Longer Duration Of Diabetes Research Articles

ASSOCIATION OF MICROALBUMINURIA AND DIABETIC RETINOPATHY IN PATIENTS WITH TYPE II DIABETES MELLITUS

Objectives: Diabetes mellitus (DM) is a long-term metabolic condition marked by decreased synthesis and thereby function of insulin, which can result in serious side effects such as nephropathy and diabetic retinopathy. Diabetic nephropathy plays a significant role in end-stage renal disease, and diabetic retinopathy is one of the main preventable causes of blindness. In patients with type 2 DM, this study intends to investigate the relationship between diabetic retinopathy and microalbuminuria while considering other risk factors such as age, duration of diabetes, and glycemic management. Methods: Ninety-seven patients with type 2 DM and diabetic retinopathy participated in this hospital-based cross-sectional study. Based on the American Academy of Ophthalmology diabetic retinopathy disease severity scale, participants were categorized. Spot urine samples were used to find out microalbuminuria, and Chi-square and t-tests were used to examine correlations between microalbuminuria, diabetic retinopathy, and other clinical and demographic variables. Results: Microalbuminuria was shown to be significantly correlated (p<0.001) with the severity of diabetic retinopathy. In addition, microalbuminuria was significantly associated with older age (p=0.002) and longer diabetes duration (p<0.001). Nevertheless, no meaningful correlations were discovered between sex, treatment history, or diabetes in the family history and microalbuminuria. Conclusion: The findings highlight the importance of strict monitoring of microalbuminuria in patients with diabetic retinopathy, especially in the elderly and with long-duration diabetes. Early detection and management of diabetes and strict control of glycemic levels will help to prevent further complications.

Diabetic retinopathy screening using artificial intelligence and its predictors among people with type 2 diabetes mellitus in an urban area of Durgapur

ABSTRACT Introduction: Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia either due to insulin resistance or due to relative or absolute insulin deficiency. Poorly controlled DM may result in both macrovascular and/or microvascular complications like diabetic retinopathy [DR]. Dilated eye examination is the most commonly employed method to diagnose DR. Nonmydriatic artificial intelligence [AI]–based technologies are the now available to screen DR. Methods: A cross-sectional observational study was conducted in urban field practice area of our medical college for 2 months duration. A total of 95 patients with type 2 DM were interviewed using predesigned, pretested semistructured schedule to collect data. Medical records were reviewed to collect relevant information. DR was screened using AI-based DR screening instrument, and venous blood sample was collected for glycated hemoglobin (HbA1C) testing. Data were analyzed using IBM SPSS [version 16]. Univariate and multivariate logistic regression tests were used, and P value ≤ 0.05 was taken as statistically significant. Results: The prevalence of DR was 17.9% in our study. Around 76.9% respondents had high fasting blood glucose [FBG: ≥126 mg/dl], and majority of the respondents [73.7%] had HbA1C value >7%. DR was significantly associated with FBG level, longer duration of diabetes, presence of hypertension, dyslipidemia, and kidney disease in univariate logistic regression and, in multivariable logistic regression, FBG level, presence of dyslipidemia and kidney disease retained their significance. Conclusion: This study had used AI-based DR screening instrument, to screen DR among T2DM patients. AI-based DR screening system can be encouraged in mass screening camps, especially in areas with inadequate number of ophthalmologists. This study also evaluated some important modifiable predictors of DR. Appropriate and early identification of such predictors may prevent DR-related blindness.

GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort study.

GLP-1 receptor agonists in kidney transplant recipients with pre-existing diabetes: a retrospective cohort study.

Low uptake of screening for retinopathy during pregnancy with pre-existing diabetes: A population-based cohort study.

Low uptake of screening for retinopathy during pregnancy with pre-existing diabetes: A population-based cohort study.

Add-On Treatment with Gliclazide for Cancer Patients with Type 2 Diabetes Undergoing Cyclic Glucocorticoid-Containing Chemotherapy.

Aims: Despite its high prevalence, studies on glucocorticoid-induced hyperglycemia are lacking. We examined the glucose profiles of patients with type 2 diabetes undergoing dexamethasone-containing chemotherapy using continuous glucose monitoring (CGM). We also investigated the effects of gliclazide on the management of hyperglycemia in these patients. Materials and Methods: Seventeen patients with type 2 diabetes who received cyclic chemotherapy with dexamethasone were enrolled in this study. During the first cycle, iPro2, a blinded CGM device, was applied for 7 days. If a patient's CGM data exhibited an increase of 20% or more in the mean glucose level after dexamethasone administration, they received the second cycle, unless they had already received sulfonylurea or their chemotherapy regimen had changed. During the second cycle, the patients were treated with gliclazide as an add-on to their routine diabetic medication. Results: Dexamethasone treatment significantly increased glucose levels, especially in patients with a longer diabetes duration (8.4 years vs. 1.2 years, p = 0.009). For the nine patients who proceeded to the second cycle, gliclazide treatment significantly ameliorated hyperglycemia. Time in range increased from 33.11% to 45.22% (p = 0.020), and time above range significantly decreased from 66.89% to 52.78% (p = 0.003). The glucose management indicators were 9.52% and 8.40% for pre- and post-gliclazide treatment, respectively. One patient visited the emergency department because of symptomatic hypoglycemia. Conclusions: Chemotherapy regimens containing dexamethasone result in high blood glucose levels even after the last dexamethasone dose in patients with pre-existing diabetes. Adding gliclazide could be beneficial in managing hyperglycemia during dexamethasone-containing chemotherapy.

Quality of life among diabetic patients in Ahmedabad, India

Background: Diabetes, affecting 422 million people worldwide, with India having the second-largest diabetic population. India accounts for 1 in 7 of the global diabetic population and 63% of all deaths from NCDs. In Gujarat, diabetes prevalence is 16% in women and 17% in men. Quality of life (QOL) includes physiological, psychological, social, and spiritual satisfaction, is a key factor in disease management. Assessing QOL helps identify patient needs, evaluate treatment regimens, and improve health management. Methods: We conducted a community based cross-sectional study among diabetic patients using a Short Form 36 V2 to measure QOL of diabetics aged >18 years. In-person interviews were conducted with 310 diabetic patients from 30 UHCs of Ahmedabad Municipal Corporation that were chosen by cluster sampling. Data was analysed using suitable statistical parameters. Results: The study included 160 male and 150 female diabetic patients, with a mean age of 55.46±9.85 years and mean diabetes duration of 5.69±3.44 years. The mean QOL score was 71.37±18.14, with males reporting higher QOL than females. Advanced age, longer diabetes duration, sedentary lifestyle, comorbidities, and complications were associated with lower QOL. Higher education, nuclear family type, higher socio-economic status (SES) and regular physical activity improved QOL. No significant association was found between QOL and religion, occupation, marital status, diet type, overcrowding, or addiction. Conclusions: Significantly associated variables with QOL included Age, gender, education, type of family, Socioeconomic status, lifestyle, physical activity, comorbidity, duration and complication of diabetes.

Risk factors for pupil changes in patients with diabetic retinopathy and cataract after phacoemulsification with intraocular lens implantation

BackgroundThis study aims to identify the risk factors associated with pupillary changes in patients with diabetic retinopathy (DR) and cataract undergoing phacoemulsification with intraocular lens implantation (PHACO + IOL).MethodsThis retrospective observational study included patients with DR and cataract who underwent phacoemulsification and intraocular lens implantation between February 2021 and August 2023. Patients were categorized into two groups based on the presence or absence of pupillary changes following surgery.ResultsA total of 162 patients were analyzed, with pupillary changes occurring in 33 cases (20.37%). Multivariate logistic regression analysis revealed that a longer duration of diabetes (OR = 2.73; 95% CI: 1.02–7.27, P = 0.045), higher lens nucleus grade (OR = 3.95; 95% CI: 1.58–9.89, P = 0.003), greater severity of DR (OR = 3.60; 95% CI: 1.40–9.28, P = 0.008), and intraoperative posterior lens capsule rupture (OR = 6.41; 95% CI: 1.75–23.47, P = 0.005) were significant risk factors for postoperative pupillary changes in DR patients undergoing PHACO + IOL.ConclusionPhacoemulsification with intraocular lens implantation is an effective treatment for patients with DR and cataract. However, factors such as the duration of diabetes, severity of DR, and intraoperative complications are associated with an increased risk of pupillary changes. Therefore, rigorous blood glucose control, adherence to standardized surgical protocols, and preventive care are recommended to optimize patient outcomes.Trial registrationNot applicable.Clinical trial numberNot applicable.

Comparative Hepatic Outcomes of SGLT2i or DPP4i Compared to GLP-1RA in CHB and T2DM Patients.

The prevalence of diabetes is increasing among chronic hepatitis B (CHB) patients. However, the relative efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) or dipeptidyl peptidase-4 inhibitors (DPP4i), compared with glucagon-like peptide-1 receptor agonists (GLP-1RA), among such at-risk populations remains unclear in terms of reducing liver-related events (LRE). Using a nationwide database (2019-2022), we identified CHB patients with diabetes (age ≥ 40) and established two new-user cohorts: SGLT2i vs. GLP-1RA and DPP4i vs. GLP-1RA. LREs included hepatocellular carcinoma, cirrhosis, liver transplantation and liver-related mortality. For appropriate balancing, propensity score matching (PSM) was performed for each cohort. Multivariate Cox regression models were used to estimate LRE risk with adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Propensity score matching provided two separate cohorts: (1) SGLT2i (n = 2297) vs. GLP-1RA (n = 461) and (2) DPP4i (n = 803) vs. GLP-1RA (n = 165) users. The LREs risk was similar across each comparison, with aHRs of 0.82 (95% CI 0.49-1.37) for GLP-1RA (vs. SGLT2i) and 0.93 (95% CI 0.41-2.07) for GLP-1RA (vs. DPP4i), indicating no significant differences. Subgroup analyses showed a trend favouring GLP-1RA over SGLT2i in females, obese individuals, antiviral therapy (AVT) users, those with diabetes complications, longer diabetes duration and physically active individuals. Compared with DPP4i, the trend was observed in AVT users and those with a shorter diabetes duration, though none were statistically significant. Overall LRE risk was comparable between SGLT2i or DPP4i vs. GLP-1RA users. Further prospective studies are required to identify who can benefit from specific medication.

Health Related Quality of Life among type 2 Diabetic Male Patients and its Correlates –Results from Primary Health Care Centre

Abstract Background: Risk of diabetes continues to increase worldwide due to population growth, urbanization. Little is known regarding the health related quality of life (HRQoL) among diabetes mellitus in India. Identifying factors influencing HRQoL could help us to form strategies for better control of diabetes. Material and Methods: To measure the quality of life among men with type 2 diabetes mellitus residing in the rural field practice area of a teaching hospital in Coimbatore and to determine sociodemographic as well as diabetes and sexual related characteristics associated with poor quality of life. This study was conducted in the rural field catchment area by enrolling 443 adult males with type 2 diabetes mellitus. The data was collected from the blood investigation reports and by face-to-face interviews using a Semi-structured. Quality of Life was assessed using the European quality of life five-dimension scale (EQ 5D 3L). A question on erectile dysfunction was also included. Logistic regression models were used to investigate the factors associated with it. Results: Patients reported “some or extreme problems” most frequently in pain/discomfort (34.8%), and in anxiety/depression (27.7%) dimensions. Older age, long duration of diabetes, having co-morbid conditions were significantly associated (P < 0.05) with mobility, self-care, usual activities, and pain/discomfort of EQ 5D in the multivariate regression model. It is also observed that 60.9% of these patients had erectile dysfunction, which was found significantly associated with increasing blood sugar values (P < 0.001). Conclusion: The study results indicated that patients with diabetes suffer from a relatively poor quality of life. More attention should be paid to the determinants of the poor quality of life. It is recommended that factors leading to derangement of quality of life as well as causing sexual dysfunction have to be addressed by the primary health care providers for the improvement of the quality of life of diabetic patients attending the primary health care center.

Characteristics of type 2 diabetes patients with overt cardiovascular diseases in Malaysia: the real-world evidence from the National Diabetes Registry

ObjectiveThe characteristics of diabetes patients with cardiovascular disease (CVD) in Malaysia are not well understood, especially in terms of metabolic control and treatment profiles. We aimed to determine the characteristics of type 2 diabetes patients with CVD in public primary care clinics in Malaysia. A cross-sectional analysis of the baseline information of an established retrospective cohort dataset was done.ResultsAmong 18,312 patients, 4.1% had CVD. In the multiple logistic regression model, CVD was associated with males, older age, longer diabetes duration, hypertension, dyslipidaemia, nephropathy, insulin, antiplatelet agents, and glycosylated haemoglobin A1c control. In contrast, LDL cholesterol control was less common among patients with CVD. The percentage of patients with CVD who achieved the recommended glycosylated haemoglobin A1c ≤ 8%, blood pressure ≤ 135/75 mmHg, and LDL cholesterol < 1.8 mmol/L were 59.5%, 25.3%, and 13.7%, respectively. Meanwhile, 44.7%, 25.6%, and 42.7% of patients without CVD achieved glycosylated haemoglobin A1c ≤ 7.0%, blood pressure ≤ 135/75 mmHg, and LDL cholesterol ≤ 2.6 mmol/L, respectively. Many patients did not achieve the recommended treatment targets. There are ample opportunities to optimise the quality of diabetes management in primary care settings in Malaysia.

Impact of Twice-Weekly Islamic Fasting on Cardiovascular Risk Factors in Women with Type 2 Diabetes Mellitus

AbstractTwice-Weekly Islamic Fasting is a unique form of intermittent fasting observed by Muslims on Mondays and Thursdays. While Ramadan and other forms of intermittent fasting have been extensively studied, limited data exist on the clinical impact of Twice-Weekly Islamic Fasting among patients with type 2 diabetes mellitus (T2DM).This study aimed to determine the prevalence and impact of Twice-Weekly Islamic Fasting on cardiovascular risk factors among Emirati women with T2DM.One hundred Muslim women from the outpatient diabetes clinic at Tawam Hospital, Al Ain, United Arab Emirates, were interviewed face-to-face using a structured questionnaire. Based on their reported observation of Twice Weekly Islamic Fasting practices, participants were categorized into two groups: group 1 (n = 37, 37%) were patients who observe this fasting pattern regularly and group 2 (n = 63, 63%) included patients who do not. Medical records were reviewed for weight, type and duration of diabetes, body mass index (BMI), type of treatment, blood pressure (BP), glycated hemoglobin (HbA1c), and lipid panel.Among 100 participants, 37% reported observing Twice-Weekly Islamic Fasting regularly. Fasting individuals were older (mean age 62 vs. 56 years, p &lt; 0.05) and with longer duration of diabetes (22 vs. 19 years, p &lt; 0.05) compared with nonfasting participants. The fasting group showed better glycemic control, with a lower mean HbA1c (7.59 ± 2.1% vs. 8.07 ± 2.0%, p = 0.077), although the difference was not statistically significant. While BMI, lipid profiles, and BP did not show any statistically significant differences, fasting participants exhibited a slightly lower systolic BP (128 ± 15.7 vs. 132.9 ± 16.4 mm Hg) and a slight improvement in total cholesterol/high-density lipoprotein ratio in participants with a diabetes duration exceeding 10 years.This pilot study found that 37% of Emirati women with T2DM practice Twice-Weekly Islamic Fasting. While statistical significance was not reached, trends suggest potential benefits for glycemic control and weight. Given the widespread observance of this practice, health care providers play a crucial role in guiding patients who choose to fast, ensuring a balance between traditional practices and safe diabetes management. Future research should investigate the long-term impact of Twice-Weekly Islamic Fasting on metabolic and cardiovascular health.

Prevalence, incidence, and risk factors of diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus.

To compare the prevalence, incidence, and factors of diabetic retinopathy (DR) and macular edema (DME) in patients with early-onset (EOD) and late-onset diabetes (LOD). Participants with type 2 diabetes mellitus (T2DM) were recruited from a community-based study conducted in southern urban China. Participants were followed up for 2 years. The prevalence and incidence of DR and DME were compared between EOD (≤40 years) and LOD (>40 years) groups, and potential factors were evaluated using multivariate logistic regression. Among 2,703 participants, 173 (6.4%) with EOD had a higher prevalence of DR than 2,530 (93.6%) with LOD (27.8% vs 15.5%, P < 0.001). Participants with EOD had a higher incidence of DR, although this difference was not statistically significant (EOD: 8.1% vs LOD: 3.6%, P = 0.12). Insulin use and higher HbA1c levels were significantly associated with DR in both EOD and LOD groups (both P < 0.05). Additionally, longer diabetes duration, higher systolic blood pressure, and the presence of albuminuria independently associated with the presence of any DR in LOD patients (all P < 0.05). For DME, HbA1c level was a significant association in EOD, while in LOD, age, BMI, insulin use, and albuminuria were significant factors (all P < 0.05). A higher prevalence of DR was observed among patients with early-onset T2DM in urban southern China. Timely diagnosis of DR and regular eye care services are needed for early-onset T2DM.

Decreased muscle strength and thigh muscle area assessed with CT imaging in older Chinese adults with long duration of type 2 diabetes.

Decreased muscle strength and thigh muscle area assessed with CT imaging in older Chinese adults with long duration of type 2 diabetes.

Awareness of diabetic retinopathy among diabetic patients in community ophthalmology clinics, Brunei Darussalam

Background: Diabetes mellitus is a significant public health issue in Brunei Darussalam and all diabetics are at risk of diabetic retinopathy (DR). Awareness of DR is one of the key factors in lowering the risk of developing it. This study aims to evaluate awareness, knowledge, and attitude (AKA) regarding DR among diabetic patients in the Brunei-Muara district who attended community ophthalmology clinics for diabetic eye screening. Subjects and Methods: This was a cross-sectional study conducted between May 2024 to August 2024, using self-administered and self-designed questionnaires. A convenience sampling method was used to recruit participants from four clinics. Data collected were on sociodemographic characteristics and the three AKA domains. The analysis was performed using multiple linear regression models, with P&lt; 0.05 considered statistically significant. Results: A total of 407 participants completed the questionnaires. The results showed that 83.5% of patients were aware that diabetes could lead to blindness. Nearly all participants (90.7%) recognized the importance of controlling blood sugar level to reduce the risk of DR, and most (86.0%) were aware of the correct screening intervals, although 18.7% believed traditional medicine could treat DR. Participants attitudes were high towards management of DR. The significant predictors for higher AKA scores were higher income, longer duration of diabetes, and non-smoker in the Multiple Linear Regression models (P &lt; 0.001). Conclusion: Despite the overall high awareness and attitude of DR, there is a need to improve knowledge regarding treatment options and dispel misconceptions about traditional medicine, particularly among those with lower socioeconomic status.

Prevalence and risk factors of painful diabetic neuropathy: A systematic review and meta-analysis.

Painful diabetes-related peripheral neuropathy (PDPN) is a common and debilitating complication of diabetes, contributing significantly to morbidity and healthcare costs. This systematic review and meta-analysis aim to determine the global prevalence of PDPN among individuals with diabetic peripheral neuropathy (DPN) and to identify associated risk factors. A comprehensive search of four English and three Chinese databases was conducted for observational studies on PDPN prevalence up to June 22, 2024. Of the 41 studies included, the pooled global prevalence of PDPN was 46.7% (95% CI, 41.8-51.7). In subgroup analysis, significant statistical differences were observed in prevalence estimates between different diagnostic methods for neuropathic pain, with neuropathic-specific pain scales indicating higher rates (P=0.03). Studies with mean diabetes duration of less than 10years or more than 15years reported higher prevalence (P<0.01). Significant risk factors for PDPN included older age (OR = 1.02, 95% CI, 1.01-1.04), female gender (OR = 1.58, 95% CI, 1.19-2.11), BMI ≥ 30kg/m2 (OR = 1.62, 95% CI, 1.43-1.83), longer diabetes duration (OR = 1.05, 95% CI, 1.01-1.08), and nephropathy (OR = 1.32, 95% CI, 1.24-1.40). Targeted screening and standardized diagnostic tools are urgently needed to enhance PDPN management and mitigate its burden globally.

The Impact of Diabetes Self-Care, Healthy Lifestyle, Social Support, and Demographic Variables on Outcomes HbA1c in Patients With Type 2 Diabetes.

Controlling HbA1c can help reduce the symptoms and complications of diabetes. However, only about 25% of adults with diabetes achieve this diabetes care goal. It can be seen that diabetes requires more research investment and breakthroughs, as well as a more complete discussion of related factors that affect diabetes control, in order to better control the disease. This study explored the effects of diabetes self-care behavior, healthy lifestyle, diabetes symptoms, social support, demographic variables, and physical examination values on HbA1c levels in individuals with type 2 diabetes. This study used a cross-sectional design and recruited 305 subjects with type 2 diabetes at a medical center. Personal data were collected using a structured questionnaire and same-day outpatient medical records. Multiple linear regression analysis identified significant predictors of HbA1c levels. These include insulin treatment (P < .001), age (P < .001), gender (P < .001), diabetes duration (P = .003), proteinuria (P < .001), diabetes self-care behaviors (P = .021), physical activity (running; P = .018), and spousal involvement in care (P = .031). Female gender, insulin treatment, longer diabetes duration, spousal involvement in care, and the presence of proteinuria were positively associated with higher HbA1c levels. In contrast, higher age, better diabetes self-care behaviors, and regular physical activity (running) were associated with lower HbA1c levels. These findings underscore the importance of considering both demographic factors and lifestyle behaviors in the management of HbA1c levels. For reasons that hinder subjects from controlling HbA1c levels, individual self-management intervention programs should be provided to improve the effectiveness of subjects in controlling HbA1c levels. The care giver should be included in the educational program of diabetes management. Running exercise contributes to the control of HbA1c levels.

Influence of perceived health provider communication, diabetes duration and age at diagnosis with confidence in diabetes self-care

IntroductionSeveral factors influence individuals’ confidence to perform diabetes-related self-care activities, including perceived patient-provider communication, diabetes duration and age at diagnosis. It has been well-documented that patient-provider communication is essential when...

Shedding light on eating disorders in adolescents with type 1 diabetes: insights and implications

Eating disorders (EDs) are complex medical conditions that pose a considerable health burden for individuals with type 1 diabetes mellitus (T1DM). EDs in individuals with T1DM are linked to poor metabolic control, which heightens the risk of diabetes complications. Consequently, regular screening for EDs is essential. This study investigates the prevalence of EDs in adolescents with T1DM, investigating the associations with diabetes duration, pubertal stage, glycemic control, and diabetes-related complications. In this cross-sectional study, 350 adolescents (155 males, 195 females) with T1DM, aged 12–18, were recruited from Mansoura University Children’s Hospital. Participants completed the Diabetes Eating Problem Survey-Revised (DEPS-R) questionnaire, with scores ≥ 20 prompting clinical interviews to confirm EDs. Clinical data, including HbA1c, BMI, and body composition, were analyzed. Socioeconomic status (SES) and family factors were assessed. The prevalence of EDs was 22.6%, including other specified feeding or eating disorders (OSFED) (68.4%), binge eating (11.4%), bulimia nervosa (7.6%), avoidant restrictive (7.6%), and anorexia nervosa (5.1%). Binary logistic regression analysis showed that the significant predictors of ED in the study cohort were diabetes duration (OR = 1.75 (1.66–1.84), p < 0.001), and HbA1c (OR = 5.94 (2.4–14.6), p < 0.001). Conclusions: Adolescents with EDs had higher (SES), more family conflicts, longer diabetes duration, and were more prone to diabetic nephropathy and poor glycemic control. Screening for EDs is recommended from pre-adolescence through early adulthood.What Is Known:• Adolescents with T1DM are more vulnerable to develop EDs compared to their peers without T1DMWhat Is New:• The DEPS-R and DSM-V were useful clinical tools for screening and for diagnosis of EDs respectively among adolescents with T1DM• We advise to screen for EDs in adolescents with T1DM who aged around 13.6 years, at Tanner stage 3, with duration of T1DM >5 years, and/or with HbA1c >7.5%

Community-Based Peer Support for Diabetes Management: 24-Month Changes Relative to Comparison Communities.

To evaluate the effectiveness of community-based peer support for diabetes self-management with HbA1c and other clinical and psychosocial outcomes over 24 months. This study used an intervention comparison design with 12 intervention communities and 4 comparison communities matched according to location in urban or suburban areas. A community organization approach was used to integrate standardization of key messages and patient education protocols, along with adaptation and innovation among multiple community partners. The primary outcome was HbA1c; secondary outcomes included BMI, fasting plasma glucose (FPG), systolic and diastolic blood pressure, LDL cholesterol (LDL-C), depressive symptoms (PHQ-8), diabetes distress, and general quality of life (EQ-5D). The analyses included 967 participants completing both the baseline and follow-up assessment. Intervention communities versus comparison communities were older (mean age 66.43 vs. 63.45 years), included more women (57.1% vs. 45.5%), and had longer diabetes duration (mean 7.95 vs. 6.40 years). Significant improvements were found for HbA1c (7.42% [58 mmol/mol] vs. 7.95% [63 mmol/mol]), BMI (25.31 vs. 25.94 kg/m2), FPG (7.91 vs. 8.59 mmol/L), and depressive symptoms (PHQ-8 score 1.39 vs. 1.41), favoring intervention communities, after adjusting for baseline values of outcome measures and confounders (P ≤ 0.028). No interactions were found with age (<65 vs. ≥65 years). Men showed modestly greater diastolic blood pressure reduction, and women showed a minor increase of LDL-C in intervention communities. These analyses by age or sex and sensitivity analyses with missing data imputation supported the robustness of findings. Culturally adapted and appropriate community-based peer support for diabetes management may improve clinical and psychosocial outcomes at 24 months among people with diabetes.

Association of Hyperuricemia With Proteinuria in Patients with Type 2 Diabetes Mallitus Experience of Tertiary Care Hospital

Diabetic nephropathy is a leading cause of chronic kidney disease and end-stage renal failure in patients with type 2 diabetes mellitus (T2DM). Albuminuria is an early marker of renal damage, while hyperuricemia has been increasingly recognized as a possible risk factor for kidney disease progression. Objective: To evaluate the relationship between elevated serum uric acid levels and the presence and severity of albuminuria in patients with type 2 diabetes. Methods: A retrospective, hospital-based study was conducted at Ziauddin University Hospital, Clifton Campus during June 2024 till November 2024. A total of 400 patients with T2DM were included using non-probability purposive sampling. Inclusion criteria were age &gt;18 years, confirmed T2DM, serum uric acid ≥7 mg/dL, and spot urine albumin–creatinine ratio (UACR) &gt;30 mg/g. Patients with UTI, stage 5 CKD, autoimmune disease, malignancy, or on medications affecting uric acid levels were excluded. Results: The mean serum uric acid level was 7.8 ± 0.6 mg/dL, and the mean UACR was 154.6 ± 85.2 mg/g. Macroalbuminuria was present in 30.5% of patients. The frequency of macroalbuminuria increased significantly with higher uric acid levels (p &lt; 0.001). A significant positive correlation was observed between serum uric acid and UACR (r = 0.42, p &lt; 0.001). Stratified analysis showed higher rates of macroalbuminuria among patients with longer diabetes duration and poorer glycemic control. Conclusion: It is concluded that hyperuricemia is significantly associated with increased albuminuria in patients with type 2 diabetes. Monitoring and managing serum uric acid levels may serve as a valuable approach in the early identification and prevention of diabetic nephropathy.