Higher Prevalence Of DM Research Articles

Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study.

The global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid pulmonary tuberculosis and diabetes mellitus (PTB-DM) presents challenges to PTB control. We conducted this study given that current research on PTB-DM has primarily focused on clinical medicine and immunology, with limited reports on the true prevalence of population-wide PTB-DM in specific regions, as well as the heightened risk of PTB-DM co-prevalence due to aging and the high prevalence of DM in Chongqing, Southwest China. This retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The medical records of 112,592 PTB patients registered in Chongqing from 2016 to 2022 were extracted. After excluding patients with incomplete records, those not residing in Chongqing, and individuals still undergoing treatment, a total of 108,003 PTB patients were included in the study. The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Chi-squared test and Fisher's exact tests was used to compare groups, and multivariable logistic regression model with stepwise backward elimination based on the Wald test was used to examine risk factors for adverse treatment outcomes. From 2016 to 2022, the incidence rate of PTB in southwest China showed a decreasing trend (AAPC = -10.22, 95% CI: -11.49% ~ -8.94%), while the incidence rate of PTB-DM increased rapidly (AAPC = 14.25, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased from 2.96 to 12.28%. PTB-DM patients were characterized by a higher proportion of males and older adult individuals, the age range of the patients was 11 ~ 100 years, with a mean age of 58.21 ± 12.02 years, with multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85%, while unsuccessful outcomes accounted for 19.15%. Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC = 12.22, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC = 14.18, 95% CI: 6.53% ~ 27.67%). Older age, retreatment, referral, and multiple positive aetiological results were risk factors for adverse treatment outcomes among PTB-DM patients. The study presents the true prevalence of PTB-DM comorbidity in the general population of Southwest China, revealing a significant upward trend in its prevalence and a higher risk of adverse outcomes among PTB-DM patients. Future efforts should focus on the prevention and control of PTB-DM comorbidity, with early screening and standardized treatment for high-risk groups such as the older adult, as well as implementing comprehensive and effective treatment and management measures for patients.

#1022 Vulnerability in onconephrology: women and people who live alone are at greater risk of depression and anxiety

Abstract Background and Aims Cancer is a common entity that after the new therapeutic advances is becoming chronic disease. For that reason, kidney disease prevalence is increasing in cancer patients. Consequently, Onconephrology is becoming an essential subspecialty. Psychiatric disorders are prevalent in both cancer and kidney patients. The impact of such disorders has not been studied in onconephrology patients. Our aim is to study the prevalence of psychiatric disorders in Onconephrology patients and their impact in the survival and quality of life of patients. Method This is a prospective study including all patients visited in the Onconephrology Unit in our center from November-2021 to February-2023. The following questionaries were evaluated at the first visit, 6 months and 12 months: sleep disorders (Epworth scale), depression (Geriatric Depression Scale (GDS) and Patient Questionnaire Health (PHQ)), cognition (Montreal scale) and anxiety (Generalized Anxiety Disorder (GAD). Clinical and analytical characteristics of the patients were collected. Results A total of 182 patients were included, mean age 68 (±11) years, 70 (38.5%) women, 56 (30.8%) diabetes mellitus, mean creatinine 1.7 (±0.88) mg/dL, and glomerular filtration rate (GFR) 44 (±21) ml/min. A total of 18 (9.9%) patients lived alone, 152 (83.5%) lived accompanied and 4 (2.2%) in residence. The most common neoplasm was lung (n = 38; 20.9%) and the reason for referral to Onconephrology was chronic kidney disease (n = 94; 51.6%). At the first visit, 81 patients (44.5%) had sleep disorder, 32.7% (n = 59) had depression, 72 (39.6%) had cognitive impairment and 14 (7.7%) had anxiety. In the univariate analysis we evidenced that patients who lived in residence presented more prevalence of depression (p = 0.013). Patients with cognitive impairment had a higher prevalence of DM (p = 0.003), worse kidney function and were older (p < 0.001). Patients who had sleep disorders were older (p = 0.01) and women had more prevalence of anxiety (p < 0.001). At six months of follow-up, women presented anxiety with more prevalence (p = 0.03) as well as those who presented oncological progressive disease (p < 0.001). Patients who lived alone presented more depression compared to patients lived accompanied (p = 0.002). At twelve months of follow-up, oncological progression was associated with depression (p = 0.034). In the multivariate analysis, age was identified as a risk factor for cognitive impairment (OR: 1.1; p < 0.001) and female sex for depression (OR: 3.39; p = 0.001). At 6 months of follow-up woman sex for anxiety disorder (OR:8.6;p = 0.01) and patients who lived alone were identified as risk factors for depression (OR: 10.8; p < 0.001). A total of 30 patients (16.5%) died during the follow-up. In the Kaplan-Meier analysis, more mortality was observed in patients with sleep disorders (p = 0.039), worse kidney function (p = 0.003) and oncological progressive disease (p = 0.028). These were not confirmed in multivariate analysis Conclusion Onconephrology patients had a high prevalence of depression and anxiety, especially female and patients who live alone. Therefore, it is essential to perform a comprehensive approach and to have tools to detect the vulnerable population to improve their survival and quality of life.

Medicinal Herbal Plants Useful for Diabetes

The world is currently facing a diabetes epidemic. The World Health Organization (WHO) reported that the global prevalence of DM was 171 million in 2000 and will increase to approximately 366 million by 2030. However, the global prevalence of DM has already reached 346 million in 2010. About 1.6 million deaths are directly attributable to diabetes. Another 2.2 million deaths were caused by high blood sugar in 2012. The prevalence of diabetes has increased more rapidly in middle- and low-income countries. The exponentially increasing future high prevalence of DM accounts for most of the mortality and morbidity worldwide. Danger sign of diabetes and related diseases. India has been the source of human development and revolution since ancient times. We have a rich history and knowledge of the plants and animals used in the healing system. Plants have been used in medicine since the ancient Indian system of Ayurveda. Thus, we found that the diabetic drug system is highly dependent on the composition of synthetic drugs. In this review, we try to complete the traditional, phytochemical and pharmacological studies of medicinal plants. Natural products were considered the best choice because they are less harmful to the environment and other non-target organisms

Study on the Mitochondrial Genome of Variants Carrying mt.3243A>G from Type-2 Diabetes Mellitus and Cataract Patients in Indonesia

The association of type-2 diabetes mellitus (T2DM) and cataract with mtDNA mutation has been reported before. Despite the high prevalence of DM and cataract in Indonesia, a study of the mtDNA variants in Indonesia in correlation with the two diseases is still limited. MT.3243A>G is one of the hotspots mutations for mitochondrial diseases, but the explanation for its occurrence in patients with pure cataract is still elusive. Therefore, the objective of this study was to analyze the mitochondrial genome variants from T2DM and cataract patients in Indonesia using the direct sequencing method. The homology analysis of the genome to the Cambridge reference sequence resulted in 86 variants, including 20 variants that cause amino acid substitutions. Based on the Mitomap data, 17 of the 20 variants were novel. Upon comparison with the 12 normal variant genomes, 11 of 17 variants were suggested to be associated with T2DM and cataract diseases since they code the protein in complex-I (ND4L, ND5, and ND6), complex-III (cytb), and complex-V (ATP6) of the respiratory complex. Interestingly, MT.3316G>A, for the first time, is shown in a pure cataract patient. In addition, the novel phenotype of MT.5460G>A and MT.10398A>G were revealed, which are T2DM and cataract in one patient. Based on our study, these diseases might be related to the disruption of the ATP metabolism due to the structure and function changes of proteins involved in the respiratory complex. This discovery is expected to offer an understanding of the origins of gene-level clinical differences, particularly in Indonesia.

Risk Assessment of Type 2 Diabetes Mellitus Using the American Diabetes Association (ADA) Diabetes Risk Test in Residents of Bah Bolon Village, Simalungun District

Background: The prevalence of DM Type 2 is expected to increase to 7079 per 100,000 individuals in 2030 and 7862 in 2040.Meanwhile, based on Riskesdas data, Indonesia has a prevalence of DM of 2.1% in 2013. The highest prevalence was in Deli Serdang (2.9%) and followed by Medan (2.7%), Pematang Siantar (2.2%), Asahan (2.1%), Gunungsitoli (2,1%), Simalungun (1.57%) and Mandailing Natal (0.3%). The ADA Diabetes Risk Test is a simple strategy that used for screening prediabetes and diabetes in asymptomatic adults. Simalungun Regency is one of the 10 districts with a high prevalence of DM after Medan, Pematang Siantar and Asahan.Bah Bolon Village is one of the villages located in Dolog Masagal District.Bah bolon village is a remote village and far from the city and health facilities covering 342 heads of families. Aim of study is to know about how much risk factor of DM type 2 in Simalungun Distric using ADA Diabetes Risk Test. Methods: This study is analytical with a cross-sectional retrospective design.Data were analyzed after distribution test, then mean difference and correlation test was using the SPPS program where p <0.05 was considered statistically significant. Result: This study showed that the prevalence ratio of the ADA Diabetes Risk Test was 3.04 which indicates that there is an increased risk of DM 3 times compared to individuals who have a low risk ADA Diabetes Risk Test score. The highest prevalence ratio is a history of hypertension. A history of hypertension increases the risk of developing T2DM sixfold. A history of hypertension has a 95% CI value of 2.19-17.84 which indicates that people with hypertension have a 2.19 to 17.84 times higher risk of developing T2DM. Conclusions: The significant association DM about 3 times in ADA Diabetes Risk Test between high score and low score, significant association between hypertension history with hyperglycemia. Keywords: DM Type 2, Risk Factors, ADA Diabetes Risk Test, Screening DM

Utilization of Expert Systems as a Source of Information in Detecting Drug Interactions in the Treatment of Diabetes Mellitus Patients: A Systematic Literature Review

Background: The high prevalence of DM, as well as drug interaction problems that increase 2.5 times for each patient prescription and the side effects of individuals with diabetes mellitus including being more susceptible to drug interactions, it is necessary to monitor drug therapy in diabetes patients Mellitus. Methods: in this study, this research uses a literature study or uses a systematic literature review or also known as descriptive analysis based on research data. Results: This study shows that the use of expert systems in pharmacy, especially for disease detection and drug interactions, has been widely developed and proven to be able to detect. Conclusion: Based on the results and discussions that have been obtained, it can be concluded that the expert system is very useful for detecting disease and is also useful for checking drug interactions with a treatment therapy.

Health Care Disparities in Diabetes and Diabetic Retinopathy

ABSTRACT Purpose To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations. Methods Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes. Results Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson’s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05). Conclusions A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.

HCV infection characteristics, treatment uptake and outcomes in patient with diabetes mellitus

BackgroundThe interplay between HCV, DM, and DAA therapy is poorly understood. We compared HCV infection characteristics, treatment uptake, and treatment outcomes in patients with and without DM. MethodsA retrospective cohort study was conducted using data from The Ottawa Hospital Viral Hepatitis Program. Statistical comparisons between diabetes and non-diabetes were made using χ2 and t-tests. Logistic regression analyses were performed to assess predictors of DM and SVR.ResultsOne thousand five hundred eighty-eight HCV patients were included in this analysis; 9.6% had DM. Patients with DM were older and more likely to have cirrhosis. HCC and chronic renal disease were more prevalent in the DM group. Treatment uptake and SVR were comparable between groups. Regression analysis revealed that age and employment were associated with achieving SVR. Post-SVR HCC was higher in DM group.ConclusionThe high prevalence of DM in our HCV cohort supports screening. Further assessment is required to determine if targeted, early DAA treatment reduces DM onset, progression to cirrhosis and HCC risk. Further studies are needed to determine if optimization of glycemic control in this population can lead to improved liver outcomes.

1088-P: Racial, Socioeconomic, and Geographical Disparities in Cardiovascular Disease (CVD) among Medicare Beneficiaries with Diabetes (DM)

Despite a high prevalence of DM and CVD in older adults in the US, relatively little is known about how CVD prevalence varies by sociodemographic factors in older adults with DM. Using the 2017-20Medicare Current Beneficiaries Survey, we examined the prevalence of self-reported myocardial infarction (MI) , heart failure (HF) , and stroke by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and others) , poverty (income-to-poverty ratio: ≤100%, &amp;lt;100%─≤120%, &amp;lt;120%─≤135%, &amp;lt;135%─≤200%, and &amp;gt;200%) , educational level (&amp;lt;high school, high school graduate, and &amp;gt;high school) , and urbanicity of residence among Medicare beneficiaries with DM aged ≥65 years. We estimated weighted adjusted prevalence of CVDs using multivariable logistic regression, controlling for age and sex. Compared to non-Hispanic White persons, non-Hispanic Black persons had a higher prevalence of HF and Hispanic persons had a lower prevalence (Figure) ; rural residents had a higher prevalence of MI, HF, and stroke than urban residents; the lowest income group (≤100%) had a higher prevalence of MI, HF, and stroke than the highest income group (&amp;gt;200%) ; and those with &amp;lt;high school had a higher prevalence of MI and stroke than those with &amp;gt;high school education (P&amp;lt;0.for all) . CVDs disproportionately affected older adults with DM who live in rural areas and have lower socioeconomic status. Disclosure J.Park: None. X.Zhou: None. P.Zhang: None.

Seroprevalence of HBV and HCV Among Diabetes Mellitus Patients Attending University of Gondar Hospital, Northwest Ethiopia.

Hepatitis B and hepatitis C viruses are common infections and main causative agents of chronic liver diseases, cirrhosis, and hepatocellular carcinoma. The liver is the major site of hormone and glucose metabolism which have deep interconnection with diabetes. Hepatitis-B and hepatitis-C virus infection and diabetes are prevalent diseases worldwide associated with increased morbidity and mortality. High prevalence of DM, HCV, and HBV showed that there is a higher chance of coexisting in an individual. Therefore, our study tried to assess the coexistence of hepatitis viruses and diabetes mellitus among DM patients at the University of Gondar comprehensive specialized hospital. The hospital-based, cross-sectional study was conducted from November 01 to December 30, 2019 to as-sess the prevalence and associated factors of HBV and HCV among diabetes patients attending at University of Gondar referral hospital. Sociodemographic data was collected using a semi-structured questionnaire. Four milliliters of blood were collected using an anticoagulant free test tube for measurement of biochemical parameters and detection of hepatitis viruses. HBsAg and anti-HCV antibody detection was performed using One Step Cassette Style HBsAg Rapid Test and EUGENE® anti-HCV rapid test, respectively. Binary and multivariable logistic regression models were used to evaluate associated risk factors for the outcome variable. A p-value of < 0.05 was considered statistically significant. A total of 288 diabetes patients were included in this study and the prevalence of HBV and HCV was 7 (2.43%) and 18 (6.25%), respectively. Hepatitis B virus showed similar prevalence for type 1 and type 2 diabetes at 2.6% and 2.3%, respectively, but HCV showed a wide variation with 17.5% and 4.3% prevalence, respectively, for both diabetes types. In a multivariable logistic regression model compared with younger age (≤ 24 years), older age ≥ 65 years (AOR: 19.545, 95% CI: 2.577 - 22.827) age groups and poor glycemic control (AOR: 18.84, 95% CI: 17.83 - 20.39) showed significant association with HBV. A considerably large number of diabetes patients tested positive for anti-HCV antibody as a marker of Hepatitis C virus infection. None of the variables showed significant association with active Hepatitis B virus infection whereas older ages (≥ 65 years) and diabetes patients with poor glycemic control showed significant association with anti-HCV antibody positivity.

Prevalence of diabetes mellitus among 80,193 gastrointestinal cancer patients in five European and three Asian countries

BackgroundDiabetes mellitus (DM) has recently been associated with an increased incidence of such digestive tract malignancies as gastric or colorectal cancer. However, systematic data on the prevalence of DM among digestive tract cancer entities, especially in terms of geographic distributions, are lacking.MethodsWe used the Oncology Dynamics database (IQVIA) to identify a total of 80,193 patients with gastrointestinal (GI) cancer (5845 esophagus, 20,806 stomach, 38,138 colon, and 15,414 rectum cancer patients) from eight European and Asian countries.ResultsThe overall prevalence of DM among all digestive tract cancer patients was 14.8% (11,866/80,193). In terms of cancer site, DM prevalence was highest in patients with colon (15.5%) or rectal (15.3%) cancer and lowest in patients with esophageal cancer (12.0%). Interestingly, we observed significant differences in DM prevalence between countries. Spain (27.8%, 31.3%) and South Korea (21.0%, 27.9%) had the highest prevalence of DM among gastric and colon cancer patients, while DM prevalence in esophageal (18.8%) and rectal (38.0%) cancer patients was highest in Germany.ConclusionOur data revealed a high prevalence of DM among digestive tract cancer patients in Europe and Asia, and showed that DM prevalence varies among digestive tract cancer sites as well as countries.

Clinical Characteristics and Short-Term Outcomes of Patients Presenting with Acute Myocardial Infarction having Multi-vessel disease - A Single Middle- eastern Tertiary-Care Center Experience

ObjectivePatients with multi-vessel coronary artery disease (MVD) compared to single-vessel coronary artery disease (CAD) have more comorbidities and poor in-hospital outcomes. We aim to analyze MVD-AMI patients regarding clinical data and short-term outcomes. MethodsThis is a retrospective analysis of the prospectively collected data registry, a single-center study reviewing the clinical details and hospital outcome measures of AMI patients referred to our center for early revascularization from 2016 to 2019. ResultOut of 3041 patients presented with AMI, 491 (16%) had MVD on coronary angiogram. MVD-AMI patients were older, had a higher prevalence of DM, HTN, and prior history of ischemic heart disease compared to the non- MVD -AMI group (p < 0.001 for all). However, they presented more with non-anterior myocardial infarction, showed higher rates of post-myocardial infarction LV dysfunction, and mortality (p < 0.001). Older MVD-AMI patients showed higher rates of in-hospital morbidities and mortality compared to younger ones (p < 0.001). MVD- AMI women and Middle Eastern patients were older and showed a higher prevalence of cardiovascular risk factors compared to MVD-AMI men and South Asian patient population respectively. There were no significant differences recorded among the different subgroups of MVD-AMI patients regarding the hospital outcome measures. ConclusionOur study highlighted the clinical characters and poor outcomes of a high-risk group of MVD-AMI with different demographic backgrounds. Although age was a strong predictor for in-hospital poor outcomes, neither gender nor ethnicity affected the outcomes in them.

HEALTH LOCUS OF CONTROL DAN SELF-EFFICACY PASIEN DM TIPE 2 DENGAN PENERAPAN MODIFIKASI PSIKOEDUKASI

It is feared that the high prevalence of DM will increase the risk of comorbidities as a result of complications of this disease. Complications that occur in DM in Indonesia include neuropathy complications in 60%, coronary heart disease at 20.5%, diabetic ulcers at 15%, retinopathy at 10%, and nephropathy at 7.1%. The study aims to treat diabetes mellitus patients with a lifelong disease that must be well managed and compliant to avoid complications that worsen the patient's condition. The type of research used in this study is quasi-experimental research. This research design using a pretest-posttest control group design. The population was in this study were elderly people suffering from Type 2 Diabetes Mellitus. From the data of the Puskesmas, the sample was taken using a systematic random sampling method. It was found that 35 respondents were in the working area of ​​Puskesmas Sentosa Baru. Psychoeducation was given for 3 weeks and every week a random blood glucose level was checked. The results of this study are the influence of the application of psychoeducation on self-efficacy in Type 2 DM patients in the work area of ​​the Puskesmas Sentosa Baru (p=0,000). This study concludes that there is an effect of the application of psychoeducation on self-efficacy in type 2 DM patients in the work area of ​​the Puskesmas Sentosa Baru.

Using the Framingham Cardiovascular Disease Risk Score to predict cognitive performance in cognitively normal non‐hispanic whites and Mexican American elders

AbstractBackgroundPrevalence of cardiovascular disease risk factors (CVRFs) is higher among Mexican Americans (MAs) that non‐Hispanic Whites (NHWs), placing this population at a higher risk of cognitive decline. The purpose of this study was to examine the relationship between the Framingham Cardiovascular Disease 10‐years risk score (FCVDRS) and cognitive performance among MAs and NHWs. This study extends the limited literature about FCVDRS and cognition among MAs.MethodWe studied 518 cognitively normal participants (92 NHWs and 426 MAs) from an epidemiological study of aging. Gender, age, hypertension treatment status, systolic blood pressure (SBP) level, smoking status, diabetes mellitus diagnosis (DM), HDL, and total cholesterol levels were used to calculate the FCVDRS for each individual. A linear regression was conducted to examine the association of FCVDRS with MMSE, logical memory I and II, Trails B, FAS, and digit span scores. A one‐way ANOVA was used to analyze the relationship of FCVDRS categories (low &lt; 10, moderate 10 – 20, high &gt; 20), and test scores, along with Tukey post hoc tests to elucidate the magnitude of differences between the groups. Education was entered as a covariate in the model.ResultMAs had a higher prevalence of DM, higher SBP, and lower HDL values. Linear regression model was significant only for executive function in MAs , F(1,352) = 7.86, p = 0.005. One ‐way ANOVA showed a significant difference for Trails B, F(2,351) = 5.21, p = 0.006, and MMSE, F(2,414) = 3.00, p = 0.005 among MAs. In both cases, post hoc test indicated that MMSE and Trails B mean scores were lower in the high risk group when compared to the low risk group. No significant trends were seen in the Non‐Hispanic White subset.ConclusionOur data has shown that FCVDRS can be used to predict performance on measures of global cognition and executive function in MAs. Although more work has to be done to further understand the predictive power of FCVDRS, there is promise in using this model to develop early intervention programs targeted to MAs.

Prevalence of diabetes and prediabetes and its risk factors in adults aged 25–64 in the Czech Republic: A cross-sectional study

AimsThe aim of this study is to establish the prevalence of diabetes (DM) and prediabetes in the Czech population aged 25–64 years and to evaluate the relationships with various cardiometabolic, sociodemographic, and lifestyle risk factors. MethodsThis was an epidemiological study with a stratified, crosssectional, random sampling design. Sociodemographic, lifestyle, and anamnestic data were collected through interviewer-administered questionnaires, medical examination, and biochemical assays. ResultsAmong the 1189 participants, 114 were diagnosed with DM (9.6%), 330 with prediabetes (27.8%) and 745 were non-diabetes/non-prediabetes individuals (62.7%). Logistic regression analysis showed that overweight, general and abdominal obesity, hypertension, and lower level of HDL (increased risk) significantly increased the risk of both prediabetes and DM, while living in the cities diminished risk of DM. Among lifestyle variables the significant increased risk of prediabetes and DM was found for smokers and ex-smokers. In other lifestyle variables (marijuana lifetime prevalence, physical activity and frequency of alcohol drinking) the significantly higher or lower risk for prediabetes or DM was not found. ConclusionsThe study shows a high prevalence of DM and prediabetes in the Czech population of age between 25 and 64, providing data on their association with several risk factors.

P0355FAMILY HISTORY OF COMPLEX TRAITS IN THE CUREGN COHORT: ASSOCIATIONS WITH RENAL FUNCTION, COMORBIDITY BURDEN AND DISEASE PROGRESSION

Abstract Background and Aims Family history (FHx) of complex traits may reflect shared genetic/environmental risk. Few studies suggest associations with increased risk of comorbidities and worsening renal function, but this has not been examined in primary glomerulopathies (GNs). Herein, we studied the association of FHx of complex traits with presentation patterns, comorbidities and disease progression in a prospective cohort of patients with primary GN. Method The Cure Glomerulopathy Networ (CureGN) is a prospective multi-center observational study of GN patients (N=2474) affected by biopsy-proven Focal Segmental Glomerulosclerosis (FSGS), Minimal Change Disease (MCD), Membranous Nephropathy (MN) and IgA Nephropathy/Vasculitis (IgAN/V). Associations of self-reported FHx of diabetes (DM), coronary artery disease (CAD), cancer (C), clotting disorders (CD), and autoimmune diseases (AD) with eGFR, UPCR at diagnosis, and comorbidities prevalence were studied using linear and logistic regression models adjusted for age, sex, ethnicity, race, BMI and other relevant clinical covariates. Associations between FHx and ESRD/40%eGFR reduction were investigated with multivariate Cox models. Results FHx of DM was associated with lower eGFR and higher UPCR at diagnosis in the entire cohort (p=0.006 and p=0.03), lower eGFR in FSGS (p=0.02) and higher UPCR in IgAN/V (p=0.01). Regarding comorbidity burden (Table 1), FHx of DM was associated with higher prevalence of DM, heart failure and infections requiring hospitalization, FHx of C with cancer, FHx of CD with higher prevalence of thrombosis and FHx of AD with inflammatory bowel, celiac diseases, asthma and drug allergies. At the survival analysis adjusted for age, sex, ethnicity, race, BMI, diagnosis group, eGFR and UPCR at diagnosis, DM, hypertension, use of immunosuppressants and RAAS-inhibitors, FHx of DM was associated with higher risk of the composite outcome of ESRD/40%eGFR reduction in the entire cohort (HR 1.39, 95%CI 1.07-1.81, p=0.01), and specifically in FSGS (HR 1.76, 95%CI 1.08-2.85, p=0.02) and in the paediatric subgroup (HR 1.98, 95%CI 1.04-3.80, p=0.04). Conclusion FHx of complex traits are associated with higher prevalence of specific comorbidities. FHx of DM identifies patients with lower eGFR at diagnosis, higher prevalence of infections and higher risk of renal disease progression. These findings, which need to be confirmed in other cohorts, suggest that FHx could be an additional useful parameter for risk stratification and management of primary GN.

A randomized clinical study to evaluate the effect of Saptachakra in management of Madhumeha w.s.r. to type 2 diabetes mellitus

Background: Non-communicable diseases are posing major health and development threats. The Worldwide, approximately 200 million people currently have type 2 DM, a prevalence that has been predicted to increase to 366 million by 2030. Diabetes Mellitus comprises a group of common metabolic disorders that share the phenotype of hyperglycemia, with an increase incidence worldwide. The Indian subcontinent has a higher prevalence of DM than any other region in the world, and two to three times the reported prevalence in western countries. Recent surveys say that diabetes is affecting 10-16% of urban population. The disease Madhumeha described in Ayurveda bears close resemblance to Diabetes Mellitus. Objectives: To evaluate the effect of Saptachakra Choorna in the management of Madhumeha w.s.r. to type 2 DM and to compare it with drug taken in the control group. Materials and Method: In the present study, two groups were taken each comprising of 20 patients who fulfilled the diagnostic and inclusion criteria. Subjects of group A were administered Saptachakra Choorna 6gms twice daily and subjects of group B were administered tablet Metformin 500 mg one tablet twice daily, both before food and for a period of 45 days. Observation and Results: In the present study, majority of the symptoms showed clinically significant improvement by Saptachakra Choorna and metformin 500 mg, however it was not statistically significant. In the glycemic parameters like FBS, PPBS, FUS and PPUS within the group administered Saptachakra Choorna 6 gms only FBS and PPBS showed significant improvement where as parameters like FUS and PPUS there was no much improvement and within the group administered tablet Metformin 500 mg significant improvement in all the parameters were observed. On comparing the results between the two groups, the group administered tablet Metformin 500 mg showed a better result than the group administered Saptachakra Choorna. Conclusion: By seeing overall improvement and applying Chi Square Test, tablet Metformin 500 mg showed a better result than Saptachakra Choorna.

P4157Coronary flow reserve but not ischemia is a strong predictor of mortality in 551 outpatients referred for stress myocardial perfusion by Rubidium-82 PET imaging

Abstract Background The assessment of myocardial ischemia in patients with suspected coronary artery disease (CAD) is encouraged by current guidelines. The ischemic burden is associated with impaired prognosis. Coronary flow reserve (CFR) is also an independent predictor of cardiovascular mortality but it is unclear which one of these two variables would be stronger to predict mortality. Purpose To evaluate the predictors of death in symptomatic stable patients with suspected CAD referred for stress myocardial perfusion (MP) Rubidium-82 PET imaging. Methods 551 consecutive patients (52% men, mean age 63 years) were enrolled in this study from February to October 2013. The primary endpoint was all-cause death. The event-free survival curves for the primary endpoint were obtained using the Kaplan-Meier method in four groups of patients based on whether ischemia was present and whether CRF was impaired (&lt;2) (Figure). Univariate analysis was performed using Cox regression to identify the variables that were associated with mortality, and the Cox proportional-hazards regression model for the multivariate analysis adjustment. Results During a median follow-up period of 32 months there were 43 deaths giving an estimated cumulative event rate of 7.8%. Univariate predictors of death were: age, higher prevalence of DM and CKD, lower LVEF and BMI. Following a multivariate analysis, only CFR was independently associated with mortality (Table). Predictors of death Variable Univariate model Multivariate model HR (95% CI) P value HR (95% CI) P value Age 1.03 (1.00–1.06) 0.036 1.01 (0.99–1.04) 0.324 Male sex 1.41 (0.76–2.56) 0.277 0.96 (0.70–1.32) 0.809 History of DM 2.12 (1,13–3,97) 0.019 – – History of CKD 4.95 (2,66–9,20) &lt;0.001 – – BMI &lt;30 1.14 (1.05–1.22) &lt;0.001 2.22 (0.93–5.26) 0.071 Rest LVEF, % 0.98 (0.96–0.99) 0.029 0.99 (0.98–1.01) 0.477 Ischemia, % 1.02 (0.97–1.06) 0.436 0.99 (0.91–1.10) 0.990 Ischemia ≥10% 1.33 (0.59–2.99) 0.488 0.90 (0.40–2.05) 0.806 CFR 0.26 (0.15–0.43) &lt;0.001 0.27 (0.16–0.46) &lt;0.001 LVEF = left ventricular ejection fraction. Survival curves for all-cause death. Conclusions In symptomatic outpatients with suspected CAD referred for stress MP Rubidium-82 PET imaging, CFR is the strongest predictor of mortality. Notably, neither the presence of ischemia nor the ischemic burden was associated with the outcome in question.

Association of serum chromium levels with malnutrition in hemodialysis patients

BackgroundChromium is an essential trace metal that reduces oxidative stress and inflammation. In patients undergoing maintenance hemodialysis (MHD), a correlation among chromium exposure, inflammation, and malnutrition remains unclear. This study examined the possible effects of serum chromium levels (SCLs) in MHD patients.MethodsInitially, 732 MHD patients in dialysis centers were recruited. A total of 647 patients met the inclusion criteria and were stratified by SCL into four equal-sized groups: first quartile (< 0.29 μg/L), second quartile (0.29–0.56 μg/L), third quartile (0.57–1.06 μg/L), and fourth quartile (> 1.06 μg/L). Demographic, biochemical, and dialysis-related data were obtained for analyses. The analysis included nutritional and inflammatory markers.ResultsAs compared with the highest quartile group, more subjects in the lowest quartile group were of an older age; had lower hemoglobin and creatinine levels; had a higher prevalence of DM and malnutrition (serum albumin level < 3.6 g/dL); and higher serum transferrin saturation and ferritin levels. A stepwise multiple linear regression analysis revealed a significant negative correlation between malnutrition and SCL (β coefficient = − 0.129, p = 0.012) and negative associations among body mass index (β coefficient = − 0.010, p = 0.041), ferritin (β coefficient = − 0.107, p = 0.001) and SCL. A multivariate logistic regression analysis also demonstrated a negative correlation between malnutrition and SCL. With a 10-fold increase in SCL, the risk ratio of malnutrition was 0.49 (95% confidence interval: 0.25–0.96; p = 0.039).ConclusionsSCL is significantly associated with malnutrition in MHD patients. Further evaluation of the relationship between clinical outcomes (morbidity/mortality) and SCL is necessitated.

“PREVALENCE OF TB IN PATIENTS WITH DM UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME”

Background: DM has been shown to be an independent risk factor for TB, and there is evidence showing high DM prevalence in TB patients in studies mainly from the southern part of India. This strong association between DM and TB raises the question as to whether TB patients should be routinely screened for DM. Many studies have been conducted to establish the relation between TB and DM using fasting blood glucose as the parameter.&#x0D; Objective: The primary objective of this study was to detect the prevalence of Diabetes Mellitus in the newly diagnosed TB patients by HbA1C and Fasting Blood Glucose.&#x0D; Design: This was a Cross Sectional study.&#x0D; Duration: The present study was conducted from January 2015 to June 2016.&#x0D; Setting: Shadan Institute of Medical Sciences, Hyderabad.&#x0D; Participants: 280 patients diagnosed with tuberculosis at the chest clinic of Shadan Institute Of Medical Sciences, Hyderabad.&#x0D; Methods: 140 out of the 280 patients who were diagnosed as TB underwent blood tests for Fasting Blood Glucose and HbA1C along with the routine investigations like CBP, ESR, Chest X ray, ECG, Sputum examination. The data of patients with TB and DM and patients with only TB was compared. The data of pulmonary and extra pulmonary TB groups was compared. The data of sputum positive and sputum negative groups was compared. Student’s t test was performed for normally distributed continuous variables and a p value was derived.&#x0D; Results: 38(27%) out of 140 patients had abnormal HbA1c i.e. &gt; 6.5% having a strong association with male gender and age more than 45 years. The majority of the patients who had diabetes in this study, also had sputum positive TB(57%). This study showed a significant difference in mean age between the two groups of TB with diabetes(44.88 ± 5.721) and TB without DM(34.598 ± 10.56).&#x0D; Conclusion: There was a high prevalence of DM amongst the TB patients registered under RNTCP. Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control.&#x0D; Keywords: Tuberculosis, Diabetes Mellitus, Blood Glucose, Sputum.