Management Of Blood Glucose Levels Research Articles

Practical considerations for continuous glucose monitoring in elite athletes with type 1 diabetes mellitus: A narrative review.

Type 1 diabetes mellitus (T1DM) refers to a metabolic condition where a lack of insulin impairs the usual homeostatic mechanisms to control blood glucose levels. Historically, participation in competitive sport has posed a challenge for those with T1DM, where the dynamic changes in blood glucose during exercise can result in dangerously high (hyperglycaemia) or low blood glucoses (hypoglycaemia) levels. Over the last decade, research and technological development has enhanced the methods of monitoring and managing blood glucose levels, thus reducing the chances of experiencing hyper- or hypoglycaemia during exercise. The introduction of continuous glucose monitoring (CGM) systems means that glucose can be monitored conveniently, without the need for frequent fingerpick glucose checks. CGM devices include a fine sensor inserted under the skin, measuring levels of glucose in the interstitial fluid. Readings can be synchronized to a reader or mobile phone app as often as every 1-5min. Use of CGM devices is associated with lower HbA1c and a reduction in hypoglycaemic events, promoting overall health and athletic performance. However, there are limitations to CGM, which must be considered when being used by an athlete with T1DM. These limitations can be addressed by individualized education plans, using protective equipment to prevent sensor dislodgement, as well as further research aiming to: (i) account for disparities between CGM and true blood glucose levels during vigorous exercise; (ii) investigate the effects of temperature and altitude on CGM accuracy, and (iii) explore of the sociological impact of CGM use amongst sportspeople without diabetes on those with T1DM.

IMO-PSO FO-PID controller based insulin infusion system for type 1 diabetes patients during post-operation condition

Blood Glucose level controls of type 1 diabetic patients (T1D) in post operative conditions are extremely important. This work proposes controllers for management and control of insulin injections to T1D in post operative care. Proposed work investigated IMO-PSO FO-PID controller as a novel approach to improve insulin delivery. The controller utilizes optimization algorithms to regulate insulin levels in real time. Particle swarm optimization (PSO) based tuning is already a proven method in insulin regulation and multiobjective PSO is well suited when combined with FO-PID which is tested. Additionally, system aims to achieve lower insulin levels, as high insulin levels have been linked to increase risks of complications for T1D patients. Results showed that IMO-PSO FO-PID controller is effective in improving glucose control, with patients experiencing fewer fluctuations and instances of hypoglycemia or hyperglycemia. Simulation results show that the use of the controller is very useful in managing blood glucose levels over a longer period and corresponding insulin infusion levels are also controlled well, which is much less than the previously reported control methodologies. This paper highlights potential benefits of using this controller in managing T1D and improving glucose control.

Optimizing Blood Glucose Regulation in Type 1 Diabetes Patients via Genetic Algorithm-Based Fuzzy Logic Controller Considering Substantial Meal Protocol

Effective management of blood glucose levels in individuals with type 1 diabetes, especially after meals, is crucial for diabetes care. Artificial pancreas systems (APS) perform automated insulin delivery in subjects with type 1 diabetes mellitus (T1DM). In this study, an optimized fuzzy logic controller was designed to achieve a euglycemic range after a substantial meal intake. All in silico simulations were performed using the MATLAB/Simulink environment, leveraging control variability grid analysis (CVGA), and the performance of the controller was evaluated. The proposed controller is based on a fuzzy-logic control law designed in three stages. First, a nonlinear framework of the glucose-insulin regulatory system was identified based on the heavy meal protocol of three patients given as follows: for subject ID 117-1, a total of 295 gCHO; for subject ID 126-1, 236 gCHO; and subject ID 128-1, 394 gCHO over a day. Then, an iterative tree structure was employed to establish a stabilizing control rule for insulin delivery, integrating inputs from two Mamdani Fuzzy Inference System (FIS) objects. Finally, a genetic algorithm refines the control system by fine-tuning the uncertainty of the fuzzy membership functions. Two scenarios were considered for three patients to assess the performance of the proposed controller. The results indicated its effectiveness under various conditions, achieving a time in the range of 61.25%, 71% and 61.10% respectively for the three subjects. The obtained results are analyzed and compared with IMC and multi-objective output feedback controllers. The findings of the study reveal that the proposed controller shows promising advancements in tailored strategies for type 1 diabetes patients, outperforming the other controllers in terms of blood glucose regulation.

Diabetic management and infection risk in total ankle arthroplasty

BackgroundAs total ankle arthroplasty (TAA) increases in popularity nationwide for the management of end-stage arthritis, it is essential to understand ways to mitigate the risk of infection. Diabetes increases the risk of infection due to compromised immunity and impaired wound-healing mechanisms. However, there is limited research on how diabetic management, inclusive of medications and glucose control, may impact infection risks post-TAA. This study aims to demonstrate the impact of diabetic management on the occurrence of periprosthetic joint infection (PJI) following TAA. MethodsThis was a retrospective study of patients who underwent a TAA at a single academic institution from March 2002 to May 2022. Patients with diabetes who developed an intraarticular infection following TAA were propensity score matched (1:3) to diabetic patients who did not. Data collection included demographics, implant types, diabetic medications, and preoperative hemoglobin A1c. PJI was diagnosed based on Musculoskeletal Infection Society (MSIS) criteria. Statistical analyses assessed differences in medication use, glucose control, and infection rates between groups. ResultsOf the 1863 patients who underwent TAA, 177 patients had a diagnosis of diabetes. The infection rate in patients with diabetes (2.8%) was higher than the total cohort rate (0.8%). Five patients with diabetes developed a PJI at an average of 2.2 months postoperatively. This cohort (n = 5) was compared to propensity score-matched controls (n = 15). There was no significant difference in diabetic medication use. Patients who developed PJI had higher rates of uncontrolled diabetes (60.0% vs. 6.7%) and average A1c levels (7.02% vs. 6.29%) compared to controls. ConclusionOur findings suggest that the elevated risk of PJI observed in individuals with diabetes subsequent to TAA may be attributed not solely to the presence of diabetes, but to inadequate glycemic control. Effectively managing blood glucose levels is imperative for achieving favorable outcomes following TAA. Level of evidenceIII

Combined Microbial Fermentation Converts Bioactive Compounds in Nitraria Tangutorum Bobrov Fruit and Displays its Antidiabetic Potential

Nitraria tangutorum Bobrov is a berry shrub with white flowers and red fruits, which grows in the deserts in the Tibetan Plateau, Mongolia, and western China. Its fruit N. tangutorum Fruit (NTF) contains various bioactive compounds, with anti-fatigue, anti-inflammatory, and neuroprotective functions. However, the high saccharide content of NTF makes it unsuitable for diabetic patients. In this study, we fermented NTF to obtain N. tangutorum Fermented Juice (NTJ), and N. tangutorum Fermented Residue (NTR), which are suitable for diabetics to consume. We characterized the bioactive compounds in NTF, NTR, and NTJ, and found that fermentation increased the diversity of bioactive compounds, and greatly reduced sucrose, glucose, and fructose content while generating trehalose, which has the potential to manage blood glucose levels. Further, NTJ displays anti-diabetic potential due to various compounds anti-diabetic properties. This study provides a basis for further clinical research on NTJ’s anti-diabetic function in humans.

Review on the Therapeutic Role of Asclepias tuberosa Seeds in Diabetes Management

Diabetes mellitus (DM) presents a significant global health challenge characterized by elevated blood glucose levels, leading to debilitating complications. Despite various therapeutic approaches, effective glucose regulation remains elusive, often accompanied by adverse effects from current medications. Medicinal plants, including Asclepias tuberosa, have shown promise in managing blood glucose levels with fewer side effects. This review highlights the potential of Asclepias tuberosa as herbal antidiabetic agents based on recent literature, suggesting avenues for further research and therapeutic development in DM management. Considering the urgent need for safer and more effective antidiabetic treatments, exploring the therapeutic potential of Asclepias tuberosa presents a promising avenue for addressing this growing public health concern. Future studies should focus on elucidating the mechanisms of action, conducting clinical trials to validate the efficacy and safety of Centaurea-based interventions in DM management, and exploring synergistic effects with existing therapies.
 Furthermore, within the context of utilizing plant materials for the treatment of Diabetes mellitus, particular attention is directed towards the utilization of Asclepias tuberosa seeds. Asclepias tuberosa, commonly known as butterfly weed or pleurisy root, is a medicinal plant native to North America. Traditionally, various parts of this plant, including the roots, leaves, and seeds, have been used in folk medicine for their purported therapeutic effects
 Keywords: Diabetes mellitus, Asclepias tuberosa, antidiabetic agents, herbal remedies, blood glucose regulation.

Giant Parotid Abscess With Significant Skin Necrosis: A Case Report.

Poor blood glucose control is a common predisposing factor for parotid abscesses; however, extensive skin necrosis secondary to parotid abscesses has rarely been reported. In this article, we present the case of a 70-year-old man with poor glycemic control admitted to our hospital with swelling, congestion, and pain in the right parotid region that had gradually increased over 15 days prior to presentation. Based on the clinical, imaging, and laboratory findings, the patient was diagnosed with a giant parotid abscess with extensive skin necrosis caused by Klebsiella pneumoniae. The abscess responded poorly to long-term treatment with intravenous broad-spectrum antibiotics, and the patient underwent daily Bacillus exchange with blood glucose level management and electrolyte monitoring via routine blood tests. At the 3 month follow-up, complete resolution of the right parotid gland abscess and skin rupture was observed.

Diabetic Gastroparesis: Navigating Pathophysiology and Nutritional Interventions

Diabetic gastroparesis (DGP) delays gastric emptying in diabetes patients, notably impacting those with type 1 and long-standing type 2 diabetes. Symptoms include early satiety, fullness, appetite loss, bloating, abdominal pain, and vomiting, arising from slow stomach-to-intestine food movement. DGP’s unpredictable nature complicates diagnosis and blood glucose management, leading to severe complications like dehydration, malnutrition, and bezoar formation. Understanding DGP’s mechanisms is crucial for effective management. Vagal dysfunction, disturbances in the interstitial cells of Cajal, reduced neural nitric oxide synthase, and increased oxidative stress contribute to the complex pathophysiology. Accurate diagnosis demands a comprehensive approach, utilizing tools like gastric scintigraphy and the Gastric Emptying Breath Test. Considering the complex relationship between DGP and glycemia, managing blood glucose levels becomes paramount. Nutritional interventions, tailored to each patient, address malnutrition risks, emphasizing smaller, more frequent meals and liquid consistency. DGP’s complex nature necessitates collaborative efforts for enhanced diagnostic strategies, improved pathophysiological understanding, and compassionate management approaches. This comprehensive approach offers hope for a future where individuals with DGP can experience improved well-being and quality of life.

A New Hope on the Horizon for Kidney and Cardiovascular Protection with SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Mineralocorticoid Receptor Antagonists in Type 2 Diabetic and Chronic Kidney Disease Patients.

Type 2 diabetes (T2D) is the leading cause of chronic kidney disease (CKD). In addition, the cardiovascular prevalence in diabetic patients is around 32.2%, with a two-fold increased mortality risk compared to those without diabetes. Recent investigations have shed light on the promising cardioprotective and nephroprotective benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and nonsteroidal mineralocorticoid receptor antagonists (nsMRAs) for individuals with T2D. The evidence robustly indicates that SGLT2i and GLP-1RA significantly reduce the risk of CKD and cardiovascular disease (CVD), all while effectively managing blood glucose levels. Furthermore, combining SGLT2i with nsMRAs amplifies the benefits, potentially offering a more profound reduction in cardiovascular and renal outcomes. The data analysis strongly supports the integration of these pharmacological agents in the management strategies for CKD and CVD prevention among T2D patients, highlighting the importance of awareness among nephrologists, especially in regions with limited healthcare resources.

Unraveling the Therapeutic Potential of Muscle Strengthening Exercises for Reversing Diabetes Mellitus.

Millions of people worldwide are affected by the serious consequences of diabetes mellitus, which is a major global health concern. We analyze the possibility of muscle- strengthening activities as an appropriate therapeutic strategy for controlling the progression of diabetes mellitus in this comprehensive review. In this review, we explore the molecular processes underlying the glucose uptake in skeletal muscle, revealing how exercise can improve insulin sensitivity and glucose homeostasis. Articles published between 2010 and 2023 were analyzed in detail by using bibliographic databases like PubMed, Medline, and Scopus. The most commonly searched terms were "muscle strengthening exercises," "diabetes mellitus," "insulin resistance," "glucose uptake," "skeletal muscle," and even "exercise therapy." The inclusion criteria were randomized controlled trials, observational studies, and systematic reviews. This allowed for the selection of sources that were related to the topic at hand and were reliable. This review highlights the benefits of exercise for diabetes mellitus, elucidating the positive effects of acute and regular exercise on glucose uptake in skeletal muscle. It also analyzes the impact of various exercise modalities, including aerobic and resistance exercises, on glucose metabolism in individuals with and without type 2 diabetes. Furthermore, this review examines the effectiveness of combining aerobic and resistance training for optimal diabetes management. Our analysis reveals promising evidence supporting the role of resistance training in diabetes mellitus reversal. Regular resistance exercise has been shown to improve glycemic control, insulin sensitivity, and muscle function in individuals with type 2 diabetes. Combining aerobic and resistance exercises appears to be more effective than single-mode training in managing blood glucose levels and enhancing overall metabolic health. However, Resistance training implementation challenges, as well as potential exercise contraindications in diabetic patients, warrant further studies.

QSAR of Oxazinanone Derivatives As 11-Β Hydroxysteroid Dehydrogenase Type 1 Inhibitor A Potent Anti Diabetic Agent

11-β hydroxysteroid dehydrogenase type 1 is a key enzyme accountable for the interconversion of physiologically inert cortisone to active cortisol thus presents an effective target for the development of pharmacologically active anti diabetic agents focused on manage blood glucose levels, improve insulin sensitivity. The 11β-HSD1 facilitates intracellular cortisol construction that have a disease-causing role in type 2 diabetes and the co-morbidities that it causes. Drugs in habiting the enzyme 11 β-HSD1 offers a potential therapy to lessen the type 2 diabetes. Oxazinanone ring has shown activities as antitumor, antihypertensive, antibacterial, anti-inflammatory, antioxidant and many more. Oxazinanone ring have emerged as potent inhibitors of 11β-HSD1 enzyme. QSAR of Oxazinanone derivatives is performed with a goal of elucidating the key characteristics that cause their anti-diabetic action. QSAR is the most widespread method to ligand-based drug design. It is supposed that structures of the molecules are directly proportional with biological activities, and thus, the biological activities can be altered with any structural changes. The process involves computational or mathematical models to find important correlations between a series of structures and functions. Step wise partial least square, multiple linear regressions, and feed forward neural network were used in a QSAR investigation on enzyme (IC50 nM). The developed models were cross confirmed by the ‘‘leave one out’’ method. The model reveals the significance of steric parameter Verloop B1 (Substitution 1) and Total lipole molecular descriptor.Total lipole bear a resemblance to lipophilicity which is a ratio of the capability of molecules to transfer between oily partition and aqueous partition. These descriptors will have an impact on the design and expansion of novel anti-diabetic 11-hydroxysteroid dehydrogenase type 1 inhibitors.

Impact of Adropin, Adiponectin, and Insulin Variations in Type 2 Diabetes

Background: Diabetes Mellitus is a chronic condition impacting biological fitness and overall health, with projections indicating a significant rise in cases globally. This study investigates the levels of adropin and adiponectin hormones in patients with Type 2 Diabetes Mellitus (T2DM) in Iraq, aiming to elucidate their potential roles in the disease's pathophysiology. Methods: Ninety blood samples were collected from 50 T2DM patients (25 females, 25 males) and 40 healthy individuals (20 females, 20 males) in Kirkuk between October 2023 and January 2024. Hormone levels were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Samples were categorized based on gender, age, and body mass index (BMI). Results: Adropin levels were significantly lower in T2DM patients (1369 ± 76.8 ng/ml) compared to healthy controls (1606 ± 42.5 ng/ml), with male patients showing a more pronounced decrease than females. In contrast, no significant difference was observed in adiponectin levels between diabetic patients (179.4 ± 28.9 mg/L) and controls (182.0 ± 38.6 mg/L). Additionally, age did not significantly affect adropin levels, while adiponectin levels were consistent across genders and age groups in both diabetic and control participants. Conclusion: The study indicates a significant reduction in adropin levels among T2DM patients, suggesting its potential role in diabetes pathophysiology, irrespective of age. Adiponectin levels remained unaffected by diabetes status, gender, or age, indicating a complex relationship that warrants further investigation. These findings emphasize the importance of managing blood glucose levels and highlight the need for further research into the mechanisms linking adropin with metabolic processes in T2DM.

Hyperglycemia as a Risk Factor for Cardiovascular Disease Post- Acute Sequelae of SARS-CoV-2 Infection

The ongoing COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has led to a surge in research examining its long-term health consequences. Among these sequelae, cardiovascular complications have emerged as significant concerns, particularly in individuals with pre-existing or post-infection hyperglycemia. This review aims to explore the association between hyperglycemia and cardiovascular disease (CVD) in the post-acute phase of SARS-CoV-2 infection. A systematic search of electronic databases including PubMed, Embase, and Google Scholar was conducted to identify relevant studies published between January 2020 and March 2024. Keywords included "hyperglycemia," "cardiovascular disease," "SARS-CoV-2," "COVID-19," "post-acute sequelae," and variations thereof. Studies focusing on the association between hyperglycemia and CVD in the context of post-acute SARS-CoV-2 infection were included. Hyperglycemia, both pre-existing and as a consequence of SARS-CoV-2 infection, has been linked to an increased risk of cardiovascular complications in the post-acute phase. Mechanistically, hyperglycemia contributes to endothelial dysfunction, oxidative stress, inflammation, and dyslipidemia, all of which are implicated in the pathogenesis of CVD. Moreover, SARS-CoV-2 infection exacerbates these pathways, further predisposing individuals to CVD. The association between hyperglycemia and CVD in the post-acute phase of SARS-CoV-2 infection underscores the importance of glycemic control in mitigating long-term cardiovascular complications. Healthcare providers should prioritize screening for hyperglycemia in COVID-19 survivors and implement interventions aimed at managing blood glucose levels to reduce the burden of CVD in this population. Future research should focus on elucidating the underlying mechanisms linking hyperglycemia and CVD post-SARS-CoV-2 infection and evaluating the efficacy of targeted interventions in preventing cardiovascular sequelae.

Physical activity/exercise and diabetes: a review statement of the American Diabetes Association

Ensuring regular physical exercise is crucial for managing blood glucose levels and promoting overall health in those with diabetes and prediabetes. Recommendations and precautions differ based on individual attributes and health conditions. This article aimed to provide a comprehensive assessment and evidence-based guidelines on physical activity and exercise for diabetic patients. An electronic literature search was conducted in the MEDLINE database using the specified search keywords: Physical, Activity, Exercise, Diabetes, Statement, and American Diabetes Association. The search was limited to publications between 2014 and 2024 to identify relevant material. Relevant search terms were utilized on Google Scholar to locate and explore relevant scholarly articles. The selection of papers was guided by certain inclusion criteria. The study was organized into several sections with particular headers in the discussion. It is advisable to suggest and prescribe physical activity and exercise to all patients with diabetes as a means of managing glucose control and promoting overall health. The advice and precautions for managing diabetes depend on factors such as the specific type of diabetes, age, level of physical activity, and any existing diabetes-related health issues. Recommendations should be customized to address the unique requirements of each individual. All adults should be encouraged to not only participate in regular physical exercise but also to reduce the overall amount of time spent being sedentary each day. It is important to interrupt prolonged periods of sitting with frequent intervals of physical activity. Ultimately, behavior- change tactics might be employed to encourage the acceptance and continuation of lifelong physical exercise.

Effect of the family-centered program on management of blood glucose levels among children with type 1 diabetes at Tabuk

Background. Diabetes mellitus (DM) is the second most common chronic disease in childhood. Diabetes care is multidimensional and should focus on preventing acute complications and reducing long-term consequences. A family-centered approach conserves the integrity of families and supports unique care for diabetic children. Purpose. The study aimed to determine the effect of a family-centered program on the management of blood glucose levels in children with type 1 diabetes mellitus at Tabuk. Methods. The researcher employed a quasi-experimental design to conduct this study. A purposive sample of diabetic children and their families was included. Tools included a structured questionnaire (sociodemographic data, anthropometric measurements), Supervisory Behaviors of Caregivers, Management Behaviors of Children with DM questionnaires, a Self-efficacy Scale, and a Blood Glucose Levels Record Sheet. The study was conducted in three phases: preparatory, performance, and evaluation. Pre-test and post-test methods were utilized for data collection. Results. There was a significant decrease in the mean scores of blood glucose levels, significant improvement in children’s management behavior for diabetic care, improvement in mothers’ supervisory behavior of management behavior for DM, and higher mean scores of mothers’ self-efficacy post compared to pre-family centered program. Conclusion. Implementing the family-centered program improved children’s diabetic management behavior and hence controlling the blood glucose levels of children with diabetes mellitus and increased mothers’ self-efficacy. Recommendation. Transformation of diabetic management in children with DM to a fully family-centered system of care should be established.

Effect of transitional nursing care on quality of life among patients with type 2 diabetes: A meta-analysis of randomized controlled trials

Background & Aims: Type 2 diabetes accounts for 95% of all diabetes cases worldwide, and its prevalence continues to rise. The constant management of blood glucose levels can be burdensome, further deteriorating patients' quality of life. This study aims to determine the effect of transitional nursing care on the quality of life among adults with type 2 diabetes.
 Methods & Materials: We conducted a meta-analysis of randomized controlled trials (RCTs) to determine the effectiveness of transitional nursing care on the quality of life of adults with type 2 diabetes. We searched for published Randomized Controlled Trials (RCTs) on PubMed, Embase, CINAHL, and the Cochrane Library. The process of study selection spanned from March 2023 to April 2023. Data synthesis was performed using Review Manager 5.4 to generate pooled effect size estimates.
 Results: A total of six studies were included in our analysis. Our results showed that transitional care significantly improved the quality of life of adults with type 2 diabetes (SMD= 0.55, 95% CI: 0.15, 0.95, Z= 2.72, p= 0.007). Compared to usual care, transitional care also significantly lowered HbA1c levels (MD= -0.39, 95% CI: -0.70, -0.07, Z= 2.41, p= 0.02).
 Conclusion: Our research identified that transitional nursing care significantly improved the quality of life among adults with type 2 diabetes. Nurses should take into account our positive findings when implementing this care model for these patients. We suggest that future researchers carry out more studies with a focus on transitional nursing care for patients with type 2 diabetes to investigate its impacts further.

The relationship between spiritual intelligence and self-management in patients with diabetes type 1

BackgroundDiabetes is widely recognized as one of the most pressing public health concerns globally. To manage blood glucose levels and reduce subsequent complications and mortality rates, self-management mechanisms have been found to be effective in controlling diabetes. This study aimed to investigate the association between spiritual intelligence and diabetes self-management in patients with type 1 diabetes in Qazvin, Iran.MethodsThis cross-sectional study included 220 adults with type 1 diabetes aged 18–35 years who referred to an outpatient diabetes clinic of a tertiary hospital in Qazvin province, and were selected through a convenience sampling method in 2022. Two valid and reliable questionnaires were used for data collection, including the 24-item questionnaire of spiritual intelligence and self-management of type 1 diabetes for adolescents (SMOD-A). To analyze the data, correlation coefficients and multiple linear regression analysis were used.ResultsThe total score of spiritual intelligence was 57.24 ± 10.77, and self-management was 77.14 ± 8.92. Among different subscales of spiritual intelligence, critical thinking obtained the highest score. In self-management, the highest score was achieved for communication.Findings also revealed that spiritual intelligence could predict 7.2% of changes in self-management among diabetes patients, and its relationship with diabetes self-management was estimated at 0.27.ConclusionThe growing prevalence of diabetes worldwide underscores the significance of self-management of the disease in the well-being of patients. This study demonstrated that spiritual intelligence played a crucial role among young adults with diabetes and assisted them in coping with stressful situations. As such, placing greater emphasis on the spiritual aspects of care is necessary, especially in the healthcare of young adults who are dealing with diabetes and its complex conditions.

Predictive calculator of the risk of perinatal complications in women with pregestational diabetes mellitus

Background. The prevalence of impaired carbohydrate metabolism among women of reproductive age is increasing worldwide. Despite tremendous progress in the treatment and management of blood glucose levels, pregnancy in women with pregestational diabetes still carries risks for the fetus.
 This study aims to develop a calculator for predicting perinatal complications in women with pregestational diabetes mellitus by mathematical modeling.
 Materials and Methods. This observational analytical study with a case-control design was conducted at the Altai Regional Clinical Perinatal Center DAR (Barnaul). The study included 147 women, with the main group comprising 95 pregnant women, including 47 with type 1 diabetes mellitus (group 1A) and 48 with type 2 diabetes mellitus (group 1B). No carbohydrate metabolism disorders were detected in 52 patients of the control group. All patients in the main group received insulin therapy. Medical documentation was analyzed, and statistical processing of the data was performed using mathematical modeling methods with appropriate software.
 Results. In order to predict the combined indicator of perinatal complications, logistic regression analysis was used to calculate coefficients (b) for each of the indicators that have the most significant influence on the formation of complications.
 The calculated values of regression coefficients can be utilized to predict the risk of perinatal complications in women with type 1 diabetes mellitus. For more practical use, a calculator for assessing the risk of perinatal complications in type 1 and type 2 diabetes mellitus was created using a computer program.
 Diagnostic evaluation of the prognostic scale (calculator) for assessing perinatal complications risk assessment in type 2 diabetes mellitus demonstrated a sensitivity of 97.6%, specificity of 87.5%, and a prognostic value of positive risk assessment of 97.5%. Therefore, the calculator enables the prediction of the risk of perinatal complications in 97.5% of cases. At the same time, the prognostic scale of perinatal complications risk and the Perinatal Complications Risk Calculator for type 1 diabetes mellitus created on its basis showed 100% sensitivity and specificity.
 Conclusion. The frequency of perinatal complications remains high, so the creation of a sufficiently effective prognostic model will make it possible to predict perinatal complications and influence the tactics of management of pregnant women and their newborns.

A causal relationship between diabetes mellitus and depression

In today’s modern world depression has become a common stress factor among both men and women irrespective of age. But to be specific, it has been found that there is a strong relationship between diabetes and depression. The rate of this relationship seems to be higher and much literature suggests us the numbers could be increasing in the future. Depression in diabetes may arise due to some factors such as comorbidities, improper management of blood glucose level, patient’s financial status in managing the conditions can precipitate depression. Other physiological factors like the increased sympathetic nervous system, HPA-axis, and increased cortisol in the brain can contribute to the development of diabetes and depression. This comorbid condition of depression and diabetes decreases the quality of life. On the other hand, people with depression have a high incidence of developing diabetes. Depression has been a significant risk factor in developing diabetes, especially T2DM. Several neuroendocrine and neurotransmitter disorders are found along with depression and diabetes this closely relates and explains the relationship between the two conditions. Insulin resistance a specific risk factor was found to correlate depression and diabetes. Antidiabetic drug, thiazolidinedione was found to lessen the effect of both depressive disorder and insulin resistance in individuals experiencing diabetes and depression.

The association between blood sugar control and hearing impairment in individuals with type 2 diabetes mellitus: a prospective study using otoacoustic emissions as a biomarker

Background: The existing association between hearing impairment and diabetes mellitus (DM) prompted us to investigate the relationship between glycaemic control, as measured by HbA1c levels, and hearing impairment in individuals with type 2 diabetes mellitus (T2DM). Methods: In this study, we assessed the auditory function of a sample of 100 individuals diagnosed with T2DM, who were aged 30 years or older and had a disease duration of at least 5 years. The evaluation was conducted using distortion product otoacoustic emissions and transient evoked otoacoustic emissions. The criteria for poor glycaemic control were established as HbA1c levels equal to or exceeding 7.5%. Results: Individuals with a haemoglobin A1c (HbA1c) level of 7.5% or higher exhibited a nearly threefold increased likelihood of developing hearing impairment in comparison to those with lower HbA1c levels. The gender-based observation revealed a stronger association in females, although the observed correlation did not reach statistical significance. Conclusions: The findings of our study establish a significant association between inadequate management of blood glucose levels and the occurrence of hearing impairment among individuals with T2DM. These results underscore the importance of achieving optimal glycaemic control as a means of preventing hearing impairment in this patient population. Further investigation is required to substantiate these findings through a comprehensive and longitudinal research approach.