T2DM Patients Research Articles

Meta-analysis on GLP-1 mediated modulation of autophagy in islet β-cells: Prospectus for improved wound healing in type 2 diabetes.

Type 2 diabetes mellitus refers to a significantly challenging health disease due to its high prevalence and risk of other chronic diseases across the world. Notably, GLP-1 has been recognized to enhance the treatment of T2DM, along with this, GLP-1 is also involved in autophagy modulation. However, ineffectiveness of few analogue types can limit the efficacy of this treatment. This study particularly aims to elucidate the influence of GLP-1 receptor analogues on wound infection and patients with type 2 diabetes. To conduct the meta-analysis, an expansive literature survey was conducted to unveil the studies and research conducted on T2DM patients that revealed whether the adoption of any GLP-1 analogue in the form of specific interventions impacts the type 2 diabetes mellitus. The literature was searched using multiple search terms, screened and data were extracted to conduct the meta-analysis and it was conducted using metabin function of R package meta. A total of 800 patients consisting of the both intervention and control groups were employed to carry out the meta-analysis to analyse and evaluate the impact of GLP-1 mediated modulation to improve wound healing in the T2DM patients. The results revealed that GLP-1 mediated modulation considering one type of analogue was an effective intervention to patients suffering from T2DM. The variations in these results depicted insignificant outcomes with the values (risk ratio [RR]: 1.03, 95% confidence interval [CI]: 0.90-1.18, p > 0.05) and enlightened the fact that adopting different GLP-1 analogues may significantly improve the efficacy of wound healing in T2DM patients. Hence, interventions of GLP-1 mediated modulation must be utilized in the clinical practice to reduce the incidence of T2DM patients.

Association of serum NF-κB levels with peripheral neuropathy in type 2 diabetes mellitus patients: a pilot study.

Hyperglycaemia-induced inflammation plays a vital role in the development of diabetic peripheral neuropathy (DPN). Recent evidences had reported the involvement of the transcription factor nuclear factor kappa-light-chain-enhancer of activated Bcell (NF-κB) in diabetic experimental models. So, this pilot study aimed to evaluate serum NF-κB levels in DPN patients. We recruited 50 T2DM patients, of which 25 were T2DM with neuropathy and 25 were T2DM without neuropathy. In all the participants peripheral neuropathy was diagnosed based on Total neuropathy score (TNS). Serum NF-κB levels were measured by ELISA. We observed that the serum NF-κB levels were higher in DPN patients in comparison to T2DM patients without neuropathy. On spearman correlation, a positive correlation was found between serum NF-κB levels and TNS in the DPN group (r=0.741, p<0.001). The regression model shows the TNS to be an independent determinant of serum NF-κB levels after adjustment for potential confounders like age, duration of diabetes, and HbA1C (B=81.34; p<0.001). NF-κB activation plays a key role in promoting inflammation which is associated with the progression of DPN. In this respect, the study of NF-κB levels in serum may be an additional diagnostic marker for DPN.

Effect of an entry-to-care intervention on diabetes distress in individuals with newly diagnosed type 2 diabetes: a study protocol for a cluster-randomized trial

BackgroundDiabetes distress (DD) affects at least 36% of T2DM patients and is often associated with insufficient support and care. This study examines an intervention that targets DD through enhanced cross-sectoral collaboration and treatment during the first 3 months following diagnosis. The intervention aims to improve care and self-management and to reduce DD.Methods and interventionThe study is designed as a cluster-randomized trial with the intervention focusing on four key elements of diabetes care: effective cross-sectoral communication and information sharing, systematic care, a “one-stop-shop” health screening and start-up conversation at the municipality, and improving patient insights into own care.This study requires 32 clusters (16/arm) to achieve 80% power and a 5% significance cut-off, with 270 patients required. GP recruitment occurred from May to Dec 2022. Patient recruitment is ongoing from May 2022 to Aug 2023. GPs were randomized 1:1 using computer-generated blocks of six.Participating GPs are located in Southern Denmark and are not participating in other trials. Patients must be 18 + years of age, have a T2DM diagnosis, and be fluent in spoken and written Danish. DD is the primary outcome and will be measured at baseline, at four months, and again at a 12-month follow-up. Secondary outcomes include quality of care, self-management, quality of life, and clinical factors. Tertiary outcomes comprise depression, stress, resilience, sleep quality, and social network quality.ConclusionThis study is among the first clinical trials exploring the development of DD from diagnosis to 12 months post-diagnosis. Many previous interventions did not directly target DD as the primary outcome. This research provides new insights into DD progression in patients newly diagnosed with T2DM and examines an intervention designed to lower DD in early diabetes stages, contributing to a better understanding of the development of DD and how this intervention affects patient well-being.Trial registrationClinicalTrial.gov NCT05571306. Registered on 07 October 2022.

Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?

Hybrid closed-loop systems (HCLS) use has shown that time in range (TIR) tends to improve more during the nighttime than during the day. This study aims to compare the conventional TIR, currently accepted as 70 to 180 mg/dL, with a proposed recalculated time in range (RTIR) considering a tighter glucose target of 70 to 140 mg/dL for the nighttime fasting period in T1DM patients under HCLS. We conducted a retrospective study that included adults patients receiving treatment with Tandem t:slim X2 Control-IQ. Daytime TIR was characterized as glucose values between 70 and 180 mg/dL during the 07:01 to 23:59 time frame. Nighttime fasting TIR was specified as glucose values from 70 to 140 mg/dL between 00:00 and 07:00. The combination of the daytime and nighttime fasting glucose targets results in an RTIR, which was compared with the conventional TIR for each patient. The 14 days Dexcom G6 CGM data were downloaded from Tidepool platform and analyzed. We included 22 patients with a mean age of 49.7 years and diabetes duration of 24.7 years, who had been using automatic insulin delivery (AID) HCLS for a median of 305.3 days. We verified a mean conventional TIR of 68.7% vs a mean RTIR of 60.3%, with a mean percentage difference between these two metrics of -8.4%. A significant decrease in conventional TIR was verified when tighter glucose targets were considered during the nighttime period. No significant correlation was found between the percentage difference values and RTIR, even among the group of patients with the lowest conventional TIR. Currently, meeting the conventional TIR metrics may fall short of achieving an ideal level of glycemic control. An individualized strategy should be adopted until further data become available for a precise definition of optimal glucose targets.

Abstract P278: 1-year Outcomes of A1c Reduction, Weight Loss, and Lowered QRISK3 Scores in Type 2 Diabetes Remission: Insights From an RCCT Leveraging Whole-Body Digital Twin Technology

Background and Aims: The effects of digital twin (DT) technology for remission of T2D on cardiovascular risk reduction is unknown. We evaluated the effectiveness of the DT to improve A1c and body weight and QRISK3 (QResearch Cardiovascular Disease Risk Algorithm 3), which is a prediction algorithm to estimate the 10-year risk for developing cardiovascular disease (CVD), in patients enrolled to achieve remission of T2DM. DT platform uses AI and Internet of Things, to integrate multi-dimensional data to give precision nutrition and health recommendations via the mobile app and by coaches. Materials and Methods: We evaluated the data from prospective cohort of 204 participants who had been on DT for 1 year. Remission was defined as A1C levels less than 6.5% without medication for over 3 months. Outcomes included the change in HbA1c, body weight and change in QRISK3 scores. The DT uses a machine learning algorithm to integrate clinical and sensor data to predict personal glucose response. Patients were connected to continuous glucose monitoring (CGM) throughout the study and self-recorded dietary intake using the mobile app. Results: The study participants had a mean diabetes duration of 3.7±2.6 years and a mean age of 44±8.2 years. Based on the ADA criteria, at 1 year, 73% (n=149/204) continued to be under remission. The mean QRISK3 at baseline was 12.6 (±10.7, 95% CI 11.2 to 14) which significantly reduced to 9.5 (±7.9, 95% CI 8.5 to 10.6) at 360 days, p=0.0009. A1c (%) at baseline was 8.9 (±1.8, 95% CI 8.6 to 9.1, minimum 5.5, maximum 16.2) which reduced to 6 (±0.6, 95% CI 5.9 to 6, minimum 4.7, maximum 9.2), p&lt;0.0001. Body weight (kg) at baseline was 78.3 (±14.2, 95% CI 76.4 to 80.2) which reduced to 70.7 (±12.8, 95% CI 69 to 72.4), &lt;0.0001. There was a significant correlation between the reduction in body weight and QRISK3 (Pearson r 0.24 95% CI 0.1 to 0.3, p=0.0004). However, the correlation between the reduction in A1c and QRISK3 (Pearson r 0.04, 95% CI -0.09 to 0.18, p=0.53 ns) was comparable. At baseline, there were 53% of participants who had low risk score (&lt;10), 28% as intermediate risk (10-20), 19% as high risk (&gt;20%) that at 1 year shifted to 67% as low risk, 23% as intermediate risk and 10% as high-risk scores. Conclusion: Incorporating the Digital Twin (DT) technology, which blends AI and IoT for tailored health guidance, our RCCT indicated significant 1-year advancements in A1c, weight, and QRISK3 scores among T2DM patients aiming for remission. The transformative potential of DT is evident, particularly in shifting a majority of participants towards lower cardiovascular risk categories.

Phase angle associated is with low ankle-brachial index in type 2 diabetes patients in Ghana

BackgroundType 2 diabetes (T2DM) is associated with high burden of atherosclerotic macrovascular disease which could be diagnosed with ankle-brachial index (ABI). Phase angle (PhA) from bioelectric impedance analysis is associated with the development of cardiovascular diseases. We investigated the association between low ABI and phase angle in T2DM patients in Ghana. MethodIn a cross-sectional study, 462 T2DM patients were systematically recruited for the study. ABI was measured using an 8 Hz continuous Doppler and ABI≤0.9 was considered to be low ABI. PhA was obtained from resistance and reactance from Bioelectric impedance analysis. ResultsThe prevalence of low ABI was 16 % in the study population. T2DM patients with low ABI have decreased PhA (7.5 ± 1.9 vs 8.3 ± 2.2 units, p = 0.004) compared to those with normal ABI. An increase in phase angle by 1° was associated with a decrease in odds of having low ABI in unadjusted [OR (95 % CI) = 0.79 (0.48 – 0.95), p = 0.007] and adjusted models [0.88 (0.43 – 0.98), p = 0.036]. ConclusionThe prevalence of low ABI in T2DM patients in this study was 16 %. Also, PhA was lower in patients with low ABI compared to those with normal ABI.

Association between SpO2 and the risk of death in elderly T2DM patients with cerebral infarction: a retrospective cohort study.

This study aimed to evaluate the SpO2 (transcutaneous oxygen saturation) -mortality link in elderly T2DM (diabetes mellitus type 2) patients with cerebral infarction and identify their optimal SpO2 range. In this investigation, we employed a comprehensive approach. Initially, we screened the MIMIC-IV database, identifying elderly T2DM patients with cerebral infarction, utilizing specific ICD-9 and ICD-10 codes. We then harnessed the power of restricted cubic splines to craft a visual representation of the correlation between SpO2 and 1-year mortality. To enhance our analysis, we harnessed Cox multivariate regression, allowing us to compute adjusted hazard ratios (HR) accompanied by 95% confidence intervals (CIs). Additionally, we crafted Cumulative Mortality Curve analyses, augmenting our study by engaging in rigorous subgroup analyses, stratifying our observations based on pertinent covariates. In this study, 448 elderly T2DM patients with cerebral infarction were included. Within 1-year post-discharge, 161 patients (35.94%) succumbed. Employing Restricted Cubic Spline analysis, a statistically significant U-shaped non-linear relationship between admission ICU SpO2 levels and 1-year mortality was observed (P-value < 0.05). Further analysis indicated that both low and high SpO2 levels increased the mortality risk. Cox multivariate regression analysis, adjusting for potential confounding factors, confirmed the association of low (≤94.5%) and high SpO2 levels (96.5-98.5%) with elevated 1-year mortality risk, particularly notably high SpO2 levels (>98.5%) [HR = 2.06, 95% CI: 1.29-3.29, P-value = 0.002]. The cumulative mortality curves revealed the following SpO2 subgroups from high to low cumulative mortality at the 365th day: normal levels (94.5% < SpO2 ≤ 96.5%), low levels (SpO2 ≤ 94.5%), high levels (96.5% < SpO2 ≤ 98.5%), and notably high levels (>98.5%). Subgroup analysis demonstrated no significant interaction between SpO2 and grouping variables, including Sex, Age, Congestive heart failure, Temperature, and ICU length of stay (LOS-ICU; P-values for interaction were >0.05). Striking an optimal balance is paramount, as fixating solely on lower SpO2 limits or neglecting high SpO2 levels may contribute to increased mortality rates. To mitigate mortality risk in elderly T2DM patients with cerebral infarction, we recommend maintaining SpO2 levels within the range of 94.5-96.5%.

Glucagon-like peptide-1 receptor agonists rescued diabetic vascular endothelial damage through suppression of aberrant STING signaling

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) protect against diabetic cardiovascular diseases and nephropathy. However, their activity in diabetic retinopathy (DR) remains unclear. Our retrospective cohort study involving 1626 T2DM patients revealed superior efficacy of GLP-1 RAs in controlling DR compared to other glucose-lowering medications, suggesting their advantage in DR treatment. By single-cell RNA-sequencing analysis and immunostaining, we observed a high expression of GLP-1R in retinal endothelial cells, which was down-regulated under diabetic conditions. Treatment of GLP-1 RAs significantly restored the receptor expression, resulting in an improvement in retinal degeneration, vascular tortuosity, avascular vessels, and vascular integrity in diabetic mice. GO and GSEA analyses further implicated enhanced mitochondrial gene translation and mitochondrial functions by GLP-1 RAs. Additionally, the treatment attenuated STING signaling activation in retinal endothelial cells, which is typically activated by leaked mitochondrial DNA. Expression of STING mRNA was positively correlated to the levels of angiogenic and inflammatory factors in the endothelial cells of human fibrovascular membranes. Further investigation revealed that the cAMP-responsive element binding protein played a role in the GLP-1R signaling pathway on suppression of STING signaling. This study demonstrates a novel role of GLP-1 RAs in the protection of diabetic retinal vasculature by inhibiting STING-elicited inflammatory signals.

Expression of circulating long non-coding MALAT1 and GAS5 under metformin treatment in type 2 diabetic patients

The most prevalent metabolic disorder is type 2 diabetes. Long non-coding RNAs are one of the most effective factors in disease pathogenesis and are also promising therapeutic targets. GAS5 and MALAT1 are two lncRNAs that participate in glucose homeostasis. This study aims to compare the expression levels of lncRNA-GAS5 and lncRNA-MALAT1 in the PBMCs of T2DM patients with healthy individuals. A total of 60 diabetic patients and 60 healthy individuals were selected, including an equal number of males and females. The two groups of diabetic patients—those who had been taking metformin and those who hadn't—were further divided into two subgroups based on their BMI. Following PBMC RNA extraction, cDNA synthesis and the Real-Time qPCR method were used to assess the relative gene expression. Some diabetes risk factors, including elevated FBP, triglycerides, and WBC, and reduced AST enzyme, were observed in Iranian T2DM patients. Additionally, diabetic patients have lower levels of GAS5 and MALAT1 gene expression; nevertheless, T2DM patients' MALAT1 expression decreased in response to metformin treatment. However, increasing in BMI, can be elevated MALAT1 and GAS5 expression in normal individuals. Our study reveals that GAS5 and MALAT1 gene expression is reduced in T2DM patients, and their expression is also related to BMI. Furthermore, it is suggested to consider the effectiveness of new diabetes drugs based on the simulation of the expression pattern of pivotal long non-coding RNAs in the pathways involved in blood sugar regulation.

Insulin and Metformin Administration: Unravelling the Multifaceted Association with Mortality across Various Clinical Settings Considering Type 2 Diabetes Mellitus and COVID-19.

Due to the molecular mechanisms of action of antidiabetic drugs, they are considered to be effective in the treatment of both COVID-19 and the post-COVID-19 syndromes. The aim of this study was to determine the effect of administering insulin and metformin on the mortality of patients with type 2 diabetes (T2DM) with symptomatic COVID-19 with the use of logistic regression models. The association between death and insulin and metformin was weak and could not be included in the multivariate model. However, the interaction of both drugs with other factors, including remdesivir and low-molecular-weight heparin (metformin), age and hsCRP (insulin), modulated the odds of death. These interactions hint at multifaceted (anti-/pro-) associations of both insulin and metformin with the odds of death, depending on the patient's characteristics. In the multivariate model, RDW-SD, adjusted with low-molecular-weight heparin treatment, age, sex and K+, was associated with mortality among patients with COVID-19 and T2DM. With a 15% increase in RDW-SD, the risk of death increased by 87.7%. This preliminary study provides the foundations for developing further, more personalized models to assess the risk of death in T2DM patients, as well as for identifying patients at an increased risk of death due to COVID-19.

Oral semaglutide effectiveness and safety in real world practice; The REVOLUTION study

AimsThis study seeks to provide insights into the practical application and effects of oral semaglutide in Saudi T2DM patients under routine medical supervision. MethodsThe primary outcome measure was the laboratory HbA1c. Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after six months and 12 months of initiation. ResultsThe analysis of this study included 245 uncontrolled (HbA1c > 7 %) T2DM patients. The mean baseline HbA1c was 10.1 % (1.2). HbA1c was reduced by an average of 3.1 % (0.8) and 3.2 % (0.8) at 6 and 12 months, respectively. The frequency of hypoglycemia events in the last three months before semaglutide was initiated was 4.4 (1.1). The frequency of hypoglycemia events in the last three months was 2.2 (0.8) and 0.7 (0.4) at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.0 % (1.4) and 19.7 % (3.4) at six months and 12 months, respectively. Lipid profile and blood pressure were improved at six months and 12 months. ConclusionsOral semaglutide provided substantial glycemic and weight-loss benefits in adult individuals with T2DM.

Mean platelet volume (MPV) as new marker of diabetic macrovascular complications in patients with different glucose homeostasis

BackgroundPlatelets play an important role in the development of cardiovascular disease (CVD). Mean platelet volume (MPV) is considered as biological marker of platelets activity and function. The aim of the present study was to evaluate MPV values and its possible correlation with arterial stiffness and subclinical myocardial damage, in normal glucose tolerance patients (NGT), in newly diagnosed type 2 diabetic (T2DM) patients and in individuals with pre-diabetes.MethodsWe enrolled 400 newly diagnosed hypertensive patients. All patients underwent an Oral Glucose Tolerance test (OGTT). Arterial stiffness (AS) was evaluated with the measurement of carotid-femoral pulse wave velocity (PWV), augmentation pressure (AP) and augmentation index (AI). Echocardiographic recordings were performed using an E-95 Pro ultrasound system.ResultsAmong groups there was an increase in fasting plasma glucose (FPG) (p < 0.0001), fasting plasma insulin (FPI) (p < 0.0001), high sensitivity c reactive protein (hs-CRP) levels (p < 0.0001) and a decrease in renal function as demonstrated by e-GFR values (p < 0.0001). From the NGT group to the T2DM group there was a rise in MPV value (p < 0.0001). Moreover, in the evaluation of arterial stiffness and subclinical myocardial damage, MPV showed a positive correlation with these parameters.ConclusionsIn the present study we highlighted that MPV is significantly increased, not only in newly diagnosed T2DM patients, but also in early stage of diabetes, indicating that subjects with pre-diabetes present increased platelets reactivity. Moreover, our results suggest that MPV is associated with increased arterial stiffness and subclinical myocardial damage, indicating MPV as new marker of CV risk.

The Rate of Insulin use and Suboptimal Glycemic Control among Egyptian Patients with T2DM: Cohort Analysis of Eighth Wave of the International Diabetes Management Practices Study (IDMPS).

The International Diabetes Management Practices Study (IDMPS) is an international annual survey aiming to study and characterize the current standards of care for managing DM in developing countries. In Egypt, DM represents a substantial burden on the healthcare system, with an estimated 10.9 million patients, ranking it 10th amongst countries with the highest prevalence of DM. Previous studies showed that to maintain safety and achieve treatment goals among diabetic patients, optimal insulin therapy should be selected individually based on the patient's needs. We reported the proportion of Egyptian T2DM patients on insulin therapy who participated in the eighth wave of the IDMPS. The 2018 IDMPS wave consisted of cross-sectional and longitudinal phases and aimed to evaluate the proportion of T2DM who were on insulin therapy in 13 countries from four regions. In Egypt, 17 physicians agreed to participate in the present study and were required to include at least one patient. A total of 180 T2DM patients were included in the cross-section phase. At the end of the ninth month of follow-up, data from 170 T2DM patients were available. A total of 39 T2DM patients (21.7%) were on insulin therapy, with a mean duration of 32.4 ± 36.6 months. More than half of the patients (n = 22; 56.4%) were on basal insulin, mainly long-acting (n = 20; 90.9%). The mean basal insulin daily dose was 0.3 ± 0.1 IU/Kg. Notably, 28.2% of the patients received insulin via vials, and 46.2% stated that they were adjusting the insulin dose by themselves. On the other hand, 60.2% of the study population was on oral antidiabetic drugs at the cross-sectional phase. Nearly 17.4% and 27% of the patients in the cross-sectional phase achieved the glycemic target per recommendations of international guidelines and the treating physicians, respectively. At the end of the longitudinal phase, the percentage of T2DM patients who achieved glycemic targets increased to 38.4% and 77.4% as per recommendations of international guidelines and the treating physicians, respectively. Overall, 38.3% of T2DM patients received diabetes education, and 28.9% were involved in an educational program provided by the physician or their clinical staff. Besides, 85.5% of T2DM patients followed their diabetes medication dosage and frequency strictly as prescribed. The proportion of insulin use in patients with T2DM aligned with the previous studies from different countries; however, it is still inadequate to achieve the targeted glycemic control. Nearly one-third of Egyptian patients received diabetes education, highlighting the need for adopting a national educational program. Nonetheless, the level of adherence among T2DM from Egypt appears to be high.

IDF23-0405 Effectiveness of Vildagliptin 100 mg SR OD in T2DM Patients with Hypertension

IDF23-0405 Effectiveness of Vildagliptin 100 mg SR OD in T2DM Patients with Hypertension

IDF23-00033 Hypoglycemic and Hyperglycemic Events During Ramadan Fasting in T2DM Patients at Surabaya Tertiary Hospital

IDF23-00033 Hypoglycemic and Hyperglycemic Events During Ramadan Fasting in T2DM Patients at Surabaya Tertiary Hospital

IDF23-0379 Switching from reference glargine (Lantus) to biosimilar glargine (Basalog) in T2DM patients, uncontrolled on OAD's

IDF23-0379 Switching from reference glargine (Lantus) to biosimilar glargine (Basalog) in T2DM patients, uncontrolled on OAD's

IDF23-0498 Subgroup analysis of Phase 3 study of dapagliflozin, glimepiride and metformin ER FDC in T2DM patients with HbA1c 9%–11%

IDF23-0498 Subgroup analysis of Phase 3 study of dapagliflozin, glimepiride and metformin ER FDC in T2DM patients with HbA1c 9%–11%

Association Between Dietary Habits and Type 2 Diabetes Mellitus in Thai Adults: A Case-Control Study.

The prevalence of T2DM is escalating in Thailand affecting over 10% of adults aged 20-79 years old. It is imperative to identify modifiable risk factors that can potentially help mitigate the risk of developing diabetes. This study aimed to investigate the relationship between dietary habits and type 2 diabetes in Chiang Mai, Thailand. This case-control study involved 300 individuals aged 25-74 years residing in Chiang Mai, Thailand including 150 newly diagnosed T2DM patients (cases) and 150 community residents without diabetes (controls). Dietary habits were assessed based on Food Frequency Questionnaire (FFQ). Socio-demographic characteristics and anthropometric information of the participants were collected. Data analysis was performed using the STATA-17. The case group participants were older and had a higher proportion of males compared to the control group. The case group exhibited a significantly higher consumption of meat, beans, nuts, soft drinks, and topping seasonings (p<0.001), conversely, a lower intake of vegetables (p<0.001), fruits (p=0.006), fish, rice (p<0.001), eggs (p=0.032), milk products, coffee, and tea (p<0.001) compared to the control group. Furthermore, the case group demonstrated a higher level of certain dietary practices such as a greater frequency of having meals with family, not removing visible fat from food (p<0.001), and eating snacks between meals compared to controls. Multiple logistic regression analysis showed that after adjusting for potential confounding factors not removing visible fat from food (aOR 5.61, 95% CI: 2.29-13.7, p<0.001) and using topping seasonings (aOR 3.52 95% CI: 1.69-7.32 p=0.001) were significantly associated with the risk of T2DM, whereas daily vegetable intake (aOR 0.32 95% CI: 0.15-0.68 p=0.003) was inversely associated with T2DM. The study findings caution against the consumption of food rich in fat and using salty seasonings, while advocating for an increased intake of vegetables to prevent the prevalence of T2DM.

Metabolic control level and glucose variability in adolescents with type 1 diabetes during low and high-intensity exercise.

The main purpose of this study was to characterize the determinants of metabolic changes in young type 1 diabetes (T1DM) and to determine glycemic variability during low and high-intensity exercise. 20 young male T1DM patients were divided into two subgroups characterized by levels of glycated hemoglobin (HbA1c): HbA1c<7.3% (better HbA1c subgroup, n=10) and with levels HbA1c>7.3% (worse HbA1c subgroup, n=10). All participants performed a maximal oxygen uptake test and two efforts of various intensities (45 minutes of aerobic exercise and 30 minutes of mixed aerobic-anaerobic intensity exercise). Continuous glucose monitors (CGM) were used to control the glucose concentration. Changes in biomarkers describing the metabolic response were similar in both groups. A comparison of applied efforts exhibited that maximal capacity effort resulted in the highest values of blood glucose (BG) at the end (150.9-160.6 mg/dl) and 1 hour after the exercise (140.2-161.3 mg/dl). BG concentration before, during, 1 hour, and 24 hours after each exercise was insignificantly higher in the worse Hb1Ac group. HbA1c levels are insufficient to confirm whether the applied effort is performed in acceptable glycemic values. The CGM monitors allow for precise control of BG variations and accurate planning of physical activity by adjusting the insulin and carbohydrate consumption dose.

Assessment of Ferritin Level and Some Biochemical Variables in Iraqi Anemic Diabetic Mellitus in Both Gender

Diabetes mellitus (DM) is a prevalent metabolic disorder characterized by elevated blood sugar levels caused by diminished tissue sensitivity to insulin, insufficient insulin production, or a combination of both factors. This is a non-communicable disease that is also highly prevalent globally. The aim of the study is to evaluate ferritin level and other biochemical variables in type 2 diabetes mellitus patients and study the effect of biochemical variables between male and female (T2DM) . Method involves enrollment of 120 participant divided into two main groups (T2DM and control group) and every group has been subdivided based on gender to (30 male and 30 female) for each group. All the groups studied for determination of anthropometric and biochemical parameters to evaluate the relationship between the studied parameters and T2DM patients. Results: the result showed that (Age, body mass index (BMI), Fasting blood sugar (FBS), triglycerides (TC), Urea, systolic blood pressure (SBP), diastolic blood pressure (DBP) and Ferritin) were significantly difference in T2DM patients (male and female) as compared with control. While ( TG and Creatinine) were non-significantly differ in T2DM patients as compared with control. Furthermore, there was non-significant difference in the studied parameters between T2DM males and females. Conclusion: from the obtained result it could be concluded that patients with T2DM have a problem associated with ferritin level that effected by T2DM and decreased because of the impaired renal dysfunction and red blood cells decrease and that causes a decrease in the level of ferritin. Age and BMI levels have a direct effect and correlated with elevation of lipid continents and high level of FBS and blood pressure. Renal function is highly elevated because of the T2DM complication, and it is conceder as a risk factor for T2DM.