Journal of Diabetes Research Reviews & Reports
Journal of Diabetes Research Reviews & Reports is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC), which publishes articles in the form of written, Video and Power Point Presentations from the arena of Diabetes Research Reviews & Reports. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of Research, Review, Case Reports, Analysis, Magazines, Editorials, Opinion, Communications, Mini-Review, Short Communications, Picturized, Book Review, Video Type and Power Point Presentations (PPTS). Articles can be submitted through online from: https://www.onlinescientificresearch.com/submit-online or can send through an E-mail with attachment to: diabetessciences@onlinescientificresearch.info
Positive Pregnancy Outcome following First Trimester Dulaglutide Exposure in a Women with Type 2 Diabetes and PCOS: A CaseReport
Background: Insulin has been the gold standard treatment for T2DM during pregnancy. However, emerging studies indicate that GLP-1 agonists have shown significant improvement in insulin resistance. Despite promising results, research conducted on pregnant animal models has shown fetal developmental defects associated with GLP-1 agonists. There is scarcity of research conducted on the use of GLP-1 agonists in human pregnancies. This case report describes the exposure to dulaglutide (GLP-1 agonist) during first trimester of pregnancy. Case: A 41-year-old female with type 2 diabetes mellitus and polycystic ovarian syndrome had been taking dulaglutide until 15 weeks of gestation. She delivered a healthy baby boy via cesarean delivery at 36 weeks’ gestation. Conclusion: In our case, exposure to dulaglutide during the first trimester showed no significant developmental effects on the baby. However, current research is insufficient to categorize GLP-1 agonists as safe during pregnancy
Copyright (c) 2024 Journal of Diabetes Research Reviews & Reports
Risk Factors and Stroke Symptoms Knowledge among Diabetes Mellitus, Hypertension and Heart Disease Patients: Literature Review
Stroke is the leading cause of disability and the second leading cause of death in the world and the biggest cause of death in Indonesia. Knowledge of stroke risk factors and symptoms can improve stroke prevention measures so as to reduce the risk of disability and death. This study aims to analyze the description of knowledge about risk factors and symptoms of stroke in patients with diabetes mellitus, hypertension, and heart disease. The research was carried out using google scholar search engine and electronic databases, such as Pubmed and Science Direct. The English keywords used are knowledge AND “risk, factors” AND “stroke symptoms”. Meanwhile, the Indonesian keywords are: pengetahuan DAN “faktor risiko” DAN “gejala stroke”. The inclusion criteria of the articles collected were articles in English and Indonesian, full text, the Cross-Sectional Study method or descriptive, and publication year between 2012-2022. This research obtained 8 articles which would then be analyzed. All articles analyzed were overseas research reports (two african continent countries and three asia continent countries) and in English. It is shown that knowledge about the risk factors and symptoms of stroke in patients with diabetes mellitus, hypertension, and heart disease is still lacking. There are 2 studies that report 56 and 77% of respondents do not know the risk factors for stroke. Knowledge of stroke symptoms in the form of decreased consciousness was found to be very poor (7.6% of respondents).
A Systematic Review on Prevention of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus
Background: Women with prior gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes mellitus (T2DM) in later life. Lifestyle interventions aimed at postpartum weight loss to reduce T2DM risk have been reported but poor compliance remains a barrier. Objectives: To assess what preventative measures reduce type 2 diabetes prevalence among women with previous gestational diabetes. Method: Search Strategy: Electronic databases CINAHL Web of Science PubMed and EMBASE were searched via the e-library gateway of the University of Nottingham using key words combined in a formal search strategy. Selection Criteria: Randomized Controlled Trials and Cluster Randomized Controlled Trials examining what preventative measures reduce type 2 diabetes prevalence among women with previous gestational diabetes were selected. Results: 14 studies were identified for inclusion in the review after a stringent criterion and their data was extracted using JBI data extraction tool. Three themes were identified across the 14 studies mainly: weight management healthy eating and medication and physical activities. Most interventions had positive outcomes however a few had no significant impact in the prevention of T2DM. Conclusion: The likelihood of developing diabetes is higher for women with a history of GDM, increases with a high BMI, high fasting glucose, impaired glucose tolerance, and elevated fasting glucose. This risk can be greatly reduced by making lifestyle adjustments or taking medication. The main risk factors that increase the risk of T2DM after GDM identified in this review were obesity, poor quality of diet and a sedentary lifestyle.
Eleanora Baffour-Agyei Eleanora Baffour-Agyei
Pre-Existing Knowledge and Self-Reported Barriers to uptake EyeCare among Type-1 Diabetic Patients attending a City DiabeticHospital at Southern Bangladesh
Purpose: To find out the knowledge about diabetic complication of eye & the barriers to uptake of diabetic eye care among Type-1 diabetic patients. Method: This is a hospital based observational case series of 100 cases of Type-1 Diabetes Mellitus (DM1). Demographic data, knowledge about diabetic complication of eye, self reported barriers to uptake diabetes eye health service were collected by face-to-face interview. Interview was done on a formulated questionnaire including pre-existing knowledge about diabetes related ocular problems and factors act as a barrier to receive eye care. All DM1 patients attending in a city diabetic hospital during one year (from October 2017 to September 2018) period were included. Written consent was taken. Patients refuse to give consent & aged more than 30 years were excluded. Results: The mean age of participants was (17.09 ± 3.92) years with range 6 to 23 years and 57% of them were female. About 59 % subjects were students. Around 50% of the respondent had knowledge about the adverse effect of diabetes on eyes, among them only 6% had knowledge about retina problems and 3% knew that blindness may happen. Only 32% of study population gave answer about the reason behind not seeking diabetic eye care and the most common (12%) answer was “not feeling necessity of eye care”. Conclusion: DM1 patients are more prone to systemic and ocular morbidity. The main reasons for not getting eye care services was lacks of awareness.Increase awareness building program can bring them to the eye health service which will very important to reduce diabetic ocular morbidity of young people who have long life in front of them.
Primary care is the backbone of any effective healthcare system. It is vital for India, a country with a large and diverse population and various health-related issues. Primary care in India serves many purposes, such as ensuring access and affordability of healthcare, preventing and managing diseases, and promoting public health.This article explores the importance of primary care in India, its challenges, and the possible ways to improve it.
Comparative Study of the Different Therapeutic Strategies of Stroke Patients in the Spanish Health System: About a Bibliographic Narrative Review
Stroke is a focal or general neurological pathology of sudden onset. This condition is usually of vascular origin. It is considered a medical emergency, which requires rapid action and its evolution and cure is time-dependent, which requires immediate decisions based on evidence. The most widely used treatment is reperfusion by fibrinolysis. Objective: to compare the therapeutic strategies in the management of the stroke care plans of the different autonomies of the Spanish territory. Methodology: This work is a bibliographic review. The search for the necessary information was carried out in the months of December 2022 and January 2023. The databases used were: Pubmed, Academic Google, Scielo, Scopus and Cochrane library. Results: 14 articles were chosen after a review of 205 articles from databases and after applying the inclusion and exclusion criteria. Conclusions: Despite the fact that the evidence supports the use of tenecteplase, only two Autonomous Communities include tenecteplase as a reperfusion treatment in their stroke care plans. Fibrinolytic treatment is possible up to 4.5 hours from the onset of symptoms and up to 6 hours, evaluating the patient individually. There is no evidence of age limitation. Both drugs, Alteplase and Tenecteplase, have similar characteristics, which is why studies with a larger sample scope are necessary. Nursing is a fundamental part of both clinical decision-making and early symptom recognition, and nursing care is included in all stroke care plans.
Copyright (c) 2025 Journal of Diabetes Research Reviews & Reports
Diabetic Ketoacidosis Complications in Pediatrics: A Narrative Review
Introduction: Around the world type I diabetes mellitus (T1D) is becoming more prevalent among pediatrics. The most common cause of mortality in children is diabetic ketoacidosis (DKA). It affects up to one-third of people with T1D. The most common complication of pediatric diabetic ketoacidosis is cerebral edema; however, it is not the only adverse effect of DKA that necessitates continuous observation. Methods: This study was conducted as a narrative review obtaining all applicable data on complications of diabetic ketoacidosis (DKA) in the pediatrics age group. Conclusion: This review of literature discusses the effects of DKA on different body systems including neurological, coagulopathy, pulmonary,gastrointestinal, infectious, and renal effects. Aim: To educate families and healthcare professionals about the significance of strict glycemic control and early identification of DKA in order to prevent the onset of those consequences, we examine each of those multisystem impacts in children.
Frequency and Awareness of Diabetes Mellitus in Participants of Primary Healthcare in the Capital of Turkey
Introduction: Awareness-based approaches are proven to reduce disease-related complications, depressive symptoms, anxiety during the disease process,economic losses due to disease, and improve quality of life in diabetes patients. This study aims to present the frequency and awareness of diabetes mellitus in patients who applied to a primary health care institution in the capital city of Turkey. Materials and Methods: This cross-sectional study was conducted in the capital city of Turkey. In statistical analysis; descriptive statistics, Mann Whitney U, Kruskal Wallis and logistic regression analysis methods were employed for the statistical analysis part of this research. Results: 24.4% of the participants had diabetes. Regarding diabetes awareness level, statistically significant differences were found in age, education level,marital status, income, attention to healthy nutrition, BMI and presence of chronic disease. Employment variable has been identified as the factor that affected the diabetes awareness score the most in multiple logistic regression analysis. When only the participants with diabetes were examined in the multiple logistic regression analysis, it was found that the factor affecting the diabetes awareness score the most was diabetes type. Other influencing factors were determined as diet for diabetes and receiving diabetes education, respectively. Conclusion: Despite of many research that were carried out under the roof of diabetes awareness in the world and in Turkey, the desired level of knowledge and awareness is yet to be reached. Further research needs to be conducted in order to reach this goal.
Brief History of Diabetes Mellitus - From Sushruta to Banting –
This text makes a brief historical tour of the knowledge of diabetes mellitus, showing the sequence of ancient discoveries and the effort of several generations of physicians and researchers to better understand a pathology than remains a challenge for contemporary medicine. It also highlights the extraordinary episode of the discovery of insulin by Banting and best, in which some serendipitous facts were exploited by the observant and brilliant mind of Frederich Banting.
Therapy Simplification with Dulaglutide in Elderly Patients: A Real World Study
Prevalence of type 2 diabetes represent an epidemic problem especially for aging of population. Median age of people affected is rising and Internation Diabetes federation suggest that 1 patients of 5 has more than 65 years. Same situation affected also Italy where in 2020 about 20% of T2D patients were older than 70 years old. This class of patients present often-severe comorbidity as cardiovascular and kidney impairment and are undergoing complex therapies with multiple daily therapy intakes and difficulties in adherence to prescribed therapy. New developed drug, as GLP1-receptor agonist, like Dulaglutide (DU), may be useful in elderly for drug’s ancillary effects and for demonstrated safety on hypoglycemic events. Nevertheless, majority of knowledge, derived from RCT-study, enrolled patients aged 20-65 years and data in elderly patients are limited. Data from real world experience could be useful to understand safety and efficacy of this drug. We retrospectively analyzed data from 751 T2D patients to evaluate DU after 6, 12 and 18 months, comparing people older and younger than 70 years. The introduction of DU, with a relevant number of insulin and sulphanilureas suspensions,statistically reduced HbA1C and body weight after 6 months while glomerular filtration rate (GFR) remained stable and these results lasted over time.About 23% patients dropped-out (8% for gastrointestinal disturbances). No significative differences in tolerability and efficacy, between the two groups were found. DU is a safe, efficacious and easy to use option even for elderly T2D patients.
Margherita Occhipinti Margherita Occhipinti
Copyright (c) 2023 Journal of Diabetes Research Reviews & Reports
Contemporary Evaluation of Incidence of Pre-diabetes and High Risk for Type 2 Diabetes Mellitus among Adults of Gujarat: ACross-Sectional Study
Background: In addition to the surge in the incidence and prevalence of type 2 diabetes mellitus (T2DM), currently more of young and middle age adults are found at risk for T2DM in developing countries like India. Aim: With this fact in the background, the current study was conducted with an aim to understand the incidence and prevalence of pre-diabetes among adults of Gujarat. Methods: The survey study was conducted in Sourashtra part of Gujarat (N=230 adults; 32.9±9.6 years), India. Based on Capillary fasting blood glucose (CFBG) subjects were grouped into non-diabetes (n=108), pre-diabetes (n=92, 40%) and T2DM (n=30). Demographic data sheet (DDS) was used to assess the origin, socioeconomic status and habit of the respondents and Indian Diabetes Risk Score (IDRS) screening form to detect the risk for T2DM. Results: Close to half of the screened subjects were newly diagnosed with pre-diabetes, among which one-ninth of them were (n=9; 9.8%) identified with high risk for T2DM. Statistical assessment manifested female subjects at higher risk based on low physical activity and higher waist circumference as compared to male. Substantially, risk identification with IDRS was in line with the expedited results of CFBG among pre-diabetes. Conclusion: Incidence of pre-diabetes among adults of Gujarat is found escalating. Matched with the data obtained from DDS, the current study identified diet, physical inactivity and higher waist circumference as most contributing factors increasing incidence of high risk for T2DM among females and more or less the same factors in male as well.
Copyright (c) 2022 Journal of Diabetes Research Reviews & Reports
Geographical Determinants of the Prevalence of Gestational Diabetes in North and South Kivu in the Democratic Republic of Congo
Objectives: To explore the geographic determinants of gestational diabetes in eastern DRC and to seek confounding factors. Methods: Cross-sectional descriptive study with a multicenter analytical aim conducted in the hot and cold season from April 2019 to February 2021. Included were 392 pregnant women at 24-28 weeks of amenorrhea. Blood glucose, cortisol, SO2, anthropometric measurements, 30 previous day’s temperature, altitude and atmospheric pressure (atm) were examined. The glycaemia ≥92mg/dL was pathological, in which case cortisolaemia was measured after matching with normal glycaemia. Data were analyzed using SPSS version 23 by calculating median, proportion, ANOVA, Pearson's Chi2 or Fisher's exact test, Wilcoxon -Mann–Whitney test. Results: The proportion of 23.8%, 37.4%, 13.8% and 25.0% of 392 pregnant women lived respectively at the altitude of 1400 m, 1500m, 1700m and 2419m. Pathological glycaemia was twice higher at < 1700 m = atm > 82% [32.9% (n = 295)] Vs ≥ 1700 m [15.0% (n = 295)] [OR 2.2 95% CI (1.5- 3.2)] (p<0.001)] and at SO2 > 95% [30.8% (n= 331)] Vs SO2 ≤ 95% [15.3% (n= 144)] [OR 2.0 95% CI (1.3 - 3.1)] (p < 0.001). Cases with pathological glycaemia had elevated cortisol [281.1 nmol/L (87.6)] (n=118) Vs normal glycaemia [261.1 nmol/L (71.1)] (n= 156)] (p= 0.024). Conclusion: The prevalence of pathological glycaemia was higher at <1700 m altitude corresponding to the atm > 82% and when the SO2 was >95%. After adjustment, blood glucose was no longer correlated with temperature.
Rogatien Mwandjalulu Kisindja Rogatien Mwandjalulu Kisindja
Pierrot Lundimu Tugirimana Pierrot Lundimu Tugirimana
Mitangala Ndeba Prudence Mitangala Ndeba Prudence
Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia (ARVC/D) in Adults: Case Report with Review of the Literature
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a cardiomyopathy of genetic origin, caused by abnormalities of desmosomes, characterized on the physiopathological level by a fibro-adipose infiltration replacing the myocardium of the right ventricle and the clinical level by an electrical instability leading to ventricular arrhythmias. ARVC/D peaks in frequency between the ages of 30 and 50. Diagnostic criteria have been established to retain the diagnosis of ARVC/D. Imaging and especially magnetic resonance imaging (MRI) play an important role in this diagnosis. We report the observation of a 48-year-old man, a former smoker, with a family history of the sudden death of a sister during a bicycle race, and who has been complaining for several years of palpitations. Clinical presentation, electrical signs, cardiac ultrasound and imaging findings lead to the diagnosis of ARVC/D. According to this observation, the authors describe the authors review the literature of this rare entity and discuss the different therapeutic approaches.
Arrhythmogenic Dysplasia of the Right Ventricle/ Genetics
Obesity in Nigerian Adults and the Associated Cause and Impact on the Population
Background: Obesity has been on the rise in developed and developing countries such as Nigeria. Data from the WHO demonstrated the prevalence of obesity increased by 15% between 2002 and 2016 in Nigeria. Here, we examine the rate of obesity in Nigerian adults and the associated cause and impact on the population. Methods: An electronic search was conducted from November 2020 to October 2022 across PubMed, PMC, Science Direct and NU search. A formal search strategy was used to combine the keywords. The retrieved studies were filtered through inclusion and exclusion criteria. Fifteen studies were included in this systematic review. The data of the included studies were extracted using the Critical Appraisal Skills Programme (CASP) checklist and results analysed with Revman meta-analysis. Results: Three key themes were identified across the 15 studies: socio-economic status, sedentary lifestyle and diet-associated obesity. Obesity was found in an average of 22% (n=1042) and 34% (n=2361) females and males, respectively. As such, the rate of obesity was overall significantly higher in Nigerian females than males. Conclusion: The prevalence of obesity in Nigeria was high with Nigerian adult females more affected. The high rate of obesity was associated with non-communicable diseases (NCDs) such as gestational diabetes, diabetes mellitus, stroke, cardiovascular disease and cancer. Support from health care professionals, nursing practitioners and governmental interventions are required to reduce the burden on and the deterioration in Nigerian adults’ health and wellbeing.
Evaluation of Serum Uric Acid Levels and Microalbuminuria in Newly Diagnosed Type 2 Diabetics with and without Hypertension
Objective: This study aims to evaluate the levels of Serum uric acid (SUA) and microalbuminuria in Healthy, Newly Diagnosed (N.D.) type 2 Diabetics and in N.D. type 2 Diabetics with hypertension. Method: Cross sectional study involving a total of 343 Individuals of Bengaluru, India from January 2018 to November 2019 were considered for the study. Venous blood and 24-hour urine sample were collected from 100 healthy, 170 N.D. type 2 Diabetics, 73 N.D. type 2 Diabetics with hypertension and analyzed for Glycated hemoglobin (HbA1c) SUA and microalbuminuria along with their demographic details. Results: There was significant increase in SUA levels and microalbuminuria in N.D. Type 2 Diabetics with hypertension compared to healthy and N.D. type 2 Diabetics. Conclusion: Hypertensive Diabetics should be monitored periodically for SUA and microalbuminuria to prevent them from developing renal complication.
Impact of COVID-19 Confinement on the Lifestyle and Metabolic Control of Adult Patients with Type 2 Diabetes Mellitus in the City of Buenos Aires (Argentina)
In 2020 in our country, a new pandemic with high social impact is added to the growing incidence of type 2 diabetes mellitus (DM2): COVID-19. In this context, it is necessary to obtain evidence as to whether the isolation measures to stop the spread of the virus brought about changes in the lifestyle and in the clinical-metabolic parameters of patients with DM2 treated at the Italian Hospital of the Autonomous City of Buenos Aires. Changes in lifestyle were evaluated using a questionnaire designed ad hoc. The clinical-metabolic parameters were obtained from the clinical history of each patient.Descriptive statistics were used for data analysis using IBM SPSS software. The sample consisted of 83 patients, with an average age of 64 ± 8 years and a prevalence of the male gender (69%). 52% perceived that the months of confinement did not affect their diet, indicating that they had continued with the same consumption of fruits, vegetables and snacks, fried or processed (53%, 54% and 45%, respectively). The majority (74%) mentioned doing less physical activity and 65% had presented at least one negative emotion. Body Mass Index (BMI), body weight, and HbA1c were significantly (p<0.05) higher after isolation. In the population studied, ASPO was associated with reduced physical activity, negative emotions, and increased BMI, body weight, and HbA1c.
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.
Evaluation of Drug Related Problems in Patients with Type 2 Diabetes
Objective: Diabetic patients usually have co-morbidities requiring the use of multiple medications, making them more vulnerable in experiencing drug related problems (DRPs) that may affect their quality of life (QOL). The objective of this study was to asses DRP in type 2 diabetes (T2D) patients and factors associated with its occurrence and the DRPs that affect QoL. Methods: A cross-sectional study was conducted among T2D patients who were attending a tertiary care teaching hospital, Lebanon. The identification and assessment of DRPs were based on the Pharmaceutical Care Network Europe tool version 8.03. The QoL was assessed using Health Related Quality of Life Brief Clinical Inventory. Results: The total number of DRP was 313 with a mean of 2.05 ± 1.03 per patient. The most common DRPs encountered were adverse drug event (31.3%), untreated symptoms or indication ( 10.54%), effect of drug treatment not optimal (7.34%) and high drug dose (7.34%). Logistic regression showed that polypharmacy and several comorbidities such as stroke, dyslipidemia, heart failure, coronary artery disease, renal and liver impairment were common factors significantly associated with different types of DRPs (p<0.005). The risk of having problems” No effect of drug treatment”,” Effect of drug treatment not optimal” and “Adverse drug event (possibly) occurring” was significantly increased in patients with abnormal HbA1c. The use of sulfonylurea increases the risk of ” Inappropriate duplication of therapeutic group” (p= 0.047). Following a low sugar diet showed to decrease the probability of having problem” Patient uses/takes more drug than prescribed” by 99.99%. On the other hand, insulin administration showed to increase 7.63 times this probability (p=0.006). The average HRQoL was 40 ± 9.900. Linear regression showed that problems “Untreated indication and “Patient uses unnecessary drug” were associated with poor QoL score. Having a medical insurance was found to be associated with better HRQoL scores. Conclusion: Early identification of DRPs and factors associated with them are essential to pre- vent and resolve them in diabetic patients by engaging clinical pharmacist, which may ultimately improve patient’s QoL.
3D Printing Dressing in Treatment of Diabetic Ulcer: A Case-Series
Diabetic foot syndrome is defined as infection, ulceration, or destruction of deep tissues of the foot (including bones) in a patient with diabetes mellitus.Complex and multifactorial management of diabetic foot ulcer is necessary to reduce costs and ensure faster healing and avoid limb amputation. In this, dressings play a key role in stimulating tissue repair. In the case series we present we have exper-imented with the use of 3D printing resorbable biopolymers gauze in diabetic vascular ulcers. In both cases the lesions healed with a period of around 3 months with signs of improvement in the bottom of the lesion as early as the fifteenth day.
Vito Michele Cassano Vito Michele Cassano
Use of Glargine u 300 in Insulin Nieve Patients…….. Use of basal Insulin in Young Newly Detected T2DM in OPD during Covid19 Pandemic
The New Onset Diabetes was very common finding in young obese persons who presented with very high sugars and weight loss as a prominent symptoms. Due to Lockdown and the FEAR of COVID 19 infection, everyone was afraid to go even near to any hospital. Similarly these persons with new severe Hyperglycemia were not willing for Hospitalisation due to fear of Covid infection.
Diabetic Kidney Disease: State of the Art
Diabetic kidney disease is one of the microvascular complications with the greatest impact on morbidity and mortality in patients with diabetes. Previously thought to be a linear series of events consisting of ultrafiltration, glomerular hypertension, albuminuria, and successive decreases in GFR, it is now known to be affected by multiple metabolic and hemodynamic pathophysiological mechanisms, leading to cell signaling pathways, oxidative stress,dysregulated autophagy, triggering structural damage and functional alterations leading to disease. There are also recognized risk factors for the disease that trigger pathophysiological mechanisms that contribute to its development, such as obesity, smoking, poor metabolic control, arterial hypertension,ethnicity, among others. Although current therapies have not completely halted the development of the disease, current efforts are focused on developing new therapies that can positively influence its onset and progression, with both SGLTi and AR-GLP1 playing a leading role, improving cardiovascular and renal outcomes, independently of their effect on the control of hyperglycemia, which is why they are currently a fundamental pillar of management. Finerenone, a mineralocorticoid receptor antagonist, is another current therapy that has been shown to have an impact on cardiovascular and renal outcomes, playing a complementary role to ACEI and ARB II in the management of albuminuria.
Christian Perez Calvo Christian Perez Calvo
Julio Contreras Pasimino Julio Contreras Pasimino
José María Mejía Barrera José María Mejía Barrera
Carlos José Brito Jacome Carlos José Brito Jacome
Felipe Herrera Lozano Felipe Herrera Lozano
Nutritional and Anti-Diabetic Properties of Cookies Supplemented with Processed Phyllantus Amarus Leaf
This study described the α-Glucosidase, α-amylase, antioxidant activity, and glycemic index of wheat - Phyllantus amarus cookies, using standard methods. It was also observed that these medicinal plants have the ability to inhibit α–amylase, α-glucosidase and reducing effect on the radical DPPH and glycemic index of the formulated cookies. The microbial count on Phyllantus amarus cookies showed that only total viable count between (2-5) 103 cfu/g shows re-sponse against the four samples tested, while Staphylococcus aureus (cfu/g), Coliform count (cfu/g), Fungi count (sfu/g) showed no response which is an ev-idence that these samples may be good for consumption. Physical characteris-tics; thickness, diameter, weight, spread ratio and hardness were also observed which ranged from 12.68mm- 14.37mm, 2.76mm - 2.90mm, 4.18g - 6.44g, 0.17- 0.21 and 8.13mm - 11.57mm respectively. The moisture, protein, ash, fat, fibre, carbohydrate contents of the control cookies (100% Wheat flour) were 5.08%, 14.60%, 1.63%, 20.75%, 1.78%, 57.95% respectively while that of wheat-Phyllantus amarus cookies ranged from 4.14 %- 4.83 %, 13.95 % - 15.92 %, 1.22 % - 2.15 %, 19.83 % - 21.40 %, 2.70 % - 3.38 %, 56.64 % - 60.38 % respectively.
Physical Characteristics of WheatPhyllantus Cookies
Empowering Lifestyle Changes in Preventing and Managing Type 2 Diabetes
Type 2 Diabetes (T2D) is a significant public health concern globally, with lifestyle factors such as poor diet, physical inactivity, and obesity playing pivotal roles in its onset and progression. This article explores the importance of empowering lifestyle changes to prevent and manage T2D. It examines the impact of dietary modifications, regular physical activity, weight management, and smoking cessation on reducing diabetes risk and improving metabolic health.Behavioral and psychological interventions, including motivational strategies and support systems, are discussed in promoting long-term adherence to healthy habits. Case studies from community-based programs and clinical interventions highlight successful outcomes of lifestyle modification efforts in preventing and managing T2D. The article concludes by addressing future directions in diabetes prevention, emphasizing the potential of further integrating technology and personalized approaches to enhance intervention effectiveness. With a growing focus on prevention and early intervention, lifestyle modifications are critical in reducing the global burden of T2D and improving health outcomes for at-risk populations.
Chronic Kidney Disease in Patients with Diabetes: Diabetic vs.Non-Diabetic Kidney Etiologies
Diabetes mellitus is a growing burden on global healthcare. Although the definition of Diabetic Kidney Disease (DKD) is that the kidney disease due to type 1 or 2 diabetes, the clinical diagnosis of DKD remains controversial. The diagnosis of DKD is highly subjective, depending on the doctor’s judgment and experience. It is necessary to distinguish the non-diabetic kidney disease from DKD at an early time, however, it is also seems difficult and inefficient.Up to date, there is lack of the diagnostic flow diagram for the disease. In this mini-review, we for the first time focused to create a diagnostic workflow for the disease.
Electrolyte Variations in Diabetic Nephropathy
Objective: The primary objective of the present study was to evaluate the serum electrolyte levels in diabetic nephropathy compared with age matched healthy control. Method: Cross sectional study involving 240 individuals in the populations of Bengaluru, India from the period of January 2019 to December 2019 was considered for the study. Venous blood was collected from 240 individuals comprising 120 Diabetics with nephropathy and 120 healthy individuals and analyzed for Glycosylated Hemoglobin(HbA1c), serum sodium, potassium, chloride, calcium, magnesium and phosphorous along with their demographic details. Results: Age, gender had a statistical significance with diabetic nephropathy, among electrolytes, calcium, potassium and chloride levels were significantly elevated while sodium, magnesium and phosphorous displayed significant decrease in Diabetics with nephropathy compared to healthy control population. Conclusion: These variations in electrolyte levels can be a signal of progression of Type 2 Diabetes into Diabetic Nephropathy. Hence frequent monitoring of these electrolytes helps in early detection of diabetic complications thus preventing it from progressing further.
A 54-year-old man with type 2 diabetes mellitus presented with limitation of movement, flexion deformity and stiff skin of both hands. The diagnosis was suspected clinically. Both wrists MRI were requested, however only the right wrist MRI was obtained for financial conditions.
Diabetic Retinopathy Trends in a Digital Screening Program of Eight and Half Years
Objectives: To share the trending of Diabetic Retinopathy (DR) over eight and half years period digital screening program of DR in Bangladesh at a tertiary eye hospital. Methods: This study analyze 8 and 1/2 years (102 months, from July 2010 to December 2018) findings of a digital screening and subsequent grading programs of DR in a tertiary eye care centre. A total 45289 eyes of 22645 diabetic person underwent retinal photography.7818 (17.26%) retinal Photographs were excluded because of unassessable for grading remaining 37471 retinal photographs were analyzed.Screening was performed by non-mydriatic digital fundus camera. Optometrist & Ophthalmologist review of all photographs were done at three level of grading system. Evaluation of the percentage distribution of degree of retinopathy was done. Data analysis was done by SPSS software version 16.0. Results: A total of 22645 patients (64.12 % male,35.88 % female) with mean age of 55.58 ± 9.88 (±SD) years were under went DR screening during a 8.5 years period. Features of DR was found in 18958 of 37471 (50.59%) retinal photographs. Non-proliferative diabetic retinopathy (NPDR) was documented in 14457 of 37471 photographs (38.59 %), while 4501 of 37471 photographs (12.00%) showed proliferative diabetic retinopathy (PDR). Diabetic Macular Edema (DME) was found in 10788 (28.79 %) of total 37471 assessable photograph and (56.90 %) of a total 18958 DR. Conclusion: DR is highly prevalent among Bangladeshi patients. In order to provide a sensitive, cost effective and easily accessible DR screening, digital imaging is a useful means.
Differences in Anthropometric Measurements and Serum Lipid Levels between Representative Samples of the United States and South Korean Populations: NHANES and KNHANES 2007 – 2008 and 2009 – 2010 Study
The objective of this study was to analyze the dynamics and differences of changes in obesity-defining parameters such as body mass index (BMI), waist circumference (WC), total cholesterol (TC), tricarboxylic acid (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in representative samples from the US and South Korea in analogous sampling frames comprising the years 2007 - 2008 and 2009 - 2010. Differences in anthropometric parameters and serum lipid levels between specific sampling frames were evaluated using a t-test for unpaired data. Age-dependent changes were analyzed using the GLM technique and the Bonferroni-Dunn post-hock test. Among all subjects, the obesity defined by BMI is cross-correlated with an increase in WC. However, in extremely obese women in the United States, there is a lack of a direct relationship between BMI and WC. There was also a clear correlation between the relative change in WC and serum lipid levels in subjects of different ethnic groups. This study showed that BMI and WC could be interchangeably used to assess the health risks associated with increased serum lipid levels in US and South Korean populations.
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Community Health Assessment findings on Diabetes among Adults in Nyeri County, Kenya, 2019
Background: The global prevalence of diabetes among adults was 8.5% in 2014. Kenya’s prevalence is at 3.3%, according to WHO. Nyeri County has an estimated prevalence of 7.2% which is significantly higher than the national prevalence. Methods: A cross- sectional study was conducted in Mukurweini Sub County, Nyeri. Systematic random sampling was used to recruit participants from a sampling frame of all adult community members. A sample of 190 households calculated at a confidence level of 95 and a 5% error margin. Every 7th household was picked and respondents were household heads. Data was collected using structured questionnaires, Key informant interviews and Focus group discussions. Knowledge levels, health seeking behavior, health care access, physical activity and nutrition were assessed. Data was analyzed and rated using the CDC CHANGE tool. Findings: Low education levels with 65% at primary and below hence low levels of knowledge on diabetes, poor uptake of physical activity as 51% never engaged in any and inappropriate dietary choices and meal timing. Low screening levels for diabetes with only 36% having ever been screened. There were no clear policies on community engagement in physical activity. Easy access to health facilities, friendly health care workers and availability of health services and medication were identified as the assets. Conclusion: Assessing the community’s knowledge, attitudes, behavior and resources provides information on how to improve diabetes prevention and treatment. It helps to inform future interventions.
Integrated Approach to Cardio-Vascular Risk in Insulin-Treated People with Diabetes based on the "Heart Project" and on Metabolic Complications Expected from Incorrect Injection Practice-Related Lipohypertrophy
Type 2 diabetes (T2DM) is known to be associated with increased cardiovascular (CV) morbidity and mortality. Over time, the CV Risk of patients with T2DM has been assessed according to various methods, often borrowed from different populations. Nevertheless, never have been evaluated changes in insulin absorption due to improper injection technique and responsible for further, well recognized CV-R factors as high glycemic variability, frequent hypoglycemia, and unsatisfactory glycemic control. Aim of the study was to intensify diabetes and its own comorbidities treatment, and in addition reduce the impact of injection technique of insulin to evaluate possible improvement in the CV-R score and NHYA score in 4499 insulin-treated T2DM subjects with (LH+) and without lipohypertrophy (LH-) due to improper injection habit. The educational training and the treatment intensification significantly reduced glycemic control, hypoglycemia rate and the mean amplitude of glycemic variability, especially in LH+ subjects, adding new knowledge to a global intervention addressed to reduce the devastating impact to the increased cardiovascular risk of diabetic people, inclusive of the risk due to LHs.