Population Of Diabetic Patients Research Articles

A trend of osteocalcin in diabetes mellitus research: bibliometric and visualization analysis

BackgroundOsteocalcin has attracted attention for its potential role in diabetes management. However, there has been no bibliometric assessment of scientific progress in this field.MethodsWe analysed 1680 articles retrieved from the Web of Science Core Collection (WoSCC) between 1 January 1986 and 10 May 2024 using various online tools. ResultThese papers accumulated 42,714 citations,with an average of 25.43 citations per paper. Publication output increased sharply from 1991 onwards. The United States and China are at the forefront of this research area.DiscussionThe keywords were grouped into four clusters: ‘Differential and functional osteocalcin genes’, ‘Differential expression of osteocalcin genes in relation to diabetes mellitus’, ‘Role of osteocalcin in the assessment of osteoporosis and diabetes mellitus’, and ‘Indirect involvement of osteocalcin in metabolic processes’. Analysis using the VoS viewer suggests a shift in research focus towards the correlation between osteocalcin levels and diabetic complications, the clinical efficacy of therapeutic agents or vitamins in the treatment of osteoporosis in diabetic patients, and the mechanisms by which osteocalcin modulates insulin action. The proposed focus areas are “osteocalcin genes”, “insulin regulation and osteoporosis “, “different populations”, “diabetes-related complications” and “type 2 diabetes mellitus”,“effect of osteocalcin expression on insulin sensitivity as well as secretion”,“osteocalcin expression in different populations of diabetic patients and treatment-related studies”.

Cutaneous Adverse Drug Reactions Associated with SGLT2 Inhibitors

Diabetes is a complex global healthcare burden involving multiple organ systems with its prevalence on the rise. SGLT2 inhibitors enhance glucose excretion. The objective of our literature review was to determine the association between cutaneous adverse drug reactions (CADRs) and the use of SGLT2 inhibitors. We collected data on CADRs related to the use of SGLT2 inhibitors from all available published articles and studied their details to understand the patterns of their association. PubMed, Cochrane, Google, and Embase were searched for relevant articles. A total of 37 papers were included and studied. Most articles were case reports followed by pharmacovigilance studies, case series, and reviews. The cutaneous findings ranged from benign eruptions to severe reactions. The available literature suggests a strong link between the use of SGLT2 inhibitors and Fournier’s gangrene/necrotizing fasciitis. T2DM patients using SGLT2 inhibitors have also developed fixed drug eruptions, drug-induced pruritus, and Sweet syndrome/acute febrile neutrophilic dermatosis, among other skin lesions. We found that SGLT2 inhibitors present a risk of developing CADRs. Raising awareness among healthcare providers regarding CADRs to SGLT2 inhibitors can reduce complications, minimize hospitalizations, and improve patient care in the vulnerable population of diabetes patients.

Saudi Clinical Studies on Traditional Herbal Medicines for Diabetes: A Systematic Review

Background: Diabetic patients in Saudi Arabia commonly use herbal medicines (HMs) to manage their condition. Research studies indicate that up to 70% of this population has tried HMs, with popular choices including Cinnamomum verum, Zingiber officinale, Trigonella foenum-graecum, Allium sativum, Aloe vera, Olea europaea, and Nigella sativa. More clinical trials evaluating their safety and effectiveness are needed to increase the adoption of these herbal remedies. Objective: This systematic review aims to review clinical research in the Saudi Arabian context on the efficacy of commonly used HMs for diabetes. Methods: A comprehensive search of medical literature was conducted to identify the most popular herbs used by Saudi diabetic patients. The PubMed, Cochrane, Medline, and ScienceDirect databases were utilized to find research studies published in Saudi Arabia that examined the effectiveness of traditional herbal remedies for managing diabetes. Results: Only four relevant studies from Saudi Arabia were identified, with three specific herbs (Trigonella foenum-graecum, Zingiber officinale, and Nigella sativa) used in all four studies. Two of the studies were blind clinical trials, but only one was double-blinded. The methodological quality of these studies was assessed using the Jadad score, with scores ranging from 1 to 3. Conclusion: Although Saudi Arabia has a large population of diabetic patients, its contribution to clinical research in this field remains limited. Establishing research groups and developing a sustainable infrastructure could help to address this problem and promote more rigorous studies on HMs.

Culturally appropriate options for diabetes self‐management: Results from a patient‐centered comparative effectiveness study

AbstractThis project compared the effectiveness of two evidence‐based models of culturally competent diabetes health promotion: the diabetes self‐management support empowerment model (DSMS) and the chronic care model (CCM). Our primary outcome was improvement in patient capacity for diabetes self‐management as measured by the diabetes knowledge questionnaire (DKQ) and the patient activation measure (PAM). Our secondary outcome was patient success at diabetes self‐management as measured by improvement in A1c, depression scores using the PHQ‐9, and body mass index (BMI). We also gathered data on the cultural competence of the program using the Consumer Assessment of Healthcare Providers and Systems Cultural Competence Set. We compared patient outcomes in two existing sites in Albuquerque, New Mexico that serve a large population of Latinx diabetes patients from low‐income households. Participants were enrolled as dyads—a patient participant (n = 226) and a social support participant (n = 226). Outcomes over time and by program were analyzed using longitudinal linear mixed modeling, adjusted for patient participant demographic characteristics and other potential confounding covariates. Secondary outcomes were also adjusted for potential confounders. Interactions with both time and program helped to assess outcomes. This study did not find a difference between the two sites with respect to the primary outcome measures and only one of the three secondary outcomes showed differential results. The main difference between programs was that depression decreased more for CCM than for DSMS. An exploratory, subgroup analysis revealed that at CCM, patient participants with a very high A1c (>10) demonstrated a clinically meaningful decrease. However, given the higher cultural competence rating for the CCM, statistically significant improvement in depression, and the importance of social support to the patients, results suggest that a culturally and contextually situated diabetes self‐management and education program design may deliver benefit for patients, especially for patients with higher A1c levels.Key Points The team was interdisciplinary. The information presented describes results of both qualitative and quantitative data and involves interpretations that are interdisciplinary in nature. The study design used methods from multiple disciplines.

HbA1c Point-of-Care Testing and its Role in the Management of Diabetes

The San Joaquin Central Valley, known for its thriving agricultural industry, faces challenges related to low socioeconomic status, limited access to healthy food, and healthcare disparities. To enhance compliance among patients with diabetes, United Health Centers (UHC) implemented in-clinic HbA1c Point-of-Care Testing (POCT) to provide instant data for managing diabetes. The total number of patients with diabetes screened was 2,020 across three sites, with the total number of those in poor control totaling 825. Despite theorizing that these HbA1c machines would improve patient management, statistical analysis revealed no significant impact on diabetes control within the population. However, a closer examination of percentage data demonstrated clinical relevance across UHC sites. Initially, only one out of three UHC sites met the organization’s goal of keeping uncontrolled diabetic patient populations below 30%. After one year of POCT utilization, two out of three sites nearly achieved this goal, resulting in a 27% reduction in poorly managed diabetic patients. While the study’s duration may have limited statistical significance, further analysis and a longer study period could confirm the positive impact of HbA1c POCT on patient compliance.

Insulin-Related Suicide Attempt in Non-Diabetic Pediatric Patient

Insulin analogs are basic drugs that are widely used in the treatment of diabetes around the world. Suicides with their use are described as rare, occurring mainly in the population of diabetic patients due to their easy access to the drug and knowledge of its properties. Among non-diabetic people, insulin is used for suicidal purposes mainly by adults with medical education. A case of a 15-year-old girl found unconscious by her mother at night was described. The patient was immediately transported to the hospital, where she was diagnosed with her first severe hypoglycemic episode of unknown origin. Once conscious and in a better state, the patient admitted to having taken insulin, which she had stolen from her diabetic mother, for suicidal purposes. The patient had no history of mental illness or self-destructive behavior. The patient was referred to psychiatric care. Suicides and suicide attempts involving insulin are usually observed among people with chronic diabetes. Moreover, such attempts are made by adults who know the mechanism of action of the drug. In the pediatric group without diabetes, such cases are extremely rare. Additionally, the issue of similar behaviors becomes very important due to the increasing popularity and availability of insulin therapy and the possibilities of obtaining information about using it to commit suicide from the Internet. Particular vigilance is required in pediatric emergency departments when a patient is identified as having a first episode of severe hypoglycemia of unknown origin.

The Self-Powered Thermoelectric System Driving an Electric Field for Raman-Spectrum Glucose Quantitative Analysis

For a long time, blood glucose monitoring has been a challenging issue in the field of medicine. Although it is possible to visit a hospital for regular blood tests to track blood sugar concentration, the physiological reactions triggered by blood collection might lead to feeling weak, dizzy, or even vomiting. Therefore, especially for diabetic patients, they need to frequently monitor their blood sugar concentration in their daily lives to ensure their health. Currently, the primary methods for blood glucose testing still rely on invasive techniques, such as using fingertip glucose meters and other methods which require skin puncture to obtain blood samples. Although these methods provide a quick assessment of current blood glucose concentration, they come with the pain and discomfort of blood collection process and the potential risk of infection. As a result, in recent years, many researchers have been dedicated to developing non-invasive blood glucose monitoring methods. However, accurately measuring glucose concentration inside the human body remains a challenging task. One of the primary issues is the presence of strong noise and background noise. To avoid this challenge, we have developed an innovative detection platform that is combines surface-enhanced Raman spectroscopy (SERS) and external electric field sensing technology. With the electromagnetic effect, we add external electric field in our platform to excite more the surface plasmon resonance. By using this method, we can achieve signal amplification to detect lower concentrations of glucose. Now, we can detect down to 0.001mM of glucose. We also exhibit self-powered electric field system, using the flexible themoelctric device to combine our platform. By the property of self-powered, we success to create a self-powered electric field system. We focus on driving themoelectric through the temperature different between body temperature and environment. The approach is aimed at generating power from the human body, providing a self-powered thermoelectric system for Raman-spectrum glucose sensors. This innovative approach holds promise for advancing non-invasive blood glucose monitoring and benefiting a larger population of diabetes patients in the future.

Insulin dependence negatively impacts outcomes in anterior cervical discectomy with fusions: a 10-year retrospective analysis

BACKGROUND CONTEXTAlthough anterior cervical discectomy and fusion (ACDF) procedures for cervical spine disease have been increasing amid a growing diabetic patient population, there is a paucity of literature focusing on insulin-dependence as a risk-factor for postoperative ACDF complications. PURPOSETo evaluate the differential impact of insulin dependence on perioperative outcomes including total length of stay, surgical, and medical complications within thirty days following ACDF. STUDY DESIGN/SETTINGA retrospective cohort, large multicenter database study. PATIENT SAMPLEThe American College of Surgeons National Surgical Quality Improvement Program database was queried to retrospectively identify patients who had undergone ACDF between 2011 and 2021 using the Current Procedural Terminology code 22551. OUTCOME MEASURESPerioperative surgical and medical complications. METHODSThe study population was divided into 3 groups 1) insulin-dependent diabetes mellitus (IDDM), 2) noninsulin-dependent diabetes mellitus (NIDDM), and 3) no diabetes mellitus (non-DM). One-way analysis of variance for continuous variables and chi-square tests for categorical variables were used to identify differences in perioperative variables between the 3 groups. Multivariable logistic regression analysis assessed the effect of diabetes mellitus status on postoperative medical and surgical outcomes. RESULTSA total of 85,758 ACDF procedures were identified between 2011 and 2021, of which 5,178 were IDDM, 9,652 were NIDDM, and 70,982 were non-DM. The rates of surgical and medical complication varied between the 3 groups. IDDM patients had the highest rates of at least one medical complication (6.1%). Only IDDM increased the risk for medical complications (OR: 1.320, 95% CI [1.144–1.518]) and extended hospital length of stay (LOS) (OR: 1.244, 95% CI [1.071–1.441]) following a multivariate logistic regression analysis. CONCLUSIONPatients with IDDM were at an increased risk for postoperative medical complications and extended hospital LOS. Personalized postoperative management, guided by risk assessment is indicated for this population. These findings can be used to improve risk stratification and informed consent for DM patients who are insulin dependent.

Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center.

Diabetes mellitus (DM) is a risk factor of infection. Although DM has been associated with worse functional outcomes after acetabular fracture, literature regarding the effect of DM on surgical site infection and other early complications is lacking. A 20-year registry from a level 1 trauma center was queried to identify 134 patients with DM and 345 nondiabetic patients with acetabular fractures. The diabetic patient population was older (57.2 versus 43.2; P < 0.001) and had higher average body mass index (33.6 versus 29.5; P < 0.001). Eighty-three patients with DM and 270 nondiabetics were treated surgically (62% versus 78%; P < 0.001). Diabetic patients who were younger (54.6 versus 61.4; P = 0.01) with fewer comorbidities (1.7 versus 2.2; P = 0.04) were more frequently managed surgically. On univariate analysis, patients with DM more commonly developed any early infection (28.4% versus 21%; P = 0.049) but were no more likely to develop surgical site infection, or other postoperative complications. Older patient age, length of stay, baseline pulmonary disease, and concurrent abdominal injury were independent predictors of postoperative infection other than surgical site infection. Diabetics that developed infection had more comorbidities (2.4 versus 1.5; P < 0.001) and higher Injury Severity Score (24.1 versus 15.8; P = 0.003), and were more frequently insulin-dependent (72.7% versus 41%; P = 0.01). Independent of management strategy, diabetic patients were more likely to develop an infection after acetabular fracture. Insulin dependence was associated with postoperative infection on univariate analysis. Optimal selection of surgical candidates among patients with DM may limit postoperative infections.

Physical performance strongly predicts all-cause mortality risk in a real-world population of older diabetic patients: machine learning approach for mortality risk stratification.

Prognostic risk stratification in older adults with type 2 diabetes (T2D) is important for guiding decisions concerning advance care planning. A retrospective longitudinal study was conducted in a real-world sample of older diabetic patients afferent to the outpatient facilities of the Diabetology Unit of the IRCCS INRCA Hospital of Ancona (Italy). A total of 1,001 T2D patients aged more than 70 years were consecutively evaluated by a multidimensional geriatric assessment, including physical performance evaluated using the Short Physical Performance Battery (SPPB). The mortality was assessed during a 5-year follow-up. We used the automatic machine-learning (AutoML) JADBio platform to identify parsimonious mathematical models for risk stratification. Of 977 subjects included in the T2D cohort, the mean age was 76.5 (SD: 4.5) years and 454 (46.5%) were men. The mean follow-up time was 53.3 (SD:15.8) months, and 209 (21.4%) patients died by the end of the follow-up. The JADBio AutoML final model included age, sex, SPPB, chronic kidney disease, myocardial ischemia, peripheral artery disease, neuropathy, and myocardial infarction. The bootstrap-corrected concordance index (c-index) for the final model was 0.726 (95% CI: 0.687-0.763) with SPPB ranked as the most important predictor. Based on the penalized Cox regression model, the risk of death per unit of time for a subject with an SPPB score lower than five points was 3.35 times that for a subject with a score higher than eight points (P-value <0.001). Assessment of physical performance needs to be implemented in clinical practice for risk stratification of T2D older patients.

Insulin Treatment Does Not Prevent EARLY Autonomic Cardiovascular and Diastolic Dysfunctions in Streptozotocin-Induced Diabetic Rats.

Recent studies have found increased cardiovascular mortality risk in patients with type 1 diabetes when compared to normoglycemic people, even when they were kept under good glycemic control. However, the mechanisms underlying this condition have yet to be fully understood. Using streptozotocin (STZ)-induced diabetic rats, we evaluated the effects of insulin replacement therapy on cardiac, autonomic, inflammatory, and oxidative stress parameters. Daily treatment with insulin administrated subcutaneously in the STZ-diabetic rats showed a reduction in hyperglycemia (>250 mg/dL) to normalized values. The insulin treatment was effective in preventing alterations in cardiac morphometry and systolic function but had no impact on diastolic function. Also, the treatment was not able to prevent the impairment of baroreflex-tachycardic response and systolic arterial pressure variability (SAP-V). A correlation was found between improvement of these autonomic parameters and higher levels of IL-10 and lower levels of oxidized glutathione. Our findings show that insulin treatment was not able to prevent diastolic, baroreflex, and SAP-V dysfunction, suggesting an outstanding cardiovascular risk, even after obtaining a good glycemic control in STZ-induced diabetic rats. This study shed light on a relatively large population of diabetic patients in need of other therapies to be used in combination with insulin treatment and thus more effectively manage cardiovascular risk.

Traumatic stress symptoms, mental splitting and burnout in health care professionals: a cross-sectional study.

Burnout syndrome usually begins with feelings of enthusiasm and idealized visualizations, and it is in contrast with subsequent disillusionment, disappointment, and symptoms which are related to chronic stress experienced later. This tendency to idealization is a parallel to the concept of "mental splitting" described by Kernberg with a pronounced "black and white" perceptual dichotomy between the early idealization and later disillusionment. This study intends examination of relationships between burnout syndrome, traumatic stress and Kernberg's concept of splitting. In this study we have assessed 90 health care professionals (50 women and 40 men) working with a population of diabetic patients utilizing Burnout Measure (BM), Splitting index (SI) and Traumatic Stress Checklist - 40 (TSC-40). Study results indicate significant Spearman correlations between burnout syndrome (BM) and traumatic stress (TSC-40) in population of men (R=0.75, p<0.01) and of women (R=0.61, p<0.01), as well as between burnout syndrome (BM) and splitting (SI) for both genders: men (R=0.40, p<0.01), women (R=0.51, p<0.01). These findings may have implications for prevention and treatment of burnout syndrome. The current study findings provide implications that the defensive mechanisms of splitting and traumatic stress may allow for the prediction of burnout symptoms. This relation may potentially be of use in both the potential detection and prevention of burnout syndrome.

The unexpected silent manifestation of myocardial infarctions in ischemic heart failure patients: Insights from a case-control study

BackgroundRecent studies show Silent Myocardial Infarction (SMI) as a quite frequent event. However, regarding severe tertiary care patients that frequently present consequences of Coronary Artery Disease (CAD) and Left Ventricular Dysfunction (LVD), the occurrence of this manifestation is unexpected and its associated factors aren't clear in the literature. AimTo compare clinical, laboratorial, ventricular and angiographic factors between silent and classical presentation of MI in patients with CAD and LVD. MethodsPatients with multivessel CAD with over 70 % obstructive lesions and LVD with EF less than 35 % were evaluated for MASS VI trial and later included in the present study. The ventricular function and coronary assessment were measured by echocardiography and SYNTAX score, respectively. The population was stratified in a SMI group and Clinically Manifested Myocardial Infarction (CMMI) group based on MI presentation for a comparison of medical parameters. ResultsFrom 132 patients, 47 (35.6 %) were classified as SMI and 85 (64.4 %) as CMMI. No differences were observed between groups regarding age, sex, diabetes mellitus, SYNTAX score, or collateral circulation. Higher proportion of NYHA II classification, inferior wall MI and lower creatinine clearance were found in SMI group. After multivariate analysis, peripheral diabetic neuropathy (OR = 4.6 [1.1‒12.7] p = 0.032) and inferior wall MI (OR = 4.1 [1.5‒11.4] p = 0.007) were significantly associated with SMI. ConclusionPeripheral diabetic neuropathy and inferior wall MI were associated with SMI presentation. Overall, associated factors tend to be similar comparing SMI and CMMI, but in the specific population of diabetic patients with chronic neuropathy a special care should be taken.

Prediction of diabetes using supervised classification

Diabetes is one of the common chronic diseases that impacts 28.7 million people in the US as of 2019, accounting for 8.7% of the total population. Early identification of diabetes is very important in disease control and management. A number of prior studies provided compelling evidence that machine learning can help identify diabetes early allowing for timely treatment. It remains a challenge to appropriately assess, optimize and refine the classification models based on specific dataset for diabetes prediction with high accuracy. In this study, we aimed to develop a model with improved accuracy for diabetes prediction. We employed six learning algorithms, logistic regression, k-nearest neighbors (k-NN), support vector machine (SVM), decision tree, random forest, and gradient boosting on the Pima Indians Diabetes Dataset. The performance of each model was evaluated for the prediction of diabetes in validation datasets using accuracy, precision, recall, and F1-score. Gradient boosting provided an accuracy of 81.8%, outperforming all other classification models in most of the performance measures. Collectively, the gradient boosting model appeared to provide an appropriate algorithm for diabetes prediction with high accuracy based on the diagnostic measurements gathered in this specific dataset. Of note, the insights yielded from this exploratory study may only be applicable to this subpopulation of diabetes patients. It remains to be further validated with datasets derived from more diverse diabetes populations before the findings can be generalized to a wider diabetes patient population.

A scoping review of type 2 diabetes mellitus in Pakistan investigating the status of glycemic control, awareness, treatment adherence, complications and cost.

The high prevalence of Type 2 diabetes mellitus(T2DM) in Pakistan is a challenge to the existing healthcare system. This is the first comprehensive review of the status of glycemic control, diabetes knowledge, treatment adherence, complications and financial burden faced by the diabetic patient population of the country. We searched PubMed, Web of Science and Scopus for studies on diabetes control, knowledge, treatment adherence, prevalence of complications and cost in Pakistan published in English from 2000 to 2024. We hand-searched Google Scholar for additional papers and included a total of 45 studies in our review. The review shows that poor glycemic control prevails among diabetic patients ranging from 44.7% to 86.4% along with half of the patients have poor diabetes knowledge (46.0% -70.0%). Treatment adherence level in diabetic patients varies widely in different studies, frequently reported complications are retinopathy (14.5%-43.0%), nephropathy (14.0%-31.0%) and neuropathy (10.8%-59.6%); and the disease poses a great deal of economic burden. Most of the studies were observational. Glycemic control and knowledge among individuals with T2DM in Pakistan are inadequate, leading to a high prevalence of complications that impose significant health and economic burdens. Further longitudinal studies generating evidence of lifestyle modifications as primary and secondary prevention strategies against diabetes in the Pakistani population can form a strong foundation for awareness campaigns and policy revisions.

Evaluation of the relationship between the prealbumin/fibrinogen ratio and diabetic nephropathy in patients with type 2 diabetes mellitus

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Introduction&lt;/title&gt; &lt;p&gt;Our aim was to compare the prealbumin/fibrinogen ratio (PFR) of diabetic patient populations with or without diabetic nephropathy.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Materials and methods&lt;/title&gt; &lt;p&gt;People with type 2 diabetes who attended the internal medicine outpatient clinic were enrolled in the study. Two groups were formed according to the proteinuria of the patients: Diabetic nephropathy and non-nephropathy group. Diabetic nephropathy was calculated using the mathematical formula of spot urine albumin/spot urine creatinine x100. Patients with proteinuria above 200 mg/g were considered to have nephropathy. PFR was simply calculated by dividing prealbumin by fibrinogen.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt;A total of 152 patients who attended our outpatient clinic were enrolled in the study. There were 68 patients in the diabetic nephropathy group and 84 in the non-nephropathy group. The prealbumin/fibrinogen ratios (PFR) were significantly lower in the nephropathic group [0.061 (0.02–0.16)] than the non-nephropathic group [0.0779 (0.01–0.75)] (p = 0.002).&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusions&lt;/title&gt; &lt;p&gt;We suggest that decreased levels of PFR can indicate diabetic nephropathy in subjects with type 2 diabetes mellitus.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Lifestyle vs Transplantation Therapies Aiding in Pancreatic Beta Cell Protection for Type 1 Diabetes

Pancreatic beta cells highly influence the level of insulin within the body. This being due to the beta cell’s ability to create and regulate the production of insulin (the hormone that manages blood sugar extent). Unfortunately, the increasing death rate of these cells has complicated insulin independence for people with type 1 and type 2 diabetes. Type 1 diabetes (T1D) continues to be a serious concern considering the globally growing incidence rate and the regard that there is no currently confirmed cure. However, multiple new cellular therapies have been explored and evaluated to aid in beta cell regeneration strategies. This literature review focuses specifically on commonly practiced beta cell regeneration therapies for type 1 diabetes. These therapeutic approaches were divided to fit into one of two categories, these categories being cellular reproduction and cell replacement which will be further expanded on throughout this article. Topics discussed within the work aim to exhibit a brief overview of the type 1 diabetes patient population, beta cell pathophysiology, and cover concepts regarding methods of measuring procedural success. The majority of this article will be centered around commonly practiced clinical strategies involving pancreas/islet cell transplantation and therapeutic lifestyle approaches. All this is concluded with a general comparison of typical beta cell therapies.

Validation of Chinese version of the 5-item WHO well-being index in type 2 diabetes mellitus patients

BackgroundFor better disease management and improved prognosis, early identification of co-morbid depression in diabetic patients is warranted. the WHO-5 well-being index (WHO-5) has been used to screen for depression in diabetic patients, and its Chinese version (WHO-5-C) has been validated. However, its psychometric properties remain to be further validated in the type 2 diabetes patient population. The aim of our study was to examine the reliability and validity of the WHO-5-C in patients with type 2 diabetes mellitus.MethodsThe cross-sectional study was conducted on 200 patients from July 2014 to March 2015. All patients should complete the WHO-5-C, the Patient Health Questionnaire-9 (PHQ-9), the 20-item Problem Areas in Diabetes Scale (PAID-20), the Mini International Neuropsychiatric Interview (M.I.N.I), and Hamilton Rating Scale for Depression (HAM-D). Internal consistency of WHO-5 was revealed by Cronbach’s alpha, and constructive validity by confirmatory factor analysis (CFA). Relationship with PHQ-9, HAM-D, and PAID-20 was examined for concurrent validity, and ROC analysis was performed for criterion validity.ResultsThe WHO-5-C presented satisfactory reliability (Cronbach’s alpha = 0.88). CFA confirmed the unidimensional factor structure of WHO-5-C. The WHO-5-C had significant negative correlation with HAM-D (r = -0.610), PHQ-9 (r = -0.694) and PAID-20 (r = -0.466), confirming good concurrent validity. Using M.I.N.I as the gold standard, the cut-off value of WHO-5-C was 42, with a sensitivity of 0.83 and specificity of 0.75.ConclusionThe WHO-5-C holds satisfactory reliability and validity that is suitable for depression screening in type 2 diabetes patients as a short and convenient instrument.

Cross Modality Feature Fusion Framework for Diabetic Retinopathy Image Classification

Diabetic retinopathy (DR) is a prevalent ocular condition and a prominent contributor to vision impairment in individuals with diabetes. Consistent monitoring through fundus photography and prompt intervention represents the most efficient strategy for controlling this ailment. Given the substantial diabetic patient population and their extensive screening needs, there is a growing inclination towards harnessing computer-aided and entirely automated methods for diagnosing DR. Over the past years, deep neural networks have achieved remarkable progress across a wide range of applications. Consequently, automating the diagnosis of DR and delivering tailored recommendations to DR patients underscores the significance of accurate and intricate DR classification. In this work, we have present a cross modality feature fusion based framework for diabetic retinopathy (DR) image classification. Here, cross modality means RGB image and it’s green channel. Initially, we have present multi-scale multi- receptive feature extraction block to learn the local and global features from both the modalities. Further, the learned features at various scale are fused effectively with present multi-level feature fusion block for image classification task. We evaluated our present framework on MESSIDOR and IDRID database by comparing it to state-of-the-art (SOTA) deep learning frame- works for DR image classification. The result analysis clearly demonstrate that the present cross-modality feature fusion based classification framework outperforms existing SOTA frameworks in terms of various evaluation parameters.

Dapagliflozin Improved Cardiac Function and Structure in Diabetic Patients with Preserved Ejection Fraction: Results of a Single Centre, Observational Prospective Study.

Sodium-glucose cotransporter inhibitors (SGLT2i) have demonstrated a reduction in cardiovascular events in diabetes and heart failure (HF). The mechanisms underlying this benefit are not well known and data are contradictory. The purpose of this study is to analyse the effect of dapagliflozin on cardiac structure and function in patients with normal ejection fraction. Between October 2020 and October 2021, we consecutively included 31 diabetic patients without prior history of SGLT2i use. In all of them, dapagliflozin treatment was started. At inclusion and during six months of follow-up, different clinical, ECG, analytical, and echocardiographic (standard, 3D, and speckle tracking) variables were recorded. After a follow-up period of 6.6 months, an average reduction of 18 g (p = 0.028) in 3D-estimated left ventricle mass was observed. An increase in absolute left ventricle global longitudinal strain (LV-GLS) of 0.3 (p = 0.036) was observed, as well as an increase in isovolumetric relaxation time (IVRT) of 10.5 ms (p = 0.05). Moreover, dapagliflozin decreased the levels of plasma creatin-kinase (CK-MB) and atrial natriuretic peptide (ANP). In conclusion, our data show that the use of SGLT2i is associated with both structural (myocardial mass) and functional (IVRT, LV-GLS) cardiac improvements in a population of diabetic patients with normal ejection fraction.