Prevalence Of Diabetes Research Articles

Sex- and age-specific differences in the use of antiarrhythmic therapies among atrial fibrillation patients: a nationwide cohort study.

Atrial fibrillation (AF) patients frequently require active rhythm control therapy to maintain sinus rhythm and reduce symptom burden. Our study assessed whether antiarrhythmic therapies (AATs) are used disproportionately between men and women after new-onset AF. The nationwide Finnish anticoagulation in atrial fibrillation (FinACAF) registry-based linkage study covers all patients with new-onset AF in Finland during 2007-2018. Study outcomes included initiation of AATs in the form of antiarrhythmic drugs (AAD), cardioversion, or catheter ablation. The study population constituted of 229 565 patients (50% females). Women were older than men (76.6 ± 11.8 vs. 68.9 ± 13.4 years) and had higher prevalence of hypertension or hyperthyroidism, but lower prevalence of vascular disease, diabetes, renal disease, and cardiomyopathies than men. Overall, 17.6% of women and 25.1% of men were treated with any AAT. Women were treated with AADs more often than men in all age groups (adjusted subdistribution hazard ratio (aSHR) 1.223, 95%-CI 1.187-1.261). Cardioversions were also performed less often on women than on men aged <65 years (aSHR 0.722, 95%-CI 0.695-0.749), more often in patients ≥75 years (aSHR 1.166, 95%-CI 1.108-1.227), while no difference between the sexes existed in patients aged 65-74 years. Ablations were performed less often in women aged <65 years (aSHR 0.908, 95%-CI 0.826-0.998) and ≥75 years (aSHR 0.521, 95%-CI 0.354-0.766), whereas there was no difference in patients aged 65-74 years. Women used more AAD than men in all age groups but underwent fewer cardioversion and ablation procedures when aged <65 years.

Patterns of diabetes mellitus by age, sex, and province among Iranian Hajj pilgrims and health care delivery during 2012-2022: A retrospective study of 469,581 participants.

Hajj is among the oldest pilgrimages in the world, there is a limited study that evaluates the epidemiological pattern of Diabetes Mellitus [1] and the medical care required and provided to pilgrims. The present study assessed the prevalence and pattern of DM in Iranian pilgrims from 2012-22. All demographic information, risk factors, and the prevalence of DM were extracted from the database and medical records of the Hajj Pilgrimage Medical Centre, Iranian Red Crescent Society through file reading. Also, to investigate the effect of the risk factors considered in the study, the multiple logistic regression model was used. The present study included data from 469,581 Hajj pilgrims. Most pilgrims were in the age group of 45 to 70 years (73.25%). The prevalence of diabetes in patients over 70 years old was the highest (16.73%). The prevalence of DM was estimated at 14.64% in women and 12.51% in men. The lowest DM prevalence was in Lorestan (7.81%), North Khorasan (9.07%), Sistan and Baluchistan (9.29%), and Hamedan (9.41), respectively. The highest prevalence rate was in Khuzestan (20.12%), Yazd (19.14), and Mazandaran (17.55), respectively. Our analysis reveals that, for instance, with each yearly increase in the age of the pilgrims (assuming other variables remain constant), the odds of having DM increase by 0.04. For the gender, the odds of having DM among women is 0.33 higher than among men, when the other variable is constant. The study results show a significant difference in the prevalence of diabetes in age, gender, and distribution in different provinces. Therefore, appropriate screening, diagnosis, and management by primary care physicians are necessary to prevent adverse health outcomes and reduce the economic burden of mortality and morbidity.

A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City

Background Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City. Methods We conducted a single-center review of people with HIV aged over 18, using medical records of active people enrolled at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) HIV Clinic (HIVC). Our analysis focused on their last visit to describe the DMC, aiming to identify gaps in control goals. We included people who had a consultation within the 12 months preceding May 2020. Results Out of the 2072 active people, medical records were available for 2050 (98.9%). Among these, 326 people (15.9%) had fasting glucose (FG) abnormalities, of which 133 (40.7%) had diabetes. The prevalence of diabetes among people with HIV was of 6.4% (133/2050). Regarding the DMC, the following proportions of people achieved control goals: 133/133 (100%) received medical care in the last 12 months, 123/123 (100%) had blood pressure (BP) <140/90 mmHg, 73/132 (55.3%) had LDL cholesterol (c-LDL) <100 mg/dl, 63/132 (47.7%) had FG <130 mg/dl, 50/116 (43.1%) had glycosylated hemoglobin (HbA1c) <7%. ABC goals (HbA1c <7%, c-LDL <100 mg/dl, BP <140/90 mmHg) were met in 28/109 (25.6%) people. 126/133 (94%) people with HIV achieved HIV-viral load <50 copies/mL. Conclusions Despite the high rate of viral suppression among people with HIV and diabetes, significant challenges remain in achieving comprehensive diabetes control. These findings highlight the need for targeted interventions to improve metabolic outcomes and the overall management of diabetes in people with HIV.

The Health of Those Who Feed Us: An Assessment of Health Inequities Along the United States Food Chain.

While the health of all depends on the food chain, few studies have focused systematically on the health of food chain workers themselves (production, manufacturing, wholesale, retail, and commercial and institutional services). In this study we used 2018 and 2019 data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine health-related metrics of food chain workers, combined and by industry sector, compared to non-food chain workers, among 32 U.S. states. Logistic regression indicated U.S. food chain workers had higher prevalences of barriers to health care access, smoking, no physical exercise, and poor self-reported health than all other workers. Patterns were similar among food chain workers in all industry sectors except wholesale. Additionally, commercial food services workers had higher prevalence of poor mental health, while institutional food services workers had higher prevalences of obesity, diabetes, and hypertension than all other workers. We discuss implications of these results for interventions, with specific attention to improving employment conditions. Food chain worker health is critical for food system sustainability and population health equity.

8469 Endocrinologists Underutilize Virtual Care Services Resulting in Suboptimal Clinical and Financial Outcomes

Abstract Disclosure: D. Terry: Employee; Self; Valendo Health. Less than 150,000 Medicare patients with diabetes (PWD) receive billable telehealth and remote monitoring services, even though over 12 million PWDs are eligible for these services. This is a missed quality opportunity, as studies show that PWDs who receive these services experience reductions in A1C levels and improvements in TIR. It is also a missed financial opportunity for Endocrinologists, who are among the lowest paid specialists in the US. The economics of Endocrinology are important, because inadequate compensation is leading to access constraints when the diabetes population is growing, and care complexity is increasing. We analyzed billed virtual health claims for every Medicare PWD in 2022. The types of services we examined included: Chronic Care Management (CCM &amp; PCM), Continuous Glucose Monitoring (CGM &amp; RPM), Medical Nutrition Therapy (MNT), and Diabetes Self-Management Training (DSMT). When we looked by Endocrinologist by virtual care service type, we found the following levels of service delivery for Endocrinologists at the median levels of utilization:4.8% of eligible PWDs received remote Continuous Glucose Monitoring support.4.2% received virtual Chronic Care Management services.6.2% received virtual Diabetes Self-Management Support.&amp;lt;1% received Medical Nutrition Therapy This is clearly a missed clinical quality opportunity as a study published in JAMA in October 2023, Comprehensive Telehealth Model to Support Diabetes Self-Management, reported the following improvements for PWDs who received virtual care for 6 months:Mean change in A1C levels: Type 1: -0.6%; Type 2: -1.0%Mean TIR Improvement: Type 1: 16%; Type 2: 18% It is also a missed financial opportunity for Endocrinology practices. Each patient with diabetes is potentially eligible for $100 or more of virtual care services per month. We’ve looked at every Endocrinology practice in the US and many are missing out on over a million dollars of annual revenue opportunity. This is important as Endocrinology organizations everywhere, independent and hospital based, are struggling to retain the doctors &amp; staff necessary to provide adequate access to care - leading to months of wait time to see an Endocrinologist. The prevalence of diabetes is growing significantly, while Endocrinologist capacity is shrinking. Value added and billable virtual care services create new opportunities for Endocrinologist to generate the revenue necessary to increase clinical capacity and improve access by creating diverse clinical teams led by Endocrinologists and supported by Diabetes Educators, Dietitians, and others with expertise in diabetes who can care for many more PWDs. Creating virtual care capabilities is also an early step in moving Endocrinology into Value-Based Care arrangements that reward providers for improving care and reducing costs rather than for generating more visits. Presentation: 6/1/2024

8156 Exploring Gender-Specific Characteristics Of Diabetes Among Young Adults In Korea: The Korea National Health And Nutrition Examination Survey 2011-2012 And 2019-2020

Abstract Disclosure: C. Chung: None. Background: The escalating global incidence of diabetes among young adults could be linked to dynamic socio-environmental changes including pandemic and climate shifts. In this investigation, we aimed to discern the distinct features of diabetes among young adults in Korea. Methods: This cross-sectional study included 63,489,047 Korean young adults (32,173,248 male, 31,315,799 female) aged 20-39 years who participated in the Korean National Health and Nutrition Examination Survey 2011-2012 and 2020-2021. Diabetes cases were identified through hospital diagnoses or the prescription of insulin or non-insulinemic anti-diabetic medications. The significant insulin resistance was defined as HOMA-IR above 2.9. Complex sampling design and cross-tabulation analyses were used to examine both socioeconomic and laboratory factors. Results: The prevalence of diabetes was higher in men in both 2011-2012 and 2020-2021 (Men vs. Women, 2011-2012: 2.2 ± 0.5 vs. 1.2 ± 0.3 %, p&amp;lt;0.001; 2020-2021: 3.0 ± 0.5 vs. 1.6 ± 0.3 %, p&amp;lt;0.001). The use of insulin and oral hypoglycemic agent (OHA) was comparable between men and women in 2011-2012 (Insulin: 18.1 ± 8.2 vs. 5.2 ± 5.1 %, p=0.305; OHA, 18.2 ± 6.3 vs. 19.5 ± 6.5 %, p=0.239), but more women used insulin and more men used OHA in 2020-2021 (Insulin: 5.3 ± 3.7 vs. 28.7 ± 9.4 %, p=0.016; OHA: 31.4 ± 7.7 vs. 19.6 ± 7.3 %, p=0.009). Execution of fundus exam (25.7 ± 10.6 vs. 68.5 ± 14.1 %, p=0.021) and diagnosis of diabetic retinopathy (0 vs. 8.9 ± 3.3 %, p=0.001) was higher in women in 2020-2021. HbA1c was higher in men in 2020-2021 (8.1 ± 0.4 vs. 7.3 ± 0.3 %, p &amp;lt;0.001), but was similar between men and women in 2011-2012 (8.4 ± 0.6 vs. 8.1 ± 0.6 %, p=0.697). Obesity, one of the most common comorbidities of diabetes, was higher in women in 2011-2012 (24.8 ± 4.8 vs. 79.4 ± 9.3 %, p&amp;lt;0.001), but was higher in men in 2020-2021 (94.4 ± 2.9 vs. 67.8 ± 11.0 %, p&amp;lt;0.001). The factors associated with increase in HOMA-IR in 2020-2021 was different between men and women. Unexpectedly, men with low mental stress showed positive correlation with HOMA-IR (B = 3.9, 95% CI 0.1-7.7, p=0.047). For women, mental stress did not affect HOMA-IR, but those with regular anaerobic exercise (B = -10.5, 95% CI -18.3 - -2.6, p=0.011) and stable employment status (B = -11.9, 95% CI -19.4 - -4.8, p=0.002) presented negative correlation with HOMA-IR. Conclusion: In comparison to before the COVID-19 pandemic, men diabetic patients showed more obese tendency after COVID-19, and there was also a statistically significant difference in HbA1c disparity with women. The higher prevalence of diabetic retinopathy despite of lower HbA1c in women during pandemic era needs to be further investigated in well-designed cohort study. Presentation: 6/3/2024

6536 National Trends in Prevalence of Prediabetes and Diabetes Among Women With Low Bone Mineral Density: 2009-2018

Abstract Disclosure: A. Atri: None. C. Anastasopoulou: None. Introduction: In recent years, bone fragility has emerged as a complication of prediabetes (preDM) and diabetes mellitus (DM), resulting in reduced bone mass and increased fracture risk, and is an important, though under-studied risk factor for osteoporosis. However, the converse relationship, trends in prevalence of preDM and DM in women with low bone mineral density (BMD) in the United States, are not well established. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) for the years 2009-10, 2013–14 and 2017–18 to include U.S. women aged ≥ 50 years with T-score ≤ -1. Osteoporosis assessment in NHANES was not completed in 2011–12 and 2015–16, and therefore not included in the analysis. Osteopenia and osteoporosis were defined by a femoral neck BMD ≤1 to 2.5, and ≤2.5 standard deviations (SDs) below the BMD of a young female adult mean (T-score). Femur neck BMD was measured by dual energy x-ray absorptiometry (DEXA). PreDM and DM were defined using HbA1c values of 5.7 - 6.4% and ≥ 6.5% respectively. Participants with missing HbA1c and BMD data were excluded. Descriptive statistics were used for comparing means and medians. The Cochran-Armitage test was utilized for trend analysis. Results: In this nationally representative sample of US women with low BMD, the median (IQR) T-score at femoral neck worsened from -1.74 (-1.4 to -2.17) in 2009-10 to -1.87 (-1.43 to -2.32) in 2017-18 (trend p = 0.001). Similarly, the prevalence of osteoporosis increased from 13.7% to 16.9% (trend p = 0.001). Overall, in this cohort, the national prevalence of both preDM and DM decreased from 40% to 32.9% and 9.6% to 9%, respectively (trend p = 0.001). Along with a reduction in the overall prevalence of osteopenia (86.3% to 83.1%, p=0.001), the prevalence of both preDM and DM decreased from 39.2% to 32.6% and 10% to 9% (p = 0.001). In those with osteoporosis, the prevalence of preDM decreased from 45.2% to 34.4% (p trend=0.001), however, the prevalence of DM increased from 7.5% to 8.7% (p trend =0.001). Overall rates of uncontrolled DM (HbA1c &amp;gt; 7%) in women with osteoporosis showed significant improvement (5.8% to 3.5%, p = 0.001). Discussion Despite worsening trend in femoral neck BMD among US women age ≥ 50 years from 2009-10 to 2017-18, the overall prevalence of preDM and DM improved by 7.1% and 0.6% respectively. However, this favorable trend was not observed among women with osteoporosis, where the overall prevalence of DM increased by 1.2%, though the rate of uncontrolled DM significantly decreased by 2.3%. Targeted interventions to improve blood glucose control among women with low BMD, especially those with osteoporosis are warranted, to improve bone health, as well as reduce fall and fracture risk. Presentation: 6/2/2024

7604 Examining Disparities in Diabetes Control and Complications: A Comparative Study of Type 2 Diabetes Mellitus Patients in Rural and Urban Saudi Arabia

Abstract Disclosure: S.F. Alqifari: None. O. Alkomi: None. P. Amirthalingam: None. T. Alrasheed: None. M. Muqresh: None. H. Hamad: None. A. Khojah: None. N. Alshehri: None. B. Alhunayhani: None. B. AbuAlhasan: None. N. Alajlan: None. S. Alatawi: None. N. Alsabeelah: None. A. Wasel: None. A. Alqifari: None. Background: The escalating global prevalence of diabetes is also mirrored in Saudi Arabia. Approximately one in four individuals in the country is diagnosed with diabetes, as reported by the World Health Organization (WHO). The Ministry of Health has taken steps to address the needs of patients with diabetes by creating more than 20 specialized diabetes care centers in various regions throughout Saudi Arabia. However, disparities in access and utilization of primary healthcare facilities persist between rural and urban provinces within the country. Highlighting these disparities would bridge healthcare gaps between rural and urban areas to enhance diabetes management, ensure better access to specialized care, and improve the overall well-being of individuals living with Type 2 Diabetes Mellitus (T2DM) in Saudi Arabia. Objectives: This study aims to examine disparities in diabetes control and complications in patients with T2DM in rural and urban Saudi Arabia. Methods: This is an observational retrospective study conducted from November 2022 until May 2023, we collected data from 13 diabetes care centers across Saudi Arabia to assess diabetes control and complications of T2DM among patients who received their care in rural and urban Saudi Arabia. Results: Among 709 patients residing in rural and urban areas, rural area patients' recent HbA1c readings were generally within the range of 7-8%. Among these patients, around 2.6% had a history of heart disease, and 6.08% had experienced cerebrovascular events. Limb numbness was reported by 44.34% of subjects, 47.82% experienced vision complications, and renal impairment was observed in 10.43% of the participants. Additionally, among male patients, 26.41% suffered from erectile dysfunction. Remarkably, 21% of the rural patients reported having been hospitalized due to diabetes complications at least once in the past 12 months. Conclusion: The study findings emphasize the importance of considering regional disparities and socio-environmental factors when managing diabetes and its complications. Additional research is needed to understand the underlying causes and develop targeted interventions for improved diabetes care in rural and urban populations in Saudi Arabia. Presentation: 6/2/2024

7513 Presence Of Hispanic/Latino Physicians In Academic Research. Are We There Yet?

Abstract Disclosure: C.E. Guillen Lopez: None. A. Patel: None. A. Rocha: None. C. Arima: None. A. Molkina: None. L. Robles: None. A. Arce Gastelum: None. Hispanic/Latino endocrinologists' presence and active involvement in diabetes research play a pivotal role in shaping the trajectory of healthcare initiatives in the United States. Diabetes, a prevalent and complex health condition, disproportionately affects diverse communities, with Hispanics/Latinos being among the groups facing higher incidence rates. In this context, the significance of Hispanic/Latino endocrinologists cannot be overstated, as their unique perspectives and cultural insights contribute to a more nuanced understanding of the multifaceted factors influencing diabetes prevalence, management, and outcomes in the U.S. By actively involving Hispanic/Latino endocrinologists in diabetes research, we not only enhance the representation of diverse patient populations but also foster a more comprehensive approach to addressing the intricate intersections of genetics, lifestyle, and socio-cultural factors contributing to diabetes disparities in the nation. In the 2021 Physician Specialty Data Report, the Association of American Medical Colleges (AAMC) incorporated physician race and ethnicity information for the first time. Within the 7,354 actively practicing endocrinologists surveyed, only 636 individuals identified as Hispanic/Latino. The majority of these endocrinologists were predominantly dedicated to clinical practice. A descriptive analysis of 1011 abstracts on diabetes and glucose metabolism presented at the Endo Society from 2021 to 2023 revealed that 549 were authored by women and 458 by men. The majority (705 posters, 69.7%) originated from the U.S., and 306 (30.26%) were classified as international posters. Among these, 152 posters (15%) were associated with the Hispanic or Latino authors, but only 91 (9%) were published in the U.S. In conclusion, the engagement of Hispanic/Latino physicians in endocrinology is indispensable for advancing healthcare. Their participation brings diverse perspectives, facilitates a better understanding of health disparities, and promotes innovative research and patient care strategies. By actively involving Hispanic/Latino physicians, we contribute to a more comprehensive understanding of endocrine disorders and work towards a healthcare system that prioritizes inclusivity, cultural sensitivity, and collaboration, ultimately benefiting the well-being of individuals across diverse communities. Presentation: 6/2/2024

Multimodal Identification of Molecular Factors Linked to Severe Diabetic Foot Ulcers Using Artificial Intelligence.

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), which often lead to hospitalization and non-traumatic amputations in the United States. Diabetes prevalence estimates in South Texas exceed the national estimate and the number of diagnosed cases is higher among Hispanic adults compared to their non-Hispanic white counterparts. San Antonio, a predominantly Hispanic city, reports significantly higher annual rates of diabetic amputations compared to Texas. The late identification of severe foot ulcers minimizes the likelihood of reducing amputation risk. The aim of this study was to identify molecular factors related to the severity of DFUs by leveraging a multimodal approach. We first utilized electronic health records (EHRs) from two large demographic groups, encompassing thousands of patients, to identify blood tests such as cholesterol, blood sugar, and specific protein tests that are significantly associated with severe DFUs. Next, we translated the protein components from these blood tests into their ribonucleic acid (RNA) counterparts and analyzed them using public bulk and single-cell RNA sequencing datasets. Using these data, we applied a machine learning pipeline to uncover cell-type-specific and molecular factors associated with varying degrees of DFU severity. Our results showed that several blood test results, such as the Albumin/Creatinine Ratio (ACR) and cholesterol and coagulation tissue factor levels, correlated with DFU severity across key demographic groups. These tests exhibited varying degrees of significance based on demographic differences. Using bulk RNA-Sequenced (RNA-Seq) data, we found that apolipoprotein E (APOE) protein, a component of lipoproteins that are responsible for cholesterol transport and metabolism, is linked to DFU severity. Furthermore, the single-cell RNA-Seq (scRNA-seq) analysis revealed a cluster of cells identified as keratinocytes that showed overexpression of APOE in severe DFU cases. Overall, this study demonstrates how integrating extensive EHRs data with single-cell transcriptomics can refine the search for molecular markers and identify cell-type-specific and molecular factors associated with DFU severity while considering key demographic differences.

A-059 Validation of self-collected capillary dried blood spot collection for clinical HbA1c testing

Abstract Background The increased prevalence of diabetes in socially disadvantaged populations requires solutions that are amenable to these communities. Unmanaged diabetes can cause cardiovascular disease, kidney damage, blindness, and limb amputation. Diabetes is traditionally diagnosed using fasting/oral glucose tolerance or hemoglobin A1c (HbA1c) tests; both of which require access to medical and laboratory facilities. Self-collected capillary dried blood spot (DBS) testing for HbA1c could alleviate health disparities by offering access to low cost and minimally invasive remote collection. The objective of this study was to validate self-collected capillary DBS specimens for clinical HbA1c testing. Methods DBS HbA1c was measured using the hemolysate application of the Roche cobas c513 Tina-quant Hemoglobin A1cDx Gen.3 assay. Calibration was performed according to the manufacturer’s package insert. Patient samples were prepared by collecting two 3mm DBS punches. Non-biological standards were prepared by placing two blank 3mm DBS punches into an empty tube and adding 10uL of standard. After 24 hours, samples were resuspended in 750uL of hemolyzing reagent and incubated for 75 minutes at room temperature (RT) while shaking at 800 RPM. Preliminary data showed that non-biological standards spotted onto DBS cards did not behave like real patient samples. A correction factor (CF) was derived (n=134) and challenged (n=20) to account for the systematic bias observed between matched patient DBS and venous specimens. Imprecision was established by running two patient DBS specimens as controls. Accuracy was evaluated using residual College of American Pathologists (CAP) proficiency testing (PT) material (n=32). Linearity was confirmed by running 5 levels of Maine Standards Linearity HbA1c Kit in triplicate. Stability of the DBS specimen and the hemolysate supernatant extracted from the DBS specimen were observed at RT. Results Specimens tested between venous and DBS HbA1c to derive the CF (n=134) had a bias of 0.26% (4.32%) and a linear equation of (y=0.938x +0.631; R=0.996). The resulting CF is: reported HbA1c% = (DBS HbA1c% - 0.631)/0.938. Matched venous and DBS specimens that challenged the CF (n=20) had a bias of -0.10% (-1.83%) and a linear equation of (y=1.06x -0.41; R=0.988). Imprecision was 2.3% and 1.3% for patient DBS control specimens with mean concentrations of 5.3% and 5.9%, respectively. Residual CAP PT samples (n=32) had an average bias of -0.05% (-0.40%). DBS HbA1c concentrations from 4.2-15.5% were linear (y=0.903x +1.15; R=0.999). The DBS specimen is stable for 60 days at RT and the hemolysate supernatant is stable for at least 10 hours at RT. Conclusions Self-collected capillary DBS specimens are acceptable for the clinical measurement of HbA1c, and effectively increase accessibility to diabetes screening and monitoring. Applying a CF to DBS patient samples removes the systematic bias observed between matched venous and DBS samples. Non-biological standards and capillary whole blood do not behave the same on DBS cards. Alternative PT for DBS specimens should be investigated as at-home collection advances.

Socioeconomic and medical determinants of state-level subjective cognitive decline in the United States.

It is important to understand the socioeconomic and medical determinants of subjective cognitive decline (SCD) at a population level in the United States. The primary outcomes are state-level rates of SCD and SCD-related functional impairment in adults aged ≥ 45, both measured in the Behavioral Risk Factor Surveillance System from 2016 to 2022. The exposures are state-level rates of poverty, unemployment, homelessness, college education, racial and ethnic minorities, uninsurance, smoking, hypertension, diabetes, and obesity as well as household income and physician density. The strongest state-level associations with rates of SCD were the prevalence of diabetes (rho=0.64), hypertension (rho=0.59), and poverty (rho=0.58; all p<0.001), and with SCD-related functional impairment were prevalence of poverty (rho=0.71), diabetes (rho=0.68), and hypertension (rho=0.53; all p<0.001). This study highlights critical links between SCD and socioeconomic and medical determinants in adults aged ≥ 45 in the United States, including the prevalence of poverty, diabetes, and hypertension. State-level analysis reveals socioeconomic and medical risk factors for subjective cognitive decline (SCD) at a population level. The prevalence of poverty is a critical contributor to the state-level prevalence of SCD. The prevalence of diabetes and hypertension are also strong state-level determinants of SCD. Addressing the burden of cognitive decline at the population level necessitates targeting socioeconomic and medical factors.

Association of socioeconomic and lifestyle factors with prevalence of diabetes in rural southwest China: a structural equation modelling approach

ObjectivesThis study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest...

Physical activity modifies the association between atherogenic index of plasma and prediabetes and diabetes: A cross-sectional analysis.

Although research has explored the association between atherogenic index of plasma (AIP) and prediabetes and diabetes, there is still not sufficient available evidence the role of physical activity (PA) in this relationship. Our purpose is to examine the complex connections between AIP, PA, and prediabetes and diabetes in a young and middle-aged population. This study included 2220 individuals from the general population, aged 20-60 years. AIP was calculated from the logarithm of the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio. PA was assessed depending to the American Heart Association (AHA) criteria and categorized into medium-high and low PA levels. We used binary logistic regression to explore associations and subsequently performed sensitivity and subgroup analyses. The 2220 participants had a mean age of 38 years, with a mean AIP of -0.1185, and a prediabetes and diabetes prevalence of 7.2%. After adjusting for auxiliary variables, AIP was positively correlated with prediabetes and diabetes (odds ratio [OR]: 3.447, 95% confidence interval [CI]: 1.829-6.497). In the low PA population, the prevalence of prediabetes and diabetes raised significantly with higher AIP (OR: 3.678, 95% CI: 1.819-7.434). This association was not meaningful in the medium to high PA population (OR: 1.925, 95% CI: 0.411-9.007). Joint and sensitivity analyze results also showed agreement. Restricted cubic spline identified a linear relationship between AIP and the prevalence of prediabetes and diabetes. Notably, the prevalence significantly increases when AIP values exceed -0.16 (p for linearity <0.05). The findings revealed heterogeneity across subgroups stratified by sex and age. PA may modify the link as regards AIP with prediabetes and diabetes in young and middle-aged populations. Adherence to PA prevents the adverse effects of abnormal glucose metabolism caused by dyslipidemia, particularly in women.

Investigating the Prevalence of Undiagnosed Diabetes and Its Associated Factors Among Healthcare Workers: A Cross-sectional Study in South of Iran

Abstract Context: Undiagnosed diabetes mellitus (DM) is a hidden aspect of the diabetes epidemic. Globally, over 50% of cases are estimated to be undiagnosed. Undiagnosed DM poses serious public health concerns due to increased risks of complications. Aims: This study aimed to investigate the prevalence and associated factors of undiagnosed diabetes among healthcare workers in southern Iran. Settings and Design: This cross-sectional study analyzed baseline data from the Shiraz University of Medical Sciences Employees Health Cohort Study, involving 5918 healthcare workers aged from 20 to 70 years. Materials and Methods: Participants completed questionnaires, underwent anthropometric measurements, and provided blood samples for clinical laboratory tests. Undiagnosed diabetes was defined as fasting plasma glucose ≥126 mg/dL in those without a previous diagnosis. Statistical Analysis Used: Univariate and multivariate logistic regression analyses were used to determine associated factors. Results: The prevalence of undiagnosed diabetes was 1.2%. Diagnosed diabetes had a prevalence of 3.1%. Together, undiagnosed cases accounted for 27.4% of total cases. Age (odds ratio [OR] = 1.09, 95% confidence interval [CI] [1.05–1.12]), male gender (OR = 1.67, 95% CI [1.01–2.74]), general obesity (OR = 3.64, 95% CI [2.45–5.91]), abdominal obesity (OR = 2.62, 95% CI [1.52–4.52]), hypertension (OR = 1.84, 95% CI [1.06–3.17]), and dyslipidemia were associated factors for undiagnosed diabetes. Conclusions: Although lower than national estimates, over one-quarter of diabetic cases among health workers remained undiagnosed, highlighting the need for improved screening, especially in high-risk groups. Expanding screening programs, raising health literacy, and increasing community access to preventive services are essential steps in addressing the public health issue of undiagnosed diabetes.

Diabetic Mastopathy – A Case Report

Introduction: Diabetic mastopathy is a rare benign condition that can occur in patients with long standing Type I or II diabetes mellitus male or female of any age. Diabetic mastopathy is a fibroinflammatory condition that resembles carcinoma of breast. Here, we report a case of Type II Diabetic female patient with suspicious breast lump in right breast Case presentation: A 62 year old female presented with complaints of lump in right breast for 10 days. Clinically, hard lump of size 8x6 cm was palpable in upper outer quadrant. Trucut biopsy showed features of Diabetic mastopathy. Patient undergone wide local excision and biopsy confirmed the diagnosis. Post operative period was uneventful. Discussion: Diabetic mastopathy is an uncommon tumor-like proliferation of fibrous tissue of the breast, clinically and radiologically mimicking breast cancer. Histopathologically, it involves periductal, perilobular and perivascular lymphocytic infiltration. Primary excision with adequate normal tissue margins is the treatment of choice Conclusion: Diabetic mastopathy is a rare clinical entity, however due to increase in prevalence of Diabetes, diagnosis of Diabetic mastopathy should be considered in patients with breast lumps

Delivery of dietary messages for type 2 diabetic patients by dental practitioners: A scoping review protocol.

The objective of this scoping review is to identify and understand the available evidence on the delivery of dietary messages to patients with type 2 diabetes in a dental setting. The outcome of a scoping review in this area will inform the development of a clinical intervention for dietary counseling at the chairside. Diabetics are at a higher risk for developing periodontal disease, and the severity of periodontal disease can impact the ability to control glucose levels. Considering the prevalence of diabetes within the community, dental practitioners are well placed to provide dietary messages to support this cohort during the management of periodontal disease. Studies that consider the population affected by type 2 diabetes and a dietary intervention in the context of a dental setting will be included. The databases selected for sources of studies are MEDLINE, EMBASE, CINAHL and SCOPUS. The scoping review will be conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Only English language studies are eligible for inclusion in this review. Terms relating to dietary advice, diabetes, dental practitioner and health education will be used to search for related studies. Screening based on abstract, and titles will be followed by full text screening with results supplied in PRISMA-SCR diagram. A data extraction tool will be used to chart the details of selected studies then presented in a venn diagram and word map along with a narrative synthesis of results.

Assessing the validity of social media in fighting COVID-19 in Africa

The severe outbreak of the COVID-19 pandemic has had a significant impact on global health, the economy, and society as a whole. To this effect, various measures both national and international were taken to respond to the pandemic. Among these measures was the rapid involvement of social media which played a vital role in the context of information dissemination, coordination of medical resources, promotion of public health campaigns, and population management and disease tracing. Besides these facilities put forward by social media, there were some weaknesses like misinformation, lack of guidance, and information leakage. Based on these numerous controversies brought about by social media during the pandemic periods, we aim to examine in this study the socio-economic effect of social media in the fight against Pandemics with particular attention on the case of the COVID-19 outbreak in Africa. Using Driscoll and Kraay's fixed effects and the Lewbel-2SLS estimators on 30 African countries, the results reveal that social media in Africa through the penetration rate of Facebook, Twitter, Instagram, Pinterest, and YouTube contribute significantly in disseminating COVID-19 in Africa. The findings equally reveal the mixed effect of other determinants of COVID-19 in this nexus. While Diabetes prevalence, the proportion of people aged 65 + , and population density contribute to the increased spread of the disease, GDP per capita and Hand Washing facilities instead prove a reducing effect of the disease. Sensitivity analysis reveals that this effect is homogenous for regional considerations of the overall sample. Based on this, appropriate suggestions are made to the various governments regarding the use of social media to prevent pandemics in the future.

Heterogeneous Association Between E-Cigarette Use and Diabetes Prevalence Among U.S. Adults

IntroductionE-cigarette use has increased among US adults. While the association between traditional cigarette smoking and the diabetes/prediabetes prevalence is well established, the relationship between e-cigarette use and these conditions remains unclear. This study examines the association between different types of cigarette use (including e-cigarettes alone, combustible cigarettes alone, and dual use) and the prevalence of prediabetes and diabetes among US adults. MethodsWe analyzed 1,285,783 observations from the 2020-2022 Behavioral Risk Factor Surveillance System surveys. Self-reported prediabetes and diabetes diagnoses were outcomes of interest. Propensity score matching with one-to-one nearest-neighbor matching was used to create balanced groups of smokers and non-smokers. Multivariable logistic regressions examined associations between self-reported smoking status and outcomes. We also conducted subgroup analyses to assess potential variations in these associations. Analyses were performed in September-December 2023. ResultsAfter propensity score matching and adjusting for covariates, sole e-cigarette users (adjusted odds ratio [AOR], 1.07; 95% CI, 1.03-1.11) and dual users (AOR, 1.28; 95% CI, 1.23-1.33) had higher odds of prediabetes diagnosis compared with never users. Sole e-cigarette use was not associated with diabetes risk, but dual users showed higher odds for diabetes diagnosis (AOR, 1.09; 95% CI, 1.06-1.11) versus never users. E-cigarette use was associated with varying odds of prediabetes and diabetes across different demographic groups. ConclusionsThis cross-sectional analysis found that e-cigarette use is associated with higher odds of prediabetes, with dual use potentially linked to increased odds of both prediabetes and diabetes. However, due to study limitations, including its cross-sectional design, self-reported data, and unmeasured confounders, these findings should be interpreted cautiously. As causal relationships and temporal sequences cannot be established, large prospective studies are needed to explore the metabolic health implications of emerging tobacco product use.

Matched Comparison Examining the Effect of Obesity on Clinical, Economic, and Humanistic Outcomes in Patients with BipolarI Disorder.

BipolarI disorder (BD-I) is associated with an increased risk of obesity, but few studies have evaluated the real-world clinical, humanistic, and economic effects associated with obesity in people with BD-I. This was a retrospective, cross-sectional analysis of responses to the 2016 and 2020 National Health and Wellness surveys. Respondents (18-64years) with a self-reported physician diagnosis of BD-I were matched to controls without BD-I based on demographic and health characteristics. Respondents were categorized by body mass index as underweight/normal weight (< 25kg/m2), overweight (25 to < 30kg/m2), or obese (≥ 30kg/m2). Multivariable regression models were used to compare obesity-related comorbidities, healthcare resource utilization (HCRU), health-related quality of life (HRQoL), work productivity, and indirect and direct costs. Before matching, the BD-I cohort was younger than the non-BD-I cohort and included more female and white respondents and a greater proportion covered by Medicaid or Medicare. After matching, the BD-I and non-BD-I cohorts had similar characteristics. A total of 5418 respondents (BD-I, n = 1806; matched controls, n = 3612) were analyzed. Obese respondents with BD-I reported the highest adjusted prevalences of high blood pressure (50%), high cholesterol (35%), sleep apnea (27%), osteoarthritis (17%), type2 diabetes (12%), and liver disease (4%). Obesity in respondents with BD-I was associated with the lowest HRQoL scores. Measures of work impairment were highest in respondents with BD-I and obesity, as was HCRU. Respondents with BD-I and obesity had the highest associated total indirect and direct medical costs ($25,849 and $44,482, respectively). Obese respondents with BD-I had greater frequencies of obesity-related comorbidities, higher HCRU, lower HRQoL, greater work impairments, and higher indirect and direct medical costs. These findings highlight the real-world burden of obesity in people with BD-I and the importance of considering treatments that may reduce this burden.