Incidence Of Diabetes Mellitus Research Articles

Прогнозирование гестационного сахарного диабета на ранних сроках беременности у женщин с ожирением

Aim. Analysis of the possibilities of predicting gestational diabetes mellitus in early pregnancy in obese women. Key points. The incidence of obesity and gestational diabetes mellitus among the female population in the world is steadily increasing. Obesity is an independent risk factor for gestational diabetes. Diabetes mellitus, which occurred during pregnancy, is associated with a number of complications for both the mother and the fetus. The presented literature review summarizes modern ideas about the prognosis of gestational diabetes mellitus in early pregnancy in obese women. Data on the effectiveness of various prognostic factors of gestational diabetes are presented. Conclusion. To date, both clinical and laboratory predictors of gestational diabetes are known, but there are no regulated criteria for its diagnosis in the early stages of pregnancy. There is a need to conduct large-scale studies in order to select the most significant predictors of this disease in obese women and introduce them into the practical activities of an obstetrician-gynecologist. Keywords: prediction, gestational diabetes mellitus, obesity.

An Epidemiological Study on Diabetes and Pre-Diabetes in an Urban Area with Reference to Lifestyle Modification

Diabetes mellitus (DM) is one of the most common non-communicable diseases (NCDs) globally. It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is an epidemic in newly industrialized and many economically developing countries. Diabetes mellitus is a chronic illness requiring continuous medical care with multifactorial risk reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Genetic factors are responsible for at least some of this. However, as evidenced by the increased incidence of diabetes mellitus in urban populations, the fast epidemiological shift linked to food pattern alterations and decreased physical activity is the main cause of the diabetes mellitus epidemic. Due to population aging, growth, urbanization, a lack of physical exercise, and a high incidence of obesity, there are more persons with DM. Lifestyle factors include eating patterns, exercise routines, alcohol consumption, and smoking. An improvement in these parameters would lead to better adherence to hypoglycemic medications. An epidemiological study on diabetes and pre-diabetes in an urban area with reference to lifestyle modification. A community-based intervention study. It was conducted in an urban area. Personal interviews using a semi-structured, pretested questionnaire were the main technique of data gathering. Detailed information has been taken on the demographic and socio-economic characteristics at both the individual and household levels. All responders provided their willingly given consent. Every second household was visited by systematic random sampling procedure to select 400 respondents. Due to non-response, inaccuracy and/or unreliability of information 50 Cases were not included in the analysis. Four more instances of diabetes were also removed from the research. Finally, analysis was carried out on 346 respondents. All respondents were questioned using a pretested, semi-structured questionnaire after giving their informed consent. Significant difference was observed with positive family history of diabetes, obesity, physical activities in male, high calorie intake, stress, chewable tobacco and blood pressure level with pre-diabetes and diabetes. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics showed more positive family histories. Compared to responders with normal blood glucose levels, pre-diabetics and diabetics were more likely to be overweight. With regard to personal habits of the respondents, smoking was associated with more than 1-fold increase risk of obtaining serum glucose level >110 mg/dl as compared to nonsmokers. The current research was an attempt to examine the effect of intervention with reference to life style modification. From the study, it is evident that overall awareness about diabetes has been found low and no awareness has been found about pre-diabetes. The present study also demonstrated that education is the fundamental tool to make the population aware of their health issues. Awareness about pre-diabetes and diabetes, which can make them beneficial for community and nation and so, they can play an innovative role for prevention of diabetes.

Analysis of the Association Between Changes in the GGT/HDL-C Ratio and the Risk of Diabetes Mellitus Based on a Latent Class Growth Mixed Modeling: A Longitudinal Cohort Study of Adults in China.

Longitudinal cohort analysis was performed to identify the association between changes in the gamma-glutamyl transferase (GGT)/high-density lipoprotein cholesterol (HDL-C) ratio trajectory and the risk of developing diabetes mellitus. This was a retrospective cohort study. We analyzed the latent trajectory classes of changes in the GGT/HDL-C ratio by applying a latent class mixture model with healthy individuals who underwent medical checkups from January 2017 to December 2021 as the study subjects. To analyze the effect of the GGT/HDL-C ratio trajectory classes on new-onset diabetes mellitus, we then applied a multivariate Cox proportional risk regression model. Statistical analysis was performed using the R-software with the LCMM package. The study cohort comprised 3410 participants. All participants were followed up for 5 years, and 95 developed diabetes (4-year incidence of 2.78%). By applying the latent class mixed model, we categorized participants into three trajectory groups: low-stability group (n = 2253), medium-increase group (n = 941), and high-increase group (n = 216). The Cox proportional risk regression model analysis showed that the hazard ratio (95% confidence interval) for the incidence of diabetes mellitus was 1.73 (1.04-2.87) in the medium-increase group and 3.96 (2.11-7.44) in the high-increase group. Moreover, we calculated the estimated model-based levels and linear slopes of the GGT/HDL-C ratios for each age group between 26 and 85 years at 10-year intervals, respectively. The results indicated the strongest correlation between the GGT/HDL-C ratio slope and diabetes in the 46-55 year age group, with an odds ratio of 1.51 (1.25-1.83). A large increase in the GGT/HDL-C ratio was highly associated with the risk of developing diabetes mellitus. This result suggests that vigilance for changes in the GGT/HDL-C ratio trajectory during community health screening can help identify potential patients with diabetes, enabling early intervention and treatment.

Uncovering the Multifaceted Influences on Type-2 Diabetes Mellitus Incidence in Public Health Centre, Indonesia

Background: Type-2 diabetes mellitus (T2DM) is an emergency disease that often occurs. Lack of knowledge, poor management of self-care, and stress are different factors that promote an increase in blood sugar levels. The objective of this study is to determine the contributing factors between self-care, knowledge, and stress related to the incidence of T2DM in the Public Health Center, Indonesia. Methods: This research used a correlational design with a cross-sectional approach during the period of July 3rd–August 3rd, 2023. Samples were chosen from 92 respondents with G Power correlation test. The research was conducted at the Public Health Center in Kediri City, Indonesia. The technique used in sample selection was purposive sampling based on inclusion criteria, namely T2DM patients aged 36–65 years, able to read and write, and willing to be the respondents in this study. The instruments used are three factorials developed by researchers, which include self-care, knowledge, and stress. The content validity index of the research instrument was validated and assessed by five experts. Bivariate analysis of the Spearman statistical test. Results: The statistical test shows a significant value for all of the variables, with P-value = 0.000 and Rho = 0.631 for self-care management, P-value = 0.012 and Rho = 0.305 for knowledge, and P-value = 0.023 and Rho = 0.187 for stress factor. Conclusion: The results of this study showed that self-care management, knowledge, and stress have significantly affected the incidence of T2DM.

Penerapan Senam Kaki Pada Penderita Diabetes Mellitus dalam Upaya Pencegahan Komplikasi Diabetes pada Kaki (Diabetic Foot)

Background: Diabetes Mellitus (DM) is a disease that is increasing every year in countries around the world. Reports from various regions in Indonesia show that the incidence and complications of DM are widespread, making it a national problem that requires more attention. A frequently encountered complication of DM is diabetic foot, which can manifest as ulcers, infection and gangrene. Actions to treat diabetic foot include preventive measures which include foot care education, diabetic shoes and foot exercises. Foot exercises are exercises carried out by DM sufferers and non-sufferers to prevent injuries and help improve blood circulation in the legs. Apart from their role in providing health education, nurses as members of the medical team can also play a role in teaching foot exercises so that DM patients are able to do foot exercises independently. Objective: To increase the knowledge and skills of DM sufferers by implementing foot exercises in an effort to prevent diabetes complications in the feet (diabetic foot). Method: Foot exercise activities are carried out on DM sufferers who do not have wounds on the feet. The methods used were lectures, questions and answers, and direct demonstrations using newspapers. Results: The results of the activities obtained were an increase in knowledge before and after providing counseling and demonstrations of foot exercises for DM sufferers. Conclusion: After carrying out this community service, the community's ability to do foot exercises has increased and can be done independently, so it is hoped that this can prevent complications in DM sufferers.

Literature Study: Risk Factors for the Incidence of Diabetes Mellitus in Productive Age in Indonesia

Diabetes mellitus (DM) is a type of degenerative disease that has increased continuously from year to year. as well as the occurrence of the biggest global health emergency in the 21st century. The increasing cases of diabetes mellitus every year have a negative impact on Indonesia, especially many diabetics are around productive age. productive age is the age with the highest rate of diabetes mellitus in Indonesia with the following age groups and prevalence: 15-24 years of age by 0.1%, age 25-34 by 0.2%, age 35-44 by 1.1%, and age 45-64 by 6.3%, thus it can be said that the increasing age is increasingly at risk of diabetes mellitus. The purpose of writing a literature review is to find out what risk factors affect the incidence of diabetes mellitus at productive age in Indonesia. The research design in the study uses the Literature Review method. Research journal articles using online database facilities through the Google Scholar page published in the period 2020-2023 (4 years). Based on the results of research from 10 articles, it was found that there was a relationship between family history, diet, sleep patterns, physical activity, obesity, and hypertension with the incidence of leprosy in Indonesia.

Pemberdayaan Kader Kesehatan Dengan Diabetes Self Management Education (DSME) untuk meningkatkan Self Manajemen Pasien Diabetes

Background: Diabetes mellitus (DM) is included in a group of metabolic disorders with the characteristics of hyperglycemia which occurs due to insulin abnormalities caused by impaired insulin secretion. Diabetes Self Management Education (DSME) is an effort that can be made to provide ongoing education for DM clients. The DSME strategy was developed in health services to increase diabetes clients' compliance in controlling their disease. Purpose: The purpose of this activity is to provide knowledge and understanding to health cadres in providing education to the community regarding the importance of self-care management, especially in diabetes mellitus. Method: This activity is in the form of Diabetes Self Management Education (DSME) training for health cadres in Bumiayu village which will be held on Friday 25 August 2023 at 09.00 WITA. This activity was attended by 15 health cadres. Results: Based on the implementation of counseling about diabetes self-care management which was attended by the Bumiayu village health cadres, the results achieved can be described. Increasing the cadres' knowledge about self-care management, the cadres are able to educate about the importance of carrying out diabetes self-care management and the cadres are able to provide care or practice directly with the community about Diabetes self-care management. Conclusion: The implementation of training activities went well and smoothly. This activity received good input from health cadres with the result that the cadres' knowledge increased after being given the material. This community service activity can be carried out periodically to reduce the incidence of DM.

Assessment of Prescribing Pattern of Anti-diabetic Drugs in a Tertiary Care Teaching Hospital

Background: There is increasing importance of PPMS because of a boost in marketing of new drugs, variations in pattern of prescribing and consumption of drugs, growing concern about delayed adverse effects, and cost of drugs and volume of prescription. Diabetes mellitus is a pandemic disease that has struck each corner of the world. According to the Indian Council of Medical Research – Indian study (ICMR), a national diabetes study, India currently has 62.4 million people with diabetes. This is set to increase to over 100 million by 2030. Objective: The aim of this study is to evaluate the prescribing pattern of drugs used to treat Diabetes Mellitus in a tertiary care teaching hospital. Methodology: A hospital based retrospective cross-sectional observational study was performed in Navodaya Medical College & Hospital, Raichur over a period of 6 months from May 2022 to October 2022. The study was performed among 80 patients having diabetes mellitus and associated comorbidities that satisfy the study criteria. Results: In this study, among 80 cases of DM diseases assessed, the incidence of diabetes mellitus is common in females (51.25%) than males (48.75%). Most frequently prescribed combination was the insulin, metformin (25%) followed by metformin, glimepiride (12.5%). Among three drug combination was most prescribed metformin, glipizide, and insulin (10%) Conclusion: Diabetes should be managed properly to enhance the quality of life of patients. metformin is the most common choice of oral antidiabetic drugs, but the use of insulin preparation treatment of type 2 DM is increasing continuously. Metformin is the most prescribed antidiabetic drugs in monotherapy.

Cross-sectional association between severe periodontitis and diabetes mellitus: A nation-wide cohort study.

To evaluate the cross-sectional association between severe periodontitis and diabetes mellitus (DM), in a representative sample of Spanish population. The di@bet.es epidemiological study is a population-based cohort study aimed to determine the prevalence and incidence of DM in the adult population of Spain. The at-risk sample at the final examination (2016-2017) included 1751 subjects who completed an oral health questionnaire. This questionnaire, together with demographic and risk factors, had been previously validated to build an algorithm to predict severe periodontitis in the Spanish population. Logistic regression models were used to evaluate the association between severe periodontitis and DM with adjustment for confounding factors. In total, 144 subjects developed DM, which yielded 8.2% cumulative incidence. Severe periodontitis was detected in 59.0%, 54.7% or 68.8% of the subjects depending on three different selected criteria at the 2016-2017 exam. All criteria used to define severe periodontitis were associated with DM in unadjusted analysis, but the magnitude of the association decreased after adjusting for significant confounders. The criteria '≥50% of teeth with clinical attachment loss ≥5 mm' presented an odds ratio of 4.9 (95% confidence interval: 2.2-10.7; p ≤ .001) for DM. Severe periodontitis is associated with DM in the Spanish population.

Developmental metformin exposure does not rescue physiological impairments derived from early exposure to altered maternal metabolic state in offspring mice

ObjectiveThe incidence of gestational diabetes mellitus (GDM) and metabolic disorders during pregnancy are increasing globally. This has resulted in increased use of therapeutic interventions such as metformin to aid in glycemic control during pregnancy. Even though metformin can cross the placental barrier, its impact on offspring brain development remains poorly understood. As metformin promotes AMPK signaling, which plays a key role in axonal growth during development, we hypothesized that it may have an impact on hypothalamic signaling and the formation of neuronal projections in the hypothalamus, the key regulator of energy homeostasis. We further hypothesized that this is dependent on the metabolic and nutritional status of the mother at the time of metformin intervention. Using mouse models of maternal overnutrition, we aimed to assess the effects of metformin exposure on offspring physiology and hypothalamic neuronal circuits during key periods of development. MethodsFemale C57BL/6N mice received either a control diet or a high-fat diet (HFD) during pregnancy and lactation periods. A subset of dams was fed a HFD exclusively during the lactation. Anti-diabetic treatments were given during the first postnatal weeks. Body weights of male and female offspring were monitored daily until weaning. Circulating metabolic factors and molecular changes in the hypothalamus were assessed at postnatal day 16 using ELISA and Western Blot, respectively. Hypothalamic innervation was assessed by immunostaining at postnatal days 16 and 21. ResultsWe identified alterations in weight gain and circulating hormones in male and female offspring induced by anti-diabetic treatment during the early postnatal period, which were critically dependent on the maternal metabolic state. Furthermore, hypothalamic agouti-related peptide (AgRP) and proopiomelanocortin (POMC) neuronal innervation outcomes in response to anti-diabetic treatment were also modulated by maternal metabolic state. We also identified sex-specific changes in hypothalamic AMPK signaling in response to metformin exposure. ConclusionWe demonstrate a unique interaction between anti-diabetic treatment and maternal metabolic state, resulting in sex-specific effects on offspring brain development and physiological outcomes. Overall, based on our findings, no positive effect of metformin intervention was observed in the offspring, despite ameliorating effects on maternal metabolic outcomes. In fact, the metabolic state of the mother drives the most dramatic differences in offspring physiology and metformin had no rescuing effect. Our results therefore highlight the need for a deeper understanding of how maternal metabolic state (excessive weight gain versus stable weight during GDM treatment) affects the developing offspring. Further, these results emphasize that the interventions to treat alterations in maternal metabolism during pregnancy need to be reassessed from the perspective of the offspring physiology.

Type 2 Diabetes in Non-Sedentary Workers with Long Working Hours “An Evidence-Based Case Report”

Background: Type 2 diabetes mellitus is a serious threat to public health and the economy. Several reviews suggested that working long hours has a negative effect on health, especially metabolic disorders.Objective: To determine whether long working hours increase the incidence of diabetes mellitus in non-sedentary workers.Methods: A literature search using PubMed, Scopus, and Proquest was conducted based on the clinical question. Selected studies were critically reviewed for their validity using Oxford University’s Center for Evidence-Based Medicine’s etiological study criteria.Result: Three relevant studies were found. A cohort study found that non-clerical workers and shift workers with long working hours had a significantly higher risk of developing diabetes with a Hazard Ratio (HR) of 2.28 (95% Confidence Interval [CI] 1.13-4.82). However, the dominant risk factor that may have influenced the outcomes could not be clearly identified. In contrast, a cross-sectional study found no significant association (p>0.05) between working overtime and diabetes prevalence among field workers. Another cross-sectional study showed that blue-collar workers with long working hours had a higher likelihood of prediabetes with an adjusted Odds Ratio (aOR) of 1.54 (95% CI 1.15-2.06). However, since this is a cross-sectional study, the causal relationship is uncertain. Conclusion: Studies regarding the relationship between long working hours and an increased risk of type 2 diabetes mellitus in non-sedentary workers showed inconsistent and unclear results. Further evaluation is still needed to find more evidence on the health effects of long working hours on workers.

PENGARUH TERAPI RELAKSASI OTOT PROGRESIF TERHADAP PENURUNAN KADAR GLUKOSA DARAH PADA DIABETES MELITUS TIPE II

ABSTRACT
 Background: Type II Diabetes Mellitus or commonly called lifestyle diabetes is diabetes caused by an unhealthy lifestyle. In someone with type II diabetes mellitus, insulin can still be produced by the pancreas, but the amount of insulin is still insufficient so that type II diabetes mellitus is considered as NIDDM (Non Insulin Dependent Diabetes Mellitus). IDF estimates that there are 463 million people in the world experiencing diabetes mellitus in 2019. There has been an increase in the incidence of diabetes mellitus by 19.9% ​​in 2020. In Central Java in 2019 there were 13.4% new cases of diabetes mellitus. Data from the Kudus Regency Health Office in 2019 noted that 17,869 people had diabetes mellitus, especially at the UPTD health centers in Japan, as many as 1,210 people had diabetes mellitus in 2022. There are 4 pillars in the management of DM, such as education in the form of knowledge about DM, regulation/diet in the form of low carbohydrates, pharmacological therapy in the form of Oral Hyperglycemic Drugs (OHO), and physical exercise, one of which is progressive muscle relaxation therapy. The purpose of this study was to determine the effect of progressive muscle relaxation therapy on reducing blood glucose levels in diabetes mellitus. The design in this study was pre-experimental, with a one-group pre-test and post-test design approach. There are two variables, namely the independent variable giving Progressive Muscle Relaxation Therapy while the dependent variable is Blood Glucose Levels in Type II Diabetes Mellitus. The population is all patients with Diabetes Mellitus in the working area of ​​the Kudus Japan Health Center in 2022 as many as 1210 people. Taken by purposive sampling technique. Collecting data using a questionnaire and checklist. Data analysis techniques using SPSS with the Wilcoxon statistical test. The Asimp.Sig result is 0.000 <0.05, then H0 is rejected, meaning that there is an effect of progressive muscle relaxation therapy. The purpose of this study was to determine the effect of progressive muscle relaxation therapy on reducing blood glucose levels in diabetes mellitus II. Respondents who used it experienced a decrease in GDS after being given progressive muscle relaxation therapy 84.7% greater than before being given the action. For this reason, it is necessary to provide progressive muscle relaxation therapy to reduce blood glucose levels in diabetes mellitus II.

Prospects for the Search for New Antidiabetic Agents Among Vanadium-containing Complex Compounds (Review)

Introduction. The epidemic increase in the incidence of diabetes mellitus (DM) makes it urgent to search for new antidiabetic agents. In clinical practice, there is an urgent question about improving and/or replacing insulin therapy for the disease. Vanadium compounds are of particular interest in connection with the identification of their multifactorial effects on the body, including insulin-like and hypoglycemic properties, which opens up prospects for the creation of a new generation of therapeutic agents for the treatment of types 1 and 2 diabetes. The focus of this review is on the structure and antidiabetic properties of vanadium complexes.Text. This review is devoted to the analysis of scientific literature on studies of vanadium-containing compounds as potential antidiabetic agents. The mechanisms of antidiabetic activity of vanadium-containing complex compounds are discussed. The prospects for searching for oxovanadium(IV) complexes with O4-coordination have been assessed.Conclusion. As a result of the analysis of the literature data, it was found that vanadium-containing complex compounds have a significant potential for use as antidiabetic agents. The relevance of the search for highly effective oxo-vanadium metal complexes based on ligands close to endogenous substrates, for example, based on derivatives of aroylpyruvic acid, is shown.

Evaluation of Risk Factors in Patients with Primary Open Angle Glaucoma and Ocular Hypertension

Objective: The purpose of our study was to compare the age, gender, intraocular pressure (IOP), central corneal thickness (CCT), spherical equivalent values, smoking, family history of glaucoma and additional systemic diseases in patients with primary open angle glaucoma (POAG) and patients with ocular hypertension (OHT); and to evaluate the relationships of these factors with each other. Material Methods: 40 patients with POAG, 40 patients with OHT and 40 individuals as control group were included in the study. Age, gender, IOP, CCT, spherical equivalent values, family history of glaucoma, history of consanguineous marriage, smoking, systemic diseases of each subject were recorded. Results: There was no significant difference in gender and average age between the groups (p=0.238 and p=0.51, respectively). IOP values was higher in POAG and OHT groups compared with the control group (p=0.000). CCT was higher in OHT group compared with the other groups (on the right, p=0.001 and p=0.008, respectively; on the left, p=0.013 and p=0.006, respectively). There was no significant correlation between IOP and CCT values. There was no significant difference in mean spherical equivalent values (on the right eye p=0.686; on the left eye p=0.640) . The incidence of diabetes mellitus, hypertension, hyperlipidemia and coronary artery disease was the similar in all groups (p=0.417, p=0.058, p=0.79, p=0.236, respectively). Family history of glaucoma is increased in POAG and OHT group compared with the control group (p=0.000). There was no significant difference in history of consanguineous marriage, smoking and alcohol consumption status among all groups (p=0.899, p=0.492, p=0,899, respectively). Conclusion: High IOP is the most important risk factor in the POAG and OHT groups. Individuals with OHT and thin CCT are at higher risk of developing POAG. The significant presence of a familial history of glaucoma in the POAG and OHT groups indicates that genetic factors could be a significant risk factor. Diabetes, hypertension, and high myopia are factors that increase the risk of glaucoma.

PROGNOSTIC SIGNS OF HEPATOPATHY FORMATION IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

Introduction. The incidence of diabetes mellitus in the world among children is steadily increasing. The main striking factor in type 1 diabetes mellitus (T1DM) is hyperglycemia, which affects the formation of liver complications such as glycogenic hepatopathy and non-alcoholic fatty liver disease (NAFLD).
 The aim of the study is to determine the prognostic signs of hepatopathy formation in adolescents with type 1 diabetes mellitus.
 Materials and methods. Clinical-anamnestic and laboratory-instrumental examination: glycosylated hemoglobin (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin and its fractions, lipidogram. According to the results of ultrasound of the hepatobiliary system, girls and boys with T1DM were divided into groups taking into account the size of the liver. The study included 87 girls and 86 boys aged 8-18 years. Methods of mathematical statistics, system-information analysis, Wald’s heterogeneous sequential statistical procedure with Kulbak’s information measure were used.
 Results. A comprehensive examination of adolescents with T1DM revealed that 70% of patients had digestive system disorders in the form of pain and dyspeptic syndromes. In 88% of boys and 68% of girls, palpation and ultrasound revealed liver enlargement (χ2 < 0,05). Atherogenic orientation of lipidogram was determined in all adolescents with T1DM. In girls, the difference in β-lipoprotein level and atherogenicity coefficient reached statistical significance compared with boys. In most adolescents, the content of high-density lipoprotein cholesterol was within normal limits, but the frequency of its decrease in boys with liver enlargement was greater compared with girls with liver enlargement (32% and 24%, respectively, χ2 < 0,05). ALT activity significantly exceeded the upper limit of normal only in the group of girls with liver enlargement. Increased ALT activity in girls with enlarged liver appeared 1.5 times more often than in boys of the similar group (respectively 68% and 43%, χ2 < 0,05).
 Conclusions. In boys with T1DM, significant informative prognostic factors for the formation of hepatopathy are the duration of the disease, increased levels of HbA1c, atherogenic lipoprotein fractions, and ALT activity. In girls with T1DM, the most significant prognostic factor was an increase in ALT activity; the overall informativeness of lipid profile parameters in girls was three times lower compared with boys. The duration of the disease and the degree of compensation were less significant for the formation of hepatopathy in girls.

Global trend analysis of diabetes mellitus incidence, mortality, and mortality-to-incidence ratio from 1990 to 2019

Diabetes Mellitus (DM) is a common chronic disease and a public health challenge worldwide. The present study aimed to analyze the trend in DM incidence, mortality, and mortality-to-incidence ratio (MIR) world over 30 years. The age-standardized DM incidence and mortality rates for both genders and different countries of the world from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) study and the Human Development Index (HDI) was obtained for all countries from the United Nations Development Program (UNDP) database. The mean trends for the indicators for developing countries, developed countries, and all countries were evaluated using Generalized Estimating Equations (GEE) and the spline model. The estimates showed that the global mean trend of DM incidence from 1990 to 2019 followed an upward trend with an annual increase of 3.73 cases per 100,000 people. The global mean of DM mortality followed an upward trend with an annual increase of 0.43 cases until 2005 followed by a downward trend after this year with an annual decrease of 0.14 and the global mean MIR followed a downward trend during the same period with an annual decrease of 0.001 per 100,000 people. Besides, the mean incidence of DM in developing countries followed an upward trend similar to the trend in developed countries. Additionally, the mean mortality rate due to DM in developing countries increased with a slope of 0.62 until 2005 and then decreased with a slope of 0.02, and the mean MIR trend in the developed and developing countries showed a downward trend. Thus, developed countries followed a relatively faster decrease in MIR than developing countries.The data from the present study show the increased incidence of DM has made it one of the most important health concerns in the world, and if this issue is not addressed, this disease can cause more concerns for communities in the coming years. This being so, more DM prevention and control programs need to be put into practice.

Incidence of Diabetes Mellitus and Its Impact on Outcomes in Patients Undergoing Surgical Pancreatectomy for Non-Malignant and Malignant Pancreatobiliary Diseases-A Retrospective Analysis.

Diabetes mellitus (DM) is a prominent risk factor for malignant and non-malignant pancreatic diseases. Furthermore, the presence of DM predicts an unfavourable outcome in people with pancreatic cancer. This retrospective observational study investigated 370 patients who underwent pancreatic resection surgery for various indications (84.3% in malignant indication) in a single surgery centre in Graz, Austria. The preoperative and postoperative diabetes statuses were evaluated according to surgery method and disease entity and predictors for diabetes development after surgery, as well as outcomes (survival and cancer recurrence) according to diabetes status, were analysed. In the entire cohort, the postoperative diabetes (postopDM) incidence was 29%. PostopDM occurred significantly more frequently in malignoma patients than in those with benign diseases (31.3% vs. 16.7%; p = 0.040, OR = 2.28). In the malignoma population, BMI, longer surgery duration, and prolonged ICU and hospital stay were significant predictors of diabetes development. The 1- and 2-year follow-ups showed a significantly increased mortality of people with postopDM in comparison to people without diabetes (HR 1-year = 2.02, p = 0.014 and HR 2-years = 1.56, p = 0.034). Local cancer recurrence was not influenced by the diabetes status. Postoperative new-onset diabetes seems to be associated with higher mortality of patients with pancreatic malignoma undergoing pancreatobiliary surgery.

Exposure to Fine Particulate Matter Increases Risk of Diabetes Mellitus: A Population-Based Cohort Study.

This nationwide cohort study aimed to examine the association between PM2.5 and diabetes mellitus (DM) risk. We recorded annual average PM2.5 exposure levels at participants' locations. PM2.5 concentrations were categorized into quartiles: Q1 (<29.5 μg/m 3 ), Q2 (29.5-33.3 μg/m 3 ), Q3 (33.4-41.2 μg/m 3 ), and Q4 (>41.2 μg/m 3 ). A total of 158,038 patients (69,688 men and 88,350 women) were enrolled. Diabetes mellitus incidence increased with higher annual PM2.5 concentrations (2.81 in Q1, 3.06 in Q2, 3.65 in Q3, and 3.89 in Q4 per 10,000 person-years). After adjusting for confounders, patients exposed to PM2.5 in Q2, Q3, and Q4 had adjusted hazard ratios of 1.14 (95% CI: 1.05-1.23), 1.40 (95% CI: 1.30-1.50), and 1.42 (95% CI: 1.32-1.53), respectively, for developing DM compared with those exposed to Q1-PM2.5 concentrations. This study observed an increased risk of DM associated with PM2.5 exposure.

Features of intrarenal hemodinamics as endotelial dysfunction indicator in patients with coronary heart disease in the post-COVID-19 period

BACKGROUND. 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.PATIENTS AND METHODS. 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. Obesepatients 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.

Path Analysis on the Effect of Stress, Sleep Quality, and Hypertension on Type 2 Diabetes Mellitus Incidence in the 30–60 years Age Group in Medan City

&lt;p&gt;&lt;em&gt;Non-communicable diseases are still the leading cause of death worldwide, affecting not only the elderly but also the productive age group. Type 2 diabetes mellitus (DM) is one of the non-communicable diseases whose prevalence continues to rise, including in Indonesia. &lt;/em&gt;&lt;em&gt;North Sumatra Province also experienced an increase in DM &lt;/em&gt;&lt;em&gt;prevalence&lt;/em&gt;&lt;em&gt;, with the highest number of cases in Medan City. The development of type 2 DM is a complex&lt;/em&gt;&lt;em&gt; process&lt;/em&gt;&lt;em&gt; and &lt;/em&gt;&lt;em&gt;is associated with several risk factors, one of which is psychological stress&lt;/em&gt;&lt;em&gt;.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;This study aims to analyze the &lt;/em&gt;&lt;em&gt;effect&lt;/em&gt;&lt;em&gt; of stress on the incidence of type 2 DM in the 30-60 year&lt;/em&gt;&lt;em&gt;s&lt;/em&gt;&lt;em&gt; age group &lt;/em&gt;&lt;em&gt;in Medan City directly and indirectly through&lt;/em&gt;&lt;em&gt; sleep quality and hypertension. The research method used a case control design with a sample size of 68 cases and controls each. Data analysis was carried out univariately and multivariately using a path analysis model. The results showed that&lt;/em&gt;&lt;em&gt; there is a direct effect between stress &lt;/em&gt;&lt;em&gt;(b=0.892; 95% CI=0.149-1.636; p=0.019)&lt;/em&gt;&lt;em&gt; on the incidence of type 2 DM in the 30 -60 years age group in Medan City. Stress increases the risk of type 2 DM indirectly through &lt;/em&gt;&lt;em&gt;poor sleep quality (b=0.886; 95% CI=0.188-1.583; p=0.013) and hypertension (b=0.859; 95% CI=0.117-1.602; p= 0.023)&lt;/em&gt;&lt;em&gt;. In addition, sleep quality &lt;/em&gt;&lt;em&gt;(b=0.820; 95% CI=0.076-1.565; p=0.031)&lt;/em&gt;&lt;em&gt; and hypertension &lt;/em&gt;&lt;em&gt;(b=1.046; 95% CI=0.249-1.841; p=0.010)&lt;/em&gt;&lt;em&gt; also have a direct effect on type 2 DM. Avoiding and managing stress, getting enough and regular sleep, and controlling blood pressure can help prevent type 2 DM.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt;Keyword: Hypertension, Sleep Quality, Stress, Type 2 Diabetes Mellitus&lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;