Journal of Diabetes Investigation最新文献

{"title":"Risk heterogeneity of bullous pemphigoid among dipeptidyl peptidase-4 inhibitors: A population-based cohort study using Japanese Latter-Stage Elderly Healthcare Database","authors":"Yumi Harano,&nbsp;Yasutaka Mitamura,&nbsp;Peng Jiang,&nbsp;Takako Fujita,&nbsp;Akira Babazono","doi":"10.1111/jdi.14004","DOIUrl":"https://doi.org/10.1111/jdi.14004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>Although the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and bullous pemphigoid (BP) has begun to be established, some studies have suggested there are risk differences among DPP-4 inhibitors. We conducted a population-based cohort study to examine the risk differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Using the claims databases of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare between April 1, 2013 and March 31, 2017, we conducted a retrospective cohort study to compare patients receiving one DPP-4 inhibitor with those who were prescribed another antidiabetic drug. The primary outcome was an adjusted hazard ratio (HR) of the development of bullous pemphigoid during a 3-year follow-up. The secondary outcome was the development of BP requiring systemic steroids immediately after the diagnosis. These were estimated using Cox proportional hazards regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study comprised 33,241 patients, of which 0.26% (<i>n</i> = 88) developed bullous pemphigoid during follow-up. The percentages of patients with bullous pemphigoid who required immediate systemic steroid treatment was 0.11% (<i>n</i> = 37). We analyzed four DPP-4 inhibitors: sitagliptin, vildagliptin, alogliptin, and linagliptin. Vildagliptin and linagliptin raised the risk of BP significantly (primary outcome, vildagliptin, HR 2.411 [95% confidence interval (CI) 1.325–4.387], linagliptin, HR 2.550 [95% CI 1.266–5.136], secondary outcome, vildagliptin HR 3.616 [95% CI 1.495–8.745], linagliptin HR 3.556 [95% CI 1.262–10.024]). A statistically significant risk elevation was not observed with sitagliptin and alogliptin (primary outcome, sitagliptin, HR 0.911 [95% CI 0.508–1.635], alogliptin, HR 1.600 [95% CI 0.714–3.584], secondary outcome, sitagliptin, HR 1.192 [95% CI 0.475–2.992], alogliptin, HR 2.007 [95% CI 0.571–7.053]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Not all the DPP-4 inhibitors could induce bullous pemphigoid significantly. Therefore, the association warrants further investigations before generalization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 6","pages":"756-766"},"PeriodicalIF":3.2,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6191466","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":"Effect of a reused insulin needle remaining in a patient's body","authors":"Yong-jie Qiao,&nbsp;Yu Xin-yuan,&nbsp;Rui-ling Xu,&nbsp;Xiao-yang Song,&nbsp;Shuo Ye,&nbsp;Ping Zhen,&nbsp;Sheng-hu Zhou,&nbsp;Hao-qiang Zhang","doi":"10.1111/jdi.14003","DOIUrl":"https://doi.org/10.1111/jdi.14003","url":null,"abstract":"<p>Diabetes is one of the most common chronic diseases at present, and insulin pen injection therapy plays an important role in the treatment of diabetes. However, the majority of patients might reuse disposable insulin pen needles for various reasons, which leads to related complications. As far as we know, this article is the first to describe a patient whose needle remained in the right upper limb while reusing a disposable insulin injection needle for subcutaneous insulin injection with the non-dominant hand. The patient went to the doctor 1 week later. The needle moved from the lateral area of the proximal upper arm (the injection site) to the posterolateral area of the distal upper arm. The needle was then successfully removed by surgery. The reuse of disposable insulin pen needles might lead to serious complications. It is suggested to strengthen the education of people living with diabetes to help them use insulin pen needles safely.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 6","pages":"821-823"},"PeriodicalIF":3.2,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6091535","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":"Signaling pathways that regulate adaptive β-cell proliferation for the treatment of diabetes","authors":"Jun Shirakawa","doi":"10.1111/jdi.14002","DOIUrl":"https://doi.org/10.1111/jdi.14002","url":null,"abstract":"<p>The decline in β-cell mass due to the failure of β-cell compensation is one cause of the development of type 2 diabetes. Therefore, elucidation of the mechanism by which an adaptive increase in β-cell mass occurs <i>in vivo</i> will lead to the development of a cure for diabetes. Insulin and insulin receptor (IR)-mediated signaling pathways play an important role in the mechanism that increases β-cell mass by compensatory β-cell proliferation in response to chronic insulin resistance. However, whether IR is required for compensatory β-cell proliferation remains controversial in some situations. It might be possible that IR acts as a scaffold for the signaling complex independent of its ligand. It has also been reported that the forkhead box protein M1/polo-like kinase 1/centromere protein A pathway plays a central role in adaptive β-cell proliferation during diet-induced obesity, hyperglycemia, pregnancy, aging and acute insulin resistance. We recently reported that the cross-talk of islets with fat tissue, in addition to the liver, through humoral factors is involved in adaptive β-cell proliferation. This accommodative response of β-cell proliferation through adipocytes was observed particularly under an acute insulin resistance state in an IR/insulin signal-independent and forkhead box protein M1/polo-like kinase 1/centromere protein A pathway-dependent manner. A remaining barrier for the treatment of human diabetes using β-cells is the differences between human and rodent islets. In this review, the focus is on signaling pathways that regulate adaptive β-cell proliferation for the treatment of diabetes considering the abovementioned issues.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 6","pages":"735-740"},"PeriodicalIF":3.2,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6105183","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":"Graft failure after allogeneic islet transplantation in a patient with type 1 diabetes and a high anti-glutamic acid decarboxylase antibody titer","authors":"Noriko Kodani,&nbsp;Daisuke Chujo,&nbsp;Aiko Terakawa,&nbsp;Kyoji Ito,&nbsp;Fuyuki Inagaki,&nbsp;Nobuyuki Takemura,&nbsp;Shinichi Matsumoto,&nbsp;Tsuyoshi Tajima,&nbsp;Norio Ohmagari,&nbsp;Kumiko Ajima,&nbsp;Tadashi Takaki,&nbsp;Yzumi Yamashita,&nbsp;Koya Shinohara,&nbsp;Hiroshi Kajio,&nbsp;Takuya Awata,&nbsp;Masayuki Shimoda","doi":"10.1111/jdi.13996","DOIUrl":"https://doi.org/10.1111/jdi.13996","url":null,"abstract":"<p>Pancreatic islet transplantation is a β-cell replacement therapy for people with insulin-deficient diabetes who have difficulty in glycemic control and suffer from frequent severe hypoglycemia. However, the number of islet transplantations carried out is still limited in Asia. We report a case of allogeneic islet transplantation in a 45-year-old Japanese man with type 1 diabetes. Although the islet transplantation was successfully carried out, graft loss was observed on the 18th day. Immunosuppressants were used in accordance with the protocol, and donor-specific anti-human leukocyte antigen antibodies were not detected. Autoimmunity relapse was also not observed. However, the patient had a high titer of anti-glutamic acid decarboxylase antibody from before the islet transplantation, and autoimmunity might thus have affected the β-cells in the transplanted islet. The evidence is still scarce to reach conclusions, and further data accumulation is required to enable proper patient selection before islet transplantation.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 5","pages":"725-729"},"PeriodicalIF":3.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13996","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6027201","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":"A novel view of the insulin signaling pathway based on prediction of protein structure by the AI platform AlphaFold","authors":"Kyosuke Sato,&nbsp;Kenji Sugawara,&nbsp;Wataru Ogawa","doi":"10.1111/jdi.13988","DOIUrl":"https://doi.org/10.1111/jdi.13988","url":null,"abstract":"<p>The predicted structures of major proteins involved in the insulin signaling pathway obtained from the AlphaFold Protein Structure Database.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 5","pages":"635-639"},"PeriodicalIF":3.2,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13988","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5685163","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":"Toward better diabetes care: Exploration and implementation","authors":"Wayne Huey-Herng Sheu","doi":"10.1111/jdi.13978","DOIUrl":"https://doi.org/10.1111/jdi.13978","url":null,"abstract":"<p>Approximately 40 years ago, I was fortunate enough to step into the field of diabetes. When I had my fellowship training in the USA, I learned how to ask a good scientific question and conduct clinical research. With collaboration with my mentors, Prof. Gerald R Reaven and Prof. Ida Chen, we participated in many clinical trials. We established the Taiwan Diabetes Registry (TDR) to track long-term changes in diabetes profiles. The ultimate purpose of medical research is to provide benefits to patients. Using electronic medical records and point-of-care glucometers, we reduced inpatients’ hyperglycemia and hypoglycemia greatly, which was also reflected by the reduction in hospital stays and readmission rates. With the advent of new technology and medications, we have to ponder where we are on the journey toward better diabetes care. We rigorously advocate diabetes care, hold many symposia and publish updated guidelines. We successfully hosted the congress of the 11th International Diabetes Federation Western Pacific Region &amp; 8th Asian Association for the Study of Diabetes Scientific Meeting 2016 at Taipei, Taiwan. As the era of precision medicine is coming, Taiwan could be considered as one of the best places to run precision medicine. The Taiwan Precision Medicine Initiative has enrolled more than half a million residents, and is currently conducting genotyping and data analysis. In conclusion. I witnessed the early days of simple and few choices for diabetes management to the current various modalities in diabetes care. As these new technologies have become available, patients will always remain at the center of the care model with warmth and humility.</p>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 5","pages":"640-644"},"PeriodicalIF":3.2,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13978","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5791695","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":"Recent updates in factors associated with incidence and screening of diabetic eye disease","authors":"Hirohito Sone","doi":"10.1111/jdi.13991","DOIUrl":"https://doi.org/10.1111/jdi.13991","url":null,"abstract":"<p>Diabetic eye disease remains a major cause of visual impairment and blindness in many countries, and presents a significant public health challenge worldwide. The global prevalence of retinopathy among people with diabetes is approximately 22%, including 6% of vision-threatening diabetic retinopathy, and 4% of macular edema cases, and the burden is expected to remain high until 2045<span>¹</span>. Similar to other complications of diabetes mellitus, numerous studies have been conducted worldwide to assess the risk factors for diabetic eye disease. Several major factors have been identified, as well as validated in a recent study<span>²</span>. The two factors, glycemic control and diabetes duration, are commonly reported in most studies.</p><p>In terms of glycemic control, most previous studies have used the levels of fasting plasma glucose or glycosylated hemoglobin as indices. However, recent advances in continuous glucose monitoring have made it possible to analyze the daily trajectory of glucose levels, including postprandial and nocturnal glucose levels. Standardized ‘time in range’<span>³</span> and glycemic variability<span>⁴</span> have been previously associated with retinopathy. However, since the influence of glycemia depends on both the duration and the glucose levels, indices that reflect both variables are expected to predict retinopathy better than the conventional glycemic indices. A recent attempt using the ‘area under the curve in range’ was unable to demonstrate a significant association with retinopathy<span>⁵</span>. Nevertheless, further research of similar indices for detailed glycemic status using the new technology is expected.</p><p>Factors related to the duration of diabetes should also be further detailed, including the effects of aging. A recent study that divided participants into early- or late-onset diabetes demonstrated that an earlier onset of diabetes is more predictive of microvascular complications, including retinopathy, than late-onset diabetes<span>⁶</span>. In addition to the age of diabetes onset, aging of the entire population is also related to the phenotype and the pathophysiology of diabetic retinopathy. In particular, diabetic macular edema is becoming increasingly prevalent in the older population of many developed countries; however, its treatment in clinical settings is insufficient<span>⁷</span>, which needs to be addressed in the future.</p><p>The association between diabetic retinopathy and other diabetic complications, as well as other morbidities and mortality, has been widely investigated<span>⁸</span>. Interestingly, a recent meta-analysis<span>⁹</span> revealed a lack of significant association between non-alcoholic fatty liver disease (NAFLD) and retinopathy, despite sharing common pathophysiological backgrounds, such as insulin resistance. Recent studies on NAFLD and metabolic dysfunctio","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 6","pages":"744-745"},"PeriodicalIF":3.2,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13991","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6075489","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":"BASP1 promotes high glucose-induced endothelial apoptosis in diabetes via activation of EGFR signaling","authors":"Fengnan Sun,&nbsp;Junwei Liu,&nbsp;Yanzheng Wang,&nbsp;Hongmei Yang,&nbsp;Danfeng Song,&nbsp;Haiyan Fu,&nbsp;Xingxing Feng","doi":"10.1111/jdi.13920","DOIUrl":"https://doi.org/10.1111/jdi.13920","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Diabetes mellitus is a common chronic disease of glucose metabolism. Endothelial dysfunction is an early event in diabetes complicated by cardiovascular disease. This study aimed to reveal the expression of BASP1 and its biological roles in endothelial cell dysfunction in diabetes complicated by cardiovascular disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>By analyzing the databases related to diabetes complicated with coronary heart disease, BASP1 was screened out as an upregulated gene. Human umbilical vein endothelial cells (HUVECs) and primary mouse aortic endothelial cells were treated with high glucose to establish cell models of diabetes-related endothelial dysfunction, and the expression changes of BASP1 were verified by RT-qPCR, western blot, and immunofluorescence. BASP1 was silenced or overexpressed by siRNA or overexpression plasmid, and its effects on cell migration, apoptosis, tube formation, inflammatory response, and ROS were detected. The possible signaling pathway of BASP1 was found and the mechanism of BASP1 on promoting the progression of endothelial dysfunction was explored using the EGFR inhibitor, gefitinib.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bioinformatics analysis indicated that the expression of BASP1 in patients with diabetes mellitus and concomitant coronary heart disease was increased. High glucose induced the upregulation of BASP1 expression in endothelial cells, and showed a time-dependent relationship. Silencing of BASP1 alleviated the damage of high glucose to endothelial cells. BASP1 regulated EGFR positively. The promoting effect of BASP1 on endothelial cell apoptosis may be achieved by regulating the EGFR pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BASP1 promotes endothelial cell injury induced by high glucose in patients with diabetes, which may be activated by activating the EGFR pathway.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 4","pages":"535-547"},"PeriodicalIF":3.2,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"5761031","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":"Sleep duration and food intake in people with type 2 diabetes mellitus and factors affecting confectionery intake","authors":"Tomoaki Akiyama,&nbsp;Tadashi Yamakawa,&nbsp;Kazuki Orime,&nbsp;Jun Suzuki,&nbsp;Rika Sakamoto,&nbsp;Minori Matsuura-Shinoda,&nbsp;Erina Shigematsu,&nbsp;Kenichiro Takahashi,&nbsp;Mizuki Kaneshiro,&nbsp;Taro Asakura,&nbsp;Shunichi Tanaka,&nbsp;Takehiro Kawata,&nbsp;Yoshihiko Yamada,&nbsp;Tetsuo Isozaki,&nbsp;Atsushi Takahashi,&nbsp;Uru Nezu Osada,&nbsp;Kazuaki Kadonosono,&nbsp;Yasuo Terauchi","doi":"10.1111/jdi.13987","DOIUrl":"https://doi.org/10.1111/jdi.13987","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>We carried out a cross-sectional study of people with type 2 diabetes mellitus to elucidate the association between sleep duration and food intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Overall, 2,887 participants with type 2 diabetes mellitus (mean age 63.0 years; 61.1% men; mean glycated hemoglobin level 7.5%) were included in this study. The participants' self-reported dietary habits and sleep duration were evaluated using a brief self-administered dietary history questionnaire and Pittsburgh Sleep Quality Index, respectively. The participants were categorized into the following four groups based on sleep duration: &lt;6, 6–6.9, 7–7.9 (reference) and ≥8 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were observed between the groups regarding energy intake (kcal/day), absolute intake (g/day) or relative intake (% energy) of carbohydrates, total fat, proteins and fibers. However, confectionery intake was higher in the &lt;6 h group and lower in the ≥8 h group than in the reference group after adjustment for confounding factors. In multivariate analysis, sleep durations &lt;6 h and ≥8 h significantly correlated with increased (95% confidence interval 0.55 to 3.6; <i>P</i> = 0.0078) and decreased (95% confidence interval −4.0 to −0.32; <i>P</i> = 0.021) confectionery intake, respectively. Confectionery intake was positively correlated with female sex, glycated hemoglobin level and dyslipidemia, whereas it was negatively correlated with alcohol consumption and current smoking status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Short sleep duration is associated with high confectionery intake in people with type 2 diabetes mellitus; this might disturb their glycemic control. Therefore, short sleepers with type 2 diabetes mellitus could improve their glycemic control by avoiding confectionery intake and maintaining adequate sleep duration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 5","pages":"716-724"},"PeriodicalIF":3.2,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13987","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6146724","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":"Electrocardiogram abnormalities and renal impairment in patients with type 2 diabetes mellitus: A healthcare facilities-based cross-sectional study in Dang district of Nepal","authors":"Mahesh Kumar Khanal,&nbsp;Pratiksha Bhandari,&nbsp;Raja Ram Dhungana,&nbsp;Yadav Gurung,&nbsp;Lal B. Rawal,&nbsp;Gyanendra Pandey,&nbsp;Madan Bhandari,&nbsp;Rijwan Bhuiyan,&nbsp;Surya Devkota,&nbsp;Maximilian de Courten,&nbsp;Barbora de Courten","doi":"10.1111/jdi.13985","DOIUrl":"https://doi.org/10.1111/jdi.13985","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims/Introduction</h3>\u0000 \u0000 <p>The global burden of diabetes mellitus is rising substantially, with a further increase in cardiovascular and kidney disease burden. These public health problems are highly prevalent in low- and middle-income countries, including Nepal. However, there is limited evidence on cardiac and renal conditions among patients with type 2 diabetes mellitus. We determined the status of electrocardiogram (ECG) abnormalities and renal impairment among patients with type 2 diabetes mellitus in Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We carried out a cross-sectional study in Tulsipur Sub-Metropolitan City of Nepal using a multistage stratified sampling technique to recruit patients with type 2 diabetes mellitus. We used World Health Organization stepwise approach to surveillance (WHO STEPS) questionnaires and carried out resting ECG to collect data of 345 patients with type 2 diabetes mellitus. Logistic regression analysis assessed the factors associated with ECG abnormalities and renal impairment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study showed that 6.1% of participants had major ECG abnormalities (95% confidence interval [CI] 3.8–8.6%), which were associated with hypertension (<i>P</i> = 0.01%) and low socioeconomic status (<i>P</i> = 0.01). The proportion of major and/or minor ECG abnormalities was 47.8% (95% CI 40.5–51%), and were significantly associated with age (odds ratio [OR] 1.04, 95% CI 1.01–1.07), higher education (OR 3.50, 95% CI 1.31–9.33), unemployment (OR 3.02, 95% CI 1.08–8.48), body mass index (OR 1.09, 95% CI 1.02–1.17) and duration of type 2 diabetes mellitus &gt;5 years (OR 2.42, 95% CI 1.19–4.93). The proportion of renal impairment was 3.5% (95% CI 1.5–4.5%) which was associated with older age (OR 1.08, 95% CI 1.00–1.17) and hypertension (OR 12.12, 95% CI 1.07–138.22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A significant proportion of patients with type 2 diabetes mellitus had ECG abnormalities and renal impairment, which were significantly associated with hypertension. Therefore, hypertension management and early screening are essential to prevent future cardiorenal complications among patients with type 2 diabetes mellitus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":190,"journal":{"name":"Journal of Diabetes Investigation","volume":"14 4","pages":"602-613"},"PeriodicalIF":3.2,"publicationDate":"2023-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.13985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"6101130","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}