Uncontrolled HbA1c Research Articles

Exploring the association of social connections and food security among adults with uncontrolled type 2 diabetes: a population-based study

BackgroundPrimary health care professionals are held accountable for various quality measures in the treatment of patients with chronic diseases such as diabetes. Uncontrolled type 2 diabetes (T2D) remains a considerable health problem; thus, further studying patients with this condition is important for delivering effective interventions. Social determinants of health (SDoH) have been shown to affect various aspects of diabetes care in different subpopulations. We studied the association of SDoH with uncontrolled T2D in a population of adult primary care patients.MethodsWe retrospectively searched our electronic health record for adult patients (≥18 years) with a diagnosis of T2D and a hemoglobin A1c (HbA1c) level of 8% or higher. Patients were empaneled to 2 primary care clinic sites between January 1, 2021, and January 31, 2022. Patients were grouped by HbA1c level to stratify patients according to the extent of uncontrolled T2D. Patient characteristics were compared among groups. Unadjusted and adjusted multinomial logistic regression analysis was used to estimate the odds of various SDoH factors among patient groups with different levels of uncontrolled T2D.ResultsThe study cohort included 1,596 patients. Most patients were White (79%), and the median age was 58.8 years. The median HbA1c level was 8.9%, and approximately 68% of patients were obese (body mass index [BMI] ≥30). When the study population was grouped by HbA1c level (8% to < 9% [n = 806], ≥9% to < 12% [n = 684], and ≥12% [n = 106]), significant differences among groups were observed in age group (P < .001), marital status (P < .001), race (P < .001), ethnicity (P = .001), and BMI category (P = .01). In groups with higher HbA1c levels, we noticed a higher percentage of patients who were aged 51 to 65 years or single. Among patients with uncontrolled HbA1c levels, more patients were obese than overweight. Patients in the intermediate HbA1c group had increased odds of food insecurity and some decreased social connections, even after adjusting for age, sex, race, ethnicity, and marital status.ConclusionsAmong patients with uncontrolled T2D, higher HbA1c levels were associated with decreased social connections and increased food insecurity. Our findings provide insight into the role of these SDoH in managing T2D and have important implications for primary care practice.

The Relationship Between Glycemic Control And Lipid Profile In Patients With Type 2 Diabetes Mellitus In Bangli Hospital

Type 2 diabetes mellitus (DM) is prone to diabetic dyslipidemia which is one of the factors in increasing the risk of cardiovascular disease complications. The purpose of this study was to determine the relationship between glycemic control and lipid profile in patients with type 2 DM. Research with a cross-sectional study was conducted at the Internal Medicine Polyclinic of Bangli Hospital in the period January 2023-December 2023 and as many as 60 patients with type 2 DM who met the inclusion criteria. Patients were grouped into type 2 DM patients with controlled glycemic control (HbA1c &lt;7%) and uncontrolled (HbA1c ≥7%). Lower levels of total cholesterol (160,444 ± 30,608 mg/dl vs 203,476 ± 45,471 mg/dl; p = 0.001), triglycerides (125,500 ± 56,019 vs 202,047 ± 91,568; p = 0.002), low-density lipoprotein (K-LDL) (93,072 ± 28,443 vs 131,571 ± 44,590; p = 0.001) in type 2 DM patients with controlled glycemic control. High-density lipoprotein (K-HDL) levels (50,022 ± 14,050 vs 41,152 ± 12,619; p = 0.019) were higher in type 2 DM patients with controlled glycemic control. Statistical tests showed a positive correlation between total cholesterol (r = 0.277; p = 0.032), triglyceride (r = 0.386; p = 0.002) and K-LDL (r = 0.357; p = 0.005) levels with HbA1c levels. There was a negative correlation between K-HDL (r=-0.366; p=0.004) and HbA1c levels. The significant correlation between HbA1c and lipid profile shows the importance of glycemic control in type 2 DM patients. This can be explained in the pathogenesis of type 2 DM during the advanced phase. There was a positive correlation between glycemic control (HbA1c) with total cholesterol, triglycerides and K-LDL. There is a negative correlation between glycemic control (HbA1c) and K-HDL.

Ameliorating effect of Tennetti-Tilla (dried figs and sesame seeds laddu) on type 2 Diabetic convalescents-A case study

Diabetes mellitus is a common endocrine disorder of impaired glucose metabolism and is increasing globally due to changes in the lifestyle of individuals. It can be controlled or reversible by following a regular diet and proper exercises. Along with the diet exercises naturally available supplements are also helpful in controlling diabetes. There are many plant-based products which can be consumed in daily diet which act as nutraceuticals. The present case study was based on the natural supplementation with dried figs and sesame seeds. A 64-year-oldman known case of Type 2 diabetes consulted at nature cure hospital with chief complaint of uncontrolled fasting sugar and HbA1c since 8 years. Using dried figs and sesame seeds named as the formulation Tennetti-tilla. Along with regular medicines 10 g of supplementation was advised for 90 days to the subject. After the study period it was observed that Fasting sugar levels have reduced from 116 mg/dl to 96 mg/dl, post prandial 147mg/dl to 118 g/dl, HBA1c 7.1% to 6%.

The Relationship between HbA1c, GDP and Disease Duration on the Occurrence of Diabetic Neuropathy at Ibnu Sina Hospital

Diabetes Mellitus (DM) affects over 693 million adults globally by 2045, with complications like neuropathy underscoring the need for effective monitoring. This observational case-control study at Ibnu Sina Hospital, Makassar, explores the relationship between HbA1c levels, fasting blood sugar (GDP), disease duration, and diabetic neuropathy. Analyzing 77 medical records, the study found that most participants were aged 56-65 years, predominantly male, with high rates of uncontrolled HbA1c (80.5%) and GDP (67.5%). Diabetic neuropathy prevalence was 61.0%. Statistical analysis revealed significant correlations between neuropathy and HbA1c levels (p=0.000), GDP (p=0.002), and disease duration (p=0.041). These findings highlight the impact of glycemic control and disease duration on neuropathy in DM patients.

The Relationship Between Glycemic Control And Lipid Profile In Patients With Type 2 Diabetes Mellitus In Bangli Hospital

Diabetes Mellitus (DM) type 2 is susceptible to diabetic dyslipidemia, which is one of the factors in increasing the risk of complications from cardiovascular disease. The aim of this study was to determine the relationship between glycemic control and lipid profile in type 2 DM patients. A cross-sectional study was conducted at the Internal Medicine Polyclinic at Bangli Regional Hospital for the period January 2023-December 2023 and a total of 60 type 2 DM patients met the inclusion criteria. Patients were grouped into type 2 DM patients with controlled glycemic control (HbA1c &lt; 7%) and uncontrolled (HbA1c≥7%). Lower levels of total cholesterol (160,444 ± 30,608 mg/dl vs 203,476 ± 45,471 mg/dl; p= 0.001), triglycerides (125,500 ± 56,019 vs 202,047 ± 91,568; p= 0.002), low-density lipoprotein (K-LDL ) (93,072 ± 28,443 vs 131,571 ± 44,590; p= 0.001) in type 2 DM patients with good glycemic control. High-density lipoprotein (K-HDL) levels (50,022 ± 14,050 vs 41,152 ± 12,619; p = 0.019) were higher in type 2 DM patients with good glycemic control. From statistical tests, a positive correlation was found between total cholesterol levels (r = 0.277; p = 0.032), triglycerides (r = 0.386; p = 0.002) and K-LDL (r = 0.357; p = 0.005) with HbA1c levels. There is a negative correlation between K-HDL (r=-0.366; p = 0.004) and HbA1c levels. The significant correlation between HbA1c and lipid profile shows the importance of glycemic control in type 2 DM patients. This can be explained in the pathogenesis of type 2 DM in the advanced phase. There is a positive correlation between glycemic control (HbA1c) and total cholesterol, triglycerides and K-LDL. There is a negative correlation between glycemic control (HbA1c) and K-HDL.

Evaluating diabetic foot care knowledge and practices at education level.

Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.

Glycosylated Hemoglobin (HbA1C) as a Predictor of Early Postoperative Outcomes After Coronary Artery Bypass Grafting: A Single-Center Observational Study.

Background Diabetic patients present a majority of patients undergoing surgical revascularization. Hyperglycemia is associated with increased adverse events. Glycosylated hemoglobin (HbA1c) is an effective biological marker for long-term glycemic control. As a result, there is an increased trend in its use as a predictor of adverse outcomes. This study aims to assess the impact of elevated HbA1c on the occurrence of postoperative complications after coronary artery bypass grafting (CABG). Methods We conducted a retrospective review of medical records from January 2015 to December 2022 for adult patients who underwent isolatedCABG. We assessed patient demographics, medication, laboratory results, HbA1c results, and clinical data. The separate statistical models were designed to assess the predictors for thedevelopment of postoperative complications. Results This retrospective single-center study was conducted on 289 consecutive adult patients who underwent on-pump CABG. Patient demographics showed that uncontrolled HbA1c was more in females (p=0.022), and hemodialysis patients (p=0.018). Across different levels of HbA1C, there were no significant differences in terms of the incidence of postoperative complications(p=0.788 for infection, p=0.372 for the need for blood transfusion, p=0.721 for heart failure, p=0.692 for arrhythmia, and p=0.712 for death). HbA1c had no predictive value for postoperative complications as indicated by multivariate and stepwise analysis in a separate model for each complicationwith receiver operator characteristics curves of each model showing similar strength of both multivariate and stepwise models. Conclusions In our data, elevated preoperative HbA1c had no predictive value for early complications and intermediate postoperative outcomes. We recommend that surgery should proceed without delay, even if patients have elevated HbA1C levels. As for elective patients with low-risk features and anatomy, optimizing preoperative glycemic control can be considered.

Hubungan Kadar HbA1c Dengan Kadar Serum Kreatinin Pada Penderita Diabetes Melitus Tipe 2 Di RSU Sinar Kasih Purwokerto

Diabetes Mellitus is a metabolic disorder caused by a decrease in insulin products in the body. The World Health Organization estimates an increase in the number of diabetes mellitus sufferers from 8.4 million in 2000 to around 21.3 million in 2030. Chronic diabetes mellitus sufferers can cause complications, one of which is kidney complications. Kidney damage can occur due to uncontrolled blood sugar levels. Complications of diabetes mellitus can be detected by examining HbA1c. HbA1c is a non-enzymatic binding of glucose molecules to hemoglobin through a post-translational glycation process. Uncontrolled HbA1c levels can cause various complications in the body.The samples used for this research were 106 samples with normal HbA1C examination results, namely 59 patients and high results, namely 47 patients. Creatinine examination with normal results was 81 patients and high results were 25 patients. The P-value from the calculation results is 0.066 higher than 0.005. Based on the results of the chi square calculation, it can be concluded that there is not a relationship between HbA1C examination and creatinine examination in type 2 diabetes mellitus patients at Sinar Kasih Hospital.

Trends in Serum Shifts: Unveiling Hyperglycaemia Links PostCOVID-19 Vaccination.

Clinical endocrinology has observed emerging endocrine complications following COVID-19 vaccination, amidst successful reductions in COVID-19 hospitalizations and deaths. The Pfizer-BioNTech and Moderna mRNA vaccines have demonstrated efficacy. Reports indicate a potential association between SARS-CoV-2 vaccination and diabetes, exploring interactions with ACE-2 receptors and molecular mimicry. Additionally, altered liver and kidney function tests post-vaccination prompt investigation into their role in predicting type 2 diabetes. This study aims to explore these biochemical abnormalities in a case-control, single-centre prospective study. This prospective study aimed to evaluate a total of five hundred healthy donors, out of which 203 qualified for final analysis. Participants were selected based on their vaccination status with a COVID-19 vaccine and prior exposure to the SARS-CoV-2 virus. Donors without prior SARS-CoV-2 infection were excluded from the study. Included participants were adults who had received three doses of the COVID-19 vaccine. A total of 203 individuals were included in the study, comprising 104 with type 2 diabetes mellitus (T2DM) and 99 without. Demographic characteristics including age, sex, nationality, Rh factors, ABO blood groups, liver function tests (LFT), kidney function tests (KFT), lactate dehydrogenase (LDH), and mineral ion levels were analysed. Among the participants, the distribution based on HbA1c levels showed 47.8% with HbA1c &#60;7% classified as normal, 38.48% with HbA1c 8-10% classified as high, and 16.64% with HbA1c &#60;10% classified as uncontrolled diabetes. Significant findings included a decrease in magnesium levels to 0.77±0.82 mmol/L (p&#60;0.04*), an increase in LDH levels to 420.70±356.26 µL (p&#60;0.01*), and elevated levels of alkaline phosphatase (143.22 ± 142.62 µL, p&#60;0.001), gamma-glutamyl transferase (GGT) (55.70 ± 32.20 µL, p&#60;0.001), and serum bilirubin (9.23 ± 4.87 µmol/L, p&#60;0.001). Creatinine levels were significantly lower at 116.75 ± 101.94 µmol/L (p#60;0.001), while uric acid levels were significantly elevated at 305.92 ± 145.04 µmol/L (p&#60;0.001) in individuals with uncontrolled HbA1c &#60;10%. A majority of these individuals belonged to the O+ blood group. This study underscores significant shifts in serum biomarkers and their complex interplay with mRNA-based SARS-CoV-2 vaccination and diabetes, particularly in uncontrolled cases. The findings suggest potential autoimmune reactions triggered by the self-adjuvant properties of mRNA and polyethylene glycol lipid conjugates. Variations observed among different blood groups may correspond to racial disparities influencing molecular mimicry mechanisms. Despite these insights, the underlying pathophysiological mechanisms remain unclear, highlighting the critical need for further research to validate and expand upon these findings.

New Pro-inflammatory Cytokines in Children and Adolescents with Type 1 Diabetes Patients with Microvascular Complications

Abstract Background Type 1 diabetes mellitus has become a global health burden, and poor glycemic control, in combination with prolonged diabetes duration, leads to the early development of microvascular complications, including diabetic kidney disease, retinopathy, and neuropathy. Therefore, it is urgent to establish new biomarkers for the early identification of at-risk patients. Objectives To investigate the role of inflammatory proteins (human growth differentiation factor 15 and interleukin 29) in the course of microvascular complications and glycemic control in T1DM. Patients and Methods Our study included 40 children with T1DM (18 T1DM patients had microvascular complications and 22 T1DM patients were free of these complications; their ages ranged from 8 to 18 years); there was also another T1DM subgroup based on glycemic control (11 T1DM patients had controlled HbA1c &amp;lt; 7% and 29 patients had uncontrolled HbA1C &amp;gt; 7%). 40 children of the same age were selected as a control group. The diagnosis of TIDM was made based on the criteria of the International Society of Pediatric and Adolescent Diabetes (ISPAD) (2022). A detailed medical history was collected, including the age of onset of diabetes, disease duration, and symptoms of diabetic complications. In the study, GDF15 and IL29 values in serum blood were investigated using the ELISA method. Results The mean age was 14.05 years in the diabetic group and 13.25 years in the control group (P = 0.178). In the T1DM patient group, the GDF15 and IL29 values were found to be significantly higher than those in the control group (P = 0.041 and 0.013, respectively). In diabetic patients, GDF15 was significantly higher in the complicated T1DM group versus the uncomplicated group (P = 0.001). Furthermore, GDF15 levels were significantly higher in uncontrolled patients with HbA1C &amp;gt; 7% than in the control group with HbA1C &amp;lt; 7% (P = 0.004); however, no significant statistical differences in IL29 levels were found between diabetic patient subgroups (P &amp;gt; 0.05). Conclusion The data from this study showed that GDF15 has an impact on glycemic control and that the presence of microvascular complications in the course of T1DM is very possible, but IL29 does not appear to play a role in the course of microvascular complications.

Uncontrolled diabetes mellitus and the progression of monoclonal gammopathy of undetermined significance to multiple myeloma in US veterans.

7551 Background: Studies have shown that, independent of obesity, the metabolic effects of diabetes mellitus (DM) promote the progression of monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM). However, it is unclear whether glycemic control is associated with MGUS progression in DM patients. We aimed to evaluate the association between poor glycemic control, measured by HbA1c &gt;6.5%, and progression. Methods: Patients diagnosed with MGUS from 1999-2021 in the Veterans Health Administration (VHA) were identified using a published natural language processing (NLP)-based algorithm. We focused on patients whose MGUS subtype was IgG, IgA, or light chain. We excluded patients lacking body weight measurements from the time of MGUS diagnosis to the end of follow-up to ensure receiving care in the VHA. We further excluded patients with extended gaps &gt;1 year between HbA1c measurements. Time-varying HbA1c measurements during the follow-up, evaluated at 1-day intervals and categorized into uncontrolled (HbA1c &gt;6.5%) or controlled (≤6.5%) DM was the exposure variable. Progression of MGUS to MM was also confirmed by a published NLP algorithm. The association between the time-varying controlled/uncontrolled DM and progression was estimated by multivariable-adjusted hazard ratio (aHR) with death as a competing event. The covariates included sex, race, MGUS subtype as well as age, body mass index, monoclonal protein level, Charlson Comorbidity Index, DM medication, and DM type (type 1, type 2 with insulin-dependency status, type 2 without insulin-dependency status), all at MGUS diagnosis. Same analysis was conducted in a subgroup of patients with non-insulin dependent DM type 2 (NIDDMT2) without insulin use between MGUS diagnosis and the end of follow-up. Results: After applying inclusion and exclusion criteria, we identified 9,682 patients with both DM and MGUS. The multivariable analysis revealed a positive association between poor glycemic control and MM progression (see Table): (aHR 1.27, 95% CI 1.13-1.42). In NIDDMT2 without insulin use (n=3,498), poor glycemic control was associated with MM progression (aHR 1.81; 95% CI 1.57-2.10). Conclusions: For patients with DM and MGUS, the risk of MGUS progression to MM was 27% higher in uncontrolled DM and 81% higher in patients with NIDDMT2. This finding highlights a modifiable risk factor for MM progression in MGUS patients. Future studies should examine if interventions to enhance glycemic control could potentially reduce MGUS progression.

Assessing the Features of Diabetic Foot Ulcers among Individuals with Type 2 Diabetes Mellitus in Thi Qar, Iraq

Background This study aimed to evaluate the characteristics of diabetic foot ulcers in individuals with type 2 diabetes mellitus (T2DM) in Iraq. Methods The study included 881 participants with T2DM and different types of foot ulcers, who attended a specialized diabetes center. Data on demographics, clinical characteristics, biochemical investigations, comorbidities, and treatment regimens were collected and analyzed. Results The majority of the cases (96.8%) were due to T2DM, with an average age of 58 years and a mean BMI of 30 kg/m2. Participants had elevated serum creatinine, blood urea, and glucose levels, with uncontrolled HbA1c levels. Comorbidities included hypertension, ischemic heart disease, diabetic neuropathy, and retinopathy. Most participants were on insulin and statins. Diabetic foot ulcers were mainly on the right foot (48%) and classified as Grade 2 in Wagner's system. Some participants had Charcot deformity or stages of amputation. Conclusions Random plasma glucose levels and diabetic retinopathy were significantly associated with the classification of foot ulcers. Further research is needed to explore additional variables related to T2DM and foot ulcers, emphasizing the importance of glucose control and retinopathy in ulcer classification.

Effects of diabetes mellitus complications on sleep quality among Saudi Arabian patients-A national study.

In diabetes mellitus (DM) patients, obtaining a good night's sleep is crucial for maintaining body caloric intake, controlling insulin levels, and reducing the likelihood of engaging in unhealthy behavior. Patients with poor sleep quality may experience impaired glycemia, playing a significant role in the development of chronic complications. This study aims to explore the effects of DM complications on sleep quality among Saudi Arabian patients. This is a cross-sectional study conducted among patients with diabetes. A self-administered, validated questionnaire translated into Arabic was distributed among diabetic patients using an online survey. The questionnaire includes sociodemographic characteristics (i.e. age, gender, marital status, etc.), the medical history of the patients, and a questionnaire about sleep quality. Out of 4171 patients involved, 52.7% were females and 27.7% were aged between 40 and 60 years old. The prevalence of patients with perceived poor sleep quality was 24.1%. Significant predictors of poor sleep quality were the gender female, having social stressors, comorbid sleep disorders, associated comorbidities, increasing HbA1c levels, being overweight/obese, and diabetes complications. Furthermore, sleep disturbance, taking sleep medications, daytime sleepiness, and having bad dreams during sleep were also identified as prognostic factors for poor sleep quality. The subjective poor sleep quality of patients with diabetes was 24.1%. Poor sleep quality was significantly demonstrated by females who were having social stressors, comorbid sleep disorders, comorbidities, uncontrolled HbA1c levels, elevated BMI levels, and complications of diabetes. However, regular physical activity and adequate sleep were estimated to be the protective factors against poor sleep quality. Further research is needed to establish the effect of sleep quality among patients with DM.

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.

HbA1c Levels in Diabetes Mellitus Screening and Diagnosis

Diabetes Mellitus is a metabolic disorder characterized by increased blood sugar due to decreased insulin secretion by pancreatic beta cells and impaired insulin function (insulin resistance). By measuring glycohemoglobin (HbA1c) you can find out what percentage of the red blood cell dye (hemoglobin) contains sugar. To analyze HbA1c levels in screening and early diagnosis of diabetes mellitus. Observational descriptive research design. The population in this study were all type 2 DM sufferers at Bangil Pasuruan Regional Hospital, totaling 79 respondents. The sample consisted of 47 respondents taken using a purposive sampling technique. The research instrument was an examination of HbA1c levels and an observation sheet. With controlled HbA1c levels, all of them have a normal BMI, eat a regular diet regularly take insulin medication, and adopt more regular exercise habits. Meanwhile, respondents with uncontrolled HbA1c had a BMI of underweight, normal, overweight, and most did not exercise regularly and did not regularly take antidiabetic drugs.

Factors associated with Adherence to Insulin Self-Administration among Children and Adolescents with Type 1 DM in Iraq

Abstract Adolescents and children with type 1 diabetes have been reported to have challenges regarding adherence to treatment regimens compared with other age groups with diabetes. The study aimed to determine the level of commitment and investigate the effects of different factors on insulin adherence in type 1 diabetes patients in Iraq. This cross-sectional study included face-to-face interview questionnaires with caregivers of children and adolescents. Interviews were conducted in the Specialized Center of Endocrinology and Diabetes in Nasiriyah City, Iraq, from October 4, 2022, to March 30, 2023. The adherence questionnaire consisted of two sections; each consisted of five questions, including insulin and blood glucose recommendations. Blood samples were obtained from the patient to determine fasting blood glucose (FBG) and glycated hemoglobin (HBA1c)—results: 180 patients (86 males and 94 females) with type 1 DM. The mean age, weight, and disease duration were 10.75 (4.36) years, 36.30 (16.41) kg, and 6.24 (3.70) years, respectively. They had uncontrolled blood glucose (208.42 95.0 mg/dl) and HBA1c (9.90 2.85%). The patients (52.2%) were girls with primary school qualifications (43.3%). Most of the caregivers (parents and guardians) were either illiterate (30.6%) or had completed primary school (33.9%). In addition, the patient's families (43.9%) had low income (0.5 million ID cards). Therefore, most patients (60%) did not visit a doctor regularly or check their blood glucose. Adherence in the studied population could be higher. Focusing on raising their patients' awareness is pivotal to enhancing their medication adherence to reduce their short- and long-term diabetic complications, improve blood glucose control, and improve clinical outcomes. Keywords: Diabetes, Adherence, Insulin self-medication, Iraqi patients.

Latent tuberculosis in children and youth with type 1 diabetes mellitus in Dar es Salaam, Tanzania: a cross section survey

BackgroundData for latent tuberculosis in patients with type 1 Diabetes in Africa is limited. We assessed the prevalence of latent tuberculosis in youth and children with type 1 Diabetes in Dar es Salaam –Tanzania.MethodsOur cross-sectional study recruited children and youth with T1DM by stage of puberty, glycaemic control, and age at diagnosis from January to December 2021 in Dar es Salaam. Participants were screened for the presence of latent Tuberculosis using the QuantiFERON test. A positive test was considered to have latent TB.ResultsOf the 281 participants, the mean age was 19 (± 6) years, 51.2% were female, and 80.8% had either a primary or secondary level of education at baseline. The prevalence of latent TB was 14.9% and was slightly higher in females (52.4%) than in males. This difference, however, was insignificant (p > 0.05). On the other hand, the proportion of latent TB was significantly higher in uncontrolled HbA1c levels (76.2%) than in those with controlled HbA1c (23.8%) [p = 0.046]. Duration of diabetes and age at diagnosis did not affect the occurrence of latent Tuberculosis [p > 0.05]. Meanwhile, in the regression model, participants with latent TB were more likely to have uncontrolled HbA1c. [p = 0.045]ConclusionsDespite the methodological limitations, this survey highlights the high prevalence of latent TB among children and youth with diabetes; shouting for better control. These results clearly show the need to screen for Tuberculosis in children and youth with diabetes and start them on prevention as per protocol, especially in tuberculosis-endemic areas like Tanzania.

THU152 HbA1c Control Of Pediatric Patients With Diabetes In The Urban Community Hospital Representing Underserved, Minority Population: Can The Frequent Encounters With Multi-Disciplinary Diabetes Team Overcome Patient-Related Adverse Variables In Improving Their Glycemic Control?

Abstract Disclosure: S. Velasquez: None. O. Ozcan: None. S. Dave-Sharma: None. Introduction: The American Diabetes association’s established goal for HbA1C across all age groups is as &amp;lt;7%. As the prevalence of diabetes continues to increase, its control in the pediatric population has become more challenging. Studies have shown controlling diabetes is especially challenging in minority ethnic groups of low income neighborhoods. Our hospital, located in the Mott Haven community, serves the minority population of mostly Hispanics and Blacks with an average household income of &amp;lt; $ 20 000 (poverty rate 39%). Objectives: This study aimed to identify different variables among patients with controlled and uncontrolled HbA1c in our unique pediatric population. Our goal was to learn from the group of patients with good diabetes control to improve the control of patients with poor glycemic control by changing the protocols involving our multi-disciplinary care team. Results: We collected data from 86 patients with diabetes (type 1 and 2) from our pediatric endocrinology clinic and divided them into 3 groups based on their HbA1c levels. 1. Good control: HbA1c &amp;lt;7.5 % in 33/86 (38%) patients, 2. Poor control: HbA1C 7.5%-10% with 34/86 (40%), and 3. Very poor control: HbA1C &amp;gt;10% with 19/86 (22%) patients. We studied the data for variables such as gender, age, ethnicity, insurance, type of diabetes, duration of diabetes, BMI, frequency of encounters with the multi-disciplinary team, and more. Of 86 patients, the average age was 15.65 (51% were females, and 49% were males). 43% had type 1 diabetes, and 57% had type 2 diabetes. The type 1 vs. Type 2 diabetes ratio among different groups was 12% Type 1 vs. 88% type 2 in the group with good control, 73.5% Type 1 vs. 26.5% Type 2 in the poor control group, and 42% type 1 vs. 58% type 2 in the group with very poor control. Obesity was found in 50% of our patients; in the good control group, it was 57%. In the poor control group, 38%, and in the very poor control group, 58%. A correlation study run between the HbA1c levels and duration of diabetes found significantly correlated (R 0.38) in the good control group. Other groups were found positively correlated yet found statistically insignificant. Conclusion: We found that Type 2 Diabetes with Obesity was more prevalent than Type 1 in our pediatric population. Patients with poor and very poor diabetes control had a longer duration of diabetes compared to patients with good control. Frequent visits with the diabetes team improved HbA1C in our patients. 84% of patients in the good control group were seen by the diabetes team more frequently (at least every 3-6 months) compared to patients with higher HbA1c. The group with very poor glycemic control patients were more obese with Type 2 Diabetes and were less frequently coming for the scheduled appointments. More efforts must be made to design the protocols to overcome patient-related obstacles to improve diabetes control. Presentation: Thursday, June 15, 2023

Evaluation of Ophthalmoscopic Findings in Type 2 Diabetic Patients at a Tertiary Level Hospital

Diabetes mellitus (DM) is a global burden of disease. Long standing disease causes macrovascular and microvascular complications. Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and it remains a leading cause of blindness and visual impairment in the working-age population in both developing and developed world. Patients with diabetes often developed other ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and maculopathy. The study was carried out to evaluate the ophthalmoscopic changes in type-2 diabetes mellitus (T2DM) patients. This hospital based cross-sectional study was conducted in the department of Medicine, Shaheed Suhrawardy Medical College Hospital, Dhaka, from September 2018 to March 2019. Patients with T2DM attended at the department of medicine within the mentioned period were enrolled after fulfilling the selection criteria. Patients with dense, lentalopacities and other media opacities which prevented posterior segment examination were excluded from the study. Sample was selected by purposive sampling method. Detail demographic data were collected from the patients and recorded in structured case report form. Clinical examination and relevant investigations were done meticulously. Then pupil was dilated and ophthalmoscopic examination was done. Among the 50 diabetic patient’s male was 54%, middle aged (49-60 years) was 54% and sedentary workers was 84.0% with a positive family history of DM was 56.0%. Most of the patients were known hypertensive (64.0%) at the time of enrolment and almost all (94.0%) were taking antihypertensive drug. Retinal photography was performed in all patients and retinopathy was detected in 29 (58%) patients. Fundoscopic findings revealed that cotton-wool spots detected in 32.0% patients, Flame-shaped hemorrhages was 16.0% patients; Arteriovenous nipping was is 18.0% patients and opticdisc swelling (Papilloedema) in 26.0% patients. In this study 21 (42%) patients had normal fundoscopic findings. Retinopathy was more common in smoker (70.0%). Uncontrolled and long-standing diabetes and high HbA1c was major risk factors for the development of retinopathy (P &lt; 0.001). In conclusion, diabetic retinopathy is more common in male smoker with uncontrolled and long-standing diabetic patients. T2DM is a major cause of blindness as it affects microvasculature of retina. Bangladesh Med J. 2021 Sept; 51(1): 33-40

Metabolic Control and Its Correlates among Diabetic Patients in Aljouf Region, Saudi Arabia: A Cross-Sectional study

Background: Throughout the world, diabetes, and its consequences, constitutes a serious problem for public health. Metabolic control can reduce the risk of diabetes complications. The present study aims to determine diabetic metabolic control among diabetic patients in the Aljouf region, Saudi Arabia, and its association with family function, depression, and other sociodemographic and clinical data. Methods: A cross-sectional study was conducted among 279 diabetic patients attending the diabetic center in a specialized hospital in Aljouf Region, Saudi Arabia. A structured anonymous questionnaire was distributed to the targeted population during a direct interview. Results: The present study showed that HbA1c was 7% among 86% of the participants. Regarding lipid profile, abnormal HDL, LDL, triglycerides, and cholesterol levels were detected among 39.4%, 41.2%, 68.5%, and 50.2% of the participants, respectively. Severe depression and severe family dysfunction were detected among 22% and 6% of the participants, respectively. Increasing age was associated with higher LDL levels and diabetes duration was associated with higher HbA1c levels in patients with diabetes. Conclusion: The study concluded that family function and depression do not directly affect diabetic patients’ diabetes metabolic control and the study showed a high prevalence of uncontrolled HbA1c levels and dyslipidemia among the study participants. Further investigation into the variables underlying the control of diabetes is required to further enhance patient outcomes because many people are still failing to meet the metabolic control objectives. Keywords: Metabolic control; Depression; Family function; Diabetes mellitus; Saudi Arabia