Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy最新文献

{"title":"Increased Insulin Requirements in Severe Cases of Covid-19 are Higher Than in Moderate Cases.","authors":"Takaaki Matsui, Emi Ushigome, Masahide Hamaguchi, Kazuki Sudo, Nobuko Kitagawa, Yuriko Kondo, Yuka Hasegawa, Dan Imai, Tomohiro Hattori, Masahiro Yamazaki, Teiji Sawa, Michiaki Fukui","doi":"10.2147/DMSO.S480598","DOIUrl":"10.2147/DMSO.S480598","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the low overall death rate of coronavirus disease 2019 (COVID-19), no study has examined the association between COVID-19 severity and the total daily insulin dose required for glycemic control. The aim of this study was to determine the maximum total daily insulin dose required according to COVID-19 severity, and the number of days required to reach the maximum insulin dose in patients with COVID-19 who used insulin during hospitalization.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included participants aged 20-90 years with a confirmed diagnosis of COVID-19 who used insulin during hospitalization at Kyoto Prefectural University of Medicine Hospital between March 4, 2020, and May 31, 2021. Factors associated with maximum insulin dose during hospitalization were evaluated using linear regression analyses.</p><p><strong>Results: </strong>The maximum insulin doses were 31.8, 76.8, and 230.7 U/day, and the numbers of days between COVID-19 diagnosis and the need for maximum insulin were 15.6, 17.1, and 13.7 days in patients without ventilator management, with ventilator management, and with ventilator and extracorporeal membrane oxygenation management, respectively. Multivariate linear regression analyses revealed that hemoglobin A1c level (β = 15.87, P = 0.001), use of a ventilator (β = 50.53, P < 0.001), and use of extracorporeal membrane oxygenation (β = 150.36, P < 0.001) were independent determinants of maximum insulin dose.</p><p><strong>Conclusion: </strong>Patients with severe COVID-19 required a significantly higher maximum insulin dose than did those with moderate COVID-19. The maximum insulin dose was reached approximately 2 weeks after onset. Furthermore, the hemoglobin A1c level on admission and the use of a ventilator or extracorporeal membrane oxygenation during hospitalization were associated with the need for maximum insulin dose.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Glucose-Lipid Metabolism in Early Pregnancy Among Overweight and Obese Women and Their Predictive Value for Gestational Diabetes Mellitus.","authors":"Xia Chen, Jianmin Zhang, Yuanru Tang, Yan Zhang, Ziwen Ma, Yifan Hu","doi":"10.2147/DMSO.S469957","DOIUrl":"10.2147/DMSO.S469957","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores the link between women's pre-pregnancy overweight and obesity and glucose and lipid metabolism in their early pregnancy. It assesses how early pregnancy glucose and lipid levels predict gestational diabetes mellitus (GDM) risk, aiming to offer foundational weight management strategies for overweight and obese women to prevent GDM.</p><p><strong>Patients and methods: </strong>This study analyzed 2172 pregnant women from 2017 to 2021 at Waitan Street Community Health Service Center, Shanghai, monitoring early pregnancy (7-10 weeks) glucose and lipid levels (TG, TC, HDL-C, LDL-C, FBG, HbA1c) and 24-week OGTT values. Pre-pregnancy BMI categorized participants into overweight and obese, normal, and underweight groups. We compared early pregnancy glycemic and lipid metrics and GDM incidence across groups, examining the relationship between pre-pregnancy BMI and early pregnancy blood metrics. The overweight and obese cohort was further split into GDM and non-GDM groups, comparing early pregnancy glycolipid indicators and assessing their predictive value for GDM development.</p><p><strong>Results: </strong>In the overweight and obese group, maternal FBG, HbA1c, TG, and LDL-C were higher, while HDL-C was lower than in normal and underweight groups (<i>P</i><0.05), with a higher GDM incidence (<i>P</i><0.05). Pre-pregnancy BMI positively correlated with FBG, HbA1c, TG, and LDL-C levels (<i>r</i>=0.556, 0.567, 0.686, 0.214; <i>P</i><0.05) but not HDL-C. Each 1-unit BMI increase raised GDM risk by 0.204 times (<i>P</i><0.05). FBG, TG, and LDL-C had high predictive accuracy for GDM in overweight and obese women, with AUCs of 0.991, 0.994, and 0.935, respectively.</p><p><strong>Conclusion: </strong>Pre-pregnancy overweight and obesity can cause early pregnancy glucose and lipid abnormalities, raising GDM risk. Early testing in such women is a strong predictor for GDM.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}