Hyperglycemia Research Articles

Diabetes Disparities: Addressing Health Inequities and Improving Outcomes in Underserved Populations

Diabetes mellitus, characterized by high blood sugar levels due to insulin deficiency or resistance, is a global public health crisis with significant disparities in prevalence, management, and outcomes, particularly among underserved populations such as racial and ethnic minorities, low-income groups, and rural residents. These populations faced higher rates of diabetes and complications due to social determinants of health, including economic instability, inadequate education, and limited access to healthcare. Barriers such as lack of insurance, transportation challenges, and cultural and linguistic differences further hindered effective diabetes management. Lifestyle and behavioral factors, including diet, physical activity, medication adherence, and mental health, play critical roles in diabetes outcomes. Policy and system-level interventions, such as expanding healthcare coverage, improving access to care, and addressing social determinants of health, are essential to reducing disparities. Technological innovations like telehealth, mobile health applications, wearable devices, and data analytics offered significant potential to enhance diabetes management in underserved populations. This review was conducted using a comprehensive analysis of current literature and existing studies to provide insights into the multifaceted nature of diabetes disparities and to highlight successful interventions and necessary policy changes to improve health outcomes for underserved populations. Addressing these inequities required a multifaceted approach, including community-based interventions, policy reforms, and technological advancements to ensure equitable diabetes care for all. Keywords: Diabetes disparities, Underserved populations, social determinants of health, Healthcare access, Technological innovations.

Study of Differences in Blood Sugar Levels of Diabetes Mellitus Patients Who Consume Rice Cooked with the Rice Cooker Method and The Steaming Method

The 2023 Indonesian Health Survey Report issued by the Ministry of Health revealed that there was an increase in the prevalence of diabetes mellitus (DM) in the population aged over 15 years based on the results of blood sugar level measurements. In the 2018 Basic Health Research, it was recorded that the prevalence of diabetes in Indonesia reached 10.9%. Now, the prevalence has reached 11.7% in 2023. The Aceh Health Office recorded that sufferers of Diabetes Mellitus until early 2023 reached 154,889 cases. The purpose of this study is to find out the difference in blood sugar levels in people with diabetes mellitus who consume rice after cooking with the rice cooker method and with the steaming method. This quantitative analytical research uses a cross-sectional study design. The population of the study was all people with diabetes mellitus at the Calang Health Center, Aceh Jaya Regency, totaling 50 people. Data collection was carried out from January 15 to March 15, 2024 using nonprobability sampling techniques. This study also took direct data by looking at the sugar content of the respondents by eating rice cooked by the rice cooker method and 1 month later by measuring the sugar content of the respondents consuming rice by cooking the rice by steaming. Data were analyzed using univariate, bivariate and multivariate statistical tests. The results of the study showed that factors related to blood sugar levels in DM patients were gender, age, education, occupation, income, physical activity, nutritional status, smoking behavior, and family history of diabetes. The factors most related to increased blood sugar levels in diabetes mellitus patients were steaming with OR=7.47, use of a rice cooker of 11.2 and family history of diabetes mellitus of 7.50. It is expected that respondents will control their blood sugar levels, so that DM sufferers and their families will cook rice using the steaming method, and control other risk factors that can cause high blood sugar levels.

Self-Care Activities Among Diabetic Patients in an Urban Health Centre in Thirumazhisai, Tamil Nadu: A Cross-Sectional Study.

Background Diabetes is a long-term medical condition characterized by consistently high blood glucose levels, which can be attributed to both genetic and environmental factors. Global diabetes prevalence is predicted to reach 10.4% by 2040, impacting over 642 million people. Diabetes is becoming more common in India; by 2030, an estimated 87 million individuals are predicted to have the disease. Self-care activities are essential for managing diabetes, yet adherence to these practices is often low in developing countries like India due to socioeconomic, cultural, and healthcare barriers. Objective In this study, the self-care practices of diabetic patients who visited an Urban Health Center in Thirumazhisai, Tamil Nadu, were assessed, along with the factors influencing these practices. Methods A three-month cross-sectional study was conducted in a facility with 200 type 2 diabetic patients who had been unwell, for a minimum of a year. The participants were selected via purposeful sampling, and interviews were conducted using the most recent version of the Summary Diabetes Self-Care Activities (SDSCA) questionnaire. The data was analyzed using SPSS version 26 (IBM Corp., Armonk, NY, USA) to discover connections between the duration of diabetes and self-care practices using descriptive statistics and chi-square tests. Results The study found that 136 (68%) of participants tested their blood sugar levels at least once in the preceding three months, 104 (52%) exercised for at least 30 minutes each day, and 96 (48%) of individuals maintained a balanced diet. On the other hand, adherence to insulin injections and oral hypoglycemic medications was lower, at 98 (49%) and 79 (39.5%), respectively. Foot hygiene was also not at its best; only 85 (42.5%) people washed their feet daily. Considerable correlations have been shown between the length of diabetes and particular self-care behaviors, including eating patterns, exercise routines, and foot hygiene. Conclusion The results emphasize the necessity of focused interventions, especially in developing nations, to enhance diabetic patients' self-care behaviors.Tailored, patient-centered strategies are essential to address the complex factors influencing diabetes management, ultimately improving glycemic control and patient outcomes.

Associations of Placental Inflammation and Oxidative Stress Biomarkers with Glucolipid Metabolism in Children: A Birth Cohort Study in China.

The maternal intrauterine immune environment may affect offspring long-term health. We aimed to investigate the association between the intrauterine placental immunological milieu and glycolipid metabolic health in children. This study enrolled 1803 mother-child pairs from the Ma'anshan birth cohort (2013-2014). Placental mRNA expression of inflammatory cytokines (interleukin-1β [IL-1β], IL-10, monocyte chemoattractant protein-1, tumor necrosis factor-α, IL-4, IL-6, IL-8, C-reactive protein, and interferon-γ) and oxidative stress biomarkers (heme oxygenase-1, hypoxia-inducible factor-1alpha, and glucose-related protein 78) was quantified using real-time quantitative polymerase chain reaction. Fasting blood glucose, insulin, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol were assessed at 5 to 6 years old. Statistical analyses included multiple linear regression, binary logistic regression, restricted cubic spline model, and the Bayesian kernel machine regression model. Placental inflammatory cytokines (IL-1β, monocyte chemoattractant protein-1, C-reactive protein, IL-6, IL-8, IL-10) and oxidative stress biomarkers (heme oxygenase-1, hypoxia-inducible factor-1alpha, glucose-related protein 78) showed positive associations with children's fasting blood glucose levels. Heme oxygenase-1 and glucose-related protein 78 exhibited negative correlations with children's fasting insulin levels. Elevated IL-6, heme oxygenase-1, hypoxia-inducible factor-1alpha, and glucose-related protein 78 were associated with increased risk of prediabetes in children. Overall upregulation of placental proinflammatory cytokines and oxidative stress factors mRNA expression correlated with higher prediabetes risk in children. Bayesian kernel machine regression analysis indicated a joint positive effect of the 12 placental inflammation and oxidative stress mixtures on children's risk of high fasting blood glucose. This exploratory study underscores significant correlations between maternal intrauterine placental inflammation, oxidative stress markers, and offspring fasting blood glucose and insulin levels. These findings highlight the potential role of intrauterine holistic immunity in shaping offspring glucose metabolism health.

The Analysis Study of Prevalence of Gastrointestinal Complication in Patients with Type 2 Diabetes Mellitus : A Comprehensive Systematic Review

Background: Diabetes, a chronic metabolic disorder, has a high prevalence worldwide due to changing lifestyles and urbanization. It is associated with life-threatening hazards and disabling complications, decreasing life expectancy. Gastroparesis, a well-known manifestation, is more prevalent in women. Understanding the prevalence of gastrointestinal complications in type 2 diabetes mellitus patients is crucial for creating effective treatment regimens. Methods: Adhering to the PRISMA 2020 principles, this systematic study focused on analyzing complete English literature texts published from 2011 to 2024. Several websites, such as ScienceDirect, PubMed, and SagePub, were used to collect the literature. Result: The study examined over 4000 publications sourced from recognized platforms such as Science Direct, SagePub, and PubMed. Following the decision to subject eight publications to further scrutiny, a comprehensive examination of the complete body of literature was conducted. Conclusion: Diabetes often leads to gastroparesis, a condition affecting the upper gastrointestinal tract, associated with metabolic imbalance, high blood sugar levels, low insulin, hormone release, and H. pylori infection. This condition is linked to the contractile activity of the duodenum, and is associated with various liver conditions, including diabetic fibrosis and cirrhosis.

Evaluation of the relationship between xanthine oxidase activity and metabolic syndrome in a population group in Bangladesh

Xanthine oxidase (XO) is an enzyme that converts hypoxanthine into xanthine and xanthine into uric acid, which is then eliminated by the kidneys. Serum XO has been linked to diabetes, hypertension, liver dysfunction, and cardiovascular diseases. However, limited information exists on the relationship between serum XO activity and MetS. This study aimed to analyze the relationship between XO activity and metabolic syndrome (MetS) and its components in an adult population group in Bangladesh A total of 601 participants aged ≥18 years were included in the study. MetS was defined based on the criteria set by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). Serum XO activity was measured using the enzyme-linked immunosorbent assay (ELISA), while other biochemical parameters were measured using colorimetric methods. The relationship between serum XO and MetS levels was determined through multivariate logistic regression analysis. Serum XO activity was found to be significantly higher in females (6.17 ± 3.77 U/L) as compared to males (4.00 ± 2.77 U/L) (p < 0.001). Furthermore, participants with MetS had significantly higher mean levels of serum XO (5.34 ± 3.39 U/L) than those without MetS (3.86 ± 2.90 U/L) (p < 0.001). The prevalence of MetS and its components, such as blood pressure and blood glucose increased across the XO quartiles (p < 0.001). Regression analysis indicated that XO activity was significantly and independently associated with the prevalence of MetS (at least p < 0.05 for all cases) and its components, including elevated blood pressure, high blood glucose, and low HDL-C (at least p < 0.05 for all cases). In conclusion, individuals with MetS had significantly higher XO levels than those without MetS. Serum XO activity showed an independent association with MetS and some of its components. Therefore, XO might serve as a useful marker of MetS. Prospective studies are needed to determine the underlying mechanisms linking XO and MetS.

Investigation of Pharmacological Screening Techniques for Diabetes Mellitus

Diabetes is the medical term for a condition in which the body fails to generate or use insulin as intended, leading to high blood sugar levels. Both in-vitro and in-vivo techniques are employed to assess the antidiabetic potential of synthetic or natural compounds that have been extracted from conventional plants. The rat paw oedema method is frequently used to screen anti-inflammatory medications. The use of animals in this procedure has drawbacks related to ethical concerns. We proposed an in vitro system in this context that would not have these drawbacks. Rat in vivo experiments are frequently used to screen anti-hyperlipidemic medications. Pharmacological screening currently entails testing novel chemical entities as plant extracts or any other type of material (synthetic or semisynthetic) in isolated preparations before testing on entire animals. Rats and mice are typically used, but occasionally higher animals like dogs and monkeys are as well. These techniques have been used to assess the majority of medications now used in therapy. Wherever possible, non-animal alternatives are being developed. Pharmacologists' constant struggle is to reconcile in vitro and in vivo results. A thorough grasp of the in vivo performance is one of the main objectives of pharmacological screening. Therefore, it would be praiseworthy to establish in vitro assessments that might be connected to in vivo performance.

Association of overexpression of PLD6, CHRAC1 and PDCD5 with type 2 diabetes mellitus.

Diabetes type 2 (DT2) is a metabolic disease characterized by high blood sugar caused by insulin resistance and/or insufficient insulin production. The pathogenesis of DT2 is complicated by both genetic predisposition and environmental and lifestyle variables. At least 150 genetic variants have been linked to the probability of having DT2. The aim of this study was to determine the expression of PLD6, CHRAC1, and PDCD5 genes in type 2 diabetic patients. Information on 12 DT2 patients was obtained from the Gene Expression Omnibus (GEO) using the series identification (ID) (GSE34008). The analysis tools GEO2R, String Utils (STRING), University of Alabama at Birmingham Cancer data analysis (UAL-CAN), and the Cancer Genome Atlas (TCGA) were used. The human protein atlas provided details on gene cancer. Only ten genes with expression differences ranging from low to high were selected. PLD6, CHRAC1, and PDCD5 were detected to have higher expression in patients compared to controls. The number of patients with primary pancreatic adenocarcinoma for SLC16A4, DERK2, and CHRAC1 was greater than that of healthy controls. Concerning the severity of cancer, all chosen genes demonstrated a greater proportion of affected individuals compared to the control group. There are multiple genes whose increased expression is linked to type 2 diabetes.

Long-Term Exposure to Polystyrene Microspheres and High-Fat Diet-Induced Obesity in Mice: Evaluating a Role for Microbiota Dysbiosis.

Microplastics (MPs) have become a global environmental problem, emerging as contaminants with potentially alarming consequences. However, long-term exposure to polystyrene microspheres (PS-MS) and its effects on diet-induced obesity are not yet fully understood. We aimed to investigate the effect of PS-MS exposure on high-fat diet (HFD)-induced obesity and underlying mechanisms. In the present study, C57BL/6J mice were fed a normal diet (ND) or a HFD in the absence or presence of PS-MS via oral administration for 8 wk. Antibiotic depletion of the microbiota and fecal microbiota transplantation (FMT) were performed to assess the influence of PS-MS on intestinal microbial ecology. We performed 16S rRNA sequencing to dissect microbial discrepancies and investigated the dysbiosis-associated intestinal integrity and inflammation in serum. Compared with HFD mice, mice fed the HFD with PS-MS exhibited higher body weight, liver weight, metabolic dysfunction-associated steatotic liver disease (MASLD) activity scores, and mass of white adipose tissue, as well as higher blood glucose and serum lipid concentrations. Furthermore, 16S rRNA sequencing of the fecal microbiota revealed that mice fed the HFD with PS-MS had greater -diversity and greater relative abundances of Lachnospiraceae, Oscillospiraceae, Bacteroidaceae, Akkermansiaceae, Marinifilaceae, Deferribacteres, and Desulfovibrio, but lower relative abundances of Atopobiaceae, Bifidobacterium, and Parabacteroides. Mice fed the HFD with PS-MS exhibited lower expression of MUC2 mucin and higher levels of lipopolysaccharide and inflammatory cytokines [tumor necrosis factor- (TNF-), interleukin-6 (IL-6), IL-1, and IL-17A] in serum. Correlation analyses revealed that differences in the microbial flora of mice exposed to PS-MS were associated with obesity. Interestingly, microbiota-depleted mice did not show the same PS-MS-associated differences in Muc2 and Tjp1 expression in the distal colon, expression of inflammatory cytokines in serum, or obesity outcomes between HFD and HFD + PS-MS. Importantly, transplantation of feces from HFD + PS-MS mice to microbiota-depleted HFD-fed mice resulted in a lower expression of mucus proteins, higher expression of inflammatory cytokines, and obesity outcomes, similar to the findings in HFD + PS-MS mice. Our findings provide a new gut microbiota-driven mechanism for PS-MS-induced obesity in HFD-fed mice, suggesting the need to reevaluate the adverse health effects of MPs commonly found in daily life, particularly in susceptible populations. https://doi.org/10.1289/EHP13913.

GTPBP8 mitigates nonalcoholic steatohepatitis (NASH) by depressing hepatic oxidative stress and mitochondrial dysfunction via PGC-1α signaling

Nonalcoholic steatohepatitis (NASH) is emerging as a major cause of liver transplantation and hepatocellular carcinoma (HCC). Regrettably, its pathological mechanisms are still not fully comprehended. GTP-binding protein 8 (GTPBP8), belonging to the GTP-binding protein superfamily, assumes a crucial role in RNA metabolism, cell proliferation, differentiation, and signal transduction. Its aberrant expression is associated with oxidative stress and mitochondrial dysfunctions. Nevertheless, its specific functions and mechanisms of action, particularly in NASH, remain elusive. In our current study, we initially discovered that human hepatocytes L02 displayed evident mitochondrial respiratory anomaly, mitochondrial damage, and dysfunction upon treatment with palmitic acids and oleic acids (PO), accompanied by significantly reduced GTPBP8 expression levels through RNA-Seq, RT-qPCR, western blotting, and immunofluorescence assays. We then demonstrated that GTPBP8 overexpression mediated by adenovirus vector (Ad-GTPBP8) markedly attenuate lipid accumulation, inflammatory response, and mitochondrial impair and dysfunction in hepatocytes stimulated by PO. Conversely, adenovirus vector-mediated GTPBP8 knockdown (Ad-shGTPBP8) significantly accelerated lipid deposition, inflammation and mitochondrial damage in PO-treated hepatocytes in vitro. Furthermore, we constructed an in vivo NASH murine model by giving a 16-week high fat high cholesterol diet (HFHC) diet to hepatocyte specific GTPBP8-knockout (GTPBP8HKO) mice. We firstly found that HFHC feeding led to metabolic disorder in mice, including high body weight, blood glucose and insulin levels, and liver dysfunctions, which were accelerated in these NASH mice with GTPBP8 deficiency in hepatocytes. Consistently, GTPBP8HKO remarkably exacerbated the progression of NASH phenotypes induced by HFHC, as proved by the anabatic lipid accumulation, inflammation, fibrosis and reactive oxygen species (ROS) production in liver tissues, which could be largely attributed to the severe mitochondrial damage and dysfunction. Mechanistically, we further identified that GTPBP8 interacted with peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) in hepatocytes. Importantly, the hepaprotective effects of GTPBP8 against mitochondrial dysfunction, oxidative stress and inflammation was largely dependent on PGC-1α expression. Collectively, GTPBP8 may exert a protective role in the progression of NASH, and targeting the GTPBP8/PGC-1α axis may represent a potential strategy for NASH treatment by improving mitochondrial functions.

Depression and Anxiety Screening of Patients With Type II Diabetes Mellitus Attending Primary Healthcare Centers in Saudi Arabia.

Diabetes mellitus is a chronic condition affecting both physical and mental health. High blood sugar levels can lead to serious complications if not managed properly. Individuals with diabetes are also at a higher risk of developing mental health disorders like depression and anxiety. The objective was to assess the prevalence of depression and anxiety among patients with type II diabetes attending primary healthcare centers in Makkah, Saudi Arabia. An analytical cross-sectional study design was employed, targeting adults with type II diabetes attending primary healthcare centers in Makkah. A total sample size of 412 participants was selected through systematic random sampling. Data were collected using validated Arabic versions of the patient health questionnaire (PHQ-9) and the general anxiety disorder (GAD-7) questionnaire, along with demographic information. Statistical analysis was conducted with non-parametric tests used to evaluate the significance of outcome variables. The median age of participants was 47 years, with 237 (57.5%) being male and 373 (90.5%) Saudi nationals. Neuropathy was the most prevalent complication, affecting 181 (43.9%) of participants. The median GAD-7 score was 5, and the median PHQ-9 score was 7. Mild to moderate depression was observed in 224 (54.4%), and 194 (47%) had mild-to-moderate anxiety. Significant associations were found between mental health outcomes and several factors: nationality (non-Saudis showed higher depression and anxiety scores, p = 0.010 and p = 0.020, respectively), marital status (divorced participants had the highest mean ranks for both conditions, p = 0.003 for depression and p < 0.001 for anxiety), and monthly income (p = 0.007 for depression and p = 0.008 for anxiety). Additionally, the presence of diabetes complications was strongly associated with higher depression and anxiety scores (p < 0.001 for both). The findings indicate a high prevalence of depression and anxiety among patients with type II diabetes in Makkah. These mental health issues are significantly associated with socio-demographic factors and diabetes complications. Integrated medical and psychological care is needed to improve the quality of life and treatment outcomes for diabetic patients.

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.

Knowledge and Awareness of Type 2 Diabetes Complications in Conflict-Affected Regions: A Cross-Sectional Study in Homs, Syria.

Background Diabetes mellitus is a significant global health problem characterized by high blood sugar levels due to either a lack of insulin or insensitivity to it. Concerns about diabetes complications are growing both globally and locally, making effective preventive measures crucial to tackle these complications. This research aimed to determine the level of knowledge and awareness regarding type 2 diabetes complications among patients in Homs, Syria, during the ongoing conflict. Methods A cross-sectional study was conducted among 1016 diabetic patients aged 16 years and above attending internal medicine and diabetes clinics in Homs City through a structured questionnaire administered via social media, telephone interviews, and paper forms. The data collected were analyzed using SPSS version 23.0 (IBM Corp., Armonk, USA). Descriptive statistics were used to summarize the demographic characteristics. In contrast, inferential statistics such as the chi-square test were used to test for associations between different variables with p-value < 0.05 as the significance level. Results The study found that 478 (47.1%) of participants were male, and 538 (53%) were female. The majority 652 (64.2%) were between 46 and 70 years old, and 422 (41.5%) had primary-level education. Most were married 750 (73.8%) and lived in urban areas 856 (84.2%). Diabetes knowledge varied significantly by age, education, occupation, and residence. Housewives and those with lower education levels had the least knowledge, while urban residents and those with 1-5 years since diagnosis had better awareness. Individuals with relatives in the medical field had higher knowledge levels.Results indicate that gender did not significantly influence diabetes knowledge (p = 0.19), while younger adults showed poorer awareness compared to older age groups (p < 0.05). Higher education levels were associated with better knowledge (p < 0.05), and a family history of diabetes correlated with greater awareness of complications. Occupation significantly impacted knowledge, with employed individuals and urban residents demonstrating higher awareness levels (p < 0.05). Diabetes knowledge peaked during the 6-10 year disease duration (p < 0.05). Conclusion This study assesses diabetes knowledge and management practices among 1016 participants in Homs, Syria, focusing on demographic and socioeconomic factors. Our findings underscore the need for targeted educational initiatives to improve diabetes management, particularly among younger, less educated, and rural populations in Homs.The analysis reveals significant knowledge gaps about diabetes across different demographics in Homs, highlighting the need for targeted educational programs, especially for younger individuals, the less educated, and rural residents. The study emphasizes the importance of education and medical practice in understanding diabetes, particularly in conflict-affected areas.

Phytochemicals and their Potential Mechanisms against Insulin Resistance.

Insulin's inception dates back to 1921 and was unveiled through a momentous revelation. Diabetes is a dangerous, long-term disease in which the body fails to generate enough insulin or utilize the insulin it creates adequately. This causes hyperglycemia, a state of high blood sugar levels, which can even put a person into a coma if not managed. Activation of the insulin receptor corresponds to two crucial metabolic functions, i.e., uptake of glucose and storage of glycogen. Type 2 diabetes mellitus (T2DM) exists as one of the most challenging medical conditions in the 21st century. The sedentary lifestyle and declining quality of food products have contributed to the rapid development of metabolic disorders. Hence, there is an urgent need to lay some reliable, significant molecules and modalities of treatment to combat and manage this epidemic. In this review, we have made an attempt to identify and enlist the major phytoconstituents along with the associated sources and existing mechanisms against insulin resistance. The conducted study may offer potential sustainable solutions for developing and formulating scientifically validated molecules and phytoconstituents as formulations for the management of this metabolic disorder.

A Comparison of the Decline in Glomerular Filtration Rate between Elderly Patients with Diabetes and those without Diabetes in Southwest China.

To investigate the effect of high blood glucose on the decline in the estimated glomerular filtration rate (eGFR) in the elderly. We compared the decline in eGFR of diabetic and non-diabetic groups in the noninterventional state and analyzed the effect of hyperglycemia on the decline in eGFR among the elderly in a retrospective analysis of 1,223 cases of elderly people aged 65 years or older with a 4-year follow-up period. The prevalence of diabetes in the elderly increased significantly from 12.67% in 2017 to 16.68% in 2021. The rate of decline in eGFR in patients with diabetes was higher than in the population without diabetes, at 9.29% and 5.32%, respectively (both p <0.05). The results of this study revealed that the prevalence of diabetes in the elderly increased significantly, and there is a more rapid decrease in the eGFR levels in those with diabetes than those without diabetes.

Serum Uric Acid and Microalbuminuria: Predictors of Renal Dysfunction in Type 2 Diabetes Patients in South-Western Uganda.

Background Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by insulin resistance and high blood glucose levels, which has become a global pandemic in recent decades and is associated with several health complications, including renal dysfunction. Serum uric acid levels are associated with kidney damage and have been linked to various health conditions. Urine microalbumin is a sensitive marker of kidney damage and is commonly used to monitor renal dysfunction in diabetes. The study aimed to compare the predictive value of serum uric acid and urine microalbumin in detecting kidney damage among T2D patients. Method This secondary data analysis used a cross-sectional dataset of 140 diabetic patients from Mbarara Regional Referral Hospital(MRRH) in Mbarara, Uganda. The main outcome was renal dysfunction, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m². Key variables included serum uric acid, urinary microalbumin, and various demographic and clinical factors. Data were analyzed using logistic regression and receiver operating characteristic (ROC) curve analysis to evaluate predictive performance. Ethics approval was obtained from the Mbarara University Research Ethics Committee. Results This study involved 140 participants with a median age of 53 years (interquartile range (IQR) 44-60.5), predominantly females (95, 67.9%), primarily educated (76, 54.3%), and mostly married (104, 74.3%). Participants with renal dysfunction were older (median age 61 years, IQR 52-69) compared to those without (median age 49, IQR 40-56), with significant differences in urinary microalbumin and serum uric acid levels (p <0.05). Renal dysfunction prevalence was 33.6% (95% CI: 26.2-41.9), higher in participants with diabetes duration ≥5 years, microalbuminuria, certain marital statuses, and higher diastolic blood pressure. Microalbuminuria (adjusted odds ratio (aOR) 4.71, 95% CI: 1.27-17.50, P = 0.021) and serum uric acid (aOR 1.01, 95% CI: 1.0002-1.0153, P = 0.045) were significantly associated with renal dysfunction. Other associated factors included age, female gender, and diastolic hypertension. Both biomarkers had significant predictive power for renal dysfunction (area under the curve (AUC) 0.62 and 0.65, respectively). Conclusion This study confirms the high prevalence of renal dysfunction among T2D patients, with a finding of 33.6%. The significant association between microalbuminuria and renal dysfunction, as well as the predictive capacity of serum uric acid and urinary microalbumin, highlight the importance of these biomarkers in identifying individuals at risk of kidney complications.

Assessment of Correlation Between Glycaemic Variability Indices and Measures of Hypoglycaemia in Patients with Type 2 Diabetes Mellitus

Abstract Introduction: Diabetes mellitus is a global health burden, and India is regarded as the diabetes capital of the world. Glycaemic variability (GV) is an established risk factor for hypoglycaemia (plasma glucose concentration &lt;70 mg/dL) and a notorious risk factor for diabetes complications. The primary aim of the study was to assess the correlation between the GV indices, HbA1c levels, and measures of hypoglycaemia in patients with type 2 DM (T2DM). Methods: In this cross-sectional study, continuous glucose monitoring (CGM) was done for a period of 14 days in T2DM patients (n = 50). The GV indices were determined from the readings obtained from the CGM monitor. Spearman’s rank correlation coefficient was used for correlation analyses. The area under the receiver operating characteristics (ROC) curve was used to assess the effectiveness of the various GV indices in predicting hypoglycaemia. Results: A total of 50 T2DM patients had a mean (SD) age of 61.84 ± 11.88 years. Among the GV indices, high blood glucose index (HBGI), average daily risk range (ADRR), and continuous overall net glycaemic action (CONGA) had a significantly positive correlation with HbA1c levels. Average episodes of nocturnal hypoglycaemia in 8 hours of night-time had a statistically significant negative correlation with the HbA1c levels (correlation coefficient: −0.301, P = 0.034). In addition, low blood glucose index (LBGI) was found to be the best predictor for the risk of hypoglycaemia in 24 hours and nocturnal hypoglycaemia. Conclusion: Various GV indices are associated with HbA1c levels and are better predictors of hypoglycaemia.

Hybrid CNN-LSTM for Predicting Diabetes: A Review.

Diabetes is a common and deadly chronic disease caused by high blood glucose levels that can cause heart problems, neurological damage, and other illnesses. Through the early detection of diabetes, patients can live healthier lives. Many machine learning and deep learning techniques have been applied for noninvasive diabetes prediction. The results of some studies have shown that the CNN-LSTM method, a combination of CNN and LSTM, has good performance for predicting diabetes compared to other deep learning methods. This paper reviews CNN-LSTM-based studies for diabetes prediction. In the CNNLSTM model, the CNN includes convolution and max pooling layers and is applied for feature extraction. The output of the max-pooling layer was fed into the LSTM layer for classification. The CNN-LSTM model performed well in extracting hidden features and correlations between physiological variables. Thus, it can be used to predict diabetes. The CNNLSTM model, like other deep neural network architectures, faces challenges such as training on large datasets and biological factors. Using large datasets can further improve the accuracy of detection. The CNN-LSTM model is a promising method for diabetes prediction, and compared with other deep-learning models, it is a reliable method.

A review on medicinal plants for the management of diabetes mellitus

Diabetes is a metabolic disorder in which there are high levels of sugar in the blood, a condition called hyperglycemia. Under normal conditions, food is broken down to glucose which then enters the bloodstream and acts as fuel for the body. The pancreas produces a hormone called insulin which helps to carry glucose from the bloodstream into muscle, fat and liver where it can be used as fuel. Diabetics are not able to move this sugar out of the bloodstream because of two primary reasons as their pancreas does not produce enough insulin and/or their cells do not respond normally to insulin, a condition called insulin resistance. This is why people with diabetes have high blood sugar levels. Diabetes mellitus can induce life-threatening health problems such as blindness, heart disease, kidney damage, and stroke. Although the cure of DM has improved over the past decades, its morbidity and mortality rates remain high. Hence, new therapeutic strategies are needed to overcome the burden of this disease. One such prevention and treatment strategy that is easily accessible to diabetic patients at low cost is the use of medicinal plants The research objective of this review article is to study DM and explore its treatment modalities based on medicinal plants. Results of numerous scientific investigations revealed that chemical constituents present in some medicinal plants possess anti-hypoglycemic activities and show promise for the prevention and/or control of DM.

Effects of nutritional education on metabolic syndrome parameters in a sample of adults in Subotica, Northern Serbia

The aim of this study is to assess the changes in metabolic syndrome parameters among adults after the implementation of nutrition education. The research was conducted as a prospective, longitudinal, quasi-experimental evaluation study from May to December 2022. The research sample included 31 employees at the College of Vocational Studies in Subotica. The study was conducted in three phases: Initial assessment (anthropometric, clinical, biochemical measurements and eating habits), Nutrition educations (onloine and face-to-dace) and Evaluative assessment (six months after the initial assessment). Data analysis included methods of descriptive and comparative statistical analysis. Nutrition education was conducted for 31 participants, but only 18 responded to the evaluative assessment. Two thirds (62%) of the participants were overweight ad had elevated cholesterol levels. Elevated triglyceride values were registered in more than a half of the participants and high blood glucose levels in 13% of participants. More than a third of the participants had three or four risk factors for the development of metabolic syndrome. After nutrition education, distribution of participants according io BMI significantly changed (I—normal: 37%; overveigt: 31%; obese:29%; E—normal:10%; overveigt:29%; obese:19%; p = 0,001). Significant changes in the distribution of total cholesterol levels (I: 5.7 mmol/l; E: 5.4 mmol/l) was determined at the evaluative assessment (p = 0.005). Statistically changes in the distribution of breakfast (p = 0.001) and vegetables (p = 0.013) intake were observed. There were not determined significant changes in other antropometric, clinical and biochemical parameters after nutrition education. Although the nutrition education intervention showed some changes in the prevalence of risk factors, significant changes require more intensive, long-term interventions tailored to individual needs.