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Summary: Objective: Rising prevalence of obesity has led to increased rates of prediabetes and diabetes mellitus (DM) in children. This study compares rates of prediabetes and diabetes using two recommended screening tests (fasting plasma glucose [FPG] and haemoglobin A1c [HbA1c]). Study Design: Data were collected prospectively from 37 multi‐component paediatric weight management programs in POWER (Paediatric Obesity Weight Evaluation Registry). Results: For this study, 3962 children with obesity without a known diagnosis of DM at presentation and for whom concurrent measurement of FPG and HbA1c were available were evaluated (median age 12.0 years [interquartile range, IQR 9.8, 14.6]; 48% males; median body mass index 95th percentile [%BMIp95] 134% [IQR 120, 151]). Notably, 10.7% had prediabetes based on FPG criteria (100–125 mg/dL), 18.6% had prediabetes based on HbA1c criteria (5.7%–6.4%), 0.9% had DM by FPG abnormality (≥126 mg/dL) and 1.1% had DM by HbA1c abnormality (≥6.5%). Discordance between the tests was observed for youth in both age groups (10–18 years [n = 2915] and age 2–9 years [n = 1047]). Conclusion: There is discordance between FPG and HbA1c for the diagnosis of prediabetes and DM in youth with obesity. Further studies are needed to understand the predictive capability of these tests for development of DM (in those diagnosed with prediabetes) and cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Background: Premature menopause (PM) is the cessation of ovarian function before age 40. PM women are more likely to have cardiovascular diseases (CVDs), diabetes, and mental disorders. This is the first study that assessed the association of single nucleotide polymorphisms (SNPs) with anti-heat shock protein 27 (Hsp27), High-sensitivity C-reactive protein (hs-CRP), and PM and serum pro-oxidant-antioxidant balance (PAB), as putative risk factors for CVDs. We aimed to explore the association of oxidative stress markers with eight different SNPs shown to be related to premature menopause. Materials and Methods: In this cross-sectional research, we included 183 healthy women and 117 premature menopausal women. We determined baseline characteristics for all participants and measured serum hs-CRP, anti-HSP-27 antibody titer, and PAB levels using the established methods. Genotyping for eight SNPs was done using the tetra amplification refractory mutation system polymerase chain reaction (Tetra-ARMS PCR) and allele-specific oligonucleotide PCR (ASO-PCR) methods. Results: We found a significant difference between mean serum PAB levels and the genetic variant of rs16991615 (P=0.03). ANCOVA showed a significant effect of the genotypes rs4806660 and rs10183486 on hs-CRP serum levels in the case and control groups, respectively (P=0.04 and P=0.007). ANCOVA also showed an association between rs244715 genotypes and anti-hsp27 serum levels in the case group (P=0.02). There was a significant effect of the genotypes of rs451417 on the serum hs-CRP level in the control group (P=0.03). Conclusion: There was a significant association of the genetic variants related to PM with oxidative stress and inflammatory markers (serum PAB, anti-hsp27 antibody, and hs-CRP). Accordingly, this seems to be an effective approach to predicting susceptible subjects for cardiovascular and mental disorders as well as various cancers. [ABSTRACT FROM AUTHOR]

The objective: to analyze the frequency of insulin resistance (IR) in patients with systemic lupus erythematosus (SLE), study of traditional and rheumatic disease-related risk factors for the development of IR, assessment of the possibility of using of Finnish Type 2 Diabetes Risk Assessment Form (FINDRISC) to detect IR. Materials and methods. 58 patients with SLE (53 women and 5 men) without diabetes mellitus (DM) and hyperglycemia were included in the one-time study. The patients have received the inpatient treatment at the regional medical and diagnostic center of the communal enterprise "Poltava Regional Clinical Hospital named after M. V. Sklifosofsky PRC" in 2020-2023. The average age of patients was 38 [28; 43] years, the average duration of the disease is 4.0 [0.6; 6.0] years. 49 (85%) patients received glucocorticoids (GC), 20 (34%) - hydroxychloroquine, 26 (45%) - immunosuppressants, 2 (3%) persons received biological drugs. In all patients fasting glucose and insulin levels were determined, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated. The value of the HOMA-IR index ≥2.77 corresponded to the presence of IR. Traditional risk factors for type 2 DM and the risk of its development in the next 10 years in patients with SLE were assessed using the FINDRISC questionnaire. Results. IR was determined in 14 (24%) of 58 patients with SLE. The average value of the HOMA-IR index was 1.8 [1.3; 2,6]. The data of patients with and without IR were similar in terms of sex, age, duration and activity of SLE, therapy performed at the time of examination, frequency of traditional risk factors for type 2 DM. Body mass index (BMI), waist circumference (WC), and insulin concentration were higher in patients with IR. The HOMA-IR index was correlated with BMI (r=0.7; p<0.001), WC (r=0.6; p<0.001), risk categories for the development of type 2 diabetes according to FINDRISС (r=0.4; p=0.04), the SLEDAI-2K index (r=-0.3; p<0.02), the serum concentration of C3 complement (r=0.4; p=0.035) and the duration of GC therapy (r=0.4; p=0.02). Conclusions. IR was diagnosed in 24% of patients with SLE without a history of DM and with a normal fasting venous blood glucose level. The HOMA-IR index increased as SLE activity decreased and the duration of GC treatment increased. However, the development of IR was statistically significantly associated only with an increase in BMI and WC. The use of the FINDRISC questionnaire, which allows to assess the risk of developing type 2 DM in the general population, did not help to detect IR in patients with SLE. [ABSTRACT FROM AUTHOR]

Introduction: Data mining in healthcare is a nascent arena of research in healthcare. Heterogeneity of Diabetes Mellitus in terms of clinical presentation calls for newer methods of research to study potential risk factors. Aim: The paper aims to use clustering techniques to identify the relationship between the four variables, namely the pre-prandial and postprandial sugar level, age and sex. Methods: The data was taken from a diagnostic laboratory in Wagholi, Pune. We conducted K-mean algorithm, EM algorithm, model-based clustering and t-mixture model. Results: It is evidenced that the data was best fitted to the t-mixture model. Our 50% samples were people with diabetes, 17% had prediabetes. Trivial correlation existed between age and sugar level. Males and females were equally at risk of having diabetes. Data presented concludes that age and sex have no effect on the risk of having diabetes. Data mining can be used to deduce meaningful clusters to drive plan-based interventions in the population. Conclusion: Methods of data mining can be used to deduce meaningful clusters in a heterogeneous dataset thus providing policymakers and healthcare researchers with novel information that will potentially contribute in formulating evidence-based policies. [ABSTRACT FROM AUTHOR]

Introduction: India is known as capital of Diabetes all over the world. Diabetes is a lifestyle disease which affects all age groups. Objective: To identify the risk of developing Diabetes in adults using Indian Diabetes Risk Score (IDRS) and identify associated factors. Material & Methods: A cross sectional study was done among 200 adults who were non-diabetic by systematic random sampling in urban area, Diphu, Assam using pre-designed semi structured questionnaire, validated IDRS and anthropometric measurements. SPSS Version 20.0 was used for data analysis. Predictors of risk of Diabetes was identified by logistic regression. Results: Among 200 participants, moderate risk was found in 106 subjects and high risk was found in 71 subjects. On multiple regression analysis, age, marital status, education, fruit consumption, blood pressure, Body mass index and physical activity were significantly associated with risk of developing Diabetes. Conclusion: Individuals at risk of diabetes should be identified by screening so that appropriate interventions can be done to prevent/delay the onset of diabetes. [ABSTRACT FROM AUTHOR]

Aims: There is limited research on the relationship between food insecurity and mortality among individuals with diabetes. This study aims to investigate the impact of food insecurity on all‐cause and cause‐specific mortality in adults with diabetes. Research Design and Methods: This study included 5749 adults with diabetes from the National Health and Nutrition Examination Survey cycles 2003–2018 and followed up until 31 December 2019. Food insecurity was measured by the Food Security Survey Module. Cox proportional hazard models were employed to estimate hazard ratios (HRs) and 95% confidence intervals for both all‐cause mortality and cause‐specific mortality. Results: The weighted prevalence of full food security, marginal food security, low food security, and very low food security was 70.8%, 11.0%, 10.4%, and 7.8%, respectively. Food insecurity demonstrated a significant correlation with diminished diet quality and reduced consumption of healthy foods. Over the course of 42,272.0 person‐years of follow‐up, we documented 1091 deaths, of which 370 were attributed to cardiovascular disease and 180 to cancer. After adjusting for multiple variables, food insecurity scores were significantly and linearly associated with increased all‐cause mortality. Comparing to full food security, participants experiencing very low food security had a multivariate‐adjusted HR of 1.48 (1.12, 1.95) for all‐cause mortality (ptrend = 0.010). Conclusions: Food insecurity was associated with increased all‐cause mortality and compromised diet quality, especially in individuals experiencing very low food security. Future strategies may necessitate the monitoring of and interventions for food insecurity among individuals with diabetes. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) following cardiothoracic surgery can pose significant challenges to patient recovery and outcome. This systematic review and meta‐analysis aim to identify and quantify the risk factors associated with SSIs in patients undergoing cardiothoracic surgery. A comprehensive literature search adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and based on the PICO paradigm was conducted across four databases: PubMed, Embase, Web of Science and the Cochrane Library, without any temporal restrictions. The meta‐analysis incorporated studies detailing the risk factors for post‐operative sternal infections, especially those reporting odds ratios (OR) or relative risks with 95% confidence intervals (CI). Quality assessment of the studies was done using the Newcastle‐Ottawa Scale. Statistical analysis was executed using the chi‐square tests for inter‐study heterogeneity, with further analyses depending on I2 values. Sensitivity analyses were performed, and potential publication bias was also assessed. An initial dataset of 2442 articles was refined to 21 articles after thorough evaluations based on inclusion and exclusion criteria. Patients with diabetes mellitus have an OR of 1.80 (95% CI: 1.40–2.20) for the incidence of SSIs, while obese patients demonstrate an OR of 1.63 (95% CI: 1.40–1.87). Individuals who undergo intraoperative blood transfusion present an OR of 1.13 (95% CI: 1.07–1.18), and smokers manifest an OR of 1.32 (95% CI: 1.03–1.60). These findings unequivocally indicate a pronounced association between these factors and an elevated risk of SSIs post‐operatively. This meta‐analysis confirms that diabetes, obesity, intraoperative transfusion and smoking heighten the risk of SSIs post‐cardiac surgery. Clinicians should be alert to these factors to optimise patient outcomes. [ABSTRACT FROM AUTHOR]

Screen time among children in most European countries is notably high and is influenced by various sociodemographic and other factors. Our study aimed to explore the associations between parents' sociodemographic characteristics, socioeconomic status, body mass index (BMI), physical activity, risk status for type 2 diabetes, and their children's BMI, physical activity, and screen time. The data were sourced from the 2016 Feel4Diabetes study, involving 12,280 parents and 12,211 children aged 6–9 years (average age 8.21 years) in a cross-sectional study design. We used a logistic regression model to identify potential factors associated with children's screen time. The results showed that mothers with tertiary education (OR = 0.64; 95%CI = 0.49–0.82; p < 0.001), the middle age group (45–54 years) (OR = 0.81 95%CI = 0.66–0.98; p = 0.033), and families with higher incomes (middle–OR = 0.85; 95%CI = 0.75–0.97; p = 0.014; high–OR = 0.8; 95%CI = 0.69–0.93; p = 0.003) were associated with a decreased chance of children spending more than 2 h/day in front of the screen. In contrast, maternal overweight/obesity (OR = 1.15; 95%CI = 1.03–1.29; p = 0.013) and lower physical activity in children were linked to an increased likelihood of more than 2 h of screen time per day. Our findings suggest that targeted interventions should be developed to mitigate excessive screen time, particularly focusing on low-income families and mothers with low educational levels. [ABSTRACT FROM AUTHOR]

Background: Poor glycemic control and high diabetes and prediabetes incidence are influenced by socioeconomic disparity. Raising awareness and ensuring that people with prediabetes are receiving medication, maintaining their glycemic control, and getting the proper care they need despite their socioeconomic situation are crucial in the fight against diabetes. This study aims to assess the sociodemographic status, self-awareness, and risk factors associated with prediabetes in Bangladesh. Methods: A cross-sectional survey was carried out among 500 participants aged >18 years to evaluate and summarize their demographic data, socioeconomic status, and responses to various questionnaires about their conditions related to prediabetes and their awareness of this condition. Results: Analysis of factors revealed that 41% and 39% of the participants had first- and second-degree relatives with diabetes, respectively. Meanwhile, 36% of the participants maintain physical activities, 30% prefer sweetened beverages, and 29% have high blood pressure. The participants were aware of different statements related to diabetes, such as how lifestyle modification and awareness can help people with prediabetes. Conclusions: This study provided insights into the underlying factors related to prediabetes and enabled us to identify the prediabetes conditions unknown to people in Bangladesh. [ABSTRACT FROM AUTHOR]

Introduction: Long COVID is now being encountered by many individuals during this pandemic. It is best diagnosed by a history consistent with acute COVID-19 followed by a prolonged recovery. Aim: This study was undertaken to detect new-onset diabetes mellitus among COVID cohorts and their associated factors. Materials and Methods: A total of 152 COVID-19 patients admitted at ESIC medical college and hospital without a known history of diabetes mellitus were included in the study. Data were collected about sociodemographic variables, their symptoms at presentation, lifestyle determinants, and measurement of blood sugar by HbA1C for a period of 6 months follow-up with three readings (baseline, third month, and sixth month) using a predesigned and pre-tested questionnaire schedule. Results: Mean HbA1c was found to be 7.28±2.09 at the third reading with new-onset diabetes mellitus development among 38 (25%). There was a positive correlation between age and mean HbA1c measurement on follow-up. Significant risk factors were the presence of comorbidities OR = 15.23 (4.42–22.46), sedentary lifestyle 6.14 (1.39–9.11), tobacco usage 6.80 (2.63–14.55), symptomatic COVID-19 presentation 2.43 (1.11–5.41), alcohol usage 2.11 (0.99–4.49) and extra physical activity 1.72 (0.66–2.32). Conclusions: There was a quarter of patients with new-onset diabetes mellitus in the present study. This will help us to identify the risk factors of this sequela at the earliest for initiating preventive strategies at the primary care level. [ABSTRACT FROM AUTHOR]

Objective: To define the incidence and risk factors for developing chemotherapy‐induced neuropathic pain (CINP). Methods: Retrospective, file‐based analysis on cancer patients who received any type of conventional chemotherapy and for whom neurological evaluation was asked to reveal the extent of chemotherapy‐induced peripheral neurotoxicity (CIPN) with or without CINP. CINP was assessed by means of the PI‐NRS and Douleur Neuropathique‐4 questionnaire. The total neuropathy score‐clinical version graded the severity of CIPN. Results: The medical files of 500 chemotherapy‐treated cancer patients were reviewed. Any grade chronic CIPN was disclosed in 343 (68.6%) patients and CINP in 127 (37%) of them, corresponding to an overall percentage of 25.4% among all 500 included patients. The logistic regression analysis identified as independent predictors for CINP development the presence of uncomplicated diabetes (OR: 2.17; p =.039) and grade 2–3 chronic CIPN (OR: 1.61; p <.001) as also the administration of combined paclitaxel plus cisplatin (reference variable), compared to oxaliplatin (OR: 0.18; p =.001) and taxanes (OR: 0.16; p <.001). The increased severity of acute OXAIPN was associated with CINP (OR: 4.51; p <.001). OXA‐treated patients with persistent CINP presented a worst likelihood to improve after chemotherapy discontinuation, than patients receiving combined paclitaxel plus cisplatin (OR: 50; p <.001). Conclusion: The incidence of CINP in our cohort was comparable to previous reports, with severities fluctuating upwards during chemotherapy and declined post‐chemotherapy. Uncomplicated diabetes, the combined paclitaxel plus cisplatin treatment and the increased severity of acute oxaliplatin neurotoxicity mostly increase the risk for developing CINP. OXA‐treated patients present less possibilities to recover from CINP after chemotherapy discontinuation, than other chemotherapies. [ABSTRACT FROM AUTHOR]

Objective: This nationwide cohort study aimed to examine the association between PM2.5 and diabetes mellitus (DM) risk. Methods: We recorded annual average PM2.5 exposure levels at participants' locations. PM2.5 concentrations were categorized into quartiles: Q1 (<29.5 μg/m³), Q2 (29.5-33.3 μg/m³), Q3 (33.4 41.2 μg/m³), and Q4 (>41.2 μg/m³). Results: A total of 158,038 patients (69,688 men and 88,350 women) were enrolled. Diabetes mellitus incidence increased with higher annual PM2.5 concentrations (2.81 in QI, 3.06 in Q2, 3.65 in Q3, and 3.89 in Q4 per 10,000 person-years). After adjusting for confounders, patients exposed to PM2.5 in Q2, Q3, and Q4 had adjusted hazard ratios of 1.14 (95% CI: 1.05-1.23), 1.40 (95% CI: 1.30-1.50), and 1.42 (95% CI: 1.32-1.53), respectively, for developing DM compared with those exposed to Q1 -PM2.5 concentrations. Conclusions: This study observed an increased risk of DM associated with PM2.5 exposure. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis and diabetes both diseases are present in large numbers in the country and we are major contributors to both globally. With the objective to understand the various traits of patients having both tuberculosis and diabetes and to ascertain various possible predictors for such occurrence based on the public health database we carried out this study. We seek answers to questions like they have any effects? Are they having any additive role to play? Methods: One-year data from the NIKSHAY portal of both districts were analyzed to look for possible associations and other variable traits. Data were analyzed using standard methods to express data in frequency and percentage. Chi-square test was used to establish association, while step-wise approach was used to calculate univariate and multivariate logistic regression analysis for knowing various predictors. P-value of <0.05 was considered statistically significant. Results: Concurrent diabetes in tuberculosis patients was close to 294 (6%) in the 4933 individuals. In total, 65.2% of the study population were male. Diagnosis of tuberculosis was made most of the time by chest X-ray (49.4%) followed by Microscopy ZN staining and cartridge-based nucleic acid amplification test (CBNAAT). Death was more among diabetics (4.4%) as compared to nondiabetics (3.5%). Conclusion: Diabetes is increasing in tuberculosis patients; improvement in data quality is needed. More research is required to reveal various other reasons that make tuberculosis patients more prone to develop diabetes. [ABSTRACT FROM AUTHOR]

The diabetic burden attributable to second-hand smoke (SHS) is a global public health challenge. We sought to explore the diabetic burden attributable to SHS by age, sex, and socioeconomic status during 1990–2019 and to evaluate the health benefit of smoke-free policies on this burden. Cross-sectional study. The diabetic burden attributable to SHS was extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 dataset. Country-level smoke-free policies were obtained from the World Health Organization Global Health Observatory. The deaths or disability-adjusted life years (DALYs) were quantified, and the average annual percentage changes were calculated. Hierarchical linear mixed models were applied to evaluate the health effects. From 1990 to 2019, the absolute number of global deaths and DALYs of diabetes attributable to SHS has doubled, and the age-standardised rate has significantly increased. The disease burden was higher in females than in males and increased with increasing age. The SHS-related diabetic burden varied across regions and countries. Age-standardised death or DALY rates first increased and then decreased with increased Socio-demographic Index (SDI), peaking in the 0.60–0.70 range. In low to low-middle, and middle to high-middle SDI countries, SHS-related diabetic deaths and DALYs were significantly lower in countries with more than 3 smoke-free public places than in countries with 0–2 smoke-free public places. More attention should be paid to females and the elderly, who bear a heavy SHS-related diabetic burden. Banning smoking in public places was associated with reduced burden of SHS-attributable diabetes, especially in low to middle social development countries. [ABSTRACT FROM AUTHOR]

To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index. This was an ecological descriptive study. Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported. At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality −28.8%; YLLs -39.8%; YLDs −1.3%; and DALYs −26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990. In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible. [ABSTRACT FROM AUTHOR]

Objective This study aimed to assess the risk of cardiometabolic disease (CMD) in patients with differentiated thyroid cancer (DTC) using a population-based nationwide cohort in Korea. Design This was a population-based cohort study. Methods We selected 2649 patients with DTC and 7947 matched controls. The primary outcome was the composite of CMD including diabetes mellitus (DM), hypertension, hyperlipidemia, cerebrovascular disease, and ischemic heart disease. The secondary outcomes were each individual type of CMD, all-cause mortality, and CMD-specific mortality. The cause-specific hazard ratios (HRs) for each outcome were estimated based on cause-specific Cox proportional hazard regression models. Results Patients with DTC had an 11% higher risk of the primary composite outcome than controls (HR, 1.11; 95% confidence interval [CI], 1.04–1.19). The risks of DM (HR, 1.22; 95% CI, 1.08–1.38) and hyperlipidemia (HR, 1.36; 95% CI, 1.24–1.48) were higher in patients with DTC. In contrast, the risk of CMD-specific mortality was lower in those with DTC (HR, 0.24; 95% CI, 0.09–0.68). A nonlinear, U-shaped relationship was observed between the daily dose of levothyroxine and the risk of DM (P =.021), but the risk of hyperlipidemia was low with high doses of levothyroxine in patients with DTC (P =.003). Conclusions Patients with DTC had an increased risk of CMD, especially DM and hyperlipidemia, but a low risk of CMD mortality. Special attention to metabolic diseases is required in the long-term follow-up of patients with DTC. [ABSTRACT FROM AUTHOR]

Background and Hypothesis Antipsychotics are first-line drug treatments for schizophrenia. When antipsychotic monotherapy is ineffective, combining two antipsychotic drugs is common although treatment guidelines warn of possible increases in side effects. Risks of metabolic side effects with antipsychotic polypharmacy have not been fully investigated. This study examined associations between antipsychotic polypharmacy and risk of developing diabetes, hypertension, or hyperlipidemia in adults with schizophrenia, and impact of co-prescription of first- and second-generation antipsychotics. Study Design A population-based prospective cohort study was conducted in the United Kingdom using linked primary care, secondary care, mental health, and social deprivation datasets. Cox proportional hazards models with stabilizing weights were used to estimate risk of metabolic disorders among adults with schizophrenia, comparing patients on antipsychotic monotherapy vs polypharmacy, adjusting for demographic and clinical characteristics, and antipsychotic dose. Study Results Median follow-up time across the three cohorts was approximately 14 months. 6.6% developed hypertension in the cohort assembled for this outcome, with polypharmacy conferring an increased risk compared to monotherapy, (adjusted Hazard Ratio = 3.16; P  = .021). Patients exposed to exclusive first-generation antipsychotic polypharmacy had greater risk of hypertension compared to those exposed to combined first- and second-generation polypharmacy (adjusted HR 0.29, P  = .039). No associations between polypharmacy and risk of diabetes or hyperlipidemia were found. Conclusions Antipsychotic polypharmacy, particularly polypharmacy solely comprised of first-generation antipsychotics, increased the risk of hypertension. Future research employing larger samples, follow-up longer than the current median of 14 months, and more complex methodologies may further elucidate the association reported in this study. [ABSTRACT FROM AUTHOR]

Context: Existing differences in persons with lower 30- or 60-minute plasma glucose (PG) levels during 75-g oral glucose tolerance test (OGTT) than fasting PG remain unclear. Objective: To clarify the characteristics of persons whose PG levels decrease after glucose administration during OGTT and their risk of incidence of diabetes in a Japanese general population. Methods: In this cohort study, a total of 3995 men and 3500 women (mean age 56.7 years) without diabetes were classified into 3 groups: (1) PG at both 30 and 60 minutes ≥ fasting PG; (2) PG at 30 minutes ≥ fasting PG and PG at 60 minutes < fasting PG; (3) PG at 30 minutes < fasting PG. The characteristics and the risk of diabetes onset were analyzed using ordered logistic regression and Cox proportional hazard regression, respectively. Results: Among 7495 participants, the numbers of individuals in the group 1, 2, and 3 were 6552, 769, and 174, respectively. The glucose response curve of the group 3 was boat shaped. Group 3 had the youngest age, lowest percentage of men, and best health condition, followed by groups 2 and 1. Among 3897 participants analyzed prospectively, 434 developed diabetes during the mean follow-up period of 5.8 years. The hazard ratio for diabetes onset in the group 2 was 0.30 with reference to the group 1. No-one in group 3 developed diabetes. Conclusion: People with lower 30-minute PG than fasting PG tended to be women, young, healthy, and at low risk of diabetes onset. [ABSTRACT FROM AUTHOR]

Background Weight gain following initiation of antiretroviral therapy (ART) is common. We assessed the impact of changes in weight in the year following ART initiation with subsequent cardiometabolic disease among AIDS Clinical Trials Group (ACTG) participants. Methods Linear regression models were fit to examine the association between change in weight/waist circumference (WC) in weeks 0–48 and change in metabolic parameters in weeks 0–48 and 48–96. Cox proportional hazard models were fit to examine the association between changes in weight/WC in weeks 0–48 and diabetes mellitus (DM), metabolic syndrome, or cardiometabolic and cardiovascular events after week 48. Results Participants (N = 2624) were primarily male (81%) and non-White (60%). Mean weight gain from 0–48 weeks was 3.6 kg (SD 7.3); 130 participants developed DM; 360 metabolic syndrome; 424 any cardiometabolic event; 28 any cardiovascular event, over 480 weeks of follow-up. In adjusted models, total cholesterol increased by 0.63 mg/dL (95% confidence interval [CI] [.38,.089]) and LDL by 0.39 mg/dL (0.19, 0.59) per 1 kg increase in weight from weeks 0 to48. Participants who experienced >10% weight gain (vs −5% to 5%) had an increased risk of DM (hazard ratio [HR] 2.01, 95% CI [1.30, 3.08]), metabolic syndrome (HR 2.24, 95% CI [1.55, 2.62]), and cardiometabolic outcomes (HR 1.54, 95% CI [1.22, 1.95]). Participants who lost more than 5% of their baseline weight had a lower risk of incident metabolic syndrome (HR 0.67, 95% CI [0.42, 1.07]). Trends for WC were similar. Conclusions Weight and body composition changes in the first year following ART initiation are associated with contemporaneous changes in metabolic parameters and subsequent cardiometabolic disease. [ABSTRACT FROM AUTHOR]

Background Persons with human immunodeficiency virus (HIV, PWH) are at increasingly higher risk for metabolic complications, including diabetes mellitus (DM). Additionally, depression is highly prevalent among PWH and has been associated with increased risk for DM in the general population. However, the association of HIV and depression with incident DM has not been well established. Methods Using the Veterans Aging Cohort Study (VACS), we selected adults with and without HIV who did not have DM at baseline. Prevalent depression was defined as having a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 10. Incident DM was identified using validated Kelly's criteria. Basic clinical and demographic characteristics were collected, and Cox proportional hazards regression models were run to test the association between depression and incident DM stratified by HIV serostatus. Results A total of 5722 participants were analyzed, 2886 (53%) had HIV and 1124 (20%) had depression at baseline. In total, 1235 (22%) participants developed incident DM during follow-up, with 26% of HIV-negative participants developing DM compared to 17% of participants with HIV. Depression was significantly associated with increased risk of incident DM among HIV-negative participants (adjusted hazard ratio [aHR] = 1.31; P value.003) but not among participants with HIV (aHR 1.09; P value.44). However, among participants with HIV with baseline viral load < 500 copies/mL, we noted a stronger association between depression and incident DM. Conclusions Incident DM in the VACS cohort is significantly higher for HIV-negative participants compared to veterans with HIV. A significant association between depression and incident DM was noted among HIV-negative participants but not among those with HIV. [ABSTRACT FROM AUTHOR]

Background: Early in the history of kidney transplantation, short-term graft survival was low. Yet some have had excellent long-term survival. Herein, we describe characteristics of pediatric recipients with > 40 years of graft survival currently alive with a functioning first graft. Methods: We reviewed all pediatric (age < 18 years) kidney transplants performed at the University of Minnesota between January 1, 1970, and December 31, 1979 (n = 148), to identify all recipients currently alive with a functioning first graft. Data are presented as medians with interquartile ranges (IQR) and proportions. Results: We identified 10 recipients with > 40-year graft survival (median follow-up: 45.0 years (IQR: 43.1, 48.1)). The median age at transplant was 13.8 years (IQR: 5.1, 16.3). All recipients were white; half were male. Of the 10, 4 had glomerulonephritis, 2 had congenital anomalies of the kidney and the urinary tract, 2 had congenital nephrotic syndrome, 1 had Alport syndrome, and 1 had cystic kidney disease as kidney failure cause. Nine patients received a living-related donor transplant, and 1 patient received a deceased-donor transplant. The median estimated glomerular filtration rate at 20 years post-transplant was 79.9 (IQR: 72.3, 98.4); at 30 years, 67.7 (IQR: 63.2, 91.8); and at 40 years, 80.3 ml/min/1.73 m2 (IQR: 73.7, 86.0). None developed rejection, 5 developed hypertension, 2 developed dyslipidemia, 1 developed diabetes, and 7 patients developed malignancy (4 skin cancer, 2 breast cancer, and 1 post-transplant lymphoproliferative disease). Conclusion: Pediatric kidney transplant recipients may achieve > 4 decades of graft survival. Cancer is a common complication warranting vigilant screening. [ABSTRACT FROM AUTHOR]

Background: The contribution of psychosocial stress in the workplace to development of type 2 diabetes mellitus (T2DM) is not well investigated. As most studies were conducted in Europe, a further test from the USA seems well justified. The objective of the current investigation was to examine prospective associations of work stress based on the effort-reward imbalance model with risk of T2DM in a national sample of US workers. Method: Using data from the national population-based Mid-life in the United States (MIDUS) study with a prospective cohort design and a 9-year follow-up period, the effects of a ratio combining data on effort and reward at work (ER ratio) at baseline on risk of T2DM at follow-up were examined in 1493 workers who were free from diabetes at the baseline survey, applying multivariable Poisson regression analysis. Results: During the follow-up, 109 individuals (7.30%) reported onset of diabetes. The analyses demonstrated a significant association between continuous data of the E-R ratio and risk of diabetes (RR and 95% CI = 1.22 [1.02, 1.46]), after adjustment for modifiable and non-modifiable risk factors at baseline. A dose-dependent response was observed with trend analysis when using quartiles of the E-R ratio. Conclusion: In the US workers, high effort in combination with low reward at work was significantly associated with elevated risk of T2DM 9 years later. The risk profiles of diabetes should be adapted in consideration of psychosocial work environment and taken into account by conceptualizing prevention programs of chronic non-communicable diseases. [ABSTRACT FROM AUTHOR]

Diabesity is a modern term that describes the coexistence of adverse health effects of diabetes mellitus and obesity and indicates a causal pathophysiological relationship between the two phenomena. The progression of diabesity leads to a deterioration of multiple organs and systems. Effective intervention for patients with diabesity must include optimal obesity therapy to prevent secondary complications. Metabolic surgery is the most effective and sustainable therapy for severe obesity and the elimination or prevention of many associated diseases, including type 2 diabetes mellitus, hypertension, sleep apnea, heart disease, and certain cancers. This review provides an up-to-date overview of surgical interventions for obesity, particularly the development of metabolic surgery. It evaluates different scoring systems for evidence-based selection of metabolic surgery based on disease severity. We reviewed different predictive scoring systems for better evidence-based selection of the best metabolic surgery for patients with diabesity. We found that medication type, fasting insulin level, and C-peptide influence the outcomes of different types of metabolic surgery and heterogeneous remission rates. There are different predictive scoring systems for evidence-based selection of the best metabolic surgery, either sleeve or mini-bypass, that will ensure the highest chance of diabetes remission. Using the metabolic score calculator is a useful tool to help medical specialists determine the optimal treatment strategy for a particular patient. More research is needed before we can agree on the ideal bariatric procedure that offers the highest chance of remission with the lowest incidence of hypoglycemia. [ABSTRACT FROM AUTHOR]

Aim: This article summarizes key research presented at the International AIDS Society (IAS) Conference in Brisbane, held in July 2023. Co‐morbidities: The REPRIEVE Trial as a conference highlight, demonstrating significantly fewer major cardiovascular events amongst people with HIV who were randomized to pitavastatin compared to placebo. Key data on weight, hypertension and incident diabetes are also summarized. Antiretroviral therapy: Novel data on doravirine and islatravir are described as are trials demonstrating efficacy dolutegravir/lamivudine first‐line in people without baseline resistance testing and in suppressed switch amongst people with historic lamivudine resistance. HIV Cure: The sixth case of HIV cure secondary to stem cell transplantation is summarized, as are new insights into the central nervous system as an HIV reservoir. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to develop a modified frailty index (MFI) to predict the risks of revision total hip arthroplasty (THA). Methods: Data from the American College of Surgeons - National Surgical Quality Improvement Program were analyzed for patients who underwent revision THA from 2015 to 2020. An MFI was composed of the risk factors, including severe obesity (body mass index > 35), osteoporosis, non-independent function status prior to surgery, congestive heart failure within 30 days of surgery, hypoalbuminemia (serum albumin < 3.5), hypertension requiring medication, type 1 or type 2 diabetes, and a history of chronic obstructive pulmonary disease or pneumonia. The patients were assigned based on the MFI scores (MFI0, no risk factor; MFI1, 1–2 risk factors; MFI2, 3–4 risk factors; and MFI3, 5+ risk factors). Confidence intervals were set at 95% with a P value less than or equal to 0.05 considered statistically significant. Results: A total of 17,868 patients (45% male, 55% female) were included and had an average age of 68.5 ± 11.5 years. Odds of any complication, when compared to MFI0, were 1.4 (95% CI [1.3, 1.6]) times greater for MFI1, 3.2 (95% CI [2.8, 3.6]) times greater for MFI2, and 10.8 (95% CI [5.8, 20.0]) times greater for MFI3 (P < 0.001). Odds of readmission, when compared to MFI0, were 1.4 (95% CI [1.3, 1.7]) times greater for MFI1, 2.5 (95% CI [2.1, 3.0]) times greater for MFI2, and 4.1 (95% CI [2.2, 7.8]) times greater for MFI3 (P < 0.001). Conclusion: Increasing MFI scores correlate with increased odds of complication and readmission in patients who have undergone revision THA. This MFI may be used to predict the risks after revision THA. [ABSTRACT FROM AUTHOR]

Context Volatile organic compounds (VOCs) are pervasive environmental pollutants that have been linked to various adverse health effects. However, the effect of ambient VOCs, whether individually or in mixtures, on diabetes remains uncertain and requires further investigation. Objective This study investigates the effects of ambient VOCs exposure, whether single or mixed, on diabetes mellitus and glucose homeostasis in the general population. Methods Urinary concentrations of VOC metabolites were obtained from the National Health and Nutrition Examination Survey. Survey-weighted logistic regression and generalized linear regression were used to explore the associations between individual VOC exposure and diabetes risk and glucose homeostasis indicators, respectively. Weighted quantile sum (WQS) regression models were applied to assess the combined effects of VOC mixtures. Results Out of 8468 participants, 1504 had diabetes mellitus. Eight VOC metabolites showed positive associations with diabetes mellitus (OR, 1.15-1.43; all P <.05), insulin resistance (IR) (OR, 1.02-1.06; P <.05), and other glucose homeostasis indicators (β, 0.04-2.32; all P <.05). Mixed VOC models revealed positive correlations between the WQS indices and diabetes risk (OR = 1.52; 95% CI, 1.29-1.81), IR (OR = 1.36; 95% CI, 1.14-1.62), and other glucose homeostasis indicators (β, 0.17-2.22; all P <.05). Conclusion Urinary metabolites of ambient VOCs are significantly associated with an increased diabetes risk and impaired glucose homeostasis. Thus, primary prevention policies aimed at reducing ambient VOCs could attenuate diabetes burden. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a commonly encountered clinical syndrome. Although it often complicates community acquired illness, it is more common in hospitalized patients, particularly those who are critically ill or who have undergone major surgery. Approximately 20% of hospitalized adult patients develop an AKI during their hospital care, and this rises to nearly 60% in the critically ill, depending on the population being considered. In general, AKI is more common in older adults, in those with preexisting chronic kidney disease and in those with known risk factors for AKI (including diabetes and hypertension). The development of AKI is associated with an increase in both mortality and morbidity, including the development of post-AKI chronic kidney disease. Currently, AKI is defined by a rise in serum creatinine from either a known or derived baseline value and/or oliguria or anuria. However, clinicians may fail to recognize the initial development of AKI because of a delay in the rise of serum creatinine or because of inaccurate urine output monitoring. This, in turn, delays any putative measures to treat AKI or to limit its degree. Consequently, efforts have focused on new biomarkers associated with AKI that may allow early recognition of this syndrome with the intent that this will translate into improved patient outcomes. Here we outline current biomarkers associated with AKI and explore their potential in aiding diagnosis, understanding the pathophysiology and directing therapy. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the associations of adolescent cardiorespiratory fitness (CRF), muscular fitness (MF), and speed‐agility fitness (SA) with middle‐aged cardiometabolic disease risk and explore sex differences. Methods: This 45‐year prospective cohort study examined the associations between objectively measured fitness at adolescence (12–19 years) and physician‐ascertained diabetes mellitus, elevated blood pressure (BP), and coronary heart disease reported either in early (37–44 years) or late (57–64 years) middle age, and self‐measurement of waist circumference (WC) in late middle age. Fitness measurements for healthy adolescents in baseline included CRF (1.5 km [girls] and 2 km [boys] run), MF (standing broad jump, sit‐ups, pull‐ups [boys], and flexed‐arm hang [girls]), and SA (50 m dash and 4 × 10 m shuttle run). Logistic regression and general linear models were adjusted for baseline age, sex, and body mass index (BMI), involving data from baseline and at least one follow‐up measurement (N up to 1358, 47% males). Results: Adolescent CRF was inversely, and regardless of adiposity, associated with middle age accumulated burden of cardiometabolic conditions in the whole sample (N = 562, ß = −0.10, 95% confidence intervals [CI] [−0.18, −0.03], p = 0.006), and elevated BP in females (N = 256, OR = 0.71, 95% CI [0.51, 0.91]). Overall, we observed stronger associations in females than in males. An inverse association of adolescent MF and SA with middle‐aged WC was observed, but it did not show as consistent associations as with CRF. Conclusions: In this study, adolescent fitness, particularly CRF, was inversely associated with the burden of cardiometabolic conditions up to 45 years. Promotion of fitness in youth may be beneficial in preventing adulthood cardiometabolic diseases. [ABSTRACT FROM AUTHOR]

Background: Family members (FMs) are a valuable source of support, as the bulk of daily diabetes treatment occurs at home. Family members' insufficient understanding of patient support can lead to poor diabetes outcomes. Lack of knowledge about good diet and exercise can lead to unhealthy food preparation and sedentary lifestyles, affecting patients and increasing the risk of diabetes. This study aims to fill the gap in the level of knowledge of FMs relating to appropriate care for diabetic patients under their care. This will relate specifically to diet and exercise. Methods: A cross-sectional survey conducted in Senwabarwana, Limpopo province, involved 200 FMs caring for diabetic patients for at least 6 months. Their experience could offer valuable insights into the competence of their care. Data were collected regarding knowledge and practice using a close-ended questionnaire, with Likert scale responses and SPSS analysis, including descriptive statistics and chi-squared tests. Knowledge was assessed on a scale ranging from poor to excellent: poor (0% - 50%), fair (51% - 60%), good (61% - 74%) and excellent (> 75%). Practice was assessed as poor (0% - 50%), fair (51% - 69%) and good (70% - 100%). Results: Thirty-one percent of participants demonstrated excellent knowledge and only 9% demonstrated good practice. Unfortunately, 53% stated that obese patients with diabetes should skip meals to lose weight. Only 3.5% and 19%, respectively, are familiar with recommendations for exercise and glucose monitoring. Barely 35.5% of FMs eat breakfast every day, while 87.5% report exercising. Conclusion: Few FMs possess excellent diabetes management knowledge but still indulge in bad practices, increasing their risk of developing diabetes. Additionally, they may potentially cause health problems for patients. Contribution: Family-centred behaviour change intervention is recommended. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the association between adiposity indices and the risk of incident diabetes and to compare their predictive ability in non-obese healthy individuals. Population-based cohort study. Data were taken from the NAGALA research study, which enrolled Japanese adults aged 18–79 years. Cox regression was used to evaluate the association between adiposity indices (including waist circumference [WC], waist-to-height ratio [WHtR], lipid accumulation product index [LAP], body roundness index [BRI], visceral adiposity index [VAI] and Chinese visceral adiposity index [CVAI]) and diabetes risk. The performance of the indices for predicting diabetes was explored using area under the receiver operating characteristic curve (AUC). A Chinese community–based population was used for validation. A total of 12,940 healthy Japanese individuals with normal body mass index and glycaemic levels were included and were followed up for a median of 6 years. Multivariable Cox models revealed a positive and significant association between all indices and incident diabetes, with the hazard ratios for the highest quartile of the indices ranging from 1.89 to 2.90 (all P -values < 0.01). A non-linear association between WC, BRI and VAI and a linear association between WHtR, LAP and CVAI and diabetes risk were observed. CVAI, VAI and LAP had comparable ability in predicting diabetes, with the highest AUC being 0.733 for CVAI. Data from 10,830 Chinese individuals confirmed these results. Adiposity indices are associated with incident diabetes in healthy non-obese individuals. Participants in the highest quartile of WC, WHtR, LAP, BRI, VAI and CVAI had an increased risk of developing diabetes. [ABSTRACT FROM AUTHOR]

Lack of sufficient physical activity (PA) has been associated with an increased risk of several non-communicable diseases (NCDs) and all-cause mortality. This study aimed to estimate the number of preventable incidence cases of NCDs attributable to insufficient PA in the Chilean population. Comparative risk assessment modelling study. This study examined data from 5834 participants aged ≥20 years from the Chilean National Survey (2016–2017). PA was assessed by the Global Physical Activity Questionnaire (GPAQ), and metabolic equivalent of tasks (METs) were assigned according to PA intensity. Estimated incidence cases of NCDs in Chile in 2019 were obtained from the Global Burden of Disease study. Relative risks for breast cancer, colon cancer, ischaemic heart disease, diabetes and stroke were obtained from a published meta-analysis and applied to the prevalence of insufficient PA estimates through the potential impact fraction equation. High levels of PA (≥8000 MET-min/week) could potentially avoid more than 22,000 (64.6 %) incidence NCD cases, ranging from 498 (10.1 %) preventable cases of breast cancer to 5629 (14.7 %) cases of diabetes. Other modelled scenarios also showed to reduce the incidence cases of all five NCDs but to a lesser extent; where at least PA recommendation was achieved, preventable NCDs were reduced by 6522 cases (18.7 %), and where a 10 % relative reduction in insufficient PA level in the population was achieved, preventable NCDs were reduced by 651 (1.8 %) cases. The study results provide estimates for the incidence cases of preventable NCDs attributable to insufficient PA, highlighting the important role of PA in NCD prevention in Chile. [ABSTRACT FROM AUTHOR]

Women living with HIV are reaching older age and experiencing menopause and age-related comorbidities. Data suggest that women living with HIV experience earlier menopause and more menopausal symptoms and age-related comorbidities compared to women without HIV. However, there are no guidelines on the screening for and management of age-related comorbidities and events in women living with HIV. Moreover, little is known about provision of care to this population across Europe. We surveyed 121 HIV healthcare providers in 25 World Health Organization European countries to ascertain screening practices for, and management of, menopause, psychosocial and sexual well-being and age-related comorbidities in women with HIV. Most respondents screened for diabetes, cardiovascular disease (CVD) risk factors and poor mental health at least annually. Low bone mineral density (BMD) was regularly checked but less than once a year. Fewer regularly screened for sexual well-being and intimate partner violence. Menstrual pattern and menopausal symptoms in women aged 45–54 were assessed by 67% and 59% of respondents. 44% stated that they were not confident assessing menopausal status and/or symptoms. CVD, diabetes, low BMD and poor mental health were managed mainly within HIV clinics, whereas menopause care was mainly provided by gynaecology or primary care. Most respondents stated a need for HIV and menopause guidelines. In conclusion, we found that whilst metabolic risk factors and poor mental health are regularly screened for, psychosocial and sexual well-being and menopausal symptoms could be improved. This highlights the need for international recommendations and clinician training to ensure the health of this population. [ABSTRACT FROM AUTHOR]

Background: Women with a history of gestational diabetes (GD) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD). Aim: To assess whether diabetes screening and CVD risk screening occurred in general practice (GP) among postpartum women with GD. Methods: This is a retrospective study of clinical record data of women with GD, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service MedicineWise, with GP sites located in Australia from January 2015 to March 2021. Documentation of screening for diabetes, assessment of lipids and measurement of blood pressure (BP) was assessed using proportions and mixed‐effects logistic regression with a log follow‐up time offset. Results: There were 10 413 women, with a mean age of 37.9 years (standard deviation, 7.6), from 406 clinics with a mean follow‐up of 4.6 years (interquartile range, 1.8–6.2 years) A total of 29.41% (3062/10 413; 95% confidence interval [CI], 28.53–30.28) had not been assessed for diabetes, 37.40% (3894/10 413; 95% CI, 36.47–38.32) were not assessed for lipids and 2.19% (228/10 413; 95% CI, 1.91–2.47) had no BP documented. In total, 51.82% (5396/10 413; 95% CI, 50.86–52.78) were screened for all three (diabetes + lipids + BP) at least once. Obesity, comorbidities and dyslipidaemia were associated with increased likelihood of screening. New diabetes diagnosis was documented in 5.73% (597/10 413; 95% CI, 5.29–6.18) of the cohort. Conclusion: Screening for diabetes and hyperlipidaemia was suboptimal in this high‐risk cohort of women with prior GD. Improved messaging that women with a GD diagnosis are at high cardiovascular risk may improve subsequent screening. [ABSTRACT FROM AUTHOR]

The article focuses on the effectiveness of a lifestyle intervention centered on weight loss in achieving remission of prediabetes and reducing the risk of developing type 2 diabetes. It mentions the study, based on the Prediabetes Lifestyle Intervention Study (PLIS) and validated with data from the Diabetes Prevention Program (DPP), identifies responders and nonresponders to the intervention.

Objectives: Women tend to have a higher risk of migraine compared to men. Apart from the conventional risk factors, this study aims to provide insight into the association between migraine and cardiovascular diseases (CVDs). The aim of this study was to assess the association between CVDs and migraine along with other conventional factors among migraineurs with and without aura. Materials and Methods: A case-control study was done among the women attending outpatient of a tertiary care hospital those having hypertension, coronary artery disease, and stroke at the age of >30-60 years, and those who do not have any of the CVDs. Conventional risk factors such as age, body mass index (BMI), physical activity, frequent junk food intake, BMI, and presence of diabetes were assessed along with migraine status adhering to the International Classification of Headache Disorders-3. Comparison of risk factors among cases and controls was done using the Chi-square test and independent t-test whichever was appropriate. Results: Our study included 191 cases and 191 controls; among the cases, hypertensives were predominant. There was a statistically significant association between migraine and any CVD with an increased risk of 12.35 times (confidence interval 7.12-21.4). The only statistically significant risk factor among the cases was the frequent intake of junk food and uncontrolled status was more among those migraineurs having an aura. Conclusion: The importance of migraine as one of the risk factors should be kept in mind among CVDs to implement prevention strategies at the earliest. [ABSTRACT FROM AUTHOR]

Context Mitochondrial DNA (mtDNA) plays a key role in diabetes mellitus and metabolic syndrome (MetS). An increasing number of studies have reported the association between mtDNA copy number (mtDNA-CN) and the risk of diabetes mellitus and MetS; however, the associations remain conflicted and a systematic review and meta-analysis on the association between mtDNA-CN and diabetes mellitus and MetS is lacking. Objective We aimed to investigate the association of mtDNA-CN and diabetes mellitus and MetS using a systematic review and meta-analysis of observational studies. Methods PubMed, EMBASE, and Web of Science were searched up to December 15, 2022. Random-effect models were used to summarize the relative risks (RRs) and 95% CIs. Results A total of 19 articles were included in the systematic review and 6 articles (12 studies) in the meta-analysis involving 21 714 patients with diabetes (318 870 participants) and 5031 MetS (15 040 participants). Compared to the highest mtDNA-CN, the summary RR (95% CIs) for the lowest mtDNA-CN were 1.06 (95% CI, 1.01-1.12; I2 = 79.4%; n = 8) for diabetes (prospective study: 1.11 (1.02-1.21); I2 = 22.6%; n = 4; case-control: 1.27 (0.66-2.43); I2 = 81.8%; n = 2; cross-sectional: 1.01 (0.99-1.03); I2 = 74.7%; n = 2), and 1.03 (0.99-1.07; I2 = 70.6%; n = 4) for MetS (prospective: 2.87 (1.51-5.48); I2 = 0; n = 2; cross-sectional: 1.02 (1.01-1.04); I2 = 0; n = 2). Conclusion Decreased mtDNA-CN was associated with increased risk of diabetes mellitus and MetS when limited to prospective studies. More longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

Aims: To explore the association between known risk factors for diabetes and diabetes prevalence among disaggregated Asian American sub-ethnic groups and to highlight the importance of looking at data in disaggregated form. Methods: Ten years of data collected by the California Health Interview Survey were pooled and analyzed. Logistic regression models, controlling for age, gender, and marital status, were used for the analysis. Comparisons were made among an aggregated sample of Asian Americans (N = 21,267) and a disaggregated sample of Asian Americans (i.e., Chinese, Japanese, Koreans, Filipinos, South Asians, and Vietnamese). Results: Disaggregated data showed that Korean Americans who smoked had three times the odds of having diabetes compared to non-smoking Korean Americans [OR = 3.02 (95% CI 1.43, 6.39)]. High blood pressure puts both Japanese and Filipino Americans at twice the odds of having diabetes as those who do not have high blood pressure ([OR = 2.23 (95% CI 1.09, 4.54) and [OR = 2.82 (95% CI 1.82, 4.36)], respectively). Although close to 10% of Vietnamese Americans in the sample were current smokers, smoking status was not associated with diabetes. Conclusions: The association between diabetes and known risk factors differ across Asian American sub-ethnic groups. Findings highlight the importance of disaggregated data and discourage a one-size-fits-all approach to diabetes care strategies. [ABSTRACT FROM AUTHOR]

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Abstract Background The prevalence of type 2 diabetes mellitus (T2DM) has been increasing rapidly in Iraq over the past few decades. Identifying the most significant factors contributing to the development of T2DM is crucial to reducing its prevalence in this region. Genetics and epigenetics have been shown to play a role in the initiation of T2DM, making it essential to study the genetic variations of diabetic patients to identify common biomarkers associated with this disorder in Iraq. Methods We conducted a systematic review and meta-analysis of published data to identify potential pathological indicators associated with T2DM in Iraq. We searched various databases and included studies that reported the association between genetic biomarkers and T2DM in Iraqi patients. We then analyzed the data using a random-effects model to estimate the overall effect size and identify the most common biomarkers associated with the risk of T2DM. Results We identified 31 explored genes in 41 studies that exhibited the most common biomarkers with a strong association with the risk of T2DM in Iraq. Our exploration embraced genomic, demographic, and sensitivity analyses, enriching insights. Conclusions Our study provides valuable insight into the genetic SNPs associated with T2DM in Iraq and offers a foundation for future research in this area. The identified SNPs can help in the development of personalized treatment options, leading to better disease management and improved patient outcomes. The study also highlights the need for further investigation into potential genetic SNPs and factors that may contribute to the development of T2DM in Iraq. While our study is limited by the sample sizes of some of the included studies, it provides a starting point for researchers seeking to identify common diagnostic markers for T2DM in Iraq.

Medication-induced diabetes (MID) is common during induction therapy for pediatric acute lymphoblastic leukemia (ALL) and has potentially significant negative consequences. Reported risk factors for MID are variable with limited data comparing patients treated with standard-risk (SR) vs. high-risk (HR) regimens. This study aims to evaluate the incidence and risk factors for MID during induction in patients with ALL from the Maritimes over a 20-year period. We performed a retrospective single-center study of 262 patients (142 males, 120 females) diagnosed with ALL at IWK Health in Halifax, Nova Scotia, Canada, from 2000 to 2019. Older age, higher body mass index, greater central nervous system status, Trisomy 21, and prednisone steroid type were risk factors associated with MID in our cohort. HR patients developed significantly more complications than SR patients including MID and infection. Screening for MID should be routine during ALL induction treatment, particularly in those with HR disease. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine whether diabetes mellitus is causally associated with osteonecrosis. Method: Using publicly accessible genome-wide association study statistics, a bidirectional two-sample Mendelian randomization analysis was carried out. In order to determine whether diabetes has a causal effect on osteonecrosis and whether osteonecrosis has a causal effect on diabetes, we extracted six date on diabetes in Europeans from IEU OpenGWAS and GWAS Catalogue and osteonecrosis in Europeans from FinnGen. We then evaluated the data using inverse variance weighting, MR-Egger regression, weighted median, weighted mode, and simple mode. The results' stability and dependability were then evaluated using sensitivity analysis and heterogeneity analysis. Finally, meta-analysis is used to further confirm if there is a relationship between diabetes and osteonecrosis. Results: When diabetes was used as an exposure factor, MR-Egger regression showed that directional fold product was unlikely to bias the results. Cochran's Q test showed only minor heterogeneity in a few data sets. Multidirectional tests Egger-intercept, MR-PRESSO and funnel plots for most data did not show multidirectional and asymmetry at the gene level. Most of the IVW results showed no causal relationship between diabetes mellitus and osteonecrosis. The results of meta-analysis of IVW methods further confirmed the absence of a causal relationship. Inverse MR analysis also showed no causal relationship between osteonecrosis and diabetes. Conclusion: Results of bidirectional MR analysis show no evidence of causal relationship between diabetes and osteonecrosis. [ABSTRACT FROM AUTHOR]

Background We investigated the association between nonalcoholic fatty liver disease (NAFLD) plus or minus a concurrent diagnosis of nonalcoholic steatohepatitis (NASH) and incident diabetes mellitus (DM) and the risk factors associated with NAFLD or NASH development. Methods In this prospective study, we analyzed people with human immunodeficiency virus (HIV; PWH) aged ≥18 years without excessive alcohol consumption or hepatitis coinfections. NAFLD was defined as controlled attenuation parameter ≥248 dB/m, whereas NASH with significant disease activity and liver fibrosis was defined as a FibroScan-AST score ≥0.67. Cox proportional hazard regression was used to investigate the association between NAFLD with or without NASH and new-onset DM. Results Of 847 PWH, the median age at baseline was 45 years (interquartile range, 38–51; 43% female). Baseline NAFLD was associated with 2.8-fold higher risk of new-onset DM after adjusting for age, sex, family history of DM, antiretroviral therapy duration, smoking, statin use, stavudine/didanosine/zidovudine exposure, time-updated body mass index, hypertension, and dyslipidemia. Combined NAFLD and NASH at baseline had 3.1-fold higher new-onset DM risk. In separate analyses, baseline DM did not predict progression to NAFLD or NASH, but tenofovir alafenamide use was associated with an increased risk of NAFLD (hazard ratio [HR], 2.01; 95% confidence interval [CI], 1.02–4.02) or NASH development (2.31; 95% CI, 1.12–5.11). Conclusions NAFLD alone or combined with NASH strongly predicts new-onset DM. This highlights the need for systematic risk assessments and management of NAFLD/NASH, as it may contribute to metabolic complications such as DM and subsequent cardiovascular diseases in PWH. [ABSTRACT FROM AUTHOR]

Background: To improve preventative health screening in regional Victoria, Australia, a collaborative student-led health prevention strategy was initiated. The aim of this study is to evaluate the impact of four health check clinics using a free 'pop-up' format within community settings. Methods: A mixed methods, explanatory sequential design was used to explore community health data and participant experiences in utilising the free health check clinics. The clinics were delivered over 6 months and located in three different communities within the regional government area. Descriptive statistics were used to analyse participant health data and a thematic analysis was utilised to determine themes from participant feedback and health outcomes. Results: The clinics were attended by 188 community members, largely impacted by government lockdowns during the coronavirus disease 2019 (COVID-19) pandemic. Health check results indicate the population is overweight and at high risk of diabetes. Participants enjoyed the free and convenient nature of the health check program and the location of the venues. Feedback from participants indicate the health education provided was useful and advocated for changes in current behaviours. Many embraced the new information and community connections and made changes to improve their future health. Others claimed to enjoy the clinic experience but reported no action from the recommendations. Conclusions: Evaluation of the health check clinics indicate they had a minor, yet positive impact on the local community in increasing engagement with preventative screening strategies. COVID-19 restrictions impacted participant numbers and thus more research is needed in a time where community movement is not limited. Access to preventative health care and screening is often challenging in regional areas. Free student-led pop-up health check clinics provide improved access and convenience, offering health education and early intervention strategies that aim to reduce future chronic health within the local population. This study demonstrates how community collaboration is able to provide screening services, support healthy behaviour change and strengthen the development of future health practitioners. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome represents aggregation of risk factors associated with an increased risk of developing type 2 diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). Assessing its incidence is an effective way for estimating the future burden of DM and ASCVD and understanding their secular trends and effect of public health measures on halting the evolution of risk factors. The present study aimed to estimate the incidence of metabolic syndrome and its predictors using a population-based cohort. Methods: A subset of Chandigarh Urban Diabetes Study cohort (n = 1023) without diabetes or metabolic syndrome was prospectively evaluated after a mean of 10.7 years. Metabolic syndrome was defined as per International Diabetes Federation criteria and diabetes as per American Diabetes Association standards. The incidence was calculated in 1000 person years, and multivariate logistic regression was used to estimate the strength of association between incident metabolic syndrome and risk factors. Results: In the followed-up individuals (n = 303), incidence of metabolic syndrome was 32.1 per 1000 person years (95% CI 26.3–38.7 per 1000 person years). Amongst those developing metabolic syndrome, ≥4 components were present in 52% individuals, with low HDL-C being the most common abnormality. Those with metabolic syndrome had a five-time higher risk of diabetes (OR: 4.94; 95% CI: 2.27–9.96; p < 0.001) and a threefold higher risk of hypertension (OR: 2.67; 95% CI: 1.30–5.48; p = 0.006). Conclusion: Asian-Indians have a high incidence rate of metabolic syndrome, which is associated with sedentary lifestyle and consequent central obesity. [ABSTRACT FROM AUTHOR]

Aim: Prediabetes is a strong predictor for type 2 diabetes mellitus (T2DM). However, the possible effects of other factors on the above association are unknown. This study aimed to determine factors associated with the progression of prediabetes to T2DM. Materials and methods: In the present prospective cohort study, 757 individuals with prediabetes included in the Fasa cohort study were identified and followed for 5 years in order to diagnose T2DM. The baseline demographic, medical, and clinical records of participants were surveyed. Latent class analysis (LCA) and Cox regression model were applied to evaluate potential factors affecting the rate of progression of prediabetes to T2DM. p values less than 0.05 were considered significant. Results: The annual cumulative incidence rate of diabetes was 124.1 per 1000 population. A total of 3 different latent classes were among participants including fatty liver & DII class (FLDc), with 18.58%, metabolic syndrome class (MSc), with 31.44%, and high-risk class (HRc), with 49.98% of the participants. Based on the results of Cox multivariate regression analysis, the risk of progression to T2DM was significantly raised with the presence of FLDc (HR = 2.37, 95% CI: 1.19, 4.74). Conclusion: Our findings show that the cumulative diabetes incidence was alarmingly high in Iran. Also, the cooccurrence of factors such as high fatty liver index, high DII score, metabolic syndrome, and waist-to-hip ratio increased the risk of diabetes in prediabetic individuals. These results point out the importance of applying effective preventive interventional programs for prediabetic individuals. [ABSTRACT FROM AUTHOR]

Objectives: Cholelithiasis or gallstones has many risk factors, such as age, sex, obesity, dyslipidemia, and diabetes mellitus (DM). Studies in developing country shown that obesity, dyslipidemia, and DM occurred in 55.0%, 76.0%, and 17.7% of adults with cholelithiasis, respectively. The aim of this study is to know the proportion of cholelithiasis risk factors. Materials & methods: This retrospective study using descriptive cross sectional design performed in one of the largest referral hospital in Jakarta Indonesia. Demographic data, and laboratory examination were collected from medical record. Patients presented with cholelithiasis from the abdominal ultrasonography was enrolled into study. Results: 93 subjects were selected through consecutive sampling, where in 65.8% were female and 77.5% age>40 years. The majority was obese (47.3%) and the obesity grade I was most prevalent. Dyslipidemia was found in 19.3% subjects with proportion of high total cholesterol was 54.5%, high LDL 90.9%, high triglycerides 27.3%, and low HDL 18.2%. DM was found in 15.0% subjects. Random blood glucose had higher proportion, accounting 57.2% with mean 140.67±89.69 mg/dl. Female and age>40 years had more proportion in cholelithiasis patients. Conclusions: Proportion of cholelithiasis with obesity 47.3%, dyslipidemia 19.3%, and diabetes 15.0%. However, the proportion of obesity, dyslipidemia and diabetes in this study was lower than other studies in Asia or developing countries. Patients with obesity grade I, high LDL and RBG>40 mg/dl should be aware to have cholelithiasis. [ABSTRACT FROM AUTHOR]