Prevalence of type 1 diabetes mellitus in Karnal district, Haryana state, IndiaDiabetology & Metabolic Syndrome - Tập 2 - Trang 1-3 - 2010
Sanjay Kalra, Bharti Kalra, Amit Sharma
Little work has been done on the prevalence of type 1 diabetes in north India. This paper reports the prevalence of type 1 diabetes in Karnal district of Haryana state, India. Prevalence of type 1 diabetes was assessed by a hospital-based registry and by analysis of data contributed by chemists and other physicians. The overall prevalence of type 1 diabetes in Karnal district is 10.20/100,000 population, with a higher prevalence in urban (26.6/100,000) as compared to rural areas (4.27/100,000). Karnal city, with a population of 222017, has a relatively high prevalence of type 1 diabetes (31.9/100,000). The prevalence in men is higher (11.56/100,000) than in women (8.6/100,000). In the 5 to 16 years age group, the prevalence is 22.22/100,000, while in the 0-5 years age group, prevalence is 3.82/100,000. This report highlights the urban-rural and male-female gradient in the prevalence of type 1 diabetes in Karnal, north India.
Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implicationsDiabetology & Metabolic Syndrome - Tập 13 Số 1 - 2021
Andrey dos Santos, Daniéla Oliveira Magro, Rosana Evangelista Poderoso, Mário José Abdalla Saad
Abstract
Background
Our understanding of the pathophysiology of the COVID-19 manifestations and evolution has improved over the past 10 months, but the reasons why evolution is more severe in obese and diabetic patients are not yet completely understood.
Main text
In the present review we discuss the different mechanisms that may contribute to explain the pathophysiology of COVID-19 including viral entrance, direct viral toxicity, endothelial dysfunction, thromboinflammation, dysregulation of the immune response, and the renin–angiotensin–aldosterone system.
Conclusions
We show that the viral infection activates an integrated stress response, including activations of serine kinases such as PKR and PERK, which induce IRS-1 serine phosphorylation and insulin resistance. In parallel, we correlate and show the synergy of the insulin resistance of COVID-19 with this hormonal resistance of obesity and diabetes, which increase the severity of the disease. Finally, we discuss the potential beneficial effects of drugs used to treat insulin resistance and diabetes in patients with COVID-19.
Association of tea and coffee consumption with the risk of all-cause and cause-specific mortality among individuals with metabolic syndrome: a prospective cohort studyDiabetology & Metabolic Syndrome - Tập 15 - Trang 1-11 - 2023
E Wu, Ying-Ying Bao, Guo-Fang Wei, Wei Wang, Hong-Quan Xu, Jia-Yin Chen, Ya-Nan Xu, Dan Han, Lin Tao, Jun-Tao Ni
The relationship between tea and coffee consumption and mortality among patients with metabolic syndrome (MetS) remains barely explored. Herein, this study aimed to examine the association between tea and coffee consumption and the likelihood of all-cause and cause-specific mortality in patients with MetS. A total of 118,872 participants with MetS at baseline from the UK Biobank cohort were included. Information on tea and coffee consumption was obtained during recruitment using a touchscreen questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were determined using Cox proportional hazards models. During a median follow-up of 13.87 years, 13,666 deaths were recorded, with 5913, 3362, and 994 deaths from cancer, cardiovascular diseases (CVD), and respiratory disease (RD), respectively. This research showed a significant inverse association between tea intake and the risk of all-cause and cancer mortality, the respective HRs (95% CI) for consuming tea 2 vs. 0 cup/day were 0.89 (0.84–0.95), and 0.91 (0.83–0.99), and tea intake ≥ 4 cups/day could reduce CVD mortality by 11% (HR 0.89; 95% CI 0.81–0.98). The U-shaped nonlinear association between coffee intake and all-cause/CVD mortality was examined (all p-nonlinear < 0.001). The HRs (95% CI) for coffee consumption 1 vs. 0 cup/day were 0.93 (0.89–0.98) and 0.89 (0.80–0.99), and for ≥ 4 vs. 0 cup/day were 1.05 (1.01–1.11) and 1.13 (1.03–1.25), respectively. Notably, the combined intake of tea and coffee presented a protective effect against all-cause mortality (HR < 1). The importance of daily tea and moderate coffee consumption in individuals with MetS to optimise health benefits are highlighted.
Mối liên hệ giữa chỉ số triglyceride-glucose và sự khởi phát rung tâm nhĩ ở bệnh nhân mắc bệnh gan nhiễm mỡ không do rượu Dịch bởi AI Diabetology & Metabolic Syndrome - Tập 15 - Trang 1-11 - 2023
Yao Zhang, Leigang Wang, Jiaxin Qi, Bing Yu, Jianqi Zhao, Lin Pang, Wenjing Zhang, Liang Bin
Bệnh gan nhiễm mỡ không do rượu (NAFLD) có liên quan đến rung tâm nhĩ (AF). Kháng insulin (IR) là nguyên nhân chính dẫn đến tỷ lệ mắc AF cao ở bệnh nhân NAFLD. Chỉ số triglyceride-glucose (TyG) là một chỉ số mới liên quan đến IR có vai trò trong việc xác định tỷ lệ mắc và mức độ nghiêm trọng của NAFLD. Tuy nhiên, vai trò của TyG trong việc xác định nguy cơ AF ở bệnh nhân NAFLD vẫn chưa được làm rõ. Một nghiên cứu hồi cứu đã được tiến hành trên 912 bệnh nhân được chẩn đoán mắc NAFLD qua siêu âm. Những bệnh nhân này được chia thành hai nhóm: (1) NAFLD+ AF và (2) NAFLD+ không AF. Phân tích hồi quy Least Absolute Shrinkage and Selection Operator (LASSO) được sử dụng để đánh giá mối tương quan giữa chỉ số TyG và nguy cơ cao mắc AF. Một đường cong đặc trưng hoạt động nhận diện (ROC) đã được xây dựng để đánh giá giá trị dự đoán của chỉ số TyG đối với AF. Các splines hình chóp bị hạn chế (RCS) được sử dụng để kiểm tra mối tương quan tuyến tính giữa TyG và nguy cơ AF. Tổng cộng có 204 bệnh nhân bị AF và 708 bệnh nhân không bị AF được đưa vào nghiên cứu này. Phân tích hồi quy logistic LASSO cho thấy rằng TyG là một yếu tố nguy cơ độc lập đối với AF (tỷ lệ odds [OR] = 4.84, khoảng tin cậy [CI] 95% 2.98–7.88, P < 0.001). RCS cho thấy nguy cơ AF tăng lên một cách tuyến tính với TyG trên toàn bộ khoảng TyG; nguy cơ này cũng rõ ràng khi bệnh nhân được phân tích theo giới tính (P cho phi tuyến tính > 0.05). Thêm vào đó, mối tương quan giữa TyG và AF là một phát hiện nhất quán trong phân tích nhóm con. Hơn nữa, phân tích đường cong ROC cho thấy mức độ TyG kết hợp với các yếu tố nguy cơ truyền thống đã cải thiện giá trị dự đoán cho rung tâm nhĩ. Chỉ số TyG hữu ích trong việc đánh giá nguy cơ rung tâm nhĩ ở bệnh nhân NAFLD. Những bệnh nhân mắc NAFLD và có chỉ số TyG cao có nguy cơ rung tâm nhĩ cao hơn. Do đó, chỉ số TyG nên được đánh giá khi quản lý bệnh nhân mắc NAFLD.
#bệnh gan nhiễm mỡ không do rượu #rung tâm nhĩ #kháng insulin #chỉ số triglyceride-glucose
Clinical outcome comparison of percutaneous coronary intervention and bypass surgery in diabetic patients with coronary artery disease: a meta-analysis of randomized controlled trials and observational studiesDiabetology & Metabolic Syndrome - - 2019
Chuannan Zhai, Hongliang Cong, Kai Hou, Yuecheng Hu, Jingxia Zhang, Zhang Yingyi
AbstractBackgroundThe optimal revascularization technique in diabetic patients with complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD), remains controversial. The current study aimed to compare adverse clinical endpoints of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM).
MethodsRelevant studies were found from MEDLINE, OVID, Science Direct, Embase and the Cochrane Central database from January 2010 to April 2019. Risk ratio (RR) with 95% confidence interval (CI) was used to express the pooled effect on discontinuous variables. Outcomes evaluated were all-cause mortality, major adverse cardiac/cerebrovascular events (MACCE), cardiac death, myocardial infarction, stroke, and repeat revascularization.
ResultsSixteen studies were included (18,224 patients). PCI was associated with the increase risk for MACCE (RR 1.59, 95% CI 1.38–1.85), cardiac death (RR 1.76, 95% CI 1.11–2.80), MI (RR 1.98, 95% CI 1.53–2.57), repeat revascularization (RR 2.61, 95% CI 2.08–3.29). The risks for all-cause mortality (RR 1.23, 95% CI 1.00–1.52) and stroke (RR 0.71, 95% CI 0.48–1.03) were similar between two strategies. Stratified analysis based on studies design and duration of follow-up showed largely similar findings with the overall analyses, except for a significant increased risk of all-cause mortality (RR 1.32, 95% CI 1.04–1.67) in long-term group, and CABG was associated with a higher stroke rate compared to PCI, which are results that were found in RCTs (RR 0.47, 95% CI 0.28–0.79) and mid-term groups (RR 0.39, 95% CI 0.23–0.66).
ConclusionsCABG was superior to PCI for diabetic patients with complex CAD (including left main CAD and/or MVD), but might be associated with a higher risk of stroke mid-term follow-up.
Number of Protocol registrationPROSPERO CRD 42019138505.
Effects of time-restricted eating with different eating windows on human metabolic health: pooled analysis of existing cohortsDiabetology & Metabolic Syndrome -
Zhongbiao Nie, Jiaming Xu, Yinchu Cheng, Zhihong Li, Ran Zhang, Wentao Zhang, Libo Zhao
Abstract
Background
Time-restricted eating (TRE), a feasible form of intermittent fasting, has been proven to benefit metabolic health in animal models and humans. To our knowledge, specific guidance on the appropriate period for eating during TRE has not yet been promoted. Therefore, to compare and assess the relative effectiveness estimates and rankings of TRE with different eating windows on human metabolic health, we conducted a systematic review and network meta-analysis (NMA).
Method
PubMed, EMBASE and the Cochrane Library were searched for randomized controlled trials that compared different eating windows on human metabolic health for adults. A Bayesian NMA was used to compare direct and indirect effects to determine the best different eating windows, and scientific evidence using GRADE.
Results
Twenty-seven RCTs comparing TRE with different eating windows on human metabolic health were reviewed, and all were included in the NMA. Compared with the normal diet group (non-TRE), the TRE group has certain benefits in reducing weight and fasting insulin. In terms of reducing fasting insulin, the 18:6 group (eating time = 6 h) was better than the 14:10 group (eating time = 10 h) and 16:8 group (eating time = 8 h) (P < 0.05); The < 6 group (eating time < 6 h) was better than the 14:10 group (P < 0.05). In terms of reducing fasting glucose, the < 6 group was better than the 14:10 group (P < 0.05). There were no statistical variations in weight, HDL, TG, and LDL across the different modes of TRE (P > 0.05).
Conclusions
Our research showed that no particular metabolic advantages of various eating windows were found. Therefore, our results suggested that different eating windows could promote similar benefits for metabolic parameters.
Effectiveness of gliclazide MR 60 mg in the management of type 2 diabetes: analyses from the EASYDia trialDiabetology & Metabolic Syndrome - Tập 10 - Trang 1-8 - 2018
Lawrence A. Leiter, Marina V. Shestakova, Ilhan Satman
Although the number of antihyperglycemic agents has expanded significantly, sulfonylureas (in particular gliclazide) remain an important option because of a variety of patient and health system factors. The large, real world, observational, and international EASYDia trial evaluated the effectiveness of gliclazide modified release (MR) 60 mg in individuals with type 2 diabetes with a broad range of diabetes history, body mass index (BMI) and background antihyperglycemic treatment. A total of 7170 participants from eight countries, age ≥ 35 years with HbA1c ≥ 7.5% and not treated with insulin, were prescribed 30–120 mg of gliclazide MR 60 mg once daily. HbA1c goals were individualized and dosing uptitrated, as required, over the 6-month long study. In this post hoc subanalysis, efficacy endpoints were analyzed according to stratified baseline HbA1c levels, weight and glucose-lowering regimens. Episodes of hypoglycemia requiring assistance were documented. At baseline, mean age was 58.9 years, HbA1c 8.8%, BMI 30.1 kg/m2, and diabetes duration 5.1 years. At study end, clinically significant HbA1c improvements (mean change − 1.78%) were noted across all baseline HbA1c strata (> 7.0 to ≤ 8.0%, > 8.0 to ≤ 9.0%, > 9.0 to ≤ 10.0%, and > 10.0%), BMI classifications (18.5 to < 25.0, 25.0 to < 30.0, and ≥ 30.0 kg/m2), and regardless of the original diabetes treatment regimen (P < 0.001 in all cases). In contrast to the subgroups with BMI 25.0–30.0 and ≥ 30.0 kg/m2 that registered weight losses of 0.9 and 2.2 kg, respectively (P < 0.001 vs. baseline weight); the BMI 18.5–24.9 kg/m2 subgroup gained a mean 0.5 kg (P < 0.02 vs. baseline weight). Severe hypoglycemic events were rare (0.06%). Progressive gliclazide MR 60 mg uptitration was well tolerated and lowered HbA1c across a broad range of HbA1c, BMI and background glucose-lowering therapy. Weight loss was noted when BMI was ≥ 25.0 kg/m2. Individuals with the highest baseline HbA1c and BMI experienced the greatest HbA1c and weight improvements. Trial registration ISRCTN Registry ISRCTN00943368 on 1st July 2011
Neck circumference as a risk factor of screen-detected diabetes mellitus: community-based studyDiabetology & Metabolic Syndrome - Tập 8 - Trang 1-8 - 2016
Mykolay Khalangot, Vitaliy Gurianov, Nadia Okhrimenko, Igor Luzanchuk, Victor Kravchenko
Whereas an increase of neck circumference (NC) had been recently identified as a new independent cardiovascular disease (CVD) and metabolic syndrome risk factor, similar assessments concerning screen-detected diabetes mellitus (SDDM) have not been made. Thyroid gland volume (ThV) can potentially affect NC however the significance of this influence concerning the risk of NC-related disease is unknown. We performed a ThV-adjusted evaluation of NC within a population-based investigation of SDDM and impaired glucose regulation (IGR) prevalence. This study contains fasting plasma glucose (FPG) and 75 g 2-h glucose tolerance test results (2-hPG) of 196 residents of Kyiv region, Ukraine, randomly selected from the rural population older than 44 y.o. who were not registered as diabetes mellitus patients. Standard anthropometric (height; weight; blood pressure; waist, hip circumferences), NC and ultrasonography ThV measurements were performed, hypotensive medication, CVD events and early life nutrition history considered. HbA1c was measured, if FPG/2-hPG reached 7.0/11.1 mmol/l respectively; HbA1c level 6.5 % was considered to be SDDM diagnostic; IGR if FPG/2-hPG reached 6.1/7.8 but less than 7.0/11.1 mmol/l respectively. Neck circumference among women with normal FPG/2-hPG was 35 (33–36) cm, IGR 36 (34.5–38) cm, SDDM HbA1c < 6.5 % 42 (40–43) cm, HbA1c > 6.5 % 42.5 (40–44) cm, p < 0.001, and for men from the same groups 38.5 (36.5–41.5) cm; 39 (37–42) cm; 42 (40–43) cm; 42.5 (40–44) cm, p = 0.063; medians (QI–QIII). Gender-adjusted logistic regression OR for SDDM HbA1c > 6.5 % vs. normal FPG/2-hPG category depending of NC as a continued variable, equaled to 1.60 (95 % CI 1.27–2.02) per cm. Additional adjusting by ThV, body mass or waist/hip index, high blood pressure, acute CVD events, or starvation history did not significantly influence this risk. Neck circumference is a new risk factor of SDDM that is independent from other indicators of adipose tissue distribution as well as from the ThV.
Hypoglycemia symptoms and awareness of hypoglycemia in type 1 diabetes mellitus: cross-cultural adaptation and validation of the Portuguese version of three questionnaires and evaluation of its risk factorsDiabetology & Metabolic Syndrome - Tập 12 Số 1 - 2020
Paula Stefenon, André Luís Marques da Silveira, Luana Seminotti Giaretta, Cristiane Bauermann Leitão, Andréa Carla Bauer
Abstract
Background
To adapt and validate the Clarke and Gold questionnaires and the Edinburgh Hypoglycemia Symptom Scale (EHSS) to Brazilian Portuguese and to determine the prevalence and risk factors associated with impaired awareness of hypoglycemia (IAH) in patients with type 1 diabetes mellitus (T1DM).
Methods
The process of translation, cultural adaptation, and validation of the questionnaires followed the recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)-Task Force for Translation and Cultural Adaptation. Patients with T1DM for a minimum of 12 months, aged 18 years or older, and with Brazilian nationality were selected to participate.
Results
A total of 123 patients were enrolled. The Clarke and Gold questionnaires as well as the EHSS exhibited adequate internal consistency, test–retest reliability, and convergent validity. The prevalence of IAH was 38.3% with the Clarke questionnaire and 25.2% with the Gold questionnaire. The prevalence increased with longer duration of diabetes, lower HbA1c, and lower eGFR.
Conclusions
The validation and cross-cultural adaptation of the proposed questionnaires to Brazilian Portuguese were adequate. In this sample of T1DM, the prevalence of IAH was high and associated with a longer duration of T1DM, lower HbA1C and lower eGFR.
