Non Diabetes Mellitus Research Articles

Continuous peri-operative glucose monitoring in noncardiac surgery

BACKGROUND Glucose management is an important component of peri-operative care. The usefulness of continuous glucose monitoring (CGM) in noncardiac surgery is uncertain. OBJECTIVE To systematically assess the glycaemic profile and clinical outcome of patients equipped with a CGM device during the peri-operative period in noncardiac surgery. DESIGN Systematic review. DATA SOURCES Electronic databases were systematically searched up to July 2024. ELIGIBILITY CRITERIA Any studies performed in the peri-operative setting using a CGM device were included. Closed-loop systems also administering insulin were excluded. Analyses were stratified according to diabetes mellitus status and covered intra-operative and postoperative data. Outcomes included glycaemic profile (normal range 3.9 to 10.0 mmol l−1), complications, adverse events, and device dysfunction. RESULTS Twenty-six studies (1016 patients) were included. Twenty-four studies were not randomised, and six used a control arm for comparison. In bariatric surgery, diabetes mellitus patients had a mean ± SD glucose of 5.6 ± 0.5 mmol l−1, with 15.4 ± 8.6% time below range, 75.3 ± 5.5% in range and 9.6 ± 6.7% above range. During major surgery, diabetes mellitus patients showed a mean glucose of 9.6 ± 1.1 mmol l−1, with 9.5 ± 9.1% of time below range, 56.3 ± 13.5% in range and 30.6 ± 13.9% above range. In comparison, nondiabetes mellitus patients had a mean glucose of 6.4 ± 0.6 mmol l−1, with 6.7 ± 8.4% time below range, 84.6 ± 15.5% in range and 11.2 ± 4.9% above range. Peri-operative complications were reported in only one comparative study and were similar in CGM and control groups. Device-related adverse events were rare and underreported. In 9.21% of cases, the devices experienced dysfunctions such as accidental removal and issues with sensors or readers. CONCLUSION Due to the limited number of controlled studies, the impact of CGM on postoperative glycaemic control and complications compared with point-of-care testing remains unknown. Variability in postoperative glycaemic profiles and a device dysfunction rate of 1 in 10 suggest CGM should be investigated in a targeted surgical group.

The relationship between daily blood glucose fluctuation and readmission in patients with acute coronary syndrome

Abstract Background Although the comprehensive diagnos and treatment of patients with acute coronary syndrome(ACS) has been greatly improved,the morbidity and mortality are still high. Previous literature has reported that about 70-75% of patients diagnosed with acute coronary syndrome have abnormal blood glucose metabolism1,and there existed gender differences. At present, most research results showed that elevated blood glucose is related to the prognosis of ACS. However, further intervention studies indicated that simply strengthen the reducement of blood glucose did not improve prognosis of these patients2. Glucose fluctuations, another dimension of blood glucose, reflect acute changes in blood glucose. However, there are few studies on the effect of blood glucose fluctuation on the prognosis of patients with ACS. Purpose This study aimed to explore the relationship between seven daily fluctuations of blood glucose and readmission in ACS patients. Methods In this study, a total of 664 patients admitted to our University from January 1, 2019 to December 31, 2019 were included and their blood glucose was monitored seven times a day during their hospitalization. The coefficient of variation of blood glucose (CV) was calculated from the results of seven daily blood glucose monitoring to represent the daily fluctuation of blood glucose. Univariate and multivariate regression analyses were performed to determine whether CV was an independent risk factor for re-hospitalization. In addition, the area under the curve (AUC) was used to evaluate the predictive efficacy of CV for outcome events. Finally, we performed a subgroup analysis based on gender and diabetes status to assess the association between CV and readmission in each subgroup. Results After a median follow-up of 21 months, the rate of readmission was 38.4%. Unstable angina pectoris (71.4%) and heart failure (16.4%) were the most common reasons for readmission. Patients with greater CV levels typically exhibited lower fasting blood glucose, higher post breakfast blood glucose, and higher admission blood glucose.The readmission rate increased with the increasing blood glucose variability after the cox regression analysis. Moreover, independent of glycated hemoglobin,CV could predict the risk of readmission in patients with ACS.When using 26.66% as the cutoff point of CV, the study population was divided into two groups and showed a significant differentiation for rehospitalization.In subgroup analysis, there was no significant association between seven daily blood glucose fluctuations and readmission in female and non-diabetes mellitus patients with acute coronary syndrome. Conclusions Besides some normal blood glucose index,seven daily fluctuations of blood glucose was associated with readmission in ACS patients. ACS patients who were male and combined with diabetes were more likely to be readmitted if their CV levels were greater.

Morphological Differences in the Abdominal Aorta Between Subjects With and Without Type 2 Diabetes.

Aim Chronic hyperglycemia is a well-known risk factor for the development of many macrovascular complications, but hyperglycemia may be reportedly protective against abdominal aneurysms. Materials and methods In this study, we evaluated morphological differences in the abdominal aorta between subjects with and without type 2 diabetes mellitus (T2DM) without abdominal aortic aneurysm and evaluated the correlation between imaging findings of computed tomography (CT) and diabetes-related parameters. Results The abdominal aortic diameter was significantly smaller in subjects with T2DM compared to non-diabetes mellitus (NDM) subjects (p=0.026). Abdominal aortic wall thickness assessed by contrast-enhanced CT was significantly greater in subjects with T2DM compared to NDM subjects (p=0.011). There was a significant single correlation between abdominal aortic diameter and age, gender, Brinkman index, HbA1c, and mean/max intima-media thickness (IMT). Multiple regression analysis showed that HbA1c was an independent negative factor affecting abdominal aortic diameter (t=-3.28, p=0.0036). And Brinkmann index was an independent factor affecting aortic wall thickness (t=2.23, p=0.034). Conclusion This study revealed the imaging characteristics of smaller abdominal aortic diameter and larger wall thickness in T2DM subjects compared to NDM subjects. The abdominal aortic wall thickening was significantly correlated with cervical IMT. Therefore, close examination for other diabetes-related macrovascular complications should be aggressively considered when these findings are present.

Left Ventricular Wall Motion as an Additional Valuable Parameter in Diabetic Patients with Normal Myocardial Perfusion Imaging.

Gated SPECT is an established technique for assessment of left ventricular function in cardiovascular disease patients. However, there is little information about the influence of diabetes mellitus on gated SPECT parameters. This study was established to assess gated SPECT parameters in Diabetes Mellitus (DM) and non-diabetes mellitus (non-DM) patients with normal Myocardial Perfusion Imaging (MPI). In this analytical cross-sectional study, 314 patients (157 DM, 157 non-DM) with normal MPI were enrolled. Prevalence of risk factors for CAD like hypertension (HTN), and dyslipidemia were found to be significantly higher (p <0.01) in DM patients compared to non-DM. No statistically significant difference was observed among the TID, ESV, EDV, PFR, TTPF, and Wall Thickness (WT) parameters between DM and non-DM patients. Wall motion (Wm) in DM patients was significantly higher compared to non-DM patients. (3.9 ± 0.51 vs. 2.69 ± 0.48 for DM and non-DM patients, respectively, p-value:0.01). Also, there was no significant difference in Wm in the two groups with and without HTN. This shows the independent effect of DM on the Wm. This study believes that the Wm parameter should be noted for the early diagnosis or prevention of heart disease in DM patients. These findings can indicate the gradual changes in the movements of the left ventricle and the beginning of the progression of diabetic cardiomyopathy.

The Relationship between Seropositive Rheumatoid Arthritis and Congestive Heart Failure: A Nationwide Longitudinal Cohort Study in Korea.

Objectives: The aim of this nationwide longitudinal cohort study is to determine the risk of congestive heart failure (CHF) associated with a seropositive rheumatoid arthritis (RA) population in Korea. Methods: In this study, National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) data from 2002 to 2003 were used. The cohort was followed up with for 12 years until December of 2015. Seropositive RA was defined as a patient prescribed with a disease-modifying anti-rheumatic drug (DMARD) among patients with the International Classification of Diseases code M05 (seropositive RA). Patients who were diagnosed before 2004 were excluded. The seropositive RA group consisted of 2765 patients, and a total of 13,825 patients were in the control group. The Kaplan-Meier method was used to calculate the 12-year CHF incidence rate for each group. A Cox proportional hazards regression analysis was used to estimate the hazard ratio of CHF. Results: The hazard ratio of CHF in the seropositive RA group was 2.41 (95% confidence interval (CI): 1.40-4.14) after adjusting for age and sex. The adjusted hazard ratio of CHF in the seropositive RA group was 2.50 (95% CI: 1.45-4.30) after adjusting for age, sex, income, and comorbidities. In females aged ≥65 and aged <65, the incidence rates in the non-hypertension, non-diabetes mellitus, and non-dyslipidemia subgroups were significantly higher in the seropositive RA group than in the control group. Conclusions: This nationwide longitudinal cohort study shows an increased risk of CHF in patients with seropositive RA.

Evaluation of Correlation between the Level of Vitamin D and Glycosylated Hemoglobin in Type 2 Diabetic Mellitus and Nondiabetic Mellitus

Background: The pancreas contains Vitamin D (Vit.-D) and an enzyme that regulates insulin levels. Vitamin D deficiency is associated with several severe health conditions, such as cardiovascular disease, diabetes, various cancers, and multiple sclerosis (MS). Therefore, the objective of the current study is to investigate the correlation between Vitamin D levels and glycosylated hemoglobin (HbA1c) in both patients and controls. Materials and Methods: The study enrolled 163 T2DM (Group I) and 174 healthy (Group II) subjects to estimate the level of Vit.-D and HbA1c in the blood serum of all subjects, using radioimmunoassay and high-performance liquid chromatography, respectively. Results: The results revealed that Group I had a lower level of Vit.-D (17.82 ± 2.23 ng/mL) than Group II. Similarly, they have high HbA1c levels, showing significant ( P &lt; 0.001; Student’s t-test). Further, in Group I, Vit.-D levels were negatively correlated with HbA1c levels ( P &lt; 0.001; r2 = 0.07, linear regression). Group I and II combined analysis revealed an inverse relationship between Vit.-D levels and HbA1c ( P &lt; 0.001; r2 = 0.021). Conclusion: The study concluded a negative correlation between Vit.-D levels and HbA1c levels in T2DM. However, Vit.-D therapy can recover this correlation, which helps control glycemic levels.

Hyperuricemia Subtypes Classified According to Renal Uric Acid Handling Manifesting Distinct Phenotypic and Genetic Profiles in People With Gout.

Hyperuricemia can be stratified into four subtypes according to renal uric acid handling. The aim of this study was to comprehensively describe the biologic characteristics (including genetic background) of clinically defined hyperuricemia subtypes in two large geographically independent gout cohorts. Hyperuricemia subtype was defined as renal uric acid overload (ROL), renal uric acid underexcretion (RUE), combined, or renal normal. Twenty single nucleotide polymorphisms (SNPs) previously identified as gout risk loci or associated with serum urate (SU) concentration in the East Asian population were genotyped. Weighted polygenic risk scores were calculated to assess the cumulative effect of genetic risks on the subtypes. Of the 4,873 participants, 8.8% had an ROL subtype, 60.9% RUE subtype, 23.1% combined subtype, and 7.2% normal subtype. The ROL subtype was independently associated with older age at onset, lower SU, tophi, and diabetes mellitus; RUE was associated with lower body mass index (BMI) and non-diabetes mellitus; the combined subtype was associated with younger age at onset, higher BMI, SU, estimated glomerular filtration rate (eGFR), and smoking; and the normal subtype was independently associated with older age at onset, lower SU, and eGFR. Thirteen SNPs were associated with gout with 6 shared loci and subtype-dependent risk loci patterns. High polygenic risk scores were associated with ROL subtype (odds ratio [OR] = 9.63, 95% confidence interval [95% CI] 4.53-15.12), RUE subtype (OR = 2.18, 95% CI 1.57-3.03), and combined subtype (OR = 6.32, 95% CI 4.22-9.48) compared with low polygenic risk scores. Hyperuricemia subtypes classified according to renal uric acid handling have subtype-specific clinical and genetic features, suggesting subtype-unique pathophysiologic mechanisms.

An Analysis of the Frequency and Progression of COVID-19 Infection in Women with Gestational Diabetes Mellitus Compared to Non-Diabetic Mellitus Pregnant Women

An Analysis of the Frequency and Progression of COVID-19 Infection in Women with Gestational Diabetes Mellitus Compared to Non-Diabetic Mellitus Pregnant Women

High-resolution magnetic resonance imaging investigation of the connection between the triglyceride-glucose index and intracranial arterial remodeling: a retrospective cross-sectional study.

Insulin resistance (IR) is associated with atherosclerotic plaque progression and the occurrence of stroke, with the triglyceride-glucose (TyG) index serving as a surrogate indicator. The present study aimed to investigate the association between TyG index levels and intracranial arterial remodeling in patients with acute ischemic stroke (AIS). Patients with AIS who visited the Neurology Department of the Second Hospital of Hebei Medical University and underwent high-resolution magnetic resonance imaging (HR-MRI) between September 2018 and October 2021 were enrolled. A total of 123 patients were finally included in the study, with 81 excluded. The TyG index levels were measured, and the characteristics of intracranial atherosclerotic stenosis (ICAS) plaques were evaluated using HR-MRI. A logistic regression model was employed to analyze the relationship between TyG index levels and remodeling mode. Patients were divided into two groups, positive remodeling (PR) and non-positive remodeling (non-PR), based on the remodeling index (RI). Patients in the PR group had a higher TyG index than those in the non-PR group {median [interquartile range (IQR)]: 9.11 (8.82-9.51) vs. 8.72 (8.30-9.23), P<0.001}. After adjusting factors such as age and gender, the TyG index was found to be significantly correlated with intracranial arterial PR [odds ratio (OR): 3.169, 95% confidence interval (CI): 1.327-7.569, P=0.009]. In non-diabetes mellitus (DM) patients, the TyG index level in the PR group was significantly higher than that in the non-PR group (8.95±0.42 vs. 8.50±0.45, P<0.001), whereas there was no such difference in patients with DM. TyG index was correlated with intracranial vessel PR, indicating that the TyG index level may be a useful marker for predicting intracranial vessel PR.

Proteomic analysis of aqueous humor reveals novel regulators of diabetic macular edema

Diabetic macular edema (DME) is the most common cause of blindness in patients with diabetic retinopathy. To investigate the proteomic profiles of the aqueous humor (AH) of individuals with diabetic macular edema (DME), AH samples were collected from patients with non-diabetes mellitus (NDM), DM, nonproliferative diabetic retinopathy (NPDR), and DME. We performed comparative proteomic analyses using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatics analyses. We identified 425 proteins in these AH samples, of which 113 showed changes in expression in DME compared with NDM, 95 showed changes in expression in DME vs. DM, and 84 showed changes in expression in DME compared with NPDR. The bioinformatics analysis suggested that DME is closely associated with platelet degranulation, oxidative stress-related pathway, and vascular-related pathways. Upregulation of haptoglobin (HP) and downregulation of fibrillin 1 (FBN1) were validated by ELISA. Receiver operating characteristic (ROC) analysis showed that HP and FBN1 could distinguish DME from NPDR with areas under the curve of 0.987 (p = 0.00608) and 0.791 (p = 0.00629), respectively. The findings provide potential clues for further analysis of the molecular mechanisms and the development of new treatments for DME. HP and FBN1 may be potential key proteins and therapeutic targets in human DME. The proteomics dataset generated has been deposited to the ProteomeXchange/iProX Consortium with Identifier: PXD033404/IPX0004353001.

Correlation of Lipid Profile and Apolipoprotein B/A-I Ratio with Insulin Resistance in Non-Diabetes Mellitus Subjects

Obesity is defined as an increase in total body mass due to excess fat, as measured by the body mass index. Obesity affects metabolism through factors such as insulin resistance, which triggers the development of chronic diseases. Lipid and ApoB/ApoA-I ratios can be considered additional assessments, especially in patients at high risk of cardiovascular diseases such as diabetes. This study aims to determine the relationship between lipid and ApoB/ApoA-I ratios with Homa-IR in in non-diabetes mellitus adult subjects. The method used in this study was a cross-sectional study involving a total of 80 non-diabetic adult subjects, consisting of 38 male and 42 female subjects. The results showed that there were significant differences between the ratios of CHOL/HDL, TG/HDL, ApoB/ApoA-I, and HOMA-IR in non-obese and obese non-DM adult subjects (4.64 ± 2.18 vs 5.23 ± 1.87, p = 0.045; 2.38 ± 1.20 vs. 3.18±1.77, p=0.013;0.58±0.17 vs. 0.66±0.17, p=0.035 and 1.47±0.80 vs. 3.34±4.37, p = 0.000), and there was no significant difference between LDL/HDL (p = 0.117). The correlation test results between the ratios of CHOL/HDL to HOMA-IR, LDL/HDL to HOMA-IR, TG/HDL to HOMA-IR, and ApoB/ApoA-I to HOMA-IR in non-DM adult subjects (p=0.05, r=0.308; p=0.037, r=0.233; p=0.000, r=0.402; p=0.19, r=0.261). This study concluded that there was a significant correlation between lipid and ApoB/ApoA-I ratios with Homa-IR in non-diabetes mellitus adult subjects.

Longitudinal Associations of Dietary Fiber Intake with Glycated Hemoglobin and Estimated Insulin Sensitivity in Adults with and without Type 1 Diabetes.

Dietary fiber, an essential bioactive compound in plant-based diets, is of public health concern based on habitual low intakes in the general population. Not much data are available on how habitual dietary fiber is associated with glycemic control in type 1 diabetes (T1D) as well as in prediabetes and normoglycemic adults. To address this gap, we conducted a six-year longitudinal analysis of an original cohort in adults with and without T1D (n = 1255; T1D: n = 563; non-diabetes mellitus (non-DM): n = 692). Dietary data were collected from a validated food frequency questionnaire, biochemical measures were obtained after an overnight fast, and anthropometric measurements were collected at baseline as well as after three and six years for the follow-up study. Glycated hemoglobin (HbA1c) and estimated insulin sensitivity (eIS) were the main outcomes examined. In adjusted analyses, dietary fiber intake was inversely associated with HbA1c in a minimally adjusted model, but it was positively associated with eIS in a model involving all relevant covariates in non-DM adults. These associations were not significant in the T1D group. Furthermore, when examined by HbA1c cut-offs for glycemic control, an inverse association with dietary fiber was only observed in adults with prediabetes (all p < 0.05). At a six-year mean (±SD) dietary fiber intake of 17.4 ± 8.8 g for non-DM and 17.0 ± 8.2 g for the T1D group, protective associations against poor glycemic control were observed in those without diabetes and in prediabetes.

Analysis of the Factors of Wound Healing Problems After Transtibial Amputation in Diabetic Patients.

Diabetes mellitus has a global impact, necessitating surgical intervention when conservative methods fail. Transtibial amputation (TTA) is commonly performed on diabetic patients, yet surgical site complications can lead to more procedures. This study aimed to identify factors linked to wound healing issues post-TTA in diabetics.A total of 181 patients who underwent TTA between 2004 and 2021 at a single hospital were included in the study. Exclusion criteria comprised trauma, non-diabetic mellitus, follow-up duration of less than 1 year, incomplete medical records, and surgeries performed by different surgeons. The comparison focused on underlying diseases other than diabetes between the group with wound problems and the group without. Additionally, factors impacting blood flow, such as presurgery hemoglobin levels, intraoperative blood transfusion, the use of antithrombotic or anticoagulant drugs, and the presence of procedures like percutaneous transluminal angioplasty (PTA) and bypass surgery, were analyzed.Among the 181 cases, 22.1% experienced problems at the surgical site while 77.9% did not. Statistical analysis revealed that age was a significant variable affecting wound healing problems after TTA in diabetic patients (p = .007). However, there were no significant differences in wound problems based on comorbidities other than diabetes (p = .209), gender (p = .677), preoperative anemia (p = .102), intraoperative blood transfusion (p = .633), the use of antithrombotic or anticoagulant medications (p = .556), and the performance of PTA or bypass surgery (p = .6).In conclusion, this study found that age was a significant variable affecting wound healing problems after TTA in diabetic patients. Although no association was observed between underlying diseases and wound healing problems, further investigation and cautious management of factors such as preoperative anemia, intraoperative blood transfusion, the use of antithrombotic or anticoagulant drugs, and the performance of PTA or bypass surgery are warranted to prevent complications and optimize wound healing outcomes in diabetic patients undergoing TTA.

Comparison of Sputum Evaluation Conversion of Pulmonary TB patients with DM and non-DM in High Burden Setting

ABSTRACT&#x0D; Background&#x0D; Tuberculosis (TB) remains a global health problem and is one of the leading causes of death worldwide. By 2022, an estimated 10 million people will suffer from TB worldwide. Based on data from the Global Tuberculosis Report in 2022, Indonesia ranks second as a high-burden country in the world after India. An estimated 1.5 million people die from tuberculosis, becoming the 13th leading cause of death worldwide and the second most deadly infectious disease after COVID-19.&#x0D; Currently, many new cases of TB are influenced by several risk factors, one of which is Diabetes Mellitus (DM). Pulmonary TB is a potential opportunistic infection for people with Diabetes Mellitus. TB patients with DM are at risk of sputum conversion failure after TB treatment, 1.69 times higher risk of treatment failure, 1.24 times higher risk of anti-TB drug resistance, 3.89 times higher risk of relapse, and 4.95 times higher risk of death during treatment compared to TB patients.&#x0D; Aim of Study&#x0D; To evaluate the sputum smear conversion results at the end of the second month of treatment of patients with Tuberculosis with Diabetes Mellitus (TB-DM) and Tuberculosis Non-Diabetes Mellitus (TB-NDM).&#x0D; Methods&#x0D; This research was analytical with a retrospective cohort design by taking secondary data from the Tuberculosis Information System (SITB). The data were recorded in SITB and registered as TB patients undergoing Anti-Tuberculosis Drug treatment and screening for Diabetes Mellitus in all districts in West Nusa Tenggara Province in 2022.&#x0D; Results&#x0D; Among 200 patients with TB in this study, male patients dominated 62% of TB patients. TB patients are mostly found in the age group 46-55 years with 28,5%. Generally, TB patients come from Mataram, with an 18% percentage. Most TB patients were diagnosed using GeneXpert (80,5%). The sputum conversion rate at the end intensive phase in TB-DM patients reached 95%, while in TB-NDM patients, only 85%. The comparative test showed a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM (p-value: 0.018, p&lt;0.05).&#x0D; Conclusion &#x0D; There is a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM.&#x0D; &#x0D; Keywords : Diabetes, diabetes mellitus, sputum conversion, tuberculosis, TB, DM

Persistent Helicobacter pylori infection leads to elevated fasting plasma glucose level: A retrospective cohort study based on a nondiabetes Chinese population.

The relationship between Helicobacter pylori (H. pylori) and fast plasma glucose (FPG) on nondiabetes populations is still inconclusive. Nowadays, not only the high infection rate of H. pylori but also the high FPG level is threatening the Chinese people. A retrospective cohort study has been established to analyze the relationship between H. pylori infection and FPG level, 18164 individuals performed healthy examination in Taizhou Hospital Health Examination Center from 2017 to 2022 were included, and hematological indicators, body parameters, and H. pylori detection by 13 C-urea breath test were collected from patients. The follow-up intervals were greater than 12months. H. pylori infection was regarded as an independent risk factor for elevated FPG after multivariate logistic regression. Additionally, the average interval time were 33.6±13.3months. Mean changed FPG values in the persistent infection group were higher than in the subgroup of persistent negative (P=0.029) as well as eradication infection (P=0.007). The aforementioned changes began to appear after 2years of follow-up. Similarly, when compared with the subgroup of persistent infection, mean changed triglyceride/high density lipoprotein (TG/HDL) values were much lower in the subgroup of persistent negative (P=0.008) and eradication infection (P=0.018), but the differences appeared after 3years of follow-up. H. pylori infection is an independent risk factor for elevated FPG in non-diabetes mellitus (DM) individuals. Persistent H. pylori infection causes an increase in FPG level and TG/HDL, which may be a risk factor for diabetes mellitus.

Differential effect of ramadan fasting on intercellular adhesion molecule-1 (ICAM-1) in diabetes mellitus and non-diabetes mellitus patients

BackgroundThe month of Ramadan is a holy month for Muslims. During this month, Muslims do not eat, drink, or smoke from sunrise to sunset. Patients with type 2 diabetes mellitus (T2DM) will also fast from dawn to dusk, creating a unique opportunity to study the effects of dietary changes during fasting period. One of the interesting results of Ramadan fasting is its effect on endothelial dysfunction, measured using Intercellular Adhesion Molecule-1 (ICAM-1) as a biological marker of endothelial function. AimTo determine the changes ICAM-1 levels in T2DM and non-DM patients during Ramadan fasting. MethodsA retrospective cohort study was performed on 26 T2DM patients and 21 non-DM, age-matched patients (aged 19–60 years). Measurement of metabolic parameters (systolic and diastolic blood pressure, total calorie intake, and intensity of physical activity), anthropometry (body weight, body mass index (BMI) and abdominal circumference), total dietary intake, and laboratory analysis (blood glucose fasting, HbA1c, lipid profile, ICAM-1) were done at 4 weeks before (T0) and 14 days after Ramadan fasting (T1). ResultThe median ICAM-1 level in T2DM patients at T0 was 340.9 (193–505) ng/mL and at T1 was 312.3 (158–581) ng/mL, while the ICAM-1 level in non-DM patients at T0 was 482 (305–653) and at T1 was 398.4 (202–526) ng/mL. There was no significant difference of ICAM-1 level between study groups at both T0 and T1 (p > 0.05). Both T2DM and non-DM patients had lower ICAM-1 level following Ramadan fasting. However, only non-DM patients had significantly lower post Ramadan ICAM-1 (p = 0.008) ConclusionThere was a significant decrease in ICAM-1 level in both T2DM and non-DM patients after Ramadan fasting.

Analysis of Urinary Fibronectin Levels in Patients with Type 2 Diabetes Mellitus and Non-Diabetes Mellitus

Diabetic nephropathy is a microvascular complication associated with high glucose levels in individuals with diabetes mellitus (DM). Fibronectin, an early marker of diabetic nephropathy, can indicate the occurrence and progression of renal damage. This cross-sectional study aimed to compare urinary fibronectin levels in patients with type 2 diabetes mellitus and non-diabetes mellitus. A sample of 50 DM patients was divided into two groups: the DM group and the non-DM group. Urinary fibronectin levels were measured using the ELISA method, while albuminuria levels were determined by the albumin-to-creatinine ratio (ACR). Statistical analysis was performed to assess the relationship between urinary fibronectin levels and urine albumin. Results: The average urinary fibronectin level in DM patients was 2.07 ± 3.04 ng/mL, which was slightly higher than the level observed in non-DM patients (1.09 ± 0.56 ng/mL). However, this difference was not statistically significant (p 0.05). Additionally, there was no significant relationship found between urinary fibronectin levels and urine albumin (p = 0.001). Conclusion: The findings of this study indicate that urinary fibronectin levels in individuals with DM were slightly higher than those without DM. However, this difference did not reach statistical significance. The lack of a significant relationship between urinary fibronectin levels and urine albumin suggests that fibronectin may provide additional information about renal damage in DM patients, independent of albuminuria. Further research is necessary to explore the clinical significance of urinary fibronectin as a potential biomarker for diabetic nephropathy.

Evaluating glucose variability through OGTT in early pregnancy and its association with hypertensive disorders of pregnancy in non-diabetic pregnancies: a large-scale multi-center retrospective study

BackgroundRecent evidence suggests increased glucose variability (GV) causes endothelial dysfunction, a central pathology of hypertensive disorders of pregnancy (HDP). We aimed to investigate the association between GV in early pregnancy and subsequent HDP development among non-diabetes mellitus (DM) pregnancies.MethodsThis multicenter retrospective study used data from singleton pregnancies between 2009 and 2019. Among individuals who had 75 g-OGTT before 20 weeks of gestation, we evaluated GV by 75 g-OGTT parameters and examined its relationship with HDP development, defining an initial-increase from fasting-plasma glucose (PG) to 1-h-PG and subsequent-decrease from 1-h-PG to 2-h-PG.ResultsApproximately 3.0% pregnancies (802/26,995) had 75 g-OGTT before 20 weeks of gestation, and they had a higher prevalence of HDP (14.3% vs. 7.5%). The initial-increase was significantly associated with overall HDP (aOR 1.20, 95% CI 1.02–1.42), and the subsequent-decrease was associated with decreased and increased development of early-onset (EoHDP: aOR 0.56, 95% CI 0.38–0.82) and late-onset HDP (LoHDP: aOR 1.38, 95% CI 1.11–1.73), respectively.ConclusionsA pattern of marked initial-increase and minor subsequent-decrease (i.e., sustained hyperglycemia) was associated with EoHDP. Contrarily, the pattern of marked initial-increase and subsequent-decrease (i.e., increased GV) was associated with LoHDP. This provides a new perspective for future study strategies.

DESCRIPTION OF PAIN IN DIABETES MELLITUS AND NON-DIABETES MELLITUS PATIENTS AT PUSKESMAS DANUREJAN 1, YOGYAKARTA

&lt;p&gt;&lt;strong&gt;Background&lt;/strong&gt; Diabetes mellitus (DM) is a disease caused by impaired glucose metabolism, failure of the pancreas to produce the insulin hormone or the body's inability to respond to the insulin hormone. The neurologic complications are neuropathic or nociceptive pain. Neuropathic pain can cause the decrease in patient’s quality of life. Knowing the spread of neuropathic pain based on anatomical predilection may help clinicians conduct early diagnosis and improve the patient's quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective&lt;/strong&gt; This study aim to determine the characteristics, prevalence and location of pain in patients with type 2 diabetes mellitus and non-diabetes mellitus at Puskesmas Danurejan I Yogyakarta.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods&lt;/strong&gt; A descriptive quantitative study on 42 secondary data from previous study in Puskesmas Danurejan I. The inclusion criteria were data of patients with neuropathic pain (electric shock-like pain, stabbing pain) and nociceptive pain (burning sensation pain) who were &amp;gt; 40 years old. The exclusion criteria were incomplete data and recorded consumed non-steroidal anti-inflammatory drugs in the last of 4 days in previous study. Univariate and bivariate analysis were used in this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt; Patients with DM accounted for 50% of cases by 21 people. Patients with DM had the most frequent comorbidities, such as hypertension (42.8%) and obesity (42.8%), Most patients with DM reported pain (85.7%) with neuropathic back pain (27.7%). Based on the type of pain, patients with DM most frequently reported neuropathic pain (66.7%) (p=0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt; There was a relationship between diabetes mellitus and the incidence of neuropatic pain but not nociceptive pain.&lt;/p&gt;

Comparison of Angiographic Findings in Diabetic and Non-Diabetic Female patients presenting with Acute Coronary Syndrome at a Tertiary Cardiac Care Center in Karachi, Pakistan

Objective: -To evaluate the angiographic differences in female patients and to compare the frequency of different angiographic findings in diabetic and non-diabetic female cases with acute coronary syndrome. Place and Duration of Study: Department of Adult Cardiology, Tabba Heart Institute Karachi, Pakistan from 1st February 2018 to 31st August 2018 Study design: Cross-sectional study Methodology: Two hundred patients presenting with acute coronary syndrome undergoing angiography with diabetes mellitus and non-diabetes mellitus were enrolled. Demographic profile of the cases was recorded Angiography was performed by experienced cardiologist for all patients. Study outcome, number of vessels involved, type of vessels, was recorded for all patients. All the collected information was recorded using pre-designed structural questionnaire. Results: 67% were diabetic and 23% were non-diabetic. In diabetic group single vessel disease was observed in 29 (23%), 2 vessel disease in 37 (29.4%) and 3 vessel disease in 49 (38.9%) while in non-diabetic group single vessel disease, 2 vessel disease and 3 vessel disease was observed in 24 (32.4%), 19 (25.37%) and 19 (25.7%) respectively (P=0.092). Three vessel disease involving LAD+ Circumflex+ RCA is 49 [38.88%] and 19 [25.67%] in diabetic and non-diabetic group respectively. Three-vessel disease was more prevalent in diabetics but it was not statistically significant (p=0.092). Conclusion: Three vessel diseases is most frequently present as angiographic finding in female patients presenting with acute coronary syndrome. Keywords: Acute coronary syndrome (ACS), Diabetes mellitus (DM), Unstable angina, ST-elevated myocardial infarction