Non-diabetic Individuals Research Articles

Safety and efficacy of sleeve gastrectomy in non-diabetic individuals with class I vs. class II obesity: a matched controlled experiment from Tehran Obesity Treatment Study (TOTS).

This study aimed to evaluate the 3-year outcomes of sleeve gastrectomy in non-diabetic individuals with class I obesity. A total of 78 participants with class I obesity and 78 participants with class II obesity, matched in terms of age, sex (93.6% female), and the rates of dyslipidemia and hypertension, were included in this prospective cohort study. Follow-up data, including metabolic features, body composition, nutritional characteristics, and surgery complications, were gathered at the baseline and 6, 12, 24, and 36 months post-bariatric surgery. Micronutrient deficiencies and comorbidities (hypertension and dyslipidemia) were evaluated in both groups using conditional logistic regression analysis, and Clavien-Dindo classification was used to compare surgical complications. Baseline characteristics of the participants in both groups were similar (n = 78, mean age: 36.4 ± 8.5). The two groups were also comparable in terms of weight loss, cardiovascular risk factors, and remission of obesity-related comorbidities 3 years following sleeve gastrectomy. Overall values of Δ total weight loss (TWL)%, Δ excess weight loss (EWL)%, and β (95% CI) were - 1.86 (1.19), and - 2.56 (4.5) with a P value of 0.118 and 0.568, respectively. The occurrence of surgical complications and undesirable outcomes were also similar between the two study groups. Bariatric surgery is an effective and safe method to achieve weight loss and alleviate cardiovascular risk factors and obesity-related comorbidities in non-diabetic individuals with class I and class II obesity.

Glucose metabolism and smaller hippocampal volume in elderly people with normal cognitive function

We investigated associations of glycemic measures, and insulin resistance and secretion measures with hippocampal and subfield volumes. In this cross-sectional study, 7400 community-dwelling participants underwent brain MRI and health checkups between 2016 and 2018. Hemoglobin A1c (HbA1c), glycated albumin (GA), homeostasis model assessment for insulin resistance (HOMA-IR), and HOMA of percent β-cell function (HOMA-β) were evaluated. The associations of each measure with a smaller volume of the hippocampus and twelve hippocampal subfields were investigated. As a result, higher HbA1c or GA and lower HOMA-β levels were significantly associated with smaller volumes in multiple hippocampal subfields. Furthermore, even when we analyzed non-diabetic individuals, substantial associations remained between higher GA or lower HOMA-β levels and smaller volumes of the whole hippocampus or the fimbria. Our findings indicate that postprandial glucose fluctuations, postprandial hyperglycemia, and low insulin secretion have a specific effect on the development of smaller hippocampal volume, suggesting that primary prevention of diabetes and/or sufficient glucose control are important for the prevention of dementia.

Unexpected Grave’s-induced acute myocardial infarction in a young female, a literature review based on a case report

IntroductionMyocardial ischemia can occur due to several causes, which result in an imbalance between the supply and demand of oxygen to cardiac muscles. One potential reason for this condition is the overwork of the heart due to hyperstimulated thyroid function.Case presentationThe patient was a 36-year-old woman who presented with left-sided chest pain, dyspnea, palpitation, and tremor. The initial evaluation showed evidence of myocardial ischemia (positive high-sensitivity troponin) caused by a hyperactive thyroid gland. The treatment for myocardial infarction, along with anti-thyroid medications, improved the patient’s condition and subsided the symptoms. The coronary angiography revealed no pathologic finding, and the hypokinetic left ventricle, observed in the first echocardiogram, was resolved. The patient was discharged with an excellent clinical condition, and after the 4-month taking of a calcium channel blocker and tapering carbimazole, the thyroid function became normal, and her symptoms resolved completely.ConclusionPatients without evident risk factors for ischemic heart disease, such as non-diabetic, nonsmoker, and young individuals who presented with acute coronary syndrome, should be evaluated for a potential background reason for the imbalance between the oxygen demand and supply of the myocardium. The presence of palpitation, weight loss, tremors, insomnia, and anxiousness, along with ischemic signs, should make the physician think about the probability of the hyperthyroid-induced cardiovascular disorder.Clinical key pointThe initial presentation of hyperthyroidism might be accompanied by severe cardiac symptoms. When the demographic features are not aligned with usual ischemic heart disease, other probable symptoms and signs should be investigated, and thyroid function should be checked. The control of thyroid hyperactivity would result in the resolution of both cardiac and non-cardiac symptoms.

NATURAL EXPOSURE TO ARSENIC-INDUCED GENOTOXIC EFFECTS IN DIABETIC AND NON-DIABETIC INDIVIDUALS

Arsenic contamination in drinking water is a global health issue linked to various adverse health outcomes, including genotoxic effects. Understanding these effects in different populations, including diabetic and non-diabetic individuals, is critical for developing targeted public health interventions. Objective: This study aimed to investigate the genotoxic effects of arsenic exposure in diabetic and non-diabetic individuals residing in arsenic-contaminated and control areas. Methods: In this cross-sectional study conducted from January to June 2024, 100 participants were recruited from areas with known differences in arsenic water contamination levels. Participants were divided equally between arsenic-contaminated and non-contaminated regions, with 15 diabetic and 20 non-diabetic individuals selected from each group. A standard questionnaire was administered to collect demographic data and medical history. Additionally, 12 water samples from the contaminated area were analyzed for arsenic concentration. Genotoxic effects were assessed using the comet assay, and DNA damage was quantified using an empirical numerical rating system. Results: Significant DNA damage was observed in the blood cells of individuals from the arsenic-contaminated area compared to those from the non-contaminated area. Diabetic individuals showed similar patterns of DNA damage to non-diabetics within the same exposure group. Even in the non-contaminated group, slight DNA damage was detected, suggesting potential contributions from other environmental factors. Conclusion: The findings demonstrate that arsenic exposure is associated with significant genotoxic effects in both diabetic and non-diabetic populations. DNA damage in non-contaminated areas also indicates a possible impact of other environmental factors. These results highlight the need for ongoing monitoring and mitigation strategies to address arsenic contamination and its health impacts.

Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Heart Failure in Patients With Type 2 Diabetes Mellitus: A Systematic Review.

Type 2 diabetes mellitus (T2DM) is a major global health concern with a strong association with increased cardiovascular morbidity and mortality. The prevalence of heart failure is significantly higher in the T2DM population compared to non-diabetic individuals. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have emerged as a promising therapeutic class for managing T2DM, with potential cardioprotective effects.This systematic review aims to comprehensively evaluate the impact of SGLT-2 inhibitors on cardiovascular outcomes in adult patients with T2DM. A comprehensive electronic search was conducted across multiple databases and registries from May 8to June 6, 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Studies published between January 2019 and June 6, 2024 that evaluated the effects of SGLT-2 inhibitors on cardiovascular outcomes in adults with T2DM were included. The risk of bias was assessed using appropriate tools based on thestudy design. A narrative synthesis was planned to summarize the findings. The search strategy identified 25 studies (22 randomized controlled trials, three cohort studies) for inclusion in the systematic review.Most of the included studies demonstrated a low overall risk of bias, although some observational studies had some limitations. The studies investigated the effects of various SGLT-2 inhibitors, including empagliflozin, canagliflozin, dapagliflozin, and others, on cardiovascular endpoints such as heart failure-related hospitalizations, mortality, cardiac structure and function, and biomarkers.The findings suggest that SGLT-2 inhibitors may have a beneficial impact on reducing the risk of heart failure-related hospitalizations and potentially improving other cardiovascular outcomes in patients with T2DM. This comprehensive systematic review provides valuable insights into the emerging role of SGLT-2 inhibitors in mitigating cardiovascular complications associated with T2DM. The findings have important clinical implications and may inform evidence-based guidelines and treatment strategies aimed at improving cardiovascular outcomes in this high-risk patient population.

Evaluation of the Blood Feeding Preference of Aedes aegypti (Diptera: Culicidae) when Offered Diabetic and Non-Diabetic Blood.

Aedes aegypti (L.,1762) is a primary vector of arboviral infections like dengue, yellow fever, Zika. Female mosquitoes are influenced by various physical and chemical cues from host when blood feeding, e.g., they find some individuals with certain blood types or certain conditions more attractive than others. This study determined whether Ae. aegypti shows a preference when offered blood from a patient with diabetes mellitus (DM), an endocrine disorder associated with abnormal glucose metabolism, compared to healthy blood from non-DMs. In the dual feeding experiments, forty newly emerged female mosquitoes were provided with two blood feeding systems with blood from a non-diabetic (healthy) and diabetic patient using artificial feeders. Blood from 12 diabetic and 12 non-diabetic patients was matched by ABO blood type (e.g., diabetic type O blood was compared with non-diabetic type O blood). The number of mosquitoes that landed and fed from each membrane was counted every 2min for thirty minutes. Ae. aegypti species significantly preferred for blood from non-diabetic individuals (50-65% among the different blood type groups) compared to blood from diabetic individuals. Using multiplex allele-specific PCR it was also determined that, Ae. aegypti significantly preferred the O blood group regardless of blood sugar level compared to others. Ae. aegypti has less preference for diabetic blood to non-diabetics. Regardless people affected with this condition need to take preventive measures to reduce mosquito bites as they tend to have weaker immune systems and can experience more severe cases of dengue.

The Effect of Iron Deficiency Anemia on Hemoglobin Glycation in Diabetics and Non-diabetics.

Background Iron deficiency anemia (IDA) is the most prevalent form of nutritional anemia worldwide, affecting a substantial portion of the population. It has significant negative effects on health and the economy, especially in poorer nations, and is more prevalent than anemia alone. Although hemoglobin A1c (HbA1c) is frequently used to track long-term glycemic management, several variables, including iron deficiency, might affect its values.For proper diabetic care, it is essential to comprehend this link. The purpose of this study is to evaluate the impact of IDA on HbA1c levels in individuals with and without diabetes. Materials and methods A hospital-based cross-sectional study was conducted at Shri B. M. Patil Medical College, BLDE (Deemed to be University). Group 1 consists of diabetic patients with IDA, Group 2 consists of diabetic patients without IDA, and Group 3 consists of non-diabetics with IDA. A total of 108 patients were involved in the study. A complete hemogram, anemia profile, and HbA1c values were also a part of the data-gathering process. IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York) was used for the statistical analysis, with a significance level of p < 0.05. Results The study found no significant changes in the mean age, gender distribution,hypertension prevalence, weight, height, pulse rate, or blood pressure across the groups. Group 2 exhibited considerably higher hemoglobin levels than Groups 1 and3. Group 1 showed substantially higher mean blood sugar and HbA1c levelsthan Group 3 (p < 0.05). Diabetic individuals had higher HbA1c levels than non-diabetic individuals, with the greatest levels found in diabetic patients with IDA. Conclusion This study found that IDA had a significant influence on HbA1c levels in diabetic patients, indicating that iron deficiency should be addressed when interpreting HbA1c levels in these individuals. These findings underscore the need for more study to better understand the processes behind this connection and the consequences for clinical management.

Impaired insulin sensitivity measured by estimated glucose disposal rate is associated with decreased myocardial mechano-energetic efficiency in non-diabetic individuals

Background and aimsImpaired myocardial mechano-energetic efficiency (MEE) has been associated with cardiac insulin resistance measured by dynamic positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) combined with euglycemic–hyperinsulinemic clamp. Estimate glucose disposal rate (eGDR) index has a good correlation with whole-body insulin sensitivity. It remains unsettled whether eGDR index is a suitable proxy of cardiac insulin sensitivity as well as its association with myocardial MEE. The aims of this study were: 1) to compare eGDR index with HOMA-IR, QUICKI and FIRI indexes for association with myocardial glucose metabolic rate (MrGlu); and 2) to determine the association of eGDR index with myocardial MEE. MethodsWe evaluated MrGlu using PET with 18F-FDG combined with euglycemic–hyperinsulinemic clamp in 50 individuals without history of coronary heart disease. Myocardial MEE per gram of left ventricular mass (MEEi) was measured in 1181 subjects by echocardiography. eGDR (mg kg-1/min) was calculated as: 21.158 - (0.09 × waist circumference in cm) - (3.407 × hypertension, 1 = yes 0 = no) - (0.551 × HbA1c%). ResultseGDR index was more strongly associated with myocardial MrGlu than HOMA-IR, QUICKI, and FIRI indexes (r = -0.662, r = -0.492, r = 0.570, and r = -0.492, respectively). Individuals in the lower tertiles of eGDR exhibited a significant reduction of MEEi as compared to those in the highest tertile (P < 0.001). In a stepwise multivariate linear regression analysis eGDR index was the major determinant of MEEi independently of well-established cardio-metabolic risk factors. ConclusionsThese data suggest that the eGDR index may be a useful marker to identifying individuals at high cardiovascular risk.

Hyperglycemia in Orthopaedic Trauma Patients: Implications, Management, and Future Directions

Physiologic stress-induced hyperglycemia (SIH) significantly impacts patient outcomes in both non-diabetic and diabetic individuals following orthopaedic trauma. This review synthesizes current literature on SIH's effects, highlighting its association with increased surgical site infections (SSI), extended hospital stays, wound complications, nonunion, need for revision surgery, and mortality. Non-diabetic patients with SIH face worse outcomes compared to euglycemic patients, including a higher risk of deep infections and systemic complications. Diabetic patients experience exacerbated hyperglycemia during trauma, leading to poor wound healing and heightened infection risk. Effective glycemic control, through preoperative optimization, intraoperative monitoring, and postoperative management, is crucial for improving outcomes. Special considerations are discussed for the geriatric population, who are particularly vulnerable to SIH-induced morbidity and mortality. Future directions emphasize developing tailored glycemia management algorithms, utilizing continuous monitoring systems, and fostering multidisciplinary collaboration to optimize care for orthopaedic trauma patients.

Circulating interleukin-33 levels in obesity and type 2 diabetes: A systematic review and meta-analysis.

Obesity and type 2 diabetes (T2D) are increasingly prevalent worldwide, and there is a critical need for novel interventions. Interleukin-33 (IL-33), an anti-inflammatory cytokine that regulates metabolism, is a promising biomarker for these conditions. The goal of this systematic review and meta-analysis is to examine the role of IL-33 in obesity and T2D, assessing its potential in predicting disease progression. A systematic search was performed on Scopus, Web of Science, and PubMed up until 30 May 2023. Each study was assessed for quality and sources of bias using the relevant critical appraisal checklists. Meta-analyses were conducted to compare IL-33 levels in individuals with obesity and T2D versus healthy controls (HC), and in obesity alone versus HC. Eighteen studies were included in the systematic review, and nine qualified for meta-analyses. The analyses showed insufficient evidence to suggest a significant difference in IL-33 levels between individuals with T2D and HC (MD = -79.95, 95% CI [-241.38;81.48]), with substantial heterogeneity across the studies observed (I 2 = 97.1%, Tau 2 =33549.15). Similarly, there was insufficient evidence to suggest a significant difference between non-diabetic individuals with obesity and HC (MD = -7.31, 95% CI [-25.74; 11.13]), and heterogeneity was noted (I2 = 86.2%, Tau2 = 342.45). There is insufficient evidence to indicate significant differences in IL-33 levels in individuals with T2D or obesity compared to HC. The results suggest a need for improved IL-33 measurement methods to reduce heterogeneity, enhancing understanding of the role of IL-33 in obesity and T2D, and informing future research and therapeutic strategies.

Independent risk factors of left ventricular hypertrophy in non-diabetic individuals in Sierra Leone - a cross-sectional study

BackgroundLeft ventricular hypertrophy (LVH) is a critical factor in heart failure and cardiovascular event-related mortality. While the prevalence of LVH in diabetic patients is well-documented, its occurrence and risk factors in non-diabetic populations remain largely unexplored. This study addresses this issue by investigating the independent risk factors of LVH in non-diabetic individuals.MethodsThis cross-sectional study, conducted meticulously, utilized data from a robust and comprehensive source, DATADRYAD, in the Sierra Leone database, collected between October 2019 and October 2021, including LVH and various variables. All variables were described and screened using univariate analysis, Spearman correlation, and principal component analysis (PCA). The lipid profile, including total cholesterols (TC), triglycerides (TG), high-density lipoprotein (HDL-C), non-high-density lipoprotein (Non-HDL-C), and low-density lipoprotein cholesterol (LDL-C), TC/HDL-C ratio, TG/HDL-C ratio, Non-HDL-C /HDL-C ratio and LDL-C/HDL-C ratio, which quartiles were treated as categorical variables, with the lowest quartile serving as the reference category. Three adjusted models were constructed to mitigate the influence of other variables. To ensure the robustness of the model, receiver operating characteristic (ROC) curves were used to calculate the cutoff values by analyzing the ROC curves. A sensitivity analysis was performed to validate the findings further.ResultsThe dataset encompasses information from 2092 individuals. After adjusting for potential factors that could influence the results, we found that TC (OR = 2.773, 95%CI: 1.805–4.26), Non-HDL-C (OR = 2.74, 95%CI: 1.7723–4.236), TC/HDL-C ratio (OR = 2.237, 95%CI: 1.445–3.463), Non-HDL-C/HDL-C ratio (OR = 2.357, 95%CI: 1.548–3.588), TG/HDL-C ratio (OR = 1.513, 95%CI: 1.02–2.245) acts as independent risk factors of LVH. ROC curve analysis revealed the predictive ability of blood lipids for LVH, with Non-HDL-C exhibiting area under the curve (AUC = 0.6109), followed by TC (AUC = 0.6084).ConclusionsTC, non-HDL-C, TC/HDL-C ratio, Non-HDL-C/HDL-C ratio, and TG/HDL-C ratio were independent risk factors of LVH in non-diabetic people. Non-HDL-C and TC were found to be essential indicators for predicting the prevalence of LVH.

The serum uric acid to serum creatinine ratio is an independent risk factor for type 2 diabetes in community-dwelling elderly: A longitudinal analysis

Background and aimElevated serum uric acid (SUA) levels are an important marker of metabolic disorders. However, SUA levels largely depend on renal clearance function. This study aims to investigate the relationship between renal function-normalized SUA [SUA to serum creatinine (SCr) ratio] and the risk of developing type 2 diabetes in a community-dwelling elderly population. Methods and resultsA retrospective cohort study was conducted on elderly, non-diabetic individuals from the Kunshan community in China, who participated in annual health check-ups between January 2018 and December 2023. The relationship between the baseline SUA/SCr ratio and the risk of type 2 diabetes was examined using Cox regression models, restricted cubic splines (RCS), and subgroup analyses. After a median follow-up of 3.88 years, 778 cases of type 2 diabetes were identified among 7671 elderly non-diabetic individuals. Adjusting for confounding variables, the baseline SUA/SCr ratio was significantly linked to type 2 diabetes risk (P < 0.001). Individuals in the highest SUA/SCr ratio quartile had a 1.323 times higher risk of developing type 2 diabetes compared to those in the lowest quartile (HR = 1.323, 95% CI 1.053–1.661, P = 0.016). RCS analysis further confirmed this positive association. Additionally, subgroup analyses suggested that this relationship was particularly pronounced in female individuals. ConclusionsIn Chinese elderly community residents, the baseline SUA/SCr ratio is linked to the risk of type 2 diabetes. Monitoring this ratio could aid in predicting and assessing the risk of type 2 diabetes.

Findings on Age at Onset of Cancer in Diabetic and Non-diabetic Populations.

Background Diabetes mellitus and cancer are two associated chronic diseases. Despite being a widely researched topic, the underlying mechanisms of this association remain unclear. One of the poorly explored topics regarding diabetes and cancer is the relation between the age of cancer onset and diabetes mellitus status; therefore, this research exposes the difference in the age of cancer diagnosis in both groups. Methods We conducted a retrospective study by reviewing the clinical files on a secondary care hospital's database. Files from first-time consultations of patients over 18 diagnosed using a histopathological report were included.The present study aimed to determine whether there is a difference in age at the onset of cancer in diabetic and non-diabetic individuals. Moreover, we calculated the average BMI at the onset for both populations. Results Our study included 8,741 patients; 1,551 (17.8%) were diabetic, and 7,190 (82.2%) were non-diabetic. From 28 types of cancer, 27 showed a difference in the age at the onset of cancer when diabetic and non-diabetic subjects were compared. This difference is significant as it suggests a potential link between diabetes and cancer, which could have implications for early detection and prevention strategies. Out of the 27 types, 17 showed statistical significance with p-values ranging from 0.048 to <0.0001 considering a 95% CI. Among those, the most significant types of cancer were breast, cervical, lung, ovarian, rectal, thyroid, and sarcoma, reporting p-values <0.0001. The mean age at onset of cancer in diabetic and non-diabetic populations was 62.7 years (SD ± 3.9) and 55.3 years (SD ± 7.9), respectively, showing a difference of 7.4 years in both groups. The BMI was statistically significant in patients with breast (p = 0.006), endometrial (p = 0.007), head and neck (p=0.014), and thyroid (p = 0.022) cancer types. Conclusion The data offer a critical view of the relationship between cancer and diabetes. Since virtually no one has produced a similar report, there is a broad field for researching the causal factors implicated in the pathway of diabetic and non-diabetic individuals who develop cancer. Research regarding metformin, diabetic neuropathy, and other possible causes must be addressed to determine whether they are involved in this process.

The Association between Body Composition Phenotype and Insulin Resistance in Post-COVID-19 Syndrome Patients without Diabetes: A Cross-Sectional, Single-Center Study.

The most frequent body composition alterations in post-COVID-19 syndrome include low muscle mass, dynapenia, sarcopenia, and obesity. These conditions share interconnected pathophysiological mechanisms that exacerbate each other. The relationship between body composition phenotypes and metabolic abnormalities in post-COVID-19 syndrome remains unclear. To evaluate the association between body composition phenotypes and insulin resistance (IR) and metabolic abnormalities in non-diabetic individuals with post-COVID-19 syndrome. A cross-sectional, single-center study involving 483 subjects with post-COVID-19 syndrome following moderate to severe acute COVID-19 requiring hospitalization. Individuals with diabetes, those who declined to participate, or those who could not be contacted were excluded. Body composition phenotypes were classified as normal weight, dynapenia, sarcopenia, dynapenic obesity, and sarcopenic obesity (SO). The average age was 52.69 ± 14.75 years; of note, 67.08% were male. The prevalence of body composition phenotypes was as follows: 13.25% were of normal weight, 9.52% had dynapenia, 9.94% had sarcopenia, 43.69% had obesity, 18.84% had dynapenic obesity, and 4.76% had SO. Additionally, 58.18% had IR. Obesity (OR: 2.98, CI95%; 1.64-5.41) and dynapenic obesity (OR: 4.98, CI95%; 1.46-6.88) were associated with IR. The most common body composition phenotypes were obesity, dynapenic obesity, and dynapenia. Furthermore, obesity and dynapenic obesity were associated with IR in post-COVID-19 syndrome.

Investigation of Glycated hemoglobin (HbA1C) and Serum Ferritin Levels in Diabetic Patients with Poor Glycemic Control in Benin City, Edo State, Nigeria

Aim/ Objective: Uncontrolled diabetes mellitus is a metabolic disorder characterized by persistent hyperglycaemia and associated complications. Assessing ferritin and glycated haemoglobin (HbA1c) levels in diabetic patients can provide valuable insights into the management and progression of the disease. This study was aimed at assessing the ferritin and HbA1c levels in patients with uncontrolled diabetes mellitus and evaluate the clinical implications of these assessments. Methodology: This was a case-control study, comprising of 60 consenting participants including 30 uncontrolled diabetes patients, 15 controlled diabetic patients, and 15 non-diabetic with no history of the disease serving as controls. Ferritin levels were measured using enzyme-linked immunosorbent assay (ELISA), and HbA1c levels were also determined using modified enzymatic reaction. Demographic and clinical data, including age, gender, diabetes duration, and medication history, were collected via questionnaires. Results: Analysis of variance (post-hoc) indicated significantly (p &lt; 0.001) higher FBS, HbA1c and ferritin in patients with uncontrolled diabetes compared with the non-diabetic individuals. In contrast, there was no significant difference (p = 0.973) in mean ferritin between patients with controlled diabetes and those with uncontrolled diabetes. In the entire study population, there was a significant relationship between ferritin and FBS (p = 0.001) and HbA1c (p &lt; 0.001) level. Conclusion: In this study, the levels of FBS, HbA1c and ferritin were higher among the uncontrolled diabetes patients. This suggests the need to include ferritin in the panel of assay when screening for diabetes mellitus and when monitoring the progression of the disease.

Anthropometrics and Mental Health Among People with and Without Type 2 Diabetes

Objectives: To investigate the relationships between anthropometric variables and the mental health of older people with type 2 diabetes compared to those without diabetes. Design: A case-control study. Setting(s): The study was conducted in Yazd, the capital city of the Yazd province in Iran. Participants: This study comprised 501 diabetic and 555 non-diabetic individuals recruited from the Yazd Health Study (YaHS). Outcome measures: The Depression Anxiety Stress Scales (DASS-21) questionnaire was used to assess mental health. The scale measured anthropometric indicators, including blood pressure, waist circumference, hip circumference, neck circumference, body fat, body muscle percentage, visceral fat, and body mass index (BMI). Results: The non-diabetic group exhibited better mental health (P≤0.01) compared to the diabetic group. Linear regression analysis indicated that, among demographic variables, gender in diabetic elderly was associated with mental health (P≤0.01), while gender, level of education, and marital status (P≤0.01) in non-diabetics were associated with mental health. Furthermore, among anthropometric factors, BMI and visceral fat (P≤0.01) in diabetics and visceral fat (P≤0.01) in non-diabetics were associated with mental health. The model obtained from liner regression based on demographic and anthropometric variables explained 6 to 13.3% and 8.8 to 15.4% of variance in mental health among diabetic (R2=0.086, P≤0.01) and non-diabetic (R2=0.162, P≤0.01) individuals, respectively. Conclusions: Gender, higher BMI, and visceral fat were associated with poor mental health among diabetic patients. The results of the present study can be used for designing appropriate interventions through different programs such as physical fitness programs.

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.

Sustained metabolic dysregulation and the emergence of diabetes: associations between HbA1c and metabolic syndrome components in Tunisian diabetic and nondiabetic groups

IntroductionMetabolic Syndrome (MetS), diabetes, and other noncommunicable diseases (NCDs) have been a major focus of research in recent decades as the prevalence of these conditions continues to rapidly increase globally. However, the timing and patterns of development from metabolic risk factors to disease states are less well understood and are especially critical to understand in low- and middle-income countries (LMICs) and populations undergoing epidemiological transitions.MethodsNationally representative sociodemographic, anthropometric, and point-of-care biomarker data from the 2016 Tunisian Health Examination Survey (n = 8170) were used to determine the prevalence of diabetes and MetS components in Tunisia and to investigate associations between glycated hemoglobin (HbA1c) and MetS components (blood pressure [BP], HDL cholesterol [HDL], triglycerides [TG], and waist circumference [WC]) in participants aged 15-97 years old. To better understand how sustained metabolic dysregulation and disease states impact these associations, diabetic and nondiabetic groups were analyzed separately.ResultsThe overall prevalence of diabetes based on measured HbA1c was 18.2%. The diabetic groups had a higher prevalence of each individual MetS component, and significantly higher (BP, TG, WC, and HbA1c) and lower (HDL) values than the nondiabetic groups. Yet, there were a higher number of significant associations between HbA1c and MetS components found in nondiabetic women and men when compared to diabetic women and men. HbA1c was positively associated with the cumulative number of MetS components, irrespective of diabetes status in men and women.ConclusionsThe prevalence of both diabetes and MetS components (particularly low HDL cholesterol and elevated TG) is high among the Tunisian population. More MetS components were associated with HbA1c in nondiabetic individuals, showing a strong connection between the development of MetS components and diabetes. However, once the diabetes disease state manifests, there is more variability in the relationships. These results show the potential for HbA1c to be an indicator of metabolic health below clinical disease cutoffs, which may allow insights into the physiological changes that precipitate the emergence of diabetes.

Comparative Proteomic Analysis of Type 2 Diabetic versus Non-Diabetic Vitreous Fluids.

Diabetic retinopathy (DR) is a leading cause of vision loss, with complex mechanisms. The study aimed to comprehensively explore vitreous humor of diabetic and non-diabetic individuals, paving the way for identifying the potential molecular mechanisms underlying DR. Vitreous samples from type 2 diabetic and non-diabetic subjects, collected post-mortem, were analyzed using liquid chromatography-mass spectrometry. Pathway enrichment and gene ontology analyses were conducted to identify dysregulated pathways and characterize protein functions. Pathway analysis revealed dysregulation in multiple metabolic and signaling pathways associated with diabetes, including glycerolipid metabolism, histidine metabolism, and Wnt signaling. Gene ontology analysis identified proteins involved in inflammation, immune response dysregulation, and calcium signaling. Notably, proteins such as Inositol 1,4,5-trisphosphate receptor type 2 (ITPR2), Calcium homeostasis endoplasmic reticulum protein (CHERP), and Coronin-1A (CORO1A) were markedly upregulated in diabetic vitreous, implicating aberrant calcium signaling, inflammatory responses, and cytoskeletal reorganization in DR. Our study provides valuable insights into the intricate mechanisms underlying DR and highlights the significance of inflammation, immune dysregulation, and metabolic disturbances in disease progression. Identification of specific proteins as potential biomarkers underscores the multifactorial nature of DR. Future research in this area is vital for advancing therapeutic interventions and translating findings into clinical practice.

Diabetic status and the performances of creatinine- and cystatin C-based eGFR equations.

The estimation of glomerular filtration rate (GFR) is one main tool to detect renal disease. The most used biomarker remains serum creatinine and the European Kidney Function Consortium (EKFCcrea) equation is the most validated in Europe. More recently, cystatin C, has been proposed. We studied the performances of the EKFC equations in a large cohort of subjects according to their diabetic status. Four cohorts from the EKFC dataset were retrospectively considered in which the diabetic status was available. GFR was measured by plasma clearances (mGFR) (iohexol or 51Cr-EDTA). The performance of the equations was assessed by calculating bias, precision (IQR) and P30 (percentage of eGFR-values within±30% of mGFR). In the whole population (n=6158), median [IQR] age was 61 [47;72] years, with 45.8% women. Mean mGFR was 60 [39;82] mL/min/1.73m². Compared to non-diabetic individuals (n=5124), diabetic patients (n=1034) were older, more frequently male, heavier, and had lower mGFR. The performance of the EKFCcys equation was similar to EKFCcrea, but the EKFCcrea+cys had better P30 than the single-biomarker equations. P30 values were substantially lower in diabetic patients than in non-diabetic but, according to a matched analysis, this is mainly explained by the difference in GFR levels between the two populations, not by diabetic status. We showed that equation combining creatinine and cystatin C present a better performance. If accuracy of equations seems better in non-diabetic than in diabetic individuals, it is more due to differences in GFR levels than to the diabetic status.