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Neonatal diabetes mellitus (NDM), defined as diabetes with an onset during the first 6 months of life, is a rare form of monogenic diabetes. The initial publications on this condition began appearing in the second half of the 1990s and quite surprisingly, the search for new NDM genes is still ongoing with great vigor. Between 2018 and early 2024, six brand new NDM‐genes have been discovered (CNOT1, FICD, ONECUT1, PDIA6, YIPF5, ZNF808) and three genes known to cause different diseases were identified as NDM‐genes (EIF2B1, NARS2, KCNMA1). In addition, NDM cases carrying mutations in three other genes known to give rise to diabetes during childhood have been also identified (AGPAT2, BSCL2, PIK3R1). As a consequence, the list of NDM genes now exceeds 40. This genetic heterogeneity translates into many different mechanism(s) of disease that are being investigated with state‐of‐the‐art methodologies, such as induced pluripotent stem cells (iPSC) and human embryonic stem cells (hESC) manipulated with the CRISPR technique of genome editing. This diversity in genetic causes and the pathophysiology of diabetes dictate the need for a variety of therapeutic approaches. The aim of this paper is to provide an overview on recent achievements in all aspects of this area of research. [ABSTRACT FROM AUTHOR]

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience’s Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study’s results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity.

BACKGROUND: Coronavirus disease (Covid-19) causes a systemic inflammatory syndrome with pulmonary involvement. Rheumatological involvement in patients with mild clinical forms of Covid-19 is uncertain. Diabetes mellitus (DM) is known to increase susceptibility to viral infections. Also, patients with DM have a reduced Angiotensin converting enzyme 2 (ACE2) expression that might contribute to the increased predisposition to severe lung injury. The aim of the work is to study the rheumatological manifestations with assessment of ACE2 level in post COVID patients with and without diabetes mellitus (DM). METHODS: We included a total of 160 consecutive patients in Covid-19 convalescent phase (after clinical recovery), all of them diagnosed with a positive PCR test. All participants were divided into two categories: 80 patients with COVID-19 and DM and another 80 patients with COVID-19 without DM. All patients subjected to history taking, clinical assessment, laboratory investigations (including serum ALT, AST, Albumin, Urea, Creatinine, FBG, HBA1c, Procalcitonin, CRP, Hemoglobin, WBC, Platelet count, Neutrophile count, Lymphocyte count, D-Dimer and ACE2). RESULTS: Patients with DM have a higher significant mean serum level of ACE2 (43.90 ± 20.04). Regarding post COVID rheumatological manifestation, patients with DM have a higher significant severe arthralgia and arthritis with higher significant serum level of anti-nuclear antibody (ANA), rheumatoid factor (RF) and Anti-citrullinated protein (CCP) (p < 0.05). COCLUSIONS: We found that COVID-19 patients with D.M have a higher risk of rheumatological complications with higher level of ACE2 than COVID-19 patients without D.M. [ABSTRACT FROM AUTHOR]

Contexto: según datos de la Federación Internacional de Diabetes (IDF, según sus siglas en inglés) correspondientes al año 2021, tres de cada cuatro pacientes con diabetes viven en países de bajos o medianos ingresos y se espera que el número de individuos alcance los 783 millones para el año 2045. La diabetes fue la causa de muerte del 12,2 % de las personas en el mundo para el año 2021 y, actualmente, los países con mayor número de personas que padecen diabetes son China, India y Estados Unidos. En América del Sur, Brasil ocupa el primer lugar, seguido de México y Colombia. El manejo integral de la diabetes es recomendado en las guías y los programas de abordaje interdisciplinario que buscan un adecuado control, con disminución de hipoglucemias, de complicaciones y generación de autocuidado. La clasificación de la diabetes es un pilar fundamental en el abordaje terapéutico, pronóstico y posibles complicaciones. Objetivo: se realizó una revisión bibliográfica narrativa de la clasificación de la diabetes y sus características. Metodología: se realizó una búsqueda de artículos indexados entre los años 2016 y 2022, en los buscadores Pubmed, Embase, Science Direct y Scopus. Resultados: se encontraron un total de 45 artículos y se seleccionaron 19 por conveniencia. Conclusión: una adecuada clasificación de la diabetes mejora el pronóstico, previene complicaciones y disminuye los gastos. La clasificación de la Asociación Americana de Diabetes y las variables propuestas no son suficientes para subclasificar los fenotipos de la diabetes mellitus tipo 2. El uso de más variables en la subclasificación generará un proceso más complejo, pero permitirá una mejor precisión en tratamientos, prevención de complicaciones y disminución de costos.

Background and Objective: Type 1 diabetes mellitus and its associated comorbidities are regarded as significant health issues. The present research aims to assess the impact of glycemic control on lipid profile of hospitalized patients with type 1 diabetes mellitus and for early diagnosis of dyslipidemia in cases with type 1 diabetes mellitus. Methods: This cross-sectional was conducted at the Pediatric Department of Al-Imamain Al-Kadhmain Medical City from March 2018 to July 2019. Information about the gender and age of the patient, the age of diagnosis and duration of diabetes, insulin therapy: 2-3 times a day, regular blood sugar checking (daily) were collected using a questionnaire. Using American Diabetes Association criteria, cases were separated into excellent and poor glycemic control groups, and lipid profile anomalies were compared. Findings: Out of the total of 128 people present in this study, 86 people (67%) had poor control. Increasing age of patients was associated with poor blood sugar control, so that between the ages of 13 and 18, 47 cases (54.7%) had poor control. It also increased the duration of poorly controlled diabetes. An increase in triglyceride level was evident in 76 people (88.4%), cholesterol in 52 people (60.5%) and low-density lipoprotein in 12 people (14%) among patients with poor control. Conclusion: The results of the present study showed that increasing age and duration of the disease and high levels of triglycerides, cholesterol and low-density lipoprotein are predictors of poor glycemic control in children with type 1 diabetes.

Introduction: Among the different ethnic groups in India, diabetes prevalence varies. Microtubule actin cross-linking factor 1 (MACF1) variant rs2296172 has been identified as a type 2 diabetes candidate gene and was found to be associated with T2D in multiple populations. Aim: To study the clinical-biochemical profiles and the mutation in MACF-1 gene variant rs2296172 and their association with type 2 diabetes in Bhargava population. Methodology: Hospital based cross sectional study was conducted in the Department of Medicine, S.P. Medical College & AGH, Bikaner.144 individuals (34 previously diagnosed type 2 diabetic and 30 non diabetic from Bhargava community and 40 type 2 diabetic and 40 non diabetic from non Bhargava community) were included in the study and evaluated for demography and laboratory investigations. Genetic analysis of these sample for MACF 1 rs2296172 variant gene polymorphism with known primer sequence was done by PCR amplification method at Multi-Disciplinary Research Unit (MDRU) of S.P. Medical College, Bikaner. Results: In our study we found that in diabetic Bhargava (db), non diabetic Bhargava (ndb), diabetic non Bhargava (dnb) and non diabetic non Bhargava (ndnb) respectively mean systolic blood pressure(135.47,117.20,127.00,117.60); mean BMI (27.70,25.16,27.91,22.59); mean waist hip ratio (.96,.93,.96,.87); mean crp (9.42,2.84,4.09,3.14); mean HDL (46.72,52.50,51.66,55.02); mean LDL (109.47,91.06,69.24,68.66); mean cholesterol (186.53,181.67,157.50,148.00). we also found MACF-1 gene rs2296172 SNPs proportion in db, ndb, dnb, ndnb study group respectively is 23.53%,13.33%,17.5%,10%. These result suggest possible role of metabolic, inflammatory and genetic factors in the prevalence of type 2 diabetes mellitus in Bhargava community. Conclusion: Our results and results from other independent cohort studies indicate that Type 2 diabetes mellitus in Bhargava community is more prevalent among elderly respondents and is associated with high socioeconomic status, obesity, dyslipidemia and elevated levels of CRP. MACF-1 rs2296172 variant gene need to be further evaluated in Indian population, so that it can be attributed as a common biomarker of type 2 diabetes mellitus in Indian population. [ABSTRACT FROM AUTHOR]

Aim: This study attempts to measure the total amounts of LH, FSH, prolactin, testosterone, and fasting Blood Glucose (F.B.G) in diabetic Women. The specimen is divided into two classes; the first class consisted of forty women who have diabetes type 2 with polycystic ovary syndrome (PCOS). The second class is twenty (control) Material and method: The results in this work showed a successive increase (LH, Prolactin, Testosterone, and fasting Blood Glucose (F.B.G)) at (P <0.005) in women who have diabetes type 2 with polycystic ovary syndrome when compared to the control class, while the outcomes indicated a decrease in the level of (FSH Hormone) at (P <0.005) when compared healthy group. Statistics and Result: Diabetes Mellitus Type 2 affects the levels of the LH Hormone (8.1±3.9), Prolactin (11.3±5.1), Testosterone Hormone (230±118.2), fasting Blood Glucose (222.1± 12.10), and the level of (FSH Hormone 5.6±1.3) in women. Hence, high blood sugar in women leads to infertility for them. Infertility affects a significant portion of women with type 2 diabetes and polycystic ovaries, which is why this issue has to be studied. One of the most crucial answers to this issue is to follow the advice given by the doctor and try to treat lowering blood sugar and reach the normal limit because high sugar affects the ovaries and thus causes infertility. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Croatica is the property of Croatian Academy of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The main aim of this research is to evaluate the social insights of type 2 diabetes (T2D), by comparing and contrasting different theoretical models that undertake social justification for such disease. Three hypotheses model the evolution of this study: (1) social and demographic determinations as well as clinical studies are not capable to provide a sustainable explanation for the impossibility of diabetes patients to maintain a proper metabolic control, they must be intimately correlated with subjective, emotional, psychological factors describing the mental health of the patient; (2) the patient must be conceived as a double-role agent, who suffers from such a disease and finds himself in the position to operate the management the disease; (3) social relationships that can facilitate or, on the contrary, reduce the risk of this chronic condition. Therefore, the research attentively selects and evaluates models of comprehending social insights of type II diabetes, inspired by Giddens’ sociological pattern of relating individual and social agencies and the Levanthal model. One of the major outcomes of this comparative study is that it frames multiple perspectives bridging medical and psychological factors in addressing causal and consequential social implications of type II diabetes. [ABSTRACT FROM AUTHOR]

Background and objectives: Considering racial/ethnic differences is necessary when recommending lifestyle modifications for patients with diabetes. Racial/ethnic diversity may affect hypoadiponectinemia responses to exercise training among individuals with type 2 diabetes. This systematic review and meta-analysis is the first to investigate effects of exercise training on circulating adiponectin concentrations in Iranians with type 2 diabetes. Methods: Literature searches of the Cochrane Central Register of Controlled Trials were carried out using the following search strategy: [exercise OR training OR physical activity OR Training] AND diabetes AND adiponectin. Next, RCTs were included and compared with each type of supervised exercise (aerobic training, resistance training, or combined training). Pooled intervention effects were evaluated and reported as standardized mean difference (MD) and 95% confidence intervals using a random effects model. Subgroup and sensitivity analysis was performed for study heterogeneity and following primary screening full text of the articles was evaluated. Results: Fourteen studies with 444 individuals (236 men and 128 women) were included in the analysis. The age of the participants ranged between 18 and 60 years. The number of exercise sessions per week ranged between 3 and 5. The duration of interventions ranged between 6 and 12 weeks. The meta)analysis showed that adiponectin levels increased significantly in diabetic subjects after physical activity (MD: 0.72 ng/dl, p<0.001,), but the heterogeneity of the study remained significant (I2= 89%). Conclusion: Overall, physical exercise, particularly aerobic exercise, increases adiponectin levels in Iranians with diabetes. However, this effect of exercise may be influenced by race/ethnic differences, type of training, frequency, type of adiponectin measurement, and complex and heterogeneous exercise responses of individual with diabetes [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of the present paper is to provide a narrative review of the markers and pathways of periodontitis-associated insulin resistance (IR). Materials and Methods: Research papers published in peer-reviewed scientific journals from 2000 to 2021 were searched systematically in Online Cochrane Library, Google Scholar, and MedLine/PubMed database. The medical subject headings (MeSH) terms used for literature search were "diabetes AND periodontal disease," "diabetes AND periodontitis," "inflammation AND insulin resistance," "Insulin resistance AND periodontal disease," and "insulin resistance AND periodontitis." Manual search for applicable work in review article peer-reviewed print journals, and latest editions of standard textbooks of pharmacology and pathology were searched for updated additional information. Relevant papers in English language on the topic and abstracts of pertinent articles after excluding the duplicates, animal studies, and in-vitro studies were also scrutinized thoroughly and finally included as required in this narrative review. Results: Literature search in MedLine/PubMed with MeSH words mentioned above revealed 4,621, 4,993, 19,349, 414, and 434 papers, respectively. Seven out of 13 systematic reviews and a total of 18 randomized clinical trials to evaluate periodontitis-induced IR were short-listed to update current evidences. The current literature in the past two decades has evaluated the effect of periodontal therapy on various type-2 diabetes (T2D) biomarkers following periodontal therapy. These indicators of periodontal disease activity and surrogate biomarkers of T2D in periodontitis may be an important diagnostic tool for the early prediction of complications due to IR. This increased systemic burden of proinflammatory cytokines by periodontitis can be reduced by periodontal therapy, thus improving the patient's overall systemic condition. Conclusion: The inflammatory response in periodontitis is characterized by dysregulated secretion of host-derived mediators of inflammation and tissue breakdown that may lead to IR. It can be comprehended that periodontal disease is a recognized amendable risk factor for T2D. [ABSTRACT FROM AUTHOR]

OBJECTIVES The aim of this study was to assess pregnancy induce diabetes and hypertension in medical doctors. METHODOLOGY This case-control study was conducted after approval by the ethics committee. A total of 72 physicians who were pregnant and diagnosed with pregnancies causing hypertension or diabetes participated in the study. Daily details of hourly blood glucose levels were recorded at the beginning and end of the day. Use SPSS version 24.0 to analyze the results. RESULTS Out of the 33 patients, 23 remained hypertensive at the end of the day, while 10 had normal hypertension at the beginning of the day. Hypotension appeared from the 39th day of which 24 of her ended high, 15 were normal and 10 were diet controlled. The maximum number of pregnancies was 40 in high-care controls and 32 in low-care controls. Out of 30(16) had high FBS at the beginning of the day and 17 of the 42 who had the highest at the end of the day had low FBS. The highest score of 17(42) was presented at the beginning of the day with low FBS and 17 at end of the day with a high ratio and high count of 42. CONCLUSION Health care is important for all patients, whether they are health workers or not. Daily Record helps patients and providers understand patient disease management and take appropriate action.

Background: Diabetes Mellitus (DM) is an established independent predictor of adverse prognosis in patients undergoing percutaneous coronary intervention (PCI) even with improvements in diabetes treatment and interventional techniques. The aim of this study was to compare long term post PCI outcome between diabetic and non-diabetic patients with ischemic heart disease (IHD). Method: The data was derived from a prospective observational study to evaluate the outcome after PCI in DM patients for 2 years. A total of 305 patients with IHD & DM were randomly selected and enrolled who underwent PCI from 2010 to 2013 in an urban cardiac hospital of Bangladesh. The study population were divided into two groups with group 1 consisting of patients with DM (n=108) and group 2 of patients without DM (n=197). After the PCI, all patients were followed up for 2 years. The incidences of bleeding, stent thrombosis, myocardial infarction (MI), stroke and repeat revascularization were compared. Results: Diabetic patients had significant adverse outcomes having MI, stroke & MACCE respectively following 1 year (p= 0.018, 0.036 & 0.017) and MI following 2 years (p= 0.013) compared to non-diabetic patients. However, in multivariate analysis, diabetes mellitus was not found to be an independent predictor for 1-year & 2-year adverse events following PCI [OR 1.016 (0.317-3.259) & p 0.979, after 1 year and 1.554 (0.087 – 27.902) & p 0.765, after 2 years]. Conclusions: The outcome of PCI after 1 year and 2 years among diabetic and non-diabetic subjects with IHD differed significantly in respect of MI, stroke & MACCE. But this study failed to identify diabetes mellitus as an independent risk factor for 1-year and 2-year adverse outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Health Sciences Journal / Revista Ciências em Saúde is the property of Hospital de Clinicas de Itajuba - Associacao de Integracao Social de Itajuba and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Overweight and obesity are well-known risk factors for type 2 diabetes mellitus (T2DM). The effect of the maximum body mass index (BMImax), which indicates the highest body weight before the diagnosis of T2DM, is not fully understood. This study aimed to explore the predictive value of BMImax in the progression of diabetes. Methods: This prospective study recruited 2018 subjects with normal glucose tolerance in Beijing, China. The subjects were followed up for eight years, and the association between BMImax and glucose outcomes was evaluated. Results: Ninety-seven of the 2,018 participants developed diabetes by the end of the study. Compared to individuals with normal glucose tolerance, those who developed diabetes were characterized by higher levels of fasting plasma glucose (FPG), 2 h postload glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-c), a higher prevalence of a familial history of diabetes and a lower level of high‐density lipoprotein cholesterol (HDL-c). Multivariate regression analysis of sex-stratified groups suggested that FPG, HbA1c, SBP and familial history of diabetes were independent risk factors for diabetes, but that BMImax was a unique indicator for female patients. Conclusions: BMImax might be an independent predictor of T2DM in females, but it does not seem to be associated with the risk of diabetes in males. BMImax could be regarded as an indicator in the prevention and management of diabetes. [ABSTRACT FROM AUTHOR]

A chronic disease categorized by high blood sugar called diabetes mellitus (DM), Its prevalence is rapidly increasing all over the world. Peptin is a peptide produced by cells of pancreas. It plays as a physiologic enhancer of glucose-mediated insulin secretion. There, the current study aimed to note differences in the levels of newly diagnosed patients with T2DM controls. This study was directed at Salah el-Deen medical Clinic in Tikrit city and included women from Salah al-Din Hospital in Tikrit in the period since Feb to Jul 2020, 40 newly diagnosed patients T2DM and 40 healthy elderly women. Preptin, Hba1c, fasting blood glucose (FBS), blood urea (BU), and serum creatinine levels will be examined. The present study discovered a significant rise in Preptin (362.460.01pg ml-1), Hba1c (8.82.7 %), FBS (205±25.7mg dl-1), BU (20.71 ±4.3 mmol l-1), and creatinine (1.1±0.2mg dl-1) in female T2DM patients compared to the control group (222.8±30.7pg ml-1, 4.6±1.3 %, 99±15. The observed link between preptin level and diabetes mellitus a suggests that this peptide may play a role in the pathogenesis of DM, which may be of particular interest to a group DM that constitutes a major public health problem. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the prevalence of diabetes and pre-diabetes (pre-DM) has been estimated; also, some factors related to diabetes and pre-diabetes in the city of Kharameh, southern Iran, were investigated. Methods: This cross-sectional study was conducted on a total of 10,474 subjects aged 40–70 years who participated in phase one of PERSIAN Kharameh cohort carried out between 2015 and 2016. Eligible individuals were included in the study by census method. Results: Prevalence of diabetes is 20.17% (95% CI: 19.95–20.39) and that of pre-diabetes is 15.74% (95% CI 15.54–15.93). Multivariate logistic regression results showed that the prevalence of diabetes had a direct relationship with increasing age (p < 0.001), being single (p = 0.005), family history of diabetes (p < 0.001), abdominal obesity (p < 0.001), hypertension (p: < 0.001), and high triglycerides (p: < 0.001); also, it had an inverse relationship with residence in rural areas (p < 0.001), education (p < 0.001), and employment (p < 0.001). Also, the prevalence of pre-diabetes showed a direct relationship with increasing age (60–70 years p = 0.010), being single (p = 0.004), living in rural areas (P < 0.001), having a family history of diabetes (both P = 0.023), abdominal obesity (P < 0.001), hypertension (P < 0.001), high cholesterol (P < 0.001) and high triglycerides (P < 0.001), and an inverse relationship with female gender (P < 0.001), education (high school P = 0.022), employment (P = 0.010), and smoking habit (P = 0.019). These results were all statistically significant. Conclusion: The present study shows the high prevalence of diabetes and pre- diabetes in the city of Kharameh. Diabetes prevention policies should be developed and implemented for the public. [ABSTRACT FROM AUTHOR]

Objetivo: analizar los factores asociados a la angustia mental en personas con diabetes mellitus durante la pandemia de COVID-19. Método: estudio transversal, realizado en dos comunidades virtuales brasileñas de la plataforma Facebook, en el período de agosto de 2020 a enero de 2021. La muestra fue de 111 personas con diabetes. La evaluación de las condiciones de salud se realizó mediante un formulario electrónico, y se utilizó el Self Report Questionnaire-20 para identificar el sufrimiento mental. Los análisis descriptivos e inferenciales se expresaron mediante frecuencias y regresión logística simple y múltiple. Resultados: el sufrimiento mental está asociado a la condición de ser de género femenino, tener antecedentes de trastorno mental (depresión y ansiedad), el diagnóstico de diabetes desde hace más de seis años y a la presencia de complicaciones oftalmológicas, que potencializan las posibilidades de inestabilidades emocionales. Conclusión: el estudio ofrece subsidios para la dirección de estrategias de apoyo que minimicen los impactos psicosociales de la pandemia en las personas con diabetes.

BackgroundOverweight and obesity are well-known risk factors for type 2 diabetes mellitus (T2DM). The effect of the maximum body mass index (BMImax), which indicates the highest body weight before the diagnosis of T2DM, is not fully understood. This study aimed to explore the predictive value of BMImax in the progression of diabetes.MethodsThis prospective study recruited 2018 subjects with normal glucose tolerance in Beijing, China. The subjects were followed up for eight years, and the association between BMImax and glucose outcomes was evaluated.ResultsNinety-seven of the 2,018 participants developed diabetes by the end of the study. Compared to individuals with normal glucose tolerance, those who developed diabetes were characterized by higher levels of fasting plasma glucose (FPG), 2 h postload glucose (PBG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDL-c), a higher prevalence of a familial history of diabetes and a lower level of high‐density lipoprotein cholesterol (HDL-c). Multivariate regression analysis of sex-stratified groups suggested that FPG, HbA1c, SBP and familial history of diabetes were independent risk factors for diabetes, but that BMImax was a unique indicator for female patients.ConclusionsBMImax might be an independent predictor of T2DM in females, but it does not seem to be associated with the risk of diabetes in males. BMImax could be regarded as an indicator in the prevention and management of diabetes.

Background: Patients' knowledge about DM is a tool that can help sufferers to carry out diabetes management throughout their lives so that the more and better people understand about their disease, the more they understand how to change their behavior. Purpose: The purpose of the study was to describe the knowledge of the elderly at the Sarimatondang Health Center, Sidamanik District in 2021. Method: This research uses descriptive research method with consecutive sampling technique where the sample is 73 respondents. The data collection instrument used a questionnaire with 20 questions. Results: The results of the research on the knowledge of the elderly about diabetes mellitus diet there are good knowledge categories 57 respondents (78%), sufficient knowledge category is 11 respondents (15%), and lack of knowledge category 5 respondents (7%). Conclusion: Research majority respondents have a good level of knowledge about diabetes mellitus diet. [ABSTRACT FROM AUTHOR]

Glucagon-like peptide-1 (GLP-1) receptor agonists modified with albumin ligands which can specificity bind to the human serum albumin (HSA) was an efficient strategy to prolong the half-time of GLP-1. Herein, we investigated the effect of small-molecule albumin ligand modification on the hypoglycemic activities of GLP-1 derivatives. Two GLP-1 derivatives MPA-C12-GLP-1 and Rhein-C12-GLP-1 were achieved by modification of the side chain amino of lysine in position 26 of the Arg34-GLP-1(7−37)-OH with Rhein and 3-Maleimidopropionic acid respectively using 12-aminolauric acid as a linker, and its specific albumin-conjugating characteristics, pharmaceutical characterization, and the antidiabetic effects were investigated. In vitro level, two GLP-1 derivatives demonstrated a higher binding capacity to GLP-1 receptor than that of Arg34-GLP-1(7−37)-OH. Interestingly, although the binding ability of MPA-C12-GLP-1 was equal to liraglutide, the binding ability of Rhein-C12-GLP-1 was 10-fold higher than liraglutide. In vivo level, the two GLP-1 derivatives can significantly increase their glucose tolerance and prolong their half-life in ICR mice, and they were also superior to GLP-1 in controlling glucose homeostasis and suppression of food intake and water consumption in db/db mice. Importantly, the two GLP-1 derivatives showed comparable efficacy to liraglutide for the therapy of type 2 diabetes mellitus. The in vitro INS-1 cells toxicity and the in vivo hepatotoxicity indicated that the Rhein-C12-GLP-1 was a safe candidate for the therapy of type 2 diabetes, and the serum biomarkers determination results showed that the Rhein-modified GLP-1 could significantly improve the HbA1c and blood lipids, and the H&E stain exhibited that the Rhein-C12-GLP-1 can effectively promote β-cell proliferation and differentiation. In conclusion, the 3-Maleimidopropionic acid or Rhein-modified GLP-1derivatives have great potential for development as a Type 2 diabetes mellitus therapeutic drug.

Copyright of Dental Press Endodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: The immune system plays a central role in the pathophysiology of gestational diabetes mellitus (GDM). Monocytes, the main innate immune cells, are especially important in the maintenance of a normal pregnancy. Objective: Here, we investigated the potential effect of monocytes in GDM. Methods: Monocyte count was monitored throughout pregnancy in 214 women with GDM and 926 women without in a case-control and cohort study. Circulating levels of inflammatory cytokines, placenta-derived macrophages, and their products were measured. Results: Throughout pregnancy, monocyte count was significantly decreased in women with GDM, and was closely associated with glucose level, insulin resistance, and newborn weight. First-trimester monocyte count outperformed that of the second and third trimester as a risk factor and diagnostic predictor of GDM and macrosomia both in the case-control and cohort study. In addition, our cohort study showed that as firsttrimester monocyte count decreased, GDM and macrosomia incidence, glucose level, and newborn weight increased in a stepwise manner. Risk of GDM started to decrease rapidly when first-trimester monocyte count exceeded 0.48 × 109/L. Notably, CD206 and interleukin 10 (IL-10) were significantly lower, whereas CD80, CD86, tumor necrosis factor a (TNF-a), and interleukin 6 (IL-6) were higher both in GDM placental tissue and peripheral blood. First-trimester monocyte count was positively related to IL-10 and CD206, but negatively related to CD80, CD86, TNF-a, and IL-6. Conclusion: Decreased monocyte count throughout pregnancy was closely associated with the development of GDM, macrosomia, and the chronic inflammatory state of GDM. First-trimester monocyte count has great potential as an early diagnostic marker of GDM. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether insulin resistance (IR) contributes to excess mortality in patients with type 2 diabetes independent of diabetic kidney disease (DKD), which is strongly associated with IR and is a major risk factor for cardiovascular disease (CVD), the main cause of death in these individuals. We tested this hypothesis in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian Multicentre Study.Methods: This observational, prospective, cohort study enrolled 15,773 patients with type 2 diabetes attending 19 Italian Diabetes Clinics in 2006-2008. Insulin sensitivity was assessed as estimated glucose disposal rate (eGDR), which was validated against the euglycaemic-hyperinsulinemic clamp technique. Vital status on October 31, 2015, was retrieved for 15,656 patients (99.3%). Participants were stratified by eGDR tertiles from T1 (≥ 5.35 mg/kg/min) to T3 (≤ 4.14 mg/kg/min, highest IR).Results: CVD risk profile was worse in T2 and T3 vs T1. eGDR tertiles were independently associated with micro- and macroalbuminuria and the albuminuric DKD phenotypes (albuminuria with preserved or reduced estimated glomerular filtration rate [eGFR]) as well as with eGFR categories or the nonalbuminuric DKD phenotype. Over a 7.4-year follow-up, unadjusted death rates and mortality risks increased progressively across eGDR tertiles, but remained significantly elevated after adjustment only in T3 vs T1 (age- and gender- adjusted death rate, 22.35 vs 16.74 per 1000 person-years, p < 0.0001, and hazard ratio [HR] adjusted for multiple confounders including DKD, 1.140 [95% confidence interval [CI], 1.049-1.238], p = 0.002). However, eGDR was independently associated with mortality in participants with no DKD (adjusted HR, 1.214 [95% CI, 1.072-1.375], p = 0.002) and in those with nonalbuminuric DKD (1.276 [1.034-1.575], p = 0.023), but not in those with the albuminuric DKD phenotypes. Moreover, the association was stronger in males and in younger individuals and was observed in those without but not with prior CVD, though interaction was significant only for age.Conclusions: The proxy of insulin sensitivity eGDR predicts all-cause mortality in type 2 diabetes, independent of confounders including DKD. However, the impact of IR in individuals with albuminuric DKD may be mediated by its relationship with albuminuria.Trial Registration: ClinicalTrials.gov , NCT00715481, retrospectively registered 15 July 2008. [ABSTRACT FROM AUTHOR]

Background Gestational diabetes mellitus (GDM) is a serious disease, which may cause complications such as preeclampsia, increased cesarean rates, and macrosomia in mothers and neonates. Objective The aim of the study was to examine whether women who have a first trimester prediabetes − glycated hemoglobin (HbA1C) range of 5.7–6.4% are more likely to have an abnormal second trimester oral glucose tolerance test (OGTT) compared with women who have a normal first trimester HbA1C. Patients and methods The study was conducted at the Obstetrics and Gynecology Department of Sayed Galal University Hospital, Al-Azhar University, during the period between August 2018 and August 2019. The study included 121 pregnant women who regularly attended the outpatient clinic in the first trimester for antenatal care and who were subjected to personal, menstrual, obstetric, past, medical, and family history; general and abdominal examination; ultrasonography and measurement of HbA1C and OGTT. Results The present study showed a statistically significant difference between women with HbA1C value in relation to prepregnancy BMI, pregnancy BMI, gestational age, method of screening, development of GDM, and at 0 h and after 1 h according to fasting value from OGTT result. Conclusion HbA1C level is a good test for identifying patients at high risk of development of GDM. It has a prognostic value in the obese population. Its value has been demonstrated when it is done during the first trimester and up to 20 weeks of gestation. This information may help in GDM screening and treatment.

Diabetes is a widespread disease that needs to be controlled. Therapeutic monitoring of drugs is very helpful in maintaining desirable doses. To study a correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Determine drug levels using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) tool. A validated LC-MS/MS method was developed to determine metformin and glimepiride levels in human plasma. DNA extraction was performed using Jena Bioscience's Blood DNA preparation, in which a column kit was used to extract DNA for genetic polymorphism. The investigation was carried out using both medications in type 2 diabetes patients alongside the genetic polymorphism. One hundred and six patients were assessed. The prevalence of homozygosity for SULT1A1 and wild-type CYP2D6 * 4 were 72.6% and 73.6%, respectively. After adjustment for daily intake of metformin, three patients out of five with the highest levels of metformin had no homozygosity (SULT1A1 genotype). Statistically, variables that demonstrated an insignificant correlation with the level of metformin were body mass index (rs (87) = 0.32, P = 0.011) and age (rs (87) =0.26, P = 0.017). The homozygous (SULT1A1 genotype) correlation was moderate (rs (87) =0.21, P = 0.052). According to the findings, patients with the wt/wt CYP2D6 genotype had considerably greater levels of endoxifen than those with the v/v CYP2D6 genotype. The study's results reported a probable correlation between the blood level of metformin (to a lesser extent, glimepiride) and genotyping (mainly the SULT1A1 genotype). Genotype-guided drug therapy may provide a novel contribution to maximize drug efficacy and/or minimize toxicity., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Advanced Pharmaceutical Technology & Research.)

Introduction: Obesity is a chronic disease, defined by the World Health Organization, which is characterized by excess body fat, in an amount that harms health. It has a multifactorial origin, with social and environmental factors being the most at risk, due to unhealthy eating habits and lack of physical activity. Obesity affects quality of life and reduces life expectancy, being directly related to the development of noncommunicable chronic diseases such as diabetes mellitus. Objective: To present available electronic tools and health technologies that address obesity associated with diabetes mellitus. Methodology: this narrative review was developed from information extracted from electronic bibliographic databases (Pubmed, ScienceDirect, Capes Periodicals and Lilacs) and from Vigitel, a surveillance system for Chronic Non-Communicable Diseases, carried out by telephone survey; use of the MySugr electronic application, which helps in the daily treatment of diabetes mellitus; and the presentation of data from DATASUS, on admissions during the COVID-19 pandemic period and the number of obese and diabetic individuals registered in the city of Salvador, Bahia, Brazil. Results: the data adopted in this work were related to overweight individuals. Few articles found associate diabetes mellitus with obesity, especially in adults. And no current electronic newsletters were found correlating the two diseases. Conclusion: More investments are needed in health information systems, which include computerized tools and the management and processing bases of primary and secondary statistical data. [ABSTRACT FROM AUTHOR]

Proteomics of human milk has been used to identify the comprehensive cargo of proteins involved in immune and cellular function. Very little is known about the effects of gestational diabetes mellitus (GDM) on lactation and breast milk components. The objective of the current study was to examine the effect of GDM on the expression of proteins in the whey fraction of human colostrum. Colostrum was collected from women who were diagnosed with (n = 6) or without (n = 12) GDM at weeks 24-28 in pregnancy. Colostral whey was analyzed for protein abundances using high-resolution, high-mass accuracy liquid chromatography tandem mass spectrometry. A total of 601 proteins were identified, of which 260 were quantified using label free spectral counting. Orthogonal partial least-squares discriminant analysis identified 27 proteins that best predict GDM. The power law global error model corrected for multiple testing was used to confirm that 10 of the 27 proteins were also statistically significantly different between women with versus without GDM. The identified changes in protein expression suggest that diabetes mellitus during pregnancy has consequences on human colostral proteins involved in immunity and nutrition.

Oxidative tissue injury and inflammatory response are the main regulators of diabetic nephropathy (DN). The potential protective effect of galangin (Gal), a powerful flavonoid with several promising bioactivities, on hyperglycemia-induced kidney injury in a rat model of DN has been investigated in this study. A rat model of diabetes was induced by intraperitoneal injection of 50 mg kg-1 streptozotocin (STZ). Rats were treated orally with Gal (15 mg kg-1 d-1) for 8 weeks. Diabetic animals demonstrated elevated levels of glucose and glycosylated hemoglobin along with reduced insulin levels. Hyperglycemia was associated with a remarkable increase in malondialdehyde and protein carbonyl along with a significant decrease in reduced glutathione, superoxide dismutase and catalase in the kidney of rats. Diabetic rats showed a remarkable increase in blood creatinine and blood urea nitrogen (BUN) and urine albumin. Additionally, diabetic rats demonstrated increased nuclear factor kappaB (NF-κB) p65 expression and pro-inflammatory cytokines (tumor necrosis factor-a, interleukin 1ß and interleukin 6) levels in the renal tissue. Gal ameliorated hyperglycemia, oxidative stress and inflammation and increased antioxidants in the kidney of diabetic rats. In addition, Gal decreased Bax and caspase-3 and increased Bcl-2 in the kidney of diabetic animals. In conclusion, Gal improved renal function and ameliorated oxidative stress, inflammation and apoptosis in the kidney of diabetic rats. Gal might have therapeutic potential for the treatment of DN, which deserves exploration in upcoming studies. [ABSTRACT FROM AUTHOR]

Today, diabetes mellitus (DM) is a global issue. it is an increment in blood sugar (hyperglysemia) and it is one of the most chronic, severe and metabolic disaeses. it is an exacting disease that affects general health, functioning, autonomy, life style and quality of life Present studies have been undertaken to determine the quality of life of patients with type II diabetes in Thiqar governorate and to test other propos ed clinical and sociodemographic factors that may influence the quality of life of these patients. Methods: This cross-sectional study was operated in 2018-2019. A 100 patients enrolled in this crosssectional study. The short model of the questionnaire, the World Health Organizations Quality of Life Appraisal (WHOQOLBREEF), was applied to determine the quality of life after being updated and translated into the regional Arabic language. Results:100 percent (100/100) was the response rate. There were 52 females, while 48 were males. For QOL overall, 85 (85percent) had a decent score, 12 (percent) had a fair score, and 3 (3percent) had a bad score. For the physical activity domain; 16 for the psychological activity domain had a poor score; 3 for the environm ental domain had a poor score;2 for the social domain had a poor score; no person had a bad score. Conclusion: It was concluded that QOL of patients with DM were good and this disease affects physical health by the first degree, psychological activity and environmental domains are slightly affected while for the social domain; there is no effects of the disease according to our study. [ABSTRACT FROM AUTHOR]

Atorvastatin, a widely prescribed 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor (HMG-CoA reductase inhibitor), is associated with various adverse effects, including many dermatologic manifestations. We present the case of a 73-year-old man who developed eosinophilic spongiosis shortly after initiating atorvastatin therapy, an adverse effect which to our knowledge has not yet been reported in association with atorvastatin. Our investigation explores the clinical and histopathologic characteristics of eosinophilic spongiosis induced by atorvastatin, delving into potential mechanisms behind statin-induced eosinophilia. A literature review, focusing on atorvastatin's dermatological side effects, revealed a limited number of relevant studies, emphasizing the scarcity of documented cases. Our aim is to raise awareness of eosinophilic spongiosis as a potential side effect of atorvastatin, emphasizing its impact on patients' quality of life. This case prompts further research into the mechanisms underlying such dermatologic reactions, contributing to a better understanding of atorvastatin's diverse adverse effects., Competing Interests: This work was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare-affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities. This material is the result of work supported with resources and the use of facilities at the Orlando VA Healthcare System (Orlando, Florida). The contents of this publication do not represent the views of the Department of Veterans Affairs or the United States Government., (Copyright © 2024, Al-Moussally et al.)

In patients with diabetes, diabetic ketoacidosis (DKA) is a well-documented potential complication, usually presenting with hyperglycemia, anion gap acidosis, and positive ketones. Metformin toxicity in the setting of acute renal failure is also a well-known cause of lactic acidosis. However, metformin-induced euglycemic ketoacidosis is less well-known or studied. We report a case of metformin toxicity in the setting of acute renal failure with both lactic acidosis and ketosis and an initial confounded clinical presentation of sulphonylurea-induced hypoglycemia. A high index of suspicion for metformin-associated lactic acidosis (MALA) and metformin-associated lactic acidosis with euglycemic ketoacidosis (MALKA) should be in place in patients who are taking metformin and presenting with acute renal failure and euglycemia., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Al-Moussally et al.)

Diabetes Mellitus (DM) is one of the biggest healthcare and financial problems worldwide. The disease is strongly associated with microvascular and macrovascular complications, causing co-existing diseases like Diabetic Retinopathy, Diabetic Neuropathy and Diabetic Nephropathy. Annual healthcare expenditures for diabetes treatment and complications prevention cost 727 billion USD in year 2017.

Aim: Evaluate the degree of acceptance of the Pharmaceutical Intervention to potentially inappropriate prescription identified by STOPP/START criteria in geriatric diabetic patients hospitalized at a third-level health institution in Cartagena- Colombia. Materials and methods: A prospective intervention study was carried out on the potentially inadequate prescriptions identified by STOPP/START criteria for a year, in patients with diabetes mellitus. Results: The population was composed of multipathological patients, in which HT, kidney disease were the most prevalent comorbidities. Due to the complexity of this type of patient and the high demand for drugs in the treatment of comorbidities appear potentially inappropriate prescription. Due to the complexity of this type of patient and the high demand for drugs in the treatment of comorbidities, potentially inappropriate threats are prescribed. The degree of acceptance of the interventions was 97.21% by the medical staff. Conclusion: The degree of acceptance of the interventions carried out according to the STOPP/START criteria suggests that these criteria are an important tool to improve pharmacological therapy. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a metabolic disorder causes changes in the blood glucose level either it can be elevated or lowered. These are classified into two type insulin dependent and insulin non-dependent. The basic treatment provided for diabetic patients are insulin therapy it has been clinically proven but this is not the only solution to cure diabetes. Metformin is widely used medicine for patients. Glucose lowering therapy is applicable for patients with severe hyperglycemia, hepatic and renal related diseases. The therapeutic applications such as The therapeutic medicines exenatide and to induce the insulin secretion and also liraglutide helps people with insulin. Other therapeutic compounds heals the defects of beta-cells secretion are compensated with the use of stitagliptin to inhibit the dipeptidyl peptidase-4 (DPP-4) enzyme, and increases the the function of Islets cells. This article further discusses about the combinational therapies available for the diabetic patients. [ABSTRACT FROM AUTHOR]

Objective To assess medication adherence in elderly patients with type 2 diabetes using the Adherence to Refills and Medications Scale（ARMS），and establish the risk forecast model of selfefficacy of inappropriate medication use based on medication adherence. Methods Patients who were hospitalized in Department of Endocrinology，Huadong Hospital, Fudan university from Jul. 2018 to Jan. 2019 were investigated by Morisky Medication Adherence Scale (MMAS-8), ARMS, and the Self- Efficacy for Appropriate Medication Use Scale（SEAMS）within 24 hours after their admission. Results Of the 505 patients enrolled，161（31.9%）were with adequate and 344（68.1%）were with inadequate selfefficacy for appropriate medication use. Two groups showed significant difference in MMAS-8，ARMS, duration of diabetes and gender（P<0.05); Spearman’s rho indicated that ARMS positively correlated and MMAS-8 negatively correlated significantly with SEAMS. Binary Logistic analysis indicated that medication adherence was the risk factor of inadequate self-efficacy for appropriate medication use（ARMS： r=0.249，OR=1.282; MMAS-8: r=-1.417, OR=0.242. ROC curve showed that the area under the curve of ARMS (AUC=0.851，P<0.001，95%CI: 0.818-0.885) was greater than MMAS-8 (AUC=0.155; P< 0.001; 95%CI: 0.121-0.189), and scores of ≥16 in ARMS can be used as a predictor for inadequate selfefficacy for appropriate medication use with a sensitivity of 80.5% and specificity of 77.6%. The risk forecast model showed good sensitivity （96.3%），specificity （73.9%） and accuracy （86.0%） in the verification group. The result of kappa statistics showed that high agreement was achieved between the verification group and risk forecast model. Conclusion Compared with MMAS-8，ARMS would be more appropriate for the evaluation of medication adherence in elderly patients with T2DM. Moreover，we can use ARMS as a tool to predict the self-management ability of medicines in the elderly patients with T2DM. [ABSTRACT FROM AUTHOR]

To observe the correlation between microangiopathy and bone mineral density in patients with type 2 diabetes. Methods A total of 2 170 patients with type 2 diabetes mellitus (1 188 postmenopausal females and 982 males aged 50 years) were included in our cross-sectional study. These patients were grouped according to 24-hour urine protein level: Group I (<30 mg), Group II (30-299 mg) and Group III ( 300 mg). Bone mineral density of the lumbar spine, hip and femoral neck was evaluated by dual-energy X-ray absorptiometry. Fundus oculi photography for diabetic retinopathy and 24-h urine protein for diabetic nephropathy were used as markers of microangiopathy in type 2 diabetes mellitus. Characteristics of the patients and bone mineral density were compared. Multivariate analysis was used to study the association between bone mineral density and microangiopathy. Results Group III had the lowest bone mineral density level in both genders. Multivariate analysis revealed that microangiopathy was negatively correlated with bone mineral density in females (lumbar: r = -0.522, P<0.001; hip: r = -0.301, P=0.010; femoral neck: r = -0.314, P=0.009), but not in males, after adjustment for age, body mass index, hypertension, hyperlipidemia, diabetic status, hepatic function, kidney function, sex hormones and 25(OH) vitamin D. Conclusion These results demonstrated an independent negative correlation between microangiopathy and bone mineral density in postmenopausal female type 2 diabetes mellitus patients. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether diabetes mellitus (DM) affects ocular surface of children with well-controlled type 1 DM.Methods: Sixty-five diabetic patients and 55 age-matched controls enrolled to study. Detailed ocular surface assessment including, ocular surface disease index (OSDI) questionnaire, tear film break-up time (TBUT) analysis, Schirmer test, and conjunctival impression cytologic analysis were performed.Results: Schirmer test and TBUT results were significantly lower in DM group than controls (p = 0.001, for all). OSDI scores of all participants were within normal range. Impression cytology analysis showed grade 0 changes in all participants and there was no difference between groups for goblet cell density (p > 0.05). The TBUT results were significantly associated with duration of DM (r = -0.309, p = 0.036).Conclusion: Diabetic children without symptoms, signs, and definite diagnosis of dry eye still had lower TBUT and Schirmer test results than controls; however, impression cytology analysis was similar in both groups. [ABSTRACT FROM AUTHOR]

Objective-Clinical trials and observational studies have provided good evidence that early glycemic control leads to a reduction in complications and improved survival in diabetics. However, elevated risk of mortality has been reported at both the lower and upper ends of long-term glucose levels. Fear of hypoglycemia has been a significant factor in suboptimal glycemic control. In this retrospective analysis we aimed to identify the incidence of hypoglycemia and their precipitating factors in elderly diabetics on good glycemic control. Material and methods- Ninety seven elderly diabetic patients attending the cardiology Out-Patients Department of a super speciality private sector hospital from 1 December 2017 to 30 November 2018 were studied retrospectively. Their demographic profile, co-morbidities and pharmacological profile were recorded. Incidence of hypoglycemic episodes and their precipitating factor were then analyzed. Result-Mean age was 71.7± 6.3 years, and 64 (66%) were male. Mean duration of diabetes was 7.3± 1.3 years. All patients had type II diabetes mellitus. Mean fasting and random capillary blood glucose levels were 116.5 ±8.7 mg/dl and 169.5±13.5mg/dl, respectively. Mean HbAlc levels of the study population was 6.8±1.14. Over the study period, 23 (23.7%) patients experienced 39 episodes of any level of hypoglycemia. HbAlc Levels in the hypoglycemia group were not significantly different from those in no-hyperglycemia group (6.85±1.13 vs. 6.63±1.04). Mean random plasma glucose values were slightly higher in no-hypoglycemia group (170.9±14.5 vs 164.9±14.9), but the difference did not reach the statistical significance. There was a markedly significant difference in mean fasting plasma glucose values between hypoglycemia and no-hypoglycemia group (101.8±8.9 vs 116.5±12.7). Sulphonylurea and insulin use was more frequent in patients experiencing hypoglycemia (9.6% and 52.2% respectively) as compared with no-hypoglycemia group (33.8% and 39.1% respectively). The most common preceding event was either skipping a meal in 12(30.8%) patients or an unplanned change in diet in 23% patients. Conclusion- Patients with longstanding diabetes and loss of warning symptoms have increased risk of severe hypoglycaemic episodes. Risk of the hypoglycemic episode is better correlated with fasting plasma glucose levels and glycemic variability rather than with HbAlc Level. Sulphonylurea drug use was the only group associated with a statistically significant risk of hypoglycemia. Skipping of a meal or a sudden change in the diet and alteration in antidiabetic drug regimen are the most important precipitating factors for hypoglycemia. [ABSTRACT FROM AUTHOR]

Background: Fatigue, nonrestorative sleep, and other sleep disorders could be pointers to serious medical problems like obstructive sleep apnea; when present in patients with diabetes, they exacerbate each other deleterious consequences. The present study aimed to assess fatigue, nonrestorative sleep, sleep duration, and daytime sleepiness among patients with type 2 diabetes. Methods: This cross-sectional descriptive study was conducted among 103 consecutive patients with type 2 diabetes and 121 healthy controls attending an outpatient clinic in Omdurman, Sudan during the period from December 2015 to June 2016. All participants signed a written informed consent and were interviewed using a questionnaire based on Epworth Sleepiness Scale to assess subjective nonrestorative sleep, sleep duration, and snoring. A blood sample was taken for the HbA1c. The local ethical committee approved the research, and chi-square test and t-test were used for data analysis. Results: Highly significant statistical differences were observed between the diabetic patients and the control subjects regarding fatigue, nonrestorative sleep, sleep duration, snoring, and excessive daytime sleepiness (p < 0.001). Patients with fatigue had higher nonrestorative sleep than those without, no significant differences were found between patients with the symptoms of fatigue and those without regarding excessive daytime sleepiness, snoring, sleep duration, and the HbA1c (p > 0.05). Conclusions: Fatigue, nonrestorative sleep, sleep duration, excessive daytime sleepiness, and snoring were common among patients with type 2 diabetes than their healthy counterparts, diabetic patients with fatigue had more nonrestorative sleep than those without. The reliance on a self-administered questionnaire is a limitation of the study. [ABSTRACT FROM AUTHOR]