Screening For Diabetes Mellitus Research Articles

A cross-sectional observational study to assess socio-demographic factors in newly diagnosed TB DM comorbidity

Background Tuberculosis (TB) and diabetes mellitus (DM) co-morbidity is one of the rising public health problems. There is growing evidence that DM is an important risk factor for TB. This study was carried out to know the prevalence of DM among newly detected sputum positive pulmonary TB patients registered in District Tuberculosis Centre and to assess the risk factors of DM among TB patients. Methods In a cross-sectional study, newly detected sputum positive pulmonary TB patients were screened for DM (those having symptoms of DM). Furthermore, they were diagnosed by detecting blood glucose levels (≥200 mg/dL). Mean, standard deviation (SD), Chi-squared and Fisher-Freeman-Halton exact tests were used to determine the significant associations. P-values less than 0.05 were considered to be statistically significant. Results A total of 215 TB patients were included in this study. The prevalence of DM among TB patients was found to be 23.7% (2.8% known and 97.8% new cases). Significant associations were found between age (>46 years old), educational status, smoking habits, alcohol consumption, physical activity, presence of DM symptoms and family history of DM. Conclusions Routine screening for DM is mandatory due to its increasing prevalence, which may help in early diagnosis and to reduce complications by proper management that in turn helps in the successful outcome of TB treatment.

A first trimester prediction model and nomogram for gestational diabetes mellitus based on maternal clinical risk factors in a resource-poor setting

BackgroundThe implementation of universal screening for Gestational Diabetes Mellitus (GDM) is challenged by several factors key amongst which is limited resources, hence the continued reliance on risk factor-based screening. Effective identification of high-risk women early in pregnancy may enable preventive intervention. This study aimed at developing a GDM prediction model based on maternal clinical risk factors that are easily assessable in the first trimester of pregnancy in a population of Nigerian women.MethodsThis was a multi-hospital prospective observational cohort study of 253 consecutively selected pregnant women from which maternal clinical data was collected at 8–12 weeks gestational age. Diagnosis of GDM was made via a one-step 75-gram Oral Glucose Tolerance Test (OGTT) at 24–28 weeks of gestation. A GDM prediction model and nomogram based on selected maternal clinical risk factors was developed using multiple logistic regression analysis, and its performance was assessed by Receiver Operator Curve (ROC) analysis. Data analysis was carried out using Statistical Package for Social Sciences (SPSS) version 25 and Python programming language (version 3.0).ResultsIncreasing maternal age, higher body mass index (BMI), a family history of diabetes mellitus in first-degree relative and previous history of foetal macrosomia were the major predictors of GDM. The model equation was: LogitP = 6.358 − 0.066 × Age − 0.075 × First trimester BMI − 1.879 × First-degree relative with diabetes mellitus − 0.522 × History of foetal macrosomia. It had an area under the receiver operator characteristic (ROC) curve (AUC) of 0.814 (95% CI: 0.751–0.877; p-value < 0.001), and at a predicted probability threshold of 0.745, it had a sensitivity of 79.2% and specificity of 74.5%.ConclusionThis first trimester prediction model reliably identifies women at high risk for GDM development in the first trimester, and the nomogram enhances its practical applicability, contributing to improved clinical outcomes in the study population.

Screening for risk factors for type 2 diabetes mellitus using the Canadian Diabetes Risk Questionnaire (CANRISK) in the East Java Provincial Health Service, Indonesia

Diabetes Mellitus remains a serious and growing global challenge for public health. Early identification of cases prevents delays in treating diabetes mellitus, which often causes various complications in the body. Diabetes Mellitus screening includes anamnesis for family and personal history of the disease, measurement of height, weight, abdominal circumference, blood pressure examination, and examination of sugar levels. One instrument that can be used to assess the risk of developing type 2 diabetes mellitus is the Canadian Diabetes Risk Questionnaire (CANRISK). The aim of this research is to find out the characteristics of respondents and the risk categories of respondents suffering from type 2 diabetes mellitus in the next 10 years using CANRISK. This research uses quantitative methods. Based on the type of research, this research uses descriptive observational research. The research design used was cross sectional. The results showed that 78% of respondents had a low-moderate risk of developing type 2 DM, 6% had a high risk of developing type 2 DM, and 16% had a very high risk of developing type 2 DM. The conclusion of this study was that the risk factors for developing Type 2 DM 2 are age, BMI, waist circumference, physical activity habits, vegetable and fruit consumption habits, history of high blood pressure and high blood sugar, history of giving birth to a baby more than 4.1 kg, family history of diabetes, parents' ethnic group, and level of education.

Screening of diabetes mellitus in patients at risk in dermatology outpatient department

Background: Type 2 diabetes mellitus (T2DM) is a widely spread multidisciplinary condition that requires the attention of many different disciplines; yet, the involvement of dermatologists in this regard has not been recognized. The current study focused on the role of dermatologists in screening the prevalence and pattern of cutaneous manifestations in diabetic and pre-diabetic patients. Methods: A randomized study was carried out from April 2023 to October 2023 in the department of dermatology at SSB Heart and Multispecialty Hospital in Faridabad, Haryana. In the current study, patients with dermatological problems suspected of diabetes mellitus were enrolled. Dermatological problems such acanthosis nigricans, dermatophyte infections, psoriasis, endogenous eczema, chronic urticaria, generalized pruritus, lichen simplex chronicus, patients older than 40, and coexisting conditions like obesity were focused in this study. Results: This study enrolled a total of 100 patients. Only 37 patients were recognized as having a high risk of diabetes, with 67.57% having a verified history of the disease. Furthermore, 32% of T2DM patients were examined for specific skin symptoms during their initial visits, with 4 individuals being found to have generalized pruritus and dermatophyte infection. Conclusions: This study finally concluded that dermatologists may play a crucial role in fighting the T2DM epidemic by early detection of T2DM and treatment initiation which may reduce the risk of serious complications.

Exploring Structural Uncertainty in Cost-Effectiveness Modeling of Gestational Diabetes Screening: An Application Example from Norway.

Screening pregnant women for gestational diabetes mellitus (GDM) has recently been expanded in Norway, although screening eligibility criteria continue to be debated. We aimed to compare the cost-effectiveness of alternative GDM screening strategies and explored structural uncertainty and the value of future research in determining the most cost-effective eligibility criteria for GDM screening in Norway. We developed a probabilistic decision tree to estimate the total costs and health benefits (i.e., quality-adjusted life-years; QALYs) associated with 4 GDM screening strategies (universal, current guidelines, high-risk, and no screening). We identified the most cost-effective strategy as the strategy with the highest incremental cost-effectiveness ratio below a Norwegian benchmark for cost-effectiveness ($28,400/QALY). We excluded inconclusive evidence on the effects of screening on later maternal type 2 diabetes mellitus (T2DM) in the primary analysis but included this outcome in a secondary analysis using 2 different sources of evidence (i.e., Cochrane or US Preventive Services Task Force). To quantify decision uncertainty, we conducted scenario analysis and value-of-information analyses. Current screening recommendations were considered inefficient in all analyses, while universal screening was most cost-effective in our primary analysis ($26,014/QALY gained) and remained most cost-effective when we assumed a preventive effect of GDM treatment on T2DM. When we assumed no preventive effect, high-risk screening was preferred ($19,115/QALY gained). When we assumed GDM screening does not prevent perinatal death in scenario analysis, all strategies except no screening exceeded the cost-effectiveness benchmark. In most analyses, decision uncertainty was high. The most cost-effective screening strategy, ranging from no screening to universal screening, depended on the source and inclusion of GDM treatment effects on perinatal death and T2DM. Further research on these long-term outcomes could reduce decision uncertainty. This article analyses the cost-effectiveness of 4 alternative gestational diabetes mellitus (GDM) screening strategies in Norway: universal screening, current (broad) screening, high-risk screening, and no screening.The current Norwegian screening recommendations were considered inefficient under all analyses.The most cost-effective screening strategy ranged from no screening to universal screening depending on the source and inclusion of GDM treatment effects on later maternal diabetes and perinatal death.The parameters related to later maternal diabetes and perinatal death accounted for most of the decision uncertainty.

IJCM_174A: Lifestyle risk factors among homeless adults in Chennai- A Cross Sectional Study

Background: India defines ‘homeless’ as those who do not live in Census houses, but rather stay on pavements, roadsides, railway platforms, staircases, temples, streets, in pipes, or other open spaces. According to 2018 GCC enumeration of urban homeless, there are 3764 men and 2962 women, in total 6726 adult population. As they have a relatively different lifestyle, it is essential to know about their lifestyle risk factors and their accessibility to healthcare. In order to attain our Sustainable Development goals, in particular SDG 3- it is essential to target the well being of the homeless population. Objective: To estimate the lifestyle risk factors among homeless population in Chennai. Methodology: All adults who were 18 years and above and who fit in the criteria for homeless where taken for the study and an Interviewer administered pre-designed questionnaire, under the following Socio Demographic Details, Behavioural Measurements which included tobacco use, alcohol consumption, diet, lifestyle advice and physical activity was used to ascertain the lifestyle risk factors among the homeless. Data was entered in MS excel and analyzed using SPSS-21. Results: Out of 341 participants, 70.7% were females,27.3% males and 2.1% transgender. 27.6% had a habit of smoking daily and among that 24.9% were using smokeless tobacco. 15% had a habit of drinking alcohol. In the past one year 57.2% had visited the hospital and 44% had visited a government facility. 27.3% did moderate work and 14.4% vigorious work. 1.5% had a habit of doing moderate exercise on a daily basis.76.8% and 54.8% had undergone screening for hypertension and diabetes mellitus respectively. Conclusion: Spreading awareness to the homeless population on lifestyle risk factors is essential to ensure their healthy living.

Review of Genetic and Artificial Intelligence approaches to improving Gestational Diabetes Mellitus Screening and Diagnosis in sub-Saharan Africa.

Background: Adverse outcomes from gestational diabetes mellitus (GDM) in the mother and newborn are well established. Genetic variants may predict GDM and Artificial Intelligence (AI) can potentially assist with improved screening and early identification in lower resource settings. There is limited information on genetic variants associated with GDM in sub-Saharan Africa and the implementation of AI in GDM screening in sub-Saharan Africa is largely unknown. Methods: We reviewed the literature on what is known about genetic predictors of GDM in sub-Saharan African women. We searched PubMed and Google Scholar for single nucleotide polymorphisms (SNPs) involved in GDM predisposition in a sub-Saharan African population. We report on barriers that limit the implementation of AI that could assist with GDM screening and offer possible solutions. Results: In a Black South African cohort, the minor allele of the SNP rs4581569 existing in the PDX1 gene was significantly associated with GDM. We were not able to find any published literature on the implementation of AI to identify women at risk of GDM before second trimester of pregnancy in sub-Saharan Africa. Barriers to successful integration of AI into healthcare systems are broad but solutions exist. Conclusions: More research is needed to identify SNPs associated with GDM in sub-Saharan Africa. The implementation of AI and its applications in the field of healthcare in the sub-Saharan African region is a significant opportunity to positively impact early identification of GDM.

Improvement of Awareness of Diabetes Mellitus Disease Risks and Self-Monitoring Motivation Through Blood Sugar Screening and Counseling for Dian Darat Village Community, Southeast Maluku

Diabetes Mellitus (DM) disease is among the top 10 causes of death in the world. It is a metabolic disease causing unusual high blood sugar level in the body. Fortunately, controlling risk factors through early detection can prevent the abnormality. Dian Darat is among villages in Southeast Maluku Regency, where DM screening is rarely carried due to its relatively remote location. This community activity aimed to provide DM disease education through blood sugar screening and counselling for village’s community. Methods included early detection of DM and counselling based on blood sugar level screening results supported by poster media. Screening test results showed that 9 out of 26 respondents (35%) had blood sugar level higher than normal. Based on results of pre- and post-test scores before and after the education, there was an increase in participants’ knowledge regarding DM disease by 62 %. (from average score of 56,15 ± 13,88 to 90,77 ± 9,77, n=26, p ≤ 0.01). Future community services are recommended on similar and more sustainable community service activities by cooperation with other relevant stakeholders to optimize results.

Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study

ObjectiveDiabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. MethodsBy retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan–Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. ResultsAfter adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277–1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. ConclusionsThere is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.

The WHO 2013 oral glucose tolerance test: The utility of isolated glucose measurements - A retrospective cohort study

ObjectiveThe WHO 2013 guidelines recommend screening for gestational diabetes mellitus (GDM) by 3-point oral glucose tolerance test (OGTT). The objective of this retrospective cohort study was to evaluate GDM diagnosed by an isolated high glucose. Study designWe included pregnant women deemed at risk for GDM were offered GDM screening. We examined the records of 1939 consecutively screened pregnancies at two teaching hospitals in Amsterdam during 2016–2020. Using the WHO 2013 diagnostic criteria, we calculated the proportion of GDM cases diagnosed by isolated abnormal glucose values. ResultsAmong those screened in our high risk cohort, GDM incidence was 31.5%. Of the GDM diagnoses, 57.0% were based on an isolated fasting glucose value, 30.9% based on multiple raised glucose measurements, 7.4% on an isolated raised 2-hour glucose and 4.7% on an isolated raised 1-hour glucose. For 1-hour glucose, the number needed to screen was 67 persons for one additional GDM case. ConclusionThe 1-hour glucose in the 3 point OGTT, as suggested by the WHO 2013 guidelines for GDM, contributes only small numbers of GDM cases and a high number needed to screen (67 for 1 additional case in a selective high risk GDM screening strategy), and is likely even less effective in universally screened populations.

Early detection of peripheral neuropathy and its correlation with retinopathy and HbA1c levels in type 2 diabetes mellitus patients

Screening of asymptomatic diabetes mellitus (DM) patients may reduce future complications. Despite having diabetic peripheral neuropathy (DPN), about 50% of type 2 diabetes mellitus (type 2 DM) patients are asymptomatic. If diabetic neuropathy is diagnosed early, the annual cost of treating diabetic neuropathy and associated complications can be decreased. The study objectives are to identify peripheral neuropathy at an early stage and to correlate peripheral neuropathy with diabetic retinopathy and HbA1c (glycated haemoglobin) in asymptomatic type 2 DM patients.: A cross-sectional analytical study was done during July and August 2022 using consecutive sampling on 105 patients who attended the General Medicine out-patient dept (OPD) at Pondicherry Institute of Medical Sciences and the Primary Health Centre (PHC) Kalapet in Puducherry, India. Patients over 18 years old with type 2 DM, who were asymptomatic for peripheral neuropathy, and had their HbA1c levels checked within the last two months were included. Patients have undergone Michigan Neuropathy Screening Instrument (MNSI) examination, biothesiometer and monofilament testing for neuropathy and Fundus examination for retinopathy. The average age of the study participants was 54.7±11.4 yrs, and they had a male-female ratio of 6:4. The retinopathy was present in 18.1% (95% CI:11.9-26.5). The prevalence of DPN by MNSI examination was 3.8% (95% CI:1.5-9.4), monofilament testing was 21.0% (95% CI:14.3-29.7) and biothesiometer was 98.1% (95% CI:93.3-99.5). A statistically significant association between DPN measured by a biothesiometer and HbA1c (p&amp;#60;0.05). There was no significant correlation between DR and HbA1c and between DPN measured by monofilament and HbA1c (p&amp;#62;0.05).The objective assessment by the biothesiometer is the best tool for detecting peripheral neuropathy at an early stage in asymptomatic type 2 DM individuals than monofilament testing.

Screening of Risk of Type 2 Diabetes Mellitus in Sungai Buluh Village, Padang Pariaman

Diabetes mellitus (DM) type 2 is a non-communicable disease, and the incidence continues to increase. Various factors can increase the incidence of type 2 DM, but many people lack the awareness to determine risk factors and the efforts that need to be made to reduce the risk of type 2 DM. This community service aims to conduct health examinations and determine the risk level of DM type 2 in Sungai Buluh, Padang Pariaman, West Sumatra. This community service activity includes health examination, determining risk levels of risk type 2 DM, and personal education to reduce the risk of type 2 DM. The instrument used to determine the risk of type 2 DM is the Finnish Diabetes Risk Score (FINDRISC). Type 2 DM screening showed that most people had a slightly increased risk 37 people (45.6%), low-risk 26 people (32.1%), high-risk 13 people (16.1%) and very high-risk five people (6.2%). It is hoped that health centers will carry out risk level screening and education on reducing the risk of type 2 DM as a planned and structured activity to increase public awareness to prevent and reduce the risk of type 2 DM.

Subsidized gestational diabetes mellitus screening and management program in rural China: a pragmatic multicenter, randomized controlled trial

BackgroundThe increasing prevalence of gestational diabetes mellitus (GDM) is a major challenge, particularly in rural areas of China where control rates are suboptimal. This study aimed to evaluate the effectiveness of a GDM subsidy program in promoting GDM screening and management in these underserved regions.MethodsThis multicenter, randomized controlled trial (RCT) was conducted in obstetric clinics of six rural hospitals located in three provinces in China. Eligible participants were pregnant women in 24–28 weeks’ gestation, without overt diabetes, with a singleton pregnancy, access to a telephone, and provided informed consent. Participants were randomly assigned in a 1:1 ratio to either the intervention or control groups using an internet-based, computer-generated randomization system. The intervention group received subsidized care for GDM, which included screening, blood glucose retesting, and lifestyle management, with financial assistance provided to health care providers. In contrast, the control group received usual care. The primary outcomes of this study were the combined maternal and neonatal complications associated with GDM, as defined by the occurrence of at least one pre-defined complication in either the mother or newborn. The secondary outcomes included the GDM screening rate, rates of glucose retesting for pregnant women diagnosed with GDM, dietary patterns, physical activity levels, gestational weight gain, and antenatal visit frequency for exploratory purposes. Primary and secondary outcomes were obtained for all participants with and without GDM. Binary outcomes were analyzed by the generalized linear model with a link of logistic, and odds ratios (OR) with 95% confidence intervals (CIs) were reported. Count outcomes were analyzed by Poisson regression, and incidence rate ratios with 95% CIs were reported.ResultsA total of 3294 pregnant women were randomly assigned to either the intervention group (n = 1649) or the control group (n = 1645) between 15 September 2018 and 30 September 2019. The proportion of pregnant women in the intervention group who suffered from combined maternal and/or neonatal complications was lower than in the control group with adjusted OR = 0.86 (0.80 to 0.94, P = 0.001), and a more significant difference was observed in the GDM subgroup (adjusted OR = 0.66, 95% CI 0.47 to 0.95, P = 0.025). No predefined safety or adverse events of ketosis or ketoacidosis associated with GDM management were detected in this study. Both the intervention and control groups had high GDM screening rates (intervention: 97.2% [1602/1649]; control: 94.5% [1555/1645], P < 0.001). Moreover, The intervention group showed a healthier lifestyle, with lower energy intake and more walking minutes (P values < 0.05), and more frequent blood glucose testing (1.5 vs. 0.4 visits; P = 0.001) compared to the control group.ConclusionIn rural China, a GDM care program that provided incentives for both pregnant women and healthcare providers resulted in improved maternal and neonatal health outcomes. Public health subsidy programs in China should consider incorporating GDM screening and management to further enhance reproductive health.Trial registrationChina Clinical Trials Registry ChiCTR1800017488. https://www.chictr.org.cn/

Does health literacy affect the decision to have gestational diabetes screening test?

Objectives: The main objective of this study is to assess the relationship between the level of Health Literacy and the patient's decision to refuse the Gestational diabetes mellitus screening test. Methods: This cross-sectional study was conducted at a high-volume public hospital from March 2020 to September 2020 with women between 24-28 weeks of gestation. Demographic characteristics and gestational diabetes mellitus screening status were recorded for each woman. The European Health Literacy Survey Questionnaire was used to assess health literacy. Results: A total of 364 women were included in the study. Two hundred and three (55.7%) women accepted the gestational diabetes mellitus screening test, and 44.2% did not. Health care, disease prevention, health promotion subscales, and the general scale scores were higher in the gestational diabetes mellitus screening group (p = 0.001, p = 0.024, p = 0.01, and p = 0.003, respectively). It was determined that a 1-point increase in the health care score decreased the probability of rejecting the gestational diabetes mellitus screening by 1.03 times (p = 0.003). Conclusions: Lower health literacy levels were associated with higher rates of gestational diabetes mellitus screening test rejection.

Screening for diabetes mellitus in a semi-rural South African cohort using glycated haemoglobin (HbA1c)

Screening for diabetes mellitus in a semi-rural South African cohort using glycated haemoglobin (HbA1c)

Prevalence and Risk Factors of Diabetes in Patients with Active Pulmonary Tuberculosis: A Cross-Sectional Study in Two Financially Affluent China Cities.

Tuberculosis (TB) and diabetes mellitus (DM) present a dual burden to public health. The screening of DM in TB patients may aid in the early detection and management of diabetes, ultimately improving treatment outcomes for those with the comorbidity of TB-DM. We aim to examine the prevalence and identify risk factors of diabetes in individuals with active pulmonary tuberculosis (PTB) in financially affluent China cities. A cross-sectional survey was conducted in adult patients with highly suspected TB in two cities of China, spanning from May 9, 2023, to June 30, 2023. We compare the clinical characteristics, nutrition status, fasting blood glucose (FBG) level, living style, and knowledge of TB and DM at admission between patients with and without DM. Univariate and multivariate logistic regression analyses were employed to identify risk factors associated with TB-DM comorbidities. Of the 322 patients diagnosed with pulmonary tuberculosis (PTB), 54 individuals (16.8%) had comorbid diabetes mellitus (DM). This included 43 males (13.4%) and 11 females (3.4%). The average age was 55.44 ± 12.36 in DM patients and 46.09 ± 16.87 in non-DM patients. A multivariate logistic regression analysis revealed that male (adjusted odds ratio [aOR]=3.29, 95% confidence interval [CI]: 1.05-10.30), age older than 47 years (aOR = 1.04, 95% CI: 1.01-1.07), having a family history of diabetes (aOR = 5.09, 95% CI: 1.28-20.32), and an elevated random blood glucose level (aOR = 1.6, 95% CI: 1.38-1.86) were risk factors for DM in patients with PTB. Furthermore, it was found that diabetes awareness (aOR = 0.07, 95% CI: 0.03-0.21) and zero, light to moderate alcohol consumption were associated with a lower risk of diabetes. Diabetes is prevalent in patients with active PTB. Screening and raising awareness of DM are recommended, particularly in men after middle age with a family history of diabetes and elevated random blood glucose. Early diagnosis of diabetes and effective diabetes prevention may reduce the dual burden of TB-DM comorbidity.

Health system costs of providing outpatient care for diabetes in people with TB in the Philippines

&lt;sec&gt;&lt;title&gt;BACKGROUND&lt;/title&gt;Diabetes mellitus (DM) is a known risk factor for active TB. A key activity in the Philippines is to integrate TB services with other disease programmes, with a target of DM screening in 90% of TB cases. However, costs of providing DM outpatient services for TB patients are not well known.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;METHODS&lt;/title&gt;We estimated the costs of providing integrated DM outpatient services within TB services from the health system perspective. Resources for outpatient DM services were valued using the bottom-up approach for capital goods, staff time and consumables. Resource quantities were obtained by interviewing 60 healthcare professionals in 11 health facilities in the Philippines.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;RESULTS&lt;/title&gt;The mean cost per service ranged from USD0.53 for DM risk assessment to USD23.72 for oral glucose tolerance test. The cost per case detected for different algorithms varied from USD17.43 to USD80.81. The monthly cost per patient was estimated at USD8.95 to USD12.36.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;CONCLUSION&lt;/title&gt;Our study provides the first estimates of costs for providing integrated DM outpatient services and TB care in a low- and middle-income country. The costs of DM detection in TB patients suggests that it may be useful to further investigate the cost-effectiveness and affordability of service delivery.&lt;/sec&gt;

Skrining Diabetes Melitus Sebagai Upaya Peningkatan Kesehatan Masyarakat Desa

Sungaibuntu is a village in West Java. Health facilities in Sungaibuntu are not adequate, this village does not have clinic and a doctor's practice, this can be a gap in the community's lack of understanding of the importance of maintaining health, one of which is Diabetes Mellitus (DM). Therefore, providing education and screening for diabetes mellitus is important as an effort to detect these diseases. The aim of this activity is to increase public knowledge and understanding regarding risk factors, early detection and self-management so that DM can be prevented and treated well. The stages of activities that will be carried out include providing DM education, measuring BMI, measuring blood pressure, and measuring blood glucose levels. The results of the activity showed an increase in participants' knowledge before and after being given DM education, while the screening results showed that 47.9% of participants were obese, 60.6% of participants had high blood pressure, and 18.3% of participants had high blood glucose levels at the time of measurement. DM education and screening can increase public knowledge and understanding regarding prevention, management, complications and good self-management. In this case, the role of the patient, family and related parties is needed so that the impact of DM can be minimized.

Automated prediction of diabetes mellitus using infrared thermal foot images: recurrent neural network approach

Millions of people worldwide are affected by Diabetes Mellitus (DM), which is a chronic disease. Evaluation of the DM indicator, namely blood glucose level, requires invasive methods such as glucometer or blood tests, which cause discomfort to the patient. Automated noninvasive monitoring methods are urgently needed to ensure consistency and better treatment. The regular monitoring of DM can prevent or delay the onset of complications. Thermal foot images have been proposed as noninvasive methods for the prediction of DM. Thermograms were acquired at Mittal Eye Hospital, Sangrur, India, from 50 participants in the diabetic (without neuropathic conditions) and non-diabetic groups using a thermal camera (FLIR E-60). This study proposes an automated prediction system for DM using thermal foot images and Recurrent Neural Network (RNN) approach. The proposed system processes the thermal images and extracts relevant features using a CNN (Convolutional Neural Network). The extracted features were then fed to the RNN to predict the presence or absence of the DM. The experimental results demonstrate that the proposed framework attains an accuracy of (97.14 ± 1.5)%, surpassing the predictive capabilities of light-weight convolutional neural network (Lw-CNN), which only achieves an accuracy of (82.9 ± 3) % in predicting DM. This performance outperformed other state-of-the-art methods in the field. Our approach has the potential to be used as prediction tool for DM. Therefore, the proposed system has the potential for prediction of DM and improve patient outcomes by enabling timely intervention. Future work should focus on evaluating the proposed system on a larger dataset and integrating it with clinical decision support systems for personalized care. This study holds the promise of transforming DM screening and diagnosis, leading to enhanced patient outcomes.

Mechanistic Insight of Innovative Biomarkers for Screening of Type II Diabetes Mellitus

Abstract: Diabetes Mellitus (DM) is a compounded, persistent illness symbolized by an increased range of glucose levels in the blood caused by cellular resistance to insulin action, insufficient insulin production by pancreatic -cells, or both. Type 1 Diabetes Mellitus (T1DM), the extremely widespread form of DM, is recorded for almost 85-90% of worldwide cases. T2DM is mostly common in middle-aged and older people, and its causes are multifaceted. The use of efficient and profitable solutions for DM screening is critical to ensure pre-identification and minimising patients' risk of acquiring the life-compromising illness. Identification of innovative biomarkers with test methods of DM is therefore critical in order to establish vigorous, non-invasive, pain-free, highly sensitive, and precise procedures for screening. The purpose of this review article is to mention and review all the necessary biomarkers that play a vital role in disease diagnosis and to highlight the present-day findings of the latest clinically validated and traditional biomarkers and procedures for determining them, which provide cost-efficient options for T2DM screening with early detection. It is concluded that various biomarkers, both conventional and innovative, go hand in hand to diagnose the DM of any type.