. The highest mortality risk was observed in long-term DM patients (≥ 5 years) (HR 1.43; 95% CI: 1.40–1.47), followed by newly diagnosed DM (HR 1.35; 95% CI: 1.30–1.40), shorter-term DM (< 5 years) (HR 1.17; 95% CI: 1.13–1.21), and prediabetes (HR 1.03; 95% CI: 1.01–1.05). These patterns persisted across Alzheimer’s disease and vascular dementia, with more pronounced effects observed in younger patients.ConclusionsGlucose dysregulation in dementia significantly increased mortality risk, particularly in newly diagnosed or long-standing DM. These findings suggest the potential benefits of maintaining normal glycemic levels in improving the survival of patients with dementia.

Prognostic Value of Plasma Endothelin-1 in Predicting Worse Outcomes in Patients with Prediabetes and Diabetes and Stable Coronary Artery Diseases.

Endothelin-1 (ET-1) is an endogenous vasoconstrictor implicated in coronary artery disease (CAD) and diabetes. This study aimed to determine the prognostic value of ET-1 in the patients with stable CAD under different glucose metabolism states. In this prospective, large-cohort study, we consecutively enrolled 7,947 participants with angiography-diagnosed stable CAD from April 2011 to April 2017. Patients were categorized by baseline glycemic status into three groups (normoglycemia, prediabetes, and diabetes) and further divided into nine groups by circulating ET-1 levels. Patients were followed for the occurrence of cardiovascular events (CVEs), including nonfatal myocardial infarction, stroke, and cardiovascular mortality. Of the 7,947 subjects, 3,352, 1,653, and 2,942 had normoglycemia, prediabetes, and diabetes, respectively. Over a median follow-up of 37.5 months, 381 (5.1%) CVEs occurred. The risk for CVEs was significantly higher in patients with elevated ET-1 levels after adjustment for potential confounders. When patients were categorized by both status of glucose metabolism and plasma ET-1 levels, the high ET-1 levels were associated with higher risk of CVEs in prediabetes (adjusted hazard ratio [HR], 2.089; 95% confidence interval [CI], 1.151 to 3.793) and diabetes (adjusted HR, 2.729; 95% CI, 1.623 to 4.588; both P<0.05). The present study indicated that baseline plasma ET-1 levels were associated with the prognosis in prediabetic and diabetic patients with stable CAD, suggesting that ET-1 may be a valuable predictor in CAD patients with impaired glucose metabolism.

Serum Magnesium and Glycemic Status in Newly Diagnosed T2DM Patients in Tertiary Care Hospital of Bangladesh

Background: Diabetes mellitus is a major global health issue. Trace elements play important role as co-factors for various events in this context. Recently, an inverse relationship between serum magnesium and glycemic control has been observed and magnesium is thought to be low in with type-2 diabetes mellitus (T2DM). Objective: This study aimed to see serum magnesium and HbA1c in newly diagnosed T2DM. Methodology: This cross-sectional study included 100 newly detected diabetes subjects (age: 40.65±11.65 years, mean ± SD; m/f: 35/65) diagnosed according to American Diabetic Association (ADA) 2016 diagnostic criteria for diabetes. 5 ml of blood was collected for serum magnesium and HbA1c measurement by utilizing atomic absorption Spectrometricanalysis and NGSP certified Bio-Rad D-10TM Hemoglobin A1c Program 220-0101 USA. All data were analyzed by SPSS (version 22.0). Results: Magnesium and HbA1c were 1.99±0.23 mg/dl and 8.65±2.18% (mean±SD). About 9% were hypomagnesemic and 91% eumagnesemic. Socioeconomically 50% were middle income group, family history was present in 48% and 11% had history of smoking. Magnesium (meanSD) was statistically similar between males and females (1.99±0.22 vs. 1.99±0.24 mg/dl, p=0.974), urban and rural subjects (1.98±0.24 vs. 1.99±0.22 mg/dl, p=0.754), subjects with or without family history of diabetes (1.95±0.22 vs. 2.02±0.23 mg/dl, p=0.117), in subjects with BMI &lt;25 Kg/m2 and 25 Kg/m2 (2.01±0.25 vs. 1.98±0.22 mg/dl, p= 0.526) as well as among various HbA1c cut-off values (&lt;6.5 vs. 6.5− 9 vs. &gt;9%: 2.08 ±0.15 vs. 1.98±0.24 vs. 1.99±0.23; p=0.257). However, magnesium level was statistically and significantly different among the age groups (&lt;25 yrs vs. 25-34 yrs vs. 35-44 yrs vs. 45-54 yrs vs. 55 yrs: 1.91±0.28 vs. 2.00±0.23 vs. 1.93±0.20 vs. 1.96±0.26 vs. 2.16±0.13 mg/dl, meanSD; p= 0.018). None of the variables showed any correlation with magnesium except age (r=0.220, p=0.028) nor any was significant independent predictor for hypomag

Clinico-Mycological Study of Dermatophytosis among Diabetic and Non-Diabetic Patients in a Tertiary Level Hospital: A Comparative Study

Abstract Background: Dermatophytosis is a major public health concern in India, especially in recent years, with an alarmingly rising trend, particularly in relation to recurrent and chronic infection. The number of studies examining the relationship between an individual’s glycemic status and the development of dermatophytosis, and a comparison of the evolving species trend between diabetic and non-diabetic patients infected with dermatophytes, is limited. Aims and Objectives: To study and compare the clinical and mycological aspects of dermatophytosis among diabetic and non-diabetic patients and to compare the culture isolates in both groups. Materials and Methods: The study included 378 patients of clinically suspected dermatophytosis, divided into two groups of 189 known diabetics and non-diabetics each. We subsequently analysed and compared the demographics, clinical data, potassium hydroxide (KOH) mount, calcofluor white (CW) staining and fungal culture results of all patients in both groups. Results: Among the 378 patients, diabetic patients had a significantly greater extent of involvement and higher rates of recurrence when compared to non-diabetics. The overall positivity rate was higher in CW staining (77.8%) as compared to KOH (57.7%) in both non-diabetics and diabetics. Trichophyton mentagrophytes was the most common isolate (47.6%) in both diabetic (55.0%) and non-diabetic (61.4%) patients, followed by Trichophyton rubrum (31.8% and 29.6%, respectively). The positivity percentages of fungal culture, KOH and CW staining increased to 100%, 77.9% and 95.7%, respectively, when scrapings were taken from ≥2 sites. Conclusion: The pattern of dermatophytosis is comparatively more chronic and severe in diabetics compared to non-diabetics. T. mentagrophytes was the most common culture isolate in both groups. CW staining can potentially be used as the initial method of choice for the diagnosis of dermatophytosis as it has significantly outperformed the conventional KOH mount. Scrapings can regularly be taken from ≥2 sites to avoid false negative results.