Nondiabetic Persons Research Articles

The effect of sweet and salty taste sensitivity on gin-gival health in relation to salivary serotonin among type1 diabetic patients aged 12-14 years

Background: This study was conducted among diabetic persons to assess the sweet and salty taste sensitivity with its effect on gingival health in relation to salivary serotonin levels. Materials and methods: A cross-sectional comparative study design was used. All patients with diabetes aged 12-14 years that attend the Paediatric hospital at Baghdad medical city with specific inclusion criteria were involved in the sample of the present study (patients group 50 patients) compared with non-diabetic persons matched in age and gender of the study sample (control group 70 patients) who were attending dental unit in the college of dentistry/university of Baghdad. A two-alternative forced choice question including each component presented at five different quantities was used to evaluate the threshold sensitivity of salt and sweet taste, sub-sample of 44 subjects was recruited from each group and matched in age and gender for salivary analysis and serotonin measurement and gingival health status was measured by using the gingival index. Results: Data analysis of this study revealed that the occurrence of the highest sweet threshold was found among diabetic persons with no significant difference. The data revealed no significant difference in the mean gingival index while salivary serotonin value was lower in diabetic subjects with a significant difference; meanwhile, it showed no significant relation with both taste thresholds. Conclusions: Within the limitation of this study, it was observed, that diabetes did not affect salty and sweet taste thresholds in addition to gingival health. Whereas salivary serotonin had a role among the diabetic patients by which it was lower among diabetic subjects.

0706 Older Age Is a Strong Risk Factor for Supine-position Dependent Obstructive Sleep Apnea

Abstract Introduction Positional obstructive sleep apnea (p-OSA) is commonly defined as a supine-position dependent OSA with the ratio of apnea hypopnea index while supine (s-AHI) to AHI while non-supine (ns-AHI) being greater than 2. Prevalence of p-OSA amongst OSA patients varies from 20 to 75% depending on the study. Previous studies using this definition showed p-OSA being more likely to be in subjects with lower BMI, smaller neck circumference, and milder OSA compared to patients with non-positional OSA (np-OSA). The primary aim of this study is to assess the prevalence of p-OSA using different cutoffs of s-AHI/ ns-AHI ratio and to evaluate the correlation of p-OSA with age, gender, neck circumference (NC), and medical comorbidities of OSA. Methods 846 participants aged 18 year or older who underwent diagnostic polysomnography at an academic sleep disorders center from July 2011 to June 2012 were recruited for this study. Inclusion criteria were total sleep time greater than 120 minutes, diagnosis of OSA, sleep time in supine position more than 10 minutes, and sleep time in non-supine position more than 10 minutes. We tested supine position dependency using the ratio of supine AHI to non-supine AHI (s-AHI/ns-AHI) and classified the subjects into p-OSA and np-OSA based on the ratio of s-AHI/ns-AHI at 2, 3, 5, and 10 respectively to assess the prevalence of p-OSA using each cut-off. For the multivariable logistic analysis of p-OSA and its association with independent variables, s-AHI/ns-AHI of 10 and ns-AHI of being less than 5 was used to define p-OSA. Multivariate analysis was conducted to explore correlation with age, gender, neck circumference, and OSA comorbidities (COPD, hypertension, diabetes). Age of 60 was used to define older age group. Results Of 356 eligible participants, p-OSA was highly prevalent when conventional s-AHI/ns-AHI ration of 2 was used resulting in p-OSA in 274 subjects (prevalence of 77%). The mean value of s-AHI/ns-AHI in this aggregate group of all 356 subjects was 11.7 (much higher than conventional ratio of 2). Thus, using s-AHI/ns-AHI ratio of 10 as the cut-off for supine-position dependency, 114 subjects were classified to have p-OSA. Logarithmic multivariate analysis demonstrated that there was a statistically significant, correlation between age and s-AHI/ns-AHI after adjusting for gender, NC, diabetes, hypertension, and COPD (p-value < 0.05). In the older group, 44.3% of older patient had s-AHI/ns-AHI > 10 compared to 30% of young patients (p-value < 0.05). 41.8% of the older group met criteria for p-OSA compared to 29.2% of younger group (p-value < 0.05). Being of older age was strong risk factor for p-OSA with odds ratio (OR) of 1.76 (confidence interval 1.01 – 3.09; p< 0.05). This effect of age on p-OSA was further modified by gender and diabetes. Older men had significantly higher OR of 3.23 (CI 1.51-6.89) for p-OSA whereas olde women was with OR of 0.79 (CI 0.33-2.42). Older persons with diabetes showed significantly higher OR than non-diabetic older persons (OR of 6.81 [CI 1.7-26.8] vs OR 1.22 [CI 0.65-2.29] respectively). Conclusion Supine-position dependency of obstructive events is much stronger than the conventional ratio of two. Thus, stricter definition is positional OSA is desired for more clinically meaningful use of this subgroup of OSA. Using stricter definition with higher supine-position dependency, an older age is significantly associated with positional OSA, especially in men or in diabetic patients. Support (If Any)

Evaluation of Diabetic Patients’ Knowledge to Cutoff Osteoporosis at Diabetes Center in Duhok City

Background: Patients with T1DM had two to six fold greater of fractures hazard compared to healthy individuals, with the dangerous being highest in T1DM females. In a recent study examining the factors that influence bone break hazards in T1DM adult persons, about 50% of the participants said they had at least one fracture after being diagnosed with diabetes. With comparison of non-diabetic persons, those with T2DM get a 1.2- to 3-fold high prevalence of breakage, especially hip fractures and moreover forearm and leg fracture. Break incidence appear higher in people with a BMI of less than 30 kg/m2 comparing to obese people, and does not appear to differentiate much by gender. Longer duration of diabetes, poor levels of physical activity, sugar and systemically corticosteroid usage, and advancing ages are all linked to an increased fracture risk in T2DM patients. Falls are another cause of fractures, particularly in diabetic women. Aims: The present study conducted to evaluate the patients’ knowledge to put off osteoporosis among a sample from a diabetes center in Duhok city. Methodology: A descriptive design aimed to evaluate diabetic patients’ knowledge from 25 November 2020 to 26 June 2021. In order to get reliable data and a representative sample, a nonprobability (accidental) sample of 27 patients were selected from the diabetes center of Azadi teaching hospital in Duhok city. The statistical data analysis approaches used in order to analyze and assess the results of the study under the application of the statistical package (SPSS) ver. (22.0). Descriptive statistical data analysis and inferential data analysis were used to analyze the finding of the present study Results: The finding of the present study shows female were more than male, constituted 19 (70.4%). The distribution of the gender variable is coincident in the study, as it is high of females, age was between (50- 60) and constituted 12 (44.4%). With regard to the marital status, most of the participants were married and constituted 23(85.2%). Regarding the educational level, most of the participants do not read and write (illiterate) and constituted 12 (44.4%). Most of the participants had low knowledge score of Relative sufficiency coefficient (RS%) less than (33.34) about osteoporosis. Conclusion: Most of the participants were suffer from type two diabetes mellitus and most of them who visit a diabetes center had minimum knowledge toward osteoporosis. Instructional programs with a large sample should be designed for all diabetic patients with both types of diabetes to improve their knowledge about osteoporosis.

A Triplex Ultrasound Evaluation of Preclinical Changes in Type 2 Diabetes in Foot Arteries.

Background and objective: Type 2 diabetes mellitus (T2DM) is a significant health problem that is becoming more prevalent worldwide. This study aimed to assess hemodynamic and morphological parameters in diabetic patients' foot arteries and compare them to those obtained in asymptomatic control group.Materials and methods: This is a cross-sectional case-control study. B-mode ultrasound, color Doppler, and pulse wave Doppler were conducted to assess the dorsalis pedis arteries (DPAs) and posterior tibial arteries (PTAs). The morphological, total vascular diameter, wall thickness, and flow Doppler indices were measured. A total of 200 hundred participants were selected randomly using a random sampling technique. One hundred diabetic patients and 100 non-diabetic persons were determined.Results: In diabetic patients, the overall grayscale diameter and wall thickness of foot arteries were statistically significantly larger than the asymptomatic group in the right DPA (p<0.01), left DPA (p<0.001), right PTA (p<0.001), and left PTA (p<0.001). In the diabetic group, the level of hemoglobin A1c (HbA1c) was positively correlated with blood flow resistive index (RI) in the right DPA (r=0.839; p<0.001), left DPA (r=0.801; p<0.001), right PTA (r=0.801; p<0.001), and left PTA (r=0.801; p<0.001). No significant differences were noted in both groups in blood flow Doppler parameters - pulsatility index (PI) and resistive index (RI).Conclusion: Overall grayscale diameters of foot arteries are larger in the diabetes group than in the control group, indicating arterial wall thickening as an early indicator of diabetes-related alterations. PI of both DPA and RI of right DPA were increased in diabetic patients more than the control group. The level of glycosylatedhemoglobin A1c (HbA1c) was strongly linked with the blood flow resistive index in diabetes patients.

Consumption of caffeinated and decaffeinated coffee enriched with cocoa and fructo-oligosaccharides among non-diabetic persons: Double blind randomized clinical trial.

Food industry has been investing in bringing to the market coffee-based drinks enriched in compounds that promise weight loss, which consequently influences diabetes risk. However, there are no clinical trials showing the effects of brewed coffee (with or without caffeine) enriched with bioactive compounds on body fat and glycemic control in healthy individuals. Therefore, we have evaluated the effect of consuming two coffee formulas enriched with cocoa and fructo-oligosaccharides (FOS) on glycemic and anthropometric biomarkers and blood pressure in non-diabetic adults for 10weeks. In general, we observed that the values of fasting plasma glucose (FPG) (p=.006) and fasting capillary blood glucose (FCBG) (p<.001) had lower values with a tendency to decrease in FCG (p=.003) and FBG (p<.005) in both formulas. We observed statistically significant reductions in waist circumference (WC) (p=.012), arm circumference (AC) (p=.015), and percentage of fat (<0.0001) for all participants. However, we noticed a greater reduction in the caffeinated formula group (-2.92%, p=.005) compared to the decaffeinated formula (-1.62%, p=.008). Consumers of both cocoa and FOS-enriched coffee formulas benefited from reduced FBG, FCG, WC, and body fat percentage. The consumption of caffeinated formula was more effective in reducing the percentage of fat, while the decaffeinated formula was more effective in reducing diastolic blood pressure. PRACTICAL APPLICATIONS: This study provides robust evidence that effects of fortified coffee on non-diabetic people is positive for reduction in blood glucose, body fat and diastolic blood pressure. This study proposes a practical and safe coffee formulation for the consumption of caffeinated and decaffeinated coffee for non-diabetic people.

Sensitivity enhancement of a plasmonic biosensor for urine glucose detection by employing black phosphorous

A novel, to the best of our knowledge, optimized structure is proposed to enhance the sensitivity of a surface plasmon resonance (SPR)-based biosensor for urine glucose detection by adding a few layers of black phosphorous (BP) (two-dimensional material) over the zinc oxide (ZnO) sandwiched in between gold (Au) and silver (Ag) bimetallic layers. Results show that with an optimized thickness of 42 nm/Au, 12 nm/ZnO, .05 nm/Ag, and 2.65 nm/BP, the sensitivity of 289°/RIU can be achieved at a 633 nm operating wavelength. This is enhanced up to 1.5 times from the conventional biosensor. It is further enhanced up to 3 times with the addition of five numbers of BP sheet layers (each sheet has a thickness of 0.53 nm) over the Au/ZnO/Ag layers, as BP possesses a high absorption coefficient at the incident wavelength of 633 nm. This biosensor is rather efficient at responding to the minute change of 0.001 in the refractive index of urine samples for non-diabetic persons (0–15 mg/dL) and diabetic persons (0.625 gm/dL, 1.25 gm/dL, 2.5 gm/dL, 5 gm/dL, and 10 gm/dL) with the corresponding refractive indices of 1.335, 1.336, 1.337, 1.338, 1.341, and 1.347. It provides significant resonance shift and higher sensitivity in terms of changes in the resonance angle shift. This proposed work has the potential to detect glucose concentration levels with higher accuracy and with faster sensor responses.

Robust Antibody Levels in Both Diabetic and Non-Diabetic Individuals After BNT162b2 mRNA COVID-19 Vaccination.

The emergence of effective vaccines for COVID-19 has been welcomed by the world with great optimism. Given their increased susceptibility to COVID-19, the question arises whether individuals with type-2 diabetes mellitus (T2DM) and other metabolic conditions can respond effectively to the mRNA-based vaccine. We aimed to evaluate the levels of anti-SARS-CoV-2 IgG and neutralizing antibodies in people with T2DM and/or other metabolic risk factors (hypertension and obesity) compared to those without. This study included 262 people (81 diabetic and 181 non-diabetic persons) that took two doses of BNT162b2 (Pfizer–BioNTech) mRNA vaccine. Both T2DM and non-diabetic individuals had a robust response to vaccination as demonstrated by their high antibody titers. However, both SARS-CoV-2 IgG and neutralizing antibodies titers were lower in people with T2DM. The mean ( ± 1 standard deviation) levels were 154 ± 49.1 vs. 138 ± 59.4 BAU/ml for IgG and 87.1 ± 11.6 vs. 79.7 ± 19.5% for neutralizing antibodies in individuals without diabetes compared to those with T2DM, respectively. In a multiple linear regression adjusted for individual characteristics, comorbidities, previous COVID-19 infection, and duration since second vaccine dose, diabetics had 13.86 BAU/ml (95% CI: 27.08 to 0.64 BAU/ml, p=0.041) less IgG antibodies and 4.42% (95% CI: 8.53 to 0.32%, p=0.036) fewer neutralizing antibodies than non-diabetics. Hypertension and obesity did not show significant changes in antibody titers. Taken together, both type-2 diabetic and non-diabetic individuals elicited strong immune responses to SARS-CoV-2 BNT162b2 mRNA vaccine; nonetheless, lower levels were seen in people with diabetes. Continuous monitoring of the antibody levels might be a good indicator to guide personalized needs for further booster shots to maintain adaptive immunity. Nonetheless, it is important that people get their COVID-19 vaccination especially people with diabetes.

Near-infrared optical spectroscopy for pancreas shrinkage estimation with multi synchrosqueezing transform and multivariate regression model.

In this article, we proposed a method to estimate pancreas shrinkage with pancreas β cell insulin secretion. The β cells in the pancreas secrete insulin and digestive enzymes after food consumption. Conventionally, the pancreas structure estimation is done with magnetic resonance imaging (MRI) and ultrasound imaging techniques. However, the structure of the pancreas changes due to islet cell death. The presence of islet cells is detected through near infrared (NIR) spectroscopy signal acquired from the epigastric region (pancreas) of the abdomen. Subsequently, the NIR spectroscopy signal from the pancreas is analyzed with multi synchrosqueezing transform (MSST); whereas, the β cell insulin secretion varies for diabetic and nondiabetic persons. The existence of β cell and insulin secretion correlates with Root Mean Square (RMS) and kurtosis via a multivariate regression model to evaluate pancreas shrinkage. In terms of numerical results, NIR spectroscopy signal from the pancreas was obtained for about 20 nondiabetic and 20 diabetic persons. The pancreas shrinkage was estimated with 88% accuracy. The results are validated with MRI pancreas images for earlier detection of the apoptotic pancreas. The pancreas shrinkage causes lower insulin emission and unpredictable blood glucose in diabetic patients. Analysis of NIR spectroscopy signals of the pancreas with MSST was done to obtain higher-order and lower-order frequency components.

Gustatory sweating in people with type 1 and type 2 diabetes mellitus: Prevalence and risk factors.

ObjectiveGustatory sweating (GS) is characterized by profuse sweating during or immediately after ingestion of food and is known as a complication of diabetes mellitus (DM). This study aimed to determine the prevalence of GS and to characterize the sweating in a cohort of patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM) as compared with a control group.MethodsIn a cross‐sectional study, 665 outpatients with T1DM and 505 outpatients with T2DM filled in an 8‐point questionnaire about GS. Answers were paired with medical data from the electronic patient records to explore associations with DM complications. The control group consisted of 1158 persons without DM answering the same questionnaire in an online version.ResultsIn people with T1DM and T2DM, the prevalence of GS was 10% (95% CI 7%–12%) and 13% (95% CI 10%–16%), respectively. In the control group, the prevalence of GS was 5% (95% CI 3%–6%). Most commonly, people sweat on the face and/or head and upper body with a duration of 10–30 min albeit in the control group <10 min. In patients with T1DM, increased HbA1c was associated with GS (OR 1.3 [95% CI 1.05–1.6], p = .016), and in T2DM, younger age (OR 0.95 [95% CI 0.92–0.99), p = .006), presence of severe peripheral neuropathy (OR 2.33 [95% CI 1.04–5.2], p = .039) and absence of proliferative retinopathy were associated with GS (OR 0.22 [95% CI 0.07–0.71], p = .011).ConclusionWe found the prevalence of gustatory sweating of 11% in a hospital‐based cohort of patients with T1DM and T2DM. This was twice as high as in non‐diabetic control persons. Associations between GS and known diabetes complications could only be demonstrated in T2DM. Compared with a control group without DM, odds for GS are higher in people with DM and age >45.

A Comparative Study of Emotional Intelligence and Self-Efficacy among Diabetic and Non-diabetic persons

Diabetes is the most chronic disease affecting people physically and psychologically. Researches indicate that people struggling from diabetes face multiple challenges of self-caring, monitoring and managing their life. The purpose of this study is to compare self-efficacy and Emotional Intelligence among Diabetic and Non-diabetics. The Self-efficacy scale and Emotional Intelligence inventory were administered on 60 individuals (30 diabetics and 30 non-diabetics). The results indicate that Diabetics and Non-diabetics differ significantly in Self-efficacy and Emotional intelligence and also revealed significant relationship between them.

Diabetes and COVID-19: A Tale of 2 Pandemics.

Diabetes and COVID-19: A Tale of 2 Pandemics.

Evaluation of predominant risk factors for type 2 diabetes mellitus among out-patients in two Nigerian secondary health facilities.

Prevention of type 2 diabetes is enabled by identification and effective management of risk factors. To evaluate the predominant risks for type 2 diabetes and identify persons at highest risk in a population; to facilitate the understanding of implications for practice. Cross-sectional survey using Canadian diabetes risk assessment questionnaire was conducted among non-diabetic persons who visited two secondary hospitals. SPSS version 18 was used for data analysis. A total of 300 respondents participated in the study, with 25.7% having family history of type 2 diabetes, while 160 (53.3%) were at high risk of developing the disease. Males (62.5%), overweight (65.1%) and obese (82.6%) participants, were at higher risk. Others found to be at high risk were respondents with high waist circumference (55.6%), respondents who did not exercise (77.0%), those who did not eat fruits/vegetable daily (54.4%), those with high blood pressure (67.5%) and those who have had raised blood sugar in the past (71.0%). Majority of the study participants was at high risk for type 2 diabetes, male participants had higher risks and lifestyles/habits were the major risks for developing the disease..

Obesity and Circulating Levels of Vitamin D before and after Weight Loss Induced by a Very Low-Calorie Ketogenic Diet.

Background: Vitamin D plays a pivotal role in calcium and phosphorus metabolism, also influencing bone tissue. Several studies have reported that vitamin D blood levels were significantly lower in people with obesity, probably due to its uptake by the adipose tissue. Clinical studies that investigated the changes of circulating levels of vitamin D following weight loss reported controversial data. A very low-calorie ketogenic diet is acknowledged as a reliable treatment to achieve a rapid weight loss. Therefore, we investigated the effect of weight loss, consequent to a very low-calorie ketogenic diet, on vitamin D blood concentrations. Methods: A cohort of 31 people with obesity underwent a very low-calorie ketogenic diet for 10–12 weeks. The serum concentrations of vitamin D, parathormone, calcium and phosphorous were measured before and after weight loss; they were compared to a control group of 20 non-obese, non-diabetic, age- and gender-matched persons. Results: Patients with obesity had a higher habitual intake of vitamin D than the control group (p < 0.05). However, the vitamin D blood levels of the obese group were significantly lower than those of the control group (p < 0.005) and they increased after weight loss (p < 0.001). At baseline, vitamin D blood concentrations of the persons with obesity were significantly correlated with both fat mass–kg (r = −0.40; p < 0.05) and body mass index (r = −0.47; p < 0.01). Following very low-calorie ketogenic diet, the change in vitamin D serum concentrations was correlated only with the change in fat mass–kg (r = −0.43; p < 0.01). Conclusion: This study confirmed that patients with obesity have lower vitamin D levels that normalize after significant weight loss, supporting the hypothesis that vitamin D is stored in the adipose tissue and released following weight loss.

Estimation and comparison of salivary flow rate and its composition in diabetic patients and nondiabetic patients

Background:Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia irregularities in the metabolism of carbohydrates, lipids and protein. It is often associated with the development of microvascular and macrovascular complications and neuropathies. The health of oral tissues is known to be related to the quality and quantity of saliva both of which may be altered in diabetes.Aim:The aim of the present study was to determine the salivary flow rate, electrolytes and total proteins in saliva of Type II diabetic patients.Materials and Methods:A total number of 120 participants were included in this study, in which 80 patients were suffering from Type II DM (which included both controlled and uncontrolled diabetes) and 40 nondiabetic persons (controls). The study population included both the genders, with an age range of 40–70 years. The study population was divided into three groups.Results:The values of total protein, sodium, potassium and salivary flow rate among controls, controlled diabetes and uncontrolled diabetes were collected, formulated and multiple comparisons between the groups using the analysis of variance and post hoc Tukey honestly significant difference analysis were done in version 16.0 of SPSS software.Conclusion:Studies with larger sample size are warranted to know the exact pathophysiology of controlled and uncontrolled Type II DM in terms of salivary flow rate, salivary electrolytes and total protein.

The impact of baseline glomerular filtration rate on subsequent changes of glomerular filtration rate in patients with chronic kidney disease

Higher baseline glomerular filtration rate (GFR) may yield subsequent steeper GFR decline, especially in patients with diabetes mellitus (DM). However, this correlation in patients with chronic kidney disease (CKD) and the presence or absence of DM remains controversial. We conducted a longitudinal cohort study in a single medical center between 2011 and 2018. Participants with CKD stage 1 to 3A were enrolled and divided into DM groups and non-DM groups, and then followed up at least every 6 months. We used a linear mixed regression model with centering time variable to overcome the problem of mathematical coupling in the analysis of the relation between baseline GFR and the changes, and compared the results from correct and incorrect specifications of the mixed models. A total number of 1002 patients with 285 diabetic and 717 non-diabetic persons was identified. The linear mixed regression model revealed a significantly negative correlation between baseline GFR and subsequent GFR change rate in both diabetic group and non-diabetic group (r = − 0.44 [95% confidence interval [CI], − 0.69 to − 0.09]), but no statistical significance in non-diabetic group after within-subject mean centering of time variable (r = − 0.09 [95% CI, − 0.41 to 0.25]). Our study showed that higher baseline GFR was associated with a subsequent steeper GFR decline in the DM group but not in the non-DM group among patients with early-stage CKD. Exact model specifications should be described in detail to prevent from a spurious conclusion.

A Large Left Atrium Myxoma Presenting as 'Positional Pre-Syncope'

A 45-year-old male was referred to the out-patient clinic of Cardiology department with complaints of recurrent lightheadedness and dizziness on standing and changing postures in bed for past 3 months. He was normotensive, and non-diabetic person with no history of chest pain, dyspnea, palpitations, TIA or stroke. His ECG was unremarkable.

Hyperglycemia: An independent accompaniment of COVID -19.

Dear Editor, In the journal's September 2020 issue, the commentary “Behera KK, Hota D, Mahapatra A. COVID 19 and diabetes: An endocrinologist's perspective. J Family Med Prim Care 2020;9:4512-5“[1] briefly summarizes the pathogenesis of increased mortality and desirable actions by the physicians in diabetic patients with COVID-19 infection. The authors have stressed the role of prevailing chronic inflammation in inviting infections in diabetes. An increased synthesis of advanced glycated end products and pro-inflammatory cytokines and prevailing high oxidant state favors production of adhesion molecules thereby causing a chronic inflammatory state in diabetes with a higher propensity to infections.[2] However, the prevalence of diabetes in COVID 19 is reported to be lower or similar to that in general population may be either because of use of DPP-4 inhibitors in treatment of diabetes or because of underreporting or higher precautionary measures taken by diabetic patients.[3] It becomes important to highlight here that dipeptidyl peptidase-4 (DPP-4) is the primary receptor of MERS- CoV, which may also be a receptor for SARS CoV-2.[4] Nonetheless, preexisting diabetes in COVID 19 infection increases the risk of complications, contributed significantly by a preexisting pro-coagulant thrombotic state, higher cytokine levels, existing vascular inflammation and endothelial dysfunction in diabetic patients.[5] COVID-19 infection in diabetic patients triggers greater release of stress hormones e.g., glucocorticoids and catecholamine which in turn further increases the blood glucose levels. However, we want to highlight the importance of monitoring of blood glucose even in nondiabetic COVID -19 positive patients, as hyperglycemia worsens the prognosis of COVID-19 more in nondiabetic person than in diabetic patient as reported by Sing A.[6] The mechanism of hyperglycemia in COVID -19 can be explained on the basis of high stress, causing release of stress hormones, which are hyperglycemic by function. Secondly attachment of SARS CoV-2 virus to ACE II receptors on pancreatic beta cells, causes dysregulated insulin release, contributing to hyperglycemia. Considering the increasing COVID-19 numbers with not yet declared community transmission stage, a regular self blood glucose monitoring along with monitoring of oxygen saturation by pulse oximetry, should be advocated for all, to raise a suspicion of possible infection and need for confirmatory testing. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

A clinical study of the pre-corneal tear film in diabetic and non-diabetic persons- a case control study

Introduction: Several local and systemic disorders predispose to the development of dry eye disease, common among them being diabetes mellitus. This study aims to assess the incidence of dry eye in diabetics and analyse the factors worsening dry eye in these patients. Materials and Methods: A total of 200 patients were included in the study. The participants were grouped under two groups- diabetics and non- diabetics group (control). All patients underwent a thorough ophthalmic examination including visual acuity, slit lamp biomicroscopy of anterior segment. Corneal sensation, tear film break up time, schirmers test, flourescein staining, Rose Bengal and lissamine green staining were also done. Results: Four hundred eyes of two hundred patients were included. There were a total of 86 (43%) males and 114 (57%) females in the study. The mean age of males was 50.13 years and the mean age of females was 50.27 years. In diabetics, 38 eyes (19%) had dry eye, out of which 24 eyes (63.15) were outdoor workers and 14 eyes (36.84%) were indoor workers and in non-diabetics, 14 eyes (7%) had dry eye out of which 12 eyes (85.71%) were of outdoor workers and 2 eyes (14.28%) were of indoor workers. Outdoor workers had statistically significant high risk of developing dry eye compared to indoor workers. Out of 52eyes with dry eye, 23 (88.46%) out of the 26 affected individuals were above 50 years of age and 3 (11.53%) were below 50 years of age. TBUT test was positive in 18 eyes (9%) in non-diabetics and 38 eyes (19%) in diabetic group. The schirmers values were significantly lower in diabetics compared to non-diabetics. Conclusion: Diabetic patients are at more risk of developing dry eye compared to controls. Keywords: Diabetes mellitus, Dry eye, Schirmers test.

Tubular Secretory Clearance Is Associated With Whole-Body Insulin Clearance.

The kidneys eliminate insulin via glomerular and peritubular mechanisms; consequently, the kidney contribution to insulin clearance may be underestimated by the glomerular filtration rate (GFR) alone. To determine associations of tubular secretory clearance with whole-body insulin clearance and sensitivity in a dedicated study of glucose and insulin metabolism. We performed an ancillary, cross-sectional study of tubular secretion in the Study of Glucose and Insulin in Renal Disease (SUGAR). Hyperinsulinemic-euglycemic clamps were performed in 57 nondiabetic persons with chronic kidney disease and 38 persons without kidney disease. We measured plasma and 24-hour urine concentrations of endogenous solutes primarily eliminated by tubular secretion. Kidney clearances of secretory solutes were calculated as the amount of blood fully cleared of that solute per minute. Whole-body insulin clearance, insulin sensitivity. Mean whole-body insulin clearance was 924 ± 228 mL/min. After adjustment for age, sex, Black race, fat and fat-free mass, each 20% lower estimated GFR was associated with a 13 mL/min lower insulin clearance (95% confidence interval [CI], 2-24 mL/min lower). Each 20% lower clearance of isovalerylglycine and xanthosine were associated with a 16 mL/min lower (95% CI, 5-26 mL/min lower) and 19 mL/min lower (95% CI, 7-31 mL/min lower) insulin clearance, respectively. Neither estimated GFR nor secretory solute clearances were associated with insulin sensitivity after adjustment. These results highlight the importance of tubular secretory pathways to insulin elimination but suggest that kidney functions in aggregate contribute only modestly to systemic insulin clearance.

RETRACTED ARTICLE: Application of back propagation artificial neural network in detection and analysis of diabetes mellitus

Diabetes Mellitus affects adults and children, causing changes in lifestyle. The diabetic affected person count has increased drastically worldwide over the last few years; about 425 million people have diabetes. By 2030, it is predicted that diabetic disorder will be the seventh leading cause of human death. Diabetes mellitus is measured invasively. This method has limitations such as patient’s preparation, piercing of the skin, which causes infection and needs for skilled technicians. In order to avoid the limitations of invasive methods, vibrations from the pancreas are acquired using a smartphone accelerometer sensor and detecting the value of diabetes. The human body has a unique energy signature for every organ, which leads to vibrations with different frequencies. The frequency of the vibration signal from the pancreas is proportional to insulin secretion and dynamics. The signals obtained from the accelerometer sensor are trained and analyzed with the Levenberg–Marquardt algorithm for obtaining the relation between the excess insulin secretion and clinical value of the diabetic level of the person. The accelerometer signals and clinical values are modeled with Regression analysis for the diabetic and non-diabetic persons. The results show the correlation between the fluid dynamics of insulin and clinical value at about 95% in prediction.