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CD163, a scavenger receptor with anti-inflammatory function expressed exclusively on monocytes/macrophages, is dysregulated in cases of diabetes complications. This study aimed to characterize circulating CD163+ monocytes in the presence (D+Comps) or absence (D−Comps) of diabetes-related complications. RNA-sequencing and mass cytometry were conducted on CD163+ monocytes in adults with long-duration diabetes and D+Comps or D−Comps. Out of 10,868 differentially expressed genes identified between D+Comps and D−Comps, 885 were up-regulated and 190 were down-regulated with a ≥ 1.5-fold change. In D+Comps, 'regulation of centrosome cycle' genes were enriched 6.7-fold compared to the reference genome. MIR27A, MIR3648-1, and MIR23A, the most up-regulated and CD200R1, the most down-regulated gene, were detected in D+Comps from the list of 75 'genes of interest'. CD163+ monocytes in D+Comps had a low proportion of recruitment markers CCR5, CD11b, CD11c, CD31, and immune regulation markers CD39 and CD86. A gene–protein network identified down-regulated TLR4 and CD11b as 'hub-nodes'. In conclusion, this study reports novel insights into CD163+ monocyte dysregulation in diabetes-related complications. Enriched centrosome cycle genes and up-regulated miRNAs linked to apoptosis, coupled with down-regulated monocyte activation, recruitment, and immune regulation, suggest functionally distinct CD163+ monocytes in cases of diabetes complications. Further investigation is needed to confirm their role in diabetes-related tissue damage. [ABSTRACT FROM AUTHOR]

This study assessed whether the addition of continuous positive airway pressure (CPAP) during weight loss would enhance cardiometabolic health improvements in patients with obesity and Obstructive Sleep Apnoea (OSA). Patients with overweight or obesity, pre-diabetes and moderatesevere OSA were randomised to receive CPAP therapy with a weight loss programme (CPAP+WL) or a weight loss programme alone (WL alone). Primary outcome: 2-hour glucose assessed by an oral glucose tolerance test. Secondary outcomes: 24 hr blood pressure, body composition (DEXA) and fasting blood markers. 17 patients completed 3-month follow-up assessments (8 CPAP+WL and 9 WL alone). Overall, participants in both groups lost ∼12 kg which reduced polysomnography determined OSA severity by ∼45 %. In the CPAP+WL group, CPAP use (compliance 5.29 hrs/night) did not improve any outcome above WL alone. There was no improvement in 2-hour glucose in either group. However, in the pooled (n = 17) analysis there were overall improvements in most outcomes including insulin sensitivity (.000965 units, p =.008), sleep systolic BP (- 16.2 mmHg, p =.0003), sleep diastolic BP (−9.8 mmHg, p = 0.02), wake diastolic BP (- 4.3 mmHg, p =.03) and sleepiness (Epworth Sleepiness Score −3.2, p =.0003). In addition, there were reductions in glucose area under the curve (−230 units, p =.009), total (−0.86 mmol/L, p = 0.006) and LDL cholesterol (−0.58 mmol/L, p = 0.007), triglycerides (−0.75 mmol/L, p = 0.004), fat mass (−7.6 kg, p <.0001) and abdominal fat (−310 cm3, p <.0001). Weight loss reduced OSA and improved sleepiness and cardiometabolic health. These improvements were not further enhanced by using CPAP. Results suggest weight loss should be the primary focus of treatment for patients with OSA and obesity. [ABSTRACT FROM AUTHOR]

This document outlines ten evidence-based strategies for promoting heart and metabolic health and slowing down the aging process of the cardiovascular system. These strategies include engaging in regular exercise and calorie restriction to reduce waist circumference and increase muscle mass, following a minimally processed Mediterranean-like diet, practicing intermittent fasting and time-restricted feeding, being physically active every day, limiting alcohol consumption, not smoking, prioritizing quality sleep, reducing stress and engaging in cognitive stimulation, fostering friendships and compassion, and minimizing exposure to pollution while connecting with nature. By incorporating these strategies into their lifestyle, individuals can take proactive steps to support their cardiovascular health and prevent chronic diseases. [Extracted from the article]

Background: There is limited information regarding the number of patients with diabetes‐related foot ulceration (DFU) who receive minor or major amputation, and how quickly these amputations occur. This study aimed to identify the incidence of index minor and major amputation among inpatients with DFU over 4 years, and where amputation occurred during the patient's index DFU‐related admission, investigate prognostic factors. Methods: The incidence of index minor and major amputation, and the admission sequence during which amputation occurred were identified from DFU‐related admissions to two public hospitals during 2014–2018. Where minor or major amputation occurred during the patient's index DFU‐related admission, prognostic factors were investigated using logistic regression. Results: DFU‐related hospital admissions were required by 564 patients. The incidence of minor amputation over 4 years was 34% (n = 193). The incidence of minor amputation during the patient's index DFU‐related admission was 28% (n = 155), which was associated with requiring revascularisation (odds ratio [OR] 2.33, 95% CI 1.53–3.55, P < 0.001). The incidence of major amputation over 4 years was 8% (n = 45). The incidence of major amputation during the patient's index DFU‐related admission was 6% (n = 31), which was associated with having more comorbidities (OR 1.58, 95% CI 1.10–2.26, P = 0.01) and receiving care for a mental health condition (OR 3.85, 95% CI 1.48–10.01, P = 0.006). Conclusion: Most amputations occurred during the patient's index DFU‐related hospital admission. Major amputation during a patient's index admission was associated with more comorbidities and mental health conditions. [ABSTRACT FROM AUTHOR]