Search

Background. Diabetic kidney disease (DKD), one of the complications of diabetes in patients, leads to progressive loss of kidney function. Timely intervention is known to improve outcomes. Therefore, screening patients to identify high-risk populations is important. Machine learning classification techniques can be applied to patient datasets to identify high-risk patients by building a predictive model. Objective. This study aims to identify a suitable classification technique for predicting DKD by applying different classification techniques to a DKD dataset and comparing their performance using WEKA machine learning software. Methods. The performance of nine different classification techniques was analyzed on a DKD dataset with 410 instances and 18 attributes. Data preprocessing was carried out using the PartitionMembershipFilter. A 10-fold cross validation was performed on the dataset. The performance was assessed on the basis of the execution time, accuracy, correctly and incorrectly classified instances, kappa statistics (K), mean absolute error, root mean squared error, and true values of the confusion matrix. Results. With an accuracy of 93.6585% and a higher K value (0.8731), IBK and random tree classification techniques were found to be the best performing techniques. Moreover, they also exhibited the lowest root mean squared error rate (0.2496). There were 15 false-positive instances and 11 false-negative instances with these prediction models. Conclusions. This study identified IBK and random tree classification techniques as the best performing classifiers and accurate prediction methods for DKD.

Metabolomics is rapidly evolving omics technology in personalized medicine, it offers a new avenue for identification of multiple novel metabolic mediators of impaired glucose tolerance and dysglycemia. Liquid chromatography–mass spectrometry, gas chromatography–mass spectrometry and nuclear magnetic resonance spectroscopy are most commonly used analytical methods in the field of metabolomics. Recent evidences showed that metabolomic profiles are link to the incidence of diabetes. In this review, an overview of metabolomics studies in diabetes revealed several diabetes-associated metabolites including 1,5-anhydroglycitol, branch chain amino acids, glucose, α-hydroxybutyric acid, 3-hydroundecanoyl-carnitine and phosphatidylcholine that could be potential biomarkers associated with diabetes. These identified metabolites can be used to develop personalized prognostics and diagnostic, and help in diabetes management.

Background: A possible relationship between thyroid hormones and glucose metabolism in diabetes has already been established. Objectives: We aimed to evaluate the thyroid function markers and their relationship with inflammation, which is considered as a pathogenic condition of diabetes. Methods: This cross-sectional study included 276 patients with type 2 diabetes. Serum levels of thyroid (TSH, FT4, and FT3) and inflammatory markers (CRP, IL-6, and TNF-α) were measured. Results: The mean age of the subjects was 55.2 years and mean diabetes duration of 16.8 years. The inflammatory markers showed significant differences with the tertiles of TSH and thyroid hormones. TSH was significantly correlated with inflammatory markers, IL-6 (r = 0.13, P = 0.020) and TNF-α (r = 0.17, P = 0.003), while FT4 had a correlation only with TNF-α (r = 0.25, P = Conclusion: Abnormalities in the thyroid hormone metabolism are related to the increased inflammatory activity as well as insulin resistance, and are associated with the disorders of glucose metabolism.

Diabetic Retinopathy (DR) is considered as a most common microvascular complication of diabetes affected by one in three people who are suffered for diabetes. Several pathophysiological mechanisms and adhesion molecules may play an etiologic role in the development of diabetes and its complications. The adhesion molecules located on both leucocytes and endothelial cells and considered as important molecules which can assessed the endothelial function. The functions of adhesion molecules involved in the cellular margination, slow rolling and transmigration of leukocytes. Hyperglycemia and its immediate biochemical sequelae or the low-grade inflammation directly alter endothelial function or influence endothelial cell functioning indirectly by induce oxidative stress and activates leukocytosis and leukocyte-endothelial cell interactions by the increased expression of adhesion molecules, growth factors, inflammatory factors, chemokines etc. and results DR. This review summarized the several pathophysiological mechanisms and role of adhesion molecules in disruption of homeostasis of vasculature by leukocytes in the development of diabetic retinopathy.

Diabetes mellitus is one of the most concerning non-communicable diseases worldwide. The prevalence of diabetes increased rapidly by the influence of socioeconomic interactions. The thrifty hypothesis postulates that certain genes that are involved in positive selection promote efficient fat deposition and storage. This is beneficial for the survival of mankind in adverse conditions. However, in this modern society, these genes have become disadvantageous as people are significantly less likely to experience famines and nutrition shortages. The socioeconomic development that has occurred during the 20th century induced abundance of food supplies in almost all regions of the world. This has led to a rapid rise in the prevalence of obesity, and type 2 diabetes as a consequence. Boom of diabetic pandemic in newly developed countries compare with others those who developed gradually can be explain by thrifty hypothesis, as a result of the difference in the exposure to environmental factors and famine by the ancestors leads. The globalization, urbanization, lack of physical activity, intake of high calorie food and migration is major cause of pandemic emergence of diabetes in high as well as middle and low-income countries.

Hormonal transition among middle-aged women with type 2 diabetes may exert an impact in the development of diabetic retinopathy (DR). In this cross-sectional study, we aimed to assess the levels of estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in the presence of DR and their relationship with risk factors for DR among pre- and post-menopausal women with type 2 diabetes. Serum levels of estradiol, FSH, and LH were measured using the immunoassay technique. All statistical analysis was performed using SPSS software. From the 255 participants, diabetes duration-matched, 35 premenopausal, and 57 postmenopausal women were selected for analysis. The levels of estradiol, LH, and FSH were found to be similar in participants with and without DR among pre- and post-menopausal women with diabetes. Estradiol level was not found to be related with the risk factors of DR among women with type 2 diabetes. In conclusion, female sex hormone, estradiol is not related to the presence of DR. Further prospective studies are necessary to reveal the mechanistic role of this hormone in the development of DR.

BACKGROUND The importance of uric acid has been increasingly appreciated because of its association with the development of diabetes mellitus and related diseases. OBJECTIVE This study was undertaken to evaluate the association of serum uric acid (SUA) level with different clinical and biochemical parameters in patients with type 2 diabetes from Saudi Arabia. METHODS Clinical and biochemical data from the patients were obtained and assessed in a cross-sectional design. Relationships between SUA level and various clinical and biochemical parameters were analysed. RESULTS SUA level was positively associated with increased incidence of cardiovascular diseases (CVD) in patients with abnormal eGFR (

Angiopoietin-2 (Ang-2) has been reported to be involved in the development of type 2 diabetes (T2D) and accelerates micro and macro vascular complication. The current study aimed to investigate serum Ang-2 levels in Saudi patients with type 2 diabetes and its complications. In this observational cross-sectional study, serum was collected from 329 T2D subjects aged 34–79 years. All subjects were evaluated for fasting blood glucose (FBG), HbA1c, lipid profile, and kidney profile. Serum concentration of Ang-2 was assayed by ELISA-based method. Mean serum Ang-2 level was significantly higher in female T2D subjects (2881 ± 1550 pg/ml) compared with male T2D subjects (2450 ± 1477 pg/ml). The mean serum Ang-2 levels in female T2D subjects significantly increased with increase in their age and BMI, while mean serum Ang-2 levels did not significantly increase among the male with their age and BMI. A significantly higher level of Ang-2 was found in patients with diabetic complications like neuropathy (3293 ± 1728 pg/ml), retinopathy (2986 ± 1645 pg/ml), and vascular complications (3152 ± 1571 pg/ml). The study has established comprehensive Ang-2 levels in various subsets of adults with diabetes. While interpreting Ang-2 levels, the differences in age and sex need to be taken into account. Diabetic patients with higher Ang-2 levels should be monitored closely and level of serum Ang-2 should be served as a marker to identify patients at high risk of diabetic complications.

Albuminuria is widely used to indicate early phases of diabetic nephropathy although it is limited by the fact that structural damage might precede albumin excretion. This necessitates identifying better biomarkers that diagnose or predict diabetic nephropathy. This is a cross-sectional hospital based study recruiting type 2 diabetic patients cohort aged 35–75 years with diabetes duration of ≥10 years. Out of total eligible 467 patients, 200 patients were with normal albumin excretion, 184 patients with microalbuminuria and 83 patients with macroalbuminuria. All the patients were tested for the 22 selected biomarkers including serum, plasma and urinary markers. Sensitivity, specificity, and area under the curve (AUC) were calculated as measures of diagnostic accuracy. Out of the tested biomarkers, urinary transferrin, urinary Retinol binding protein (RBP) and serum osteopontin had the best diagnostic value for diabetic nephropathy presence based on the AUC value. The rest of the biomarkers had comparatively less or even no discriminative power. The urinary transferrin and RBP and serum osteopontin, had the best diagnostic value in type 2 diabetic patients at different stages of diabetic nephropathy. Further longitudinal prospective studies are needed to evaluate the predictive power of those markers for detecting diabetic nephropathy before any structural damage occurs.

Diabetic retinopathy (DR) and Diabetic Kidney Diseases (DKD) are the common microvascular complication of diabetes and are responsible for the major cause of blindness and end-stage kidney disease worldwide. Variation in the level of cell adhesion molecules is an indicator of the pathogenesis of diabetes and its complications. We hypothesized that a significant difference in cell adhesion molecules (ICAM 1, VCAM 1, ESEL, PSEL and LSEL) in diabetic subjects which can help in prediction and progression of DR and DKD. To examine the association of cell adhesion molecules in diabetes, DR and DKD a cross-sectional study was conducted on a total of 467 type 2 diabetes (T2D) subjects with a duration of diabetes ≥10 years and age ≥ 35 years. The subjects were divided into four groups. The first group is T2D patients with DR (n=62); the second group is T2D patients with DKD (n=113) and the third group is T2D with both DR and DKD (n=154) and group four is T2D patients without DR and DKD as control (n=138). Serum cell adhesion molecules (ICAM 1, VCAM 1, ESEL, PSEL and LSEL) were assessed by biochip immunoassay. The mean age of participants was 54.64 ± 6.11 years. A total of 46.3% of T2D patients were having retinopathy and 57.7% were diagnosed with both DR and DKD. There was a significant difference between the cell adhesion molecules in DR and DKD groups. The cell adhesion molecules also showed significant correlation with common risk factors of DR and DKD. The higher level of cell adhesion molecules in DR and DKD is useful to identify the development and progression of diabetic complications. Thus, early identification can prevent the development of further complication through better management.

Diabetes is a chronic condition; those with diabetes are at high risk of developing diabetes complications. One important approach to tackle the diabetes burden is to screen for undiagnosed diabetes and to identify factors that lead to the risk of developing diabetes in the future. The earlier identification of individuals at risk of developing diabetes is crucial for delaying or preventing the onset of type 2 diabetes. Numerous studies have demonstrated that circulating concentrations of branch chain amino acids (BCAAs) predict the risk for developing diabetes; thus, contributing to the recent resurgence of interest in these common analytes. The present review aimed to address the recent findings regarding BCAAs and their role in insulin resistance and diabetes. Recent studies demonstrate that BCAAs are strongly associated with a number of pathological mechanisms causing insulin resistance and type 2 diabetes. The research findings related to BCAA signaling pathways and metabolism broaden our understanding of this topic. However, it remains unclear how increased levels of BCAAs will assist in the prediction of future insulin resistance or type 2 diabetes. Future research needs to determine whether BCAAs are a causative factor for insulin resistance and type 2 diabetes, or just a biomarker of impaired insulin action.

Aim The aim of this study was to investigate the role of elevated glycated LDL (low-density lipoprotein) in the progression of diabetic kidney disease among type 2 diabetes (T2D) subjects. Materials and methods This case-control observational study is a part of Saudi Diabetes Kidney Disease (SAUDI-DKD) study conducted during the period from April 2014 to June 2015. This study cohort is divided into two groups; the first group was T2D patients without diabetic nephropathy (DN) (n = 24) and the second group was T2D with DN (n = 45). Serum glycated LDL levels were determined by ELISA. Pearson's correlation analysis was performed, and the diagnostic accuracy was assessed using the area under the ROC curve. Results There was a threefold increase of serum glycated LDL level among diabetic subjects when compared with non-diabetic subjects and this level progressively increased with the progression of DN. The glycated LDL was found to have a significant diagnostic accuracy with AUC of 0.685 and 0.775 for cases with microalbuminuria and macroalbuminuria respectively. Conclusion The glycated LDL could play a significant role in predicting diabetic patients who are susceptible to develop DN among T2D patients.

Type 2 diabetes (T2D) is a wide-spread, chronic metabolic disorder, affecting millions of people worldwide. The epidemic of diabetes has placed a huge strain on public health, longevity and economy. T2D occurs as a result of both genetic and environmental factors and is heterogeneous in its presentation across individuals. This review gives an overview of the genetic variations identified by genome-wide association studies which predispose individuals to T2D and those which are responsible for variable drug response across patients, and the necessity to adopt a personalized approach to diabetes management. We also include a perspective on diabetes in Arabs, given the high incidence of T2D and consanguineous marriages, and the need to understand associated genetic components in this vulnerable population.

The world is seemingly facing a global increase in people suffering from diabetes especially in developing countries. The worldwide occurrence of diabetes for all age groups in year 2000 was estimated to be 2.8% and this number is most certainly expected to rise to 4.4% by 2030. Maturity-onset of diabetes of the young, or MODY, is a form of monogenic diabetes that is caused by mutations occurring in a number of different genes. Mutations in different genes tend to cause a slightly different variant of diabetes. MODY is typically diagnosed during late childhood, adolescence, or early adulthood and is usually observed to develop in adults during their late 50's. One of the main drawbacks in its diagnosis is that many people with MODY are misdiagnosed as having type 1 or type 2 diabetes. However, a molecular and genetic diagnosis can result in a better treatment and could also help in identifying other family members with MODY. This article explores the historical prospect and the genetic background of MODY, a brief summary of the first case reported and the significant factors that differentiate it from type 1 and type 2 diabetes.

Background Saudi Arabia is a community thrilled by sudden social and economical changes, leading to a sharp increase in the prevalence of abnormal glucose metabolism. Age-specific diabetes and impaired fasting glucose prevalence is the focus of this study with the expected risk factors. Methods A nationwide, household, randomized, population based cohort of 18 034 participants aged ≥30 years was selected to test for abnormal glucose metabolism using fasting plasma glucose (FPG) according to American Diabetes Association (ADA) criteria. Results The prevalence of diabetes was 25.4% with 40.3% being unaware of their disease, while impaired fasting glucose (IFG) affected 25.5% of the total sample. IFG to diabetes ratio was one in this study, decreasing with age and increasing with body weight. Age ≥45 years, hypertension, history of gestational diabetes mellitus (GDM), and high triglycerides are the strongest risk factors in diabetic patients, while history of GDM, dyslipidemia, obesity, and high triglycerides are the most significant risk factors in IFG participants. Conclusions Abnormal glucose metabolism has reached an epidemic level in this society, where half of adults and older are affected. Risk factors are behind this epidemic and the quick shift from IFG to diabetes in this society. 摘要 背景： 沙特阿拉伯是一个正处于社会与经济快速变化时期的国家，这导致糖代谢异常的患病率急剧上升。这项研究的焦点是特定年龄段的糖尿病与空腹血糖受损的患病率以及预期的危险因素。 方法： 这是一项全国性、以家庭为单位、基于人群的随机队列研究，挑选了18034名年龄 ≥30岁的参与者，根据美国糖尿病协会的标准使用空腹血糖（FPG）检测他们的糖代谢是否异常。 结果： 糖尿病患病率为25.4%，并且40.3%的人不知道他们有糖尿病，在全部的样本人群中空腹血糖受损的患病率为25.5%。在这项研究中空腹血糖受损与糖尿病的比值为1，这个比值随着年龄增加而减少，随着体重增加而增加。在糖尿病患者中年龄 ≥45岁、高血压、妊娠糖尿病病史以及高甘油三酯血症是最强的危险因素，而GDM病史、血脂异常、肥胖以及高甘油三酯血症是空腹血糖受损最显著的危险因素。 结论： 在这个社会中糖代谢异常已经达到了一个流行病的水平，并且已经累及到了一半的成年人与老年人。在这个社会中空腹血糖受损向糖尿病的转变非常迅速，而危险因素却隐藏在这个流行病的背后。

Diabetes is estimated to be one of the major causes of deaths in most countries due to its high prevalence rate, which was 8.8% in 2015. Hyperglycemia detected during pregnancy is known as gestational diabetes mellitus and it increases the potential risk of development of Type 2 diabetes in mothers with its varying prevalence rate of 1–14% in different populations. It also leads to the higher risk of developing abnormal glucose tolerance and obesity in their child at an early age. Recent studies show that potential mediators of insulin resistance such as adipokines – adiponectin, leptin and resistin are important for glucose and lipid metabolism. Adipokines are directly involved in the regulation of insulin secretion and insulin sensitivity in the liver, muscle and adipose tissue. It is also involved in inflammation, adipose tissue accumulation, adverse fat distribution and subsequently affects glucose metabolism. This review highlights the role of resistin (an adipokine) in the development of gestational diabetes mellitus.

BACKGROUND AND OBJECTIVES: Saudi Arabia underwent opulence-driven socio-cultural and lifestyle changes leading to soaring rates of diabetes mellitus. This study exposes the epidemiology of abnormal glucose metabolism namely: diabetes and impaired fasting glucose (IFG) in 13 administrative regions of Saudi Arabia. DESIGN AND SETTINGS: This is a nationwide, household, population-based cross-sectional study that was conducted through primary health care centers during the period 2007–2009. PATIENTS AND METHODS: A nationwide, household, population-based cohort of 53 370 participants aged 0–100 years adjusted to be compatible with population census was interviewed and anthropometric measures were collected. Fasting blood sample was used to screen for IFG and diabetes. RESULTS: The overall prevalence of abnormal glucose metabolism was 34.5%, which included 22.6% patients with IFG, 11.9% patients with diabetes, and 6.2% patients who unaware of their disease. Diabetes prevalence was 40.2% for subjects aged ≥45 years and 25.4% for those aged ≥30 years that decreased to 11.9% when the full age spectrum was considered. Type 1 diabetes prevalence was 0. 8%, contributing only to 6.6% of the total population of patients with diabetes. The top 5 regions with the highest abnormal glucose metabolism prevalence were Makkah (43.4%), Aljouf (41.7%), Eastern region (37.16%), Madinah (35.4%), and Qassim (33.7%). Urbanization, age, and obesity were behind the wide variations in diabetes and IFG prevalence in the 13 regions. CONCLUSION: Abnormal glucose metabolism has reached an epidemic state in Saudi Arabia, where one-third of the population is affected and half of diabetic cases were unaware of their disease. This observation warrants an urgent strategy for launching diabetes primary prevention and screening programs.

Macro elements are the minerals of which the body needs more amounts and are more important than any other elements. Trace elements constitute a minute part of the living tissues and have various metabolic characteristics and functions. Trace elements participate in tissue and cellular and subcellular functions; these include immune regulation by humoral and cellular mechanisms, nerve conduction, muscle contractions, membrane potential regulations, and mitochondrial activity and enzyme reactions. The status of micronutrients such as iron and vanadium is higher in type 2 diabetes. The calcium, magnesium, sodium, chromium, cobalt, iodine, iron, selenium, manganese, and zinc seem to be low in type 2 diabetes while elements such as potassium and copper have no effect. In this review, we emphasized the status of macro and trace elements in type 2 diabetes and its advantages or disadvantages; this helps to understand the mechanism, progression, and prevention of type 2 diabetes due to the lack and deficiency of different macro and trace elements.

Saudi Arabia is a community thrilled by sudden social and economical changes, leading to a sharp increase in the prevalence of abnormal glucose metabolism. Age-specific diabetes and impaired fasting glucose prevalence is the focus of this study with the expected risk factors.A nationwide, household, randomized, population based cohort of 18 034 participants aged ≥30 years was selected to test for abnormal glucose metabolism using fasting plasma glucose (FPG) according to American Diabetes Association (ADA) criteria.The prevalence of diabetes was 25.4% with 40.3% being unaware of their disease, while impaired fasting glucose (IFG) affected 25.5% of the total sample. IFG to diabetes ratio was one in this study, decreasing with age and increasing with body weight. Age ≥45 years, hypertension, history of gestational diabetes mellitus (GDM), and high triglycerides are the strongest risk factors in diabetic patients, while history of GDM, dyslipidemia, obesity, and high triglycerides are the most significant risk factors in IFG participants.Abnormal glucose metabolism has reached an epidemic level in this society, where half of adults and older are affected. Risk factors are behind this epidemic and the quick shift from IFG to diabetes in this society.

In subjects with impaired insulin action, alterations of the serum sodium and potassium concentrations have been reported. The resulting cationic imbalance, along with the osmotic effect of the elevated sugar levels, could influence the course of diabetes mellitus management. Therefore, this study was conducted to compare the fasting blood glucose and HbA1c levels with those of the serum electrolytes. Blood samples were collected for assessment of HbA1c, fasting blood glucose (FBS), and electrolytes using different automated methods. A significant association between the serum sodium and FBS levels among types 1 and 2 insulin-treated patients, and type 2 oral agent patients was observed. A total of 138 diabetic subjects were randomly selected from any gender aged between 25 and 65 years at the University Diabetes Center, King Saud University, Riyadh KSA. The subjects were classified into types 1 or 2 DM using ADA criteria. Blood samples were collected for assessment of HbA1c, FBS, and electrolytes using different automated methods. It showed a significant association between serum sodium, FBS among type 1, type 2 insulin treated, and type 2 oral agent groups. However, the association of sodium and HbA1c was insignificant when analyzed individually. A statistically significant association (P

Background Diabetes mellitus (DM) is the most common chronic endocrine disorder, affecting an estimated 371 million people worldwide. It is associated with microvascular and macrovascular complications, including diabetic nephropathy (DN), a primary cause of end-stage renal disease (ESRD). Among the Gulf countries, Saudi Arabia has the highest number of people with diabetes and about 30-40% diabetic patients suffer from DN. Diabetes imposes a large economic burden on healthcare systems. Healthcare expenditures due to diabetes account for 11% of the total medical expenditures in the world in 2011. Mostly, individuals exposed to long durations of diabetes with relatively poor glycemic control develop progressive DN. However, some patients appear to be at increased risk while some will remain relatively protected. Differential disease risk in DN may be partly attributable to genetic susceptibility. A recent review identified genetic variants in the ACE and MTHFR genes to be significantly associated with type 2 diabetes in Arabs [1]. Inflammatory cytokines and angiogenic factors are important modulators in the pathogenesis of DN. We aimed to determine which of the previously investigated genetic variants in these pathways are significantly associated with the development of DN in diabetes and to examine the functional role of these genes.