Diabetes Mellitus In People Research Articles

Modern Aspects of the Clinic, Diagnosis and Treatment of Prediabetes

Prediabetes is a common violation of carbohydrate metabolism, the medical and social relevance of which is due to the negative impact on the incidence of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD). The analyzed literature emphasizes the presence of a close pathogenetic relationship between type 2 DM/prediabetes and CVD. This relationship becomes even more relevant, taking into account, on the one hand, the persistent upward trend in the prevalence of carbohydrate metabolism disorders in the population, and on the other hand, the fact that in patients with dysglycemia it is cardiovascular complications that are the main cause of death. However, while the significance of type 2 DM as a risk factor for CVD is widely known and its presence immediately stratifies most patients to a group of high or very high cardiovascular risk, the contribution of prediabetes to the development of CVD remains underestimated among the therapeutic and cardiological communities. The high prevalence of prediabetes creates prerequisites for a further increase in the incidence of type 2 DM and CVD in the Russian Federation, which requires doctors of various specialties to be wary of early detection of prediabetes, since timely preventive measures can significantly reduce the risk of type 2 DM and its complications in the future. Currently, the effectiveness of both non-drug and drug strategies in preventing the development of type 2 DM in people with prediabetes has been confirmed, more and more data are accumulating about the possibility of effective prevention of CVD in prediabetes. According to modern research, the primary role of measures to actively change lifestyle in the treatment and prevention of prediabetes is emphasized, at the same time, the effectiveness of these measures can be reduced due to insufficient commitment of the patients themselves to their independent long-term implementation. Therefore, the strategy of prescribing metformin for the prevention of type 2 diabetes is absolutely justified if the doctor and patient recognize the inefficiency or inability to follow the recommendations for active lifestyle changes for a long time. The article presents the data on the etiology, epidemiology, diagnosis, and approaches to the management of patients with prediabetes from the standpoint of modern recommendations.

Development of Type 2 Diabetes Mellitus in People With Intermediate Hyperglycemia.

Development of Type 2 Diabetes Mellitus in People With Intermediate Hyperglycemia.

A review of glycaemic changes on vision in phakic, aphakic and pseudophakic people with diabetes

Background: One of the leading causes of preventable blindness is cataract affecting approximately 18 million people worldwide. Twenty per cent of cataract operations worldwide are performed on people with diabetes mellitus (PDM).Aim: The aim of this review article is to analyse the scientific literature relating to visual changes associated with diabetes mellitus (DM) in pseudophakic, aphakic and phakic people, and to discuss the consequences of these changes for optometrists.Method: A literature search was conducted on PubMed, the University of KwaZulu-Natal Libraries and Google Scholar databases from August 2017 to August 2018.Results: Acute and chronic hyperglycaemia in DM causes myopia in phakic PDM, whilst in aphakic PDM it causes a hyperopic shift in refraction. It has been reported that contrast sensitivity and visual acuity are affected by changes in blood glucose. People with DM have increased central corneal thickness as compared to non-diabetics, whilst only the posterior corneal curvature is affected by hyperglycaemia in PDM. No evidence exists on the effects of glycaemic changes in pseudophakes.Conclusion: It should be noted that high blood glucose level (BGL) induces transient myopia and hyperopia in chronic phakic PDM and aphakic PDM, respectively. All refractive procedures, including prescription of spectacles, corneal refractive procedures and lens extraction, should be deferred until normalisation of BGL in phakic and pseudophakic PDM, as higher sugar levels affect corneal curvature and thickness and overall vision.

Overview and project highlights of an initiative to integrate diabetic retinopathy screening and management in the public health system in India.

Purpose:Diabetes is a public health concern in India and diabetic retinopathy (DR) is an emerging cause of visual impairment and blindness. Approximately 3.35–4.55 million people with diabetes mellitus (PwDM) are at risk of vision-threatening DR (VTDR) in India. More than 2/3 of India's population resides in rural areas where penetration of modern medicine is mostly limited to the government public health system. Despite the increasing magnitude, there is no systematic screening for the complications of diabetes, including DR in the public health system. Therefore, a pilot project was initiated with the major objectives of management of DR at all levels of the government health system, initiating a comprehensive program for the detection of eye complications among PwDM at public health noncommunicable disease (NCD) clinics, augmenting the capacity of physicians, ophthalmologists and health support personnel and empowering carers/PwDM to control the risk of DR through increased awareness and self-management.Methods:A national task force (NTF) was constituted to oversee policy formulation and provide strategic direction. 10 districts were identified for implementation across 10 states. Protocols were developed to help implement training and service delivery.Results:Overall, 66,455 PwDM were screened and DR was detected in 16.2% (10,765) while VTDR was detected in 7.5%. 10.1% of those initially screened returned for the next annual assessment. There was a 7-fold increase in the number of PwDM screened and a 7.6-fold increase in the number of PwDM treated between 2016 and 2018.Conclusion:Services for detecting and managing DR can be successfully integrated into the existing public health system.

THE EFFECT OF HEALTH EDUCATION THROUGH SESSION-HEALTH APPLICATION MEDIA ON BEHAVIOR MANAGEMENT BEHAVIOR OF DIABETES MELITUS IN BENGKULU CITY

Background: Diabetes mellitus (DM) is a chronic disease that requires specific self-management behavior for a lifetime, to avoid long-term diabetic complication. Education about diabetes self-management for people with diabetes mellitus and families is absolutely necessary to overcome diabetic complications. The use of smartphones as educational media provides space for people with DM without restrictions on place and time.Objective: The aims of this study was to identify the effect of health education through the Salam-Sehat application media on diabetes self-management behavior.Method: This research is quantitative with pre-experiment design with one group pre-test post-test. The population of this study was all people with DM in Bengkulu City. Sample was selected by using Multi Stages Cluster Sampling technique. The sample size was determined using the Slovin formula which results are 384 respondents. The sample was selected by using proportional random sampling. The Data were analyzed by using the Wilcoxon Signed Rank Test.Result: The results showed that the average DM self-management behavior before being given education through the Salam-Sehat application was 35.42 and the average DM self-management behavior after being given education through the Salam-Sehat application was 65.18. There is significant influence of health education through Salam-Sehat application media for self-management behavior among diabetes mellitus people in Bengkulu City, with Asymp value. Sig (p) = 0.000.Conclusion: It is expected that the research results of the Salam-Sehat application can be used as an online-based health education media that provides convenience in obtaining health information without being limited by space and time for people with DM in Bengkulu City. Key words: Diabetes Mellitus, Self-Management, Application.

Diabetes mellitus in people living with HIV/AIDS: prevalence and associated risk factors

ABSTRACTThe objectives of this study were to estimate the prevalence of diabetes mellitus in people with HIV/AIDS and to assess the associated risk factors. A cross-sectional study with 168 patients treated at an infectious disease outpatient. Were investigated sociodemographic, epidemiological and clinical variables through interview using forms. Casual plasma glucose, blood pressure and anthropometric data were recorded. For the analysis, we used descriptive statistics and logistic regression. The results showed that most patients were male, single, with 9–12 years of schooling, in the category of sexual exposure and heterosexual. The prevalence of diabetes mellitus was 7.14%, and risk factors were smoking, alcohol use, inadequate diet, increased abdominal circumference, overweight, age over 45 years, family history of diabetes and personal history of hypertension. Women were 5.29 times more likely to have increased abdominal circumference (P < 0.001). Men (P = 0.003), married (P = 0.035), with monthly income greater than two times the minimum wage (P = 0.035) were more likely to be hypertensive. Diabetes occurred in older patients (P = 0.008). In conclusion, the prevalence of people with HIV/AIDS and diabetes mellitus was 7.14%, and most had modifiable risk factors for diabetes, including smoking, alcohol use, inadequate diet and overweight, needing health education interventions for diabetes prevention.

Lipid Profile and Diabetes Mellitus in People With HIV

Lipid Profile and Diabetes Mellitus in People With HIV

Anti-diabetic agents for prevention of type 2 diabetes mellitus in people with pre-diabetes: a systematic review and network meta-analysis protocol

IntroductionType 2 diabetes mellitus (T2DM) is a substantial health problem worldwide. Pre-diabetic state is associated with increased risk for the development of diabetes. There are various pharmacological therapies with glucose-lowering...

PILOT STUDI: MANAJEMEN DIRI PASIEN DIABETES MELITUS DI RUMAH SAKIT HL. MANAMBAI ABDULKADIR

Background: The population of people with diabetes mellitus is increasing every year, furthermore included into number three of deadliest disease in Indonesia. The total number of patients with diabetes mellitus currently are 10.3 million, predicted in 2045, the population will increase to 16.7 million. The main cause population of people with diabetes mellitus are increasing due to public awareness regarding self-management is still less. No researcher has been conducted research about diabetes self-management in HL. Manambai Abdulkadir hospitals. Objectives of the Pilot Study: the main objective in this pilot study was to understand the self-management of people with diabetes mellitus in HL Manambai Abdulkadir hospitals. Methodology: The participants in this pilot study were people diabetes mellitus type 2 in HL Manambai Abdulkadir hospitals using cross sectional design by diabetes self-management, self-efficacy, diabetes self-management knowledge and diabetes distress scale questionnaire. Results: 60% of patients in HL Manambai Abdulkadir hospitals had lack of self-management. The result from measuring of distress scale, knowledge and self-efficacy of patients are related to self-management of patients with diabetes mellitus with P Value &lt;0.05. Conclusion: further research is needed with additional interventions to overcome the lack of self-management to people who suffer diabetes mellitus in HL Manambai Abdulkadir Hospital.

Lorcaserin for prevention and remission of type 2 diabetes mellitus in people with overweight or obesity: protocol for a systematic review and meta-analysis

IntroductionHigh body mass index (BMI) is associated with risk of diabetes. Lorcaserin is a selective 5-hydroxytryptamine 2C agonist which exerts robust benefits on long-term weight loss by suppressing appetite among...

A qualitative study on barriers and enablers to uptake of diabetic retinopathy screening by people with diabetes in the Western Province of Sri Lanka

BackgroundBlindness and visual impairment from diabetic retinopathy (DR) are avoidable through early detection and timely treatment. The Western Province of Sri Lanka has the highest prevalence of diabetes mellitus (DM) (18.6%) in the country. A situational analysis identified a significant gap in DR screening services (DRSS) uptake in this region. Barriers that hinder people with DM (PwDM) from attending DRSS are poorly understood. The purpose of this study is to understand the factors which influence the uptake of DRSS and follow-up to inform health promotion strategies and improve the uptake of these services.MethodsEleven focus group discussions (FGDs) were conducted with PwDM who presented to medical, general eye and vitreoretinal services in three public sector institutions (two tertiary and one secondary level) in the Western Province between October 2016 and March 2017. We enrolled six groups (four Sinhala speaking, two Tamil) of women and five groups (three Sinhala and two Tamil) of men representing ethnicity and gender. We performed a thematic analysis and described the main themes and subthemes using the socio-ecological model as a framework.ResultsWe identified lack of knowledge of both the condition and the need for screening as key barriers to access DRSS. Socio-cultural factors in the family environment, economic reasons and institutional factors were also important barriers. Additional reasons include long waiting time at eye clinics and poor referrals exacerbated by the lack of a systematic DRSS. In addition, attitudes to DRSS such as fear of discomfort from the procedure and the need for accompaniment following mydriasis were also deterrents to follow-up screening.ConclusionThis study has shown that there are inter-related user, family, and institutional factors which affect the uptake of DRSS. Understanding how DR is conceptualised by PwDM in this region is essential to refine strategies to improve access to DRSS. Strategies to improve knowledge need to be more culturally acceptable and relevant to PwDM and their families, with increased availability of DRSS at convenient locations may increase timely uptake of screening.

A benefit–harm analysis of adding basal insulin vs. sulfonylurea to metformin to manage type II diabetes mellitus in people with multiple chronic conditions

ObjectivesThe benefits and harms of diabetes treatments need to be carefully weighed in people with type II diabetes mellitus (DM) and multiple chronic conditions (MCCs). Our objective was to quantitatively assess the benefits and harms of the addition of basal insulin (insulin) vs. sulfonylurea (SU) to metformin in people with DM and MCCs. Study Design and SettingData inputs into the benefit–harms analysis included (1) baseline risks of patient-centered outcomes (death, myocardial infarction, stroke, severe hypoglycemia, diarrhea, nausea) from cohorts and trials; (2) treatment effects for the addition of insulin vs. SU from a network meta-analysis; and (3) patient preference survey for outcome weights. Statistical analysis calculated the probability that adding insulin has greater benefits than harms, when compared with an SU, overall and by prespecified subgroups. ResultsIncluding the six outcomes, the probability of net benefit for insulin compared with SU was similar, across subgroups by age and diabetes duration (probability range, using conditional logit weights: 0.44–0.56). Adding patient preferences for treatment burden associated with insulin injections shifted the probability to favor SU over insulin (probability range, using conditional logit weights: 0.01–0.12). ConclusionIn people with DM and MCCs, we demonstrated incomplete evidence to conclude if basal insulin or SU should be added in people with DM and MCCs on metformin alone. The benefit–harm balance was sensitive to treatment preferences, that is., perceived treatment burden, indicating the importance of shared-decision making in caring for people with MCCs who are at high risk for experiencing harms associated with diabetes management.

Diabetes mellitus in patients with mental disorders: Prevalence and associated factors

People with mental disorders have comorbid physical illnesses, particularly an increased risk of diabetes mellitus (DM), found in many psychiatric disorders; schizophrenia, major depression and bipolar disorder. This elevated risk is associated with increased mortality, more so, as treatment of such medical conditions is not easily accessible by people with mental disorders. The aim of the paper is to determine the prevalence and associated factors for DM in patients with mental disorders in Kano, northwest Nigeria. In this cross-sectional study, one hundred and fifty-seven consecutive patients, aged 18 years and above, attending the outpatient psychiatry clinic of Aminu Kano Teaching Hospital were recruited. Sociodemographic and clinical characteristics questionnaires were completed. Height, weight and blood pressure were measured. Subsequently 3 mL of blood was taken using aseptic venepuncture technique and glycated hemoglobin (HbA1c) levels were detected, with a cutoff point of 6.5% used for diagnosis of DM. The age of the patients ranged between 18-79 years with a mean (SD) of 35.5 (±10.6) years. Majority of the patients 91 (58%) were female. Schizophrenia was the most common diagnosis (37.6%) The prevalence of DM was 24.2%. A statistically significant association was found between DM and age (P=0.021), duration of illness (P=0.016) and diagnosis of schizophrenia (P=0.027). DM is common in patients with mental disorders. Associated factors for DM in people with mental disorders include increasing age, prolonged duration of illness and a diagnosis of schizophrenia, the latter being an independent predictor of DM in people with mental disorders.

Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia.

Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia.

Socio-demographic characteristics, dietary habits and physical activity influence on nutritional status of the diabetics: a cross sectional study

Diabetes mellitus, a chronic, debilitating disease, is associated with a range of severe complications which include cardiovascular disease, renal disease and blindness. Demographic and epidemiological evidences suggest that the incidence of diabetes is increasing worldwide. Diabetes mellitus in people of all ages is reaching epidemic proportions in Bangladesh. The main objective of this cross sectional study was carried out to evaluate that nutritional status of the diabetic patients influence by socio-economic level, dietary habits and physical activity.A total of 282 diabetic outpatients were recruited using Simple Random Sampling technique from three referral diabetic centers namely-Kushtia Diabetic Shomity, Bheramara Diabetic Shomity and Diabetic Shomity Kumarkhali, Kushtia, Bangladesh. The nutritional status of each participant was screened. Direct method of nutritional assessment including anthropometric measurement, biochemical measurement, clinical assessment and dietary method was carried out. Socio economic data were also collected. Data were analyzed using the computer program Statistical Package for Social Sciences (SPSS) version 22.The result reveals that51.1% (n=144) of the total participants were male and 48.9% (n=138) were female. About 28.4% population studied were between 51-60 years, 94.7% married, 44.7% were unemployed and 50.4% were resided in urban area. Based on Body Mass Index (BMI), mean BMI of male was 23.32 ± 3.47 and that of female was 25.83 ± 4.46, half of the respondents (48.9%) had an acceptable nutritional status with a BMI between 18.5-24.9 (62.3% male; 37.7% female) whilst 4.6% of the respondents were underweight with BIMs below 18.5. The female who were observed were 22 (88.0%) and the male were 3 (12.0%) showing a very great prevalence of obesity (BMI more than 30.0). Study showed that 98 (34.7%) respondents bear diabetes from their family and 147 (52.1%) respondents have family history of hypertension The mean blood hemoglobin level was 12.49±1.47g/dl, in which male hemoglobin level was 12.85±1.48g/dl and of female was 12.11±1.36g/dl. The result shows that about 29.8% (n=84) patients had no formal education; among them more were female 65.5% (n=55). More of the patient (50.7%) had family member of 4-6. About 33.0% of the studied patients were low-income level (25.9% were from upper-lower and 7.1% were from lower socio-economic status). Among 37.6% (n=106) overweight (BMI 25.0-29.9) diabetic patients more were female 56.6% (n=60) and 55.7% (n=59) were unemployed. So, female sex, lower educational status, more family member, low monthly family income group and unemployment are associated with malnutrition. Unemployed housewives represented to have both extremes of nutritional status- under nutrition and over nutrition. In the study, most of the patient 126 (44.7%) were unemployed, among them almost all the patient 124 (98.4%) were female. Diabetic care seeking by rural people and female appeared encouraging emphasizing the need of decentralization of diabetic care center to periphery.Asian J. Med. Biol. Res. March 2018, 4(1): 123-134

Prevalence of diabetes mellitus in people clinically diagnosed with periodontitis: A systematic review and meta-analysis of epidemiologic studies.

Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis was extracted or if possible calculated. From the 803 titles and abstracts that came out of the search, 27 papers met the initial criteria. Prevalence of diabetes was 13.1% among subjects with periodontitis and 9.6% among subjects without periodontitis. Based on subanalysis, for subjects with periodontitis, the prevalence of diabetes was 6.2% when diabetes was self-reported, compared to 17.3% when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries (17.2%, n=18,002) and the lowest in studies describing populations from Europe (4.3%, n=7,858). The overall odds ratio for patients with diabetes to be among subjects with periodontitis as compared to those without periodontitis was 2.27 (95% CI [1.90;2.72]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. The overall prevalence and odds of having diabetes are higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe.

Management of type 2 diabetes mellitus in people with severe mental illness: an online cross-sectional survey of healthcare professionals

ObjectivesTo establish healthcare professionals’ (HCPs) views about clinical roles, and the barriers and enablers to delivery of diabetes care for people with severe mental illness (SMI).DesignCross-sectional, postal and online survey.SettingTrusts...

Evaluation of kidney function and risk factors of retinopathy in Type 2 diabetes mellitus people in South Africa.

Diabetic retinopathy (DR) is a disease of the retina and an important microvascular complication of diabetes, frequently causing blindness in adults. The study aims to evaluate kidney function and risk factors for the development of retinopathy in Type 2 diabetes mellitus (DM) patients. A total of 140 participants (54 Type 2DM without retinopathy, 44 with DR and 42 normal, healthy controls) consented to participate in the study. Fasting plasma glucose (FPG), glycosylated haemoglobin (HbA1c), lipid profile and renal function tests were measured using routine laboratory methods. A significant increase in FPG, HbA1c, serum triglycerides (TG), serum urea, urine albumin, the urine albumin/creatinine ratio (UACR) and, a significant decrease in high-density lipoprotein cholesterol (HDL-C) was observed in DR patients, compared to controls. In multivariate logistic analysis, FPG, insulin treatment and UACR were the risk factors found to be significantly associated with the presence of retinopathy. According to the Receiver Operating Characteristic (ROC) curve analysis, the diagnostic performance of UACR≥1.45mg/mmol-1l-1 was the optimal cut-off point. A mild alteration in renal function was observed in DR patients and UACR is found to be an important risk factor and can be a valuable marker for predicting DR.

Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588 408 records from the UK.

AimsTo investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age.MethodsWe conducted a cross‐sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes.ResultsRelative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18–34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35–54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti‐psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness.ConclusionsThe relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti‐psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account.

CURVELET FUSION ENHACEMENT BASED EVALUATION OF DIABETIC RETINOPATHY BY THE IDENTIFICATION OF EXUDATES IN OPTIC COLOR FUNDUS IMAGES

Rapid growth of Diabetes mellitus in people causes damage to posterior part of eye vessel structures. Diabetic retinopathy (DR) is an important hurdle in diabetic people and it causes lesion formation in retina due to retinal vessel structures damage. Bright lesions (BLs) or exudates are initial clinical signs of DR. Early BLs detection can help avoiding vision loss. The severity can be recognized based on number of BLs formed in the color fundus image. Manually diagnosing a large amount of images is time consuming. So a computerized DR grading and BLs detection system is proposed. In this paper for BLs detection, curvelet fusion enhancement is done initially because bright objects maps to largest coefficients in an image by utilizing the curvelet transform, so that BLs can be recognized in the retina easily. Then optic disk (OD) appearance is similar to BLs and vessel structures are barriers for lesion exact detection and moreover OD falsely classified as BLs and that increases false positives in classification. So these structures are segmented and eliminated by thresholding techniques. Various features were obtained from detected BLs. Publicly available databases are used for DR severity testing. 260 fundus images were used for the performance evaluation of proposed work. The support vector machine classifier (SVM) used to separate fundus images in various levels of DR based on feature set extracted. The proposed system that obtained the statistical measures were sensitivity 100%, specificity 95.4% and accuracy 97.74%. Compared to existing state-of-art techniques, the proposed work obtained better results in terms of sensitivity, specificity and accuracy.