Poor Blood Glucose Control Research Articles

437-P: Establishing a Simple Decision-Making Model for the Differential Diagnosis of Diabetes Kidney Disease and Nondiabetes Kidney Disease in T2D Patients through Machine Learning

Objective: To study the 2-DM patients with renal biopsy, analyze the risk factors of DKD and establish a simple decision model to differentiate DKD and NDKD. Methods: 99 2-DM patients were admitted to hospital in Beijing from December 1, 2018 to December 31, 2021. All of the patients accepted kidney biopsy and biochemical test, fundus photography and OCTA. According to the pathological reports, 99 cases were divided into DKD group and NDKD group. The difference indicators of the two groups were compared. The risk factors of DKD were analyzed by logistic regression. A simple and convenient method to distinguish DKD and NDKD was established through the decision tree model. Results: This study was a cross-sectional study. Compared with DKD and NDKD groups, the ratio of male/female in DKD group was higher than that in NDKD group (P=0.033), DR prevalence rate was significantly higher than that in NDKD group (P<0.001), course DM, FBG, HBAIC, SBP, TC and EGFR were also higher than those in NDKD group, and HGB decreased. Binary logistic regression analysis was conducted to determine whether DKD was combined. After adjusting for the above indicators, age, DR, course of DM, HBA1C and HGB were still independently related to DKD. A decision tree model was established with the training set: the course DM, DR, and HBA1C were risk factors of DKD. The accuracy of prediction classification is 75%, the sensitivity was 46.2%, and the specificity was 88.9%. Conclusion: If the patients with type 2 diabetes kidney injury have poor blood glucose control, no DR but anemia, a renal puncture should be considered for definite diagnosis of NDKD. Disclosure L.Zhang: None. Funding Beijing Science & Technology Development of Traditional Chinese Medicine (JJ-2020-25)

Association between metabolic syndrome components and impulse control disorders in Parkinson's disease.

Current evidence on management of impulse control disorders (ICDs) in Parkinson's disease (PD) remains scarce, and exploring modifiable risk factors is crucial. We evaluated the profiles of ICDs in PD patients and aimed to determine the associations between ICDs, metabolic syndrome components and other clinical features. We enrolled patients diagnosed with PD in this study and conducted comprehensive clinical assessments. We recruited 39 PD patients with ICDs and 66 PD patients without ICDs. Out of the 39 patients with ICDs, 19 (48.7%) had one impulse control disorder, while 20 (51.3%) had two or more. The most commonly reported symptom of ICDs was compulsive eating (48.7%). Significant differences were observed between the PD patients with and without ICDs in terms of their HbA1c levels, history of diabetes mellitus, dopamine agonist use, levodopa equivalent dose of dopamine agonists (LED DA), and Hamilton Depression Rating Scale (HAMD) scores. HbA1c levels were significantly higher in the PD patients with compulsive eating. Stepwise logistic regression analyses were performed with the dependent variables of ICDs (yes/no) and compulsive eating (yes/no). Among the 105 PD patients, those with ICDs exhibited higher levels of HbA1c, HAMD score and LED DA than those without ICDs (p < 0.01). Among 39 PD patients with ICDs, those with compulsive eating exhibited higher levels of HbA1c (OR = 2.148, 95% CI = 1.004-4.594, p < 0.05). Among 105 PD patients, those with compulsive eating exhibited higher levels of HbA1c, LED DA and HAMD score (p < 0.05). This study provides insights into the profiles of ICDs in PD patients and their associations with various clinical features. Compulsive eating was the most common ICDs symptom reported. Notably, HbA1c levels were found to be higher in patients with compulsive eating, indicating that poor blood glucose control may be a potential risk factor for ICDs in PD. However, it should be noted that the higher HbA1c levels could also be a consequence of compulsive eating rather than a causal factor for ICDs in PD. Further research is needed to confirm the modifiable risk factors for ICDs in PD.

Glycaemic control and avenues for improvement among people with type 2 diabetes mellitus from rural Sri Lanka - a retrospective cohort study.

The majority of Sri Lankans and South Asians are rural dwellers but follow-up data on glycaemic control and its associations in rural communities are sparse. We followed up a cohort of hospital-based rural Sri Lankans with diabetes from diagnosis up to 24-months. We conducted a retrospective cohort study of people with type-2 diabetes (T2DM) diagnosed 24 months before enrolment who were being followed up at Medical/Endocrine clinics of five hospitals selected by stratified random sampling in Anuradhapura, a rural district of Sri Lanka from June 2018 to May 2019 and retrospectively followed them up to the diagnosis of the disease. Prescription practices, cardiovascular risk factor control and their correlates were studied using self-administered and interviewer-administered questionnaires and perusing medical records. Data were analysed using SPSS version-22. A total of 421 participants [mean age 58.3±10.4 years, female 340 (80.8%)] were included in the study. Most participants were started on anti-diabetic medications in addition to lifestyle measures. Of them, 270 (64.1%) admitted poor dietary-control, 254 (60.3%) inadequate medication-compliance and 227 (53.9%) physical inactivity. Glycaemic control was assessed mainly on fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) data were available in only 44 (10.4%). Target achievements in FPG, blood pressure, body mass index and non-smoking at 24-months following initiation of treatment were 231/421 (54.9%), 262/365 (71.7%), 74/421 (17.6%) and 396/421 (94.1%) respectively. In this cohort of rural Sri Lankans with type-2 diabetes mellitus, all were started on anti-diabetic medications at the diagnosis, but glycaemic target achievement was inadequate at 24 months. We identified the major patient-related reasons for poor blood glucose control were poor compliance with diet/lifestyle and/or medications and misconceptions about antidiabetic medications. None.

Type 1 diabetes in low and middle-income countries - Tanzania a streak of hope.

In several of the Low and Middle Income countries , many patients with Type 1 diabetes (T1D) are most probably not diagnosed at all which may contribute to their low incidence. As an example of a country with low income and poor resources, we have chosen to study T1D in children/young people in Tanzania. Analyses of casebooks and statistics at several Tanzanian hospitals treating young patients with insulin dependent diabetes, usually Type 1 diabetes, and collection of information from different organisations such a Tanzanian Diabetes Association, Life for a Child, Changing Diabetes in Children and World Diabetes Foundation. The incidence in several areas is low. However, a lot of data are often missing at studied clinics and therefore the incidence might be higher, and with increased awareness in recent years the number of patients has increased many-folds. Most patients present with typical symptoms and signs of T1D, and a high proportion with plausible ketoacidosis , although this proportion has decreased from about 90% to about 40% in recent decades. Many patients have poor blood glucose control, and complications often develop already after short diabetes duration. In recent years resources have increased, awareness has increased and diabetes clinics started where staff has got training. There are problems with diabetes care in Tanzania but several facts give hope for the future.

Glycated hemoglobin with ≥7.0% results in patients from a Regional Hospital in Costa Rica

Objective: Analyze the HbA1c results from patients attached to Ciudad Quesada health area that received attention in the clinical laboratory from San Carlos’ Hospital during 2021 and 2022. Methods: Data from HbA1c values &gt;7.0% was collected monthly from patients attached to Ciudad Quesada health area, from which also sex, age and EBAIS was registered. The information was further analyzed using Microsoft Excel and the statistics program R studio. Results: For the year 2021 a total of 2104 results of patients with HbA1c ≥ 7.0% were accounted, as for 2022 the total was of 1656, where the greater frequency was in women. In 2021 most of the patients with ≥ 7.0% HbA1c receive attention in San Pablo’s EBAIS, while in 2022 it was in San Juan’s EBAIS. Conclusions: The greater number of people with HbA1c values over or equal to 7% that belong to Ciudad Quesada’s healthcare area are women. The results might underestimate the real number of poor controlled patients because the years from which the data was collected correspond with the time the COVID-19 pandemic was ongoing. The age group corresponding with people between 51-70 years old are the ones most frequently found with the values of interest. Further studies must be made in order to determine the factors why these patients have such a poor blood glucose control.

EFFECT OF BLOOD GLUCOSE CONTROL TOWARDS PLASMA AND VITREOUS LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND PLACENTAL GROWTH FACTOR IN DIABETIC RATS

Purpose: To compare plasma and vitreous level of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) in diabetic rats with poor blood glucose (BG) control, reconstitution of good BG control, and nondiabetic rats, and to investigate the effect of reconstitution of good BG control to VEGF and PlGF plasma and vitreous level. Methods: This is an experimental study using eighteen Sprague Dawley rats which were divided into intervention group (n=14) and control group (n=4). Intervention group were given Streptozotocin (STZ) injection to induce diabetes. After 4 weeks, intervention group was randomly divided into group I for termination and group II for reconstitution of good BG control with insulin for the following 4 weeks, and so was the control group. Plasma and vitreous samples were taken. VEGF and PlGF levels were evaluated with enzyme-linked immunosorbent assay (ELISA). Results: Seventeen of 18 rats survived in intervention group. BG level of intervention group II decreased dramatically to normoglycemia. ELISA at month 1 showed that VEGF vitreous level tend to be higher in intervention group I compared to control I, 196.36 ± 65.24 pg/dL and 123.64 ± 44.99, respectively (p=0.20). ELISA at month 2 showed that PlGF vitreous level of intervention group I were significantly higher compared to control I, 59.04 ± 2.48 and 51.93 ± 3.15, respectively (p=0.01). Vitreous and plasma VEGF of intervention group I and II were not different, while vitreous and plasma PlGF were significantly higher in group II. Conclusions: Vitreous levels of VEGF and PlGF were increased in diabetic rats compared to nondiabetic, and reconstitution of good BG control for 1 month were unable to reduce VEGF and PlGF levels.

The Mechanism of Hyperglycemia-Induced Renal Cell Injury in Diabetic Nephropathy Disease: An Update.

Diabetic Nephropathy (DN) is a serious complication of type I and II diabetes. It develops from the initial microproteinuria to end-stage renal failure. The main initiator for DN is chronic hyperglycemia. Hyperglycemia (HG) can stimulate the resident and non-resident renal cells to produce humoral mediators and cytokines that can lead to functional and phenotypic changes in renal cells and tissues, interference with cell growth, interacting proteins, advanced glycation end products (AGEs), etc., ultimately resulting in glomerular and tubular damage and the onset of kidney disease. Therefore, poor blood glucose control is a particularly important risk factor for the development of DN. In this paper, the types and mechanisms of DN cell damage are classified and summarized by reviewing the related literature concerning the effect of hyperglycemia on the development of DN. At the cellular level, we summarize the mechanisms and effects of renal damage by hyperglycemia. This is expected to provide therapeutic ideas and inspiration for further studies on the treatment of patients with DN.

Measuring Diabetes Complications, Risk Factors and Capacity for Managing Diabetes: An Initial Step to Improve Diabetes Care at The Primary Health Centre in Tonga

Background: The small Pacific Island nation like Tonga has faced a crisis for decades due to premature loss of lives and disabilities due to diabetes. However, there is limited peer-reviewed literatures on the rates of diabetes complications and capacity for providing quality diabetes care in Tonga. The lack of adequate information in local context triggers significant challenges to make informed decision, proper planning, and effective implementation to improve diabetes care. Aim: This study aims to determine the prevalence of diabetes complications and associated risk factors among people with diabetes, and the capacity for managing diabetes as an initial step towards strengthening diabetes care at the primary health care setting in Tonga. Methods: This cross-sectional study was conducted on a sample of 207 people with diabetes from the primary health care centre in Tonga. People with diabetes were screened by qualified health professional using a standardised protocol, and the capacity of diabetes care was assessed by a standardised assessment form. Results: Of the 207 people with diabetes aged between 20 and 80 years screened for diabetes related complications, 135 (74%) had family history of diabetes, 57 (28%) female subjects had history of gestational diabetes, and 28 (14%) subjects were current smokers. The prevalence of overweight was 51%, obese was 38% and hypertension was 44%. The percentage of subjects with high cholesterol was 42%. HbA1c was measured and subjects with good, poor, and very poor blood glucose control were 15%, 49% and 36% respectively. The percentage of people with diabetes who had retinopathy was 18% and who were at risk of developing diabetic foot ulcer was 14%. This study also found that people with diabetes did not attend regular follow-up visits at the health care centre and the capacity to provide quality diabetes care services is limited. Conclusion: This study highlighted the urgent need to improve the quality and accessibility of diabetes care to reduce diabetes complications. The findings also provided a timely reminder to government and development partners to invest additional resources to effectively manage diabetes at the primary health care level. Tonga will require to strengthen a resilient health system to improve screening for early detecting of diabetes complications and enhance management services at the primary health care setting.

Association of Serum Zinc Level with severity of chronic kidney disease in diabetic patients: a cross-sectional study

BackgroundIn recent years, it has been reported that diabetic patients tend to have a lower zinc intake due to unbalanced diet accompanying changes in lifestyle habits. We investigated serum zinc concentration in diabetic patients according to the stage of nephropathy.MethodsWe enrolled 227 diabetic patients (119 men, 108 women, average age 65.7 ± 14.7 [mean ± standard deviation]) who were hospitalized for diabetes treatment due to poor blood glucose control. We investigated the relationship between fasting serum zinc concentration and estimated glomerular filtration rate (eGFR) and albuminuria (urinary albumin-to-creatinine ratio, UACR), as well as serum zinc concentration by stage of diabetic kidney disease and chronic kidney disease.ResultsThe mean HbA1c value was 10.5 ± 2.1%. Serum zinc concentration was 75.5 ± 16.0 μg/dL in males and 75.7 ± 12.2 μg/dL in females, showing no gender difference and no significant relationship with diabetes type. The serum zinc concentration was negatively correlated with age (r = − 0.309, P < 0.001) and positively correlated with eGFR (r = 0.144, P = 0.030). A tendency was observed of serum zinc concentration to decrease after overt nephropathy, with values of 76.4 ± 14.1 μg/dL in pre-nephropathy (stage 1, n = 131), 78.5 ± 13.2 μg/dL in incipient nephropathy (stage 2, n = 65), 66.4 ± 14.3 μg/dL in overt nephropathy (stage 3, n = 25), and 65.7 ± 11.9 μg/dL in kidney failure (stage 4, n = 6). Serum zinc showed a negative trend with estimated GFR (P = 0.004) and significant reduction in albuminuria, with stage A3 (n = 29, 65.7 ± 13.9 μg/dL) having lower levels than A1 (n = 131, 76.4 ± 14.1 μg/dL, P = 0.001) and A2 (n = 67, 78.4 ± 13.1 μg/dL, P < 0.001).ConclusionsIn diabetic patients, serum zinc concentration tended to decrease as age increased and also as renal function deteriorated. This study suggests that consideration of zinc deficiency is necessary in patients with overt albuminuria.

Establishment of blood glucose control model in diabetic mice.

To explore the established method of the diabetic mouse blood glucose control model and preliminary observation of its influence on the retinas of diabetic mice. The db/db BKS-DB (Leprko/ko) mice were randomly divided into two groups: the poor blood glucose control group (PG group, n=18) and the stable blood glucose control group (SG group, n=12), with BKS-DB (Leprwt/wt) as the normal blood glucose control group (NG group, n=18). According to the blood glucose values for 5 intervals which were monitored during the period of adaption, the PG group was injected with insulin aspart twice daily, fasted for 2h and then returned to normal. The SG group was injected with insulin aspart twice and insulin glargine once daily and fed with a quantitative ration. Fundus images were collected after eight weeks. The glycosylated hemoglobin (HbA1c), mean blood glucose level (MBG), standard deviation of blood glucose (SDBG), coefficient of variation of blood glucose (CVBG), and mean amplitude of glycemic excursion (MAGE) in each group were examined and calculated. The HbA1c, MBG, SDBG, CVBG, and MAGE levels in the PG group were significantly higher than those in the NG and SG groups (all P<0.05). MBG, SDBG, CVBG, and MAGE levels in the SG group were higher than those in the NG group (all P<0.05). There was no significant difference in HbA1c levels between the NG and SG groups (P>0.05). Preliminary observation of fundus images in the PG group and SG groups showed scattered retinal bleeding spots, while bleeding was more obvious in the PG group. The blood glucose control model of type 2 diabetes mellitus mice can be successfully established by subcutaneous injection of insulin aspart insulin glargine and rationed food, which is valuable for studying the mechanism of blood glucose fluctuations in diabetic complications in vivo.

Knowledge on diabetes and its related factors among the people with type 2 diabetes in Thailand: a cross-sectional study

BackgroundType 2 diabetes mellitus (T2DM) is a global public health problem with complications related to knowledge guiding self-care. Limited knowledge might result in poor control of blood glucose, but there is no previous investigation measuring diabetes knowledge in people diagnosed with T2DM in Thailand. This study was aimed to investigate level of diabetes knowledge and related factors among people with T2DM in Thailand.MethodThis cross-sectional study was conducted in a Northeastern province in Thailand among 276 people with T2DM, 195 women and 81 men, using a standardized self-report questionnaire, the Diabetes Knowledge Test. The data were analyzed using Pearson’s chi-square test, one-way analysis of variance, and independent samples t-test.ResultsThe majority of respondents had poor diabetes knowledge in all subscales; total knowledge of diabetes (96.7%), general knowledge of diabetes (71.7%), and insulin use knowledge (92.3%). There was no difference found in knowledge scores between males and females. Having finished secondary school education or higher, being employed, or having diabetes-related complications were related to increased total diabetes knowledge and general diabetes knowledge.ConclusionThe people with T2DM had poor diabetes knowledge, and those using insulin also had poor knowledge about the use of insulin.

High Prevalence of Demodex Infestation is Associated With Poor Blood Glucose Control in Type 2 Diabetes Mellitus: A Cross-Sectional Study in the Guangzhou Diabetic Eye Study.

The aim of this study was to investigate the association between type 2 diabetes mellitus (T2DM) and ocular Demodex mite infection. About 381 patients with T2DM from nearby communities were enrolled, and 163 age-matched and sex-matched nondiabetic patients from the cataract clinic were included as the control group. All subjects underwent personal history and demographic data collection, ocular examination, and lash sampling, followed by microscopic identification and counting of Demodex mites. Binocular fundus photography was performed for diabetic patients. Statistical correlation between ocular Demodex infestation and T2DM and blood glucose control status was performed. The Demodex mite infestation rate (62.5% vs. 44.8%, P < 0.001) and count [3 (0-12) vs. 2 (0-9.6), P = 0.01], especially of Demodex brevis (18.9% vs. 4.9%, P < 0.001) [0 (0-1) vs. 0 (0-0), P < 0.001], were significantly higher in the T2DM patient group than that in the control group. The ratio of Demodex brevis to Demodex folliculorum in the T2DM patient group was significantly higher than that in the control group (1:3 vs. 1:9, P < 0.001). Diabetic patients presented with more cylindrical dandruff (55.1% vs. 39.3%, P = 0.001). Ocular Demodex infestation was strongly associated with poor blood glucose control (HbA 1 c > 7%) (odds ratio = 1.82; 95% confidence interval, 1.12-2.94; P = 0.2) and female sex (odds ratio = 1.69, 95% confidence interval, 1.08-2.65, P = 0.02). No association was found between Demodex infestation and the severity of diabetic retinopathy. Patients with T2DM, especially those with poor blood glucose control, tend to have a higher prevalence of ocular Demodex infestation, suggesting that high blood glucose is a risk factor for demodicosis .

Exploring facilitators and barriers to self-management engagement of Chinese people with type 2 diabetes mellitus and poor blood glucose control: a descriptive qualitative study

AimsTo explore facilitators and barriers to self-management engagement of Chinese people with poorly controlled type 2 diabetes.MethodsPurposive sampling method was used for recruitment. Semi-structured interview and thematic analysis was used for data collection and analysis.ResultsTwenty-six semi-structured interviews were conducted. Poor blood glucose control introduced awareness of susceptibility to complications, while mental disorders could be concomitant. General knowledge about healthy lifestyle and unhealthy habits impeded lifestyle management. Temporary remission of hyperglycemia and no perceived symptoms interfered engagement of medication therapy and regular blood glucose monitoring. Family and work environments could impact self-management engagement. Accessibility to reliable diabetes-related information influenced self-management engagement.ConclusionsAwareness of susceptibility to complications motivated self-management engagement, while the awareness could cause mental disorders that need to be addressed.Customized lifestyle plans and behavior change technologies were crucial for lifestyle management. The progression of diabetes, importance of continuity of medication therapy, and the value of blood glucose monitoring should be clarified in diabetes education.Building diabetes-friendly social environments and providing reliable diabetes-related information were essential.

Risk factors of acute cerebral infarction in patients with primary hypertension.

To explore the risk factors of acute cerebral infarction (ACI) in patients with primary hypertension. Patients diagnosed with primary hypertension and ACI and confirmed by MRI, who were admitted to Honghuagang District people's Hospital, Zunyi City, from January 2020 to December 2020, were selected. Concurrent patients with primary hypertension were selected as the control group. The risk factor including sex, age, smoking, drinking, laboratory examination, and other complications was analyzed. Three hundred patients with hypertensive ACI and 117 cases with hypertension were included. The laboratory examination comparison between the two groups showed that patients in the ACI group had higher glycosylated hemoglobin, D-dimer and FDPs then patients of the control group (P < 0.05). There was significant association between diabetes mellitus and acute cerebral infarction in patients with primary hypertension (OR = 1.452, P = 0.004). Poor control of blood glucose in pre-morbid diabetes mellitus may be related to the occurrence of ACI. Diabetes mellitus is an independent risk factor in ACI patients with primary hypertension.

Effect of personality on blood glucose control in patients with type 1 diabetes

ObjectiveThe diagnosis of type 1 diabetes mellitus (DM1) has a major impact on young people and their families. Psychosocial factors, patient motivation, participation and acceptance of the disease are essential to achieve good blood glucose control. Our aims were to analyse personality traits and how they are related to blood glucose control in patients with DM1. MethodsSixty-two patients with DM1 over 18 years of age, with at least one-year disease duration and absence of advanced chronic complications were studied. Clinical, biological and personality parameters were measured. The Millon Index of Personality Styles was administered for personality assessment. ResultsSignificant correlations between different personality variables and glycated haemoglobin (HbA1c) values were found. Individuals with poor blood glucose control had significantly higher scores on the Feeling-guided (53.6±25.7 vs 36.2±26.8, p=0.021), Innovation-seeking (36.7±24.1 vs 21.9±21.4, p=0.025), Dissenting (41.1±24.4 vs 15.6±16.6, p=0.001), Submissive (41.5±25.1 vs 28.3±14.7, p=0.038) and Dissatisfied (37.5±27.5 vs 19.5±20.2, p=0.015) scales. This psychological profile is characterised by greater focus on emotions and personal values (feeling-guided), the tendency to reject conventional ideas (innovation-seeking), an aversion to complying with norms and a preference for autonomy (unconventional/dissenting), labile self-confidence (submissive/yielding) and expressed disagreement with others (dissatisfied/complaining). Factor analysis based on the main components of the variance yielded four factors. Factor characterised as related to rebelliousness or independent judgement and action was correlated with poor blood glucose control (r=0.402, p<0.05). ConclusionThe rebellious or non-conformist personality type is closely associated with poor blood glucose control in patients with DM1.

Factors influencing diabetes self-management among adults with type 2 diabetes mellitus in China.

In China, the prevalence of Type 2 Diabetes Mellitus (T2DM) continues to rise, and Diabetes Self-Management (DSM) is generally suboptimal. Thus, identifying the factors influencing DSM in adults with T2DM is crucial for healthcare providers. This study aimed to 1) describe DSM among adults with T2DM in Wenzhou, China, 2) examine the correlations between diabetes knowledge, perceived self-efficacy, fatalism, social support, and DSM, and 3) determine how much power of the correlated independent variables could predict DSM. This study adopted the cross-sectional design and included 108 adults with T2DM who were randomly selected from the outpatient clinic of a hospital in Wenzhou, China. Data were recruited using a demographic questionnaire, and standardized tools were utilized to determine the correlation between DSM, diabetes knowledge, perceived self-efficacy, fatalism, and social support. Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression analysis. 62% of participants had poor blood glucose control (HbA1c ≥8.0%) and suboptimal DSM. Significant factors related to DSM were diabetes knowledge (r = 0.594, p <0.001), perceived self-efficacy (r = 0.447, p <0.001), and social support (r = 0.312, p = 0.001). The regression analysis revealed that all variables significantly explained 38.2% of the variance in DSM among adults with T2DM. However, only diabetes knowledge and perceived self-efficacy significantly predicted DSM (β = 0.468, p <0.001; β = 0.184, p = <0.05, respectively). The findings indicated that increasing diabetes knowledge and perceived self-efficacy could help improve DSM in T2DM to ascertain the ultimate treatment outcomes. Nurses and healthcare providers should improve the ability of patients and their families to think critically and act autonomously.

Influence of Information-Based Continuous Care on Disease Control and Treatment Compliance of Elderly Diabetic Patients.

Background The incidence of diabetes is increasing year by year. For elderly diabetic patients, poor blood glucose control and worsening immune function greatly increase the risk of complications, which will seriously affect their quality of life. Purpose This paper primarily clarifies the influence of information-based continuous care on disease control and treatment compliance of elderly diabetic patients. Methods From December 2018 to December 2021, 106 elderly diabetic patients were selected, and their clinical data were retrospectively studied. Patients were grouped according to the type of care they received: an observation group (OG) comprising 56 cases receiving information-based continuous care and a control group (CG) including 50 cases treated with routine nursing. The two cohorts of patients were compared regarding disease control, treatment compliance, glucose and lipid metabolism (GLM), and self-management. Results After analysis, it was found that the disease control and treatment compliance were statistically higher in OG compared with CG. OG also showed significantly reduced fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), total cholesterol (TC), and triglyceride (TG) after nursing that were all lower compared with CG. In terms of self-management, OG outperformed CG in diet, exercise, blood glucose monitoring, and adherence to medical regimens. Conclusions Information-based continuous care has beneficial effects on disease control and treatment compliance of elderly diabetic patients and can help control blood sugar and optimize patients' self-management level, with high clinical promotion value.

ASSOCIATION BETWEEN RISK FACTORS AND COGNITIVE IMPAIRMENT AMONG TYPE 2 DIABETES MELLITUS PATIENTS

Background: Diabetes mellitus type 2 is considered as one of the leading causes of illness and mortality through over the globe. Diabetic retinopathy, neuropathy, and nephropathy are all effectively screened on a regular basis. Recent research have shown that cognitive deterioration can occur in patients with diabetes and that it can go unnoticed for a long time, implying that routine screening is necessary. &#x0D; Methodology: An observational cross sectional study was conducted among 158 patients with complaint of T2DM aged between 60-79 years of age were found with cognitive impairment on the basis of MMSE score in a tertiary care centre. Detailed history along with laboratory and biochemical data were taken from patients after taking written informed consent and approval of Institutional Ethical committee through the pre-structured questionnaire. &#x0D; Results: Mild cognitive impairment was noted in 88 (55.69%) type 2 diabetes mellitus patients and Normal cognitive function in 70 (44.30%). Those with MCI had higher HbA1c (6.57 ± 1.27 vs. 6.13 ± 1.22), higher FBS (148.34 ± 18.61 vs. 145.25 ± 16.31), PPBS (173.91 ± 42.64 vs. 167.47 ± 38.15) and TNF-α (79.32 ± 8.74 vs. 72.98 ± 6.76), which were statistically significant. The cognitive domains of executive function, naming, attention, language, and memory showed a statistically significant difference between those with Mild cognitive impairment and Normal cognitive function. There were no differences in the mean age, duration of disease, and education level between the groups. &#x0D; Conclusion: The significant prevalence of Mild cognitive impairment in type 2 diabetes patients emphasizes the value of routine screening of cognitive functions. Further research into the link between cognitive impairment and poor blood glucose control is needed to see if improving blood glucose control can assist in enhancing cognitive functions.

Effect of the Early Application of Evolocumab on Blood Lipid Profile and Cardiovascular Prognosis in Patients with Extremely High-Risk Acute Coronary Syndrome.

Proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors significantly reduce low-density lipoprotein cholesterol (LDL-C) and improve the prognosis of patients with acute coronary syndrome (ACS). However, the feasibility and safety of early application of PCSK9 inhibitors on the basis of statins combined with ezetimibe to strengthen lipid lowering in extremely high-risk coronary heart disease populations are still unknown.This study was a prospective, randomized controlled study. A total of 136 patients with extremely high-risk ACS with LDL-C ≥ 3.0 mmol/L after percutaneous coronary intervention (PCI) treatment were randomly assigned 1:1 to the control group (atorvastatin 40 mg/day and ezetimibe 10 mg/day) or the evolocumab group (evolocumab 140 mg every 2 weeks combined with atorvastatin 40 mg/day and ezetimibe 10 mg/day). We compared the blood lipid profiles, major adverse cardiovascular events (MACEs), and adverse reactions. MACEs included cardiogenic death, nonfatal myocardial infarction, nonfatal stroke, and readmission due to angina. Adverse reactions included allergies, myalgia, poor blood glucose control, and liver damage.Within 1 month, the average level of LDL-C in the evolocumab group decreased from 3.54 to 0.57 mmol/L and that in the control group decreased from 3.52 to 1.26 mmol/L. The LDL-C compliance (< 1.0 mmol/L) rate was significantly increased in the evolocumab group compared with the control group (82.35% versus 22.06%, P < 0.01). The average level of lipoprotein (a) (Lp (a) ) in the control group increased by 9.94 ± 51.93% from baseline after treatment, but evolocumab reduced the Lp (a) level (-38.84 ± 32.40%). Additionally, evolocumab further reduced the levels of apolipoprotein B/A1 (-70.56 ± 22.38% versus -51.29 ± 18.14%), cholesterol (-54.76 ± 18.10% versus -41.16 ± 18.14%), and apolipoprotein B (-66.47 ± 26.89% versus -46.78 ± 24.12%) compared with those in the control group, all P < 0.01. The blood lipid levels of both control and evolocumab groups stabilized after 1 month. During the 3-month follow-up, the incidence of MACEs after PCI was lower in the evolocumab group than in the control group (8.82% versus 24.59%, P = 0.015), and evolocumab combined with statins and ezetimibe did not increase the occurrence of adverse reactions (13.24% versus 11.48%, P = 0.762).In patients with extremely high-risk ACS with high levels of LDL-C, adding evolocumab to their treatment regimen as early as possible may enhance lipid lowering, increase the patient's LDL-C compliance rate in the short term, and improve cardiovascular prognosis but will not increase adverse reactions.

Incidence, progression and regression of diabetic retinopathy in a northeastern Chinese population

AimTo determine the incidence, progression and regression of diabetic retinopathy (DR), with corresponding risk factors, in a northeastern Chinese population of patients with type 2 diabetes.MethodsAmong 2006 patients who completed...