Non-diabetic Group Research Articles

Salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and its changes after non-surgical periodontal therapy.

A bidirectional relationship has been reported between diabetes mellitus and periodontitis. The present study aimed to estimate salivary fructosamine in diabetic and non-diabetic individuals with healthy and diseased periodontium and to measure its changes after non-surgical periodontal therapy. Another aim was to identify the cut-off value of salivary fructosamine to diagnose diabetes mellitus and to correlate it with glycated hemoglobin. Salivary fructosamine and HbA1c were assessed in periodontally healthy individuals and periodontitis patients (n = 60 in each group). Both groups comprised of equal number of patients with and without diabetes mellitus. Salivary fructosamine estimation was repeated 4weeks after non-surgical periodontal therapy in periodontitis patients. HbA1c and Salivary fructosamine were significantly higher in the periodontally diseased compared to the healthy group. Significantly higher values of these biomarkers were noticed in diabetic patients with periodontitis compared to the non-diabetic group. Periodontal therapy significantly reduced salivary fructosamine in both diabetic and nondiabetic periodontitis patients. A significant positive high correlation was noticed between salivary fructosamine and HbA1c (r = 0.76). The cut-off value of salivary fructosamine was found to be 68µg/mL with 95% sensitivity, 81.67% specificity, 83.82% positive predictive value, and 94.23% negative predictive value. Periodontitis can contribute to glycemic control and periodontal therapy can bring about improvement in glycemic status. Salivary fructosamine could be used as an alternate glycemic biomarker and its advantages over HbA1c include simple and non-invasive collection of saliva and it can provide intermediate glycemic status. 2020/11/038496.

Carbapenem-resistant Acinetobacter baumannii infections among diabetic and non-diabetic patients and possible effective combination treatments

BackgroundCarbapenems are one of the most noteworthy choices for treating multidrug-resistant Acinetobacter baumannii (A. baumannii). Currently, carbapenem-resistant A. baumannii (CRAB) represents a healthcare problem worldwide, particularly among diabetic patients who are more susceptible to microbial infections. The aim of this study was to investigate the differences in antibiotic susceptibility profiles, the abundance of carbapenem resistance genes across A. baumannii-infected diabetic and non-diabetic patients, and the antimicrobial activity of different antibiotic combinations on highly resistant isolates.MethodsData of 99 A. baumannii-infected patients were collected during the period from 2018 to 2022 and categorized according to patients’ diabetes status into either diabetic or non-diabetic group. A total of 45 A. baumannii isolates were collected during 2021 and 2022 from the main hospital laboratory to be reidentified and genetically confirmed. Antibiotic susceptibility, including carbapenems, was determined using disc agar diffusion and broth microdilution methods. The isolates were screened for OXA-23, GES, VIM, and NDM carbapenem-resistant genes. Five antibiotic combinations were assessed using the double-disk synergy and checkerboard methods.ResultsThe findings of the current study revealed that multidrug resistance increased gradually, from 56% in 2018 to 95.6% in 2022. Moreover, CRAB increased among diabetics and non-diabetics. Resistance rates of imipenem, meropenem, and doripenem reached 68.8%, 61.8%, and 47.4% in diabetics and 97.9%, 83.3%, and 50% in non-diabetics, respectively. The VIM gene was the most prevalent gene with prevalence rates of 100% and 96.15% in diabetics and non-diabetics, respectively. Moreover, all A. baumannii isolates carried at least two of the selected carbapenem-resistant genes. Across the different used combinations, only the tigecycline-meropenem combination showed synergistic activity in 50% of diabetic and 66.7% of non-diabetic isolates.ConclusionsAn increased carbapenem resistance was observed among A. baumannii-infected individuals, both diabetic and non-diabetic. The MEM/TCG combination was the only one that showed synergistic or additive effects against highly resistant isolates making it a viable alternative treatment option.

Assessment of pain intensity and analgesic requirements in patients with diabetes mellitus after STEMI

Abstract Introduction Patients with diabetes encounter a significantly higher risk of myocardial infarction, heart failure, and mortality following acute cardiac events. Examining pain intensity and analgesic needs in patients with diabetes can provide a comprehensive understanding of the pain experienced and individual analgesic needs in patients with diabetes. Aim of the study The aim was to assess pain intensity and analgesic requirements in patients with diabetes mellitus after STEMI. Material and Methods The study involved 104 participants (58 female and 46 male, with a mean age of approximately 72 years, M±SD= 11 yeas). The study was conducted at the Heart Institute, in the Intensive Cardiology Unit, and data were collected from patients following STEMI Participants were divided into two groups: 54 people with diabetes and 50 people without diabetes. The influence of factors such as gender, age, existing diseases, haemoglobin levels and the presence of diabetes on pain intensity was analysed. In the diabetes group, the effects of treatment method, duration of illness and diabetes compliance on pain intensity were also considered. A visual analogue scale (VAS) was used to assess pain, and analgesia requirement was assessed using an analgesic ladder. The level of significance wasp < 0.05. Results The analysis indicated the effect of diabetes on pain intensity in patients with myocardial infarction. Those with diabetes experienced significantly less pain, however glycated HbA1c levels above 7.0 mg/dl predisposed to experiencing more pain. The b standardized regression coefficient indicated for diabetes ,a strong negative correlation (β=-0.77 ,p = 0,008), and for HbA1c level ,a strong positive correlation (β=0.88 ,p =0,889). Comparative analysis of analgesics revealed lower usage in the diabetes group(p=0.002). Diabetes Patients, the most frequent use of first-line drugs while the group of patients without diabetes needed second-level analgesic treatment. Those with diabetes rated their pain level as low ,while the non-diabetic group was dominated by respondents with an intermediate pain level. Non-adherence to diabetic recommendations correlated with higher pain intensity , with a strong positive correlation (β coefficient=0.90, p = 0,010 ). No significant impact was observed based on gender, age, the presence of comorbidities, or the influence of diabetes treatment methods and duration on the intensity of perceived pain. Conclusions The analysis indicated the effect of diabetes on pain intensity in patients with myocardial infarction. Those with diabetes experienced significantly less pain than non-diabetes patients. Diabetes patients required a lower level of the analgesics ladder.

Magnetic resonance imaging combined with serum endolipin and galactagoglobin-3 to diagnose cerebral infarction in the elderly with diabetes mellitus.

Magnetic resonance imaging (MRI) combined with serum endothelin and galactagoglobin-3 (Gal-3) can improve the clinical diagnosis of diabetes mellitus complicated with cerebral infarction. To analyze the clinical value of MRI combined with serum endolipin and Gal-3 for the diagnosis of cerebral infarction in the elderly with diabetes mellitus. One hundred and fifty patients with acute cerebral infarction hospitalized between January 2021 and December 2023 were divided into two groups according to comorbid diabetes mellitus, including 62 and 88 cases in the diabetic and nondiabetic cerebral infarction groups. Serum samples were collected to detect the expression of serum endolipoxins, and Gal-3, and cranial MRI was performed at admission. Differences between the two groups were compared to analyze the diagnostic value of these parameters. Serum endolipin and Gal-3 expression were higher in the diabetic cerebral infarction group (P < 0.05). The arterial wall area, vessel area, normalized wall index, and lumen stenosis rate were higher in the diabetic cerebral infarction group, while the rate of arterial lumen moderate and severe stenosis was 48.39% higher (36.36%, P < 0.05). The percentage of large (29.03%) and multiple infarcts (33.87%) in the diabetic cerebral infarction group was higher (13.64% and 20.45%), and the incidence rate of lacunar infarcts was lower (37.10% vs 65.91%) (P < 0.05). The total incidence of arterial plaque in patients in the diabetic cerebral infarction group was 96.77% higher (69.32%), while the incidence of necrotic lipid core plaque was 58.06% higher (26.14%) (P < 0.05). Receiver operating characteristic curve analysis was performed to assess the diagnosis utility of these techniques. MRI in combination with serum endoglin and Gal-3 had the highest area under the curve, the Yoden index, sensitivity and specificity (P < 0.05). The expression of serum endolipin and Gal-3 in elderly patients with diabetes mellitus with cerebral infarction showed an elevated trend, and the degree of luminal stenosis was severe. MRI predominantly revealed large and multiple infarct foci. This combined index examination can improve the clinical diagnosis of diabetes mellitus combined with cerebral infarction.

Diabetes and Functional Impairment in Osteoarthritis: Investigating Correlations, Associations, and Progression.

Introduction Diabetes and osteoarthritis (OA) are prevalent chronic conditions, often occurring concurrently and complicating patient management. While the individual impact of each condition on functional impairment is well documented, their combined effect remains poorly understood. This study aims to elucidate the relationship between diabetes and OA-related functional impairment. Methodology This was a cross-sectional study of 290 participants with unilateral knee OA. Their demographic, clinical, and diabetes data were collected. Functional impairment was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index-Center for Rheumatic Diseases (WOMAC-CRD). Statistical analyses investigated the relationships between diabetes, OA severity, and functional impairment. Result Diabetic participants showed significantly worse physical function and overall disability, with lower WOMAC-CRD scores. Mean WOMAC-CRD pain scores were 6.46 (SD = 1.088) and 6.48 (SD = 1.101) for the diabetic and non-diabetic groups, respectively. Mean WOMAC-CRD stiffness scores were 6.48 (SD = 1.101) and 6.56 (SD = 1.083) for diabetic and non-diabetic groups. Diabetic participants had a mean WOMAC-CRD physical function score of 55.93 (SD = 2.484), compared to 64.02 (SD = 2.542) for non-diabetic participants. The mean total WOMAC score was 68.80 (SD = 2.857) for diabetic participants and 77.06 (SD = 2.933) for non-diabetic participants. Longer diabetes duration correlated negatively with physical function and total WOMAC scores. Discussion The findings suggest that diabetes exacerbates functional impairment in OA patients, particularly affecting physical function and overall disability. Chronic inflammation and the accumulation of advanced glycation end-products may contribute to the observed deterioration in joint function. Conclusion Integrated management strategies addressing both diabetes and OA are essential for optimizing patient care.

COMPARATIVE ANALYSIS OF IN-STENT RESTENOSIS IN DIABETIC AND NON-DIABETIC PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION IN PAKISTAN

Coronary artery disease (CAD) is a major global killer. Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has improved CAD treatment. However, in-stent restenosis (ISR) remains a significant issue, especially for diabetic patients. Objective: This study aimed to compare ISR rates between diabetic and non-diabetic patients after PCI in a Pakistani hospital. Methods: We conducted a cross-sectional survey at Hayatabad Medical Complex, Peshawar, from January to December 2023. The study involved 273 patients aged 40-85 who underwent PCI with DES. Participants were split into diabetic and non-diabetic groups. Those with chronic kidney disease, previous coronary artery bypass graft surgery, or incomplete follow-up data were excluded. Data were gathered from medical records. ISR was marked by a luminal diameter reduction of more than 50% within the stent or 5 mm of its edges. We used chi-square tests and logistic regression for analysis, employing SPSS version 26.0. Results: The ISR rate was 23% overall. Diabetic patients showed a higher ISR rate (30%) than non-diabetic patients (16%). Logistic regression revealed diabetes (OR = 2.1, 95% CI: 1.3-3.2, p &lt; 0.01), hypertension (OR = 1.8, 95% CI: 1.1-2.9, p &lt; 0.05), and smoking (OR = 1.6, 95% CI: 1.0-2.5, p &lt; 0.05) as significant predictors of ISR. Conclusion: This study highlights a higher ISR incidence in diabetic patients post-PCI. It underscores the need for meticulous monitoring and tailored strategies for this high-risk group. Managing hypertension, smoking, and dyslipidemia is essential to lower ISR rates and enhance outcomes.

Anthropometric indicators and cardiovascular diseases risk in pre-diabetic and diabetic adults: NHANES 1999–2018 cross-sectional analysis

BackgroundSince cardiovascular disease (CVD) stands as the primary cause of death in those with diabetes, and given the substantial influence of obesity as a common risk factor for both diabetes and atherosclerotic conditions, this investigation sought to find the relationship between anthropometric indicators and CVD risk within these populations. MethodsOur study examined 36,329 adults, including those with diagnosed diabetes, pre-diabetes, and without diabetes from National Health and Nutrition Examination Survey (NHANES) data spanning 1999 to 2018. Various anthropometric indicators such as body mass index (BMI), waist circumference, weight-adjusted waist index (WWI), waist-to-height ratio (WHtR), weight, and height were assessed. Baseline characteristics were compared among the three groups after weighting. Participants were then grouped based on anthropometric indicators, and logistic regression models were used to analyze the association between these indicators and CVD risk in the total diabetes group (including diabetic and pre-diabetic individuals). Threshold effect analysis was conducted to explore nonlinear relationships, and mediation analyses assessed whether serum parameters influenced these relationships. ResultsThis cross-sectional study involved 36,329 participants, weighted to a count of approximately 160.9 million, including over 45.9 million pre-diabetic individuals and around 16.6 million diabetic individuals. Baseline analysis showed significant associations between all six anthropometric indicators and CVD risk across patients with different diabetes statuses. Weighted restricted cubic spline (RCS) curve analysis highlighted increased CVD risk among the total diabetes group for each anthropometric indicator compared to the non-diabetic group. Anthropometric indicators were then divided into quartiles, and after adjusting for confounders, Model 3 revealed that the highest BMI group had a heightened risk of CVD compared to the lowest BMI group. Similar trends were observed in the WWI and WHtR subgroups. Threshold effect analysis of anthropometric indicators unveiled nonlinear associations between waist circumference, height, WWI and CVD risk. Mediation analysis suggested that lipid parameters, especially HDL, significantly mediated these relationships. ConclusionIn individuals with diabetes and pre-diabetes, BMI, weight, and WHtR displayed a consistent, linear increase correlation with CVD risk. Conversely, the link between waist circumference, height, and WWI and CVD risk showcased a more complex, nonlinear pattern. Moreover, HDL level emerged as notable mediator in the association between anthropometric indicators and the risk of CVD.

Comparison of Postoperative Wound Infection in Controlled Diabetic and Non-Diabetic Patients in Elective Operations

Background: Diabetes mellitus (DM) is a systemic disease that alters the metabolism of blood sugar. Poorly controlled diabetes or hyperglycaemia is associated with an array of micro-vascular, macro-vascular, and neuropathic complications. There is a widely held belief that infections are usually more frequent and severe in diabetic patients. Diabetes prevalence is increasing in the developed &amp; developing countries, and the appropriate management of patients with diabetes has become increasingly important for the prevention of hospital-acquired infections. Postoperative wound infection continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques. There is little information regarding postoperative wound infection in controlled diabetic patients undergoing elective operation. Objectives: The aim of our study was to evaluate the postoperative wound infection in controlled diabetic and non-diabetic patients in elective operations. Materials &amp; method: This cross sectional comparative study was conducted in Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of October 2011 to March 2012. A total seventy three patients with controlled diabetics and seventy three non-diabetics were selected. Inclusion criteria were patients undergoing clean and cleancontaminated elective operations. Un-controlled diabetes, patient undergoing contaminated and dirty operation, patient with tuberculosis, jaundice, uraemia, having cortico-steroids /chemoradiation and operated for malignancies were excluded. After preoperative preparation specific operation was done. All patients were followed up for 30 days of post operative period for development of any postoperative wound infection. All information recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS-16 and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result: The patients of diabetic group [31 male, 42 female; mean age, 44.5 (SD 8.2) years] and non-diabetic group [40 male, 33 female; mean age, 43.1 (SD 9.4) years] were similar in age and sex (p&gt;0.05 each). The rate of postoperative wound infection after elective abdominal surgery was 7.5% [in controlled diabetic group was 12.3% and that of non-diabetic group was 2.7% (p&lt;0.05)] and the patients of diabetic group were 5.0 times more likely to develop wound infection as compared to that of non-diabetic group (OR=4.992; 95% of CI=1.040–23.971) in clean and clean contaminated elective abdominal surgery. The length of postoperative hospital stay was significantly more in diabetic group than that of non-diabetic group (8.2 (SD ± 2.9) vs 6.8 (SD ± 3.2) days; p&lt;0.01). Conclusion: Postoperative wound infection was higher in controlled diabetic patients than that of non-diabetic. These results support the consideration of diabetes as an independent risk factor for SSIs after elective surgery. Continued efforts are needed to improve surgical outcomes for diabetic patients. J Dhaka Med Coll. 2022; 31(2) : 226-231

Systemic/Immune-Modulation of Olea europaea Leaf Extract in Fetuses of Alloxan-Induced T1 Diabetic Rats.

Maternal glucose is the principal macronutrient that sustains fetal growth. Prolonged exposure of the fetus to hyperglycemia from the early stages of pregnancy accelerates the maturation of the stimulus-secretion coupling mechanism in β cell autoimmunity, which leads to early hyperinsulinemia in type 1 diabetes mellitus (T1DM). Nowadays, diabetes mellitus (DM) is the most common medical complication of pregnancy, and among young women, the prevalence of overt diabetes and undiagnosed hyperglycemia is rising. Even though conventional medication is effective in treating DM, it is expensive and has harmful side effects. Herbal medicine will thus incorporate alternative therapy and be more effective and less toxic. Due to their bioactive components, olive leaves (Olea europaea) are frequently used medicinally; however, little is known about how this plant affects the immune system when it comes to diabetes. The current study used a pregnant mother rat model of alloxan-induced T1DM to examine the antidiabetic properties and embryonic safety of olive leaves. Forty adult female Sprague Dawley rats were split up into four groups as follows: nondiabetic, diabetic, olive, and diabetic-olive groups. All the mother rats were sacrificed on the 20th day of pregnancy, and fetuses were collected for further investigations. In diabetic pregnant mothers, fetuses had systemic modulation-negative effects. These effects were significantly reversed when the diabetic groups were supplemented with extracts from olive leaves. The findings showed that the olive leaf extract inhibits the diabetogenic effect mediated by alloxan with effective and protective systemic immunomodulation during embryonic development.

Non-diabetes status after diagnosis of impaired glucose tolerance and risk of long-term death and vascular complications: A post hoc analysis of the Da Qing Diabetes Prevention Outcome Study.

The association between years of non-diabetes status after diagnosis of impaired glucose tolerance (IGT) and the risk of long-term death and cardiovascular outcomes needed to be clarified. In this post hoc analysis, we included 540 individuals with IGT who participated in the original Da Qing Diabetes Prevention Study (DQDPS). In the DQDPS, all participants were diagnosed with IGT by a 75 g oral glucose tolerance test and randomized to intervention or control groups with a 6-year lifestyle intervention trial. After the completion of the trial, death, cardiovascular events, and microvascular complications were monitored over a 30-year follow-up. In this post hoc analysis, the Cox analysis assessed the extended risk of these outcomes in individuals who either remained non-diabetes status or progressed to diabetes at the end of 2, 4, and 6 years after diagnosis of IGT. In all participants, the difference in the cumulative incidence rate of the outcomes between the diabetes and non-diabetes group gradually increased over 30 years. Compared with the diabetes group, a significantly lower risk of all-cause death (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.57 to 0.97, p = 0.026), cardiovascular events (HR: 0.63; 95% CI: 0.49 to 0.82, p < 0.001), and microvascular complications (HR: 0.62; 95% CI: 0.45 to 0.86, p = 0.004) first emerged in individuals who remained non-diabetes at the 4 years visit, whereas the significant risk reduction in cardiovascular death was first observed at the end of 6 years (HR: 0.56; 95% CI: 0.39 to 0.81, p = 0.002) after adjustment for age, sex, smoking status, BMI, systolic blood pressure, blood glucose, total cholesterol, intervention, and medications (including insulin plus oral hypoglycaemics, antihypertensives, and lipid-lowering agents). The results in the original intervention group alone were similar to the whole group. The main limitations of our study are the limited number of participants and the sole ethnicity of the Chinese population. In this study, we observed that maintaining several years of non-diabetes status after IGT diagnosis was associated with a significant reduction in long-term risk of death and vascular complications, and for most of these outcomes, maintaining at least 4 years of non-diabetes status may be needed to achieve a significant risk reduction.

Dexamethasone effect on serum glucose concentration in diabetic versus non-diabetics patients undergone laparoscopic cholecystectomy: A randomized controlled trial.

Objective: To evaluate dexamethasone’s effect on serum glucose concentration in diabetic versus non-diabetics patients undergone laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesiology, Lady Reading Hospital, Peshawar. Period: January 2022 to December 2022. Methods: One hundred and eight patients presenting for laparoscopic cholecystectomy were included. Patients were divided in two groups, fifty four patients in diabetic group and fifty four in non-diabetic group. Dexamethasone was administered in both groups prior the anesthesia induction. Blood glucose levels were recorded at baseline, at 6th and 12th hours in both groups. Results: Total 108 patients divided in two groups, 54 in diabetic group, and 54 in non-diabetic group. Patient’s mean age was 38.67±13.66 years in diabetic group while 42.31±12.58 years in non-diabetic group. Mean BMI was 25.27±2.34 kg/m2 in diabetic group while 24.96±2.20 kg/m2 in non-diabetic group. The gender distribution of the patients in both groups is presented in Figure-1. No noteworthy significance in the rise of blood glucose levels was discerned between the two groups from baseline to the 6th hour. However, a substantial increase in blood glucose levels at the 12th hour was evident in the non-diabetic group (P = 0.0001). Conclusion: We conclude that 8 mg dexamethasone triggers a significantly elevated hyperglycemic surge in non-diabetic patients as compared to diabetics.

Unique Ultrastructural Alterations in the Placenta Associated With Macrosomia Induced by Gestational Diabetes Mellitus

Abstract Objective To investigate the morphological and ultrastructural alterations in placentas from pregnancies with gestational diabetes mellitus (GDM)–induced macrosomia, term nondiabetic macrosomia, and normal pregnancies. Methods Sixty full-term placentas were collected, and clinical data along with informed consent were obtained from pregnant women who underwent regular visit checks and delivered their newborns in Northwest Women’s and Children’s Hospital between May and December 2022. Placentas were divided into three equal groups: normal pregnancy (control group), nondiabetic macrosomia group, and macrosomia complicated with GDM (diabetic macrosomia) group. Gross morphological data of placentas were recorded, and placental samples were processed for examination of ultrastructural and stereological changes using transmission electron microscopy. Analysis of variance and chi-squared test were used to examine the differences among the three groups for continuous and categorical variables, respectively. Results The baseline characteristics of mothers and neonates did not differ across the three groups, except for a significantly higher birth weight in the diabetic macrosomia group (4172.00 ± 151.20 vs. 3192.00 ± 328.70, P &lt; 0.001) and nondiabetic macrosomia group (4138.00 ± 115.20 vs. 3192.00 ± 328.70, P &lt; 0.001) compared with control group. Examination of the placentas revealed that placental weight was also highest in the diabetic macrosomia group compared with control group (810.00 ± 15.81 vs. 490.00 ± 51.48, P &lt; 0.001) and nondiabetic macrosomia group (810.00 ± 15.81 vs. 684.00 ± 62.69, P &lt; 0.001), but the ratio of neonatal birth weight to placental weight (BW/PW) was significantly lower in the diabetic macrosomia group compared with that in the control group (5.15 ± 0.19 vs. 6.54 ± 0.63, P &lt; 0.001) and nondiabetic macrosomia group (5.15 ± 0.19 vs. 6.09 ± 0.52, P &lt; 0.001) group. In contrast, the BW/PW ratio in nondiabetic macrosomia did not differ significantly from that in the control group. Distinct ultrastructural changes in terminal villi and stereological alterations in microvilli were observed in the diabetic macrosomia group, including changes in the appearance of cytoplasmic organelles and the fetal capillary endothelium and thickness of the vasculo-syncytial membrane and basal membrane. Conclusion Significant ultrastructural and stereological alterations were discovered in the placentas from pregnant women with macrosomia induced by GDM. These alterations may be the response of the placenta to the hyperglycemia condition encountered during pregnancies complicated with GDM.

Worsening of Diabetes Control Measures and Decreased Kidney Function in Pre-Diabetic Kidney Donors Compared to Non-Diabetic Donors Whose BMI Before Kidney Donation was Above 30

The incidence of end-stage renal disease has increased dramatically over the past two decades. Kidney transplantation is the best treatment option for individuals with end-stage renal disease, and living donor kidney transplantation has significant advantages over deceased donor kidney transplantation. Although there are criteria for assessing living kidney donors, different medical centers handle certain medical problems differently. The aim of this study is to investigate how kidney donation affects renal biochemical indicators, blood pressure measurements, and glucose control in healthy young female adults without diabetes compared to a pre-diabetic group. A prospective cohort study recruited 142 female kidney donors, who were divided into two cohorts based on their diabetic history (pre-diabetic and non-diabetic). The participants were monitored for seven years after kidney donation. Key clinical and biochemical markers were measured before and after donation. The pre-diabetic group had higher mean values for blood pressure readings, body mass indices, Oral Glucose Tolerance Test, HbA1c (DCCT) (%), serum creatinine levels, proteinuria, and lower e-GFR compared to those in the non-diabetic group. All these findings were statistically significant. Pre-diabetic donors are at an increased risk for many adverse clinical and biochemical outcomes, including hypertension, glucose tolerance, and worsening kidney function tests and should be advised that their condition may worsen over time and can result in end-organ complications. If the donors decide to proceed, they should be closely and frequently monitored during both the short- and long-term periods.

Periodontitis in patients with diabetes and its association with diabetes-related complications. A register-based cohort study

ObjectiveTo evaluate the association between type 1 diabetes (T1D)/type 2 diabetes (T2D) and periodontitis and assess the influence of periodontitis on diabetes-related complications.DesignObservational study; longitudinal analysis of register data.SettingSwedish primary...

Non-ST Elevation Myocardial Infarction in Patients With Hypertensive Emergency.

Background Hypertensive emergencies represent high-cardiovascular-risk situations defined by severe increases in blood pressure. The prevalence of hypertension in non-ST elevation myocardial infarction (NSTEMI) is higher compared to STEMI and there is a lack of studies on NSTEMI patients with hypertensive emergencies. Patients with diabetes exhibited a higher rate of hypertensive emergencies. This study's primary aim was to investigate the coronary artery disease profile in hypertensive emergency patients withNSTEMI, and the secondary aim was to determine the impact of diabetes on the development of hypertensive emergencies. Methodology A total of 100 patients with NSTEMI and hypertensive emergency presenting to the hospital were enrolled in the study. The duration of the study was 24 months. The patients were also sub-grouped into diabetic and nondiabetic. Baseline characteristics were noted, and coronary angiogram and renal angiogram were also done. Based on variables, the chi-square test and t-test were employed to assess the significance. P-value < 0.05 was considered statistically significant. Results The mean age at presentation for patients with NSTEMI and hypertensive emergency was 58 years. Patients consuming alcohol were slightly higher (28, 28%) than those who smoked (23, 23%). Among all, 48 (48%) patients had diabetes. When considering the number of vessels, diabetic patients had more single-vessel diseases (18, 37.5%) and nondiabetic patients had more double-vessel diseases (15, 28.8%). The mean ejection fraction of the diabetic group was 56.1% ± 6.8% and the nondiabetic group was 54.2% ± 7.7%. Among all the patients, 52 (62.6%) used combination drugs, while 39 (46.9%) were on defaulter drugs. Conclusions Several risk factors like age, smoking, alcohol, and nonadherence to drugs were found to have an association with the occurrence of hypertensive emergency. Diabetes was found to be significantly associated with unfavorable coronary anatomy among the population.

Relationship Between the Hemoglobin, Albumin, Lymphocyte Count, Platelet Count (HALP) Score and Type 2 Diabetes Retinopathy.

To explore the correlation between hemoglobin, albumin, lymphocyte count, platelet count (HALP) score and type 2 diabetic retinopathy (DR). The study was conducted on 674 patients with type 2 diabetes (T2DM). According to the results of the fundus examination, they were divided into non-diabetic retinopathy group (NDR, n=388) and diabetic retinopathy group (DR, n=286). Collected patients baseline data, calculated HALP score, analyzed the correlation between HALP score and DR. In all patients, male patients and female patients, the HALP score of the DR group was lower than that of the NDR group (P<0.001), and the HALP score was negatively correlated with the incidence of DR (P<0.05). HALP score was independent risk factors for DR, regardless of gender. In male patients, HALP score and DR had a linear relationship, but in female patients, HALP score and DR showed a nonlinear relationship, and HALP score was more sensitive to the onset of DR in male patients. The combined diagnostic model of HALP score, course of disease, SBP and BUN was used to diagnose DR, and it was found that the diagnostic value was the highest among male patients, with AUC of 0.761, sensitivity of 58.3% and specificity of 80.3%. HALP score was an independent risk factor for DR, attention should be paid to monitoring HALP score, especially in male T2DM patients. The accuracy of HALP score, disease course, SBP and BUN combined model diagnosis of DR was high, which can become a biological indicator for early screening of DR.

Prevalence of toxoplasmosis in Iraqi patients with diabetic type 2

Background. The obligate intracellular protozoan parasite Toxoplasma gondii is a member of the phylum Apicomplexa. In people with impaired immune systems, it can result in opportunistic infections. Diabetes mellitus is regarded as a metabolic disease that raises the host's vulnerability to and risk from several infections, including T. gondii infection. The main object of this study is to ascertain the toxoplasmosis seroprevalence and correlation among Iraqi patients with type 2 diabetes. Methods. The level of Toxoplasma antibodies IgG, IgM, and IgA was measured in 109 samples of Iraqi diabetes type 2 patients using immunochromatography rapid test, CMIA, and ELISA. Eighty samples, considered to be a healthy control group, were collected from a private laboratory in Baghdad, Iraq, between March 2022 and June 2022, with an age range of 15 to 85 years. Results. Comparing the diabetes patient group to the non-diabetic control group, the results showed that the diabetic patient group had the highest mean glucose levels in their fasting test (174.55 ± 3.96 mg/dL), random test (216.89 ± 4.96 mg/dL), and HbA1C (7.1 ± 0.178), respectively. Furthermore, the study demonstrated that, in an immunochromatography fast test, the group of diabetic patients had the largest distribution of IgG anti-Toxoplasma when compared to the non-diabetic control group. Additionally, all samples were seronegative for anti-Toxoplasma IgM and IgA, with significant differences in CMIA and ELISA. However, 51/109 (46.79%) and 30/80 (37.5%) of the diabetes group and the non-diabetic group, respectively, showed seropositive for anti-Toxoplasma IgG. Conclusion. This study found that no acute toxoplasmosis detected in the studied cases while chronic toxoplasmosis detected among diabetic type 2 patients.

Incident Cancer Risk of Patients with Prevalent Type 2 Diabetes Mellitus in Hungary (Part 2).

(1) Background: Among the chronic complications of type 2 diabetes mellitus, cancer has become the leading cause of death in several countries. Our objective was to determine whether prevalent type 2 diabetes mellitus is associated with a higher incidence of cancer. (2) Methods: This study comprised a nationwide analysis conducted in Hungary. The study population was divided into two groups: a type 2 diabetes mellitus group vs. a non-diabetic group. The primary outcome was the risk related to overall cancer incidence; a key secondary outcome was the overall incidence of cancer in distinct study years; and a further outcome was the annual percent changes. (3) Results: The odds ratio related to the overall incidence of cancer was 2.50 (95% confidence interval: 2.46-2.55, p < 0.0001) in patients with diabetes as related to non-diabetic controls. The odds ratio was higher in males than in females [ORmales: 2.76 (2.70-2.82) vs. ORfemales: 2.27 (2.22-2.33), p < 0.05 for male-to-female comparison]. The annual cancer incidence rate declined in non-diabetic controls, but not in patients with diabetes [-1.79% (-2.07--1.52%), p < 0.0001] vs. -0.50% (-1.12-+0.10%), p = 0.0991]. Several types of cancer showed a decreasing tendency in non-diabetic controls, but not in patients with type 2 diabetes. (4) Conclusions: Type 2 diabetes is associated with a higher risk of cancer. While the cancer incidence decreased for non-diabetic individuals with time, it remained unchanged in patients with T2DM.

Hospital Outcome of Hypertensive Non-ST elevation Myocardial Infarction Patients in Diabetic and Non-Diabetic Groups

Objective: Acute myocardial infarction is one of the leading causes of all acute emergencies and is becoming an important public health problem in developing countries. Non-ST elevation myocardial infarction (NSTEMI) is more heterogeneous in its presentation and may be poorly characterized in clinical practice, leading to greater variation in diagnosis and treatment. Patients with diabetes and hypertension who develop an NSTEMI are at increased risk for poor hospital outcomes. This study aims to assess the differences between hypertensive diabetic and hypertensive non-diabetic patients with NSTEMI and to evaluate the prognostic impact of selected clinical and laboratory parameters on the occurrence of hospital complications. Methods: This was a cross-sectional analytical study. All the adult hypertensive patients of newly diagnosed NSTEMI with or without diabetes mellitus admitted to Ibrahim Cardiac Hospital &amp; Research Institute, Dhaka who fulfilled the inclusion and exclusion criteria were enrolled. The study population comprised 100 hypertensive patients with their first NSTEMI and were divided into two groups according to the presence of type 2 diabetes mellitus. Group I (n = 40) patients were diabetic and Group II (n = 60) were non-diabetic. The hospital outcome of the study population was recorded. The incidence of in-hospital adverse clinical events in the two groups was compared by using the odds ratio of the two binomial proportion analyses. Results: Among 100 hypertensive NSTEMI patients, 40% were diabetic (Group I) and 60% were non-diabetic (Group II). The mean age was 58.1±10.2 years in the case of the diabetic group (Group I) and 56.3±10.5 years in the non-diabetic group (Group II) ranging from 30-70 years. Male patients (66%) were predominant in the study. The most common clinical presentation was chest pain which was 77.5% in Group I and 83.3 % in Group II followed by sweating (12.5% and 16.7%), dyspnea (10.0% and 11.7%), syncope (5.0% and 6.7%) and atypical chest pain (2.5% and 3.3%) respectively. Smoking was the commonest risk factor which was 62.5% in Group I and 75% in Group II followed by dyslipidemia (32.5% and 36.7%), family history of IHD (30% and 23.3%) and obesity (22.5% and 13.3%) respectively. Diabetic hypertensive patients had significantly higher heart rates, hypertensive peaks, and more episodes of asymptomatic ST segment depression. The most common in-hospital complications were heart failure (30% and 16.7%), arrhythmias (22.5% and 6.7%), renal failure (10% and 5.0%), cerebral ischemia (7.5% and 1.7%), death (7.5% and 3.3%) and cardiogenic shock (5.0% and 3.3%) in Group I and Group II respectively. Conclusion: In-hospital adverse clinical events were more frequent in diabetic hypertensive individuals compared to non-diabetics.

Longitudinal Three-Year Associations of Dietary Fruit and Vegetable Intake with Serum hs-C-Reactive Protein in Adults with and without Type 1 Diabetes.

High-sensitivity C-reactive protein (hs-CRP) is a widely used clinical biomarker of systemic inflammation, implicated in many chronic conditions, including type 1 diabetes (T1D). Despite the increasing emphasis on dietary intake as a modifiable risk factor for systemic inflammation, the association of hs-CRP with fruit and vegetable consumption is relatively underexplored in T1D. To address this gap, we investigated the longitudinal associations of dietary pattern-derived fruit and vegetable scores with hs-CRP in adults with and without T1D. Additionally, we examined the impact of berry consumption as a distinct food group. Data were collected in the Coronary Artery Calcification in Type 1 Diabetes study over two visits that were three years apart. At each visit, participants completed a food frequency questionnaire, and hs-CRP was measured using a particle-enhanced immunonephelometric assay. Mixed effect models were used to examine the three-year association of fruit and vegetable scores with hs-CRP. Adjusted models found a significant inverse association between blueberry intake and hs-CRP in the nondiabetic (non-DM) group. Dietary Approaches to Stop Hypertension- and Alternative Healthy Eating Index-derived vegetable scores were also inversely associated with hs-CRP in the non-DM group (all p-values ≤ 0.05). Conversely, no significant associations were observed in the T1D group. In conclusion, dietary pattern-derived vegetable scores are inversely associated with hs-CRP in non-DM adults. Nonetheless, in T1D, chronic hyperglycemia and related metabolic abnormalities may override the cardioprotective features of these food groups at habitually consumed servings.