Diabetes epidemiology and management最新文献

{"title":"Role of lowered level of serum vitamin D on diabetic foot ulcer and its possible pathomechanism: A systematic review, meta-analysis, and meta-regression","authors":"Muhammad Iqhrammullah ,&nbsp;Teuku Fais Duta ,&nbsp;Meulu Alina ,&nbsp;Intan Qanita ,&nbsp;Muhammad Alif Naufal ,&nbsp;Najlaika Henira ,&nbsp;Ghina Tsurayya ,&nbsp;Raisha Fathima ,&nbsp;Arita Yuda Katiara Rizki ,&nbsp;Shakira Amirah","doi":"10.1016/j.deman.2023.100175","DOIUrl":"10.1016/j.deman.2023.100175","url":null,"abstract":"<div><h3>Aim</h3><p>To investigate the association between serum vitamin D (SVD) level and DFU development and to emphasize the involved pathomechanism.</p></div><div><h3>Methods</h3><p>The search was performed on 12 databases for literature published until 10 March 2023. The protocol has been registered on PROSPERO (CRD42023415744). The selection for the included records followed PRISMA framework. Meta-analyses using random effects model were performed and the data were presented as SMD and 95% CI. Meta-regression was performed to identify factors contributing to the heterogeneity in the pooled analysis.</p></div><div><h3>Results</h3><p>Twenty-one studies were included in the systematic review with a total number of patients reaching 9,570. Of which, as many as 18 studies were eligible for the meta-analysis. The SDV level is significantly lower in DFU group (<em>p</em>-total=0.0037; SMD= -1.2758; [95% CI: -2.0786 to -0.4730]). Based on the meta-regression, age, study location (based on the continent), and total cholesterol level contribute to the high heterogeneity (<em>p</em>&lt;0.01). In the pooled analysis, inflammatory markers such as serum levels of CRP (<em>n</em> = 4), ESR (<em>n</em> = 3), IL-6 (<em>n</em> = 3), and IL-8 (<em>n</em> = 2) are found significantly higher in DFU group at <em>p</em>&lt;0.01.</p></div><div><h3>Conclusion</h3><p>Lowered SVD level is associated with DFU, where the pathomechanism for this relationship might involve inflammation and infection susceptibility.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000549/pdfft?md5=a793bb5ca98f0b390dd67ecff08899f0&pid=1-s2.0-S2666970623000549-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47167251","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":"Platelet-rich plasma (PRP) as therapy for diabetic foot ulcer (DFU): A systematic review and meta-analysis of the latest randomized controlled trials","authors":"Fara Syafira ,&nbsp;Muhammad Baharul Iman ,&nbsp;Pariyana ,&nbsp;Rita Sriwulandari","doi":"10.1016/j.deman.2023.100178","DOIUrl":"10.1016/j.deman.2023.100178","url":null,"abstract":"<div><h3>Objectives</h3><p>Diabetic foot ulcer (DFU) is a prevalent and serious complication of diabetes, associated with significant morbidity and mortality rates. Platelet-rich plasma (PRP) is a promising therapy for accelerating DFU healing, with numerous randomized controlled trials (RCTs) supporting its efficacy and safety. Therefore, this systematic review aims to identify, critically assess, and synthesize the most recent available RCTs regarding the effectiveness of clinical PRP for treating DFU compared to standard treatment or other alternative therapies.</p></div><div><h3>Methods</h3><p>This study uses a comprehensive review and synthesis of existing research according to the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched selected databases using a combination of search terms: “((PRP) OR (\"platelet-rich plasma\")) AND (\"diabetic foot ulcer\")) OR (\"diabetic lower-extremity ulcer\"))” from PubMed, ProQuest, ScienceDirect, and Google Scholar in the last five years (2018–2023). Following a systematic review protocol, we selected 9 eligible articles for final analysis. Pertinent data was examined using MedCalc ver 20.215 then the results were displayed visually using forest plots.</p></div><div><h3>Results</h3><p>The findings from the meta-analysis revealed that PRP exhibited a healing rate that was twice as high as the control group (Relative Effects (REs) = 2.338; 95% Confidence Interval (CI) = 1.056 to 1.857, <em>P</em> = 0.019). Additionally, the healing time was shortened by 2 days (REs = -2.815; 95% CI = -3.252 to -0.576, <em>P</em> = 0.005), and there was a difference of 0.482 cm² in the reduction of ulcer area between the two groups (REs = 0.482; 95% CI = -2.428 to 4.002, <em>P</em> = 0.630). Importantly, none of the Randomized Controlled Trials (RCT) studies reported any adverse events in the PRP group.</p></div><div><h3>Conclusions</h3><p>PRP represents a feasible and secure supplementary therapeutic alternative for managing DFU.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000574/pdfft?md5=1ee81b675261c67273496cc19986f9a2&pid=1-s2.0-S2666970623000574-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47333016","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":"Evolution of the burden of diabetes among adults and children in Québec, Canada, from 2001 to 2019: A population-based longitudinal surveillance study","authors":"Sarah O'Connor ,&nbsp;Philippe Robert ,&nbsp;Jacinthe Leclerc ,&nbsp;Paul Poirier ,&nbsp;Marjolaine Dubé ,&nbsp;Pierre-Luc Trépanier ,&nbsp;Linda Perron ,&nbsp;Claudia Blais","doi":"10.1016/j.deman.2023.100177","DOIUrl":"10.1016/j.deman.2023.100177","url":null,"abstract":"<div><h3>Introduction</h3><p>Many developed countries, including Canada, have observed reductions in incidence of diabetes. Given the latest improvements in the case definition of diabetes for the younger population in Quebec, Canada, we sought to examine the evolution of diabetes among adults and children in Quebec, between 2001 and 2019.</p></div><div><h3>Methods</h3><p>Crude and age-standardized incidence and prevalence of diabetes among individuals ≥1 year were calculated using data from the Quebec Integrated Chronic Disease Surveillance System (n≈8,351,500 in 2019), using two case definitions for adults and the youth respectively. Age-standardized all-cause hospitalizations and mortality proportions were calculated among the population ≥20 years.</p></div><div><h3>Results</h3><p>Between 2001 and 2019, age-standardized incidence decreased by 30%, with a crude incidence of 4.6 per 1,000 in 2019. Incidence rates decreased from age group ≥50 years but increased by 25% for the group of 1-19 years. Age-standardized prevalence increased by 42% (crude prevalence in 2019: 8.1%). Males had higher incidence and prevalence of diabetes, with an incremental gap between sexes increasing with age. All-cause hospitalization and mortality proportions among individuals with diabetes declined by 21% and 29% respectively between 2001 and 2019. Age-standardized hospitalizations and mortality ratios for individuals with/without diabetes remained stable and were 2.7 (99% Confidence Intervals [CI]: 2.7-2.8) and 2.2 (99% CI: 2.1-2.3) in 2019, respectively.</p></div><div><h3>Conclusion</h3><p>Despite the reduction of incidence among adults, diabetes incidence increased among the youth and remained high among adults, especially for males. These results highlight the importance of improving earlier preventive care and initiatives for reducing the diabetes burden in Quebec.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41367649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in ambulatory glucose profile in people with type 1 diabetes using an automated insulin delivery system - two year follow-up retrospective analysis of real-world data","authors":"Michael Müller-Korbsch ,&nbsp;Antonia Kietaibl ,&nbsp;Yves Haufe ,&nbsp;Peter Fasching","doi":"10.1016/j.deman.2023.100150","DOIUrl":"10.1016/j.deman.2023.100150","url":null,"abstract":"<div><p>The number of available automated insulin delivery (AID) systems is increasing in Austria and people with diabetes (PwD) replace sensor-augmented pump (SAP) therapy more and more frequently. The present study is the two years follow-up of our prior monocentric, retrospective analysis conducted between 2019 and 2021, comparing SAP and open-source AID systems in people with type 1 diabetes. This second-year analysis included 25 PwD and investigated glycemic changes based on ambulatory glucose profiles (AGP). In comparison to the first year, a worsening of mean glucose (125.4 to 135.2 mg/dl, <em>P</em> = 0.038), time in range ((TIR), 84.2 to 77.0%, <em>P</em> = 0.012), time above range ((TAR), 11.6% to 18.5%, <em>P</em> = 0.017) and glycemia risk index ((GRI), 24.8 to 35.0%, <em>P</em> = 0.026) was observed. The reduction of mean glucose and glucose variability with AID in the first year was due to a significant decrease in time in hyperglycemia with resulting higher TIR and lower GRI. In this second-year follow up, TIR and GRI showed a significant deterioration, a familiar phenomenon in diabetology. However, open-source AID systems showed continuous safety, as there was no increase in time below range (TBR) even after two years. Despite the slight deterioration in the glycemic parameters, open-source AID systems were able to demonstrate sufficient glycemic control according to international consensus guidelines while offering the characteristic benefits of a reduced burden of diabetes management. A descriptive comparison of different AID algorithms indicated an improved glycemic control with more advanced features such as basal rate modification, auto bolus function and autotuning.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44132854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the incidence of lower limb amputation in people with and without diabetes in Wales between 2008–2018","authors":"J Hayes ,&nbsp;JM Rafferty ,&nbsp;WY Cheung ,&nbsp;A Akbari ,&nbsp;R Thomas ,&nbsp;S Bain ,&nbsp;C Topliss ,&nbsp;JW Stephens","doi":"10.1016/j.deman.2023.100144","DOIUrl":"10.1016/j.deman.2023.100144","url":null,"abstract":"<div><h3>Background</h3><p>There is variance in the incidence of lower extremity amputation across and within countries including within the UK. National data shows up to a fourfold variance in the amputation rate throughout the regions of England and differences in amputation incidence have been reported in Scotland and Ireland. Lower extremity amputation rate has yet to be documented within Wales. The aim of this cohort study was to examine trends in diabetes and non-diabetes related lower extremity amputation incidence within the Welsh population and to examine the influence of diabetes on the relative risk of amputation.</p></div><div><h3>Materials and Methods</h3><p>All first-time amputations between 2008-2018 were extracted from SAIL, a repository of all routine medical data of residents of Wales. People with diabetes were identified using an algorithm utilising data from several clinical and non-clinical sources. Crude and direct age and sex adjusted incidences were estimated over time.</p></div><div><h3>Results</h3><p>Over the period 3505 major amputations and 4335 minor amputations occurred. The diabetes population greater than 17 years of age increased by 29.4% from 143,595 in 2008 to 206,818 in 2018. There was a statistically significant rate reduction in major amputation in both populations. In the diabetes population the number of major amputations reduced from 6.9 [5.5–8.5]/10 000 person years (PY) in 2008 to 4.9 [5.4–6.2]/10 000 PY in 2018. However, for major amputation, the risk of incident amputation in people with diabetes was 7.3 fold higher [7.1–7.5] than those without diabetes. The relative risk of minor amputation for those with diabetes was higher at 11.9 [11.8 –1.01]. There was no reduction in this risk over the period.</p></div><div><h3>Conclusion</h3><p>This study found that rates of major amputation decreased over the study period but the risk of amputation for persons with diabetes remained substantial. As the population with diabetes increases so do crude rates of amputation, providing a substantial financial and societal cost to the Welsh Population.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45065478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technologies will not make diabetes disappear: how to integrate the concept of diabetes distress into care","authors":"Guy Fagherazzi","doi":"10.1016/j.deman.2023.100140","DOIUrl":"10.1016/j.deman.2023.100140","url":null,"abstract":"<div><p>Diabetes epidemiology has evolved rapidly since the 90 s and so are the technologies for diabetes treatment and care. With each new innovation coming to the market, hopes that technologies will solve the numerous, complex, issues related to diabetes are present. However, if it is now demonstrated that, overall, those technologies - when available - bring major benefits to people living with diabetes, they do not make the disease disappear. In this short review, we discuss the interconnections between technologies and diabetes distress, an often underlooked consequence of the continuous demands of diabetes. We define the concept of diabetes distress, discuss which dimensions can be positively impacted thanks to the use of diabetes technologies and what will likely not be solved by them. With the emergence of closed-loop insulin delivery systems, it is of utmost importance to give sufficient space to the assessment of the emotional dimension of diabetes care in clinical routine.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43314709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects between old and new antidiabetic agents on metabolic- associated fatty liver disease (MAFLD)","authors":"André J. Scheen","doi":"10.1016/j.deman.2023.100145","DOIUrl":"10.1016/j.deman.2023.100145","url":null,"abstract":"<div><p>Type 2 diabetes (T2DM) and liver disease, mainly metabolic-associated fatty liver disease (MAFLD), previously named non-alcoholic fatty liver disease (NAFLD), coexist in many patients. While physicians were reluctant to use glucose-lowering agents other than insulin in patients with T2DM and liver disease for many decades, the scene changed in recent years. While metformin gave controversial results in patients with MAFLD, pioglitazone was the first to demonstrate unequivocal positive effects, but its use in clinical practice is limited by safety concerns. New glucose-lowering agents, both glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, raised new hope. Indeed, besides a good safety profile, these agents, which are associated with weight loss, pleitotropic effects and cardiorenal protection, have also proven their efficacy in improving MAFLD. The positive effects on liver fat content, hepatic enzymes used as markers of steatosis and indices of tissue inflammation are now well demonstrated, yet available data on fibrosis are more limited. Thus, more dedicated studies, using liver biopsies, are still warranted to demonstrate the efficacy of these two pharmacological classes in preventing the progression from simple steatosis to fibrosis/cirrhosis and further confirm this new opportunity for the management of patients with T2DM and MAFLD.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46569275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent class analysis to identify childhood predictors of abnormal glycemic status in young adults with cystic fibrosis","authors":"Florence Racine ,&nbsp;Miguel Chagnon ,&nbsp;Valérie Boudreau ,&nbsp;Katherine Desjardins ,&nbsp;Cécile Q.T. Nguyen ,&nbsp;Marie-Hélène Denis ,&nbsp;Rémi Rabasa-Lhoret ,&nbsp;Geneviève Mailhot","doi":"10.1016/j.deman.2023.100141","DOIUrl":"10.1016/j.deman.2023.100141","url":null,"abstract":"<div><h3>AIMS</h3><p>Data on the clinical course of patients with cystic fibrosis (CF) from childhood to CF-related diabetes (CFRD) diagnosis in adulthood are limited. We evaluate whether childhood trajectories of parameters of interest in CF are associated with the risk of abnormal glucose tolerance (AGT) in early adulthood.</p></div><div><h3>Methods</h3><p>Pediatric and adult data from 108 subjects with CF followed annually were paired. Participants were grouped according to predominant childhood trajectories for weight, height, body mass index, lung function, glycated hemoglobin levels, fasting glycemia, and 2h post-oral glucose tolerance test glucose levels. Multivariable logistic regression was performed to identify parameters that predict glucose tolerance status in adulthood.</p></div><div><h3>Results</h3><p>Univariate analyses reveal that the risk of developing an AGT in adulthood is greater in subjects who are homozygous vs. heterozygous for the ΔF508 mutation, have pancreatic insufficiency vs. sufficiency, or have higher fasting glycemia values at 10 years old rising rapidly vs. lower values that are gradually rising until 17 years old. Multivariable logistic regression retains only fasting glycemia as a significant predictor for the occurrence of AGT in adulthood.</p></div><div><h3>Conclusions</h3><p>Fasting glycemia may be a clinical marker of interest to better target children with CF at risk of developing an AGT in early adulthood.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44318852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between albuminuria and retinal microvascular dysfunction in type 2 diabetes with and without hypertension","authors":"Charles Antwi-Boasiako ,&nbsp;Kwaku Amponsah Obeng ,&nbsp;Kwesi Nyan Amissah-Arthur ,&nbsp;Latif Musah ,&nbsp;Benjamin Abaidoo ,&nbsp;Henry Wedoi Awuviri ,&nbsp;Joseph Agyapong Abbey ,&nbsp;Pelagia Awula ,&nbsp;Ruth Korkor Tei ,&nbsp;Charles Agyemang ,&nbsp;Albert.G.B. Amoah ,&nbsp;Charles F. Hayfron-Benjamin","doi":"10.1016/j.deman.2023.100139","DOIUrl":"10.1016/j.deman.2023.100139","url":null,"abstract":"<div><h3>Background</h3><p>Studies assessing the concordance of albuminuria and retinal microvascular dysfunction (RMD) in type 2 diabetes (T2D) have yielded inconsistent results. Similar to ethnicity, hypertension may be a potential explanatory variable. We compared the association between albuminuria and RMD in West Africans with T2D with and without hypertension.</p></div><div><h3>Materials and methods</h3><p>This was a cross-sectional study among 177 systematically sampled Ghanaians with T2D aged ≥ 35 years. Albuminuria was based on urinary albumin-creatinine ratio≥30 mg/g. Retinal images were analyzed and graded according to the Early Treatment Diabetic Retinopathy Study criteria. Logistic regression was used to examine the associations of albuminuria and RMD with adjustments for age, sex, socioeconomic status, diabetes duration, HbA1c, smoking, systolic blood pressure (BP), BMI, and total cholesterol.</p></div><div><h3>Results</h3><p>RMD was more prevalent in individuals with albuminuria than in those without albuminuria (41.7% vs. 24.0%, <em>p</em> = 0.026). In the fully adjusted model, albuminuria remained significantly associated with RMD (odds ratio 2.41[95% CI:1.00–5.80], <em>p</em> = 0.049); the association between albuminuria and RMD was more pronounced in individuals with hypertension (3.10 [1.01–9.50], 0.048) than without hypertension (1.70[0.33–8.77],0.523). In analyses stratified by BP control, albuminuria was significantly associated with RMD in individuals with suboptimal BP (2.76[1.07–7.14], 0.037) but not in individuals with optimal BP (0.24[0.00–17.04],0.512)</p></div><div><h3>Conclusion</h3><p>Our study shows positive associations between albuminuria and RMD among West Africans with T2D, with the strength of association, accentuated in individuals with hypertension/suboptimal BP. Future studies could further characterize the role of hypertension in the associations between albuminuria and RMD.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46804618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between diabetic retinopathy, cognitive impairment, and quality of life – a cross sectional study","authors":"Parvathy Geetha Sajeev ,&nbsp;Srikanth Krishnagopal ,&nbsp;Karthick Subramanian","doi":"10.1016/j.deman.2023.100142","DOIUrl":"10.1016/j.deman.2023.100142","url":null,"abstract":"<div><h3>Background</h3><p>Diabetic retinopathy (DR), a microangiopathy caused by Type 2 Diabetes Mellitus (T2DM), is associated with significant visual disability leading to suboptimal quality of life. Retinal microvasculature changes can reflect similar changes in the grey matter and blood-brain barrier. Microvascular changes in the brain are associated with cognitive dysfunction. The present study aimed to find the association between Diabetic Retinopathy (DR) and Cognitive Impairment (CI) and its relationship with Quality of Life (QoL).</p></div><div><h3>Methodology</h3><p>A cross-sectional observational study was conducted in a tertiary care hospital among patients (aged 18 years and above) with pre-existing T2DM as per Standards of Care in Diabetes-2023 criteria. Patients with visual acuity less than 3/60, or education below 6th grade, or with comorbid mental or neurocognitive disorders illness were excluded from the study. DR grading was done using the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. Cognitive functions and quality of life were measured using Montreal cognitive assessment (MoCA) and World Health Organization – Quality of Life scale – brief version (WHO-QOL BREF). The primary outcome measures (cognitive impairment and quality of life) were compared between patients with DR (DR+) and patients without DR (DR-). A <em>P</em> &lt; 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>Diabetic retinopathy was diagnosed in 48.5% (83 out of 171) of the sample. The DR+ group were predominantly male, significantly older, had comorbid immature cataract and hypertension than the DR- group. Also, the DR+ group had significantly reduced scores in all domains of MoCA and QoL. among patients with DR, those with severe and moderate NPDR had more cognitive impairment than mild NPDR. Age and duration of diabetes did not correlate with MoCA and QoL scores.</p></div><div><h3>Conclusion</h3><p>The presence of diabetic retinopathy is associated with cognitive impairment and reduced quality of life in this study population. The association is independent of the age of patient and the duration of diabetes mellitus.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"11 ","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43983039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}