IF 2.4

Diabetology Pub Date : 2024-08-01 Epub Date: 2024-08-21 DOI: 10.3390/diabetology5030027

KiBeom Kwon, Taylor A Brown, Juan C Arias Aristizábal, David G Armstrong, Tze-Woei Tan

{"title":"Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance.","authors":"KiBeom Kwon, Taylor A Brown, Juan C Arias Aristizábal, David G Armstrong, Tze-Woei Tan","doi":"10.3390/diabetology5030027","DOIUrl":"10.3390/diabetology5030027","url":null,"abstract":"Objective: This study investigates the outcomes of Medicaid beneficiaries with diabetic foot ulcers (DFUs) who had transitioned to commercial insurance.Methods: We utilized the PearlDiver claims database to identify adult patients diagnosed with a new DFU between 2010 and 2019. The study cohort comprised 8856 Medicaid beneficiaries who had at least three years of continuous enrollment after DFU diagnosis. Medicaid beneficiaries who transitioned to Medicare during follow-up were excluded. Adjusted comparisons of outcomes were performed by propensity matching the two groups for age, gender, and Charlson Comorbidity Index (CCI) in a 1:1 ratio. We used logistic regression and Kaplan-Meier estimate to evaluate the association between insurance change (from Medicaid to commercial insurance) and major amputation.Results: Among the 8856 Medicaid beneficiaries with DFUs, 66% (n = 5809) had transitioned to commercial insurance coverage during follow-up. The overall major amputation rate was 2.8% (n = 247), with a lower rate observed in patients who transitioned to commercial insurance compared to those with continuous Medicaid coverage (2.6% vs. 3.2%, p < 0.05). In multivariable analysis, Medicaid beneficiaries who transitioned to commercial insurance had a 27% lower risk of major amputation (study cohort: odds ratios [OR] 0.75, 95% CI 0.56-0.97, p = 0.03; matched cohort: OR 0.65, 95% 0.22, 0.55, p = 0.01) compared to those with continuous Medicaid coverage.Conclusions: Transitioning from Medicaid to commercial insurance may be associated with a lower risk of major amputation among Medicaid beneficiaries with DFUs.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"5 3","pages":"356-364"},"PeriodicalIF":2.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559626","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}

引用次数: 0

Does the Efficacy of Semaglutide Treatment Differ between Low-Risk and High-Risk Subgroups of Patients with Type 2 Diabetes and Obesity Based on SCORE2, SCORE2-Diabetes, and ASCVD Calculations? 根据 SCORE2、SCORE2-糖尿病和 ASCVD 计算结果，2 型糖尿病和肥胖症患者的低风险亚组和高风险亚组之间的塞马鲁肽疗效是否存在差异？

Diabetology Pub Date : 2024-01-04 DOI: 10.3390/diabetology5010003

Martina Matovinović, Andrej Belančić, Juraj Jug, F. Mustač, Maja Sirovica, Mihovil Santini, Anja Bošnjaković, M. Lovrić, M. Lovrić Benčić

{"title":"Does the Efficacy of Semaglutide Treatment Differ between Low-Risk and High-Risk Subgroups of Patients with Type 2 Diabetes and Obesity Based on SCORE2, SCORE2-Diabetes, and ASCVD Calculations?","authors":"Martina Matovinović, Andrej Belančić, Juraj Jug, F. Mustač, Maja Sirovica, Mihovil Santini, Anja Bošnjaković, M. Lovrić, M. Lovrić Benčić","doi":"10.3390/diabetology5010003","DOIUrl":"https://doi.org/10.3390/diabetology5010003","url":null,"abstract":"Background: Diabetes is the primary contributor to cardiovascular disease risk, and when combined with obesity, it further underscores the significance of cardiovascular risk assessment. Methods: A retrospective study of 64 patients with type 2 diabetes (T2D) and obesity on once-weekly subcutaneous semaglutide stratified by cardiovascular risk categories determined using the SCORE2/SCORE2-OP, SCORE2-Diabetes, and ASCVD score calculations. We compare the differences between groups (ASCVD: low + borderline + intermediate versus high-risk group; SCORE2/SCORE2-OP: low + moderate versus high + very high-risk group and SCORE2-Diabetes: low + moderate versus high + very high-risk group) in terms of change from baseline in body mass index (BMI) and HbA1c and weight loss outcomes. Results: Patients in the high-risk group, according to ASCVD risk score, had statistically better results in weight loss ≥ 3%, ≥5%, and ≥10% compared to ASCVD low + borderline + intermediate and without difference regarding HbA1c. According to SCORE2/SCORE2-OP, the high + very high-risk group had statistically better HbA1c and weight loss results but only for ≥5% versus the low + moderate risk group. Based on the score SCORE2-Diabetes, the high + very high-risk group had statistically significant better results in lowering HbA1c and weight loss but only for ≥5% versus the low + moderate risk group. Conclusions: To the best of our knowledge, this study represents the initial investigation linking glycemic control and weight reduction outcomes in individuals with T2D and obesity treated with once-weekly semaglutide stratified by cardiovascular risk categories determined using the SCORE2/SCORE2-OP, SCORE2-Diabetes and ASCVD score calculations.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"54 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386732","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}

引用次数: 0

A Comparative Analysis of Machine Learning Models for the Detection of Undiagnosed Diabetes Patients 用于检测未确诊糖尿病患者的机器学习模型比较分析

Diabetology Pub Date : 2024-01-03 DOI: 10.3390/diabetology5010001

S. Cichosz, Clara Bender, Ole Hejlesen

{"title":"A Comparative Analysis of Machine Learning Models for the Detection of Undiagnosed Diabetes Patients","authors":"S. Cichosz, Clara Bender, Ole Hejlesen","doi":"10.3390/diabetology5010001","DOIUrl":"https://doi.org/10.3390/diabetology5010001","url":null,"abstract":"Introduction: Early detection of type 2 diabetes is essential for preventing long-term complications. However, screening the entire population for diabetes is not cost-effective, so identifying individuals at high risk for this disease is crucial. The aim of this study was to compare the performance of five diverse machine learning (ML) models in classifying undiagnosed diabetes using large heterogeneous datasets. Methods: We used machine learning data from several years of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 to identify people with undiagnosed diabetes. The dataset included 45,431 participants, and biochemical confirmation of glucose control (HbA1c) were used to identify undiagnosed diabetes. The predictors were based on simple and clinically obtainable variables, which could be feasible for prescreening for diabetes. We included five ML models for comparison: random forest, AdaBoost, RUSBoost, LogitBoost, and a neural network. Results: The prevalence of undiagnosed diabetes was 4%. For the classification of undiagnosed diabetes, the area under the ROC curve (AUC) values were between 0.776 and 0.806. The positive predictive values (PPVs) were between 0.083 and 0.091, the negative predictive values (NPVs) were between 0.984 and 0.99, and the sensitivities were between 0.742 and 0.871. Conclusion: We have demonstrated that several types of classification models can accurately classify undiagnosed diabetes from simple and clinically obtainable variables. These results suggest that the use of machine learning for prescreening for undiagnosed diabetes could be a useful tool in clinical practice.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"24 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139388854","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}

引用次数: 0

Comorbidity of Type 2 Diabetes and Dementia among Hospitalized Patients in Los Angeles County: Hospitalization Outcomes and Costs, 2019–2021 洛杉矶县住院患者中 2 型糖尿病和痴呆症的合并症：2019-2021年住院结果和成本

Diabetology Pub Date : 2023-12-18 DOI: 10.3390/diabetology4040052

D’Artagnan M. Robinson, Dalia Regos-Stewart, Mariana A. Reyes, Tony Kuo, N. Barragan

{"title":"Comorbidity of Type 2 Diabetes and Dementia among Hospitalized Patients in Los Angeles County: Hospitalization Outcomes and Costs, 2019–2021","authors":"D’Artagnan M. Robinson, Dalia Regos-Stewart, Mariana A. Reyes, Tony Kuo, N. Barragan","doi":"10.3390/diabetology4040052","DOIUrl":"https://doi.org/10.3390/diabetology4040052","url":null,"abstract":"Hospitalizations for diabetes and dementia can impose a significant health and economic toll on older adults in the United States. This study sought to examine differences in hospitalization characteristics and outcomes associated with diabetes and dementia, separately and together, using 2019–2021 discharge record data from the California Department of Health Care Access and Information. The sampled group were residents of Los Angeles County who were aged 50+ at the time of the study. The multivariable linear regression analysis showed that compared to those with no diabetes or dementia, patients with diabetes alone exhibited the highest total charges, while those with comorbid diabetes and dementia exhibited lower charges (p < 0.05). The multinomial logistic regression found that patients with comorbid diabetes and dementia had the highest odds of having a length of stay of 7+ days (Adjusted Odds Ratio = 1.49; 95% Confidence Interval (CI) = 1.44–1.53). A matched case–control analysis revealed that comorbid diabetes and dementia were associated with significantly lower odds of hypertensive disease than diabetes alone (Matched Odds Ratio = 0.81; 95% CI = 0.67–0.97). Collectively, these results highlight the complex factors that may influence the variable hospitalization outcomes that are common occurrences in these three distinct disease profiles. Study findings suggest a need to consider these complexities when developing policies or strategies to improve hospitalization outcomes for these conditions.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138964404","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}

引用次数: 0

Global Trends in Risk Factors and Therapeutic Interventions for People with Diabetes and Cardiovascular Disease: Results from the WHO International Clinical Trials Registry Platform 糖尿病和心血管疾病患者风险因素和治疗干预的全球趋势：世界卫生组织国际临床试验登记平台的结果

Diabetology Pub Date : 2023-12-08 DOI: 10.3390/diabetology4040050

Musawenkosi Ndlovu, P. Dludla, N. Muvhulawa, Yonela Ntamo, Asanda Mayeye, Nomahlubi Luphondo, Nokulunga Hlengwa, A. Basson, S. Mabhida, S. Hanser, S. Mazibuko-Mbeje, B. Nkambule, D. Ndwandwe

{"title":"Global Trends in Risk Factors and Therapeutic Interventions for People with Diabetes and Cardiovascular Disease: Results from the WHO International Clinical Trials Registry Platform","authors":"Musawenkosi Ndlovu, P. Dludla, N. Muvhulawa, Yonela Ntamo, Asanda Mayeye, Nomahlubi Luphondo, Nokulunga Hlengwa, A. Basson, S. Mabhida, S. Hanser, S. Mazibuko-Mbeje, B. Nkambule, D. Ndwandwe","doi":"10.3390/diabetology4040050","DOIUrl":"https://doi.org/10.3390/diabetology4040050","url":null,"abstract":"This study presents a comprehensive analysis of 898 clinical trials conducted between 1999 and 2023, focusing on the interplay of metabolic syndrome, cardiovascular diseases (CVDs), and type 2 diabetes mellitus (T2D). This study draws upon data sourced from the International Clinical Trials Registry Platform (ICTRP) until August 2023. The trials were predominantly interventional (67%) or observational (33%). A geographical distribution reveals that while the United States registered approximately 18% of the trials, other regions like Australia, the United Kingdom, and multicounty trials made substantial contributions. Most studies (84%) included both male and female participants, with adults aged 18 to 65 years predominantly represented. The trials aimed at treatment (21%) and prevention (21%), emphasizing the dual focus on addressing existing CVD risk and preventing its development. Notably, CVDs (29%), T2D (8%), and the coexistence of both (21%) constituted the primary conditions of interest. Key interventions encompassed lifestyle and behavioral modifications, dietary supplementation, and drug therapies, with metformin and statins leading in pharmacological treatments. Interestingly, additional interventions such as glucagon-like peptide-1 agonists and dipeptidyl peptidase IV inhibitors are gaining recognition for their potential in managing metabolic syndrome-related conditions. Moreover, the report highlights a growing focus on inflammation, body mass index, blood pressure, body weight, and major adverse cardiovascular events as primary outcomes. Overall, the study highlights the importance of ICTRP as the source of data for clinical trials targeting metabolic syndrome, CVDs, and T2D and the growing recognition of diverse intervention strategies to address this critical global health concern.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"32 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138587503","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}

引用次数: 0

Could Microbiome Be the Common Co-Denominator between Type 2 Diabetes and Pancreatic Cancer? 微生物组可能是 2 型糖尿病和胰腺癌之间的共同致病因子吗？

Diabetology Pub Date : 2023-12-07 DOI: 10.3390/diabetology4040049

M. Golčić, Andrej Belančić

引用次数: 0

Correction: Brandão Palma et al. Biological Evidence of Improved Wound Healing Using Autologous Micrografts in a Diabetic Animal Model. Diabetology 2023, 4, 294–311 更正：Brandão Palma 等人，在糖尿病动物模型中使用自体微移植改善伤口愈合的生物学证据。糖尿病学》2023 年第 4 期，294-311 页

Diabetology Pub Date : 2023-11-24 DOI: 10.3390/diabetology4040047

引用次数: 0

Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant 女性2型糖尿病患者的性功能障碍——一个重要的生活质量决定因素

Diabetology Pub Date : 2023-11-13 DOI: 10.3390/diabetology4040046

Marija Rogoznica, Dražen Perica, Barbara Borovac, Andrej Belančić, Martina Matovinović

{"title":"Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant","authors":"Marija Rogoznica, Dražen Perica, Barbara Borovac, Andrej Belančić, Martina Matovinović","doi":"10.3390/diabetology4040046","DOIUrl":"https://doi.org/10.3390/diabetology4040046","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is a multisystemic disease with a high global burden and chronic complications. Sexual dysfunction (SD) in patients with T2DM is an often-overlooked complication, despite its high impact on quality of life (QoL). Female sexual disorders can affect women of reproductive age as well as menopausal women. Proposed mechanisms are intertwining a variety of physiological, neurological, vascular, hormonal, and psychological variables. The impairment of sexual function has been linked to hyperglycemia, insulin resistance, chronic low-grade inflammation, endothelial dysfunction, neuropathy, and hormonal abnormalities. There are many different manifestations of female sexual dysfunction, such as insufficient sexual desire, diminished arousal, difficulty in eliciting orgasm, and pain during sexual engagement. Numerous studies have shown that the QoL of patients living with diabetes mellitus (DM) is lower than that of those without DM. SD in women with T2DM leads to deteriorated QoL. Treatment must be individualized based on the diagnosis and the sexual dysfunction as well as underlying medical, psychological, and interpersonal issues. The goal of modern medical care for patients living with diabetes is not to delay death but to improve their health and QoL. The present review article aimed to raise awareness about female sexual dysfunction in patients with T2DM and to provide an overview of its impact on QoL.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"56 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346594","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}

引用次数: 0

Educating Medical Students on How to Prescribe Anti-Hyperglycaemic Drugs: A Practical Guide 教育医学生如何开抗高血糖药物:实用指南

Diabetology Pub Date : 2023-11-07 DOI: 10.3390/diabetology4040043

Erik M. Donker, Andrej Belančić, Joost D. Piët, Dinko Vitezić, Jelle Tichelaar

{"title":"Educating Medical Students on How to Prescribe Anti-Hyperglycaemic Drugs: A Practical Guide","authors":"Erik M. Donker, Andrej Belančić, Joost D. Piët, Dinko Vitezić, Jelle Tichelaar","doi":"10.3390/diabetology4040043","DOIUrl":"https://doi.org/10.3390/diabetology4040043","url":null,"abstract":"In the light of the rapidly increasing global incidence of, and therapeutic arsenal for, diabetes type 2, this brief report underscores the need for advancements in clinical pharmacology and therapeutics (CPT) education with regard to diabetes type 2. We advocate for the comprehensive training of medical students and junior doctors in line with current guidelines, and emphasize the importance of teaching how to draw up individualized treatment plans based on patients’ specific risk factors and conditions, such as cardiovascular risks, weight, and risk of hypoglycaemia. Within the curriculum, traditional teaching approaches should be replaced by innovative methods such as problem-based learning, which has been shown to be more effective in developing prescribing knowledge and skills. The inclusion of real-world experience and interprofessional learning via so-called student-run clinics is also recommended. Subsequently, innovative assessment methods like the European Prescribing Exam and objective structured clinical examinations (OSCE) are highlighted as essential for evaluating knowledge and practical skills. By adopting these educational advances, medical education can better equip future practitioners to adequately manage the complex pharmacological treatment of diabetes.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"58 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539708","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}

引用次数: 0

Exploring Diabetic Retinopathy Patterns in Saudi Arabia: Gender and Diabetes Type Comparison 探讨沙特阿拉伯糖尿病视网膜病变模式:性别和糖尿病类型比较

Diabetology Pub Date : 2023-11-07 DOI: 10.3390/diabetology4040042

Samraa Hussain, Naji AlJohani

{"title":"Exploring Diabetic Retinopathy Patterns in Saudi Arabia: Gender and Diabetes Type Comparison","authors":"Samraa Hussain, Naji AlJohani","doi":"10.3390/diabetology4040042","DOIUrl":"https://doi.org/10.3390/diabetology4040042","url":null,"abstract":"Aims: To determine the prevalence and predictors of diabetic retinopathy (DR) in Saudi males and females with diabetes. Methods: This cross-sectional study enrolled 507 patients with diabetes between May and August 2018. The data extracted from patients’ records included demographic and clinical information and laboratory investigations. The retinopathy data were based on fundus photography graded into five categories: no DR, NPDR, MNPDR, SNPDR, and PDR. Results: The patients’ mean age was 47.3 years, the majority (59.3%) being female and T2DM being the most common type (52.4%). The prevalence of no DR was 51.4%; NPDR, 4.4%; MNPDR, 7.7%; SNPDR, 3.7%; and PDR, 5.1%. The duration of DM, as well as the severity of hypertension and neuropathy values rose significantly as DR progressed, underlining the pivotal role of hyperglycemia as the primary driver of diabetic complications. The odds ratio for the presence of hypertension was 1.8 (95% CI 0.9–3.5); hypertension showed the highest risk of DR. Stratification according to gender showed a significantly higher DR risk in females than males. Interestingly, nephropathy played a significant role in the DR risk in T1DM. Conclusions: Among T1DM and T2DM patients, the severity of DR is associated with risk factors including the DM duration, hyperglycemia, hypertension, and neuropathy. The impact of these factors varies with gender and diabetes type. Therefore, the severity of DR could define patients at a high risk of macro/microvascular complications and enable earlier interventions to reduce morbidity and mortality among T1DM and T2DM patients.","PeriodicalId":72798,"journal":{"name":"Diabetology","volume":"73 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539544","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}

引用次数: 0

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