Diabetes epidemiology and management最新文献

{"title":"Characteristics of non-fasting patients with diabetes type 2 in the DAR global surveys of 2020 and 2022","authors":"Bachar Afandi ,&nbsp;Khadija Hafidh ,&nbsp;Rachid Malek ,&nbsp;M Yakoob Ahmedani ,&nbsp;Inass Shaltout ,&nbsp;Reem Alamoudi ,&nbsp;Zanariah Hussein ,&nbsp;Mohamed Hassanein","doi":"10.1016/j.deman.2024.100217","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100217","url":null,"abstract":"<div><h3>Introduction</h3><p>The decision to fast or not is quite complex. Personal, medical and religious matters may influence it for individuals with diabetes. However, a diagnosis of diabetes does not constitute an automatic exemption from Ramadan fasting. We aimed to evaluate the characteristics of the non-fasting cohort and explore the potential reasons during Ramadan through the global Ramadan surveys of 2020 and 2022.</p></div><div><h3>Method</h3><p>The Diabetes and Ramadan (DaR) Global Study is an observational retrospective survey conducted between 2020 and 2022, which included adult patients (18 and older) who fasted and those who opted not to fast. The survey captured demographic data and patient characteristics (co-morbidities, duration and type of diabetes, diabetes-related complications and medications, development of acute complications during Ramadan, hospitalisations and ER visits) for both groups.</p></div><div><h3>Results</h3><p>Of 12,059 patients, 1822 (14.5 %) did not fast during Ramadan; that population leaned towards females (54.6 %). They had an average age of 60.58 years (SD=12.12) with a statistically significant difference from the fasting population, averaging 54.29±11.45 (<em>p</em> = 0.000). Also of note was the more significant average duration of diabetes in the non-fasting cohort (12.54 years vs 9.44). There are notable regional differences in rates of fasting that ranged between 6.3 % and up to 51.2 % of patients opting not fast in certain regions (Chart 1). The risk factors that showed apparent differences of high statistical significance (<em>p</em> ≤ 0.001) included: long duration of diabetes of over ten years, age above 60+ years, HbA1c value over 9 %, use of insulin therapy, and being affected by one or more vascular complications (these include CKD, CVD, and diabetic foot problems).</p></div><div><h3>Conclusions</h3><p>Many factors and comorbidities might influence patients’ decisions when planning Ramadan fasting. The non-fasting population's demographic and clinical profiles reveal distinctive features, emphasising a need for tailored risk assessments. Furthermore, regional disparities in the decision to fast underscore the multifaceted nature of this decision-making process. The new IDF-DAR risk assessment tool can help to stratify patients’ risk during Ramadan fasting and bridge the gap among different populations and cultures.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000222/pdfft?md5=4eb5e3f489f47bab3d4af0c5dbecd660&pid=1-s2.0-S2666970624000222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140558176","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":"Phase angle associated is with low ankle-brachial index in type 2 diabetes patients in Ghana","authors":"Jennifer Adjepong Agyekum ,&nbsp;Kwame Yeboah","doi":"10.1016/j.deman.2024.100216","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100216","url":null,"abstract":"<div><h3>Background</h3><p>Type 2 diabetes (T2DM) is associated with high burden of atherosclerotic macrovascular disease which could be diagnosed with ankle-brachial index (ABI). Phase angle (PhA) from bioelectric impedance analysis is associated with the development of cardiovascular diseases. We investigated the association between low ABI and phase angle in T2DM patients in Ghana.</p></div><div><h3>Method</h3><p>In a cross-sectional study, 462 T2DM patients were systematically recruited for the study. ABI was measured using an 8 Hz continuous Doppler and ABI≤0.9 was considered to be low ABI. PhA was obtained from resistance and reactance from Bioelectric impedance analysis.</p></div><div><h3>Results</h3><p>The prevalence of low ABI was 16 % in the study population. T2DM patients with low ABI have decreased PhA (7.5 ± 1.9 vs 8.3 ± 2.2 units, <em>p</em> = 0.004) compared to those with normal ABI. An increase in phase angle by 1° was associated with a decrease in odds of having low ABI in unadjusted [OR (95 % CI) = 0.79 (0.48 – 0.95), <em>p</em> = 0.007] and adjusted models [0.88 (0.43 – 0.98), <em>p</em> = 0.036].</p></div><div><h3>Conclusion</h3><p>The prevalence of low ABI in T2DM patients in this study was 16 %. Also, PhA was lower in patients with low ABI compared to those with normal ABI.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000210/pdfft?md5=20ec669293ad684e8b07be6d669947a6&pid=1-s2.0-S2666970624000210-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180046","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":"Association of prediabetes with stroke in young metabolically healthy tobacco users: A population-based analysis","authors":"Advait Vasavada ,&nbsp;Arankesh Mahadevan ,&nbsp;Manisha Jain ,&nbsp;Subramanian Gnanaguruparan ,&nbsp;Rupak Desai","doi":"10.1016/j.deman.2024.100210","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100210","url":null,"abstract":"<div><h3>Background</h3><p>Diabetes and tobacco use are well-established risk factors for stroke. However, the intersection of prediabetes, tobacco use, and stroke among young individuals remains underexplored. This study aims to investigate the association between pre-diabetes and stroke risk in young tobacco users.</p></div><div><h3>Methods</h3><p>Using the National Inpatient Sample (2019) and relevant ICD-10 codes, we identified young patients with tobacco use disorder and pre-diabetes. Regression analysis considered risk factors (gender, demographics, income, comorbidities) to assess stroke odds.</p></div><div><h3>Results</h3><p>Among 1,017,540 stroke hospitalizations, 1.9 % were pre-diabetic. Pre-diabetics were often older (median age 36 vs. 31), male (59.4 %), Black (33.8 %), and Hispanic (12.2 %), with higher rates of comorbidities, including drug abuse, alcohol abuse, COPD, and CKD (<em>p</em> &lt; 0.001). They also exhibited higher rates of stroke events (1.9 % vs. 0.5 %, <em>p</em> &lt; 0.001). Multivariable analysis after adjusting for confounders, young metabolically healthy smokers with pre-diabetes had a higher risk of stroke (aOR 3.31, 95 % CI [1.67–6.55], <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Prediabetes could potentially triple stroke risk in young tobacco smokers. Prospective research is warranted to explore the causal association between pre-diabetes and stroke in the setting of tobacco use.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000155/pdfft?md5=a95efa544ec5b5f638e4cf57c191dc00&pid=1-s2.0-S2666970624000155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140191303","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":"Early diagnosis of Charcot neuro-osteoarthropathy using MRI and its effect on patient outcomes: A seven-year retrospective audit","authors":"Laksh Lukkhoo ,&nbsp;Sharlene Vu ,&nbsp;Joanna Scheepers ,&nbsp;Deborah Schoen","doi":"10.1016/j.deman.2024.100208","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100208","url":null,"abstract":"<div><h3>Background</h3><p>There remains a paucity of research comparing the diagnostic and therapeutic outcomes between Magnetic Resonance Imaging (MRI) and x-ray modalities for Charcot neuro-osteoarthropathy CNO. This retrospective study investigates the use of offloading devices, duration of offloading and final footwear outcomes dependent on imaging at diagnosis.</p></div><div><h3>Methods</h3><p>Medical records from a secondary hospital high-risk foot clinic in Perth, Western Australia, were systematically reviewed. Data collected included baseline medical history, location of CNO, Eichenholtz stage or Chantelau and Grutznel grade at diagnosis, type and duration of offloading, and final footwear outcomes.</p></div><div><h3>Results</h3><p>Twenty-eight patients met the inclusion criteria. All had diabetes and peripheral neuropathy. All patients received either an MRI (43%) or x-ray (57%) to confirm the diagnosis of active CNO. Five (17.9%) patients who were diagnosed on MRI had grade 0 CNO whilst 23 (82.1%) patients who were diagnosed on x-ray had stage 1 CNO. No statistical significance was found between the type and duration of offloading, resolution of CNO, footwear and transtibial amputation (TTA) outcomes across those diagnosed with MRI or x-ray.</p></div><div><h3>Conclusion</h3><p>No statistical significance in patient outcomes was found between those diagnosed with grade 0 on MRI and those diagnosed with stage 1 on x-ray.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000131/pdfft?md5=2b43b95910ef45809f0883f0f651baf3&pid=1-s2.0-S2666970624000131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180047","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":"Oral semaglutide effectiveness and safety in real world practice; The REVOLUTION study","authors":"Abdulrahman Alsheikh ,&nbsp;Ali Alshehri ,&nbsp;Saad Alzahrani ,&nbsp;Anwar AlJammah ,&nbsp;Fahad Alqahtani ,&nbsp;Metib Alotaibi ,&nbsp;Raed Aldahash ,&nbsp;Amani M. Alhozali ,&nbsp;Fahad Alsabaan ,&nbsp;Mohammed Almehthel ,&nbsp;Naser Aljuhani ,&nbsp;Ali Aldabeis ,&nbsp;Moneer Alamri ,&nbsp;Waleed Maghawry ,&nbsp;Naweed Alzaman ,&nbsp;Alshaima Alshaikh ,&nbsp;Omar M. Alnozha ,&nbsp;Emad R Issak ,&nbsp;Saud Alsifri","doi":"10.1016/j.deman.2024.100209","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100209","url":null,"abstract":"<div><h3>Aims</h3><p>This study seeks to provide insights into the practical application and effects of oral semaglutide in Saudi T2DM patients under routine medical supervision.</p></div><div><h3>Methods</h3><p>The primary outcome measure was the laboratory HbA1c. Secondary measures included fasting blood glucose (FBG), weight, and hypoglycemia. All variables were checked after six months and 12 months of initiation.</p></div><div><h3>Results</h3><p>The analysis of this study included 245 uncontrolled (HbA1c &gt; 7 %) T2DM patients. The mean baseline HbA1c was 10.1 % (1.2). HbA1c was reduced by an average of 3.1 % (0.8) and 3.2 % (0.8) at 6 and 12 months, respectively. The frequency of hypoglycemia events in the last three months before semaglutide was initiated was 4.4 (1.1). The frequency of hypoglycemia events in the last three months was 2.2 (0.8) and 0.7 (0.4) at 6-month and 12-month follow-up visits, respectively. The percent reduction in body mass index (BMI) was an average of 13.0 % (1.4) and 19.7 % (3.4) at six months and 12 months, respectively. Lipid profile and blood pressure were improved at six months and 12 months.</p></div><div><h3>Conclusions</h3><p>Oral semaglutide provided substantial glycemic and weight-loss benefits in adult individuals with T2DM.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000143/pdfft?md5=94b2da85bd56858ce5bfeb30f75ce245&pid=1-s2.0-S2666970624000143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140067375","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":"Correlation of fasting C-peptide levels with abdominal adipose tissue thickness and pancreatic size amongst poorly controlled diabetic elderly patients","authors":"Pratibha Pereira ,&nbsp;Jehath Syed ,&nbsp;Sri Harsha Chalasani ,&nbsp;Tejeswini C J ,&nbsp;Shilpa Avarebeel ,&nbsp;Kshama Ramesh","doi":"10.1016/j.deman.2024.100207","DOIUrl":"10.1016/j.deman.2024.100207","url":null,"abstract":"<div><h3>Background</h3><p>Insulin resistance (IR) and diabetes are common chronic conditions amongst elderly patients, that may lead to increase in abdominal adipose tissue deposits and pancreatic size.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted in the geriatric OPD in a tertiary care hospital for a period of six months to correlate fasting C-peptide levels, abdominal adipose tissue thickness, and pancreatic size in poorly controlled diabetic elderly patients. Diabetic elderly patients with HBA1c level &gt;7 % were enrolled with their consent. Body mass index (BMI), fasting C-peptide, abdominal adipose tissue thickness and pancreatic size were measured using standard laboratory techniques. The data obtained were assessed categorically and represented as [n (%)]. T-test was used to compare the two groups (<em>p</em> &lt; 0.05).</p></div><div><h3>Results</h3><p>A total of 101 patients were enrolled. The study results showed no significant correlation between subcutaneous fat and pre-peritoneal fat thickness; and fasting c-peptide levels (<em>p</em> = 0.801, <em>p</em> = 0.316). However, there was a significant correlation between the fasting c-peptide levels and pancreatic size (<em>p</em> = 0.001). It was also observed the study participants had a decreased pancreatic size, with the mean size being 4.837 cm in males, and 4.4418 cm in females.</p></div><div><h3>Conclusion</h3><p>Intra-peritoneal fat thickness and pancreatic size can be used as surrogate marker for IR along with C-peptide. All elderly with uncontrolled type 2 diabetes mellitus behaving like type 1 diabetes mellitus needs further evaluation and pathogenic process must be explored. Sarcopenic obesity evaluation must be a part of uncontrolled type diabetes mellitus management.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266697062400012X/pdfft?md5=3e80eb94b7d81dd9fee42e764da4ea07&pid=1-s2.0-S266697062400012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139822225","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 efficacy of a 24-hour preoperative pause for SGLT2-inhibitors in type II diabetes patients undergoing bariatric surgery to mitigate euglycemic diabetic ketoacidosis","authors":"Samer Younes","doi":"10.1016/j.deman.2024.100201","DOIUrl":"10.1016/j.deman.2024.100201","url":null,"abstract":"<div><p>The case emphasizes the risk of euglycemic diabetic ketoacidosis (DKA) after bariatric surgery and SGLT2 inhibitor use, highlighting the importance of patient education and healthcare provider monitoring. Potential causes include increased urinary glucose excretion from SGLT2 inhibitors, reduced carbohydrate intake post-surgery, and possible insulin discontinuation effects. The current recommendation from AACE to discontinue SGLT2 inhibitors 24 h before surgery may require additional research to determine the optimal timing of discontinuation.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000064/pdfft?md5=3808f245b626705f75d58c6562d8d766&pid=1-s2.0-S2666970624000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638009","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 Sten-O Starter on Glycemic Management in Children and Adolescents with Type 1 Diabetes in the North Region of Denmark","authors":"C. Bender ,&nbsp;M.H. Jensen ,&nbsp;S.B. Skindbjerg ,&nbsp;A. Nielsen ,&nbsp;C. Feldthaus ,&nbsp;S. Hangaard ,&nbsp;L.A. Hasselbalch ,&nbsp;M. Madsen ,&nbsp;O. Hejlesen ,&nbsp;S.L. Cichosz","doi":"10.1016/j.deman.2024.100200","DOIUrl":"10.1016/j.deman.2024.100200","url":null,"abstract":"<div><h3>Objective</h3><p>Educational material on type 1 diabetes (T1D) is limited. An educational application named Sten-O Starter has been implemented for children and adolescents with T1D and their parents; however, its effect on glycemic management is unknown. The objective was therefore to examine the clinical impact of the Sten-O Starter on glycemic management among children and adolescents with T1D.</p></div><div><h3>Methods</h3><p>The levels of glycated hemoglobin (HbA1c) at 0–12 months after diagnosis were compared between two cohorts (the intervention received Sten-O Starter and the control received usual care). A mixed model of repeated measurements adjusted for age, sex, and HbA1c at diagnosis was used. A subgroup analysis of the cohorts was performed in which the time in range, time above range, and time below range (TBR) were compared at 6 months and 12 months after diagnosis using the Wilcoxon rank sum test.</p></div><div><h3>Results</h3><p>181 children and adolescents were included and all HbA1c measurements from the time of diagnosis to 12-month follow-up: No significant difference (<em>p</em> = 0.35) was found in HbA1c changes between the cohorts. However, the difference in median HbA1c at the 12-month follow-up between the intervention cohort and the control cohort (50 mmol/mol vs. 54 mmol/mol) was borderline significant (<em>p</em> = 0.059). A subgroup analysis of 30 children and adolescents revealed that TBR was significantly different (intervention: 1.2 % vs control: 2.6 %; <em>p</em> = 0.02) at 6 months and at 12 months (intervention: 1 % vs control; 2 %; <em>p</em> = 0.05).</p></div><div><h3>Conclusion</h3><p>The results indicate improved glycemic management among children and adolescents with T1D after use of the Sten-O Starter.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000052/pdfft?md5=78225e962fd0c9873d3318d1a85af450&pid=1-s2.0-S2666970624000052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636490","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":"Prevalence of anxiety and depression among pregnant women with diabetes and their predictors","authors":"Hamid Reza Salimi ,&nbsp;Mark D. Griffiths ,&nbsp;Zainab Alimoradi","doi":"10.1016/j.deman.2024.100198","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100198","url":null,"abstract":"<div><h3>Background</h3><p>Addressing mental health of diabetic pregnant women is important as it might increase the chance of obstetric complications, preterm birth, and neonatal complications.</p></div><div><h3>Aim</h3><p>The present study investigated the prevalence of anxiety and depression among pregnant women with diabetes and their predictors.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted in 2023. The sample comprised 350 pregnant women with diabetes (pre-pregnancy or gestational) referred to comprehensive health centers in Qazvin Province, Iran. Fertility and demographic characteristics, anxiety, depression, partner social support, self-efficacy, medication adherence, and fear of hypoglycemia were assessed.</p></div><div><h3>Results</h3><p>Among the sample, 28.9 % had pre-pregnancy diabetes and 71.1 % had gestational diabetes. Anxiety and depression were reported by 74.9 % and 79.4 % of all participants (significantly higher among those with pre-existing diabetes compared to gestational diabetes). Self-efficacy (OR: 0.91 [95 % CI: 0.86; 0.96]) and spouse's social support (OR: 0.68 [95 % CI: 0.56; 0.82]) were significant predictors of abnormal anxiety. Fear of hypoglycemia (OR: 1.06 [95 % CI: 1.02; 1.09]), medication adherence (OR: 1.05 [95 % CI: 1.01; 1.09]), self-efficacy (OR: 0.86 [95 % CI: 0.82; 0.91]), partner social support (OR: 0.62 [95 % CI: 0.49; 0.78]), diabetes type (pregnancy vs. pre-pregnancy diabetes; OR: 0.26 [95 % CI: 0.09; 0.77]), perceived family economic status (fair vs. good; OR: 3.08 [95 % CI: 1.12; 8.49]), and diabetes treatment (insulin vs. diet; OR: 0.21 [95 % CI: 0.08; 0.55]) were significant predictors of abnormal depression.</p></div><div><h3>Conclusion</h3><p>Diabetic pregnant women should be evaluated for anxiety and depression during their prenatal visit. Improving self-efficacy, increasing medication adherence, reducing the fear of hypoglycemia, and improving the spouse's social support might all be helpful in reducing anxiety and depression among pregnant women with diabetes.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000039/pdfft?md5=5a940c40ff9e60080f5d645b93b57421&pid=1-s2.0-S2666970624000039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493834","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":"Paradoxical real-life underuse of GLP-1 receptor agonists in type 2 diabetes patients with atherosclerotic cardiovascular disease","authors":"André J. Scheen","doi":"10.1016/j.deman.2024.100197","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100197","url":null,"abstract":"<div><h3>Introduction</h3><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce the risk of cardiovascular (CV) complications in patients with type 2 diabetes (T2DM) and atherosclerotic cardiovascular disease (ASCVD) in placebo-controlled CV outcome trials, yet the use of these cardioprotective agents remains rather low in clinical practice.</p></div><div><h3>Methods</h3><p>Analysis of the proportion of T2DM patients treated with GLP-1RAs in retrospective observational studies by comparing patients with versus without established ASCVD.</p></div><div><h3>Results</h3><p>Nine cohorts from seven studies were collected in the international literature between 2019 and 2022. Overall, the percentages of patients treated with GLP-1RAs were low (&lt; 10 %) in most studies, yet a progressive increase was noticed over time. The use of GLP-1RAs in patients with ASCVD was slightly lower in 7 out of 9 cohorts not higher when compared to the use in patients without ASCVD (odds ratio 0.80, 95 % CI 0.79–0.81).</p></div><div><h3>Conclusion</h3><p>Despite a positive trend over the last decade, the real-world use of GLP-1RAs remains limited, especially in patients with established ASCVD. Bridging the gap between clinical evidence of cardioprotective effects of GLP-1RAs and their underuse in clinical practice in T2DM patients at high/very high CV risk should be considered as a key objective for health care providers, especially cardiologists.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"14 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000027/pdfft?md5=5e80426d3bcd7892020ab00db2400be9&pid=1-s2.0-S2666970624000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493833","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}