Increasing Prevalence Of Diabetes Research Articles

The Evaluation of the protective roles of canagliflozin and zinc sulphate on body weight and hepatic histology in diabetic dyslipidemia

The significant increase in diabetes prevalence in the past decade has placed a considerable strain on the global healthcare system, especially in developing nations such as Pakistan. Although current therapy options effectively manage blood glucose levels, their accompanying adverse effects can hinder patient adherence. This study investigates the therapeutic properties of Canagliflozin, a SGLT-2 inhibitor, recognized for its tolerance and supplementary advantages on body weight and blood pressure, when used in combination with Zinc Sulphate. Zinc is acknowledged for its function in the regulation of hyperglycemia and dyslipidemia. The study involved the use of a type-2 diabetic rat model, induced by a high-fat diet and streptozotocin to examine the separate and combined impacts of Canagliflozin and Zinc Sulphate on the liver's histology. A total of forty-eight male Sprague-Dawley rats were separated into six groups and the treatments were delivered for eight weeks. Body weights were observed and histological evaluations of the liver were performed with the NASH-CRN scoring system. The findings exhibited a notable decrease in body weight among the diabetic-induced groups in comparison to the normal control. The combined utilization of Canagliflozin and Zinc Sulphate showed a heightened efficacy in managing diabetes related weight loss and steatosis of liver in the rat model having type-2 diabetes. This indicates a possible combined treatment strategy that should be further investigated to enhance the management of hepatic steatosis in individuals with diabetes. The study also proposes the potential for using a reduced dosage of Canagliflozin in combination with Zinc, so limiting adverse effects.

Early prediction of the impact of public health policies on obesity and lifetime risk of type 2 diabetes: A modelling approach.

Help public health decision-making requires a better understanding of the dynamics of obesity and type 2 diabetes and an assessement of different strategies to decrease their burdens. Based on 97,848 individual data, collected in the French Health, Health Care and Insurance Survey over 1998-2014, a Markov model was developed to describe the progression of being overweight to obesity, and the onset of type 2 diabetes. This model traces and predicts 2022-2027 burdens of obesity and type 2 diabetes, and lifetime risk of diabetes, according to different scenarios aiming at minimum to stabilize obesity at 5 years. Estimated risks of type 2 diabetes increase from 0.09% (normal weight) to 1.56% (obesity II-III). Compared to the before 1995 period, progression risks are estimated to have nearly doubled for obesity and tripled for type 2 diabetes. Consequently, over 2022-2027, the prevalence of obesity and type 2 diabetes will continue to increase from 17.3% to 18.2% and from 7.3% to 8.1%, respectively. Scenarios statibilizing obesity would require a 22%-decrease in the probability of move up (scenario 1) or a 33%-increase in the probability of move down (scenario 2) one BMI class. However, this stabilization will not affect the increase of diabetes prevalence whereas lifetime risk of diabetes would decrease (30.9% to 27.0%). Combining both scenarios would decrease obesity by 9.9%. Only the prevalence of obesity III shows early change able to predict the outcome of a strategy: for example, 6.7%-decrease at one year, 13.3%-decrease at two years with scenario 1 stabilizing obesity at 5 years. Prevalences of obesity and type 2 diabetes will still increase over the next 5 years. Stabilizing obesity may decrease lifetime risks of type 2 diabetes without affecting its short-term prevalence. Our study highlights that, to early assess the effectiveness of their program, public health policy makers should rely on the change in prevalence of obesity III.

Prevalence trends and racial-ethnic disparities of diabetes and prediabetes among children and adolescents in the United States from 2019 to 2021

ObjectiveThis study investigated disparities in diabetes and prediabetes prevalence among US children and adolescents using 2019–2021 National Health Interview Survey (NHIS) data. With rising trends in diabetes, understanding prevalence rates and associated disparities is crucial for targeted interventions. MethodsAnalyzing a cross-sectional sample of 19,490 participants aged 3–17, we employed NHIS data to calculate prevalence rates. Stratification by sociodemographic factors, race/ethnicity, and family income allowed for in-depth analyses. ResultsBetween 2019 and 2021, overall diabetes prevalence was 1.18%, comprising 0.87% prediabetes and 0.46% diabetes rates. Disparities were evident, with higher prediabetes rates in non-Hispanic black and Hispanic children and elevated diabetes rates in non-Hispanic white and Hispanic children. Subgroup analyses revealed associations within age, gender, education, and income strata. ConclusionsThe study highlighted potential increases in diabetes prevalence from 2017 to 2021 and persistent racial/ethnic disparities. The 12–17 age subgroup exhibited significant disparities, emphasizing the need for early intervention. Targeted strategies were imperative to mitigate diabetes and prediabetes prevalence in vulnerable populations, particularly non-Hispanic black and Hispanic children. This study underscored the urgency of addressing health disparities for improved overall well-being and healthcare outcomes.

The Scope of Precision Medicine in Management of Type 2 Diabetic Patients with Hypertension

There is an exponential increase in prevalence of diabetes and hypertension worldwide and more so in India, and despite of numerous state and national awareness programs and evidence-based approach in management of these diseases, the burden of mortality and morbidity, instead of decreasing, has been rapidly climbing upwards. Hence, there is definite need of precision medicine approach, even though the pathway would be challenging, can provide more precise treatment to an individual based on his/her genetic, phenotypic, and metabolic make up.

Current knowledge of morbidities and direct costs related to diabetic foot disorders: a literature review.

Diabetes is a chronic disease associated with numerous complications including diabetic foot disorders, which are associated with significant morbidity and mortality as well as high costs. The costs associated with diabetic foot disorders comprise those linked to care (direct) and loss of productivity and poor quality of life (indirect). Due to the constant increase in diabetes prevalence, it is expected that diabetic foot disorder will require more resources, both in terms of caregivers and economically. We reviewed findings on management, morbidity, mortality, and costs related to diabetic foot disorder.

Area-level deprivation and individual-level socioeconomic correlates of the diabetes care cascade among black south africans in uMgungundlovu, KwaZulu-Natal, South Africa.

South Africa is experiencing a rapidly growing diabetes epidemic that threatens its healthcare system. Research on the determinants of diabetes in South Africa receives considerable attention due to the lifestyle changes accompanying South Africa's rapid urbanization since the fall of Apartheid. However, few studies have investigated how segments of the Black South African population, who continue to endure Apartheid's institutional discriminatory legacy, experience this transition. This paper explores the association between individual and area-level socioeconomic status and diabetes prevalence, awareness, treatment, and control within a sample of Black South Africans aged 45 years or older in three municipalities in KwaZulu-Natal. Cross-sectional data were collected on 3,685 participants from February 2017 to February 2018. Individual-level socioeconomic status was assessed with employment status and educational attainment. Area-level deprivation was measured using the most recent South African Multidimensional Poverty Index scores. Covariates included age, sex, BMI, and hypertension diagnosis. The prevalence of diabetes was 23% (n = 830). Of those, 769 were aware of their diagnosis, 629 were receiving treatment, and 404 had their diabetes controlled. Compared to those with no formal education, Black South Africans with some high school education had increased diabetes prevalence, and those who had completed high school had lower prevalence of treatment receipt. Employment status was negatively associated with diabetes prevalence. Black South Africans living in more deprived wards had lower diabetes prevalence, and those residing in wards that became more deprived from 2001 to 2011 had a higher prevalence diabetes, as well as diabetic control. Results from this study can assist policymakers and practitioners in identifying modifiable risk factors for diabetes among Black South Africans to intervene on. Potential community-based interventions include those focused on patient empowerment and linkages to care. Such interventions should act in concert with policy changes, such as expanding the existing sugar-sweetened beverage tax.

Socioeconomic inequalities in diabetes prevalence: the case of Egypt between 2008 and 2015

BackgroundThere is a steady increase in diabetes prevalence globally and many studies imply that high socioeconomic status (SES) is inversely related to diabetes prevalence. However, there is scarcity in literature from countries like Egypt regarding this topic.MethodsThis study aims to investigate prevalence of diabetes in Egypt between 2008 and 2015, and the effect of SES. Diabetes prevalence -based on self-reports of past diagnosis- was measured using two datasets Egypt DHS 2008 (10,917 participants) and EHIS 2015 (16,485 participants). Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were applied for diabetes controlling for age, gender, educational level, employment status and place of residence. Extend of difference in diabetes prevalence between the two time points was measured by combining the two datasets using the EDHS 2008 as reference.ResultsDiabetes prevalence was higher in 2015 (4.83%) compared to 2008 (3.48%). It was more in women at both time points (4.08% and 5.16% in 2008 and 2015 respectively) compared to men (2.80% and 4.43% in 2008 and 2015 respectively). Older age and living in urban areas were positively related to diabetes prevalence at both time points. Men had a significant higher chance of developing diabetes in 2015 (OR = 1.45, p-value = 0.001). Men with higher education had higher chance of developing diabetes (OR = 1.76), in contrast to women (OR = 0.59). Employment decreased the chance of developing diabetes for men (OR = .72), but had minimal effect on women (OR = 1.06).ConclusionDiabetes prevalence in Egypt has increased between the years 2008 and 2015 and evident social inequalities were found. Women had more diabetes than men and were more affected with low SES. Unlike women, highly educated men had higher chance of developing diabetes in 2015 compared to 2008. This might be attributed to behavioral and sociocultural factors.

Community Social Capital and Population Health Outcomes

While the association between economic connectedness and social mobility has now been documented, the potential linkage between community-level economic connectedness and population health outcomes remains unknown. To examine the association between community social capital measures (defined as economic connectedness, social cohesion, and civic engagement) and population health outcomes (defined across prevalence of diabetes, hypertension, high cholesterol, kidney disease, and obesity). This cross-sectional study included communities defined at the zip code tabulation area (ZCTA) level in all 50 US states. Data were collected from January 2021 to December 2022. Multivariable regression analyses were used to examine the association between population health outcomes and social capital. Adjusted analyses controlled for area demographic variables and county fixed effects. Heterogeneities within the associations based on the racial and ethnic makeup of communities were also examined. In this cross-sectional study of 17 800 ZCTAs, across 50 US states, mean (SD) economic connectedness was 0.88 (0.32), indicating friendship sorting on income; the mean (SD) support ratio was 0.90 (0.10), indicating that 90% of ties were supported by a common friendship tie; and the mean (SD) volunteering rate was 0.08 (0.03), indicating that 8% of individuals within a given community were members of volunteering associations. Mean (SD) ZCTA diabetes prevalence was 10.8% (2.9); mean (SD) high blood pressure prevalence was 33.2% (6.2); mean (SD) high cholesterol prevalence was 32.7% (4.2), mean (SD) kidney disease prevalence was 3.0% (0.7), and mean (SD) obesity prevalence was 33.4% (5.6). Regression analyses found that a 1% increase in community economic connectedness was associated with significant decreases in prevalence of diabetes (-0.63%; 95% CI, -0.67% to -0.60%); hypertension (-0.31%; 95% CI, -0.33% to -0.29%); high cholesterol (-0.14%; 95% CI, -0.15% to -0.12%); kidney disease (-0.48%; 95% CI, -0.50% to -0.46%); and obesity (-0.28%; 95% CI, -0.29% to -0.27%). Second, a 1% increase in the community support ratio was associated with significant increases in prevalence of diabetes (0.21%; 95% CI, 0.16% to 0.26%); high blood pressure (0.16%; 95% CI, 0.13% to 0.19%); high cholesterol (0.16%; 95% CI, 0.13% to 0.19%); kidney disease (0.17%; 95% CI, 0.13% to 0.20%); and obesity (0.08%; 95% CI, 0.06% to 0.10%). Third, a 1% increase in the community volunteering rate was associated with significant increases in prevalence of high blood pressure (0.02%; 95% CI, 0.01% to 0.02%); high cholesterol (0.03%; 95% CI, 0.02% to 0.03%); and kidney disease (0.02%; 95% CI, 0.01% to 0.02%). Additional analyses found that the strength of these associations varied based on the majority racial and ethnic population composition of communities. In this study, higher economic connectedness was significantly associated with better population health outcomes; however, higher community support ratios and volunteering rates were both significantly associated with worse population health. Associations also differed by majority racial and ethnic composition of communities.

Diabetes and associated cardiovascular complications: The role of microRNAs

Diabetes mellitus (DM) refers to a complex cluster of metabolic disorders characterized by hyperglycemia caused by inadequate insulin secretion, insulin resistance, or excessive glucagon secretion. If not correctly treated, the prolonged effects of DM-associated metabolic perturbations lead to systemic vascular complications and cardiovascular disease (CVD), the principal cause of mortality among patients with DM. Given the increase in the global prevalence of diabetes, novel diagnostic and therapeutic procedures are necessary for its effective identification and treatment. Recent findings point to an important role of microRNA (miRNAs) in DM initiation and progression, as well as the occurrence of associated cardiovascular complications. miRNAs are short, highly conserved, single-stranded, non-coding RNAs that contribute to the maintenance of physiological homeostasis through the regulation of crucial processes such as metabolism, cell proliferation, and apoptosis. The increased availability of high-throughput methodologies for identifying and characterizing non-coding RNAs has led to considerable interest in miRNAs as potential biomarkers and therapeutic agents for DM. In this review, we first comprehensively detail the regulatory miRNAs involved in the pathophysiology of DM and diabetic cardiomyopathy (DCMP). Subsequently, we summarize findings regarding the utility of several of these miRNAs as potential prognostic and diagnostic biomarkers for DM and DM-associated CVD. Finally, we evaluate the potential of miRNA-based therapeutic approaches for treating DM and DCMP in the clinical setting.

Arsenic metabolism, diabetes prevalence, and insulin resistance among Mexican Americans: A mendelian randomization approach.

Differences in arsenic metabolism capacity may influence risk for type 2 diabetes, but the mechanistic drivers are unclear. We evaluated the associations between arsenic metabolism with overall diabetes prevalence and with static and dynamic measures of insulin resistance among Mexican Americans living in Starr County, Texas. We utilized data from cross-sectional studies conducted in Starr County, Texas, from 2010-2014. A Mendelian randomization approach was utilized to evaluate the associations between arsenic metabolism and type 2 diabetes prevalence using the intronic variant in the arsenic methylating gene, rs9527, as the instrumental variable for arsenic metabolism. To further assess mechanisms for diabetes pathogenesis, proportions of the urinary arsenic metabolites were employed to assess the association between arsenic metabolism and insulin resistance among participants without diabetes. Urinary biomarkers of arsenic metabolites were modeled as individual proportions of the total. Arsenic metabolism was evaluated both with a static outcome of insulin resistance, homeostatic measure of assessment (HOMA-IR), and a dynamic measure of insulin sensitivity, Matsuda Index. Among 475 Mexican American participants from Starr County, higher metabolism capacity for arsenic is associated with higher diabetes prevalence driven by worse insulin resistance. Presence of the minor T allele of rs9527 is independently associated with an increase in the proportion of monomethylated arsenic (MMA%) and is associated with an odds ratio of 0.50 (95% CI: 0.24, 0.90) for type 2 diabetes. This association was conserved after potential covariate adjustment. Furthermore, among participants without type 2 diabetes, the highest quartile of MMA% was associated with 22% (95% CI: -33.5%, -9.07%) lower HOMA-IR and 56% (95% CI: 28.3%, 91.3%) higher Matsuda Index for insulin sensitivity. Arsenic metabolism capacity, indicated by a lower proportion of monomethylated arsenic, is associated with increased diabetes prevalence driven by an insulin resistant phenotype among Mexican Americans living in Starr County, Texas.

1256-P: Should Clinical Guidelines for Diabetes Screening Use Waist Circumference Instead of Body Mass Index?

Introduction: Diabetes is increasing in the US. The USPSTF and ADA recommend screening based on body mass index (BMI). We evaluated if waist circumference was a better predictor of diabetes than BMI. Methods: We used NHANES (2015-2018). We identified nonpregnant adults ages ≥20 years (N=10,614). A mediation analysis was performed, assessing if the association of BMI (kg/m2) with diabetes prevalence was mediated by waist circumference (cm), using survey weighted logistic regression. Estimates were US representative. Results: We identified 233,874,251 weighted adults. A one-point BMI increase was associated with a 0.95% (95% CI: 0.84%, 1.07%, P<0.001) increase in diabetes prevalence. Similarly, a one-centimeter increase in waist circumference was associated with a 0.51% (95% CI: 0.46%, 0.55%, P<0.001) increase in diabetes prevalence. After adjusting for waist circumference, BMI was not associated with diabetes prevalence (P<0.001) (Figure), while waist circumference continued to predict diabetes prevalence by 0.87% (95% CI: 0.73%, 1.01%, P<0.001) per one-centimeter increase. The association of BMI for diabetes prevalence was fully mediated by waist circumference (indirect effect ≥ total effect). Conclusion: The predictive ability of BMI for diabetes is fully mediated by waist circumference. Clinical guidelines could consider waist circumference to replace BMI in screening guidelines. Disclosure R.Aggarwal: None. N.Chiu: None. D.L.Bhatt: Board Member; Bristol-Myers Squibb Company, Research Support; Lexicon Pharmaceuticals, Inc., Sanofi, Lilly, Boehringer Ingelheim Inc., AstraZeneca, Novo Nordisk.

1255-P: Prevalence Trends of Diabetes Subgroups in Mexico—A Data-Driven Analysis of Nationally Representative Surveys Spanning 2016–2021

Background: Diabetes subgroups are a promising framework for characterizing diabetes heterogeneity but data on the epidemiology and sociodemographic profile of these subgroups in the Mexican population are sparse. Methods: We conducted a serial cross-sectional analysis of the National Health and Nutrition Survey in Mexico (2016-2021). Diabetes subgroups (obesity related [MOD], severe-insulin deficient [SIID], severe-insulin resistant [SIRD], and age-related [MARD]) were classified using self-normalizing neural networks using HbA1c, time since diabetes diagnosis, HOMA2-IR, HOMA2-B, and BMI. Sociodemographic inequalities were proxied with the social lag index, which captures state-level social disadvantage. Results: Diabetes prevalence in Mexico increased from 13.3% (95%CI 11.5-15.1) in 2016 to 15.8% (95%CI 13.6-17.9) in 2021, with the highest increases in the Northern-Pacific, Central-Pacific, and Center regions. SIDD was the most prevalent diabetes subgroup in Mexico, followed by MOD, MARD, and SIRD. Increases in diabetes prevalence were primarily attributed to MOD and SIRD. SIID had higher aggregation in states with higher social lag (Fig. 1). Conclusion: Diabetes subgroups in the Mexican population display geographic and sociodemographic differences, which may help identify populations at higher risk of health disparities and adverse outcomes. Disclosure N.Antonio villa: None. A.Caballero: None. J.A.Seiglie: Consultant; BDMT Global, Techspert Expert Network. O.Bello-chavolla: None. D.Ramírez-garcía: None. C.Fermin: None. A.Vargas-vázquez: None. M.R.Basile-alvarez: None. A.Nuñez: None. C.D.Paz cabrera: None. L.Fernández chirino: None.

Long-term air pollution exposures on type 2 diabetes prevalence and medication use

BackgroundType 2 diabetes has raised great public health concerns due to its association with the increased risk of several adverse health outcomes. We aimed to investigate the association of criteria air pollutants and traffic density with the prevalence of type 2 diabetes and antidiabetic medication use in California. MethodsA cross-sectional study was conducted using 2005 California Health Interview Survey (CHIS) data, linked with criteria air pollutant exposure measures, including government-monitored ozone (O3), particulate matter (PM10, PM2.5) and nitrogen dioxide (NO2), residential traffic density, and land use regression modeled NOX, NO, and NO2 estimates for Los Angeles County only based on the respondents’ geocoded residential addresses. Weighted logistic regression models were used to examine the influences of 36-month average exposures to each air pollutant and traffic density on diabetes prevalence and medication use. ResultsAmong 31,483 CHIS 2005 state-wide respondents, 6.7% of adults reported having been diagnosed with type 2 diabetes. We observed type 2 diabetes prevalence was positively associated with exposures to O3, PM10, and PM2.5, and with NO, NO2, and NOx only in Los Angeles County. For each 10ppb increase in O3 or 10ug/m3 increase in PM10 or PM2.5, the odds of taking any medication increased by 40%, 56%, and 50%; taking pills increased by 33%, 31%, and 41%; taking insulin increased by 43%, 53%, and 46%; and taking both insulin and pills increased by 70%, 60%, and 88%, respectively. When traffic density within 750 feet of a respondent's home increased by one interquartile, 7% increase in odds of using any medication and taking pills was also observed. ConclusionThis study adds to evidence indicating greater air pollution exposure is associated with increased diabetes prevalence. It also provides new evidence demonstrating a strong association between pollutant exposure and antidiabetic medication use in adult Californians.

Maternal PBDE exposure disrupts gut microbiome and promotes hepatic proinflammatory signaling in humanized PXR-transgenic mouse offspring over time.

Developmental exposure to the persistent environmental pollutant, polybrominated diphenyl ethers (PBDEs), is associated with increased diabetes prevalence. The microbial tryptophan metabolite, indole-3-propionic acid (IPA), is associated with reduced risk of type 2 diabetes and lower-grade inflammation and is a pregnane X receptor (PXR) activator. To explore the role of IPA in modifying the PBDE developmental toxicity, we orally exposed humanized PXR-transgenic (hPXR-TG) mouse dams to vehicle, 0.1 mg/kg/day DE-71 (an industrial PBDE mixture), DE-71+IPA (20 mg/kg/day), or IPA, from 4 weeks preconception to the end of lactation. Pups were weaned at 21 days of age and IPA supplementation continued in the corresponding treatment groups. Tissues were collected at various ages until 6 months of age (n = 5 per group). In general, the effect of maternal DE-71 exposure on the gut microbiome of pups was amplified over time. The regulation of hepatic cytokines and prototypical xenobiotic-sensing transcription factor target genes by DE-71 and IPA was age- and sex-dependent, where DE-71-mediated mRNA increased selected cytokines (Il10, Il12p40, Il1β [both sexes], and [males]). The hepatic mRNA of the aryl hydrocarbon receptor (AhR) target gene Cyp1a2 was increased by maternal DE-71 and DE-71+IPA exposure at postnatal day 21 but intestinal Cyp1a1 was not altered by any of the exposures and ages. Maternal DE-71 exposure persistently increased serum indole, a known AhR ligand, in age- and sex-dependent manner. In conclusion, maternal DE-71 exposure produced a proinflammatory signature along the gut-liver axis, including gut dysbiosis, dysregulated tryptophan microbial metabolism, attenuated PXR signaling, and elevated AhR signaling in postweaned hPXR-TG pups over time, which was partially corrected by IPA supplementation.

Transportation-related Environmental Mixtures and Diabetes Prevalence and Control in Urban/Metropolitan Counties in the United States.

Diabetes rates in the United States are staggering and climbing. Importantly, traditional risk factors fail to completely account for the magnitude of the diabetes epidemic. Environmental exposures, including urban and metropolitan transportation quality, are implicated as contributors to disease. Using data from the county-level Environmental Quality Index (EQI) developed for the United States, we analyzed associations between transportation and air quality environmental metrics with overall diabetes prevalence and control within urban/metropolitan counties in the United States from 2006 to 2012. Additionally, we examined effect modification by race/ethnicity through stratification based on the county-level proportion of minority residents. Last, we applied mixture methods to evaluate the effect of simultaneous poor transportation factors and worse air quality on the same outcomes. We found that increased county-level particulate matter air pollution and nitrogen dioxide along with reduced public transportation usage and lower walkability were all associated with increased diabetes prevalence. The minority proportion of the population influences some of these relationships as some of the effects of air pollution and the transportation-related environment are worse among counties with more minority residents. Furthermore, the transportation and air quality mixtures were found to be associated with increased diabetes prevalence and reduced diabetes control. These data further support the burgeoning evidence that poor environments amplify diabetes risk. Future cohort studies should explore the utility of environmental policies and urban planning as tools for improving metabolic health.

Quantifying the contribution of 31 risk factors to the increasing prevalence of diabetes among US adults, 2005-2018.

No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States. This study aimed to determine the extent to which an increase in the prevalence of diabetes was related to concurrent changes in the distribution of diabetes-related risk factors among US adults (aged 20 years or above and not pregnant). Seven cycles of series of cross-sectional National Health and Nutrition Examination Survey data between 2005-2006 and 2017-2018 were included. The exposures were survey cycles and seven domains of risk factors, including genetic, demographic, social determinants of health, lifestyle, obesity, biological, and psychosocial domains. Using Poisson regressions, percent reduction in the β coefficient (the logarithm used to calculate the prevalence ratio for prevalence of diabetes in 2017-2018 vs. 2005-2006) was computed to assess the individual and collective contribution of the 31 prespecified risk factors and seven domains to the growing burden of diabetes. Of the 16,091 participants included, the unadjusted prevalence of diabetes increased from 12.2% in 2005-2006 to 17.1% in 2017-2018 [prevalence ratio: 1.40 (95% CI, 1.14-1.72)]. Individually, genetic domain [17.3% (95% CI, 5.4%-40.8%)], demographic domain [41.5% (95% CI, 24.4%-76.8%)], obesity domain [35.3% (95% CI, 15.8%-70.2%)], biological domain [46.2% (95% CI, 21.6%-79.1%)], and psychosocial domain [21.3% (95% CI, 9.5%-40.1%)] were significantly associated with a different percent reduction in β. After adjusting for all seven domains, the percent reduction in β was 97.3% (95% CI, 62.7%-164.8%). The concurrently changing risk factors accounted for the increasing diabetes prevalence. However, the contribution of each risk factor domain varied. Findings may inform planning cost-effective and targeted public health programs for diabetes prevention.

Association of urinary iodine concentration with prediabetes/diabetes in adults: Analysis of the NHANES 2005–2016

Background & AimsIodine is required for synthesizing thyroid hormones and regulating human metabolism. Iodine deficiency can lead to thyroid function abnormalities, which are closely associated with disturbances in glucose-insulin homeostasis. Research on the relationship between iodine and diabetes/prediabetes in adults was sparse and inconsistent. We assessed trends in urinary iodine concentration (UIC) and diabetes/prediabetes prevalence and focused on the association between iodine and diabetes/prediabetes among U.S. adults. MethodsWe analyzed the National Health and Nutrition Examination Survey (NHANES) data from the 2005–2016 cycles. Linear regression was employed to evaluate UIC and prediabetes/diabetes prevalence trends over time. Both multiple logistic regression and restricted cubic splines (RCS) were performed to evaluate the association of UIC with diabetes/prediabetes. ResultsA distinctly declining trend in median UIC and a significant increase in diabetes prevalence in U.S. adults from 2005 to 2016 were observed. The fourth quartile of UIC was associated with a 30% lower risk for prediabetes, compared with the first quartile (OR=0.70, 95% CI: 0.56–0.86, Ptrend=0.001). However, UIC was not significantly associated with the prevalence of diabetes. The RCS model suggested a significant nonlinear relationship between UIC and the risk of diabetes (P for nonlinearity =0.0147). Stratification analysis showed that the negative associations of UIC with the risk of prediabetes were more pronounced in participants who were men, aged 46–65, overweight, light alcohol drinkers, and nonactive smokers. ConclusionsOverall, the adults’ median UIC in the U.S. population was a declining trend. However, diabetes prevalence increased significantly from 2005 to 2016. Higher UIC was associated with a lower risk of prediabetes.

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

BackgroundDiabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified.MethodsUsing DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using “wealth index” and “weight perception” as additional variables.ResultsThere was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged “60 years or older” with a wealth index of “rich” or “richer”, followed by participants from the same age group who were “poor” or “poorer” and participants aged “40–59 years” with a wealth index of “rich” or “richer”. Subsequently were participants from the age group “15–39 years” with a weight perception of “overweight” or “obese”.ConclusionDiabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.

Drug-induced mitochondrial toxicity: Risks of developing glucose handling impairments.

Mitochondrial impairment has been associated with the development of insulin resistance, the hallmark of type 2 diabetes mellitus (T2DM). However, the relationship between mitochondrial impairment and insulin resistance is not fully elucidated due to insufficient evidence to support the hypothesis. Insulin resistance and insulin deficiency are both characterised by excessive production of reactive oxygen species and mitochondrial coupling. Compelling evidence states that improving the function of the mitochondria may provide a positive therapeutic tool for improving insulin sensitivity. There has been a rapid increase in reports of the toxic effects of drugs and pollutants on the mitochondria in recent decades, interestingly correlating with an increase in insulin resistance prevalence. A variety of drug classes have been reported to potentially induce toxicity in the mitochondria leading to skeletal muscle, liver, central nervous system, and kidney injury. With the increase in diabetes prevalence and mitochondrial toxicity, it is therefore imperative to understand how mitochondrial toxicological agents can potentially compromise insulin sensitivity. This review article aims to explore and summarise the correlation between potential mitochondrial dysfunction caused by selected pharmacological agents and its effect on insulin signalling and glucose handling. Additionally, this review highlights the necessity for further studies aimed to understand drug-induced mitochondrial toxicity and the development of insulin resistance.

Common procedures and conditions leading to inpatient hospital admissions in adults with and without diabetes from 2015 to 2019 in Germany : Acomparison of frequency, length of hospital stay and complications.

To evaluate common surgical procedures and admission causes in inpatient cases with diabetes in Germany between 2015 and 2019 and compare them to inpatient cases without diabetes. Based on the German diagnosis-related groups (G-DRG) statistics, regression models stratified by age groups and gender were used to calculate hospital admissions/100,000individuals, hospital days as well as the proportion of complications and mortality in inpatient cases ≥ 40years with or without adocumented diagnosis of diabetes (type1 or type2). A total of 14,222,326 (21%) of all inpatient cases aged ≥ 40years had adiagnosis of diabetes. More middle-aged females with vs. without diabetes/100,000individuals [95% CI] were observed, most pronounced in cases aged 40-< 50years with myocardial infarction (305 [293-319] vs. 36 [36-37], p < 0.001). Higher proportions of complications and longer hospital stays were found for all procedures and morbidities in cases with diabetes. Earlier hospitalizations, longer hospital stays and more complications in inpatient cases with diabetes together with the predicted future increase in diabetes prevalence depict huge challenges for the German healthcare system. There is an urgent need for developing strategies to adequately care for patients with diabetes in hospital.