Blood HbA1c Levels Research Articles

New-onset diabetes after kidney transplantation: Assessing urinary Wilm's tumor-1 protein to predict renal allograft dysfunction

PurposeNew-onset diabetes after transplantation (NODAT) is a frequent metabolic complication associated with podocyte damage and renal allograft dysfunction. Thus, Wilm's tumor-1 (WT-1) protein, as a podocyte marker, holds promise as an option to evaluate renal allograft dysfunction in NODAT. Therefore, the study aimed to investigate urinary WT-1 levels in NODAT patients during the first year after kidney transplantation (KTx). Materials and methodsKTx patients were categorized into non-NODAT and NODAT groups. Fasting blood glucose, glycated hemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), serum creatinine, estimated glomerular filtration rate (eGFR), and urinary WT-1 were measured at 3, 6, 9, and 12-months post-KTx. ResultsThe NODAT group manifested elevated levels of blood glucose and HbA1c during the first year post-KTx. Also, exhibited elevations in ACR and serum creatinine levels at 6, 9, and 12-months post-KTx when compared to non-NODAT group. Conversely, eGFR values in the NODAT group demonstrated significant declines at 3, 6, and 9-months post-KTx relative to non-NODAT. Furthermore, NODAT group exhibited a median annual eGFR of 47 ​mL/min/1.73 ​m2. Urinary WT-1 levels at 3, 6, 9, and 12-months post-KTx were significantly higher in the NODAT group compared to non-NODAT. Additionally, noteworthy positive correlations were identified between urinary WT-1 and HbA1c levels, along with significant negative correlations between urinary WT-1 and eGFR at the 3, 6, 9, and 12-months post-KTx. ConclusionThe increased urinary WT-1 levels from 3-months post-KTx in NODAT patients may indicate the first sign of podocyte injury, predicting a renal allograft dysfunction in these patients.

Dysregulated inflammatory response to urogynecologic meshes in women with diabetes and its implications

BackgroundDiabetes is an independent risk factor for mesh complications in women undergoing mesh-augmented surgical repairs of stress urinary incontinence and/or pelvic organ prolapse. The underlying mechanism remains unclear. ObjectivesTo define the diabetes-associated alterations in the host inflammatory response to mesh and correlate them with perioperative glucose managements. Study DesignDeidentified demographics and medical records of patients who underwent mesh removal and participated in a Mesh Biorepository study were reviewed (n=200). In patients with diagnosed diabetes (n=25), blood glucose management prior to initial mesh implantation, and before and after mesh removal was assessed by blood glucose and HbA1c levels. Age- and BMI-matched tissue samples excised from patients with or without diabetes were examined. Transcriptomic profiles of immune cell markers, immune mediators, key inflammatory regulators, cell senescence, and epigenetic enzymes were determined by multiplex transcriptomic assays (NanoString). Ratio of apoptotic cells to CD68+ macrophages were examined with immunofluorescence. Protein profile of 12 molecules involved in apoptotic cell clearance were assayed with a multiplex protein assay (Luminex). ResultsDemographic and clinical characteristics, including duration between mesh implantation and removal, reason for removal, and type of mesh, etc., were comparable between patients with and without diabetes, except for 11.6% higher BMI in the former (p<0.001). In patients with diabetes, suboptimal management of blood glucose following mesh implantation was observed, with 59% of the patients having loosely or poorly controlled glucose before and after the mesh removal. Ongoing chronic inflammatory response was observed in the excised mesh-tissue complexes in both groups, while markers for M2 macrophages (mannose receptor C-type 1 [Mrc1]) and helper T cells (CD4 molecule [Cd4]) were increasingly expressed in the diabetic vs. nondiabetic groups (p=0.023, 0.047, respectively). Furthermore, the gene expression of proinflammatory C-C motif chemokine ligand 24 (Ccl24) and C-C motif chemokine ligand 24 (Ccl13) were upregulated by 1.5- and 1.8-fold (p=0.035, 0.027, respectively), while that of interleukin 1 alpha (Il1a) was paradoxically downregulated by 2.2-fold (p=0.037) in the diabetic vs. nondiabetic group. Interestingly, strong positive correlations were found between the expression of Ccl13, SET domain bifurcated histone lysine methyltransferase 2 (Setdb2), and M2 macrophage markers, as well as between the expression of Il1a, activator protein-1 transcription factor subunit (Fosl1), and dendritic cell markers, suggesting the involvement of macrophages and dendritic cells in the diabetes-dysregulated proinflammatory response. Supportively, apoptotic cell clearance, which is an important function of macrophages, appeared to be impaired in the diabetic group with a significantly increased protein level of calreticulin (CALR), an ‘eat-me’ signal on apoptotic cell surface (p=0.03), along with an increase of AXL receptor tyrosine kinase (AXL) (p=0.03), which mediates apoptotic cell clearance. ConclusionsDiabetes was associated with altered long-term inflammatory response in complicated mesh implantation, particularly involving innate immune cell dysfunction. Suboptimal blood glycemic control following mesh implantation may contribute to this immune dysregulation, necessitating further mechanistic studies.

DIABETES SELF MANAGEMENT TERHADAP HBA1C DAN KADAR GULA DARAH PADA KELOMPOK PREDIABETES SEBELUM DAN SESUDAH INTERVENSI

Prediabetes is a condition in which a person has blood glucose levels that are higher than normal but not yet high enough to be classified as diabetes. The aim of this study was to determine the effect of diabetes self-management on blood sugar and HbA1c levels in the prediabetes group before and after intervention in the Kalumpang Community Health Center working area, Ternate. This research uses the Pre-Experimental method (one-group pre-post test design with control). Based on the data, the number of samples in this study was 25 which included control and intervention groups with a total of 50 samples. Inclusion criteria are individuals who are willing to be respondents, cooperative individuals, individuals aged 45 – 54 years, individuals who are willing to fill out a 24 hour food recall questionnaire, individuals who have HbA1c levels: ≥5.7% - &lt;6.5%, GDP : ≥100- &lt;126 mg/dl and GD2PP :≥140- &lt;200 mg/dl. Meanwhile, the exclusion criteria are individuals who are not willing to be respondents and individuals who are not cooperative. Data analysis to test the results of treatment before and after treatment used the Paired T-Test. The study's results showed a significant difference between the patient's blood sugar and HbA1c before and after the intervention. Compared with the control, there was a significant difference in blood sugar levels and HbA1c between the intervention and control groups. The main finding of this study is that diabetes self-management has an impact on HbA1c and blood sugar levels in the prediabetes group.

Effects of SGLT2 Inhibitors and DPP-4 Inhibitors on Advanced Glycation End Products.

Clinical trials have revealed that sodium glucose cotransporter 2 (SGLT2) inhibitors suppress the onset of heart failure and cardiovascular death in diabetic patients. On the other hand, few reports have been published concerning such effects of dipeptidyl peptidase-4 (DPP-4) inhibitors. We undertook the present study to evaluate the effects of SGLT2 inhibitors and DPP-4 inhibitors on the advanced glycation end products (AGEs), well known as a risk factor for the development of cardiovascular disorders.Type 2 diabetes mellitus were divided into two groups and treated with either SGLT2 inhibitors or DPP-4 inhibitors for 3 months. Before and after the 3-month treatment period with each drug, the AGEs and diabetes-related parameters were measured. Methylglyoxal-derived hydroimidazolone-1 (MG-H1) was measured as one of the AGEs.In the SGLT2 inhibitor group, both the blood HbA1c and MG-H1 levels decreased significantly after the 3-month treatment period. In the DPP-4 inhibitor group, only the blood HbA1c level decreased significantly, with no significant change of the blood MG-H1 level.SGLT2 inhibitor reduced both the blood levels of HbA1c and AGEs (MG-H1). Considering that the blood levels of AGEs are associated with the risk of heart failure and cardiovascular disorders, the results of the present study suggest that the effect of SGLT2 inhibitors in suppressing cardiovascular death might be mediated by the reduction in the blood levels of AGEs induced by this class of drugs. DPP-4 inhibitors showed no significant effects on the blood levels of AGEs.

THERAPEUTIC EFFECT OF MORINGA LEAF DECOCTION TO DECREASE BLOOD SUGAR LEVELS AND HBA1C VALUES OF DIABETICS TYPE II DIABETES MELLITUS AT KARANG PANJANG AMBON HEALTH CENTER

Abstract Type 2 Diabetes (T2DM) is the most common type of diabetes and is still become one of the causes of death. One way of managing T2DM is mostly by controlling blood sugar, HbA1c levels, developing a healthy diet and herbal alternative therapies. One intervention that does not require expensive costs can be done to improve treatment outcomes in patients with T2DM by controlling blood glucose levels and HbA1c is through moringa leaf decoction therapy. Moringa oleifera (Moringa oleifera) contains and benefits from moringa leaves which have high nutritional value, are rich in minerals, vitamins, and other important phytochemicals. Extracts from the leaves are used to treat malnutrition, as a potential antioxidant, anticancer, anti-inflammatory, antidiabetic and antimicrobial agents. This study aims to analyze the therapeutic effect of moringa leaf decoction to decrease blood sugar and HbA1C levels of Type II diabetes mellitus patients in Karang Panjang Ambon Health Center. Sampling technique using consecutive sampling in one intervention group. The study was conducted for seven days with the number of subjects involved in this study as many as 27 people who were measured blood sugar levels and HbA1C before and after treatment. This study is a type of quantitative research using pre-experimental approach one group pre-post design. The results of the study obtained the value of SIG 0.000 &lt; 0.050 this states that there is a significant effect of moringa leaf decoction therapy to reduce blood sugar levels and HbA1c values in patients DM Type II Keywords: moringa leaves, diabetes mellitus Type II, blood sugar, HbA1c

Sex Differences in the Primary Prevention of Cardiovascular Diseases in a Dutch Primary Care Setting.

Sex differences in the primary prevention of cardiovascular diseases (CVD) have been shown, but the evidence is mixed and fragmented. In this study, we assessed sex differences in cardiovascular risk factors assessment, risk factor levels, treatment, and meeting of treatment targets, within a Dutch primary care setting. Data were obtained from individuals aged 40 to 70 years old, without prior CVD, registered during the entire year in 2018 at one of the 51 general practices participating in the Julius General Practitioner's Network (JGPN). History of CVD was defined based on the International Classification of Primary Care (ICPC). Linear and Poisson regressions were used to investigate sex differences in risk factor assessment, risk factor levels, treatment, and meeting of treatment targets. We included 83,903 individuals (50% women). With the exception of glycated hemoglobin (HbA1c), all risk factors for CVD were more often measured in women than in men. Lipid measurements and body mass index values were higher in women, while blood pressure (BP) and HbA1c levels were higher in men, along with estimated glomerular filtration rate (eGFR) levels. Among individuals with elevated BP or cholesterol levels, no sex difference was observed in the prescription of antihypertensive medications (RR 1.00, 95% CI: 0.94-1.06) but women were less likely than men to receive lipid-lowering medications (RR 0.87, 95% CI: 0.79-0.95). Among treated individuals, women were more likely than men to meet adequate levels of blood pressure (RR 1.17, 95% CI: 1.09-1.25) and less likely to meet target levels of cholesterol (RR 0.90, 95% CI: 0.83-0.98). While women were more likely to have their CVD risk factors measured, they were less likely to be prescribed lipid-lowering medications and to meet target levels. When treated, men were less likely to achieve adequate blood pressure control.

Exploring the nexus: prevalence, risk factors, and clinical correlations of urinary tract infections in diabetes mellitus patients - a comprehensive retrospective analysis

Aims: This study investigates the frequency and associated factors of urinary tract infections (UTIs) in patients with diabetes mellitus (DM). Methods: This retrospective chart review focused on patients with diabetes mellitus. Data collection involved demographic details, DM diagnosis, comorbidities such as hypertension, hyperlipidemia, and coronary artery disease, along with medication usage. Laboratory values including blood glucose and HbA1c levels were also analyzed. The primary outcome of interest was the diagnosis of UTI, identified from clinical records. Results: 173 DM patients were included in the study. These patients were divided into two groups according to the presence of UTI: 52 patients in the UTI group and 121 patients in the non-UTI group. The incidence of UTI was significantly higher in women (37.9%) compared to men (10.2%). No significant differences were observed between the groups in terms of age, presence of hypertension, hyperlipidemia, or coronary artery disease. Interestingly, the usage of SGLT-2 inhibitors was significantly higher in the UTI group compared to the non-UTI group (26.8% vs. 14%, p=0.043). No significant differences were found in other medication usage or in the levels of glucose and HbA1c between the groups. Conclusion: The study highlights the increased risk of UTIs in DM patients, particularly among women and those using SGLT-2 inhibitors. These findings suggest the need for careful monitoring and tailored approaches in managing UTIs in DM patients, considering gender and specific DM treatments.

Preparation of bio-synthesized Ag nanoparticles and assessment of their antidiabetic and antioxidant potential against STZ-induced diabetic albino rats

Bio-synthesized silver nanoparticles (AgNPs) were successfully obtained using the leaf extract from Ventilago maderaspatana. Extensive analysis was conducted to evaluate the physical and chemical characteristics of the bioderived AgNPs. XRD analysis confirmed their cubic structure, and revealed a well-defined size distribution with average crystallite size of 11.7 nm. FE-SEM and TEM images visually supported the observed size range. The presence of plant-mediated phytochemicals on the surface of AgNPs was confirmed through DLS, FTIR, and TGA/DTA studies. To assess their antidiabetic potential, rats were induced with streptozotocin, resulting in elevated levels of biochemical parameters associated with diabetes. Conversely, serum insulin levels (2.50 ± 0.55) and glucokinase activity (64.50 ± 8.66) decreased. However, treatment with AgNPs demonstrated a dose-dependent reduction in blood glucose, total protein, albumin, and HbA1c levels, effectively restoring them to normal ranges. Moreover, the treatment significantly increased insulin levels (7.55 ± 0.63) and glucokinase activity (121.50 ± 4.60), indicating the antidiabetic potential of V. maderaspatana-mediated AgNPs. Notably, the exitance of phytochemicals, like flavonoids and phenols, on the surface of AgNPs facilitated their ability to neutralize reactive oxygen species (ROS) through electron donation. This property enhanced their overall antidiabetic efficiency.

Impact of COVID-19 restrictions on diabetes mellitus management in Qatari primary care settings

IntroductionIn 2019, Coronavirus Diseases 2019 (COVID-19) emerged as a pandemic making diabetic patients among the most vulnerable to this virus. Previous studies showed contradicting evidence for the impact of “lockdown” on the management of diabetic patients. New models of service delivery were introduced in Primary Health Care Corporation (PHCC) (Qatar’s largest primary care provider) to ameliorate the risk of infection to both patients and health care workers including converting face to face chronic disease appointments (NCD, antenatal, and preventive visits) to telephone and video consultations. This study aimed to compare access and outcomes of PHCC registered diabetics pre-COVID and during the COVID-19 lockdown period.MethodsThe study was conducted as a 3 year historic cohort using PHCC’s electronic health record system. Individuals with an established diagnosis of diabetes mellitus (DM) before January 2019 and having at least one clinical encounter per year in a PHCC health center during the study period starting Jan 2019 to Dec 2021 were recruited. Pre-COVID-19 period was defined as the interval between January 2019 and February 2020, while the COVID-19 lockdown period was defined as the interval between February 2020 to December 2021. The study used a paired observation approach on selected process indicators on delivery of health services in line with PHCC’s diabetes management guidelines (at least two HbA1C tests done per year and at least one each of the following per year—low-density lipids (LDL) test, ophthalmology screening, podiatry assessment, health education and dietetics clinic consultations) and outcome indicators (blood pressure readings and the results of two laboratory tests: blood HbA1c and serum LDL level).ResultsCOVID-19 was associated with an overall mean reduction of 0.9 per year of consultations. Similarly, the delivery of annual assessments as per guidelines were also impacted. Of these, the probability of achieving the designed target for two HbA1C tests per year was reduced by almost a half (paired OR=0.47) during COVID-19 compared to pre- COVID-19 period. Conversely, a significant increase in the probability of having at least one each of LDL test, ophthalmology screening and dietetics consultation was observed (paired OR=1.84, 1.62 and 1.94 respectively) during COVID-19. The probability of having inadequate glycemic control (HbA1C > =7%) was significantly increased by 32% during COVID-19 period. Likewise, the probability of experiencing inadequately controlled blood pressure was significantly increased by 47% during the pandemic. Conversely, the probability of having Inadequately controlled blood lipids (LDL 2.6 mmol/L+) was significantly reduced by 9%.ConclusionsThe impact of the COVID-19 pandemic on the primary health care services in Qatar has highlighted PHCC’s resilience by the introduction of virtual consultations during COVID-19 restrictions. Only one process indicator was significantly impacted during COVID-19 restrictions, namely having at least two HbA1C tests per individual with diabetes per year. However, the control of the disease according to HbA1c and blood pressure measurements showed a noticeable deterioration during COVID-19.

Polyphenol-Standardized Aphanamixis polystachya Leaf Extract Ameliorates Diabetes, Oxidative Stress, Inflammation, and Fibrosis in Streptozotocin-Induced Diabetic Rats

Background. Diabetes is a rising disorder that affects millions of people annually. It also creates more complications, such as neuropathy, oxidative stress, and hepatic and kidney impairment. Aphanamixis polystachya plant, which possesses multiple medicinal values, is used in this study to explore its potential in treating diabetes. Methods. A single dose (65 mg/kg) of intraperitoneal streptozotocin injection was utilized to mediate diabetes in Sprague-Dawley rats. Diabetic animals were treated orally with 250 or 500 mg/kg of standardized leaves’ extract of A. polystachya (AP) for 28 days to evaluate the antidiabetic and organ-protective effects of the plant. Different biochemical and histological markers are measured according to the established protocol. Results. Our results demonstrated a significant decrease in blood glucose (p &lt;0.001) and HbA1c (p &lt;0.05) levels in the diabetic animal after administering AP (250 and 500 mg/kg doses) compared to the control groups. AP can also regularize lipids, glycogen, alanine aminotransferase, and aspartate aminotransferase. Furthermore, serum urea nitrogen and creatinine decreased after treatment with AP in diabetic rats. AP also reduced oxidative stress markers and showed a substantial elevation in antioxidant enzymes in diabetic animals. Overall, AP at 500 mg/kg revealed comparable results against the standard antidiabetic drug glyburide. Besides, the histological investigation showed the AP’s efficacy in attenuating kidney tissue inflammation and damage. HPLC data elucidated that the AP leaf extract contains polyphenols with potential antioxidant, antidiabetic, and organ protective agents: gallic acid, rutin hydrate, and quercetin hydrate. Conclusion. Taken together, AP may be one of the potential sources of antidiabetic agents.

Predicting Diabetes in Libya Using AI: A case Study

This study investigates the application of artificial intelligence (AI) techniques for predicting diabetes in Libya, a region with limited healthcare data. Utilizing a dataset from the Diabetes and Endocrinology Clinic in Al-Marj, Libya, we examined records of 2,009 patients between April 2019 and May 2023. Our methodology involved applying various AI algorithms, including logistic regression, decision trees, random forests, support vector machines (SVMs), and neural networks, to predict diabetes outcomes. These algorithms were assessed using metrics like precision, recall, F1 score, and the area under the receiver operating characteristic (ROC) curve. The findings indicate a promising potential of AI in forecasting diabetes, particularly when analyzing factors such as fasting blood sugar levels, HbA1c levels, hypertension, heart disease, age, and gender. The majority of the algorithms demonstrated high accuracy, suggesting their utility in enhancing healthcare outcomes in Libya. This research not only provides insights into the effectiveness of AI in diabetes prediction but also underscores the importance of such technologies in regions with scarce health data. It opens pathways for further exploration in the use of AI for healthcare improvement in similar contexts.

Nilotinib-induced Diabetes in Japanese Patients with Chronic Myeloid Leukemia.

Objective This study aimed to examine the risk of diabetes mellitus induced by nilotinib, a second-generation tyrosine kinase inhibitor. Methods This retrospective study included 25 patients with chronic myeloid leukemia (CML) treated with nilotinib at our hospital. Four patients had diabetes mellitus at the start of nilotinib administration (prior DM group), and five patients were newly diagnosed with diabetes mellitus after the start of nilotinib administration (new DM group). Sixteen patients who were not diagnosed with diabetes mellitus were classified into the non-DM group. Changes in the blood glucose and HbA1c levels were evaluated in each group at the time of nilotinib administration and two years later. Results Molecular genetic remission of CML was achieved in 81.8% of patients with diabetes and 72.2% of patients without non-DM group. There were no cases in this study in which nilotinib was changed or discontinued owing to hyperglycemia. There was no difference in the blood glucose levels at the start of nilotinib treatment among the groups. Two years after starting nilotinib, the blood glucose levels in the new DM group (232 (186-296) mg/dL) and prior DM group (168 (123-269) mg/dL) were significantly higher than those in the non-DM group (100 (91-115) mg/dL). ΔHbA1c levels in the new DM group (1.3 (0.9-2.2) %) and prior DM group (1.6 (0.7-1.7) %) were significantly higher than those in the non-DM group (-0.2 (-0.3-0.1) %). Conclusion Nilotinib caused diabetes in 23.8% of the participants, but there were no hyperglycemia-related severe adverse events. Therefore, nilotinib may be safely continued with regular monitoring for the development of diabetes after nilotinib administration.

A laboratory-based cross-sectional study about helicobacter pylori infection and diabetes.

Despite the numerous articles discussing the relationship between diabetes mellitus type 2 (DMT2) and chronic Helicobacter pylori (H. pylori) infection the results have been inconsistent, necessitating further research. This study investigated the coexistence of Helicobacter pylori infection and DMT2. We conducted a study in selected laboratories in Tehran, measuring the H.Pylori stool antigen (HpSA) in individuals referred by physicians for a glycosylated hemoglobin A1c (HbA1c) test. Out of the 2500 patients who were referred to randomly selected laboratories, a total of 2025 (81%) patients had serum HbA1c levels above 6.5%. of 2025 patients with HbA1c levels above 6.5%, 1321 (52.84%) had HpSA in their stool. No significant gender difference was observed, with a mean age ± SD, 48.65 ± 7.55. HpSA was positive in 52.84% of the DM group, while in the non-DM group, HpSA was positive in 37.36% of cases. Fecal antigen titers are not related to gender (P = 0.274) but are related to age (r = 0.213, P=0.034). Long-term infection with Helicobacter pylori may be significantly associated with elevated HgA1c.Testing for H. pylori infection, regular monitoring of blood sugar and HbA1c levels in high-risk people can prevent DMT2.

Determinants of 30-day mortality in elderly patients admitted to a cardiovascular surgery intensive care unit.

This study aims to identify the factors influencing 30-day morbidity and mortality in patients aged 65 and older undergoing cardiovascular surgery. Data from 360 patients who underwent cardiac surgery between January 2012 and August 2021 in the Cardiovascular Surgery Intensive Care Unit (CVS ICU) were analyzed. Patients were categorized into two groups: "mortality+" (33 patients) and "mortality-" (327 patients). Factors influencing mortality, including preoperative, intraoperative, and postoperative risk factors, complications, and outcomes, were assessed. Significant differences were observed between the two groups in factors affecting mortality, including extubation time, ICU stay duration, blood transfusion, surgical reexploration, aortic clamp duration, glomerular filtration rate (GFR), blood urea nitrogen (BUN), creatinine, hemoglobin A1c (HbA1c) levels, and the lowest systolic blood pressure during the first 24 hours in the ICU (p<0.05). The "mortality+" group had longer extubation times and ICU stays, required more blood transfusions, and had higher BUN-creatinine ratios, but lower systolic blood pressures, GFR, and HbA1c levels. Mortality was also higher in patients needing noradrenaline infusions and those who underwent reoperation for bleeding (p<0.05). By optimizing preoperative renal function, minimizing extubation time, shortening ICU stays, and carefully managing blood transfusions, surgical reexplorations, aortic clamp duration, and HbA1c levels, we believe that the mortality rate can be reduced in elderly patients. Key strategies include shortening aortic clamp times, reducing perioperative blood transfusions, and ensuring effective bleeding control.

Optimising antidiabetic medication management for type 2 diabetes and renal dysfunction in Can Tho City, Vietnam.

The research aimed to delineate and investigate the utilisation of antidiabetic drugs in type 2 diabetes patients with kidney failure at a hospital in Can Tho City, Vietnam. The research analysed the use of antidiabetic drugs at various time points, determined the drug interaction rate, and evaluated the appropriate use of drugs and the relationship with the achievement of target blood glucose and HbA1c levels. A two-tailed Student's t-test was employed to compare continuous variables, an ANOVA test was used to assess multiple values, and an χ2 test was utilised to evaluate categorical variables. Insulin monotherapy was the predominant regimen for treating type 2 diabetes in patients with impaired kidney function. Metformin was the most prescribed oral medication. Approximately 85.78% of patients received safe and appropriate diabetes treatment. Statistical analysis revealed a significant relationship between achieving target blood glucose and HbA1c after 3 months and factors such as safe drug use and minimal drug interactions (p < 0.05). Patients with chronic kidney disease demonstrated better blood glucose control compared to those with acute kidney disease. The most common drug used for type 2 diabetes patients with impaired kidney function was insulin monotherapy, with usage increasing with the severity of chronic kidney disease. The chronic kidney disease group exhibited a higher rate of achieving target blood glucose and HbA1c compared to the acute kidney disease group. Rational, safe, and interaction-free drug use significantly contributed to better blood sugar control compared to less prudent medication choices.

Cardiometabolic health across menopausal years is linked to white matter hyperintensities up to a decade later.

The menopause transition is associated with several cardiometabolic risk factors. Poor cardiometabolic health is further linked to microvascular brain lesions, which can be detected as white matter hyperintensities (WMHs) using T2-FLAIR magnetic resonance imaging (MRI) scans. Females show higher risk for WMHs post-menopause, but it remains unclear whether changes in cardiometabolic risk factors underlie menopause-related increase in brain pathology. In this study, we assessed whether cross-sectional measures of cardiometabolic health, including body mass index (BMI) and waist-to-hip ratio (WHR), blood lipids, blood pressure, and long-term blood glucose (HbA1c), as well as longitudinal changes in BMI and WHR, differed according to menopausal status at baseline in 9,882 UK Biobank females (age range 40-70 years, n premenopausal = 3,529, n postmenopausal = 6,353). Furthermore, we examined whether these cardiometabolic factors were associated with WMH outcomes at the follow-up assessment, on average 8.78 years after baseline. Postmenopausal females showed higher levels of baseline blood lipids (HDL = 0.14, p < 0.001, LDL = 0.20, p < 0.001, triglycerides = 0.12, p < 0.001) and HbA1c ( = 0.24, p < 0.001) compared to premenopausal women, beyond the effects of age. Over time, BMI increased more in the premenopausal compared to the postmenopausal group ( = -0.08, p < 0.001), while WHR increased to a similar extent in both groups ( = -0.03, p = 0.102). The change in WHR was however driven by increased waist circumference only in the premenopausal group. While the group level changes in BMI and WHR were in general small, these findings point to distinct anthropometric changes in pre- and postmenopausal females over time. Higher baseline measures of BMI, WHR, triglycerides, blood pressure, and HbA1c, as well as longitudinal increases in BMI and WHR, were associated with larger WMH volumes ( range = 0.03-0.13, p ≤ 0.002). HDL showed a significant inverse relationship with WMH volume ( = -0.27, p < 0.001). Our findings emphasise the importance of monitoring cardiometabolic risk factors in females from midlife through the menopause transition and into the postmenopausal phase, to ensure improved cerebrovascular outcomes in later years.

Association of Type‐2 diabetes mellitus with voxelwise tau uptake patterns

AbstractBackgroundDysfunctional insulin signaling and elevated hemoglobin‐A1c (HbA1c) ‐ both associated with type‐2 diabetes mellitus (T2DM) ‐ may result in increased tau hyperphosphorylation, thereby increasing the risk of Alzheimer’s Disease (AD)‐related neuropathology in T2DM patients. Individuals with both AD and T2DM show different profiles of tauopathy compared to individuals with just AD. Here, we evaluated voxelwise tau‐PET patterns with and without T2DM to clarify T2DM‐associated patterns of tau deposition in cognitively intact older adults.MethodWe examined 502 cognitively intact adults from the Health and Aging Brain Study: Health Disparities who had available 18F‐PI‐2620 tau‐PET, florbetaben‐PET (Aβ) (n = 462), MRI T1‐weighted scans (Siemens‐3T), and blood HbA1c levels (n = 492) (Table1). Voxelwise regression models were run in SPM12 using warped 18F‐PI‐2620 standardized uptake value ratio (SUVR) images as the outcome variable (gray matter of the posterior cerebellum reference region) and covarying for age, sex, and education. The first model assessed the effect of T2DM consensus diagnosis on tau uptake. The second model examined the relationship between HbA1c and tau uptake. Both voxelwise regression models were rerun adding global Aβ‐SUVR, obesity, and hypertension as covariates (Figure1).ResultVoxelwise regressions were corrected at voxel p&lt;0.001, cluster FWE p&lt;0.05. T2DM diagnosis was associated with higher 18F‐PI‐2620 uptake in the medial and inferior occipital regions, posterior cingulate, and parahippocampus. Higher HbA1c levels were associated with more 18F‐PI‐2620 uptake in parietal and frontal regions. When covarying for global Aβ‐SUVR, obesity, and hypertension, T2DM diagnosis was associated with 18F‐PI‐2620 uptake in the posterior cingulate. In the HbA1c model, no clusters survived FWE correction after covarying for global Aβ‐SUVR, obesity, and hypertension (Figure1). ConclusionIndependent of common T2DM comorbidities and brain amyloid, T2DM subjects demonstrated a 18F‐PI‐2620 tau uptake pattern that was different from the characteristic age‐associated medial temporal lobe pattern. Our voxelwise approach allowed us to identify regions that may distinguish T2DM‐related pathology from AD‐related changes. The difference in significant clusters between models could be due to HbA1c levels being controlled by medication in some T2DM patients – an area for future study.

Correlation of D-dimer Levels with Fasting Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus

Chronic hyperglycemia in patients with Type 2 Diabetes Mellitus (T2DM) can cause damage to various organs, resulting in both microvascular and macrovascular complications that lead to an increased risk of cardiovascular disease. One of the markers that can detect vascular disorders is D-dimer levels. Fasting blood glucose (FBG) analysis in T2DM patients associated with D-dimer levels is important to know to be used as an indicator in connection with diabetes complications, especially vascular complications. This study aims to determine the correlation between D-dimer levels and FGB. The study was conducted in three hospitals in North Sulawesi province. The study population was T2DM patients (as evidenced by fasting blood glucose &gt;126mg/dL) who examined themselves in the period January-June 2023. Samples were obtained using the total sampling method, where all populations that met the inclusion and exclusion criteria were used as participants. Ninety-four patients with T2DM (62 women and 32 men) were eligible to be participants in this study. Blood pressure, GDP and D-dimer were examined. Based on the results of the blood pressure examination, 40 participants suffered from hypertension and 54 participants did not. The average values of blood glucose, HbA1c and D-dimer levels in hypertensive and non-hypertensive participants are not much different. The results of the analysis using Spearman's rho showed that there was a moderate correlation between D-dimer levels and GDP (p=0.03, r=0.302). In conclusion, although there is a moderate correlation between D-dimer levels and fasting blood glucose levels, D-dimer is not recommended to be used as an indicator of complications in T2DM.

Brown Seaweed Consumption as a Promising Strategy for Blood Glucose Management: A Comprehensive Meta-Analysis

Diabetes is a chronic condition that can lead to various complications; therefore, there is a need to emphasize prevention and management. Dietary interventions, such as the Mediterranean diet or calorie-restricted regimens, coupled with exercise-induced weight reduction, have been recommended for enhancing diabetes management. Seaweeds contain various functional components, such as polyphenols and fucoidan, which have been reported to exert multiple benefits, including blood glucose regulation, improved intestinal health, and enhanced of lipid profiles. The association between blood glucose and seaweed consumption has been established in previous research. We searched the PubMed, RISS, Google Scholar, ScienceDirect, and Cochrane Library databases to identify relevant studies after applying the selection/exclusion criteria, and 23 studies were ultimately included in this analysis. Comprehensive Meta-Analysis (CMA) software version 4.0 was used to assess statistical significance and heterogeneity. In this meta-analysis, postprandial blood glucose, glycated hemoglobin (HbA1c), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) levels demonstrated significant improvements in the seaweed group compared to the control group. Conversely, fasting blood glucose and insulin levels did not show significant associations with seaweed consumption. Subgroup analysis revealed that a high dose (1000 mg or more) was more beneficial than a low dose, and seaweeds such as Laminaria digitata, Undaria pinnatifida, Acophyllum nodosum, and Fucus vesiculosus were found to be more effective at improving blood glucose levels than control treatments. Therefore, based on our research, seaweed supplementation appears to be a promising strategy for reducing postprandial blood glucose, HbA1c, and HOMA-IR levels, thereby enabling better blood glucose management and leading to a decreased risk of type 2 diabetes.

Study of the influence of GLP-1 receptor agonists on the metabolic activity of the intestinal microbiota in patients with type 2 DM

The aim: to investigate the peculiarities of the metabolic activity of the intestinal microbiota in patients with type 2 diabetes under the influence of glucagon-like peptide-1 receptor agonist therapy. Materials and methods: 21 patients with type 2 diabetes mellitus were included in the study, the average age was 57.2±8.53 years (M±SD), the HbA1c level was 8.29±0.88 % (M±SD). Patients were prescribed raGLP-1 at the maximum tolerated dose for 6 months. Before and after the course of treatment, indicators of body composition were determined by the bioelectrical impedance method (TANITA BC-545N analyzer, Japan), characteristics of carbohydrate metabolism and the lipid spectrum of blood serum, as well as the concentration of GLP-1, trimethylamine-N-oxide (TMAO) by the immunoenzymatic method, of short-chain fatty acids (SCFA) by the method of chromatographic research. Results. After 6 months of therapy with liraglutide against the background of a statistically significant decrease in fasting blood glucose and HbA1c levels (p&lt;0.05), a decrease in body mass index and waist circumference (p&lt;0.05), a decrease in the content of visceral (p&lt;0.05 ) and total fat (p&lt;0.05) in patients with type 2 diabetes, there was a decrease in the concentration of TMAO in blood serum (p&lt;0.05) and an increase in the concentration of SCFA: acetic, propionic (p&lt;0.05) in the coprofiltrate and a tendency to increase in the level of butyric acids. Data analysis also established an increase in the concentration of endogenous GLP-1 in the blood (p&lt;0.05). Conclusions. The detected changes in microbial metabolites may indicate a positive effect of raGLP-1 on the composition of the intestinal microbiota and its metabolic activity in patients with T2DM, which in turn contributes to the improvement of endogenous secretion of incretins