Higher Risk Of Diabetes Mellitus Research Articles

Glucoherb versus metformin on glycemic markers and glycosylated hemoglobin in prediabetes patients; a clinical trial study

Introduction: There is a high risk of diabetes mellitus in pre-diabetic patients. Objectives: The aim of the study was to compare the effect of the extracts of these herbs in the formulation of Glucoherb supplementation versus metformin in pre-diabetes patients on glycemic markers and glycosylated hemoglobin. Patients and Methods: Pre-diabetic patients who had indication of drug treatment according to the criteria of the American Diabetes Association, were selected and randomly divided into two groups of Glucoherb and metformin. Body mass index (BMI), fasting blood sugar (FBS), 2 hours postprandial blood glucose (BS2PP) and glycosylated hemoglobin (HbA1c) were measured before and after the intervention. Results: The mean BMI, FBS, BS2PP and HbA1c levels were significantly decreased after intervention in both Glucoherb and metformin groups (P < 0.05) without any significant difference between them (P < 0.05). Conclusion: Glucoherb showed similar efficacy to metformin in reducing blood glucose, BMI and HbA1c in pre-diabetic patients.

Sex differences in the risk of diabetes mellitus among individuals with psoriasis: A retrospective cohort study in Québec, Canada

Sex differences in the risk of diabetes mellitus among individuals with psoriasis: A retrospective cohort study in Québec, Canada

Management of Type II Diabetes by Modulating the Modifiable Risk Factors: A Future Roadmap for Prevention of Cerebrovascular Complications.

Background:Indian Diabetes Risk Score (IDRS) is a screening tool for quantifying the risk of diabetes mellitus (DM) development in the Indian population. The present study has evaluated the level of risk of developing DM in Chandigarh and Panchkula based on the IDRS score.Methods:As a part of a national diabetes control trial funded by the Ministry of Health and Family Welfare (MoHFW) and the Ministry of AYUSH, Government of India, 1,916 participants from the Chandigarh and Panchkula regions were assessed for the risk of developing DM. Risk assessment was done on the basis of the IDRS score which includes age, family history, waist circumference, and physical activity as its contributing factors. Participants with an IDRS score <30 were in the low-risk category, those with 30 to 50 were in the moderate-risk category, and those with >60 were in the high-risk category for DM.Results:Out of the 1,916 screened respondents (59.86% females and 40.14% males), 894 participants (46.65%) were at a high risk for DM (IDRS >60), 764 (39.87%) were at a moderate risk (IDRS = 30–60), and 258 (13.46%) were at a low risk (IDRS <30). Waist circumference contributed to 35.90% of the high-risk category followed by age (19.67%) and physical activity (11.67%). Age and waist circumference also showed a strong correlation with the total IDRS score.Conclusion:The Chandigarh and Panchkula population showed a high tendency to develop DM based on the IDRS score. Modifiable risk factors such as waist circumference and physical activity were the major contributing factors. Apart from the modifiable risk factors, age was also another major contributing risk factor. Based on these outcomes, lifestyle modifications like yoga and exercise can be proposed for this population as a preventive approach to reduce the risk of developing DM and other associated cerebrovascular complications.

Epidemiology of nonalcoholic fatty liver disease in non‐obese populations: Meta‐analytic assessment of its prevalence, genetic, metabolic, and histological profiles

As a subgroup of nonalcoholic fatty liver disease (NAFLD), patients with non-obese NAFLD may also have an increased risk of adverse hepatic and metabolic outcomes. We aimed to estimate the prevalence and incidence of non-obese NAFLD and to describe its clinical characteristics in this systematic review and meta-analysis. We performed a systematic search of 1235 citations published up to Mar 2020. Meta-analyses, stratified analyses and meta-regression were all performed. Of the 46 studies included, 28 cross-sectional and longitudinal studies of 155 846 non-obese participants reported a pooled NAFLD prevalence of 14.5% (95% confidence interval [CI] 12.3%-17.1%). A multivariate meta-regression analysis showed the trend that the prevalence varied by their geographical location. Further stratified analyses showed that NAFLD was relatively prevalent among people aged ≥45 years (16.2%; 95% CI 10.8-23.4) and those in South America (25.7%; 95% CI 24.4-27.0). The PNPLA3 rs738409 gene polymorphism was more frequently observed in non-obese NAFLD than in both obese NAFLD and non-obese controls, while the metabolic profiles of non-obese NAFLD were less severe than those of the obese NAFLD group. Patients with non-obese NAFLD had 4.81-fold and 5.43-fold higher risk of diabetes mellitus and metabolic syndrome, respectively, than the non-obese controls. Non-obese NAFLD is common, particularly in South America and among people aged ≥45 years. Metabolic diseases and PNPLA3 rs738409 gene polymorphism are more frequent in the non-obese NAFLD group than in non-obese controls.

Association of dietary patterns with the newly diagnosed diabetes mellitus and central obesity: a community based cross-sectional study

AimThe purpose of this study was to investigate the association of dietary patterns with the risk of insulin resistance (IR), diabetes mellitus (DM), and central obesity in China.MethodsWe performed a cross-sectional study on 1432 participants, aged 40–65 years in Hangzhou, Zhejiang province, China. Dietary intake was assessed using a semi-quantitative food frequency questionnaire.ResultsFactor analysis extracted four major dietary patterns: vegetable-fruits, rice–meat, seafood–eggs, and sweet–fast. The vegetable-fruits pattern was inversely associated with HOMA-IR (p < 0.001 in both genders), while sweet–fast food pattern was significantly associated with higher HOMA-IR (p = 0.002 in male, and p < 0.001 in female). The vegetables–fruits pattern was inversely correlated with visceral fat area (VFA) (p = 0.029 in males, and p = 0.017 in females), while sweet–fast food pattern presented a significant direct association (p < 0.001 in male) with VFA in males. There was no association observed between the rice–meat pattern or the seafood–eggs pattern and HOMA-IR or VFA. After adjustment for potential confounding factors, participants in the highest tertile of vegetable-fruits pattern showed a significantly lower risk of DM in both males and females (OR: 0.30, 95% CI: 0.13–0.70 in male, and OR: 0.28, 95% CI: 0.11–0.72 in female), and lower risk of central obesity was observed in males (OR: 0.50, 95% CI: 0.29–0.86 in male). Conversely, participants in the highest tertile of sweet–fast food pattern had higher risk of DM (OR: 2.58, 95% CI: 1.23–5.88 in male), and central obesity (OR: 2.85, 95% CI: 1.67–4.86 in male) only in male. While neither the rice–meat pattern nor the seafood–eggs pattern showed significant association with DM or central obesity in both genders.ConclusionsOur findings indicated low risk of IR, DM, and central obesity with vegetable-fruits pattern while inverse relation with sweet–fast food pattern.

Psoriatic Arthritis and Diabetes Mellitus: A Narrative Review.

IntroductionPsoriatic arthritis (PsA) is a chronic immune-mediated inflammatory spondyloarthropathy associated with psoriasis. PsA is frequently associated with metabolic disorders including, obesity, metabolic syndrome, and diabetes mellitus (DM). Type 2 DM is among the most common metabolic disorders, with a prevalence ranging from 2.4 to 14.8% in the general population.MethodsWe conducted a narrative review of the English-language studies from January 1989 to September 2019 investigating the risk of type 2 DM in patients with PsA, the pathogenic mechanism linking DM to PsA, and the effects on insulin sensitivity exerted by systemic therapies for PsA.ResultsThe prevalence of type 2 DM in patients with PsA ranges from 6.1 to 20.2%, generally higher when compared to the general population. The higher risk of DM is reported in women with more severe forms of PsA. Elevated serum levels of adipokines, including TNF-α, which inhibits the autophosphorylation of the insulin receptor and suppresses the expression of glucose transporter 4, favor insulin resistance and could partially explain the association between PsA and DM. Moreover, adiponectin and omentin, with insulin-sensitizing and anti-atherogenic properties, are decreased in patients with PsA. Some of the treatments for PsA could affect the glucose homeostasis. Systemic corticosteroids are known to impair insulin resistance, whereas apremilast (phosphodiesterase type 4 inhibitor) and TNF-α inhibitors could exert neutral effect or reduce the insulin-resistance. The role of IL-17 or IL-23 inhibitors has been marginally investigated.ConclusionsPatients affected by PsA have a higher prevalence of type 2 DM compared with the general population. The mechanism linking PsA with DM has not been completely clarified, but some of the principal mediators could be TNF-α and adipokine, especially adiponectin and omentin. Apremilast and TNF-α inhibitor may have a favorable effect and could be safely used in patients with DM.

Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome.

Metabolic syndrome is associated with increased risk of cardiovascular disease. This study investigated the correlation between adipocyte and inflammation biomarkers, and metabolic syndrome and its components. The study included 80 patients with normal body-mass index and 80 obese patients. The groups were assessed for serum values of adiponectin, leptin and highly sensitive C reactive protein (hsCRP), the homeostatic model assessment of insulin resistance (HOMA-IR), as well as the influence of these biochemical markers on the prevalence of metabolic syndrome and its components. Leptin, HOMA-IR and hsCRP had statistically significant (P<0.01) higher values in the group of obese subjects, while adiponectin had statistically significant (P<0.01) lower values. The prevalence of metabolic syndrome was 35% in the obese group and 5% in the normal weight group. Adiponectin and HOMA-IR were the variables significantly associated with metabolic syndrome (P<0.01), adiponectin/HOMA-IR ratio and leptin/adiponectin ratio were also associated with metabolic syndrome (P<0.01). No relationship was found between metabolic syndrome and hsCRP. Adiponectin and adiponectin/HOMA-IR were associated with all the components of metabolic syndrome and they can be useful to identify patients with high risk of diabetes mellitus and cardiovascular disease.

Diabetes Risk among Medical Students in Tabuk City, Saudi Arabia

Introduction: Diabetes risk estimation is essential for the implementation of preventive measures. Objectives: We aimed to assess the diabetes risk among medical students in Tabuk, Saudi Arabia. Methods: This cross-sectional study was conducted among 169 medical students in the Medical College, University of Tabuk, Saudi Arabia, from October 2017 to April 2018. Participants signed a written informed consent and then responded to a questionnaire modified from the Finnish and the ARABRISK diabetes score. The questionnaire consisted of eight components inquiring about age, BMI, central adiposity, fruit and vegetable consumption, physical activity if found to have high blood pressure or blood sugar, and family history of diabetes mellitus. The Statistical Package for Social Sciences (SPSS) was used for data analysis. Results: Out of 169 students (68% with a family history of diabetes), obesity and overweight were found in 21.3 and 26.6%, respectively, 45.6% had central adiposity, more than half were not practicing exercise daily, and 60.4% were not consuming fruits and vegetables daily. A significant percentage was found to have high blood sugar (9.5%) and high blood pressure (4.7%). The diabetes risk score was high or moderate in 16% of the students. Conclusion: Medical students in Tabuk City were at high risk for diabetes mellitus. Obesity, overweight, central adiposity, physical inactivity, and less consumption of fruits and vegetables substantially contributed to the risk. Measures to prevent obesity, improving fruit and vegetable consumption, and exercise are needed.

Prediction of the risk of developing diabetes mellitus among Bangladeshi adults by using risk assessment score

Background: Diabetes mellitus (DM) is considered as one of the major health problems worldwide. The rising prevalence of type 2 diabetes mellitus (T2DM) in Bangladesh is primarily attributed to rapid urbanization and associated changes in lifestyle, such as sedentary lifestyle, higher calorie food intake and stressful life. Studies support the utilization of riskassessment scoring systems in quantifying individual’s risk for developing T2DM. Thus, a simple risk-assessment scoring system for early screening of T2DM among Bangladeshi adults will be beneficial to identify the high-risk adults and thus taking adequate preventive measures in combating DM.The purpose of the study was to calculate the risk assessment score of developing T2DM within 10 years among Bangladeshi adults.&#x0D; Methods: The cross-sectional observational study was carried out in the outpatient department (OPD) of Medicine, MARKS Medical College &amp; Hospital, a tertiary care hospital in Dhaka, Bangladesh from February 2018 to July 2018 among randomly sampled 205 adult subjects. Subjects undiagnosed with diabetes mellitus and had previous history of high blood glucose during pregnancy or other health examination (i.e. impaired fasting glucose, impaired glucose tolerance or gestational diabetes mellitus) were included. From a review of literature regarding risk factors of developing DM in Bangladesh, the Finnish Diabetes Risk Score (FINDRISC) system was found to be more useful for the Bangladeshi adults. The Finnish Diabetes Risk Score (FINDRISC) questionnaire was used to collect the data including demographic characteristics and different risk factors and to calculate total risk score for predicting the risk of developing T2DM within 10 years.&#x0D; Results: Among 205 subjects, male and female were 57.1% and 42.9% respectively. The Mean (±SD) age of the study subjects was 37.64±1.07 years. In this study, both non-modifiable and modifiable risk factors showed statistically significant association with the FINDRISC among Bangladeshi adults (p&lt;0.05). There was a significant association among FINDRISC with history of previous high blood glucose, and treated hypertensive Bangladeshi adults.33.65% of the Bangladeshi adults had slightly elevated diabetes risk score (DRS). This study predicts that 17.55% of the Bangladeshi adults may have moderate to high risk to develop T2DM within the consecutive 10 years.&#x0D; Conclusion: This study provides a simple, feasible, non-invasive and convenient screening FINDRISC tool that identifies individuals at risk of having T2DM. People with high risk of DM should be referred for early intervention and changes to a healthy lifestyle and primary prevention to prevent or delay the onset of T2DM.&#x0D; Birdem Med J 2020; 10(1): 40-47

A case control study of association of Acanthosis nigricans, Insulin resistance and Type 2 diabetes mellitus in a tertiary care centre in South India

Introduction: Acanthosis Nigricans is a dermatosis characterized by velvety, papillomatous, brownish black, hyperkeratotic plaques typically on the intertriginous surfaces and neck. Acanthosis Nigricans is commonly associated with disorders associated with insulin resistance, including obesity, type 2 diabetes mellitus and Polycystic ovarian syndrome. Hyperinsulinaemia is thought to play a pivotal role. Aims: To find the association of Acanthosis Nigricans with insulin resistance and type 2 diabetes mellitus and its correlation with anthropometric measurements such as waist circumference, waist hip ratio and BMI.Settings and Design: This is a hospital based cross sectional analytical study including 30 cases with acanthosis nigricans and 30 controls. Materials and Methods: All cases and controls underwent clinical examination, relevant anthropometric measurements, fasting sugar and fasting insulin levels. Statistical analysis used: Collective data was analysed by frequency, percentage, mean, Standard Deviation, Karl-Pierson correlation, Chi- square test and t-test. Results: In our study AN was significantly associated with increase in BMI, WC, WHR, skin tags, low physical activity, family history of DM, fasting glucose, and fasting insulin levels (p=0.000) as compared to controls. There was no significant association of AN with age, gender, comorbid conditions and blood pressure. Grade of AN, number of sites also were significantly associated with hyperinsulinemia. Therefore screening for AN would provide a simple and noninvasive method for identifying people who may have hyperinsulinemia and high risk for diabetes mellitus. Conclusions: AN was significantly associated with increase in BMI, WC, WHR, skin tags, low physical activity, family history of DM, fasting glucose, and fasting insulin levels Keywords: Acanthosis nigricans, Body mass index, Insulin resistance.

Adipose Single-Cell Analysis Reveals Clonal Expansion of Potentially Antiviral CX &lt;sub&gt;3&lt;/sub&gt;CR1 &lt;sup&gt;+&lt;/sup&gt; CD4 &lt;sup&gt;+&lt;/sup&gt; T Cells with T &lt;sub&gt;1&lt;/sub&gt; Transcriptome in Diabetic Persons with HIV

Persons with HIV (PWH) are at high risk for diabetes mellitus. Adipose tissue T cells are a central regulator of inflammation and adipocyte function, and the known establishment of a HIV reservoir in adipose could contribute to metabolic dysregulation. Here, we show that CD4+ T cell subsets increased in the adipose of diabetic PWH, specifically CD69+ and CD69lo CD57+ GPR56+ CX3CR1+, are clonally expanded with shared T cell receptors, suggesting a common lineage. We observed that both CD69+ and CX3CR1+ CD4+ T cells have transcriptomes consistent with a TH1 profile in diabetics versus TH2 in non-diabetics. CX3CR1+ CD4+ T cells from diabetic PWH also have increased expression of genes in innate immune pathways, not present in CD69+ cells, suggesting functional differences. This study sets the stage for future investigations to determine whether viral antigens in adipose tissue may promote clonal expansion of pro-inflammatory CX3CR1+ and CD69+ CD4+ T cells.

Recommended First-Line Antiretroviral Therapy Regimens and Risk of Diabetes Mellitus in HIV-Infected Adults in Resource-Limited Settings.

ObjectiveThe use of some antiretroviral drugs has been associated with a higher risk of diabetes mellitus (DM) in HIV-infected patients, but the risk associated with antiretroviral drug combinations remains unclear. We investigated the association between first-line antiretroviral therapy (ART) regimens, recommended by the World Health Organization (WHO) in 2016, and the risk of DM in adults.MethodWe selected all HIV-infected adults within the Thai National AIDS Program who started a first-line ART regimen consisting the following between October 2006 and September 2013: zidovudine+lamivudine+nevirapine; tenofovir disoproxil fumarate (TDF)+lamivudine+nevirapine; zidovudine+lamivudine+efavirenz; TDF+lamivudine/emtricitabine+efavirenz; zidovudine+lamivudine+ritonavir-boosted lopinavir (LPV/r); or TDF+lamivudine+LPV/r. Diagnosis of DM was defined as having at least 2 of the following characteristics: fasting plasma glucose ≥126 mg/dl, 2010 WHO ICD-10 codes E11-E14, or prescription of antidiabetic drugs. To identify ART regimens associated with DM, we used competing risks regression models that considered mortality without DM as a competing event and adjusted for sex, age, pancreas disease, and stratified by groups defined by a score summarizing the propensity to receive a specific first-line ART regimen.ResultsData from 35 710 adults (49.1% male; median age, 35.0 years; median follow-up, 2.0 years) were included. In the multivariable analysis with zidovudine+lamivudine+nevirapine as the reference group, a higher risk of DM was observed with TDF+lamivudine/emtricitabine+efavirenz (adjusted sub-distribution hazard ratio [aSHR], 1.6; 95% confidence interval [CI], 1.3–1.9), zidovudine+lamivudine+efavirenz (aSHR, 2.0; 95% CI, 1.7–2.3), and TDF+lamivudine+LPV/r (aSHR, 2.7; 95% CI, 1.9–3.9).ConclusionsSeveral of the WHO recommended ART regimens, particularly tenofovir + lamivudine +LPV/r and regimens containing efavirenz, may be associated with an increased risk of DM.

Prevalence, Awareness, Treatment, Control, and the Associated Factors of Diabetes in an Iranian Kurdish Population.

Aims This study is aimed at estimating the prevalence, awareness, treatment, and glycemic control of diabetes mellitus (DM) and its associated factors in an Iranian Kurdish population. Methods Baseline data of the Ravansar Non-communicable Disease (RaNCD) cohort study, consisting of adults aged 35-65 years, were used. Diabetes was defined as a fasting plasma glucose (FPG) of 126 mg/dl or higher, being on diabetes medication, and/or diabetes confirmed by a health practitioner. Results Nine thousand nine hundred ninety-nine participants were assigned to this study. The prevalence of DM, awareness, treatment, and glycemic control of DM were 8.19, 74.97, 74.75, and 32.68, respectively. Based on the adjusted models, increased age (p < 0.01); obesity or overweight (p < 0.01); being ex-smoker (p < 0.05); suffering from dyslipidemia (p < 0.01), hypertension (p < 0.01), or both of them (p < 0.01); and positive family history in the first-degree relatives (p < 0.01) were strongly associated with a high risk of DM, while engagement in regular physical activity (p < 0.05) was a protective factor. Female gender (p < 0.01), being older than 55 years, positive family history in the first-degree relatives (p < 0.01), suffering from both hypertension and dyslipidemia (p < 0.01), and obesity or overweight (p < 0.005) were negatively associated with DM awareness. Being married and widowed (p < 0.05 and <0.05) and a high BMI (p < 0.01) were strong predictors of receiving treatment for DM. Six to nine years of schooling (p < 0.05) and suffering from hypertension (p < 0.05) increased the probability of DM being controlled. Conclusions When the prevalence of DM is notable, awareness and probability of receiving treatment and controlling FPG are of particular importance. A considerable proportion of the patients were aware and on treatment, which may partly be due to improving primary health care services in Iran.

한국 성인의 고 위험 당뇨에 대한 스트레스와 체질량 지수의 성별 차이

한국 성인의 고 위험 당뇨에 대한 스트레스와 체질량 지수의 성별 차이

Risk of diabetes mellitus in physicians: a nationwide study in Taiwan

BackgroundThe heavy workload of physicians in Taiwan may contribute to poor lifestyles and increased risk for diabetes mellitus (DM). We conducted this study to determine the risk for DM among physicians in Taiwan.MethodsWe used the Taiwan National Health Insurance Research Database to identify 28,440 physicians and 56,880 comparisons (general population) matched at a ratio of 1:2 by age and sex. Participants who had been diagnosed with DM before 2007 were excluded. We compared the risk for DM between physicians and comparisons by following up since 2007 to 2013. Comparisons among physician subgroups were also performed.ResultsAfter adjustment for hypertension, hyperlipidemia, hyperuricemia, coronary artery disease, congestive heart failure, hyperthyroidism, hypothyroidism, and polycystic ovary syndrome, physicians had a lower risk for DM than the comparisons (adjusted odds ratio [AOR]: 0.75; 95% confidence interval [CI]: 0.68–0.82). In comparisons among physicians, emergency physicians (AOR: 2.21; 95% CI: 1.44–3.40) and surgeons (AOR: 1.26; 95% CI: 1.05–1.52) had a higher risk for DM than other specialists.ConclusionsThis study found that physicians have a lower risk for DM than the general population and emergency physicians and surgeons have a higher risk for DM than other specialists. Thus, more attention should be paid to the occupational health of these doctors.

Prevalence and Major Risk Factors of Diabetes Mellitus Among Adult Mental Disorder Inpatients from 2005 to 2018 in Beijing, China: A Longitudinal Observational Study

Background: The prevalence of diabetes mellitus was often reported as higher in mental illness inpatients compared to the general population, but large study of the prevalence of diabetes among mental illness inpatients in China was scarce. We aim to investigate the prevalence, trends, and major risk factors of diabetes mellitus among adult mental disorder inpatients in Beijing, China. Methods: We did a longitudinal observational study using data from Beijing Municipal Commission of Health and Family Planning Information Center, including 188856 adult inpatients with mental disorders in 19 specialized psychiatric hospital from 2005 to 2018 in Beijing. Data of demographic characteristics was obtained from electronic health record (EHR) data. Schizophrenia, diabetes, and comorbidities were defined according to ICD-10 codes of discharge diagnosis. Overall prevalence of diabetes in adult mental disorder inpatients was calculated, and annual prevalence of diabetes was calculated and adjusted to the overall participant population. Univariate and multivariate logistic regression analysis was performed to obtain crude odds ratios (cORs) and adjusted odds ratios (aORs) for the risk of diabetes in patients with different demographic characteristics, with schizophrenia versus other mental disorders, and with different comorbidities. We also calculated the prevalence of diabetes in different age groups under a stratification of schizophrenia or other mental disorders. Findings: Out of 188856 adult inpatients, 23558 had diabetes mellitus, the prevalence was 12.47% (95% confidence interval (CI): 12.33-12.62%). The prevalence was 13.42% (95%CI: 13.18-13.66%) among patients with schizophrenia, and 11.81% (95%CI: 11.61-12.00%) among patients with other mental disorders. 87.48% patients with diabetes mellitus was coded as type 2 diabetes mellitus (T2DM), the prevalence of T2DM was 10.91% (95%CI: 10.77-11.05%). During 2005-2018, the prevalence of diabetes mellitus in adult patients were increasing with admitted year, from adjusted prevalence of 6.05% in 2005, to 12.41% in 2010, 14.48% in 2015, 14.08% in 2018. After adjusting for gender, ethnic origin, marriage status, payment, and hospital grade, results from the multivariate analysis showed that increasing age, diagnosed as schizophrenia (aOR=1.22, 95%CI: 1.18-1.26), comorbidity with hypertensive diseases (aOR=3.11, 95%CI: 3.01-3.22), lipoprotein metabolism disorders (aOR=2.03, 95%CI: 1.96-2.10), fatty liver (aOR=1.91, 95%CI: 1.84-1.98) were major risk factors of diabetes mellitus in adult mental disorder inpatients. Interpretation: The prevalence of diabetes mellitus was high among adult mental disorder inpatients in Beijing, China. Patients who were elderly, with schizophrenia, and those with hypertensive diseases, lipoprotein metabolism disorders, and fatty liver had higher risk for diabetes mellitus. Prevention and treatment of diabetes mellitus is of utmost relevance in hospitalized mental illness patients. Funding Statement: This study was supported by the grant from National Natural Science Foundation of China (No. 71874003 and No. 81703240). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study used information that is available in database of the Beijing Municipal Commission of Health and Family Planning Information Center, and all identifiable information was removed. Patients and the public were not involved in the design and conduct of the study.

Loneliness, Cardiovascular Disease, and Diabetes Prevalence in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

The relationship between loneliness and both cardiovascular disease (CVD) and diabetes mellitus (DM) has been understudied in U.S. Hispanics, a group at high risk for DM. We examined whether loneliness was associated with CVD and DM, and whether age, sex, marital status, and years in U.S moderated these associations. Participants were 5,313 adults (M (SD) age = 42.39 (15.01)) enrolled in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Loneliness was assessed via the 3-item Revised UCLA Loneliness Scale. Level of reported loneliness was low. Loneliness was significantly associated with CVD: OR 1.10 (CI 1.01-1.20) and DM: OR 1.08 (CI 1.00-1.16) after adjusting for depression, demographics, body mass index, and smoking status. Age, sex, marital status, and years in U.S. did not moderate associations. Given that increased loneliness is associated with higher cardiometabolic disease prevalence beyond depressive symptoms, regardless of age, sex, marital status, or years in the U.S., Hispanic adults experiencing high levels of loneliness may be a subgroup at particularly elevated risk for CVD and DM.

Meta‐analysis on the association between the frequency of tooth brushing and diabetes mellitus risk

Epidemiological studies suggested that the frequency of tooth brushing might be associated with the risk of diabetes mellitus (DM), but the results were inconsistent, and no systematic review was conducted to focus on this topic. In this meta-analysis, we synthesized available observational epidemiological evidences to identify the association between tooth brushing and DM risk and investigate the potential dose-response relationship of them. We searched PubMed and Embase from their inception through December 2017 to identify observational studies examining the association between tooth brushing and the risk of DM. Reference lists from retrieved articles were also reviewed. We quantitatively combined results of the included studies using a random-effects model. Dose-response meta-analysis was conducted to further examine the effect of tooth brushing frequency on DM risk. We identified 20 relevant studies (one cohort study, 14 case-control studies, and 5 cross-sectional studies) involving 161 189 participants and 10 884 patients with DM. Compared with the highest tooth brushing frequency, the lowest level was significantly associated with an increased risk of DM (OR 1.32; 95% CI, 1.19-1.47), and there was no significant heterogeneity across the included studies (p=0.119, I2 =28.1%). Exclusion of any single study did not materially alter the combined risk estimate. The dose-response analysis indicated that the summary odds of DM for an increment of one time of tooth brushing per day was 1.20 (95% CI, 1.16-1.24). Integrated epidemiological evidence supports the hypothesis that low frequency of tooth brushing may be a risk factor of DM, and lower frequencies of tooth brushing were significantly associated with higher risk of DM.

Diabetes Mellitus Risk Assessment Among Egyptians Versus Saudi Arabians Nursing Employees: Comparative Study

Purpose: Diabetes mellitus is the uppermost vital public health challenges in the world. More than 150 million adults are affected and the total number is predicted to double in the next 25 years. The present study aiming to assess the diabetes mellitus risk among Egyptians versus Saudi Arabian's nursing employees. Methods: A convenient sample of 150 employees from each country were collected. The study was conducted at faculties of Nursing at Menoufia University, Egypt and Jouf University, Kingdom of Saudia Arabia. Two tools were utilized for data collection, self-administered questionnaire and self-risk assessment screening score. Results: Both groups had a good total knowledge score (74% of Egyptians vs. 58% of Saudi Arabians) with a statistically significant difference. More than half of Egyptians had negative attitude compared to nearly half of Saudi Arabians who had a positive attitude. Nearly two-thirds of Egyptians had good practice vs. 44% of Saudi Arabians who had a bad practice. More than two-thirds of Egyptians vs. more than three-fourths of Saudi Arabians were scored high risk for diabetes mellitus. Conclusion: Based on the findings, there were statistically significant differences among Egyptians versus Saudi Arabian's nursing employees in total knowledge, practice and attitude scores of diabetes mellitus. Total risk assessment screening score of diabetes mellitus has shown a statistically significant difference between both groups. Recommendations : Large-scale awareness programs should be implemented after identifying the appropriate means to spread the message to the common population about all aspects of diabetes. Keywords: Diabetes mellitus, Knowledge, Practices, Attitude, Risk assessment. DOI : 10.7176/JHMN/59-04

Investigating the Relationship between Magnesium levels and Diabetes Mellitus in Pregnant Women.

Gestational diabetes mellitus (GDM) is defined as one of the three main types of diabetes mellitus (DM). It is established that GDM is associated with exceeding nutrient losses owing to glycosuria. Magnesium (Mg), as one of the essential micronutrients for fetus development, acts as the main cofactor in most enzymatic processes. The aim of this study was to measure serum and cellular levels of Mg, albumin, creatinine, and total protein to further clarify the relationship between these components and DM in pregnant women. Blood samples were obtained from 387 pregnant women. The participants were classified into four groups based on their type of diabetes, namely GDM (n=96), DM (n=44), at high-risk of DM (n=122), and healthy controls (n=125). All participants' fasting blood sugar (FBS), creatinine, albumin, Mg, and total protein in the serum levels and red blood cell Mg (RBC-Mg) were measured during 24-28 weeks of gestation. Groups were compared for possible association between DM and abortion, gravidity, and parity. The serum levels of creatinine, FBS, albumin, Mg, and RBC-Mg were statistically different among four groups (P =0.001). Significant lower levels of RBC- Mg was observed in all studied groups in comparison with controls. Given a positive correlation between DM and abortion, it seems that decreased levels of RBC-Mg and serum albumin can increase the risk of abortion in pregnant women. Our data demonstrated significant alterations in albumin, Mg, and creatinine concentrations in women with DM or those at high risk of DM during their gestational age. It seems that the measurement of these biochemical parameters might be helpful for preventing the complications, and improving pregnancy outcomes complicated with DM.