Non-diabetic Individuals Research Articles

Study of HbA1c levels in non-diabetic individuals recovered from Covid-19.

To study the glycemic control by estimating HbA1c levels among previously non-diabetic individuals aged above 40 years, who recovered from coronavirus disease 2019 (Covid-19) infection. This is an analytical cross-sectional study of people affected with Covid-19 infection, who were home-isolated, hospitalized, and discharged. The simple random sampling technique was used for the study group. Tirupati City, Andhra Pradesh State, India. We assessed socio-demographic profiles, hba1c levels, RBS, and severity of infection. The obtained laboratory reports were analyzed by using means and proportions after entering data in MS Excel and converted to SPSS software new version. The study participants comprised mostly middle age group males and females (mostly 40-60 years, with 60% of them being females). Most of the study subjects were healthy, and 58% of them have normal hba1c levels. 32% of them are in border line diabetic. The prevalence of diabetes post Covid-19 infection is 10%. The majority of participants have normal random blood sugar levels (around 92%), and very less individuals have abnormal random blood sugar levels (2% of the subjects). There is no significant association between hypertension and raised blood sugar levels post Covid-19 infection. Based on the study, Covid-19 infection has an impact on blood sugar levels and altered glycemic control, switching a few individuals into diabetic and a significant number of individuals into the pre-diabetic state, who are non-diabetic individuals before Covid-19 infection.

Duke Treadmill Score Predicts Coronary Artery Disease Severity in Diabetics and Non-Diabetics

Coronary artery disease (CAD) is a significant cause of mortality and morbidity on a global scale. The Duke Treadmill Score (DTS) is a clinical evaluation that uses exercise stress testing to determine the severity of coronary artery disease (CAD). Objective: This study was to see how well DTS predicted the severity of CAD in diabetic and non-diabetic individuals. Methods: A prospective cohort study was conducted in the Department of Cardiology, PIMS, Islamabad, from March 2023 to September 2023. Total 450 patients were separated into diabetes (225) and non-diabetic (225) groups. Diabetes was diagnosed using American Diabetes Association criteria. The validated DTS scores exercise duration, ST-segment deviation, and angina symptoms to predict severe CAD. -11 or above is high risk, -10 to +4 is moderate, and +5 or more is low risk. Results: A study of 450 patients comprised 282 (62.6%) male and 168 (37.3%) female, with an average age of 58.4±13.2years. On coronary angiography, 170 diabetics (75.6%) and 130 non-diabetics (57.8%) had substantial CAD. Hypertension was 52.9% in diabetics and 49.3% in non-diabetics (p=0.920). Diabetics had 10.6% dyslipidemia and non-diabetics 9.3% (p=0.058). Conclusions: DTS may predict CAD severity in diabetics and non-diabetics, according to one study. Diabetes is a key risk factor for CAD, and DTS may aid in risk estimation. DTS findings and CAD risk assessment may potentially be affected by patient characteristics, exercise capacity, and treadmill technique.

Nasal MRSA carriage is a risk factor for development of antibiotic resistance in diabetic foot ulcers and is significantly higher than diabetic and non-diabetic individuals without foot ulcer

BackgroundDiabetic foot ulcer (DFU) is a major complication of diabetes often impacted by polymicrobial infection in the wound site. Diabetic patients are immunocompromised in nature and hence vulnerable to infection once the skin barrier is breached. Microbiological culture-based methods show that Staphylococcus aureus (SA) is the most frequently isolated bacteria from the DFU wounds. SA and its most clinically important antibiotic resistant variant methicillin-resistant S. aureus (MRSA) are commonly found in the nasal vestibule and colonization of SA as well as MRSA in any wound site can aggravate the condition. We hypothesize that the presence of nasal MRSA carriage can serve as a potential risk factor contributing to the emergence of antibiotic resistance in diabetic foot ulcer wounds.MethodsIn the present study, we have compared the carriage of SA and MRSA in nasal cavity and foot skin among DFU patients (D+F+, n = 50), diabetic patients without any ulcer (D+F-, n = 50), and healthy controls (D-F-, n = 40) by using bacterial culture and PCR based methods. The D+F+, D+F- and D-F-individuals were further categorized based on the presence or absence of MRSA and clinical parameters were compared between MRSA+ ve and MRSA-ve individuals in each of the three groups mentioned above.ResultsOur results show that, (a) nasal MRSA carriage is significantly higher (p < 0.05) in D+F+ group than the D+F- and D-F- and significantly associated with wound MRSA carriage in D+ F+ individuals (O.R. = 4.09; 95% C.I. = 1.12–15.05) and (b) the HbA1C level is significantly higher (p < 0.02) in wound MRSA positive, compared to MRSA negative D+F+ patients. Interestingly more than half of the MRSA (64%) isolated from DFU wound were identified to be multidrug resistant.ConclusionThese findings strongly suggest that nasal MRSA carriage can act as a risk factor for development of antibiotic resistance in diabetic foot ulcers and it is therefore important to screen nasal and wound sites of these patients regularly. We have also developed a rapid multiplex PCR assay to detect MRSA from clinical isolates or microbial DNA isolated from clinical samples in the hospital settings.

Cardiovascular diseases: clinical presentation and treatment in patients with and without diabetes mellitus at a tertiary care hospital

Background: cardiovascular diseases are a significant global health challenge is due to their high prevalence and impact on mortality rates. This encompasses a wide range of heart and blood vessel disorders. Diabetes mellitus is a major risk factor for any cardiovascular disease. Objective was to assess the cardiovascular disease among diabetic and non-diabetic individuals. To find out symptoms and management of heart diseases both diabetic and non-diabetic patients. Methods: A prospective cross-sectional study design was conducted at Navodaya Medical College Hospital &amp; Research Centre, Raichur, spanning a duration of six months starting from January 2023 until June 2023. A total of 200 cases were gathered throughout the study period. Results: Among 200 cases 114 patients were male and 86 patients were female. 74 (37%) patients had cardiovascular disease with diabetic and 126 (63%) patients had cardiovascular disease without diabetes. the most common type of cardiovascular disease was found non-ST elevation MI (NSTEMI) 29.73% with diabetic patients and coronary artery disease 23.01% were found most common with non- diabetic patients. Aspirin was the most common drug both diabetic 74 (17.79%) and non- diabetic patients 126 (18.69%). Conclusions: The study highlights the importance of early detection and effective management of diabetes to reduce the risk of cardiovascular complications. Additionally, it underscores the need for healthcare providers to closely monitor diabetic patients' cardiovascular health and implement preventive measures to enhance overall patient outcomes.

Correlation of Glycated Hemoglobin with Oxidative Stress in Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) has a heavy disease burden and is one of the leading causes of death worldwide. It is considered to be evolving from a complex and multifactorial metabolic disorder to an inflammatory condition. The strong link between hyperglycemia and oxidative stress has long been established. Oxidative stress leads to the generation of inflammatory mediators and reactive oxygen species, which results in an inflammatory state, which plays a key role in the pathogenesis of diabetic complications. We aimed to correlate the levels of Glycated Hemoglobin with Oxidative Stress.This cross-sectional study included 200 subjects, 100 were type 2 diabetic patients and 100 were healthy non-diabetic individuals. The data were analyzed using a t test. The results showed that as the Glycated Hb increased, the levels of FBS, MDA increased and Serum SOD, Glutathione and Catalase levels decreased. The results showed a positive correlation between HbA1c and fasting blood glucose (r = 0.417, p= 0.000) and MDA (r= 0.340, p=0.000). Whereas negative correlation was observed between HbA1c and other antioxidant parameters, SOD (r= 0.025, p=0.803) Catalase (r= 0.096, p= 0.342), Glutathione (r= -0.164, p= 0.103). It is hereby concluded for the present study that when glycated Hb increases the natural antioxidants that is SOD, catalase and glutathione decrease to combact the increased formation of ROS. Serum MDA, a marker of lipid peroxidation, increased with increased glycated Hb, and shows a positive correlation, indicating that lipid peroxidation increased, when glycation of Hb increased, thus depicting an increased chance of macrovascular complication in type 2 diabetics.

Acoustic Analysis and Prediction of Type 2 Diabetes Mellitus Using Smartphone-Recorded Voice Segments

ObjectiveTo investigate the potential of voice analysis as a prescreening or monitoring tool for type 2 diabetes mellitus (T2DM) by examining the differences in voice recordings between nondiabetic and T2DM individuals. Patients and MethodsTotal 267 participants diagnosed as nondiabetic (79 women and 113 men) or T2DM (18 women and 57 men) on the basis of American Diabetes Association guidelines were recruited in India between August 30, 2021 and June 30, 2022. Using a smartphone application, participants recorded a fixed phrase up to 6 times daily for 2 weeks, resulting in 18,465 recordings. Fourteen acoustic features were extracted from each recording to analyze differences between nondiabetic and T2DM individuals and create a prediction methodology for T2DM status. ResultsSignificant differences were found between voice recordings of nondiabetic and T2DM men and women, both in the entire dataset and in an age-matched and body mass index (BMI [calculated as the weight in kilograms divided by the height in meters squared])-matched sample. The highest predictive accuracy was achieved by pitch (P<.0001), pitch SD (P<.0001), and relative average pertubation jitter (P=.02) for women, and intensity (P<.0001) and 11-point amplitude perturbation quotient shimmer (apq11, P<0.0001) for men. Incorporating these features with age and BMI, the optimal prediction models achieved accuracies of 0.75±0.22 for women and 0.70±0.10 for men through 5-fold cross-validation in the age-matched and BMI-matched sample. ConclusionOverall, vocal changes occur in individuals with T2DM compared with those without T2DM. Voice analysis shows potential as a prescreening or monitoring tool for T2DM, particularly when combined with other risk factors associated with the condition. Trial Registrationclinicaltrials.gov Identifier: CTRI/2021/08/035957

Differential Responders to a Mixed Meal Tolerance Test Associated with Type 2 Diabetes Risk Factors and Gut Microbiota-Data from the MEDGI-Carb Randomized Controlled Trial.

The global prevalence of type 2 diabetes mellitus (T2DM) has surged in recent decades, and the identification of differential glycemic responders can aid tailored treatment for the prevention of prediabetes and T2DM. A mixed meal tolerance test (MMTT) based on regular foods offers the potential to uncover differential responders in dynamical postprandial events. We aimed to fit a simple mathematical model on dynamic postprandial glucose data from repeated MMTTs among participants with elevated T2DM risk to identify response clusters and investigate their association with T2DM risk factors and gut microbiota. Data were used from a 12-week multi-center dietary intervention trial involving high-risk T2DM adults, comparing high- versus low-glycemic index foods within a Mediterranean diet context (MEDGICarb). Model-based analysis of MMTTs from 155 participants (81 females and 74 males) revealed two distinct plasma glucose response clusters that were associated with baseline gut microbiota. Cluster A, inversely associated with HbA1c and waist circumference and directly with insulin sensitivity, exhibited a contrasting profile to cluster B. Findings imply that a standardized breakfast MMTT using regular foods could effectively distinguish non-diabetic individuals at varying risk levels for T2DM using a simple mechanistic model.

Fibroblast Growth Factor 21 in Gestational Diabetes Mellitus and Type 2 Diabetes Mellitus.

Women who develop GDM present a metabolic condition similar to that found in type 2 diabetes, characterized by impaired insulin response. Due to similar pathophysiologic mechanisms found between type 2DM and GDM, there is a great interest in finding markers that will lead to the understanding of a possible common origin to both diseases. The aim of this study was to determine serum FGF21 levels in 2DM and GDM and its correlation with selected metabolic parameters. The study included 54 2DM patients and 52 nondiabetic individuals (control group 1) as well as 74 GDM women and 32 healthy pregnant controls (control group 2). Serum FGF21 was determined by enzyme-linked immunosorbent assay (ELISA), in all groups, and correlated with biochemical parameters of glucose metabolism and insulin resistance (HbA1c, HOMA index, TG, and HDL cholesterol). FGF21 concentration was significantly higher in 2DM as compared with control group 1 (p < 0.01). In the 2DM group, FGF21 was positively correlated with HOMA index (p = 0.022, R = 0.398). In the GDM group, the positive relationships with FGF21 were observed with glucose (p = 0.020, R = 0.264) and TG (p = 0.013, R = 0.283) while HDL-C levels were correlated negatively (p = 0.004, R = -0.326). Serum FGF21 levels were significantly higher in 2DM patients than those without diabetes. Moreover, serum FGF21 levels were associated with selected metabolic parameters, suggesting that it may play acrolein glucose and lipid metabolism.

DiabeticSense: A Non-Invasive, Multi-Sensor, IoT-Based Pre-Diagnostic System for Diabetes Detection Using Breath.

Diabetes mellitus is a widespread chronic metabolic disorder that requires regular blood glucose level surveillance. Current invasive techniques, such as finger-prick tests, often result in discomfort, leading to infrequent monitoring and potential health complications. The primary objective of this study was to design a novel, portable, non-invasive system for diabetes detection using breath samples, named DiabeticSense, an affordable digital health device for early detection, to encourage immediate intervention. The device employed electrochemical sensors to assess volatile organic compounds in breath samples, whose concentrations differed between diabetic and non-diabetic individuals. The system merged vital signs with sensor voltages obtained by processing breath sample data to predict diabetic conditions. Our research used clinical breath samples from 100 patients at a nationally recognized hospital to form the dataset. Data were then processed using a gradient boosting classifier model, and the performance was cross-validated. The proposed system attained a promising accuracy of 86.6%, indicating an improvement of 20.72% over an existing regression technique. The developed device introduces a non-invasive, cost-effective, and user-friendly solution for preliminary diabetes detection. This has the potential to increase patient adherence to regular monitoring.

Repurposing Metformin for periodontal disease management as a form of oral-systemic preventive medicine

BackgroundDespite the improvements in treatment over the last decades, periodontal disease (PD) affects millions of people around the world and the only treatment available is based on controlling microbial load. Diabetes is known to increase the risk of PD establishment and progression, and recently, glucose metabolism modulation by pharmaceutical or dietarian means has been emphasised as a significant modulator of non-communicable disease development.MethodsThe impact of pharmaceutically controlling glucose metabolism in non-diabetic animals and humans (REBEC, UTN code: U1111-1276-1942) was investigated by repurposing Metformin, as a mean to manage periodontal disease and its associated systemic risk factors.ResultsWe found that glucose metabolism control via use of Metformin aimed at PD management resulted in significant prevention of bone loss during induced periodontal disease and age-related bone loss in vivo. Metformin also influenced the bacterial species present in the oral environment and impacted the metabolic epithelial and stromal responses to bacterial dysbiosis at a single cell level. Systemically, Metformin controlled blood glucose levels and age-related weight gain when used long-term. Translationally, our pilot randomized control trial indicated that systemic Metformin was safe to use in non-diabetic patients and affected the periodontal tissues. During the medication window, patients showed stable levels of systemic blood glucose, lower circulating hsCRP and lower insulin levels after periodontal treatment when compared to placebo. Finally, patients treated with Metformin had improved periodontal parameters when compared to placebo treated patients.ConclusionThis is the first study to demonstrate that systemic interventions using Metformin in non-diabetic individuals aimed at PD prevention have oral-systemic effects constituting a possible novel form of preventive medicine for oral-systemic disease management.

Correlation of Carotid Intima-Media Thickness with One-hour Postload Plasma Glucose (1h-PPG) in Overweight and Obese North Indian Adults

Background: Cardiovascular morbidities like arterial stiffness and atherosclerosis have a negative association with insulin resistance, which can be identified by carotid intima media thickness (CIMT) measurement. One-hour postload plasma glucose (1 h-PPG) is a novel marker for early identification of insulin resistance, but very few studies are available on its relationship with CIMT. Objective: To identify the correlation of CIMT with 1 h-PPG in overweight and obese adults without diabetes. Methods: Individuals not having known diabetes or other chronic illnesses were identified and subjected to the initial anthropometric analysis for body mass index (BMI) calculation. A standard oral glucose tolerance test was performed on individuals with a BMI of ≥25 kg/m2 for 1 h-PPG values, and a B-mode ultrasound scan of the neck was used for CIMT measurement. A Pearson’s correlation statistical test was applied for correlation identification. Results: A total of 94 nondiabetic individuals participated, of whom 55 (58.5%) were women. Mean age, BMI, and CIMT values of the study population were 38.8 (±8.09) years, 29.6 (±3.22) kg/m2, and 0.72 (±0.10) mm, respectively. Average 1 h-PPG levels were 150.7 (±21.11) mg/dl, and the Pearson’s coefficient ( r) value with CIMT was 0.5792 ( P &lt; 0.05). Further, correlation analysis demonstrated an r-value of −0.0029 for BMI, −0.1293 for waist-hip ratio, −0.0047 for waist-height ratio, 0.3862 for glycated hemoglobin (HbA1c), and −0.2930 for 2 h-PPG. Conclusion: In euglycemic adults, the early insulin resistance defining parameter, i.e., 1 h-PPG levels had a consistent positive correlation with CIMT, which is a marker of the initial stages of atherosclerosis.

Non-Invasive Method of Human Exhaled Breath Analysis for Diabetes Detection Using Bidirectional Long-Short-Term Memory Algorithm

Volatile organic compounds (VOCs) have the potential to be used as biomarkers for pathophysiological and physical abnormalities associated with several disorders. A promising non-invasive metabolic monitoring method is the Analysis of VOCs in exhaled breath. It may also be used to monitor the development of certain diseases and their early detection. Diabetes is a metabolic disease and a complicated syndrome. The relationship between oxidative stress, inflammatory syndrome, hypertension, and diabetes is complicated. This study describes the creation of an Internet of Things (IoT) based breath analyzer to identify and track diseases using exhaled breath. Diabetic breath biomarkers and breath analysis are the main topics of discussion. A group of 25 diabetic patients and 15 non-diabetic individuals were tested using this system. Data is initially gathered using the wired module and the Cool Term software. The system is created for both wired and wireless devices. A deep learning algorithm analyses the disease characteristics after data collection. It clearly distinguishes between samples with diabetes and those without with 84% accuracy. This technology could detect a non-transmissible or transmissible disease early, preventing infection to others.

THU300 Assessment Of NAFLD Burden In An Employee Wellness Program Among Non-obese Patients Without Evident Metabolic Abnormalities

Abstract Disclosure: F. Bril: None. J. Louie: Employee; Self; Quest Diagnostics. D. Shiffman: Consulting Fee; Self; Quest Diagnostics. M.J. McPhaul: Employee; Self; Quest Diagnostics. Stock Owner; Self; Quest Diagnostics. The increasing prevalence of obesity in the US and worldwide has fueled a dramatic increase in the number of patients affected with nonalcoholic fatty liver disease (NAFLD). NAFLD is the deposition of excess fat in hepatocytes and is associated with increased insulin resistance. Unfortunately, there is a widespread belief that NAFLD is the liver manifestation of the metabolic syndrome (MetS). The aim of the study was to determine whether NAFLD can exist in the absence of the typical metabolic abnormalities that define MetS (i.e., obesity, hyperglycemia, dyslipidemia), and whether patients with NAFLD and without metabolic abnormalities would be missed if NAFLD scores based on adiposity, dyslipidemia or glycemia are used. Methods: We studied employees and spouses who participated in an annual wellness program that includes laboratory tests and anthropometric measurements. To assess the proportion of individuals likely to be affected with NAFLD we used the product of fasting intact insulin (II) and alanine transaminase (ALT) levels (II*ALT), a measure highly correlated with liver fat as measured by magnetic resonance spectroscopy in non-diabetic individuals (Bril et al, JCEM 2021) as well as fatty liver index (FLI, a clinical score for NAFLD based on BMI, triglycerides [TG], waist circumference and gamma-glutamyl transferase [GGT]). NAFLD was defined as II*ALT ≥ 290 or FLI ≥ 60. Individuals with diabetes, BMI &amp;lt;18.5, and those with missing data were excluded from the analysis. Results: In total, 29,977 participants met our criteria. Of these, 9,642 (32%) had prediabetes (PreD) and 20,335 (68%) were normoglycemic (NG: normal HbA1c and normal fasting plasma glucose). In the NG population, 2,443 (12.0%) individuals were identified as likely having NAFLD using II*ALT criteria. Even among non-obese patients (&amp;lt;30 kg/m2) with normal TG (&amp;lt;150 mg/dL) and normal HDL-C (males: ≥40 mg/dL; females ≥50 mg/dL), we identified 4.1% (n =426) who were likely to have NAFLD by the II*ALT criteria. Moreover, among patients considered ‘metabolically healthy obese’ due to the absence of hyperglycemia or dyslipidemia, 17.2% were likely to have NAFLD. Of note, FLI detected a smaller percentage of patients at risk of NAFLD among non-obese patients without hyperglycemia and dyslipidemia: 223 (2.1%). Among patients with PreD, those non-obese with normal TG and HDL-C showed a prevalence of NAFLD of 12.4% based on II*ALT, and only 5.5% based on FLI. Conclusion: A substantial percentage of patients has NAFLD even in the absence of obesity, dyslipidemia, and hyperglycemia. This implies that NAFLD can exist in the absence of MetS. While longitudinal studies are needed for confirmation, it suggests that NAFLD can predate the development of these metabolic abnormalities. Therefore, diagnostic methods that do not rely in adiposity, hyperglycemia, or dyslipidemia are needed to identify these patients. Presentation: Thursday, June 15, 2023

A case–control study to evaluate hematological indices in blood of diabetic and non-diabetic individuals in Ibb City, Yemen

Diabetes mellitus (DM) is a chronic, metabolic illness characterized by an elevation of blood sugar levels. Patients with diabetes show changes in hematological indices. The study aimed to determine hematological indices, ESR, CRP, blood pressure (BP), and weight and their relationship with a fasting blood sugar (FBS) level and different variables in diabetic mellitus patients (DM) compared with healthy control (HC). A total of 202 participants (102 DM group and 100 HC group) were selected randomly. Data were collected using a questionnaire. Blood samples were collected from different places and investigated in Zain Medical Laboratories in Ibb City, Yemen (September 2022 to May 2023). GraphPad Prim was used to analyze the results. P-value ≤ 0.05 was considered statistically significant. The mean and standard deviation of age, weight, gender, residence, marital status, education levels, economic status, regular exercise, following a strict diet, and family history of diabetes revealed significant differences between DM and HC groups (P < 0.0001, P = 0001, P = 0.0027, P = 0.0002, P < 0.0001, P < 0.0001, P = 0.0002, P = 0.0011, P < 0.0001 and P = 0.0001, respectively). FBS results, systolic and diastolic BP, MCV, WBCs, monocytes, eosinophils, and platelets displayed significant differences between both groups (P < 0.0001, P < 0.0001 and P = 0.0404, P = 0.0191, P < 0.0001, P = 0.0253, P < 0.0001, and P = 0.0229, respectively). ESR exhibited statistical significance (P < 0.0001), while CRP displayed no significance. A Pearson's correlation showed that weight, Hb, RBCs, PCV, and WBCs were statistically negatively correlated with FBS whereas other hematological indices showed no correlation with FBS. In conclusion, DM patients had relatively higher levels of MCV, WBCs, eosinophils, platelets and ESR than the control group.

Assessment of glycemic variability and lifestyle behaviors in healthy nondiabetic individuals according to the categories of body mass index.

There are limited data about the association between body mass index (BMI), glycemic variability (GV), and life-related factors in healthy nondiabetic adults. This cross-sectional study was carried out within our ethics committee-approved study called "Exploring the impact of nutrition advice on blood sugar and psychological status using continuous glucose monitoring (CGM) and wearable devices". Prediabetes was defined by the HbA1c level of 5.7-6.4% and /or fasting glucose level of 100-125 mg/dL. Glucose levels and daily steps were measured for 40 participants using Free Style Libre and Fitbit Inspire 2 under normal conditions for 14 days. Dietary intakes and eating behaviors were assessed using a brief-type self-administered dietary history questionnaire and a modified questionnaire from the Obesity Guidelines. All indices of GV were higher in the prediabetes group than in the healthy group, but a significant difference was observed only in mean amplitude of glycemic excursions (MAGE). In the multivariate analysis, only the presence of prediabetes showed a significant association with the risk of higher than median MAGE (Odds, 6.786; 95% CI, 1.596-28.858; P = 0.010). Additionally, the underweight (BMI < 18.5) group had significantly higher value in standard deviation (23.7 ± 3.5 vs 19.8 ± 3.7 mg/dL, P = 0.038) and coefficient variability (22.6 ± 4.6 vs 18.4 ± 3.2%, P = 0.015), compared to the normal group. This GV can be partially attributed to irregularity of eating habits. On the contrary, the overweight (BMI ≥ 25) group had the longest time above the 140 or 180 mg/dL range, which may be due to eating style and taking fewer steps (6394 ± 2337 vs 9749 ± 2408 steps, P = 0.013). Concurrent CGM with diet and activity monitoring could reduce postprandial hyperglycemia through assessment of diet and daily activity, especially in non- normal weight individuals.

Assessment of serum and salivary visfatin levels in newly diagnosed patients of type-II DM.

Type II diabetes mellitus (T2DM) is a metabolic disorder. It is thought to be an autoinflammatory disease, as inflammatory mediators are associated with the progression of the disease. Visfatin, an adipokine, is linked to insulin resistance. We aimed to study serum and salivary visfatin levels, at the time of diagnosis of T2DM, in middle-aged individuals, in the context of other diagnostic parameters like fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated haemoglobin A1c (HbA1c). Thirty newly diagnosed T2DM (Group-I, T2DM) patients and 30 healthy nondiabetic individuals (Group-II, health controls [HC]) matched for age and sex were studied. In both the groups, we assessed serum and salivary visfatin levels, and serum high-sensitivity C-reactive protein (hs-CRP) levels. We also compared serum and salivary visfatin levels and serum hs-CRP levels between Group-I and Group-II individuals. The correlation between the groups was tested using Pearson's correlation. A P- value < 0.001 was considered to be statistically significant. The data was tabulated using software MS Excel and analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 22.0. A positive correlation with a value of 0.8836 and a P value of 0.001 was noted between serum and salivary visfatin of Group-I. This is the first study in the Indian scenario to study the serum and salivary visfatin in newly diagnosed T2DM individuals. Serum visfatin and hs-CRP levels increased in T2DM, thus defining the link between visfatin, inflammation and T2DM, but we failed to notice a positive correlation.

Impact of type 2 diabetes on surgical site infections and prognosis post orthopaedic surgery: A systematic review and meta-analysis.

The escalating prevalence of type 2 diabetes raises concerns about adverse postoperative outcomes like surgical site infections (SSIs) and deep vein thrombosis (DVT) in orthopaedic surgeries. This meta-analysis aims to resolve inconclusive evidence by systematically quantifying the risks in type 2 diabetic patients compared to non-diabetic individuals. The meta-analysis was conducted adhering to the PRISMA guidelines and based on the PICO framework. Four primary databases were searched: PubMed, Embase, Web of Science and the Cochrane Library, with no temporal restrictions. Studies included were either prospective or retrospective cohort studies published in English or Chinese, which assessed orthopaedic surgical outcomes among adult type 2 diabetic and non-diabetic patients. The meta-analysis employed the Newcastle-Ottawa Scale for quality assessment and used both fixed-effect and random-effects models for statistical analysis based on the level of heterogeneity. Out of 951 identified articles, nine studies met the inclusion criteria. The odds ratio (OR) for developing postoperative SSIs among diabetic patients was 1.63 (95% CI: 1.19-2.22), indicating a significantly elevated risk compared to non-diabetic subjects. Conversely, no statistically significant difference in the risk of postoperative DVT was found between the two groups (OR: 0.82; 95% CI: 0.55-1.22). Sensitivity analysis confirmed the stability of these outcomes. Patients with type 2 diabetes are at a higher risk of developing SSIs post orthopaedic surgery compared to non-diabetic individuals. However, both groups demonstrated comparable risks for developing postoperative DVT.

Remnant cholesterol has an important impact on increased carotid intima-media thickness in non-diabetic individuals

To investigate the correlation the correlation between residual cholesterol (RC) and increased carotid intima-media thickness(cIMT) in non-diabetic individuals. This study included 1786 non-diabetic individuals who underwent carotid ultrasound. RC was calculated based on total cholesterol (TC), LDL-C, and high density lipoprotein cholesterol (HDL-C). The subjects were divided into the cIMT thickening group (cIMT ≥ 0.1 cm) and non-thickening group (cIMT < 0.1 cm) groups based on cIMT, binary logistic regression with different models and receiver operating characteristic (ROC) curves were adopted to evaluate the predictive ability of RC in cIMT. Of the research participants , their median age was 55 (49–51) years, 1121 (63%) were male, and 209 (12%) had hypertension, and people in the cIMT thickening group (925) were more likely to be older and male than those in the non-thickening group (843). Across the different RC subgroups, there was an increasing trend in maximum cIMT (P < 0.001) as RC levels increased within quartiles. RC was found to be an independent risk predictor for cIMT thickening (all P < in models 1–3); and this result persisted in the LDL-C normal subgroup (P = 0.002). The results suggested that RC was an independent predictor of cIMT thickening in non-diabetic individuals and had a strong atherogenic effect.

Association between Periodontitis and HbA1c Levels in Non-Diabetic Patients: A Systematic Review and Meta-Analysis.

A high detection rate of diabetes among dental visitors has been reported recently. This systematic review aimed to evaluate the association between periodontitis and glycated hemoglobin (HbA1c) levels among non-diabetic individuals. The EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed, and Open GREY databases were searched, and observational studies published until 1st June 2023 were identified. A methodological quality assessment was conducted based on the original and modified versions of the Newcastle-Ottawa scale. Cohort, case-control, and cross-sectional studies that performed clinical periodontal examinations and measured HbA1c levels in non-diabetic adults were included. A meta-analysis was conducted to estimate the weighted mean difference (WMD) between individuals with and without periodontitis. In total, 29 case-control and 5 cross-sectional studies were selected from 2583 potentially eligible articles. Among them, sixteen case-control and three cross-sectional studies with moderate to high quality were selected for the meta-analyses. The HbA1c levels in periodontitis patients were significantly higher than those in individuals with healthy periodontal conditions (WMD = 0.16; p < 0.001) among the non-diabetic populations. This study reveals a significant association between periodontitis and HbA1c levels in non-diabetic populations. Thus, HbA1c screening may be recommended to detect potential hyperglycemia in non-diabetic periodontitis patients.

Genetic polymorphisms in Nrf2 and FoxO1: implications for antioxidant enzyme activity in diabetes

In diabetes, persistent hyperglycemia generates excess reactive oxygen species (ROS), leading to oxidative stress (OS). In response to OS, transcription factors (TFs) Nrf2 and FoxO1 get activated, which induce the expression of antioxidant enzymes catalase (CAT) and superoxide dismutase (SOD). It is well documented that the antioxidant response in diabetic individuals is very low. Since Nrf2 and FoxO1 are the major TFs activating these genes, we were interested in determining if single nucleotide polymorphisms (SNPs) in genes for these TFs have any association with lowered antioxidant enzyme activity in diabetic individuals. The activity of CAT and SOD and total antioxidant capacity (TAC) were quantified from the serum samples of diabetic (n = 98) and non-diabetic (n = 90) individuals. Genomic DNA was isolated, and Nrf2 and FoxO1 were amplified and sequenced by Illumina NextSeq500. Data were screened for SNPs in amplified regions. An independent samples t-test to find an association between CAT, SOD, and TAC and allele frequency of SNP with the diabetic condition was carried out. We found decreased CAT and SOD activity and significantly low TAC in diabetic individuals. Thirty-two and thirty-four SNPs and Single-nucleotide variants (SNVs) were observed in Nrf2 and FoxO1, respectively. However, a statistically significant difference in the allele frequency distribution between study groups was observed only in two intronic SNPs, rs17524059:A > C and rs60373589:Indel(A) of Nrf2 and FoxO1, respectively. SNPs, rs17524059 in the Nrf2 and rs60373589 of FoxO1, were not associated with reduced CAT and SOD activity and level of TAC in Indian diabetic individuals. Communicated by Ramaswamy H. Sarma