Risk Factors For Diabetes Mellitus Research Articles

Effects of HCV Clearance with Direct-Acting Antivirals (DAAs) on Liver Stiffness, Liver Fibrosis Stage and Metabolic/Cellular Parameters.

Chronic hepatitis C (CHC) is a clinical and pathological syndrome with various causes and is characterized by varying degrees of hepatocellular necrosis and inflammation. It is a significant cause of liver transplantation and liver-related death worldwide. The hepatic manifestations of CHC are typically characterized by slowly progressing liver fibrosis, which is a non-specific and often disproportionate response to tissue damage. A large majority of HCV patients have extrahepatic manifestations with varying degrees of severity. HCV infection is a risk factor for cardiovascular disease and diabetes mellitus, which increases insulin resistance, oxidative stress, and iron overload and causes chronic systemic inflammation. HCV infection is treated using direct-acting antivirals (DAAs) with cure rates of over 95 percent, minimal side effects, and shorter therapeutic courses. Despite the effective elimination of the virus, it seemed pertinent to understand to what extent HCV clearance eliminates or attenuates all the systemic alterations already induced by the virus during infection and chronicity. Our study aimed to determine whether eliminating HCV with DAAs alters the severity of liver disease (liver stiffness and liver fibrosis stage by TE) and the metabolic/cellular profile of patients with CHC. A group of 329 CHC patients from a Gastroenterology and Hepatology outpatient department were prospectively studied. Of these, 134 were also studied with DAAs. The liver fibrosis stage was evaluated by transient elastography (TE) using a FibroScan® device, and two groups were established for the analysis of liver stiffness (LS): mild and moderate stiffness (fibrosis F1 and F2; F1/2) and severe stiffness (fibrosis and cirrhosis F3 and F4; F3/4). Metabolic/cellular parameters were evaluated before and after antiviral treatment using standard methods: alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl-transpeptidase (γ-GT), haptoglobin (Hp), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), free iron (Fe), transferrin saturation (TS), total iron binding capacity (TIBC), ferritin (Ft), glycemia, insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and platelets count. The results were statistically analyzed using SPSS 24.0 for Windows. Comparing the fibrosis stage before and after DAAs treatment, we verify a reduction in LS in 85.7% of patients and an improvement in liver fibrosis stage in 22.2% of them after DAAs treatment. Before DAAs treatment, patients showed a 2.410 risk for higher fibrosis stages (F3/4). Comparing metabolic/cellular parameters before and after DAAs treatment, patients showed lower ALP, AST, ALT, γGT, TG, Fe, TIBC, and Ft values and higher TC, LDL, and Hp values after treatment. As such, HCV elimination reduces iron overload and insulin resistance. On the other hand, it caused dyslipidemia, raising total cholesterol and LDL to levels outside the reference values. The improvement in the liver fibrosis stage by TE was mainly associated with higher baseline platelet count and HDL values and lower insulin resistance. With this study, we were able to contribute to the knowledge of the effects of HCV elimination with DAAs on liver disease and metabolic profile to improve the quality of treatment and follow-up of these patients after HCV elimination.

RISK FACTORS FOR DIABETES MELLITUS ACCORDING TO THE INDIVIDUAL REGISTRATION OF PRIMARY CARE IN A MUNICIPALITY IN THE NORTH OF MINAS GERAIS-MG

Objective: To analyze the completion of the individual e-SUS registration form and identify the completion of the factors that correlate to the onset of diabetes mellitus. Methods: Descriptive study based on documents, in which the individual registration forms of users assigned to an area covered by the Family Health Strategy were used for analysis. Results: It was identified that data such as family history, anthropometric measurements, dietary components, and frequency of physical exercise are not addressed in the registration forms, factors considered predisposing to the disease. There is an underreporting of risk factors for diabetes mellitus since there is no adequate description of them. Conclusion: The individual registration forms of primary care show inconsistencies in the face of factors correlated to the development of metabolic diseases, especially DM, leading to an underreporting of these factors.

Importance of Inflammatory Markers as Common Risk Factors in Diabetes Mellitus and Acute Ischemic Stroke

Diabetes mellitus is a chronic inflammatory condition and it may lead to various secondary complications such as acute ischemic stroke. The common connecting pathophysiology in Type 2 Diabetes Mellitus (T2DM) and Acute Ischemic Stroke (AIS) are the inflammatory pathways. In the present study we compared and evaluated the Neutrophil lymphocyte ratio, Platelet lymphocyte ratio and C - reactive protein between Diabetes Mellitus and Acute ischemic stroke with Diabetes mellitus (AISDM).

Retrospective analysis on incidence and risk factors of post-transplant diabetes mellitus after lung transplantation and its association with clinical outcomes

BackgroundPost-transplant diabetes mellitus (PTDM) is a common complication after transplantation. We aim to explore potential risk factors of PTDM and its association with outcomes after lung transplantation (LTx). MethodsA retrospective study was conducted in 100 patients who underwent LTx at our institution from 2017 to 2021. Patients' information was collected, and genotyping for single nucleotide polymorphisms known to potentially increase the risk of Type 2 DM was performed. Univariate and multivariate analyses were conducted to identify risk factors for PTDM. The primary outcome was the incidence of PTDM. Secondary outcomes were associations between PTDM and clinical outcomes following LTx. ResultsThirty-nine patients (39.0%) developed PTDM, while 10 patients (25.6%) recovered subsequently. The incidence of PTDM was associated with age > 45 (HR: 2.919, 95% CI [1.021–8.348]), pre-transplant HbA1c > 5.7% (HR: 2.344, 95% CI [1.201–4.573]), KCNJ11 rs5215 (HR: 2.090, 95% CI [1.050–4.162]) and tacrolimus concentration > 8 ng/mL in the first month (HR: 2.090, 95% CI [1.050–4.162]). Patients with PTDM experienced elevated fasting blood glucose levels (FBG) during the first month post-transplantation (p < 0.001), and required a longer duration for FBG to return to normal levels (p < 0.001). However, the presence of PTDM did not significantly impact renal function, incidence of infection episodes, chronic lung allograft dysfunction or mortality following LTx. ConclusionAdvanced age, elevated HbA1c levels, KCNJ11 gene polymorphism, and early exposure to tacrolimus are all significant risk factors for PTDM following LTx. The clinical implications of these factors warrant attention.

Examining incidence of diabetes in people with HIV: tracking the shift in traditional and HIV-related risk factors.

The risk factors of diabetes mellitus (DM) in people with HIV (PWH) may be dynamic in a life course manner. This study aimed to describe incidence of DM and investigate the trajectory of changes in risk factor associated with DM incidence over around 15 years among a statewide cohort of PWH in South Carolina (SC). This is a population-based cohort study. Data were retrieved from the integrated statewide electronic health records between 2006 and 2020 in SC. Separate subgroup analysis was conducted according to the patients' different follow up duration (i.e., 5, 10, and 15 years) to observe the evolving risk factors of DM development, using multivariable logistic regressions. The DM incidence among a total of 9115 PWH was 8.9 per 1000 person-years. In the overall model, being >60 years old, hypertension, and obesity were positively associated with DM while alcohol consumption, years of HIV diagnosis and high percentage days of viral suppression were negatively associated with the outcome. In the subgroup analyses, similar risk factors were observed. The odds of DM increased in a graded fashion with age. Hypertension was positively associated with DM in all groups and retention to care was negatively associated with the outcome in groups 1 and 3. This large-scale population-based study has revealed a relatively lower incidence of DM among PWH than some other US States. The evolving risk factors over time underline the need for maintaining retention to care to prevent the occurrence of DM.

Association of serum folic acid levels in response to fasting blood glucose in early pregnancy with the risk of gestational diabetes mellitus: A retrospective cohort study

ObjectiveWith increasingly prevalent folic acid consumption in early pregnancy, concerns about its potentially negative effect on maternal metabolism have been raised. Recent findings regarding folic acid levels in the first trimester and the risk of gestational diabetes mellitus have been inconclusive. The aim of this study was to investigate the association of folic acid status in early pregnancy with gestational diabetes mellitus as well as examine whether glucose levels can be modulated by folic acid status during the same first trimester. MethodsThis was a retrospective cohort study based on 27 128 Chinese pregnant women who registered during their first prenatal visit from January 2015 to December 2019. Serum folic acid and fasting blood glucose concentrations were measured during the 9th to 13th gestational weeks. Binary logistic regression was applied to estimate the odds ratios of gestational diabetes mellitus by using the serum folic acid levels quartiles with adjustment for major confounders. To investigate the potential effect of modifying key risk factors for gestational diabetes mellitus, we established subgroups, in which analyses were stratified by age (<25, 25–29, 30–34, and ≥35 y), parity (nulliparous and parous), prepregnancy body mass index (< 18.5, 18.5–23.9, and ≥ 24 kg/m2), and family history of diabetes (yes and no). ResultsThe positive association between maternal folate concentrations and fasting blood glucose was observed: the risk for hyperglycemia was higher in those in the middle (Q3) and higher (Q4) quartiles compared with those in Q1 and Q2. A higher risk for gestational diabetes mellitus was found in hyperglycemia of early pregnant women with high folate concentrations (Q3: odds ratio = 5.63; 95% CI, 4.56–6.95, and Q4: odds ratio = 5.57; 95% CI, 4.68–6.64) compared with normal fasting glucose mothers with folate concentrations in Q1 and Q2 after accounting for multiple covariables. Similar patterns were observed for different subgroups. Restricted cubic spline plots had a positive correlation of serum folic acid level with fasting blood glucose concentration as well as risk of gestational diabetes mellitus in a nonlinear pattern, with 32.5 nmol/L as the cutoff point for folic acid level. ConclusionsOur findings underscore the importance of maintaining an appropriate folic acid concentration for preserving a lower risk of gestational diabetes mellitus, especially in women with relatively higher blood glucose in early pregnancy. Additionally, folic acid concentration > 32.5 nmol/L may be considered a risk factor for gestational diabetes mellitus. This research suggested that folic acid levels should be monitored during the first trimester from the first prenatal checkup to prevent adverse effects of excessive folic acid intake.

Diyabet Aşikar Olmasa da Komplikasyonları Aşikar Olabilir, Prediyabet Hastalarında Nefropatinin Sıklığı

BACKGROUND/AIMS: Prediabetes is considered a risk factor for diabetes mellitus (DM) and cardiovascular diseases. Complications are also detected during diagnosis in 10-40% of diabetes patients. Diabetic nephropathy is one of the critical microvascular complications of diabetes. Studies have shown that prediabetes is associated with the development of glomerular hyperfiltration and albuminuria, as in the early stages of diabetes. Identifying patients before overt DM occurs is important for early diagnosis and treatment of nephropathy and DM. The aim of our study is to investigate the presence and frequency of nephropathy in prediabetes patients. METHODS: Patients who applied to the outpatient internal medicine and endocrinology outpatient clinics and whose random fasting blood sugar was ≥100 mg/dl were evaluated. Oral glucose tolerance test (OGTT) was performed and HbA1C values were measured. 280 patients diagnosed with prediabetes and evaluated for nephropathy were included in the study. RESULTS: Nephropathy was detected in 81 (28.9%) of the patients. The average HbA1C value of the group with nephropathy was 6.28% (sd: 0.52) and the average HbA1C value of the group without nephropathy was 6.05% (sd: 0.29). The average HbA1C value was found to be significantly higher in the group with nephropathy (p=0.000). CONCLUSIONS: The fact that nephropathy was detected in 28.9% of the patients showed once again the seriousness of prediabetes. Therefore, patients with prediabetes, especially those with higher HbA1C values, need to be evaluated more carefully in terms of nephropathy and CKD.

The Influence of Autogenic Relaxation in Lowering Stress and Blood Sugar Levels in Clients with Type II Diabetes Mellitus

Introduction: Stress is identified as one of the modifiable risk factors for diabetes mellitus. High stress levels can trigger an increase in blood sugar levels. There are four approaches to controlling blood sugar levels: pharmacological therapy, nutritional therapy, physical activity, and education on self-management of diabetes, such as implementing autogenic relaxation therapy. Autogenic relaxation is a form of mind-body intervention that originates from within an individual, involving short phrases or sentences that promote a sense of tranquility. The aim of this research is to examine the influence of autogenic relaxation in reducing stress levels in clients with Type II diabetes mellitus. Methods: The research design employed is a quasi-experiment with a group control and pre-post-test. The intervention group received autogenic relaxation sessions lasting 15-20 minutes, six times with a one-day interval between sessions. The control group was observed without any intervention. Results: The results revealed a significant difference between the intervention and control groups for the variables of stress (p-value 0.000) and blood sugar (p-value 0.008). Conclusion: The analysis indicates that autogenic relaxation therapy can effectively reduce stress and blood sugar levels in Type II diabetes mellitus clients. We recommend that healthcare services implement autogenic relaxation therapy programs to assist clients with Type II diabetes mellitus in addressing stress-related issues and managing their blood sugar levels

The Relationship Between Mothers’ Characteristics and Mothers’ Level of Knowledge About Children’s Diet in Overweight Children With A Risk of Diabetes Mellitus in An Elementary School in Tangerang

Diabetes Mellitus (DM) is a disease characterized by high blood sugar levels that could occur in school-age children. One of the risk factors of DM is being overweight, which is influenced by an unbalanced diet. Good knowledge of mothers in providing good nutritional intake to overweight children can reduce the risk of DM in children. This study aims to identify the relationship between mothers’ characteristics (age, occupation, education level, exposure to information from mass media, and family history of DM) and mothers’ level of knowledge about the diet of overweight children with the risk of DM in children aged 6-12 years in an elementary school in Tangerang. This study used a descriptive quantitative method with univariate and bivariate analysis. A purposive sampling of 31 mothers with overweight children was involved. The research instrument was a questionnaire measuring the mothers' level of knowledge about the diet of overweight children with a risk of DM. The results showed that only education level revealed a relationship with mothers’ level of knowledge (p-value &lt;0.05), while other characteristics indicated no relationship (p-value &gt; 0.05). Increasing mothers ‘knowledge about healthy diets for children can be obtained from formal education, but non-formal education also plays an important role. Schools can reach out to health units to provide health education about the diet of school-age children and provide a clean and healthy canteen. Further research should identify other factors influencing the mother's knowledge level.

Correlation of glucose and lipid metabolism, renal function and retinopathy in diabetic retinopathy patients using OCTA detection.

To investigate the correlation between glucose and lipid metabolism, renal function, and retinopathy in patients with diabetic retinopathy (DR) based on optical coherence tomography angiography (OCTA). A total of 584 diabetic patients who underwent treatment at The Second Affiliated Hospital of Dalian Medical University from March 2022 to June 2023 were retrospectively selected as research participants. They were categorized into a NDR group (n=366) and a DR group (n=218) based on the presence or absence of DR. Relevant indexes of glucose and lipid metabolism, renal function, and OCTA findings were collected. Logistic regression analysis was applied to identify the influencing factors of diabetes mellitus complicated with DR. ROC curves were drawn to examine the diagnostic value of the screened influencing factors for diabetes mellitus complicated with DR. Finally, Spearman correlation coefficients were calculated to examine the relevance between influencing factors and the severity of DR Lesions. Logistic regression showed that high levels of angiography 3 × 3 inner vascular density (IVD_33) and angiography 3 × 3 inner perfusion density (IPD_33) were protective factors for diabetes mellitus complicated with DR, and diabetic peridiabetic vascular disease (DPVD), elevated blood urea nitrogen (BUN), and urea levels were risk factors for diabetes mellitus complicated with DR (all P<0.05). ROC curve displayed that the areas under the curve (AUC) of IVD_33, DPVD, BUN, IPD_33, and Urea in predicting diabetes mellitus with DR were 0.779, 0.705, 0.621, 0.723, and 0.632, respectively. The AUC of combined prediction with OCTA index was higher than that of combined prediction without OCTA index (0.781 VS 0.84, P<0.05). Spearman correlation coefficient displayed that IVD_33 and IPD_33 were negatively correlated with the severity of DR, whereas DPVD and Urea showed a positive correlation (P<0.05). Our findings provide valuable insights for the initial clinical assessment of diabetic patients with DR and aid in the early determination of DR severity. Corresponding intervention measures should be formulated as early as possible to remedy patients' outcomes.

Effect of regular physical activity and lifestyle changes on insulin resistance in patients after kidney transplantation.

Insulin resistance (IR) is the most significant risk factor for post-transplant diabetes mellitus (PTDM). This study aimed to determine the effects of regular physical activity on IR and PTDM in patients after kidney transplantation (KT). The study group (n = 22) participated in aerobic or combined sports (aerobic and anaerobic). Monitoring was provided by asports tracker (Xiaomi Mi Band 4, compatible with the Mi Fit mobile application). Waist circumference was significantly lower (p = 0.0437, p= 0.0372), graft function was better (p= 0.0036, p= 0.0137), fasting blood glucose was lower (p = 0.0016, p= 0.0003), C-peptide level was lower (p = 0.0447, p= 0014) in the 3rd and 6th months of monitoring, and low-density lipoprotein was lower at 6months (p = 0.0444) in the observed group than in the control group. IR was significantly lower at 6 months (p = 0.0202), and fasting blood glucose was significantly lower at 3 and 6 months (p = 0.0227) in the observed group. We confirmed the significant effect of regular physical activity on preventing the development of IR and impaired fasting glucose levels in patients after KT (Tab. 1, Fig. 4, Ref. 27). Text in PDF www.elis.sk Keywords: kidney transplantation, insulin resistance, physical activity.

Potential Protective Effect of Anti-zinc Transporter 8 Autoantibodies on Gestational Diabetes Mellitus in Iraqi Population

Background: The human zinc transporter 8 (ZNT8), also known as the solute carrier family 30A, member 8 (SLC30A8), is a β-cell specific integral membrane protein, mainly restricted to the membrane of insulin secretory granules. ZnT8 plays a crucial role in both insulin synthesis and secretion as well as the viability of β-cells. The recently identified autoantibodies targeting the β-cell surface epitopes of ZnT8 have been proposed as a new risk factor for gestational diabetes mellitus (GDM). Due to the lack of prior research studies on the role of β-cell surface autoantibodies against ZnT8 in the immunologic etiology of GDM in Iraqi population, this study has been designed to explore the association between the rs13266634 C&gt;T polymorphism in the SLC30A8 gene and the serum levels of ZnT8 as well as Zinc Transporter-8 Autoantibody (ZnT8A) in women diagnosed with GDM. Methods: A total of 50 participants with GDM and 50 controls from the Baghdad Teaching Hospital/Pregnancy Care unit at the Medical City, Baghdad, Iraq, were recruited in this case–control study. Serum levels of ZnT8 and ZnT8A were assayed with enzyme-linked immunosorbent assay, and Taqman real time polymerase chain reaction (RT-PCR) was used for rs13266634 single nucleotide polymorphism (SNP) genotyping. Results: ZnT8A levels were significantly lower in women with GDM than non-GDM women (P ≤ 0.01). A ZnT8A level lower than 20.0 pg/mL was significantly associated with a threefold higher risk for GDM with P ≤ 0.001. ZnT8 levels were significantly higher in the GDM subjects (P ≤ 0.05). The T allele at the rs13266634 C&gt;T SNP significantly conferred a higher risk of GDM (P = 0.002). In view of that, the TT genotype, compared to the CC genotype, showed a significant association with increased GDM risk (P ≤ 0.01). Serum ZnT8A concentrations were significantly low among GDM women who had CT genotype (P = 0.003). Conclusion: The T variant at the SLC30A8 rs13266634 C&gt;T polymorphism appears to play a key role in determining the β-cell autoimmunity by inducing an autoantibody response due to its hyperactivity of zinc transportation.

The association of red and processed meat with gestational diabetes mellitus: Results from 2 Canadian birth cohort studies.

Red and processed meat is considered risk factors of gestational diabetes mellitus (GDM), but the evidence is inconclusive. We aimed to examine the association between red and processed meat intake and odds of GDM among South Asian and White European women living in Canada. This is a cross-sectional analysis of pregnant women from two birth cohorts: SouTh Asian biRth cohorT (START; n = 976) and Family Atherosclerosis Monitoring In earLY life (FAMILY; n = 581). Dietary intake was assessed using a validated 169-item semi-quantitative food-frequency questionnaire (FFQ). Multivariate logistic regression models were used to examine the associations between gestational diabetes and: 1) total red and processed meat; 2) unprocessed red meat; 3) processed meat and GDM after adjustment for potential confounders. There were 241 GDM cases in START and 91 in FAMILY. The median total red and processed meat intake were 1.5 g/d (START) and 52.8 g/d (FAMILY). In START, the multivariable-adjusted odds ratio (OR) showed neither lower nor higher intakes of unprocessed red meat (p-trend = 0.68), processed meat (p-trend = 0.90), or total red and processed meat (p-trend = 0.44), were associated with increased odds of GDM, when compared with medium intake. Similar results were observed in FAMILY except for processed meat intake [OR = 0.94 (95% CI 0.47-1.91), for medium versus low and OR = 1.51 (95% CI 0.77-2.29) for medium versus high; p-trend = 0.18] after adjusting for additional dietary factors such as the diet quality score, total fiber, saturated fat and glycemic load. Medium compared with low or high red and processed meat intake is not associated with GDM in White Europeans and South Asians living in Canada.

Serum Vitamin D Levels and Vascular Endothelial Growth Factor in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study

Introduction: Diabetes Mellitus (DM) is the most common noncommunicable disease and the fifth leading cause of death worldwide. Recent research has demonstrated that low Vitamin D levels and high Vascular Endothelial Growth Factor (VEGF) in middle-aged and elderly populations represent a risk factor for Type 2 Diabetes Mellitus (T2DM). Aim: To estimate the Vitamin D and VEGF levels in study subjects with T2DM and healthy controls and to correlate the Vitamin D level and VEGF with HbA1c % in study subjects with T2DM. Materials and Methods: A cross-sectional study was undertaken from October 2014 to November 2016 at the Department of Medicine in collaboration with the Department of Biochemistry, Bangalore Medical College and Research Institute, Bangalore. The study included 50 T2DM subjects on oral hypoglycaemic agents for five years and 50 age and sexmatched healthy controls selected randomly from the general population. In all the study subjects, Random Blood Glucose (RBG), LFT, Renal Function Test (RFT), HBA1c, serum Vitamin D, and serum VEGF were estimated. Student t-test and Chisquare/Fisher-Exact test were used to find the significance of study parameters between cases and controls. Multivariate logistic regression analysis was done to assess the risk factors for DM. Results: The mean age of the cases was 50.9±9.7 years and of controls was 49.76±7.7 years. Among the 50 cases, 19 (38%) were men and 31 (62%) were women. Among the 50 controls, 27 (54%) were men and 23 (46%) were women. The mean Body Mass Index (BMI) among cases was 27.21±4.59 and in controls was 24.82±2.63 (p-value=0.0016). The mean serum 25(OH) Vitamin D levels in cases were 11.39±3.32 ng/mL and in controls were 28.06±11.14 ng/mL (p-value &lt;0.001). The mean serum VEGF levels in cases were 97.52±16.96 pg/mL and in controls were 56.37±17.74 pg/mL (p-value &lt;0.001). Conclusion: The present study found that subjects with T2DM have lower serum 25(OH) Vitamin D levels and higher serum VEGF levels than those without T2DM. Serum Vitamin D decreases and serum VEGF-A levels increase with increasing HbA1c%, correlating with vascular complications.

Diagnostic significance of individual glucose values in oral glucose tolerance test and the associated risk factors for gestational diabetes mellitus in pregnant mothers: A cross-sectional study

Background: The diagnosis of gestational diabetes mellitus (GDM) is mainly based on oral glucose tolerance test (OGTT) in Sri Lankan clinical setting. The present study was to assess the diagnostic significance of individual glucose values in 75g OGTT in a group of pregnant mothers, to modify the test procedure to make it more convenient and cost-effective and to identify the associated risk factors for GDM.Methods: A total of 150 pregnant women within the second trimester and attending the antenatal clinics at Teaching Hospital Mahamodara were recruited for the study. Data collection was carried out via an interviewer-administered questionnaire followed by retrieval of laboratory data on OGTT.Results: Seventeen pregnant women (11.33%) were diagnosed with GDM by OGTT based on the WHO criteria. Diagnosis was based on either fasting or 2-hour glucose values alone or by increased levels in more than one of those parameters. None of them were diagnosed based on the 1-hour glucose value alone. The AUC values were 0.951 (0.884, 1.000), 0.829 (0.715, 0.942) and 0.859 (0.776, 0.943) respectively for fasting, 1-hour and 2-hour glucose concentrations (CI 95%). GDM was associated with uncontrolled sweet consumption (X2=5.86, p=0.015) and no association was observed with reference to maternal age, parity, BMI, positive family history of diabetes, and prior history of GDM or diabetes mellitus.Conclusion: Fasting and 2-hour plasma glucose values have higher diagnostic accuracy over 1-hour glucose values and the findings suggest the performance of fasting and 2-hour samples alone in the standard 75g OGTT procedure for the diagnosis of GDM.

Seasonal Fluctuations in Hemodynamic Characteristics in Patients with Increased Meteosensitivity: a Survey

INTRODUCTION. Currently, the Russian Federation occupies one of the first places among the developed countries of the world in terms of mortality from cardiovascular diseases, 3–5 times higher than in developed countries. Arterial hypertension, smoking, diabetes mellitus, obesity, and other risk factors contribute to the onset and progression of cardiovascular diseases, and lifestyle modification and reduction in risk factor levels can slow their development. An increase in physical activity along with a decrease in the total calorie content of food is mandatory for reducing body weight. When combining physical exercises with climatotherapy (health path, physical exercises in the open air), it is necessary to take into account external meteorological conditions, as well as increased meteosensitivity of some patients, which are able to neutralize the therapeutic effects achieved by using, for example, health path.&#x0D; AIM. To study the frequency and seasonality of the main meteopathic reactions in patients with cardiovascular diseases.&#x0D; MATERIALS AND METHODS. We conducted a verbal and communicative examination of 735 patients with a body mass index of 25 kg/m2 and over, who were treated in the health resort complex “Vulan“. The analysis of patients’ answers about arterial pressure increases and complaints about other meteopathic reactions during the year according to self-monitoring data was carried out. Macroclimatic characteristics of the location of the health resort complex were also studied. The study was performed as part of the research work under the state assignment of the Ministry of Health of the Russian Federation, reg. No. 121040200110-0.&#x0D; RESULTS. It was revealed that the highest frequency of increased blood pressure recorded by patients is registered in March, October, November and December, the lowest is recorded in May, June and August. At the same time, the frequencies of other meteopathic reactions, such as fear, anxiety, shortness of breath, and others, are evenly distributed throughout the year.&#x0D; CONCLUSION. The study evaluated the natural climatic factors of the resort located on the Black Sea coast of the North Caucasus, by the example of the health resort complex “Vulan“ in connection with the search of favorable seasons for the treatment of cardiological patients with increased meteosensitivity. The results obtained allow us to make proposals to supplement the current regulatory documents with the data on the identified favorable periods of health resort treatment for cardiologic patients, expanding the seasonality for referring patients to the resorts of the Black Sea coast of the North Caucasus.

The Influence of Airborne Particulate Matter on the Risk of Gestational Diabetes Mellitus: A Large Retrospective Study in Chongqing, China.

Emerging research findings suggest that airborne particulate matter might be a risk factor for gestational diabetes mellitus (GDM). However, the concentration-response relationships and the susceptible time windows for different types of particulate matter may vary. In this retrospective analysis, we employ a novel robust approach to assess the crucial time windows regarding the prevalence of GDM and to distinguish the susceptibility of three GDM subtypes to air pollution exposure. This study included 16,303 pregnant women who received routine antenatal care in 2018-2021 at the Maternal and Child Health Hospital in Chongqing, China. In total, 2482 women (15.2%) were diagnosed with GDM. We assessed the individual daily average exposure to air pollution, including PM2.5, PM10, O3, NO2, SO2, and CO based on the volunteers' addresses. We used high-accuracy gridded air pollution data generated by machine learning models to assess particulate matter per maternal exposure levels. We further analyzed the association of pre-pregnancy, early, and mid-pregnancy exposure to environmental pollutants using a generalized additive model (GAM) and distributed lag nonlinear models (DLNMs) to analyze the association between exposure at specific gestational weeks and the risk of GDM. We observed that, during the first trimester, per IQR increases for PM10 and PM2.5 exposure were associated with increased GDM risk (PM10: OR = 1.19, 95%CI: 1.07~1.33; PM2.5: OR = 1.32, 95%CI: 1.15~1.50) and isolated post-load hyperglycemia (GDM-IPH) risk (PM10: OR = 1.23, 95%CI: 1.09~1.39; PM2.5: OR = 1.38, 95%CI: 1.18~1.61). Second-trimester O3 exposure was positively correlated with the associated risk of GDM, while pre-pregnancy and first-trimester exposure was negatively associated with the risk of GDM-IPH. Exposure to SO2 in the second trimester was negatively associated with the risk of GDM-IPH. However, there were no observed associations between NO2 and CO exposure and the risk of GDM and its subgroups. Our results suggest that maternal exposure to particulate matter during early pregnancy and exposure to O3 in the second trimester might increase the risk of GDM, and GDM-IPH is the susceptible GDM subtype to airborne particulate matter exposure.

Clinical presentation, risk factors, and outcomes of stroke in Shabwah Governorate, Yemen

Background: There is a lack of reliable information on stroke risk factors, clinical presentation, and mortality. The aim of this study was to describe stroke risk factors, clinical presentations, and in-hospital mortality and to identify the independent predictors of mortality among stroke patients admitted to three hospitals in Shabwa Governorate, Yemen. Methods: This retrospective and cross-sectional study was conducted from July 1, 2022, to June 30, 2023, in three hospitals in Shabwah Governorate, namely, Shabwah General Hospital Authority, Al Shifa Specialized Hospital, and Afya Specialized Hospital. Results: We involved 124 stroke cases, of whom 92 (74.2%) were males and 32 (25.8%) were females. Their mean age was 64.98±16.22 years, and hypertension was the most common risk factor, accounting for 71.0% (n=88) of cases. Ischemic stroke was detected in 95 (76.6%) cases, intracerebral hemorrhage (ICH) was detected in 25 (20.2%) patients, and subarachnoid hemorrhage (SAH) was detected in 4 (3.2%) cases. The in-hospital mortality was 27(21.8%), and according to bivariate analysis, the in-hospital mortality was significantly associated with hypertension (p=0.015), diabetes mellitus (DM) (p&lt;0.0001), ischemic heart disease (p=0.002), rheumatic heart disease (p&lt;0, 0001), and cardiomyopathy (p=0.004). In addition, in-hospital mortality was significantly associated with coma (p&lt;0.0001), ischemic stroke (p&lt;0.0001), ICH (p=0.013), and SAH (p=0.032). However, in multivariate logistic regression analysis, only coma (adjusted odds ratio [OR]=11.21, 95% confidence interval [CI]=3.42–36.75, p&lt;0.0001) and DM (adjusted OR=5.8, 95% CI=1.79–18.85, p=0.003) were found to be independent risk factors for in-hospital mortality. Conclusion: In Shabwah Governorate, Yemen, ischemic strokes were more common than hemorrhagic strokes, with men more likely to have a stroke than women and the majority of cases being elderly. DM and coma were found to be independent risk factors for in-hospital mortality. Therefore, appropriate treatment of DM and other vascular risk factors is recommended to improve stroke outcomes.

A study on the relationship between malignancy and diabetes

Today, malignancy and diabetes mellitus are important health problems with an increasing prevalence that have high morbidity and mortality. The purpose of this study was to examine the presence of overt diabetes mellitus (DM) in individuals with malignancy diagnosis, evaluate the effect of pre-diagnosis glucose control on the patients, DM duration and treatment options for malignancy development and type, and investigate the risk of DM development on non-diabetic patients with malignancy after cancer treatment. A total of 469 patients between the ages of 26 and 70 with different malignancies were divided into 3 groups. Group I: Patients with overt DM that were diagnosed before the malignancy diagnosis or diagnosed during the malignancy diagnosis (n=97); Group II: Patients that developed DM during the malignancy (anticancer) treatment (n=17), Group III: Non-diabetic patients with malignancy diagnosis (n=355). Group I participants were found to have the highest mean BMI value (33.2±6.7kg/m2) and lowest weekly physical activity duration (p<0.05). While 28.8% of the patients with overt DM before diagnosis were found not to be followed up for DM, 18.8% were not using antidiabetic medication. A total of 29.4% of the patients who developed DM during the malignancy treatment were found to have pancreas surgery and 17.5% had corticosteroid treatment. Appropriate screening programs should be developed for diabetic patients, taking into account the common risk factors of cancer and DM. Also, oncological treatments in patients with malignancy may lead to the development of DM. Therefore, the effects of decided anticancer treatment on glucose metabolism should not be overlooked and glucose metabolism in the patient must be monitored regularly.

Establishment of gestational diabetes risk prediction model and clinical verification

ObjectiveThe present study aimed to evaluate the risk factors for gestational diabetes mellitus (GDM) and build and validate an early risk prediction model of GDM by comparing the differences in the indicators of the first trimester of pregnancy between pregnant women with GDM and non-gestational diabetes mellitus (NGDM). Thus, this study provided a theoretical basis for early intervention of GDM.MethodsA total of 6000 pregnant women who underwent a routine prenatal examination in Qinhuangdao Maternal and Child Health Hospital (Qinhuangdao City, Hebei Province, China) from January 2016–2022 were retrospectively selected and randomly divided into a modeling cohort (4200 cases) and validation cohort (1800 cases) at a ratio of 3:7. According to the results of oral glucose tolerance test (OGTT), they were divided into NGDM and GDM groups. The modeling cohort consisted of 2975 NGDM and 1225 GDM cases, while the validation cohort consisted of 1281 NGDM and 519 GDM cases. The differences in general conditions and laboratory indicators between different groups were compared, and logistic regression analysis was further used to establish a risk prediction model for GDM in the first trimester. The receiver operating characteristic curve (ROC) and Hosmer–Lemeshow (HL) tests were used to evaluate the prediction of the model efficacy.ResultsAge, pre-pregnancy body mass index (BMI), glycosylated hemoglobin (HbA1c), blood uric acid (UA), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) in the first trimester were independent risk factors for GDM (P < 0.05). The model equation was Y = 1/{1 + exp[− (− 18.373 + age × 0.065 + BMI × 0.030 + first-trimester HbA1c × 2.519 + UA × 0.014 + TG × 0.224-HDL-C × 0.635)]}. The area under the ROC curve (AUC) of the model cohort was 0.803 (0.788–0.817), the sensitivity was 72.0%, and the specificity was 73.5%. The AUC of the validation cohort was 0.782 (0.759–0.806), the sensitivity was 68.6%, and the specificity was 73.8%. The P values of the HL test in both the training and validation sets were > 0.05, indicating a satisfactory model fit.ConclusionAge, pre-pregnancy BMI, HbA1C in early pregnancy, blood UA, TG, and HDL-C are independent risk factors for GDM. The risk prediction model established by combining age, pre-pregnancy BMI, and laboratory indicators in the first trimester can provide a theoretical basis for early screening, monitoring, and intervention of GDM high-risk pregnant women.