Total Number Of Diabetic Patients Research Articles

Hypoglycemia with Beta-Blocker in Patients with Type II Diabetes

Objective: To ascertain the frequency of hypoglycemia in diabetic patients using beta blockers.Study Design: A descriptive cross-sectional study.Place and Duration of Study: The study was conducted in the Department of Nephrology and Medicine, Lady Reading Hospital Peshawar, Pakistan, from 10th October 2021 to 10th April 2022.Materials and Methods: The total number of diabetic patients with hypoglycemia was 196, who were included in this study. The patients’ medical record was assessed, and the use of beta-blocker was noted and recorded.Results: This study included those patients whose ages ranged from 30 to 70 years, with a mean age of 51.964±6.38 years. The average duration of diabetes was 7.989±2.74 years, and an average weight of 87.178 kg. Male patients were 71.9%, and females were 28.1%, 43.9% of diabetic patients who had hypoglycemia used beta blockers. Conclusion: According to this study, diabetic people who take oral beta-blockers have a higher risk of developing hypoglycemia. This research shows that Beta Blocker use causes increased chances of hypoglycemia in people with diabetes.

MODELING DIABETES PATIENTS' ATTENDANCE AT BAGAMOYO DISTRICT HOSPITAL USING AUTOREGRESSIVE INTEGRATED MOVING AVERAGE (ARIMA) MODELS.

This study presented the use of Autoregressive Integrated Moving Average (ARIMA) technique to modeling the diabetes patients' attendance at Bagamoyo district hospital using monthly time series data. The data used in the analysis of this study are monthly reading of diabetes patients data covered the period from January 2014 to December 2021. The data were retrieved from the hospital electronic health management information system. The Autoregressive Integrated Moving Average (ARIMA) approach was applied to the diabetes patients' data through the model identication, estimation, diagnostic checking, stationary and forecasting in R statistical software. The study identied Autoregressive Integrated Moving Average ARIMA (0, 1, 1) model to be the best one to t for the monthly total number of diabetes patients' attendance hospital outpatient department for seven years of monthly data. This was veried by Akaike's Information Criterion (AIC) and Bayesian Information Criterion (BIC) of the model selection criteria, Autoregressive Integrated Moving Average ARIMA (0, 1, 1) model shown the smallest values, hence this was selected as an adequate model to represent the Bagamoyo district hospital diabetes patients data. The forecast values indicate clearly that diabetes patients' attendance at Bagamoyo district hospital would be on an increase rate per month during the year 2022. Therefore, the government needs to put in place more and to engage necessary requirements for a satisfying healthcare system by increasing the medical supplies to the Bagamoyo district hospital.

A meta-analysis of prevalence of diabetic retinopathy in China

Objective: To analyze and summarize the prevalence of diabetic retinopathy (DR) in China, and provide scientific evidence for its prevention and intervention. Methods: Literature search of PubMed, Web of Science, Embase, Wanfangdata, Vip and CNKI between 1990 and 2020 was performed to retrieve epidemiological studies of DR in China. The total prevalence of DR was analyzed by performing a meta-analysis, and the prevalences of DR in different regions and age groups were also evaluated by subgroup analyses. Results: A total of 40 studies were enrolled. The total sample size of the general population was 282 620, and the total number of diabetic patients was 47 022. The prevalence of DR in the general population and diabetic patients was 1.7% (95%CI: 1.4%-2.0%) and 22.4% (95% CI: 18.8%-26.1%), respectively. The highest prevalence of DR was found in patients aged 50-59 years (22.1%). Among the diabetic population, the prevalence of DR was high in North (27.7%) and Northeast China (23.7%), but the East China had the largest estimated number of DR patients (4 971 000). Moreover, the prevalence of DR in rural areas (34.0%) was higher than that in urban areas (18.7%). Conclusions: The prevalence of DR is high in Chinese diabetic population, and there are differences among regions and age subgroups. The results of the current meta-analysis emphasize the necessity of DR screening for diabetic population, especially in rural areas.

How to tackle the growing problem of type 2 diabetes in the European Union?

Abstract Background There is an alerting increase in the population affected by type 2 diabetes mellitus (T2DM) in the European Union (EU) with significant socioeconomic burden. According to an estimation by the International Diabetes Federation, by 2030, the total number of diabetic patients will be 38 million in EU. The “screen and treat” strategies that predominantly applied in policies to prevent T2DM have not achieved significant success, as reported by a large systematic review and meta-analysis published in 2017. Although the member states of the EU have almost full responsibilities for actions in the field of health, the EU has to tackle non-communicable diseases by targeting health determinants and lifestyle mostly through non-binding policies. The goal of this work is to review the T2DM prevention policies in the EU and compare with tobacco policies, from a legal perspective. Methods Following the systematic search and screening of policies from EUR-lex, a content analysis was carried out by using MonQcle as publicly available legal text document analysis platform, by two coders. The search was limited for regulations, directives and white papers. Results Our data collection consisted of 19 documents including 10 regulations, 6 directives and 3 white papers with relevance to T2DM, covering the following topics: health infrastructure and services, informational policies, economic policies, environmental policies, command and control and social policies. The identified policies covered the time frame of 1972 to 2020. Diabetes was targeted as part of non-communicable diseases. None of the policies was legally binding addressing T2DM directly which is in sharp contrast to the tobacco control policies in the EU. Conclusions T2DM, in fact, is largely preventable. EU institutions should consider to reframe T2DM prevention strategies and consider applying a wide range of population-level legislative and innovative actions to prevent T2DM e.g. taxes on unhealthy food products. Key messages T2DM is a largely preventable disease, effective legal tools should be created and applied matching the scale of such public health problem. T2DM policies of the EU may be subject to change due to additional value of actions taken by the EU compared to that could have been achieved by member states alone.

Prevalence and implications of depression in type-2 diabetes mellitus: a follow up study

Background: There are not many longitudinal or prospective studies to determine the association between Diabetes Mellitus (DM) and depression in Indian scenario. Present study was mainly intended to find out the prevalence of depression in diabetic individuals and its impact on diabetes. The aim of the present endeavour was to study the prevalence of depression in diabetic patients, its impact on the clinical course of diabetes and to study the association between clinical courses of depression and diabetes.Methods: It is a prospective analytical study done in MGMCRI. All diabetic patients, aged 30years and above were taken up. Those who screened positive for depression were further assessed using PHQ9 questionnaire and were subjected to antidepression management. From the total number of diabetic patients screened, the prevalence of depression was calculated. Equal number of T2DM patients who screened negative for psychiatric disorders were taken as control. PHQ-9, FBS, PPBS, HbA1c were measured at baseline and repeated at 3rd month of follow-up.Results: In our study the prevalence of depression among diabetic individuals was found to be 15%. The difference in improvement of HbA1c from baseline to follow up was statistically significant when compared between groups having mild, moderate and severe depression, with maximum fall of HbA1c in the group with severe depression. This implies the positive effect of treating depression on glycemic control.Conclusions: This study shows that when diabetes and depression were addressed together it has a positive effect on the glycemic control and the depressive symptoms emphasizing the need for a collaborative management and need for screening diabetes patients for depression for a better care.

Estimation of magnesium level in type 2 diabetes mellitus and its correlation with HbA1c level.

SummaryBackgroundType 2 diabetes mellitus (T2DM) is a common disease; the total number of diabetes patients is expected to reach 366 million by 2030. Magnesium has received considerable attention for its potential role in improving insulin sensitivity and preventing diabetes and its cardiovascular complications. Hypomagnesaemia is linked to poor control of type 2 diabetes mellitus, and depletion of serum magnesium occurs exponentially with duration of disease. The aim of this study was to measure serum magnesium level and the correlation of magnesium level with HbA1c in type 2 diabetes mellitus.MethodsIn this cross‐sectional study, we included 100 diabetic patients; blood is taken for measurement of both magnesium and HbA1c levels. Patients with risk factors of magnesium deficiency were not included.ResultsOf the total 100 patients recruited in our study, majority had diabetes for 8.0 years duration. The mean age of the patients was 53.97 ± 10.65 years, most of them were on oral hypoglycaemic agents (84.9%) followed by combination of oral hypoglycaemic agents and insulin (10.5%), and a small percentage were on insulin alone (4.7%). The mean of serum magnesium and HbA1c levels was 1.88 ± 0.25 mg/dL and 8.38% ± 1.53%, respectively. The majority of the patients had a normal level of magnesium (95.0%); however, most of them had uncontrolled blood glucose (82.0%). The study showed that the serum magnesium level and HbA1c are not significantly correlated (P = 0.462).ConclusionNormal magnesium levels were observed in majority of patients, there is no significant correlation between serum magnesium and HbA1c levels in patients with T2DM, but larger‐scale clinical trials are needed in future.

UNANI FORMULATIONS FOR MANAGEMENT OF DIABETES: AN OVERVIEW

Diabetes is a leading cause of death. In India, total number of diabetic patients is expected to be 79.4 million in 2030. It is a multifactorial disease leading to several complications. Traditional medicines are being looked up once again for its treatment; the WHO also recommended its further investigation. In this review, these drug its pharmacological activity and its formulation in Greco-Arab or Unani Medicine in India is explored. Single-drug used in formulation with reported anti-diabetic and related beneficial property are Gymnema sylvestre, Azadirachta indica, Aloe vera, Momordica charantia, Acacia arabica, Eugenia jambolana, Trigonella foenum graecum, Punica granatum, etc. Phytomedicine used in Unani medicine presents an exciting opportunity for the development of new types of therapeutics for diabetes mellitus with a holistic approach, which includes various photochemical groups such as alkaloids, terpenes, and phenolics. Beside hypoglycemic activity, these drugs also have antioxidants, bitter and other activity related to disturbance in carbohydrate metabolism. They are used in the form of decoctions, infusions, tablets, pills, and powder such as Qurse Dhayabitus, Qurse Tabasheer, Safoof Gilo, Qurse Marwareed, Qurse Gulnar, Dawaul Misk Talkh, Sharbate Afsanteen, Roghane Qusht, and Ma-Us-shaeer and common marketed formulation is Dolabi tablets, Qurs Kushta baiza murgh, Qurs Kushta Zamarrud, Qurs Ziabetus, Safoof Ziabtes, Diab-eaze, etc. There is the tremendous scope of Unani single and compound formulations in the comprehensive management of diabetes particularly Type-2 diabetes; it can also be utilized as an adjuvant with the conventional drug due to its diverse and related beneficial pharmacological activity in diabetes.

Paradoxical high augmentation index in females with diabetes mellitus.

The relationship between diabetes mellitus (DM) and augmentation index (AIx) remains unclear. We conducted an observational cross‐sectional study. Subjects were patients who underwent coronary angiography. We examined the relationship between high AIx and several factors. The total number of diabetic patients was 144, and median AIx was 0.256. In diabetic patients, the significant relationship between female gender and high AIx (median cut‐off value, ≥0.256) was found by the multivariate logistic analysis (adjusted odds ratio = 2.888; 95% confidence interval: 1.032‐8.081). The significant relationship between female gender and high AIx was found in patients with DM.

MODERN POSSIBILITIES OF THERAPY OF TYPE 2 DIABETES MELLITUS PATIENTS. EFFECTIVENESS AND CARDIOSAFETY OF ALOGLIPTIN FROM THE POINT OF VIEW OF EVIDENCE-BASED MEDICINE

According to the IDF (2016) 1 of 11 adult patients suffers from diabetes mellitus (DM). The total number of diabetic patients is 415 million. By 2040, according to analysts of the International Diabetes Federation, the number of the sick increases and the disease will affect 1 in 10 people. It is extremely important to maintain all indicators of carbohydrate metabolism (fasting glucose and postprandial, HbA1c) within the target values. Currently existing recommendations are not obligatory and do not give the strict guidance on the priority use of a group of hypoglycemic drugs and other drugs. The choice of patient-orientated approach, based on the effectiveness and safety of drugs. On the basis of numerous clinical studies have proven the effectiveness and safety of Alogliptin in the treatment of patients with type 2 diabetes.

Epidemiology of Type 1 Diabetes Mellitus in Korea through an Investigation of the National Registration Project of Type 1 Diabetes for the Reimbursement of Glucometer Strips with Additional Analyses Using Claims Data.

BackgroundThe aim of this study was to estimate the prevalence and incidence of type 1 diabetes mellitus (T1DM) in Korea. In addition, we planned to do a performance analysis of the Registration Project of Type 1 diabetes for the reimbursement of consumable materials.MethodsTo obtain nationwide data on the incidence and prevalence of T1DM, we extracted claims data from July 2011 to August 2013 from the Registration Project of Type 1 diabetes on the reimbursement of consumable materials in the National Health Insurance (NHI) Database. For a more detailed analysis of the T1DM population in Korea, stratification by gender, age, and area was performed, and prevalence and incidence were calculated.ResultsOf the 8,256 subjects enrolled over the 26 months, the male to female ratio was 1 to 1.12, the median age was 37.1 years, and an average of 136 new T1DM patients were registered to the T1DM registry each month, resulting in 1,632 newly diagnosed T1DM patients each year. We found that the incidence rate of new T1DM cases was 3.28 per 100,000 people. The average proportion of T1DM patients compared with each region's population was 0.0125%. The total number of insurance subscribers under the universal compulsory NHI in Korea was 49,662,097, and the total number of diabetes patients, excluding duplication, was 3,762,332.ConclusionThe prevalence of T1DM over the course of the study was approximately 0.017% to 0.021% of the entire population of Korea, and the annual incidence of T1DM was 3.28:100,000 overall and 3.25:100,000 for Koreans under 20 years old.

Comparative Study of Compliance Between Hospital and Primary Care Diabetic Patients

Modern day chronic diseases such as diabetes are related with the lifestyle, especially unhealthy diet and physical inactivity. This study aims to determine the level of compliance of diabetic patients with their doctors' advice about diet and physical activity, comparing ambulatory patients with those who were recently hospitalized. We developed a combined database of the two studies. Both studies were cross-sectional studies using systematic random sampling comprising patients of T2DM, and including the following variables: health facility used by the patient; age; gender; marital status; education; whether the patient received health education in the past; patient's weight and height and presence of other diseases; family history of diabetes; current smoking; dietary habits; and exercise. We used the SPSS data reduction method factor analysis to summarize the data on these two dimensions (diet and exercise) into a single summary variable each. The total number of diabetic patients included in this study was 442. Prevalence of smoking was 7.2% (6.3% among PHC patients and 9.4% among hospital patients; p=0.16). A little more than one third of the PHC patients and nearly three fourth of hospital patients had hypertension, coronary artery disease (CAD) or both (p<0.001). Similarly, a significantly greater proportion of the hospital patients had a family history of diabetes (p<0.001). Obesity was significantly higher among the PHC patients (p=0.011). The prevalence of unhealthy diet was significantly higher among hospital patients (p<0.001). Percentage of patients having unhealthy diet was significantly higher in among hospital patients in both sexes (p < 0.05), and in the 40-59 age-group; having secondary and higher level education, the prevalence of unhealthy diet was several times higher among hospital patients (p < 0.001); same was true among married patients, where the percentage of unhealthy diet was almost twice among hospital patients (p < 0.001). Finally, the prevalence of unhealthy diet was significantly higher among non-obese hospital patients than the non-obese PHC patients (p = 0.001). The prevalence of physical inactivity among male hospital patients was significantly higher than the male PHC patients (p=0.028). In the age 60 years and above, physical inactivity was significantly higher among hospital patients (p < 0.001). Similarly, among patients having less than secondary school education, physical inactivity was significantly higher among hospital patients (p = 0.002). Prevalence of unhealthy diet is significantly higher among hospital patients. We conclude that health care providers in Saudi Arabia should put greater emphasis on health education about diet and exercise. with T2DM.

An Efficient Approach for Detection of Exudates in Diabetic Retinopathy Images Using Clustering Algorithm

Diabetic retinopathy is a kind of disorder which occurs due to high blood sugar level. This disorder affects retina in many ways. Blood vessels in the retina gets altered . Exudates are secreted, hemorrhages occur, swellings appear in the retina. Diabetic Retinopathy (DR) is the major cause of blindness. Automatic Recognition of DR lesions like Exudates, in digital fundus images can contribute to the diagnosis and screening of this disease. In this approach, an automatic and efficient method to detect the exudates is proposed. The real time retinal images are obtained from a nearby hospital. The retinal images are pre-processed via. Contrast Limited Adaptive Histogram Equalization (CLAHE). The preprocessed colour retinal images are segmented using K-Means Clustering technique. The segmented images establish a dataset of regions. To classify these segmented regions into Exudates and Non-Exudates, a set of features based on colour and texture are extracted. Classification is done using support Vector Machine This method appears promising as it can detect the very small areas of exudates. Keywords - Diabetic Retinopathy, Exudates, fundus image, k means clustering, SVM I. INTRODUCTION The retina is the inner and most important layer of the eye. It is composed of several important anatomical structures which can indicate various diseases. Cardiovascular disease such as stroke and myocardial infarcation can be identified from retinal blood vessels. Diabetic Retinopathy is the common retinal complication associated with diabetes. It is a major cause of blindness in both middle and advanced age groups. The International Diabetes Federation reports that over 50 million people in India have this disease and it is growing rapidly (IDF 2009a) (2). The estimated prevalence of diabetes for all age groups worldwide was 2.8% in 2000 and 4.4% in 2030 meaning that the total number of diabetes patients is forecasted to rise from 171 million in 2000 to 366 million in 2030 (3). Therefore regular screening is the most efficient way of reducing the vision loss. Diabetic Retinopathy is mainly caused by the changes in the blood vessels of the retina due to

Dietary Fatty Acids in Metabolic Syndrome, Diabetes and Cardiovascular Diseases

In the last few decades, the prevalence of overweight and essential obesity has been undergoing a fast and progressive worldwide increase. Obesity has been in turn linked to type II diabetes, with the total number of diabetic patients worryingly increasing, in the last fifteen years, suggesting a pandemic phenomenon. At the same time, an increase in the prevalence of cardiovascular diseases has been also recorded. Increasing evidence suggests that the diet is involved in such escalation. In particular, the progressive globalization of food industry allowed massive supply, at a relatively low price, of a great variety of pre-packed food and bakery products, with very high energy content. Most of this food contains high amounts of saturated fatty acids (SFA) and of hydrogenated or trans fatty acids (TFA), that probably represent the prominent risk factors in the diet. Herein we will report diffusion and possible impact on health of such molecules, with reference to coronary heart disease, insulin resistance, metabolic syndrome and diabetes. We will also discuss the cellular and molecular mechanisms of action of fatty acids and fatty acid-derivatives which have been involved either in promoting or in preventing human pathologies. Free fatty acids (FFA) are not indeed only essential fuels for the organism. They also act as ligands for both membrane and nuclear receptors involved in different signaling pathways. Notably, some of these pathways can induce cell stress and apoptosis. Most important, FFA can affect glucose-induced insulin secretion and activate β-cell death. These events can be at least in part counteracted by polyunsaturated fatty acids.

Risk of retinal neovascularization in the second eye in patients with proliferative diabetic retinopathy

This study aimed to evaluate the risk of proliferative diabetic retinopathy (DR) in the fellow eye of an eye with existing proliferative DR. Our DR screening programme database listed 1513 diabetes patients alive at the time of the study. Seventy-six had proliferative DR in one or both eyes. In 28 of the 76 (37%) diabetes patients, proliferative DR was diagnosed in both eyes at the same examination. Another 28 patients developed proliferative DR in the second eye within 5 years of its diagnosis in the first eye, bringing the total number of diabetes patients with proliferative DR in both eyes at 5 years to 56 (74%). Almost all the diabetes patients eventually developed proliferative DR in the second eye. The median duration of diabetes before the development of proliferative retinopathy was 19 years for type 1 and 14 years for type 2 diabetes. Proliferative DR is a bilateral disease. Diabetes patients with proliferative DR in one eye are at high risk of developing neovascularization in the second eye and close follow-up is recommended.

Drug prescriptions and costs in diabetic polyneuropathy

Numerous medications are used in the treatment of diabetic polyneuropathy (PNP) without evidence of their efficacy. This study was undertaken to obtain the costs of drugs prescribed to patients with PNP throughout the Federal Republic of Germany in primary-care practices. Data (stored in the Medi-Plus data bank of the Institute for Medical Statistics, Frankfurt) from 400 primary-care practices were analysed for the year 1996 with regard to diagnoses and prescriptions for 40,112 diabetics over the age of > or = 20 years. A polyneuropathy (PNP) had been diagnosed in 3548 patients (8.8%) (age: 68 +/- 12 years, 56% women). The cost of medications listed for the treatment of PNP was identified and extrapolated to the total prescription cost for treated diabetic PNP in the whole of Germany. In addition the proportion of costs for drugs with unproven efficacy was calculated. Antidepressives were prescribed for 13%, carbamazepine for 4%, and lipoic (thioctic) acid for 41% of diabetics with PNP. Annual costs per patient (mean value) were DM 203 for lipoic acid, DM 53 for vasoactive drugs and DM 42 for analgesics. Projection for the estimated total number of diabetic patients with PNP treated in primary care practices (n = 361,400) gave a total cost of DM 116 million (95% confidence limit: DM 109-123), of which DM 41 million (35%) was for medications of unproven efficacy. In Germany one third of drug costs for diabetic patients with PNP in primary care is for medications of unproven efficacy. Cost-effective guidelines for the treatment of diabetic PNP are urgently required.

Type 2 diabetes mellitus: A review of pharmacological treatment

Type 2 diabetes mellitus, is a disease with a rising prevalence worldwide. It is currently estimated that 190 million people around the world suffer from diabetes mellitus, with over 330 million predicted to have the condition by 2025 and 366 million by the year 2030. It is predicted that the developing countries will contribute 77.6% of the total number of diabetic patients in the world by the year 2030. This rapidly growing prevalence among developing countries is attributed to the effects of urbanization, industrialization and globalization on these countries. There has been substantial progress over the last decade in the development of new agents for the treatment of type 2 diabetes especially focusing on the underlying pathophysiology. Despite this and the numerous guidelines from diabetes organisations only less than 40% of patients achieve recommended glycaemic targets. We therefore decided to do a review of the pharmacological treatment of type 2 diabetes mellitus to highlight the pharmacology and effectiveness of these agents and their roles in the management of type 2 diabetes. We reviewed the literature on the subject using materials from library search, articles in journals, internet search and conference abstracts. The global burden of type 2 diabetes mellitus, the various pharmacological agents available for the treatment of type 2 diabetes mellitus, including novel agents were discussed. The prevalence of type 2 diabetes mellitus is increasing worldwide and the predicted increase is much higher in developing countries compared to the developed countries. There are obviously an enormous number of therapies available for the treatment of type 2 diabetes mellitus and if effectively deployed it will be possible to achieve target diabetic control in most of our patients. This however, should not detract us from adopting measures that will reduce the prevalence of type 2 diabetes mellitus in our population bearing in mind that prevention is more cost effective especially given our low socioeconomic development and the very high predicted rise in the burden of type 2 diabetes mellitus in our developing world.

Diabetes care in Slovenia: now and in the future

AbstractSlovenia has about two million inhabitants: the estimated total number of diabetic patients is approximately 100‐000 (prevalence circa 5%). The first specialised hospital diabetes department was established in 1945. Today, diabetes health care is delivered at primary, secondary and tertiary health care levels. Patients on diet and exercise or oral hypoglycemic agents are treated by general practitioners and those on insulin by specialist diabetologists. Specialist out‐patient diabetes clinics are held at all general hospitals. A structured foot care prevention and treatment programme is running at the majority of out‐patient diabetes clinics, as well as screening for retinopathy. Renal dialysis is available throughout the country for those patients with end‐stage renal failure. A specialised clinic for diabetic pregnancy has been set up at the University Hospital in Ljubljana. Diabetic health care in Slovenia is provided free of charge.The Slovenian Endocrinology Association (which brings together physicians engaged in diabetology), the Slovenian Nurse Endocrinology and Diabetology Association, and the Slovenian Diabetic Foot Working Group were established in 1970, 1988 and 1995, respectively. Postgraduate diabetology courses for doctors have been run since 1982, and for nurses since 1996; diabetic foot training courses have been held since 1995. In addition, countrywide there are 39 diabetic patients' societies which are united under the umbrella of the Slovenian Diabetic Association. Copyright © 2004 John Wiley &amp; Sons, Ltd.

Increased frequency of HCV and HBV infection in type 2 diabetic patients

The aim of our study was to verify if the diabetic population can be considered at risk for HBV (B hepatitis virus) and/or HCV (C hepatitis virus) correlated viral hepatitis. We examined 1514 diabetic patients, 668 males and 846 females. In patients who had, on at least two occasions, pathological transaminase values (AST and/or ALT), the markers for HBV and HCV infection were determined. Of the 1514 patients studied, 295 (19.48%) had pathological values of ALT and /or AST. Among the hypertransaminase patients (295), 69 were not tested for the markers because they refused to give informed consent; of the remaining 226 patients, 54 were negative and 172 (76.6%) were positive for at least one of the hepatitis markers (HBV, HCV or both). Those who were anti-HCV positive were 115 (38.98%), of which 50 were also positive to hepatitis B (16.9%), while those positive only to the B markers were 57 (19.3%). If we compare the patients with positive markers (172) to the total number of diabetic patients studied (1514), we find that there is a hepatitis B and/or C prevalence of 11.36%, with no statistically significant difference between females (95/846, 11.23%) and males (77/668, 11.53%). The prevalence of only hepatitis C was 7.6%, while only hepatitis B was 7.1%. In conclusion, our study shows an increasing prevalence of hepatitis C and B, often associated, in type 2 diabetic patients that allows us to define them as a group at risk for viral hepatitis.

Clinical islet transplantation--registry report, accomplishments in the past and future research needs.

This review provides the results of a recent analysis of the Islet Transplant Registry on clinical adult islet transplants performed worldwide through June 30, 1992. Between December 12, 1893 and June 30, 1992, 167 adult islet transplants were performed at 25 institutions worldwide, including 104 at 9 institutions in North America, 62 at 15 institutions in Europe, and 1 elsewhere. The total number of diabetic patients reported to be insulin independent after adult islet allotransplantation through June 30, 1992, was 19. In an analysis by era, the percentage of patients that showed positive basal C-peptide levels (i.e., > or = 1 ng/mL at > or = 1 mo) posttransplant, and that became insulin independent (> 1 wk) in the 1985-1989 era (n = 35 cases) were 20% and 6%, and in the 1990-1992 era (n = 69 cases) were 64% and 20%, respectively, and thus have improved significantly (p < 0.001 and p < 0.05). For the 1990-1992 period, the percentage of patients who showed positive basal C-peptide levels post-transplant, and who became insulin independent in the single donor pancreas group (n = 31 cases) were 52% and 13%, and in the multiple donor pancreata group (n = 36 cases) were 75% and 28%, respectively. Islet graft function rates were nearly identical for grafts prepared from pancreata stored < or = 6 h (n = 27) and > 6 < or = 12 h (n = 29), so that 67% and 72% showed positive basal C-peptide levels, and 30% and 21% of the recipients became insulin independent, respectively. No single patient showed islet graft function sufficient to allow withdrawal from insulin, if the pancreata have been stored for more than 12 h. In regard to recipient category for the six groups, namely IAK (islet after kidney), SIK (simultaneous islet kidney transplantation), SIL (simultaneous islet liver transplantation), SIL(C) (simultaneous islet liver transplantation after cluster operation), SIKL (simultaneous islet kidney liver transplantation), and SIH-L (simultaneous islet heart-lung transplantation), the number of patients who showed positive basal C-peptide levels post-transplant was 11 (58%), 17 (57%), 5 (83%), 8 (80%), 1 (50%), and 0 (0%), and the number of insulin independent patients was 4 (21%), 4 (13%), 0 (0%), 6 (60%), 0 (0%), and 0 (0%), respectively. Comparing the two largest recipient categories, namely IAK and SIK, no difference in the outcome of these transplants was apparent.(ABSTRACT TRUNCATED AT 400 WORDS)