Prevalence Of Diabetes Research Articles

Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants

Individuation of a cut-off value of triglyceride-glucose index for incident diabetes mellitus in patients with essential hypertension.

The prevalence of obesity and diabetes, risk factors for atherosclerotic vascular diseases, is increasing worldwide; therefore, it is desirable to early identify them to reduce cardiovascular events. Thus, we investigated whether the triglyceride-glucose index (TyG index), a new marker of insulin resistance, is associated with incident diabetes in patients with newly diagnosed arterial hypertension. We selected 585 patients with newly diagnosed arterial hypertension referred to our tertiary Clinic of Catanzaro University Hospital for the evaluation of their cardiometabolic risk profile. None of the patients had diabetes mellitus at enrollment and took any drug known to affect glucose metabolism. Patients underwent medical history collection, clinical examination and laboratory tests. The TyG index was calculated as the ln [fasting TG (mg/dl) × FPG (mg/dl)/2], as previously suggested. During the follow-up [mean 8.5years (range 3.1-10.7)], there were 78 new cases of incident diabetes (1.57% patient-year). Patients who developed diabetes mellitus were older and had a higher body mass index (BMI), baseline blood pressure, fasting glucose, insulin, homeostatis model sssessment (HOMA) index, triglyceride, creatinine and hs-CRP mean values, while estimated glomerular filtration rate values were lower. At the Cox regression analysis, covariates significantly associated with incident diabetes were: BMI (HR = 2.842, 95%CI = 2.299-3.514), TyG index (HR = 2.392, 95%CI = 1.745-3.192), age (HR = 1.944, 95%CI = 1.527-2.474), hs-CRP (HR = 1.409, 95%CI = 1.153-1.722), and HOMA (HR = 1.325, 95%CI = 1,079-1.756). The best estimated cut-off value of TyG index in predicting diabetes was 4.71. In addition, we documented a significant relationship between TyG index and HOMA (r = 0.575; p < 0.0001). Present data demonstrate that TyG index, a simple and cost-effective marker of insulin resistance, is useful in predicting incident diabetes in patients with arterial hypertension.

Metabolic and hepatic phenotypes in sarcopenic obesity and impact of bariatric surgery

Background & AimsSarcopenic obesity (SO) is associated with cardiometabolic disorders and steatotic liver disease and carries major health risks. We assessed the hepatic and metabolic clinical phenotype associated with SO in patients with obesity undergoing bariatric surgery (BS). We also evaluated whether weight-loss and metabolic improvement post-surgery differ between patients with and without SO. Methods972 consecutive patients from a single-center BS cohort who underwent whole-body dual-energy X-ray absorptiometry (DXA) and peri-operative liver biopsy were included. SO was diagnosed using the AIM-SO score, an AI-assisted unbiased clustering algorithm based on body composition. One-year post-surgery, 862 patients were reassessed for AIM-SO score changes. ResultsPre-operatively, 207 (21.3%) patients were diagnosed with SO. These patients had significantly higher prevalence of type-2 diabetes (T2D), arterial hypertension and obstructive sleep apnea (OSA) compared to patients without SO (all p≤0.003). Patients with SO had more severe liver damage: higher grades of moderate/advanced steatosis (64.2% vs. 47.3%), steatohepatitis (44.4% vs. 32.3%) and advanced fibrosis (12.1% vs. 6.0%) (all p≤0.01). One-year post-BS, 58.5% of patients had remission of SO. Patients with persistent SO exhibited less weight-loss than those with SO remission (–23.8 kg vs. –29.1 kg, p<0.001) and had lower rates of remission for T2D (41.9% vs. 69.8%), arterial hypertension (20.8% vs. 45.3%), and metabolic syndrome (47.6% vs. 75.0%) (all p≤0.009). ConclusionThe DXA-based AIM-SO score identifies patients with SO who are at greater risk of hepatic and cardiometabolic comorbidities, and predicts less favorable weight-loss and metabolic improvements post-BS.

Association between sarcopenic obesity and osteoarthritis: The potential mediating role of insulin resistance

BackgroundSarcopenic obesity (SO) and osteoarthritis (OA) are highly prevalent musculoskeletal conditions that significantly impair health-related quality of life. AimThis study investigated the association between SO and OA, and explored the potential mediating role of insulin resistance in this relationship. We utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. MethodsThis cross-sectional analysis employs NHANES data collected from 1999 to 2018, including participants aged 18 years and older. SO was assessed using dual-energy X-ray absorptiometry (DXA) measurements. Insulin resistance was estimated using the triglyceride-glucose (TyG) index. OA status was based on self-reported physician diagnosis. Statistical analyses included weighted logistic regression, restricted cubic spline (RCS) interaction analysis, mediation analysis using structural equation modeling (SEM), and receiver operating characteristic (ROC) curve analysis. Subgroup analyses were conducted based on age, sex, and diabetes status. ResultsThe sarcopenic obese group demonstrated the highest prevalence of OA (23.4 %), hypertension (47.8 %), and diabetes (12.0 %). Additionally, they exhibited elevated levels of triglycerides, cholesterol, glucose, blood urea nitrogen (BUN), creatinine, and uric acid. Logistic regression revealed significant positive associations between sarcopenic obesity, the TyG index, and OA risk. RCS analysis identified significant non-linear relationships and interactions of the TyG index with age, sex, and diabetes status on OA risk. Mediation analysis indicated that the TyG index mediated approximately 4.9 % of the effect of sarcopenic obesity on OA risk. ROC curve analysis demonstrated moderate diagnostic accuracy for the TyG index (AUC = 0.65), which improved when incorporated into the multivariate model (AUC = 0.78). Subgroup analyses confirmed significant associations between the TyG index and sarcopenic obesity with OA risk across different age, sex, and diabetes status categories. ConclusionOur findings suggest a significant correlation between insulin resistance, as measured by the TyG index, and elevated OA risk in individuals with sarcopenic obesity. Targeting insulin resistance through future research may be a promising avenue to lower OA risk in this population.

Oral health behavior associated with cardiometabolic outcomes: A nationally representative cross-sectional study in Portugal

BackgroundOral diseases are associated with the development of cardiometabolic diseases. This study aimed to evaluate the relationship between oral health behaviors (tooth brushing and oral health appointments) with cardiometabolic diseases. MethodsData from the First National Health Examination Survey were used. Participants aged 25–74 years and diagnosis of acute myocardial infarction (n = 4442), stroke (n = 4441), hypertension (n = 4450) and diabetes (n = 4327) were analyzed. A fifth subsample (n = 2555) included participants aged 40–69 for calculating cardiovascular risk. Poor oral health behavior was defined as brushing once a day or less and having the last oral health appointment at 12 months or more. Poisson regression models assessed the relationship between poor oral health behavior and these cardiometabolic outcomes. ResultsAmong 4.450 participants, 20.5 % had poor oral health behavior. A statistically significant association was found between poor oral health behavior with diabetes (PR: 1.44 [95 % CI: 1.10–1.98], and high/very high cardiovascular risk (PR: 1.42 [95 % CI: 1.25–1.62]). In the sensitivity analysis the association with diabetes and high/very high cardiovascular risk persisted when considering only brushing behavior but not when considering only oral health appointments at 12 months or more. ConclusionsIndividuals with poor oral health behavior had a higher prevalence of diabetes and high/very high cardiovascular risk. Sensitivity analysis suggested that regular tooth brushing may be the main behavior for preventing diabetes and cardiovascular risk. The results suggest that regular tooth brushing may act in prevention for diabetes and cardiovascular risk.

Prediabetes and cardiovascular risk factors: the effectiveness of a guided self-determination counselling approach in primary health care, a randomized controlled trial

BackgroundIdentify individuals who are at risk of Type 2 diabetes, who also are at a greater risk of developing cardiovascular disease is important. The rapid worldwide increase in diabetes prevalence call for Primary Health Care to find feasible prevention strategies, to reduce patient risk factors and promote lifestyle changes. Aim of this randomized controlled trial was to investigate how a nurse-lead Guided Self-Determination counselling approach can assist people at risk of type 2 diabetes to lower their coronary heart disease risk.MethodsIn this randomized controlled study, 81 people at risk of developing type 2 diabetes were assigned into an intervention group (n = 39) receiving Guided Self-Determination counselling from Primary Health Care nurses over three months and a control group (n = 42) that received a diet leaflet only. Measurements included the Finnish Diabetes Risk Score questionnaire and biological measurements of Hemoglobin A1c protein, Body Mass Index, fasting blood glucose, Blood pressure, Cholesterol, High-density lipoprotein, and triglycerides, at baseline (time1), 6 (time2) and 9 months (time 3).ResultsA total of 56 participants, equal number in intervention and control groups, completed all measurements. A significant difference between the intervention and control groups, in coronary heart disease risk was not found at 6 nor 9-months. However, within-group data demonstrated that 55.4% of the participants had lower coronary heart disease risk in the next ten years at the 9-month measurement. Indicating an overall 18% relative risk reduction of coronary heart disease risk by participating in the trial, with the number needed to treat for one to lower their risk to be nine. Within the intervention group a significant difference was found between time 1 and 3 in lower body mass index (p = 0.046), hemoglobin A1c level (p = 0.018) and diastolic blood pressure (p = 0.03).ConclusionsAlthough unable to show significant group differences in change of coronary heart disease risk by this 12-weeks intervention, the process of regular measurements and the guided self-determination counselling seem to be beneficial for within-group measures and the overall reduction of coronary heart disease risk factors.Trial registrationThis study is a part of the registered study ‘Effectiveness of Nurse-coordinated Follow-Up Programme in Primary Care for People at Risk of T2DM’ at www.ClinicalTrials.gov (NCT04688359) (accessed on 30 December 2020).

Insulin resistance during androgen deprivation therapy in men with prostate cancer.

Androgen deprivation therapy (ADT) in prostate cancer (PCa) has been associated with development of insulin resistance. However, the predominant site of insulin resistance remains unclear. The ADT & Metabolism Study was a single-center, 24-week, prospective observational study that enrolled ADT-naive men without diabetes who were starting ADT for at least 24 weeks (ADT group, n=42). The control group comprised men without diabetes with prior history of PCa who were in remission after prostatectomy (non-ADT group, n=23). Prevalent diabetes mellitus was excluded in both groups using all three laboratory criteria defined in the American Diabetes Association guidelines. All participants were eugonadal at enrollment. The primary outcome was to elucidate the predominant site of insulin resistance (liver or skeletal muscle). Secondary outcomes included assessments of body composition, and hepatic and intramyocellular fat. Outcomes were assessed at baseline, 12, and 24 weeks. At 24 weeks, there was no change in hepatic (1.2; 95% confidence interval [CI], -2.10 to 4.43; p=.47) or skeletal muscle (-3.2; 95% CI, -7.07 to 0.66; p=.10) insulin resistance in the ADT group. No increase in hepatic or intramyocellular fat deposition or worsening of glucose was seen. These changes were mirrored by those observed in the non-ADT group. Men undergoing ADT gained 3.7 kg of fat mass. In men with PCa and no diabetes, 24 weeks of ADT did not change insulin resistance despite adverse body composition changes. These findings should be reassuring for treating physicians and for patients who are being considered for short-term ADT.

Waist-to-Height Ratio as a Key Predictor for Diabetes and Hypertension in Lao PDR National Health Survey.

This study aimed to determine the potential predictive value of four noninvasive anthropometric indices in screening for the risk of diabetes and hypertension in the Lao population. The data used for this study were collected as part of the National Health Survey which used the World Health Organization's stepwise approach, covered 17 provinces and Vientiane capital, and had a representative sample of 3240 participants above 18 years old. Among the anthropometry indices tested, waist-to-height ratio (WHtR) had the highest predictive power for the prevalence of diabetes (area under the curve [AUC] = 0.73) and hypertension (AUC = 0.70). It is suitable for use in urban or rural areas and for fieldwork. The WHtR can serve as a public health and clinical screening tool, as there are no differences between sexes, ages, and ethnicities when monitoring diabetes and hypertension risk in Lao PDR, using the optimal cutoff point of 0.5 for both diabetes and hypertension.

Predictive Factors for Diabetes Mellitus: Insights from Complete Blood Count Analysis

The 10th edition of the International Diabetes Federation reports that 537 million people worldwide had diabetes in 2021. In Southeast Asia, countries like Malaysia are facing a growing burden of diabetes. This highlights the urgent need for innovative and resourceful approaches to diabetes management. As the prevalence of diabetes continues to rise in these countries, tailored strategies are necessary. To identify and evaluate the potential prognostic indicators for diabetes mellitus, this study involved a dataset consisting of 500 entries, comprising demographic information and selected blood cells from the Complete Blood Count (CBC) test results obtained from the Clinical Laboratory Faculty of Medicine &amp; Health Sciences, Universiti Malaysia Sabah. Using univariate and multivariate logistic regression analysis, the prognostic predictors for diabetes mellitus were identified. In the univariate analysis, all variables are statistically significance at 5% level of significance. However, at multivariate analysis, only age, mean corpuscular hemoglobin concentration (MCHC), white blood cells (WBC) and hematocrit (HCT) emerged as significant predictors of diabetes mellitus. Notably, the abnormal level in WBC exhibited the greatest association with diabetes mellitus, reflecting a 114.7% increased risk compared to a normal WBC level. The statistic value obtained from Hosmer-Lemeshow was 0.944 indicating a well-fitting model. Additionally, the receiver operator characteristic (ROC) curve has a value of 0.7, indicating a strong performance of the model. In conclusion, CBC parameters can be accurate markers and useful in assisting clinical decision-making when properly applied and interpreted.

Challenging the American College of Obstetricians and Gynecologists' Clinical Practice Update on Screening for Pre-existing Diabetes and Early Gestational Diabetes.

A recent American College of Obstetricians and Gynecologists Clinical Practice Update continues to recommend targeted (as opposed to universal) screening for pregestational diabetes, no longer recommends screening for early gestational diabetes mellitus (GDM), and provides updated guidelines for immediate postpartum testing for diabetes in patients with GDM. Here, we present data that the targeted screening paradigm, which has repeatedly been shown to fail in practice because of its complexity, no longer makes sense in the context of the high and rising prevalence of diabetes and diabetic risk factors, and we argue that the time has come for universal early pregnancy screening for pregestational diabetes. Furthermore, the recommendation against early screening for GDM is based on 2021 U.S. Preventive Services Task Force guidance, which in turn is based almost entirely on a single underpowered study that excluded individuals at highest risk and does not account for more recent research showing benefits of early diagnosis and treatment. Universal early pregnancy screening for pregestational diabetes may also help to identify patients at risk who will benefit from early GDM diagnosis and treatment and may provide rationale for prioritizing postpartum diabetes testing.

Serum neurofilament light chain: a novel biomarker for cardiovascular diseases in individuals without hypertension

Serum neurofilament light chain (sNFL) is a biomarker for axonal injury. Previous studies have linked sNFL levels to cardiovascular risk factors such as diabetes and hypertension, but its association with cardiovascular diseases (CVD) remains unclear. This study aims to explore the association between sNFL and CVD and evaluates its predictive value. Utilizing NHANES 2013–2014 data, this study included 2,035 participants aged ≥ 20 years with measured sNFL quantified using a Siemens immunoassay. CVD was self-reported and included myocardial infarction, stroke, heart failure, coronary heart disease, or angina. Logistic regression models assessed the association between sNFL levels and CVD. The predictive value of sNFL for CVD was evaluated using area under the curve (AUC) and DeLong test. Participants with higher sNFL levels were typically older, male, non-Hispanic white, smokers, and had lower socioeconomic status, higher CVD, hypertension, and diabetes prevalence. Higher sNFL levels were significantly associated with increased odds of CVD (adjusted OR = 1.41, 95% CI: 1.05–1.88). The association was significant in non-hypertensive individuals (OR = 2.72, 95% CI: 1.61–4.62) but not in hypertensive individuals (OR = 1.13, 95% CI: 0.81–1.56). sNFL addition to traditional risk models improved predictive accuracy, especially in non-hypertensive individuals (AUC from 0.827 to 0.856). sNFL levels are significantly associated with CVD in the general population, with a strong predictive value in non-hypertensive individuals. Future longitudinal studies should validate sNFL’s efficacy in various populations and explore the underlying mechanisms of its relationship with hypertension and CVD.

Prevalence and influence factor of drug-related problems in inpatients with kidney disease: a prospective single central study

AimsTo investigate the prevalence and influencing factors of drug-related problems (DRPs) in inpatients with kidney disease to provide reference data for pharmaceutical care.MethodsThe basic information, diagnoses, and medication reconciliation (MR) of inpatients in the Department of Nephrology at our hospital between October 2020 and September 2021 were collected. The Chinese-modified DRP version based on the PCNE classification (Version 9.1) was used to assess, intervene and statistically analyze the results of the patients’ DRPs. The influence factor of DRPs in inpatients with kidney disease was analyzed by the multivariate binary logistic regression.ResultsOf 623 patients included in this study, 132 (21.80%) had DRPs. The prevalence of anemia was significantly higher in patients with DRPs than those without DRPs (43.18% vs. 28.72%, p &amp;lt; 0.05), the mean number of drug types consumed (7.25 ± 3.44 with DRPs vs. 5.93 ± 3.58 without DRPs, p &amp;lt; 0.05) and the proportion of ≥5 drugs (%) (79.55% with DRPs vs 58.04% without DRPs, p &amp;lt; 0.05) were significantly increased. In addition, the prevalence of hypertension (76.52% vs. 68.64%), diabetes (27.27% vs. 22.20%) and hyperuricemia (16.67% vs. 13.65%) in DRP patients were higher than those without DRPs, but there was no statistical difference (p &amp;gt; 0.05). The logistic regression analysis showed that patients with anemia (OR = 1.702, 95%CI: 1.146–2.529, p = 0.008), average number of medication types taken (OR = 1.089, 95%CI: 1.034–1.147, p = 0.001) significantly increased the risk of DRPs. The distribution of harm levels was as follows: 78 problems (59.09%) were level C, 29 (21.97%) were level B, 10 (7.58%) were level D, 7 (5.30%) were level A, 7 (5.30%) were level E, and 1 (0.76%) were level F. All DRPs were resolved after 128 interventions.ConclusionRenal anemia, the average number of drug varieties consumed, and the proportion of ≥5 drugs are associated with the occurrence of DRPs. Pharmacists conducting MR services can reduce DRPs of inpatients in the department of nephrology and ensure patient drug safety.

KECEMASAN PADA PASIEN DENGAN LUKA KAKI DIABETIK

The prevalence of diabetes continues to increase from year to year in 2021. There were 90 million cases and 5.5% are predicted to have diabetic foot ulcers, and it is predicted that it will increase by 68% in 2045 with 152 million patients. This study was conducted to determine whether there was a relationship between duration of diabetes and age on the level of anxiety in patients with diabetic foot ulcers at the Kitamura clinic in Pontianak. This type of research is descriptive analytic with a cross sectional approach. The sample used in this study were 60 respondents with diabetic foot ulcers who received treatment at the Kitamura Pancasila Pontianak Clinic, the instruments used in this study were the Anxiety Inventory (S-AI) Form questionnaire to measure anxiety levels and observation sheets for respondent demographic data. The results of the Spearman Ranks test obtained with the results of significance (2-tailed) or p value = 0.005 there is a relationship between the length of time suffering from DM with anxiety levels in diabetic foot ulcers patients and there is no relationship between age and anxiety levels in diabetic foot ulcers patients with p-value 0.064. Conclusion, there was no relationship between age and anxiety level and there was a relationship between duration of DM and anxiety level in patients with DM.

Economic disadvantage during childhood, obesity, and diabetes across three birth cohorts of older Mexicans.

Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in three cohorts of Mexican adults. Data on those 60-69 years old from the 1930-39, 1940-49, and 1950-59 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent reports. Supplementary analyses using HbA1c as a criterion for diabetes were conducted. A regression-decomposition approach was implemented. Logistic regression models included adjustments for sociodemographic characteristics and access to medical care. Diabetes prevalence was 23% overall and 11%, 25%, and 26% in the 1930-39, 1940-49, and 1950-59 cohorts, respectively. EDDC declined across successive cohorts, while the prevalence of overweight/obesity at age 50 increased. EDDC and overweight/obesity were associated with higher odds of reporting diabetes. A scenario that eliminates disadvantaged EDDC reduced diabetes prevalence by 11% in a pooled sample, while eliminating overweight/obesity reduced it by 30%. Overweight/obesity explained 42% of the rise in diabetes prevalence between the 1930-39 and 1950-59 cohorts. Improvement in EDDC explained 18% of the rise in diabetes prevalence between 1930-39 and 1950-59 cohorts. High body weight across Mexican birth cohorts seemed to offset the potential benefits from improvements in childhood conditions on adult diabetes risk.

Determinants of Complications of Diabetic Among Adult with Type 2 Diabetic Patients at Hubaal Specialist Hospital and Libaan Hospital in Mogadishu: Case Control Study

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Diabetes mellitus is a major global health issue characterized by persistently high blood sugar levels due to insufficient insulin production or decreased insulin efficacy. Over 422 million adults have diabetes worldwide, with an expected rise to 642 million by 2040. Type 2 diabetes accounts for about 90% of these cases. Sub-Saharan Africa is seeing a notable rise in type 2 diabetes due to lifestyle changes and an aging population In Somalia, the private-sector-dominated healthcare system, exacerbated by prolonged armed conflicts, struggles with affordable diabetes management, leading to increased diabetic complications. With an estimated 5% prevalence of diabetes in Somalia, the lack of routine screening and limited access to affordable healthcare further elevate the prevalence and complications, particularly among those with type 2 diabetes. &amp;lt;i&amp;gt;Objective&amp;lt;/i&amp;gt;: This study aimed to identify socio-demographic, healthcare, lifestyle, and clinical factors associated with diabetic complications among adults with type 2 diabetes at selected hospitals in Mogadishu, Somalia. &amp;lt;i&amp;gt;Methods&amp;lt;/i&amp;gt;: A case-control study of 187 type 2 diabetes patients used purposive sampling and structured questionnaires to collect data. Analysis was performed using SPSS version 27.0 with bivariate and logistic regression, and significance was set at p ≤ 0.05. &amp;lt;i&amp;gt;Results&amp;lt;/i&amp;gt;: The study found that participants aged over 47 years had significantly higher odds of developing diabetic complications compared to those aged 18-27 years (OR: 3.17, 95% CI: 1.26-7.96, p = 0.014). In the multiple regression analysis, the duration of diabetes significantly influenced the risk of complications, with those diagnosed for 5-10 years (AOR: 3.50, 95% CI: 1.19-10.28, p = 0.029) and more than 10 years (AOR: 3.59, 95% CI: 1.36-9.49, p = 0.011) having increased odds. Uncontrolled blood glucose levels were also a significant predictor of complications (AOR: 3.55, 95% CI: 1.82-6.91, p &amp;lt; 0.001). Other factors, such as marital status and monthly income, were not significant in the multiple regression analysis. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: This study highlights the importance of early detection and management of diabetes to prevent complications, especially among older adults and those with longer disease duration. Interventions should focus on improving glycemic control and managing comorbid conditions. Targeted education and support for patients, especially those at higher risk, are crucial to mitigating the impact of diabetic complications.

Cerebral Embolic Protection by Geographic Region

Transcatheter aortic valve replacement (TAVR) is an established treatment option for many patients with severe symptomatic aortic stenosis; however, debris dislodged during the procedure can cause embolic stroke. The Sentinel cerebral embolic protection (CEP) device is approved for capture and removal of embolic material during TAVR but its efficacy has been debated. To explore regional differences in the association of CEP utilization with stroke outcomes in patients undergoing TAVR. This post hoc analysis of a prospective, postmarket, randomized clinical trial evaluating TAVR performed with or without the CEP took place at 51 hospitals in the US, Europe, and Australia from February 2020 to January 2022. Patients with symptomatic aortic stenosis treated with transfemoral TAVR were included. Randomization was stratified according to center, operative risk, and intended TAVR valve type. Patients were excluded if the left common carotid or brachiocephalic artery had greater than 70% stenosis or if the anatomy precluded placement of the CEP device. Data for this post hoc study were analyzed from August to October 2024. TAVR with or without CEP. The primary end point was the rate of all stroke events at hospital discharge or 72 hours post-TAVR, whichever came first. Neurological examinations were performed at baseline and postprocedure to identify stroke, disabling stroke, and other neurological outcomes. The Stroke Protection With Sentinel During Transcatheter Aortic Valve Replacement (PROTECTED TAVR) trial enrolled and randomized 3000 patients (1803 [60.1%] male; mean [SD] age, 78.9 [7.8] years): 1833 in the US cohort (TAVR alone: 919, TAVR with CEP: 914) and 1167 patients in the outside the US (OUS) cohort (TAVR alone: 580, TAVR with CEP: 587). Patients in the US cohort were younger, more predominantly male, had a lower prevalence of atrial fibrillation, and had a higher prevalence of bicuspid aortic valve, diabetes, and peripheral vascular disease compared with the OUS cohort. In the main trial, the incidence of stroke within 72 hours after TAVR or before discharge did not differ significantly between the CEP group and the control group, and there was no interaction by geographic region. In this post hoc analysis, patients treated with CEP in the US cohort exhibited a 50% relative risk reduction for overall stroke and a 73% relative risk reduction for disabling stroke compared to TAVR alone; a treatment effect on stroke risk reduction was not observed in the OUS cohort. The PROTECTED TAVR trial could not show that the use of CEP had a significant effect on the incidence of periprocedural stroke during TAVR. Although there was no significant interaction by geographic region, this exploratory post hoc analysis suggests a trend toward greater stroke reduction in the US cohort but not in the OUS cohort. These findings are hypothesis generating, and further research is needed to determine if regional differences in patient characteristics or procedural practices affect CEP efficacy. ClinicalTrials.gov Identifier: NCT04149535.

The Induction of Diabetes by High-Sugar and High-Fat Diets and Potential Applications of Healthy Eating

The rising prevalence of diabetes has intensified research in this field. Among the various causes of diabetes, insulin resistance plays a crucial role. High-sugar, high-fat diets are known to induce hyperglycemia and obesity, which significantly affect the progression of insulin resistance. It should be noted that obesity can significantly increase insulin resistance, thereby inducing prediabetes and aggravating diabetic symptoms. Additionally, such diets disturb the balance of intestinal flora. Controlling carbohydrate intake through low-carb or ketogenic diets can effectively improve glucose and lipid metabolism, improving insulin sensitivity, reducing insulin resistance, and lowering insulin levels. Adjustments to diet can also help shape a healthy gut flora composition. Furthermore, consuming natural products like flavonoids can also contribute to the improvement of diabetic symptoms. This article summarizes the impact of high-sugar, high-fat diets on the progression of diabetes, their effects on insulin resistance and intestinal flora, and the regulatory benefits of a healthy diet in managing diabetes.

Trends in diabetes morbi-mortality and its association with abdominal obesity among Tunisian adults

Abstract Introduction Tunisia is undergoing rapid nutritional transition, with increasing rates of abdominal obesity. Coupled with rising diabetes prevalence, it poses significant challenges to public health. This study aimed to estimate the morbi-mortality prevalence and trends of diabetes among Tunisian adults, particularly examining its association with abdominal obesity. Methods We conducted a secondary data analysis on adults aged 35 to 70 from three national surveys in Tunisia, in 1996 (n = 3513), 2005 (n = 7700), and 2016 (n = 6007) respectively. Mortality data was sourced from the Tunisian National Information System on Causes of Death in 2020. The underlying cause of death was determined using the IRIS software, following WHO guidelines for tabulating mortality statistics. Diabetes was defined according to the American Association of Diabetes criteria. Abdominal obesity was defined as a waist-to-height ratio ≥ 0.6. We performed chi-squared test for trend analysis. Results A total of 17220 participants were analyzed. We found a significant upwards trend in diabetes prevalence (p &amp;lt; 10-3): it increased from 13.1%[11.9-14.3] in 1996 to 15.1% [12.5-17.4] in 2005, then to 20.5%[18.9-22.1] in 2016. Linear trend test concluded to significant increase in diabetes prevalence estimated at 56.6% in two decades. Diabetes was significantly associated with abdominal obesity (Odds ratio (OR)=2.17[2.11-2.21]). Diabetes was the leading cause of death among Tunisian adults in 2020 (n = 22715). The proportional mortality due to diabetes was estimated at 6.2% (n = 1407) (6.4% for men and 6% for women). The age group with the highest proportional mortality due to diabetes was 65-70 years old (44.6%). Conclusions Our findings highlight the burden of diabetes on public health in Tunisia and its association with abdominal obesity. Hence the urgency to strengthen comprehensive preventive and control measures to alleviate its repercussions among the Tunisian population. Key messages • The prevalence of diabetes increased significantly amongTunisian adults in the past two decades. • Immediate implementation of targeted interventions and policy measures is imperative to effectively address this issue.

Towards more effective health monitoring: a comparison of different data sources

Abstract Background Monitoring the prevalences of chronic diseases and their risk factors at the population level is important to support effective prevention measures, health service planning and health policy-making. The utilization of register information is cost-effective in population health monitoring, but the validity of information is important to assess. The aim of this study was to compare the information on most common chronic diseases and risk factors collected from a population-based Healthy Finland survey and national health registers. Methods The study population comprised of 4785 individuals aged 20 years or over from the nationally representative Healthy Finland Health Examination Survey conducted in 2023. Information on the most common chronic diseases were derived from both survey data (including measured and self-reported data) and the national registers. The prevalence in survey data were compared with prevalence in register data for those individuals who participated in the survey. Register data was examined for the previous five years and was obtained from the Care Register for Health Care and medical registers, depending on availability of data. Weighted prevalences were calculated taking into account the sampling design and non-response. Results For all examined risk factors and diseases, the prevalence was higher in survey data than in register data. The difference was the greatest for elevated blood pressure: the prevalence in survey data was 48.6% (95% CI 46.5, 50.7) versus 17.3% (15.6, 19.0) in register data. The prevalence of diabetes was 11.5% (10.4, 12.5) in survey and 6.9% (5.9, 7.9) in register data. For sleep apnea, the prevalence in survey data was 8.4% (7.4, 9.3) and 4.4% (3.7, 5.1) in register data. Conclusions Register-based information provides more reliable prevalences on diseases needing urgent treatment. Survey data brings out also previously unidentified diseases cases that do not show in registers. Key messages • Register data is cost-effective in health monitoring, but surveys are needed for monitoring risk factors. • Utilizing diverse data sources enhances getting reliable information to support decision-making.

Current Status of Diabetes Prevention and Control in China and Early-Stage Intervention Strategies

In recent years, the prevalence of diabetes in China has continued to rise, with the adult prevalence expected to reach 12.8% by 2023. To control this trend, the government has introduced several policies and invested substantial funds in the prevention and treatment of diabetes, achieving certain results. Prediabetes is a stage where blood glucose metabolism can still be restored. For individuals in this stage, dietary and exercise intervention programs are recommended to prevent or delay the onset of diabetes, improve quality of life, and reduce the burden of disease on individuals, families, and society.