Incidence Of Diabetes Mellitus Research Articles

Review on Diabetes Mellitus: An Insight into the Current Scenarios, the Challenges of Therapy, and Application of Traditional Drugs

Abstract: Diabetes mellitus, an epidemic of the 21st century, is listed as one of the top ten causes of death around the world by the World Health Organization and is a complicated disease to deal with. Medically, a metabolic disorder characterized by elevated blood glucose levels and altered metabolism of biological macromolecules, mainly carbohydrates. Diabetes mellitus has a worldwide prevalence, and populations of all high, middle, as well as low-income countries, are affected by it. More than 400 million persons are currently living with diabetes. Many risk factors, such as lack of exercise, irregular diet, drinking, and smoking habits, as well as genetic factors, also contribute to the increased incidence of diabetes mellitus in the modern era. The conventional therapies for diabetes are based on insulin, insulin analogues, peptides, and oral hypoglycemics. The primary objective is to lower the elevated blood glucose levels and manage the distress to enhance the quality of life of the patient. The management of diabetes is very crucial to avoid complications having serious consequences such as the extra economic burden due to these complications. Conventional drug therapy has its own adverse effects, and its timely availability and cost are still an issue in many low and middle-income countries. Diabetes mellitus has been reported in various ancient kinds of literature along with various natural remedies (plants/herbals) useful in it. These plant-based remedies offer the benefits of lesser or no adverse effects, easy availability due to natural abundance, and low cost. Therefore, extensive research work is carried out in the past few decades to identify and understand the underlying principles of plant-based/herbal medicines to develop new potential lead molecules and a relatively safer, easily available and more economical alternative treatment therapy for diabetes mellitus.

Male-female differences following concomitant coronary artery bypass grafting and aortic valve replacement surgery.

Combined coronary artery bypass grafting (CABG) and aortic valve replacement (AVR), and female sex are associated with increased perioperative mortality in clinical risk scores. This study investigated male-female differences in short-term outcome stratified by age groups. All patients undergoing AVR and CABG between January 2001 and June 2021 at our institution were included. 1963 patients were grouped by decades into: 59years and younger (n=127), 60-69 (n=471), 70-79 (n=1070), and 80years and older (n=295). The primary end points of this study were 30 and 180days mortality. Secondary end points were influence of preoperative risk factors and impact of sex on survival and postoperative major adverse events. Female patients showed higher 30 and 180days mortality after combined CABG and AVR surgery (8.3% vs. 4.2%, P<0.01; 15.8% vs. 9.4%, P<0.01). Stratified by age groups, 30 and 180days mortality remained significantly higher in septuagenarians (9.6% vs. 2.5%, P<0.01; 16.3% vs. 7.7%, P<0.01). Females were significantly older, had better preserved left ventricular function, and higher incidence of diabetes mellitus compared with male patients in this subgroup (P<0.01; P=0.01; P<0.01). Additionally, females received significantly less internal mammary artery (IMA) conduits (P<0.01). Female sex (OR: 3.33, 95% CI: [1.76-6.31]; 1.93, [1.22-3.06]), higher age (1.28, [1.13-1.45]; 1.16, [1.06-1.26]), diabetes mellitus (1.93, [1.03-3.60]; 1.70, [1.08-2.67]) and LVEF <30% (3.26, [1.48-7.17]; 2.23, [1.24-4.02]) were correlated with 30 and 180days mortality, respectively. Upon multivariable testing, sex (1.77, [1.21-2.58]) and LVEF <30% (3.71, [2.39-5.76]) remained independent predictors for major adverse postoperative events. Infrequent use of IMA grafts was associated with increased 30 and 180days mortality as well as adverse events (0.47, [0.25-0.87]; 0.46, [0.29-0.72]; 0.61, [0.42-0.88]). Sex disparities in baseline characteristics may delay operative intervention in female patients. The inherent risk profiles might be responsible for outcome differences in septuagenarians.

Analysis of correlative factors of female coronary slow-flow phenomenon: A retrospective study.

The coronary slow-flow phenomenon (CSFP) is a manifestation of coronary artery disease wherein coronary angiography reveals no apparent stenosis; however, there is a delay in blood flow perfusion. Given its increased occurrence in male patients, with the majority of subjects in previous studies being male, this study aimed to explore whether distinct risk factors are present in female patients with CSFP. This single-center retrospective study focused on female patients diagnosed with CSFP by using coronary angiography. Eligible patients meeting the predefined inclusion and exclusion criteria were divided into the study group (presenting with CSFP) and control group (displaying normal epicardial coronary arteries). Comparative analyses of clinical and diagnostic data were performed. Ninety-two patients with CSFP and an equal number of controls were enrolled in this study. Patients with CSFP exhibited a higher prevalence of smokers (P = .017) and a heightened incidence of diabetes mellitus (DM) (P = .007). Significantly elevated levels of total cholesterol (TC) (P = .034) and free fatty acids (FFA) (P = .016) were observed in the CSFP group compared to those in the control group. Additionally, patients with CSFP displayed lower levels of apolipoprotein E (ApoE) (P = .092), free thyroxine (FT4) (P = .001), and total thyroxine (TT4) (P = .025). Logistic regression analysis indicated that smoking (P = .019), FFA (P < .001), ApoE (P = .015), and FT4 (P < .001) were independent risk factors for CSFP, accounting for confounding factors. Additionally, the area under the ROC curve (AUC) of the combined effect of smoking, ApoE, FT4, and FFA on CSFP was 0.793 (95% CI: 0.729-0.857, P < .01). In addition to the established risk factors for smoking, diabetes, and hyperlipidemia, female patients with CSFP exhibited significant differences in apoE, FFA, FT4, and TT4 levels compared to the control group. Smoking, FFA, and FT4 levels emerged as independent risk factors for CSFP.

#1227 The role of P-selectin (CD62P) expression in renal tissue in the development of diabetic nephropathy

Abstract Background and Aims The prevalence of diabetic nephropathy (DN) is increasing in line with the increase in the incidence of diabetes mellitus (DM) worldwide. The latest data from the International Diabetes Federation (IDF) predicts that by 2045, more than 10.5% of adults worldwide will have diabetes. This will lead to kidney damage in 100-250 million people. DN is characterized by structural and functional changes. As a result of chronic hyperglycemia, pathogenic changes in the vascular wall develop, and the frequency of micro- and macrovascular complications associated with morbidity and mortality among patients with diabetes increases. However, the exact mechanism of vascular complications is not completely clear. Endothelial dysfunction plays a key role in triggering the development of inflammatory mechanisms that are associated with vascular complications in patients with type 2 diabetes mellitus (T2DM). Activation of the endothelium due to increased release of cytokines and expression of adhesion molecules promotes platelet activation and their adhesion to the activated endothelium. Selectins (E-selectin, L-selectin and P-selectin) play a major role in the development of microvascular complications. The aim of the study was to examine the role of P-selectin (CD62p) expression in the glomerular endothelium and peritubular capillaries in patients with different morphological classes of DN and to evaluate its effect on the development and progression of morphological changes in renal tissue. Method Was examined 49 patients with T2DM complicated by the development of DN. The average age of the patients was 66.58 ± 3.27 years. There were 35 women, 14 men. The duration of the disease was 17.70 ± 0.35 years. The duration of DN from the moment of detection of microalbuminuria to the morphological examination of the renal tissue and diagnosis was 1.65 ± 0.34 years. All patients underwent light and immunofluorescence microscopy of kidney tissue biopsies obtained by intravital puncture biopsy. Morphological changes in tissue were assessed in accordance with the latest international classification of diabetic nephropathy developed by the Scientific Committee of the Pathology Society, USA. According to light microscopy data, class IIa (mild mesangial expansion) was detected in 12 patients, class IIb (severe mesangial expansion) in 14 patients, class III (Kimmelstil–Wilson nodular lesions) in 19 patients, and class IV (advanced diabetic glomerulosclerosis) in 5 patients. In addition to light microscopy, the expression of CD62β (P-selectin) in the glomerular endothelium and in peritubular capillaries was determined in all patients. FITc-labeled monoclonal antibodies (FITC anti-human CD62p Antibody, clone AK4 Cat#304904), were used (Biolegend, USA). Results Analysis of biopsy tissue from DN patients showed that CD62p expression is detected both in the glomerular endothelium (1.6383 ± 0.4789 (95% CI: 0.9574-2.7234)) and in peritubular capillaries (1.1702 ± 0.1308 (95% CI: 0.9149–1.4250)). Using the linear regression method with the calculation of the coefficients of determination R2 (R Square), the values of the F criterion, significant regression models were obtained: Expression of CD62p in the glomerular endothelium promotes the development and progression of arteriolar hyalinosis (R2=0.213, F=12.476 p=0.001); expansion of the mesangial matrix (R2=0.362, F=26.09, p=0.0001); thickening of the basement membrane (R2=0.127, F=6.57, p=0.014); development and progression of nodular Kimmelstiel–Wilson lesions (R2=0.106, F=5.360, p=0.025). Expression of CD62p in peritubular capillaries promotes the development of interstitial sclerosis (R2=0.549, F=54.732, p=0.0001). The severity of CD62p expression in the glomerular endothelium depends on the morphological class of DN in patients (R2=0.216, F=12.684, p=0.001). Conclusion

#1411 Intrarenal hemodynamics in patients with coronary heart disease in the post-COVID-19 period

Abstract Background and Aims Coronary heart disease (CHD) and obesity are common pathologies in patients who have had COVID-19. Endothelial dysfunction (ED) markers determination has been important in such patients due to the high risk of cardiovascular diseases progression and complications development. THE AIM Assessment of endothelial dysfunction severity in patients with CHD and obesity in the post-COVID-19 period to improve the management of these patients. Method 49 patients were examined, who had COVID-19 a year ago. The first group (n=24) included patients with coronary artery disease in the post-COVID period. The second group (n=25) included patients with CHD and obesity who had COVID-19. We evaluated data from an ultrasound examination of the kidneys with duplex scanning of the renal arteries (resistance index (RI), pulsation index (PI)). We also studied the medical history, performed an objective examination, the results of a biochemical blood test, albuminuria levels. Results We demonstrated higher RI and PI of interlobar, segmental arteries in persons of the second group. An increase in RI and PI of segmental arteries accompanied by an increase in uric acid (p=0.001). The average level of microalbuminuria in the first group was 15.71 ± 4.51 μg/l, in the second group it was 24.38 ± 5.38 μg/l (p=0.110). Increasing glucose levels accompanied by an elevation of C-reactive protein levels. Obese patients had significantly higher levels of total cholesterol, triglycerides, low density lipoproteins than patients in the first group. Conclusion We observed changes in lipid metabolism, a higher incidence of diabetes mellitus in females, and changes in intrarenal hemodynamic parameters associated with uric acid levels in patients with coronary heart disease and obesity in the post-COVID-19 period.

Machine Learning Approach to Metabolomic Data Predicts Type 2 Diabetes Mellitus Incidence.

Metabolomics, with its wealth of data, offers a valuable avenue for enhancing predictions and decision-making in diabetes. This observational study aimed to leverage machine learning (ML) algorithms to predict the 4-year risk of developing type 2 diabetes mellitus (T2DM) using targeted quantitative metabolomics data. A cohort of 279 cardiovascular risk patients who underwent coronary angiography and who were initially free of T2DM according to American Diabetes Association (ADA) criteria was analyzed at baseline, including anthropometric data and targeted metabolomics, using liquid chromatography (LC)-mass spectroscopy (MS) and flow injection analysis (FIA)-MS, respectively. All patients were followed for four years. During this time, 11.5% of the patients developed T2DM. After data preprocessing, 362 variables were used for ML, employing the Caret package in R. The dataset was divided into training and test sets (75:25 ratio) and we used an oversampling approach to address the classifier imbalance of T2DM incidence. After an additional recursive feature elimination step, identifying a set of 77 variables that were the most valuable for model generation, a Support Vector Machine (SVM) model with a linear kernel demonstrated the most promising predictive capabilities, exhibiting an F1 score of 50%, a specificity of 93%, and balanced and unbalanced accuracies of 72% and 88%, respectively. The top-ranked features were bile acids, ceramides, amino acids, and hexoses, whereas anthropometric features such as age, sex, waist circumference, or body mass index had no contribution. In conclusion, ML analysis of metabolomics data is a promising tool for identifying individuals at risk of developing T2DM and opens avenues for personalized and early intervention strategies.

Women with a history of gestational diabetes mellitus present an accumulation of cardiovascular risk factors at age 46-A birth cohort study.

The incidence of gestational diabetes mellitus (GDM) is globally increasing, and it has been associated with later type 2 diabetes, metabolic syndrome (MetS), and cardiovascular disease (CVD). However, long-term population-based studies investigating common CVD risk factors years after pregnancy are lacking. To evaluate the future mortality and morbidity in cardiovascular and metabolic diseases, we conducted a thorough investigation of midlife risk factors in women with and without previous GDM. A prospective population-based cohort study was conducted of 3173 parous women from the Northern Finland Birth Cohort, 1966. Subjects were obtained from the national register or patient records. Those with a GDM diagnosis formed the GDM cohort (n = 271), and those without a previous GDM diagnosis formed the control cohort (n = 2902). Clinical examinations were performed on participants at the age of 46 and included anthropometric measurements, oral glucose tolerance test (OGTT), biochemical measurements, and cardiovascular assessment. At the age of 46, women in the GDM cohort had a higher body mass index (BMI, 29.0 kg/m2 vs 26.3 kg/m2, p < 0.001) and greater waist circumference (94.1 cm vs 86.5 cm, p < 0.001) than the control cohort. In the GDM cohort, a higher incidence of impaired glucose tolerance (12.6% vs 7.3%, p = 0.002), more previously diagnosed and OGTT-detected type 2 diabetes (23.3% vs 3.9%, p < 0.001), lower high-density lipoprotein (1.53 mmol/L vs 1.67 mmol/L, p = 0.011), higher triglycerides (1.26 mmol/L vs 1.05 mmol/L, p = 0.002) and a higher fatty liver index (6.82 vs 2.47, p < 0.001), were observed even after adjusting for BMI, polycystic ovary syndrome, parity, level of education, physical activity, smoking, and alcohol consumption. The women in the GDM cohort also had more MetS (42.6% vs 21.9%, p < 0.001) and higher risk scores for CVD and fatal events (Framingham 4.95 vs 3.60, p < 0.001; FINRISK 1.71 vs 1.08, p < 0.001). Women with a previous diagnosis of GDM exhibit more risk factors for CVD in midlife and are at a higher risk for cardiovascular events later in life.

ASPECTS OF THE USE OF ANTIDIABETIC DRUGS IN PHARMACEUTICAL PRACTICE ON THE BASIS OF RATIONAL PHARMACOTHERAPY

The aim of the article. To study of the incidence of diabetes mellitus in Ukraine and to determine the prospects for the use and pharmaceutical development of antidiabetic drugs. Materials and methods. Data from the State Registers of Medicinal Products of Ukraine, of Wholesale and Retail Prices for Medicinal Products declared in Ukraine under an international non-proprietary or generic name (01.01.2024). Were used: systematic and comparative analysis, processing and synthesis, and generalization to determine the forecasted prospects. Results. In Ukraine the number of diabetes patients increased by 11% in the group of children and adolescents; in the group of elderly patients – by 12.5%, among the adult working – 20%, diabetes of the II type predominates. The trend of increase in the number of studies on the search for therapeutic alternatives for the treatment of type II diabetes and list of medicines on the pharmaceutical market has been revealed. In Ukraine drugs for oral use include APIs of the following pharmacological groups: sulfonylureas; meglitinides; biguanides; thiazolidinedione; α-glucosidase inhibitors; DPP-4 inhibitors; SGLT-2 inhibitors. Mechanism of action of the new class of oral hypoglycemic agents, approved by the FDA, consists in blocking SGLT-2 proteins from the proximal convoluted tubule in the kidney, leads to the prevention of reabsorption and excretion of the glucose molecule. This allows its use in combination with insulin and other antidiabetic drugs for the treatment of type I and II diabetes in patients of various age categories. According to the volume of clinical studies, SGLT-2 inhibitor SGLT-2 derivative gliflozin API drugs are the second largest group of antidiabetic drugs recommended for use by FDA and EMA regulatory bodies. Conclusions. The pharmaceutical development of mono and combined drugs with APIs SGLT-2 inhibitors gliflozin derivatives in combination with APIs with metformin, DPP-4 inhibitors, APIs thiazolidinedione derivatives is promising for solving the problem of diabetes treatment and prevention of complications for patients of different age groups including working population in Ukraine.

Association between the triglyceride-glucose index and subclinical left ventricular systolic dysfunction in obese patients

BackgroundThe association between the triglyceride–glucose (TyG) index and subclinical left ventricular (LV) systolic dysfunction in obese patients remains unclear. This study aimed to investigate the relationship between the TyG index and LV global longitudinal strain (GLS) in obese patients.MethodsA total of 1028 obese patients from January 2019 to January 2024 were included in the present study. Clinical parameters and biochemical and echocardiographic data were obtained from the participants. LV GLS was obtained from the GE EchoPAC workstation for evaluating subclinical LV function. The TyG index was calculated as Ln (fasting TG [mg/dL] × fasting glucose [mg/dL]/2). LV GLS was compared between obese patients with a high TyG index and those with a low TyG index.ResultsObese patients with a high TyG index had greater incidences of hypertension, diabetes mellitus and hyperlipidaemia. The LV GLS was significantly lower in the high TyG index group than in the low TyG index group (P = 0.01). After adjusting for sex, age, body mass index, heart rate, hypertension, diabetes mellitus, dyslipidaemia, blood urea nitrogen, serum creatinine, LV mass and LV hypertrophy, the TyG index remained an independent risk indicator related to an LV GLS < 20% (OR: 1.520, 95% CI: 1.040 to 2.221; P = 0.031).ConclusionsWe concluded that an increase in the TyG index is independently associated with subclinical LV systolic dysfunction in obese patients.

Development and validation of machine learning models to predict unplanned hospitalizations of patients with diabetes within the next 12 months

BACKGROUND: The incidence of diabetes mellitus (DM) both in the Russian Federation and in the world has been steadily increasing for several decades. Stable population growth and current epidemiological characteristics of DM lead to enormous economic costs and significant social losses throughout the world. The disease often progresses with the development of specific complications, while significantly increasing the likelihood of hospitalization. The creation and inference of a machine learning model for predicting hospitalizations of patients with DM to an inpatient medical facility will make it possible to personalize the provision of medical care and optimize the load on the entire healthcare system.AIM: Development and validation of models for predicting unplanned hospitalizations of patients with diabetes due to the disease itself and its complications using machine learning algorithms and data from real clinical practice.MATERIALS AND METHODS: 170,141 depersonalized electronic health records of 23,742 diabetic patients were included in the study. Anamnestic, constitutional, clinical, instrumental and laboratory data, widely used in routine medical practice, were considered as potential predictors, a total of 33 signs. Logistic regression (LR), gradient boosting methods (LightGBM, XGBoost, CatBoost), decision tree-based methods (RandomForest and ExtraTrees), and a neural network-based algorithm (Multi-layer Perceptron) were compared. External validation was performed on the data of the separate region of Russian Federation.RESULTS: The best results and stability to external validation data were shown by the LightGBM model with an AUC of 0.818 (95% CI 0.802–0.834) in internal testing and 0.802 (95% CI 0.773–0.832) in external validation.CONCLUSION: The metrics of the best model were superior to previously published studies. The results of external validation showed the relative stability of the model to new data from another region, that reflects the possibility of the model’s application in real clinical practice.

Long-term exposure to transportation noise and diabetes mellitus mortality: a national cohort study and updated meta-analysis

BackgroundLong-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort.MethodsDuring 15 years of follow-up (2001–2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined).ResultsHRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively).ConclusionsThis study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.

Nutrition Knowledge and Food Frequency Among People with Diabetes Mellitus

Diabetes Mellitus is one of the chronic diseases that causes the highest death in Indonesia. In fact, the number of cases of pain continues to increase. Riskesdas 2018 data shows that the total number of diabetes cases in Indonesia is 8.5%. Complications include heart attacks and strokes, severe leg infections (causing gangrene, which may result in amputation), end-stage renal failure, and sexual dysfunction. After 10-15 years from the time of diagnosis, the prevalence of all complications of diabetes increases markedly. Efforts that can be made to prevent diabetes mellitus are managing lifestyle, regular physical activity, maintaining diet, and conducting early examinations. The purpose of this study was to determine the relationship between nutrition knowledge and food frequency with the incidence of diabetes mellitus. This was an observational analytic study with a cross-sectional study design conducted in Malang. A sample of 54 people was selected by purposive sampling technique. The dependent variable is the incidence of diabetes mellitus. Independent variables include nutrition knowledge and food frequency. The data were collected by questionnaire and analyzed using Pearson correlation. Nutrition knowledge (r = 0.40; p = 0.003) and food frequency (r = 0.33; p = 0.017) related to diabetes mellitus and statistically significant. Good nutritional knowledge and regular food frequency can prevent diabetes mellitus.

Socio-Cultural Factors on the Tradition of Consuming Sweet Food Dishes during Events in Central Java with the Incidence of Diabetes Mellitus

The high number of diabetes mellitus sufferers in Indonesia is a serious concern because of the very high risk of other diseases and even death. One aspect that needs to be considered is the behavior of consuming sweet foods which is still an inseparable part of Central Javanese cultural traditions. This research aims to analyze socio-cultural factors regarding the tradition of consuming sweet dishes during the Tedhak siten event in Central Java with the incidence of diabetes mellitus. This research uses a literature review research method with library study data collection techniques. The data that has been collected is then analyzed in three stages, namely data reduction, data presentation and drawing conclusions. The research results show that socio-cultural factors, such as the tradition of sweet foods at events in Central Java, have a complex relationship with the incidence of diabetes mellitus. Even though this tradition has important cultural values in Central Javanese society, consuming sweet foods excessively or too often can increase the risk of developing diabetes mellitus. So it is important for people to pay attention to their food choices in order to avoid and reduce the high risk of developing diabetes mellitus, even though this tradition has strong cultural values

Oral Glucose Tolerance Test as a Risk Marker for Developing Post-Transplant Diabetes Mellitus

IntroductionThe incidence of post-transplant diabetes mellitus (PTDM) can reach 30% during the first 6 months after kidney transplantation (KT), increasing the risk of graft failure and mortality. There is no well-established biomarker for predicting PTDM occurrence. This study evaluated the association between the abnormal 2-hour oral glucose tolerance test (OGTT) and the PTDM incidence. MethodsA retrospective single-center study, including adult kidney transplant recipients from deceased donors, was performed between March 2021 and June 2022. Exclusion criteria: age <18 years; pretransplant diabetes mellitus (DM); death with a functioning graft; loss of follow-up and/or graft failure before 6 months post-transplant. The results of pretransplant OGTT, fasting (FPG), and afternoon plasma glucose levels at hospitalization and FPG in the first, second, and third months post-transplant were evaluated. For analysis, patients were grouped according to the PTDM diagnosis: PTDM and non-PTDM. ResultsFrom 164 KT performed in the period, 50 (30%) were included, most male (n = 34, 68%), with a mean age of 48.3 ± 12.5 years. Nine patients (18%) developed PTDM, 44% between 3 and 6 months. General characteristics and immunosuppressive therapy were similar between the groups. The mean FPG in the pretransplant OGTT was significantly higher in the PTDM group compared with the non-PTDM group (85.7 ± 7.9 vs 79.1 ± 8.2, P = .03). The number of patients classified as impaired glucose tolerance (IGT) on the pre-transplant OGTT was significantly higher in the PTDM group. ConclusionIGT in the pretransplant OGTT was associated with PTDM cases in kidney transplant recipients without a previous diagnosis of DM.

Correlation Between Blood Urea Nitrogen and Short- and Long-Term Glycemic Variability in Elderly Patients with Type 2 Diabetes Mellitus Who Were hospitalized:A Retrospective Study.

Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by insulin resistance and progressively impaired insulin secretion resulting in dynamic fluctuations in glucose levels.High blood urea nitrogen (BUN) levels have been linked to decreased insulin sensitivity, suppressed insulin synthesis and increased risk of incident diabetes mellitus in humans as well as insulin use in patients with T2DM.This study characterize the association between BUN levels and short-term and long-term glycemic variability(GV) in the elderly patients with T2DM who were hospitalized. A total of 927 elderly patients with T2DM were included in the study. The short-term GV was quantified using parameters such as standard deviation (SD), coefficient of variation (CV), time in range (TIR), and mean amplitude of glycemic excursions (MAGE), based on multi-point fingertip blood glucose monitoring. The long-term GV was quantified using parameters such as SD, CV, variation independent of the mean (VIM), and average successive variability (ARV), based on fasting blood glucose(FPG). The relationship between BUN levels and short-term and long-term GV in elderly T2DM who were hospitalized was explored using methods such as Spearman correlation coefficient, linear regression analysis, logistic regression analysis, and interaction tests. In elderly patients with T2DM were hospitalized, there is a significant correlation between BUN levels and both short-term and long-term GV. BUN is negatively correlated with the GV parameter TIR (r=-0.12, P=0.000), and positively correlated with SD (r=0.12, P=0.000), CV (r=0.07, P=0.026), MAGE (r=0.11, P=0.001), FPG-SD (r=0.08, P=0.013), and FPG-CV (r=0.08, P=0.014).Furthermore, the association remains consistent across different age, gender, BMI, and haemoglobin A1c (HbA1c) subgroups (P interaction > 0.05). In elderly patients with T2DM were hospitalized, BUN levels were positively associated with GV.Therefore, monitoring BUN levels were beneficial in assessing the degree of GV.

Increasing Trend of Gestational Diabetes Among Pregnant Females

Introduction: Gestational Diabetes mellitus (GDM) incidence has risen in recent decades affecting nearly 15 percent of females who experience elevated blood sugar levels during their pregnancy. Aims and Objectives: To assess the increasing trend of gestational diabetes among pregnant females visiting DHQ Hospital Narowal. Place and Duration of study: Data was collected at DHQ Hospital Narowal during 2018 &amp; 2023. Material and Methods: The study was carried out at DHQ Hospital, Narowal. During study period, 3600 pregnant females aged between 18 to 45 years were enrolled and examined for gestational diabetes mellitus in each year 2018 &amp; 2023. The collected data was entered and analyzed in computer software SPSS version 25.0. Data was presented in tables and graphs for both quantitative and qualitative variables. pvalue? 0.05 was taken as significant. Results: Among 3600 pregnant females in year 2018, 75.1% were 18-30 years old and 24.9% were 31-45 years old. Among pregnant females in year 2023, 89.0% were 18-30 years old and 11.0% were 31-45 years old. Among pregnant females, 15.9%, 42.4% and 41.7% had gestational age 0-12 weeks, 13-28 weeks and 29-40 weeks in 2018, respectively. In 2023, 29.6%, 22.1% and 48.3% females had gestational age 0-12 weeks, 13-28 weeks and 29-40 weeks, respectively. Among these pregnant females, 20.1% in 2018 and 35.0% in 2023 were diagnosed with gestational diabetes while the increasing trend was found to be 14.9%. Conclusion: This study concluded that there was an increasing trend of gestational diabetes mellitus among pregnant females in Narowal.

Vitamin D efficacy in type 1 and type 2 diabetes.

It is well known that vitamin D has a profound effect on calcium and bone metabolism, but its influence on other organs (extraskeletal effect) has been proposed. Consistently, vitamin D deficiency is associated with an increased incidence of various diseases, including type 1 and type 2 diabetes, as reported by many observational studies. However, there has been no consensus on whether vitamin D deficiency is a causative factor in the incidence of diabetes mellitus. There have been no randomized controlled trials (RCTs) aimed at preventing the onset of type 1 diabetes with vitamin D intake. In addition, the results of RCTs evaluating the preventive effect of vitamin D supplementation on type 2 diabetes development have been inconsistent. The recent observational studies, randomized controlled trials, and meta-analyses are confirming that vitamin D or active vitamin D administration is effective in preventing the incident of type 1 and type 2 diabetes.

FACTORS ASSOCIATED WITH INCIDENCE OF DIABETES MELLITUS IN INTERNAL DISEASE POLY BUDI LESTARI BEKASI HOSPITAL

Introduction: The World Health Organization (WHO) states, the number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years has increased from (4.7%) in in 1980 to (8.5%) in 2014. Diabetes prevalence is increasing faster in middle and low income countries. In 2015, an estimated 1.6 million deaths were directly caused by Diabetes. 2.2 million other deaths were caused by high blood glucose in 2012. Nearly half of all deaths due to high blood glucose occurred before the age of 70 years. Research Objectives : To determine the factors related to the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Bekasi Hospital in 2019. Research Methods : This research method uses Analytical Quantitative Design with Cross Sectional Approach, with Independent Variables, Heredity, Diet and Sports Habits while the Dependent Variable is Diabetes Mellitus, with a population of 300 patients during the last 6 months July-December 2019, for sampling using accidental sampling as many as 35 respondents, the type of statistical test used is chi square. Research Results : The results showed that there was a significant relationship between heredity, diet, exercise habits with the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Hospital in Bekasi with a P.Value value of 0.014 or P.Value ≤  (0.05) with OR (Odds Ratio) = 0.050. Suggestion : It is expected that hospitals can provide maximum health services for patients seeking treatment and input for nurses in providing health education to patients with Diabetes Mellitus about Factors Related to Diabetes Mellitus.

Association of Maternal Vitamin B12 and Folate Levels with Gestational Diabetes Mellitus and Insulin Resistance

Background: The incidence of gestational diabetes mellitus (GDM) has increased in recent decades. Established prevention methods for GDM include diet and exercise. Recent interest has focused on the roles of vitamin B12 and folate in the development of GDM. These micronutrients are essential for one-carbon metabolism, which is involved in many metabolic pathways. However, the study results were conflicting and varied by geographic area. Objectives: The aim of this study was to evaluate the relationship between GDM and vitamin B12 levels in our region. Methods: This case-control study enrolled 180 pregnant women at 24 - 28 weeks of gestation. Half of the participants had GDM, and the other half were healthy individuals. All participants attended outpatient pregnancy care clinics at Shiraz University of Medical Sciences from June 2020 to April 2021. Gestational age, age, and body mass index were matched between the two groups. Vitamin B12, folate, insulin, and homocysteine levels were measured in both groups and insulin resistance was calculated. The results were compared between the two groups, and the relationship between vitamin B12 levels and insulin resistance in each group was investigated. Results: Vitamin B12 deficiency was present in 15.6% of the women with GDM. There were no cases of vitamin B12 deficiency in the control group. The GDM group had lower vitamin B12 levels (365.22 ± 136.82 pg/mL vs. 496.08 ± 156.46 pg/mL, P = 0.001). There was a negative correlation between serum vitamin B12 level and insulin resistance index (P = 0.001, r = -0.62). Folate levels were higher in the GDM group (17.93 ± 3.66 ng/mL vs. 14.60 ± 5.32 ng/mL, P = 0.001), but these levels did not significantly relate to insulin resistance or GDM. Conclusions: In our region, there is a significant relationship between low levels of vitamin B12 and both insulin resistance and GDM, which suggests the need for larger studies and attention to the detection and treatment of vitamin B12 deficiency during pregnancy.

Very short sleep duration reveals a proteomic fingerprint that is selectively associated with incident diabetes mellitus but not with incident coronary heart disease: a cohort study

BackgroundThe molecular pathways linking short and long sleep duration with incident diabetes mellitus (iDM) and incident coronary heart disease (iCHD) are not known. We aimed to identify circulating protein patterns associated with sleep duration and test their impact on incident cardiometabolic disease.MethodsWe assessed sleep duration and measured 78 plasma proteins among 3336 participants aged 46–68 years, free from DM and CHD at baseline, and identified cases of iDM and iCHD using national registers. Incident events occurring in the first 3 years of follow-up were excluded from analyses. Tenfold cross-fit partialing-out lasso logistic regression adjusted for age and sex was used to identify proteins that significantly predicted sleep duration quintiles when compared with the referent quintile 3 (Q3). Predictive proteins were weighted and combined into proteomic scores (PS) for sleep duration Q1, Q2, Q4, and Q5. Combinations of PS were included in a linear regression model to identify the best predictors of habitual sleep duration. Cox proportional hazards regression models with sleep duration quintiles and sleep-predictive PS as the main exposures were related to iDM and iCHD after adjustment for known covariates.ResultsSixteen unique proteomic markers, predominantly reflecting inflammation and apoptosis, predicted sleep duration quintiles. The combination of PSQ1 and PSQ5 best predicted sleep duration. Mean follow-up times for iDM (n = 522) and iCHD (n = 411) were 21.8 and 22.4 years, respectively. Compared with sleep duration Q3, all sleep duration quintiles were positively and significantly associated with iDM. Only sleep duration Q1 was positively and significantly associated with iCHD. Inclusion of PSQ1 and PSQ5 abrogated the association between sleep duration Q1 and iDM. Moreover, PSQ1 was significantly associated with iDM (HR = 1.27, 95% CI: 1.06–1.53). PSQ1 and PSQ5 were not associated with iCHD and did not markedly attenuate the association between sleep duration Q1 with iCHD.ConclusionsWe here identify plasma proteomic fingerprints of sleep duration and suggest that PSQ1 could explain the association between very short sleep duration and incident DM.