Diabetes epidemiology and management最新文献

{"title":"The relative importance of gestational weight gain and pre-gestational diabetes on perinatal outcomes: A retrospective cohort study","authors":"Karen Wong ,&nbsp;Stephanie Gill ,&nbsp;Phil Murphy ,&nbsp;Joan Crane","doi":"10.1016/j.deman.2022.100095","DOIUrl":"10.1016/j.deman.2022.100095","url":null,"abstract":"<div><h3>Aims</h3><p>The objective of this study is to determine the risks of macrosomia, LGA, and Caesarean section associated with a diagnosis of pre-gestational diabetes or gestational weight gain.</p></div><div><h3>Methods</h3><p>This is a retrospective cohort study utilizing data from the Perinatal Surveillance Database of Newfoundland &amp; Labrador from 2001 – 2020. Multivariate logistic regression analyses were used to determine odds ratios (OR) associated with GWG and pre-gestational diabetes for the outcomes macrosomia, LGA, and CS, while controlling for other known risk factors.</p></div><div><h3>Results</h3><p>There were 234 pregnancies complicated by pre-gestational diabetes and 22,048 without diabetes included. There was no significant difference in absolute GWG between groups (15.2 kg vs. 15.5 kg, <em>p</em> = 0.12), however more women with pre-gestational diabetes had excessive GWG (85.1% vs. 78.5%, <em>p</em> = 0.04). Pre-gestational diabetes was a significant predictor of LGA (OR 5.21, 95% CI 3.96 – 6.87), macrosomia (OR 2.63 95% CI 1.98 – 3.48), and Caesarean section (OR 3.44, 95% CI 2.60 – 4.56). The OR associated with excessive GWG were lower for these same outcomes (LGA OR 2.73, 95% CI 2.40 – 3.11; macrosomia 2.38, 95% CI 2.12 – 2.69; Caesarean section OR 1.29, 95% CI 1.19 – 1.39).</p></div><div><h3>Conclusions</h3><p>We have identified that pre-gestational diabetes is the most significant risk factor for poor outcomes such as LGA, macrosomia, and Caesarean section, although excessive GWG also plays a role.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000452/pdfft?md5=7dec95b2b88ab6c4751a552549a55b97&pid=1-s2.0-S2666970622000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46948819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy in diabetes: A nation-wide, pharmacy-based, observational study","authors":"Etienne Larger ,&nbsp;Laure Alexandre-Heymann ,&nbsp;Simon Pilet ,&nbsp;Thomas Raoul ,&nbsp;Lucas Perray ,&nbsp;Milka Maravic","doi":"10.1016/j.deman.2022.100088","DOIUrl":"10.1016/j.deman.2022.100088","url":null,"abstract":"<div><h3>Aim</h3><p>The aim of the present study was to build a classification of diabetes according to the time-sequence of treatment. A second aim was to describe the diversity of drugs prescribed for diabetes and associated conditions in a nation-wide cohort of patients with diabetes.</p></div><div><h3>Patients and method</h3><p>LRx is an outpatient care nation-wide medication dispense database. It consists of a panel of 10,000 retail pharmacies in France. We developed an algorithm to find out the number of patients treated for diabetes from July 2018 to June 2019 and to classify diabetes types and the sequence of drugs dispense over the years, including treatments for the control of diabetes itself and drugs for associated conditions.</p></div><div><h3>Results</h3><p>A raw number of 2.3 million patients was studied, corresponding to an extrapolated 3.9 million patients in mainland France. Seven percent were classified as having Type 1 Diabetes, 86% Type 2 Diabetes (T2D), 0.5% insulin-treated gestational diabetes, and 6% remained unclassified. In subjects with T2D, metformin was the most frequently prescribed glucose lowering drug, followed by DPP4 inhibitors and sulfonylureas. Main coprescribed medication classes were lipid-modifying agents and antihypertensive agents. Of note, about a third of the patients received neuropsychiatric drugs and 40% a proton-pump inhibitor. We also had an unbiased view of compliance to treatment, that was below 50%.</p></div><div><h3>Conclusion</h3><p>The algorithm we built could be used to monitor changes of strategies to control blood glucose and comorbidities. Our findings highlight the burden of polypharmacy in patients with diabetes.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000385/pdfft?md5=235f82eef1731a4e5e1d69894d8d499b&pid=1-s2.0-S2666970622000385-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48374540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and warnings after one year of Minimed 780 G hybrid closed loop pump treatment in type 1 diabetes adults","authors":"Didier Gouet ,&nbsp;Pierre Henri Ducluzeau ,&nbsp;Harivola Andriantaolo ,&nbsp;Claire Cordroc'h ,&nbsp;Frédérique Duengler ,&nbsp;Sophie Gaulier ,&nbsp;Thierry Godeau ,&nbsp;Céline Olivier ,&nbsp;Caroline Allix-Beguec","doi":"10.1016/j.deman.2022.100110","DOIUrl":"10.1016/j.deman.2022.100110","url":null,"abstract":"<div><p>The benefits of a hybrid closed loop insulin pump system are generally compared to non-automated insulin pump treatment of type 1 diabetics whose glycemic control was often unsatisfactory. Here we report the results of a monocentric cohort of type 1 diabetics with a good glycemic control before the switch to the hybrid system. 83 adult patients were followed up for 12 months after the implementation and training of the hybrid system. We observed a significant improvement in the glycemic mean index at 3 and 6 months but not at 12 months, accompanied by a 10% increase in insulin requirements over the first few months. Surprisingly, the time spent in hypoglycemia did not decrease. An analysis shared with patients leads us to propose several measures to consider before switching to a hybrid closed loop system.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000609/pdfft?md5=209e15c0fa56a4163d35fc68ccaf7b27&pid=1-s2.0-S2666970622000609-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43071480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of adiposity indices and their association with insulin resistance and β-cell dysfunction in primary prevention for diabetes in Mexican population","authors":"Froylan David Martínez-Sánchez ,&nbsp;Alejandra Diaz-Jarquin ,&nbsp;Valerie Paola Vargas-Abonce ,&nbsp;Jose Luis Torres-Cuevas ,&nbsp;Anna Paula Guerrero-Castillo ,&nbsp;David Medina-Julio ,&nbsp;Clara Elena Meza-Arana ,&nbsp;Alfonso Gulias-Herrero ,&nbsp;Miguel Ángel Gómez-Sámano","doi":"10.1016/j.deman.2022.100091","DOIUrl":"10.1016/j.deman.2022.100091","url":null,"abstract":"<div><h3>Introduction</h3><p>Impaired adiposity function, Insulin resistance (IR), and β-cell dysfunction predispose to type 2 diabetes (T2D). Some indices, such as the Visceral Adiposity Index (VAI), Dysfunctional Adiposity Index (DAI), and Atherogenic Index of Plasma (AIP), have been developed as surrogates of dysfunctional adiposity. However, the association of these indices with IR and β-cell dysfunction in primary prevention for T2D has not been fully studied.</p></div><div><h3>Materials and Methods</h3><p>This was a cross-sectional study that included 401 asymptomatic subjects with at least two risk factors for T2D that underwent an oral glucose tolerance test. A HOMA-IR ≥2.5 and a Disposition Index ≤1.24 were used to define IR and β-cell dysfunction, respectively.</p></div><div><h3>Results</h3><p>Mean age of the subjects was 50.4 ± 9.6 years, 71.6% were women, had a mean BMI of 30.3 ± 6.4 kg/m² 27.6% and 11.6% had newly diagnosed T2D. After multiple regression analysis the VAI, DAI, and AIP were associated with IR (1.218 [1.103–1.345], 1.355 [1.150–1.597], and 2.533 [1.733–3.703], respectively), and β-cell dysfunction (1.119 [1.029–1.217], 1.193 [1.034–1.376], and 1.960 [1.357–2.830], respectively). Likewise, the AIP was the only index associated for newly T2D diagnosis (1.974 [1.224–3.184]).</p></div><div><h3>Conclusions</h3><p>The VAI, DAI and AIP were independently associated with IR and β-cell dysfunction in patients at high risk for T2D.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000415/pdfft?md5=9715e4a063b55a16f39eaf439b059266&pid=1-s2.0-S2666970622000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48919287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant correlation between taste dysfunction and HbA1C level and blood sugar fasting level in type 2 diabetes mellitus patients in at a tertiary care center in north India","authors":"Jitendra Singh Kushwaha,&nbsp;Vishal Kumar Gupta,&nbsp;Archana Singh,&nbsp;Richa Giri","doi":"10.1016/j.deman.2022.100092","DOIUrl":"10.1016/j.deman.2022.100092","url":null,"abstract":"<div><p>Type 2 diabetes mellitus (T2DM) effect quality of life very much and causes various complications. Diabetic autonomic neuropathy (DAN) is one of the common complications in diabetes. The taste threshold affected by various factors such as age, ethnic backgrounds, drugs, local and systemic diseases, consumption of alcohol, smoking, and tobacco chewing. The present study is undertaken with the objectives to compare the alteration in taste threshold for four primary sensations in Type 2 DM with autonomic neuropathy. 60 patients of T2DM with autonomic neuropathy and 60 healthy controls were taken for the study. Autonomic neuropathy was assessed clinically. Chemical taste test using four solutions of basic tastes (sweet, sour, salty, bitter) were done. Taste dysfunction for sweet was significant in T2DM with uncontrolled hyperglycemia. The taste dysfunction in T2DM patients was not related to gender, disease duration, and type of treatment taken. The study found a significant correlation between taste dysfunction, HbA1C level and blood sugar fasting level in T2DM patients. The taste dysfunction was mainly for sweet. Sour and bitter did not show any difference in case groups compared to controls.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000427/pdfft?md5=d5c188e5199cddf47df8a59dd9a9334f&pid=1-s2.0-S2666970622000427-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48605437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and prevalence of diabetic retinopathy in the Greenlandic Inuit: A register-based study","authors":"Trine Jul Larsen ,&nbsp;Marit Eika Jørgensen ,&nbsp;Michael Lynge Pedersen ,&nbsp;Henrik Lund-Andersen ,&nbsp;Stine Byberg","doi":"10.1016/j.deman.2022.100108","DOIUrl":"10.1016/j.deman.2022.100108","url":null,"abstract":"<div><h3>Aims</h3><p>Assess the incidence and prevalence of diabetic retinopathy (DR) among all persons registered with diabetes in the electronic medical records (EMR) from 2016 to 2020 and investigate factors associated with both incident and prevalent DR.</p></div><div><h3>Methods</h3><p>We calculated the five-year incidence rate of DR per 1000 person years, and calculated the prevalence of DR, using Poisson regression analysis. We calculated the incidence rate ratios (IRR) in univariate and multivariate Poisson regression analysis, to assess risk factors associated with incident DR. We calculated the Odds ratios (OR) to assess risk factors of prevalent DR in univariate and multivariate Logistic regression analyses.</p></div><div><h3>Results</h3><p>We found 10.4% persons developed incident DR during follow-up, equivalent to an incidence rate of DR of 29.2 pr. 1000 (95%CI: 22.9–37.3) person years. The total prevalence of DR was 13.6%. Higher HbA₁c levels and longer diabetes duration were significantly associated with incident and prevalent DR. Higher levels of LDL cholesterol were significantly associated with a lower risk of incident DR.</p></div><div><h3>Conclusion</h3><p>The incidence and prevalence of DR in Greenland is lower than in most other parts of the world. In agreement with previous studies on risk factors for DR, HbA₁c levels and diabetes duration were associated with incident/prevalent DR.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000580/pdfft?md5=b7212d42583fa6614a5a2dff535e2579&pid=1-s2.0-S2666970622000580-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48205186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissatisfaction with teeth in type 2 diabetes is associated with increased risk of cardiovascular disease","authors":"Edvin Ström ,&nbsp;Tobias Rudholm Feldreich ,&nbsp;Johan Ärnlöv ,&nbsp;Carl Johan Östgren ,&nbsp;Fredrik H Nystrom ,&nbsp;Magnus O Wijkman","doi":"10.1016/j.deman.2022.100090","DOIUrl":"10.1016/j.deman.2022.100090","url":null,"abstract":"<div><h3>Background and aim</h3><p>Poor dental health status has been linked to increased risk of cardiovascular events in type 2 diabetes (T2D). Less is known about self-perceived dental health and cardiovascular risk. Our aim with this study was to investigate this association.</p></div><div><h3>Methods</h3><p>Recruitment of T2D patients took place between 2005 and 2008 in Swedish primary care. Teeth satisfaction was assessed by questionnaire at baseline. The major adverse cardiovascular events (MACE) in this study were hospitalization due to myocardial infarction, stroke or cardiovascular death. Cox regression models were used.</p></div><div><h3>Results</h3><p>Out of 761 participants 601 had complete data. Ninety-two MACEs occurred (median follow-up time: 11.6 years). Those satisfied with their teeth (<em>n</em> = 458) had 61 events (1.2 events per 100 person-years), while those dissatisfied with teeth (<em>n</em> = 143) had 31 events (2.2 events per 100 person-years). Dissatisfaction with teeth was associated with an increased risk of MACE independent of age, sex and levels of CRP (HR 1.85, 95% CI 1.20 – 2.86).</p></div><div><h3>Conclusions</h3><p>In patients with T2D, dissatisfaction with teeth was associated with increased risk of MACE and may be considered as a marker of risk.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000403/pdfft?md5=29e9378172ddd24679d945389d1bc2ae&pid=1-s2.0-S2666970622000403-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47967153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of in-hospital versus ambulatory glucose variability on coronary plaque vulnerability in patients with coronary artery disease","authors":"Kazuya Tateishi,&nbsp;Yuichi Saito,&nbsp;Tatsuro Yamazaki,&nbsp;Hideki Kitahara,&nbsp;Yoshio Kobayashi","doi":"10.1016/j.deman.2022.100104","DOIUrl":"10.1016/j.deman.2022.100104","url":null,"abstract":"<div><h3>Aim</h3><p>The impact of in-hospital and ambulatory glucose variability (GV) on lipid core plaques (LCP) is unclear. We evaluated the relation of GV during hospitalization and after discharge to LCPs.</p></div><div><h3>Methods</h3><p>A total of 35 patients undergoing percutaneous coronary intervention (PCI) under near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) guidance for acute myocardial infarction (MI) and stable coronary artery disease were prospectively included. LCP was evaluated with a lipid core burden index (LCBI) and a maximum LCBI in 4 mm (max LCBI_4mm) in the non-target vessel using NIRS-IVUS. GV was measured by a flush glucose monitoring system.</p></div><div><h3>Results</h3><p>In-hospital mean amplitude of glucose excursion (MAGE) was significantly higher than that after discharge (73.4±26.8 vs. 66.0±22.8 mg/dl, p=0.03). In the entire study population, LCBI and maxLCBI_4mm in the non-target vessel were correlated with MAGE after discharge (r=0.51, p=0.002 and r=0.39, p=0.02), but not significantly correlated with in-hospital MAGE. The relations of MAGE to higher LCBI and maxLCBI_4mm were more evident in patients with acute MI.</p></div><div><h3>Conclusions</h3><p>GV was greater during hospitalization than after discharge in patients undergoing PCI. Greater GV after discharge was significantly associated with higher LCBI and maxLCBI4_mm, suggesting that ambulatory GV may be closely link to coronary atherosclerosis.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000543/pdfft?md5=10ec5acc4955d4493ff1da78c5292170&pid=1-s2.0-S2666970622000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47445095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal arteriole tortuosity changes over time in a veteran population with diabetes","authors":"Danielle L. Weiler ,&nbsp;Carla B. Engelke ,&nbsp;Matthew A. Rhodes ,&nbsp;Sean P. Rowan ,&nbsp;Amanda E. Mendez Roberts ,&nbsp;Wendy W. Harrison","doi":"10.1016/j.deman.2022.100105","DOIUrl":"10.1016/j.deman.2022.100105","url":null,"abstract":"<div><h3>Purpose</h3><p>Arteriole tortuosity is an important sign of retinal disease which is associated with diabetic retinopathy, but it is unclear how arteriole tortuosity changes over time in populations with diabetes. It has been suggested that retinal vasculature geometry changes precede diabetic retinopathy. Here, we evaluate whether arteriole tortuosity changes precede diabetic retinopathy by examining arteriole tortuosity and retinopathy at two points in time four years apart.</p></div><div><h3>Methods</h3><p>A population of 126 subjects had retinal photographs at baseline and approximately four years later (48 ± 9 months) in a telehealth screening program. The photographs from both eyes at baseline and follow up were graded for tortuosity (straight, wavy, or tortuous) and retinopathy using clinical ETDRS guidelines. Consensus grades (across graders) were used, but when consensus was not reached or the image quality was too poor to grade, the subject was removed from analysis. Other health markers, such as duration of diabetes, hemoglobin A1c (HbA1c), neuropathy status, and insulin usage, were also recorded. Differences in time points were assessed with paired t-tests.</p></div><div><h3>Results</h3><p>Of the 109 subjects (218 eyes) included in final analysis, 24 eyes had retinopathy at baseline and 26 eyes had retinopathy at follow up, which was almost all mild (93%). Tortuosity was largely unchanged at follow up (76%) and on average was straight or wavy. Nine eyes had decreased tortuosity (4.3%). The final 19.7% had arteriole tortuosity which increased a level from baseline. The subjects with increased tortuosity had a shorter duration of diabetes at baseline (5.8 years vs 7.4 years, <em>p</em>&lt;0.04). There was no relationship between retinopathy development and arteriole tortuosity increasing or between HbA1c and change in tortuosity.</p></div><div><h3>Conclusions</h3><p>It appears that retinal arteriole tortuosity may increase most over early years of diabetes development and then stabilize. Therefore, it may be more valuable to monitor retinal arteriole tortuosity in early years of diagnosis in both clinical and telemedicine settings. More research is needed following changes in tortuosity over time in patients with diabetes.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000555/pdfft?md5=4387cf75c1fd74022bab0706393bfbfb&pid=1-s2.0-S2666970622000555-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45790762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The retinal nerve fiber layer thickness is useful for the assessment of diabetic retinopathy severity","authors":"Zulvikar Syambani Ulhaq ,&nbsp;Yuliono Trika Nur Hasan ,&nbsp;Sarah Herawangsa ,&nbsp;Mohamad Ahnaf Audris ,&nbsp;Muhammad Fauzan Al Farizy ,&nbsp;Rafli Dhafa Aditya ,&nbsp;Ratu Belqys Rosadeila Putri","doi":"10.1016/j.deman.2022.100075","DOIUrl":"10.1016/j.deman.2022.100075","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the alterations of individual retinal layer thickness at different stages of diabetic retinopathy (DR) and its role in determining DR severity.</p></div><div><h3>Methods</h3><p>In this study, 51 patients with nonproliferative DR (NPDR) and 57 patients with proliferative DR (PDR) were enrolled. The individual retinal layer thickness was measured according to the image segmentation of the macular scan collected from the optical coherence tomography (OCT) result. Comparative analysis was performed in addition to assessment of the diagnostic performance of the retina layer using receiver-operating-curve (ROC) analysis. Moreover, correlation analysis was conducted to examine the association between HbA1c and retina layer changes.</p></div><div><h3>Results</h3><p>In PDR subjects, the retinal nerve fiber layer (RNFL, <em>p</em> &lt; 0.0001), ganglion cell layer (GCL, <em>p</em> &lt; 0.0001), inner plexiform layer (IPL, <em>p</em> = 0.0025), ganglion cell-inner plexiform layer (GC-IPL, <em>p</em> &lt; 0.0001), and ganglion cell complex (GCC = RNFL+GCL+IPL, <em>p</em> &lt; 0.0001) thickness were decreased compared to NPDR subjects. RNFL exhibited a better performance than GCL, GC-IPL, or GCC (AUC for RNFL = 0.76, <em>p</em> &lt; 0.0001) in discriminating DR severity (cut-off of 16.62 μm (84.21% sensitivity and 70.59% specificity). The RNFL, GCL, IPL, GC-IPL, GCC, inner nuclear layer (INL), and total retinal layer (TLR) thickness correlated negatively with HbA1c levels in PDR group.</p></div><div><h3>Conclusion</h3><p>Measurement of retinal degeneration, particularly by evaluating RNFL thinning is potentially useful for early identification of DR progression.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970622000257/pdfft?md5=d82faa32600e4a4ed0b600b73c2f7327&pid=1-s2.0-S2666970622000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42676644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}