Type 2 Diabetes Mellitus Patient Research Articles

Investigation of Fractal Dimension Analysis and Radiomorphometric Indices in Children with Type 1 Diabetes Mellitus

Background: Diabetes mellitus (DM) disrupts bone metabolism, leading to slowed bone development, poor bone quality, and osteoporosis. Objectives: The aim of this study was to examine changes in the bones of adolescents with type-1 diabetes mellitus (T1DM) using fractal dimension (FD) analysis method and panoramic radiomorphometric indices. Methods: Fractal dimension values and radiomorphometric measurements of 36 children with T1DM and 36 healthy individuals were compared using panoramic radiographs. The panoramic mandibular index (PMI), mental index (MI), mandibular cortical width (MCW), amount of alveolar bone resorption (AABR), antegonial index (AI), and gonial index (GI) were measured. Mandibular cortical index (MCI) was recorded as C1, C2, and C3 classes. Results: For the angulus and corpus regions, the T1DM patient group had lower FD values, and there was a statistically significant difference between the T1DM patient group and the control group (P = 0.003, P = 0.029). Mental index, MCW, and AI values were higher in the control group than in the T1DM patient group and were statistically significant (P = 0.014, P = 0.001, P < 0.001, respectively). Conclusions: In this study examining the mandible in pediatric patients with T1DM using radiomorphometric measurements and fractal analysis method, it can be concluded that T1DM affects bone morphology and trabecular structure

Semaglutide 6-months therapy of type 2 diabetes mellitus restores adipose progenitors potential to develop metabolically active adipocytes

BackgroundNowadays type 2 diabetes mellitus (T2DM) leads to population mortality growth. Today glucagon-like peptide type 1 receptor agonists (GLP-1 RA) are one of the most promising glucose-lowered drugs with anorexigenic and cardioprotective effects. The present study aims to determine the effects of GLP-1 RA semaglutide 6-month therapy on T2DM patient metabolic parameters and adipose progenitor cell health. MethodsT2DM patients (N = 8) underwent clinical characterization and subcutaneous fat biopsy at start point and after semaglutide 6-month therapy. Adipose-derived stem cells (ADSC) were isolated by enzymatic method. Cell proliferation analysis was performed by MTT and immunocytochemistry. White and beige adipogenesis was analyzed by BODIPY493/503 staining and confocal microscopy. Adipocyte’s metabolic properties were estimated by 3H- and 14C-based metabolic assays. Thermogenesis analysis was performed by ERthermAC staining and confocal microscopy. Protein markers were assessed by Western blotting. ResultsSemaglutide 6-month therapy demonstrated significant anorexigenic and glucose-lowering effects. However, insulin sensitivity (HOMA-IR and M-index) was unchanged after therapy. Semaglutide 6-month therapy increased ADSC proliferation and white and beige adipogenesis. Moreover, lipid droplets fragmentation was observed in beige adipocytes. Both white and beige adipocytes after semaglutide therapy demonstrated 2–3 fold growth of glucose uptake without changes in insulin sensitivity. Newly formed white adipocytes demonstrated glucose utilization for active ATP synthesis, whereas beige adipocytes for canonical thermogenesis. ConclusionsOur study has revealed that semaglutide 6-month therapy has not only systemic anorexigenic effects, but can markedly improve adipose tissue health. We have demonstrated critical restoration of ADSC renewal functions, which potentially can be involved in semaglutide based weight loss.

The short-term cost-effectiveness of once-weekly semaglutide versus once-weekly dulaglutide for the treatment of type 2 diabetes mellitus in Colombian adults.

Type 2 Diabetes Mellitus (T2DM) is a highly prevalent disease worldwide and in Colombia, representing one of the main causes of death and placing a considerable burden on healthcare systems. 13 classes of drugs are approved for the treatment of T2DM, with Glucagon-like Peptide-1 (GLP-1) receptor agonists being a first-line treatment option for patients with or at high risk of certain cardiovascular diseases and chronic kidney disease. The objective of this study is to conduct a short-term cost-effectiveness analysis of once-weekly semaglutide versus once-weekly dulaglutide in Colombian adults with T2DM, from a third-party payer perspective. Numbers needed to treat were calculated for different single and composite endpoints of the SUSTAIN 7 trial, annual costs for once weekly semaglutide 1.0 mg and dulaglutide 1.5 mg were extracted from the public SISMED database. With these inputs a cost of control model was developed, to obtain the annual cost of bringing one T2DM patient to relevant clinical outcomes by using semaglutide or dulaglutide. Semaglutide was considered cost-effective compared to dulaglutide across all pre-specified endpoints, even in the different scenarios evaluated in the sensitivity analyses, and in a particularly pronounced manner for weight loss outcomes. Semaglutide at a dose of 1.0 mg once-weekly was cost-effective compared to dulaglutide 1.5 mg across all outcomes in the short-term, making it an appropriate first-line choice in the treatment of T2DM when deciding between these two GLP-1 receptor agonists. This is the first short-term cost-effectiveness study of semaglutide and dulaglutide in T2DM Colombian patients. Our modeled results suggest that once-weekly semaglutide represents a cost-effective option for treating individuals with T2DM in Colombia who are not achieving glycaemia control with metformin, and it would be expected to improve HbA1C, promote greater weight loss and reduce costs from a third-payer perspective compared with treatment with dulaglutide.

Association between serum osteocalcin and atherosclerosis in Type-2 diabetes mellitus: a cross-sectional study

BackgroundThe past few decades have seen a marked increase in the macrovascular complications of Type-2 diabetes mellitus (T2DM) such as coronary heart disease, peripheral arterial disease, and cerebrovascular disease. This has been predominantly attributed to the increased atherosclerosis in these patients. Atherosclerosis usually remains an asymptomatic condition and this poses a significant challenge in its early diagnosis and timely intervention. Hence, there is an immediate need for exploring novel tools to aid in the early detection of atherosclerosis, especially in T2DM patients. Osteocalcin (OC), synthesized by osteoblasts, is a protein hormone found in the skeletal system. This protein is considered as a marker for bone density and in recent times has been gaining interest due to its protective role in cerebrovascular diseases(CVD).MethodsWe conducted a cross-sectional study and evaluated the association between serum OC levels and atherosclerosis in 113 T2DM patients. Carotid intima-media thickness (CC-IMT) was used as an estimate of atherosclerosis and patients were divided into two groups (CC-IMT < 0.9 and ≥ 0.9). Correlation of serum OC levels and glycemic parameters and lipid profiles were studied and compared between both groups.ResultsThere is a significant negative correlation between the CC-IMT estimates and serum OC levels. CC-IMT also has a significant association with other biochemical parameters such as fasting blood sugar, glycated hemoglobin and high-density lipoprotein.ConclusionAlthough the independent association of serum OC could not be established in the T2DM patient population, overall, the results favor low serum OC as a prognostic marker for atherosclerosis.

Novel Insight Into the Relationship of Vitamin D Hydroxylase and Vitamin D With Obesity in Patients With Type 2 Diabetes Mellitus.

In patients with type 2 diabetes mellitus (T2DM) and obesity, there is often a vitamin D deficiency, which is crucial for many physiological processes. The enzyme 25-D hydroxylase activates vitamin D, and its status has been linked to glucose and lipid metabolism in these patients. This study investigates the correlation between the levels of 25-D hydroxylase and 25-hydroxyvitamin D, and their impact on glucose and lipid metabolism in Saudi patients with T2DM and obesity. This study involved 150 Saudi participants (ages 35-70) of both genders from King Faisal Medical Complex in Taif. The participants were divided into control, type 2 diabetic, and obese diabetic patient groups, with 50 subjects in each group. Serum levels of 25(OH) vitamin D and 25-D hydroxylase were measured using ELISA. In contrast, an automatic analyzer for chemistry tests was used to measure fasting blood glucose (FBG), aspartate transaminase(AST), alanine transaminase (ALT), and lipid profile levels. Hemoglobin A1c (HbA1c)% was analyzed using the automatic glycosylated hemoglobin analyzer. In addition, the body mass index (BMI) value was calculated using the equation (BMI = weight in kilograms/height in meters squared). In obese with T2DM and T2DM patient groups, there were significant increases (p < 0.0001) in BMI, FBG, HbA1c%, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), AST, and ALT levels and significant decreases (p < 0.0001) in 25(OH) vitamin D, 25-D hydroxylase, and high-density lipoprotein cholesterol (HDL-C) levels compared to the control group. There were significant positive correlations between vitamin D with 25-D hydroxylase and HDL-C and negative correlations with HbA1c%, FBG, TC, TG, LDL-C, ALT, AST, and BMI in the studied patient groups. This study shows that lower levels of the enzyme 25-D hydroxylase are linked to reduced vitamin D levels in people with T2DM and obese diabetic patients. Additionally, there was a notable correlation between vitamin D levels and BMI, lipid profile, FBG, HbA1c%, AST, and ALT levels.

Effects of 3-month dapagliflozin on left atrial function in treatment-naïve patients with type 2 diabetes mellitus: assessment using 4-dimensional echocardiography

BackgroundThe sodium-glucose transporter-2 (SGLT-2) inhibitor dapagliflozin can improve left ventricular (LV) performance in patients with type 2 diabetes mellitus (T2DM). However, the effects on left atrial (LA) function in treatment-naïve T2DM patients remain unclear. The aim of our study was 1) to investigate the effects of 3-month treatment with dapagliflozin on LA function in treatment-naïve patients with T2DM using 4-dimensional automated LA quantification (4D Auto LAQ) and 2) to explore linked covariation patterns of changes in clinical and LA echocardiographic variables. Methods4D Auto LAQ was used to evaluate LA volumes, longitudinal and circumferential strains in treatment-naïve T2DM patients at baseline, at follow-up, and in healthy control (HC). Sparse canonical correlation analysis (sCCA) was performed to capture the linked covariation patterns between changes in clinical and LA echocardiographic variables within the treatment-naïve T2DM patient group. ResultsThis study finally included 61 treatment-naïve patients with T2DM without cardiovascular disease and 39 healthy controls (HC). Treatment-naïve T2DM patients showed reduced LA reservoir and conduit function at baseline compared to HC, independent of age, sex, BMI and blood pressure (LASr: 21.11 ± 5.39 vs. 27.08 ± 5.31 %, padjusted = 0.017; LAScd: -11.51 ± 4.48 vs. -16.74 ± 4.51 %, padjusted = 0.013). After 3-month treatment with dapagliflozin, T2DM patients had significant improvements in LA reservoir and conduit function independent of BMI and blood pressure changes (LASr: 21.11 ± 5.39 vs. 23.84 ± 5.74 %, padjusted < 0.001; LAScd: -11.51 ± 4.48 vs. -12.75 ± 4.70 %, padjusted < 0.001). The clinical and LA echocardiographic parameters showed significant covariation (r = 0.562, p = 0.039). In the clinical dataset, changes in heart rate, insulin, and BMI were most associated with the LA echocardiographic variate. In the LA echocardiographic dataset, changes in LAScd, LASr, and LASr_c were most associated with the clinical variate. ConclusionCompared with HC, treatment-naïve patients with T2DM had lower LA function, and these patients benefited from dapagliflozin administration, particularly in LA function.

Value of radiomics-based two-dimensional ultrasound for diagnosing early diabetic nephropathy

Despite efforts to diagnose diabetic nephropathy (DN) using biochemical data or ultrasound imaging separately, a significant gap exists regarding the development of integrated models combining both modalities for enhanced early DN diagnosis. Therefore, we aimed to assess the ability of machine learning models containing two-dimensional ultrasound imaging and biochemical data to diagnose early DN in patients with type 2 diabetes mellitus (T2DM). This retrospective study included 219 patients, divided into a training or test group at an 8:2 ratio. Features were selected using minimum redundancy maximum relevance and random forest-recursive feature elimination. The predictive performance of the models was evaluated using the area under the receiver operating characteristic curve (AUC) for sensitivity, specificity, Matthews Correlation Coefficient, F1 score, and accuracy. K-nearest neighbor, support vector machine, and logistic regression models could diagnose early DN, with AUC values of 0.94, 0.85, and 0.85 in the training cohort and 0.91, 0.84, and 0.84 in the test cohort, respectively. Early DN diagnosing using two-dimensional ultrasound-based radiomics models can potentially revolutionize T2DM patient care by enabling proactive interventions, ultimately improving patient outcomes. Our integrated approach showcases the power of artificial intelligence in medical imaging, enhancing early disease detection strategies with far-reaching applications across medical disciplines.

Difference of Clinical Parameters and Correlation between Type-1 and Type-2 Diabetes Mellitus (DM) Subjects in Bangladesh

Type I and Type 2 diabetes are the two main types with types diabetes accounting for the majority (&gt;85%) of total diabetes prevalence. Both forms of diabetes can lead to multisystem complications of microvascular endpoints including retinopathy, nephropathy and neuropathy and microvascular endpoints including is cadmic heart disease, stroke and peripheral vascular disease. The premature morbidity, mortality, reduced life expectancy and financial and other others costs of diabetes make if an important public health condition. The aim of this study was to observe the clinical condition and consequences patients with diabetes mellitus in Bangladesh. A descriptive cross-sectional study was conducted for the study. Data are collected from BIHS General Hospital. The results showed that, among 100 patients 20% patient was affected by Type-1 Diabetes Mellitus (DM) and 80% patient was affected by Type-2 Diabetes Mellitus (DM). In comparison between Type-1 and Type-2 DM patient’s result showing that Fasting Plasma Glucose (FPG) and 2 hour ABF plasma Glucose range is slightly high in Type-1 DM than Type-2 DM. On the other hand, Creatinine, HbA1C, TSH, Total cholesterol (TC), Triglycerides (TG), HDL ranges are increased in Type-2 DM patient. In this study males are affected 62% and females are 32%. So the ratio between male and female is 2:3. More patients were found in the age between 50-60 years and has risk among 40-50 years. Eating the right foods and adopting other life style behaviors that promotes healthy blood sugar and insulin levels will give you the best chance at avoiding diabetes.

Hyperkalemia in Patients with Type 2 Diabetes Mellitus: Risk Factors and Clinical Outcomes

Hyperkalemia is one of life-threatening electrolyte abnormalities. Diabetes mellitus (DM) is among the diseases in which patients can commonly develop hyperkalemia due to various factors. This study aimed to determine the occurrence of hyperkalemia and potential risk factors that contribute to development of hyperkalemia among type 2 diabetes mellitus (T2DM) patients. This is a single centered retrospective study in all deceased diabetic patients who were previously admitted to Sultan Ismail Petra Hospital, Kelantan state of Malaysia from January 2017 to December 2017 with or without hyperkalemia. A total of 132 patients were studied after screening for eligibility from medical records. Hyperkalemia was defined as potassium level ≥5.5 mEq/L. Univariate and multiple logistic regression analysis were used to identify potential risk factors associated with hyperkalemia. The occurrence of hyperkalemia among T2DM patients was 54.5%. In multivariable analysis, stage 4 CKD (eGFR: 15-29 ml/min/1.73m2) (AOR=0.154, 95%CI=0.003,0.763), use of ARB (AOR=26.269, 95%CI=1.25,548.50) and length of stay (AOR=1.007, 95%CI=1.001,1.013) were the significant risk factors for hyperkalemia. No significant difference between diabetes patients with hyperkalemia (DMHK) group with diabetes patients without hyperkalemia (DMWOHK) group in terms of clinical outcomes. Among diabetic patients with hyperkalemia, the mean time from development of hyperkalemia until death was 99.92±119.07 hours. In conclusion, this study shows that hyperkalemia is common among T2DM patient in our study setting. Although a number of factors may contribute to the high occurrence of hyperkalemia, the use of ARB, advanced CKD at stage 4 and length of stay are major determinants of hyperkalemia occurrence. Aggressive management of hyperkalemia may be beneficial as to prevent significant clinical outcomes requiring intensive care management and cardiac problem lead to death.

Perceived School Experience of Children and Adolescents With Type 1 Diabetes in the Kingdom of Saudi Arabia.

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children globally affecting more than 1.2 million children worldwide. It is challenging to manage in children and adolescents, as it can have much more serious psychosocial impacts in these groups. The objective of this study was to investigate the perceived experience of children and adolescents with T1DM regarding the management of their condition while in school. We used a cross-sectional study design with descriptive statistics and non-probability consecutive sampling in this work. This study was conducted at the Department of Pediatrics, Qassim Armed Forces Hospital, Al-Qassim, SaudiArabia, from July 2018 to December 2018. In this study, we included 84 school-aged children and adolescents from various schools in the Qassim region of the Kingdom of Saudi Arabia who had T1DM and met the inclusion criteria. After we obtained written informed consent from the participants, they filled out a survey questionnaire about their perceived school experience while being a T1DM patient. Although most of the children believed that they were not prevented from managing their diabetes at school, most also believed that school personnel did not have adequate knowledge about diabetes. In this study, adolescents and children with T1DM had mixed perceptions of their experience at school.

The short-term cost-effectiveness of once-weekly semaglutide versus once-weekly dulaglutide for the treatment of type 2 diabetes mellitus in Colombian adults

Background: Type 2 Diabetes Mellitus (T2DM) is a highly prevalent disease worldwide and in Colombia, representing one of the main causes of death and placing a considerable burden on healthcare systems. 13 classes of drugs are approved for the treatment of T2DM, with Glucagon-like Peptide-1 (GLP-1) receptor agonists being a first-line treatment option for patients with or at high risk of certain cardiovascular diseases and chronic kidney disease. The objective of this study is to conduct a short-term cost-effectiveness analysis of once-weekly semaglutide versus once-weekly dulaglutide in Colombian adults with T2DM, from a third-party payer perspective. Methods: Numbers needed to treat were calculated for different single and composite endpoints of the SUSTAIN 7 trial, annual costs for once weekly semaglutide 1.0 mg and dulaglutide 1.5 mg were extracted from the public SISMED database. With these inputs a cost of control model was developed, to obtain the annual cost of bringing one T2DM patient to relevant clinical outcomes by using semaglutide or dulaglutide. Results: Semaglutide was considered cost-effective compared to dulaglutide across all pre-specified endpoints, even in the different scenarios evaluated in the sensitivity analyses, and in a particularly pronounced manner for weight loss outcomes. Semaglutide at a dose of 1.0 mg once-weekly was cost-effective compared to dulaglutide 1.5 mg across all outcomes in the short-term, making it an appropriate first-line choice in the treatment of T2DM when deciding between these two GLP-1 receptor agonists. Conclusions: This is the first short-term cost-effectiveness study of semaglutide and dulaglutide in T2DM Colombian patients. Our modeled results suggest that once-weekly semaglutide represents a cost-effective option for treating individuals with T2DM in Colombia who are not achieving glycaemia control with metformin, and it would be expected to improve HbA1C, promote greater weight loss and reduce costs from a third-payer perspective compared with treatment with dulaglutide.

Profiling of patients with type 2 diabetes based on medication adherence data.

Type 2 diabetes mellitus (T2DM) is a complex, chronic disease affecting multiple organs with varying symptoms and comorbidities. Profiling patients helps identify those with unfavorable disease progression, allowing for tailored therapy and addressing special needs. This study aims to uncover different T2DM profiles based on medication intake records and laboratory measurements, with a focus on how individuals with diabetes move through disease phases. We use medical records from databases of the last 20 years from the Department of Endocrinology and Diabetology of the University Medical Center in Maribor. Using the standard ATC medication classification system, we created a patient-specific drug profile, created using advanced natural language processing methods combined with data mining and hierarchical clustering. Our results show a well-structured profile distribution characterizing different age groups of individuals with diabetes. Interestingly, only two main profiles characterize the early 40-50 age group, and the same is true for the last 80+ age group. One of these profiles includes individuals with diabetes with very low use of various medications, while the other profile includes individuals with diabetes with much higher use. The number in both groups is reciprocal. Conversely, the middle-aged groups are characterized by several distinct profiles with a wide range of medications that are associated with the distinct concomitant complications of T2DM. It is intuitive that the number of profiles increases in the later age groups, but it is not obvious why it is reduced later in the 80+ age group. In this context, further studies are needed to evaluate the contributions of a range of factors, such as drug development, drug adoption, and the impact of mortality associated with all T2DM-related diseases, which characterize these middle-aged groups, particularly those aged 55-75. Our approach aligns with existing studies and can be widely implemented without complex or expensive analyses. Treatment and drug use data are readily available in healthcare facilities worldwide, allowing for profiling insights into individuals with diabetes. Integrating data from other departments, such as cardiology and renal disease, may provide a more sophisticated understanding of T2DM patient profiles.

Drug repurposing for reducing the risk of cataract extraction in patients with diabetes mellitus: integration of artificial intelligence-based drug prediction and clinical corroboration.

Diabetes mellitus (DM) increases the incidence of age-related cataracts. Currently, no medication is approved or known to delay clinical cataract progression. Using a novel approach based on AI, we searched for drugs with potential cataract surgery-suppressing effects. We developed a drug discovery strategy that combines AI-based potential candidate prediction among 2650 Food and Drug Administration (FDA)-approved drugs with clinical corroboration leveraging multicenter electronic health records (EHRs) of approximately 800,000 cataract patients from the TriNetX platform. Among the top-10 AI-predicted repurposed candidate drugs, we identified three DM diagnostic ICD code groups, such as cataract patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), or hyperglycemia, and conducted retrospective cohort analyses to evaluate the efficacy of these candidate drugs in reducing the risk of cataract extraction. Aspirin, melatonin, and ibuprofen were associated with a reduced 5-, 10-, and 20-year cataract extraction risk in all types of diabetes. Acetylcysteine was associated with a reduced 5-, 10-, and 20-year cataract extraction risk in T2DM and hyperglycemia but not in T1DM patient groups. The suppressive effects of aspirin, acetylcysteine, and ibuprofen waned over time, while those of melatonin became stronger in both genders. Thus, the four repositioned drugs have the potential to delay cataract progression in both genders. All four drugs share the ability to directly or indirectly inhibit cyclooxygenase-2 (COX-2), an enzyme that is increased by multiple cataractogenic stimuli.

Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes

Diabetes mellitus (DM) is still one of the most common diseases worldwide, and its prevalence is still increasing globally. According to the American and European recommendations, metformin is considered a first-line oral hypo-glycemic drug for controlling type 2 DM (T2DM) patients. Metformin is the ninth most often prescribed drug in the world, and at least 120 million diabetic people are estimated to receive the drug. In the last 20 years, there has been increasing evidence of vitamin B12 deficiency among metformin-treated diabetic patients. Many studies have reported that vitamin B12 deficiency is related to the ma-labsorption of vitamin B12 among metformin-treated T2DM patients. Vitamin B12 deficiency may have a very bad complication for the T2DM patient. In this review, we will focus on the effect of metformin on the absorption of vitamin B12 and on its proposed mechanisms in hindering vitamin B12 absorption. In addition, the review will describe the clinical outcomes of vitamin B12 deficiency in metformin-treated T2DM.

Serum 25-Hydroxyvitamin D Levels in Type 2 Diabetes Patients in North China: Seasonality and the Association between Vitamin D Status and Glycosylated Hemoglobin Levels.

Previous studies have reported a correlation between vitamin D levels and seasonality in healthy populations. However, there are few studies on the seasonal variation in vitamin D levels and its relationship with glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to investigate seasonal changes in serum 25-hydroxyvitamin D [25(OH)D] levels and the associations between these vitamin D concentrations and HbA1c levels in T2DM patients in Hebei, China. A cross-sectional study of 1,074 individuals with T2DM was conducted from May 2018 to September 2021. Levels of 25(OH)D in these patients were assessed based on both sex and season, and relevant clinical or laboratory variables that could impact vitamin D status were also considered. In the T2DM patient cohort, the mean blood 25(OH)D levels were 17.05 ng/mL. A total of 698 patients (65.0%) had insufficient serum 25(OH)D levels. The vitamin D deficiency rates were significantly higher in the winter and spring compared to the autumn (P < 0.05), indicating that seasonal fluctuations can have a significant impact on 25(OH)D levels. The levels of vitamin D inadequacy were highest in the winter (74%), and females were more likely than males to be deficient (73.4% vs. 59.5%, P < 0.001). In comparison to the winter and spring, both males and females showed higher 25(OH)D levels in the summer (P < 0.001). HbA1c levels were 8.9% higher in those with vitamin D deficiencies than in nondeficient patients (P < 0.001). HbA1c and vitamin D levels were negatively correlated (r = -0.119, P < 0.001). Vitamin D deficiencies are particularly prevalent among T2DM patients in Hebei, China, with exceptionally high rates in the winter and spring. Female T2DM patients were at an elevated risk of vitamin D deficiency, and vitamin D levels were negatively correlated with HbA1c.

Cognitive protection of sinomenine in type 2 diabetes mellitus through regulating the EGF/Nrf2/HO-1 signaling, the microbiota-gut-brain axis, and hippocampal neuron ferroptosis.

Recent years have witnessed a growing research interest in traditional Chinese medicine as a neuroprotective nutrient in the management of diabetic cognitive dysfunction. However, the underlying molecular mechanisms of sinomenine in mediating ferroptosis of hippocampal neurons have been poorly understood. This study sought to decipher the potential effect and molecular mechanism of sinomenine in the cognitive dysfunction following type 2 diabetes mellitus (T2DM). Multi-omics analysis was conducted to identify the microbiota-gut-brain axis in T2DM patient samples obtained from the publicly available database. In HT-22 cells, erastin was utilized to create a ferroptosis model, and streptozotocin was injected intraperitoneally to create a rat model of DM. It was noted that intestinal flora imbalance occurred in patients with T2DM-associated cognitive dysfunction. Sinomenine could reduce Erastin-induced hippocampus neuronal ferroptosis by increasing EGF expression. EGF protected hippocampal neurons against ferroptosis by activating the Nrf2/HO-1 signaling pathway. Furthermore, in vivo results confirmed that sinomenine blocked ferroptosis of hippocampal neurons and alleviated cognitive dysfunction in T2DM rats. Collectively, these results suggest that sinomenine confers neuroprotective effects by curtailing hippocampal neuron ferroptosis via the EGF/Nrf2/HO-1 signaling and microbiota-gut-brain axis. It may be a candidate for the treatment of diabetic cognitive dysfunction.

U-shaped association between serum IGF2BP3 and T2DM: A cross-sectional study in Chinese population.

To clarify the expression of N6-methyladenosine (m6 A) modulators involved in the pathogenesis of type 2 diabetes mellitus (T2DM). We further explored the association of serum insulin-like growth factor 2 mRNA-binding proteins 3 (IGF2BP3) levels and odds of T2DM in a high-risk population. The gene expression data set GSE25724 was obtained from the Gene Expression Omnibus, and a cluster heatmap was generated by using the R package ComplexHeatmap. Differential expression analysis for 13 m6 A RNA methylation regulators between nondiabetic controls and T2DM subjects was performed using an unpaired t test. A cross-sectional design, including 393 subjects (131 patients with newly diagnosed T2DM, 131 age- and sex-matched subjects with prediabetes, and 131 healthy controls), was carried out. The associations between serum IGF2BP3 concentrations and T2DM were modeled by restricted cubic spline and logistic regression models. Two upregulated (IGF2BP2 and IGF2BP3) and 5 downregulated (methyltransferase-like 3 [METTL3], alkylation repair homolog protein 1 [ALKBH1], YTH domain family 2 [YTHDF2], YTHDF3, and heterogeneous nuclear ribonucleoprotein [HNRNPC]) m6 A-related genes were found in islet samples of T2DM patients. A U-shaped association existed between serum IGF2BP3 levels and odds of T2DM according to cubic natural spline analysis models, after adjustment for body mass index, waist circumference, diastolic blood pressure, total cholesterol, and triglyeride. Multivariate logistic regression showed that progressively higher odds of T2DM were observed when serum IGF2BP3 levels were below 0.62 ng/mL (odds ratio 3.03 [95% confidence interval 1.23-7.47]) in model 4. Seven significantly altered m6 A RNA methylation genes were identified in T2DM. There was a U-shaped association between serum IGF2BP3 levels and odds of T2DM in the general Chinese adult population. This study provides important evidence for further examination of the role of m6 A RNA methylation, especially serum IGF2BP3 in T2DM risk assessment.

Assessment of serum magnesium and correlation with glycemic control and complication in type 2 diabetes mellitus – A cross-sectional study in a tertiary care hospital in eastern zone of India

Background: Diabetes mellitus (DM) is an expanding global health problem. Type 2 DM (T2DM) patients account about 90% of total DM patients. Magnesium is important for different physiological mechanism. Hypomagnesemia is common in T2DM patient. Magnitude of hypomagnesemia is related with glycemic control and is associated with complications of T2DM. Aims and Objectives: Our aim of the study was to assess the prevalence of hypomagnesemia in patients of T2DM patients and to find their correlation with glycemic control and complications of T2DM patients in rural population of eastern zone of India. Materials and Methods: The hospital-based cross-sectional study includes 99 male and female DM patients between 15 and 60 years age. Fasting blood sugar, postprandial blood sugar, HbA1c, serum total magnesium, and urine albumin creatinine ratio were measured. Data were entered into Microsoft Excel spreadsheet and then analyzed by SPSS (version 25.0; SPSS Inc.) and GraphPad Prism (version 5.0). P &lt; 0.05 was considered statistically significant. Results: From our study, we observed that hypomagnesemia is common in T2DM patients. The magnitude of hypomagnesemia is correlated with glycemic control (P &lt; 0.0001). Moreover, hypomagnesemia is associated with diabetic kidney diseases (P &lt; 0.05). Conclusion: It can be concluded that serum magnesium should be monitored in all T2DM patients and should be managed appropriately because hypomagnesemia may induce complications in T2DM patients.

Case Study Presenting Remarkable Improvements of all Parameters in a Long-Term T2DM Patient with Multiple Chronic Comorbidities by Sugar fit’s -Tech/Ai-Driven Platform with Daily Personalised Life Coaching and Expert Medical Advice

Background: Type 2 diabetes mellitus (T2DM) is not only one of the leading causes of mortality, but its impact on healthcare costs and burden is becoming unsustainable each year. The quality of life and life expectancy are both significantly impacted by this chronic metabolic condition. To help control their blood glucose levels, patients with T2DM adhere to a self-management regimen as instructed by a professional. Various technological options are available now to help self-management. Methods: Here, we present a case of a 64-year-old female with insulin-dependent type 2 diabetes mellitus, multiple co-morbidities, depression, confined to her room, and inability to walk for about a year. After six months of the Sugar fit approach with daily-personalized life coaching, expert medical advice, tech-enabled, AI-driven model, she showed tremendous improvement in every parameter. Results: Before joining sugar fit, the patient was on 44 units of rapid insulin and 18 units of long-acting and oral anti-diabetic medications. The patient’s Hba1c at baseline was 8%; six months later, it is 6.8% with all rapid and long insulin stopped and oral meds essentially the same as before. She has reduced creatinine from 1.88 to 1.37 and triglycerides from 1015 to 448, respectively. Her BP medications have been reduced to 50%. She walks for 2 km every day and is socially active with resolved depression. She has lost 3 kgs of weight and 3 inches of waist circumference. Conclusions: The findings indicate that a tech-enabled, AI-driven model with intensive, personalized coaching, lifestyle modification, and expert physician guidance has shown remarkable results even in this particularly complicated case. The findings indicate that the personalized and individualized frequent lifestyle coaching and expert physician opinion enabled by superior technology and AI-driven Insights resulted in marked improvement of all parameters and significant medication reductions even in Diabetes of long duration with comorbidities

EMPOWERMENT OF DIABETES MELLITUS PATIENT DURING COVID-19 PANDEMIC ERA THROUGH ONLINE GATHERING

Introduction: In the COVID-19 pandemic, social restriction and lock-down policies were implemented. It has far-reaching implications in many sectors of life including health, particularly in patients with chronic diseases, one of which is Type-1 Diabetes Mellitus (T1DM). The purpose of this community service in the form of online gathering is to facilitate patients to ask questions and consult with pediatricians, due to the limitations of patients to consult directly due to the pandemic. Methods: Community service is conducted online for T1DM patients or their relatives on Sunday, September 26, 2021, from 12.00 - 13.30 WIB. The Community service was divided into several stages, including before, during, and after the online gathering. The T1DM patients or their relatives are participants in this community services. The topic are types of Diabetes Mellitus, clinical presentation, disease progression, the diagnostic process, and its management therapy of type 1 diabetes mellitus. Results: The community service was attended by 54 parents of T1DM patient. The online gathering goes smoothly, without being constrained by something. During the online gathering, subjects actively participate in every session during the online gathering. Several questions were asked by the participants and answered well by the speakers. Conclusion: This community services activities allow participant to be able to ask question about their problem according to diabetes mellitus. Participants can consult online with pediatricians. This online gathering has a limited time, so participants can be divided into several breakout rooms with several accompanying pediatricians, so that the QnA session can be done optimally.