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Survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa 亚的斯亚贝巴医院 2 型糖尿病患者糖尿病神经病变的存活率、发病率和预测因素
Frontiers in clinical diabetes and healthcare Pub Date : 2024-05-02 DOI: 10.3389/fcdhc.2024.1386426
Eden Tilahun, Abdata Workina, Asaminew Habtamu, Hailu Tufa, Fikadu Abebe, Ayele Fikadu, Fulea Atomsa
{"title":"Survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa","authors":"Eden Tilahun, Abdata Workina, Asaminew Habtamu, Hailu Tufa, Fikadu Abebe, Ayele Fikadu, Fulea Atomsa","doi":"10.3389/fcdhc.2024.1386426","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1386426","url":null,"abstract":"Background Diabetic neuropathy is a very common complication of diabetes mellitus. Thus, measuring the incidence of diabetic neuropathy is a key element in tracking the progress of epidemics of diabetes mellitus and an indication of early accessibility for healthcare in terms of type 2 diabetic patients. Objective To assess survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa from June 25 to August 25, 2023. Methods An institutional-based retrospective follow-up study design was used among newly diagnosed type 2 diabetic patients at hospitals of Addis Ababa. A chart review tool that contains socio-demographic, clinical, and comorbidity characteristics, biochemical characteristics, and the status of type 2 patients was used. A cleaned data was exported from Epi-data manager 4.6 version to SPSS version 25 for analysis. Bivariate Cox regression analysis was done to identify predictors of diabetic neuropathy at a 95% confidence level. Result A total of 414 type 2 diabetic patients were included in the study. Of these, 97 (23.4%) developed diabetic neuropathy. Variables like having hypertension (AHR 11.25, 95% CI 3.73–33.93), anemia (AHR 4.18, 95% CI 1.78–9.82), high-density lipoprotein < 40 mg/dl (AHR 5.07, 95% CI 1.38–18.67), high creatinine level (AHR 14.67, 95% CI 4.27–50.40), diabetic retinopathy (AHR 4.32, 95% CI 1.32-14.18), and diabetic nephropathy (AHR 2.50, 95% CI 1.09–6.57) were associated with the incidence of diabetic neuropathy. The mean time to develop diabetic neuropathy was 4.94 years, CI (4.50–5.38), and the mean survival time was 6.61 years. Conclusion The incidence of diabetic neuropathy was high relative to other studies. Variables like having hypertension, anemia, high-density lipoprotein, high creatinine level, diabetic retinopathy, and diabetic nephropathy were predictors of diabetic neuropathy. The mean time to develop diabetic neuropathy was 5 years, with a survival mean time of 7 years.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018271","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
Survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa. 亚的斯亚贝巴医院 2 型糖尿病患者糖尿病神经病变的存活率、发病率和预测因素。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-05-02 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1386426
Eden Tilahun, Abdata Workina, Asaminew Habtamu, Hailu Tufa, Fikadu Abebe, Ayele Fikadu, Fulea Atomsa
{"title":"Survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa.","authors":"Eden Tilahun, Abdata Workina, Asaminew Habtamu, Hailu Tufa, Fikadu Abebe, Ayele Fikadu, Fulea Atomsa","doi":"10.3389/fcdhc.2024.1386426","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1386426","url":null,"abstract":"<p><strong>Background: </strong>Diabetic neuropathy is a very common complication of diabetes mellitus. Thus, measuring the incidence of diabetic neuropathy is a key element in tracking the progress of epidemics of diabetes mellitus and an indication of early accessibility for healthcare in terms of type 2 diabetic patients.</p><p><strong>Objective: </strong>To assess survival, incidence, and predictors of diabetic neuropathy among type 2 diabetic patients in hospitals of Addis Ababa from June 25 to August 25, 2023.</p><p><strong>Methods: </strong>An institutional-based retrospective follow-up study design was used among newly diagnosed type 2 diabetic patients at hospitals of Addis Ababa. A chart review tool that contains socio-demographic, clinical, and comorbidity characteristics, biochemical characteristics, and the status of type 2 patients was used. A cleaned data was exported from Epi-data manager 4.6 version to SPSS version 25 for analysis. Bivariate Cox regression analysis was done to identify predictors of diabetic neuropathy at a 95% confidence level.</p><p><strong>Result: </strong>A total of 414 type 2 diabetic patients were included in the study. Of these, 97 (23.4%) developed diabetic neuropathy. Variables like having hypertension (AHR 11.25, 95% CI 3.73-33.93), anemia (AHR 4.18, 95% CI 1.78-9.82), high-density lipoprotein < 40 mg/dl (AHR 5.07, 95% CI 1.38-18.67), high creatinine level (AHR 14.67, 95% CI 4.27-50.40), diabetic retinopathy (AHR 4.32, 95% CI 1.32-14.18), and diabetic nephropathy (AHR 2.50, 95% CI 1.09-6.57) were associated with the incidence of diabetic neuropathy. The mean time to develop diabetic neuropathy was 4.94 years, CI (4.50-5.38), and the mean survival time was 6.61 years.</p><p><strong>Conclusion: </strong>The incidence of diabetic neuropathy was high relative to other studies. Variables like having hypertension, anemia, high-density lipoprotein, high creatinine level, diabetic retinopathy, and diabetic nephropathy were predictors of diabetic neuropathy. The mean time to develop diabetic neuropathy was 5 years, with a survival mean time of 7 years.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11096570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960423","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
Associated factors of diabetic retinopathy in type 1 and 2 diabetes in Limpopo province in South Africa 南非林波波省 1 型和 2 型糖尿病患者糖尿病视网膜病变的相关因素
Frontiers in clinical diabetes and healthcare Pub Date : 2024-05-02 DOI: 10.3389/fcdhc.2024.1319840
Debree Khisimusi Maluleke, C. Ntimana, R. G. Mashaba, K. P. Seakamela, E. Maimela
{"title":"Associated factors of diabetic retinopathy in type 1 and 2 diabetes in Limpopo province in South Africa","authors":"Debree Khisimusi Maluleke, C. Ntimana, R. G. Mashaba, K. P. Seakamela, E. Maimela","doi":"10.3389/fcdhc.2024.1319840","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1319840","url":null,"abstract":"Diabetic retinopathy (DR) is the major cause of vision impairment or blindness in individuals who have diabetes. It has accounted for 2.6% of all cases of blindness, and 1.9% of all cases of vision impairments globally. There is a lack of data on the prevalence of diabetic retinopathy and its associated factors amongst diabetic rural populations. Hence, the current study aimed to determine factors associated with diabetic retinopathy (DR) among diabetes mellitus (DM) patients undergoing diabetic therapy.The study was cross-sectional in design and the participants were selected using convenient sampling. STATA version 15 software was used for data analysis. Chi-square was used to compare proportions. Logistic regression was used to determine the relationship between DR and associated risk factors.The prevalence of DR was 35.3%, of which 32% were mild and 3.4% were moderate non-proliferative DR (NPDR). Females were more unemployed than males (32.1% versus 16.8%, p=0.0058). Males were found to drink alcohol (21.8% versus 1.9%, p<0.001) and smoke cigarettes (4% versus 0.3%, p=0.0034) more than females. Being aged ≥ 55 years (OR: 2.7, 95% CI: 1.6-4.4), with matric qualification (OR: 0.6; 95% CI: 0.4-1.0); employed (OR: 1.4, 95% CI: 1.2-1.6); having high systolic blood pressure (OR=1.4, 95%CI=1.1-1.7) were the independent determinants of DR.The prevalence of diabetic retinopathy was 34%. DR was determined by high systolic blood pressure, old age, and employment. Although not statistically significant, gender, hyperglycemic state, poor glycemic control, smoking, and increased body mass index (BMI) were associated with increased risk of developing DR.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141020935","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
Virtual insulin pump initiation is safe effective in children adolescents with type 1 diabetes. 虚拟胰岛素泵对患有 1 型糖尿病的儿童青少年安全有效。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1362627
Benjamin Udoka Nwosu, Margaret Pellizzari, Maia N Pavlovic, Jason Ciron, Rashida Talib, Rubab Sohail
{"title":"Virtual insulin pump initiation is safe effective in children adolescents with type 1 diabetes.","authors":"Benjamin Udoka Nwosu, Margaret Pellizzari, Maia N Pavlovic, Jason Ciron, Rashida Talib, Rubab Sohail","doi":"10.3389/fcdhc.2024.1362627","DOIUrl":"10.3389/fcdhc.2024.1362627","url":null,"abstract":"<p><strong>Objective: </strong>There is no head-to-head comparison of the safety and efficacy of virtual versus in-office insulin pump initiation for youth with type 1 diabetes in the US. The study's aim was to determine the safety and efficacy of virtual versus in-office pump initiation in pediatric type 1 diabetes.</p><p><strong>Research design and methods: </strong>A longitudinal retrospective study of 112 subjects: 65% (n=73), ages 11.2 ± 3.8 years(y), received in-office training; and 35% (n=39), ages 12.0 ± 4.0y, received virtual training. The number of White subjects was 40 (55%) in the in-office group, and 25 (66%) in the remote group; while Black subjects were 11 (15%) in the in-office group and 4 (10%) in the virtual group. Data were collected at pump initiation, 3 and 6 months.</p><p><strong>Results: </strong>There were no significant differences in sex, race, height, weight, BMI, and the duration of diabetes between the groups at baseline. There was no significant difference in A1c between the groups at 0, 3, and 6 months. A1c correlated significantly with the glucose management indicator at 0, 3, and 6 months: baseline: r=0.49, p<0.0001; 3 months: r=0.77, p<0.0001; and 6 months: r=0.71, p<0.0001. There was no relationship between A1c or TIR and pubertal status, BMI, sex, or race. A1c was significantly elevated in the non-White individuals at 6 months only: 57.9 mmol/mol (50.8-69.4) versus 51.9 mmol/mol (46.5-59.6)], p=0.007.</p><p><strong>Conclusion: </strong>Virtual insulin pump initiation is safe and effective in children with type 1 diabetes. This approach could accelerate the adoption of the use of diabetes technology in minority populations in the US.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923581","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
Type 2 diabetes is linked to higher physiologic markers of effort during exercise. 2 型糖尿病与运动时较高的费力生理指标有关。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-04-29 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1346716
Amy G Huebschmann, Rebecca L Scalzo, Xinyi Yang, Sarah J Schmiege, Jane E B Reusch, Andrea L Dunn, Kristina Chapman, Judith G Regensteiner
{"title":"Type 2 diabetes is linked to higher physiologic markers of effort during exercise.","authors":"Amy G Huebschmann, Rebecca L Scalzo, Xinyi Yang, Sarah J Schmiege, Jane E B Reusch, Andrea L Dunn, Kristina Chapman, Judith G Regensteiner","doi":"10.3389/fcdhc.2024.1346716","DOIUrl":"10.3389/fcdhc.2024.1346716","url":null,"abstract":"<p><strong>Background: </strong>People with type 2 diabetes (T2D) have lower rates of physical activity (PA) than the general population. This is significant because insufficient PA is linked to cardiovascular morbidity and mortality, particularly in individuals with T2D. Previously, we identified a novel barrier to physical activity: greater perceived effort during exercise in women. Specifically, women with T2D experienced exercise at low-intensity as greater effort than women without T2D at the same low-intensity - based on self-report and objective lactate measurements. A gap in the literature is whether T2D confers greater exercise effort in both sexes and across a range of work rates.</p><p><strong>Objectives: </strong>Our overarching objective was to address these gaps regarding the influence of T2D and relative work intensity on exercise effort. We hypothesized that T2D status would confer greater effort during exercise across a range of work rates below the aerobic threshold.</p><p><strong>Methods: </strong>This cross-sectional study enrolled males and post-menopausal females aged 50-75 years. Measures of exercise effort included: 1) heart rate, 2) lactate and 3) self-report of Rating of Perceived Exertion (RPE); each assessment was during the final minute of a 5-minute bout of treadmill exercise. Treadmill exercise was performed at 3 work rates: 1.5 mph, 2.0 mph, and 2.5 mph, respectively. To determine factors influencing effort, separate linear mixed effect models assessed the influence of T2D on each outcome of exercise effort, controlling for work rate intensity relative to peak oxygen consumption (%VO<sub>2</sub>peak). Models were adjusted for any significant demographic associations between effort and age (years), sex (male/female), baseline physical activity, or average blood glucose levels.</p><p><strong>Results: </strong>We enrolled n=19 people with T2D (47.4% female) and n=18 people (55.6% female) with no T2D. In the models adjusted for %VO<sub>2</sub>peak, T2D status was significantly associated with higher heart rate (p = 0.02) and lactate (p = 0.01), without a significant association with RPE (p = 0.58).</p><p><strong>Discussions: </strong>Across a range of low-to-moderate intensity work rates in older, sedentary males and females, a diagnosis of T2D conferred higher objective markers of effort but did not affect RPE. Greater objective effort cannot be fully attributed to impaired fitness, as it persisted despite adjustment for %VO<sub>2</sub>peak. In order to promote regular exercise and reduce cardiovascular risk for people with T2D, 1) further efforts to understand the mechanistic targets that influence physiologic exercise effort should be sought, and 2) comparison of the effort and tolerability of alternative exercise training prescriptions is warranted.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917609","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
Erratum: Correlation analysis between foot deformity and diabetic foot with radiographic measurement. 勘误:足部畸形与糖尿病足的影像测量相关性分析。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-03-06 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1392508
{"title":"Erratum: Correlation analysis between foot deformity and diabetic foot with radiographic measurement.","authors":"","doi":"10.3389/fcdhc.2024.1392508","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1392508","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcdhc.2023.1121128.].</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178003","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
Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes 确保忠实性:为服务不足的西班牙裔/拉美裔 2 型糖尿病患者推广糖尿病远程管理计划时应考虑的关键因素
Frontiers in clinical diabetes and healthcare Pub Date : 2024-02-16 DOI: 10.3389/fcdhc.2024.1328993
Sabrina Martinez, C. Nouryan, Myia S. Williams, Vidhi H. Patel, Paulina Barbero, Valeria Correa Gomez, Jose Marino, Nicole Goris, Edgardo Cigaran, Dilcia Granville, Lawrence F. Murray, Yael T. Harris, Alyson Myers, Josephine Guzman, A. Makaryus, Samy I. McFarlane, R. Zeltser, Maria Pena, Cristina Sison, M. Lesser, Myriam Kline, Ralph J DiClemente, R. Pekmezaris
{"title":"Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes","authors":"Sabrina Martinez, C. Nouryan, Myia S. Williams, Vidhi H. Patel, Paulina Barbero, Valeria Correa Gomez, Jose Marino, Nicole Goris, Edgardo Cigaran, Dilcia Granville, Lawrence F. Murray, Yael T. Harris, Alyson Myers, Josephine Guzman, A. Makaryus, Samy I. McFarlane, R. Zeltser, Maria Pena, Cristina Sison, M. Lesser, Myriam Kline, Ralph J DiClemente, R. Pekmezaris","doi":"10.3389/fcdhc.2024.1328993","DOIUrl":"https://doi.org/10.3389/fcdhc.2024.1328993","url":null,"abstract":"The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated.This study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient’s preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices.Key elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961132","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
Post-transplant diabetes mellitus: risk factors and outcomes in a 5-year follow-up. 移植后糖尿病:5 年随访的风险因素和结果。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1336896
Matheus Rizzato Rossi, Marilda Mazzali, Marcos Vinicius de Sousa
{"title":"Post-transplant diabetes mellitus: risk factors and outcomes in a 5-year follow-up.","authors":"Matheus Rizzato Rossi, Marilda Mazzali, Marcos Vinicius de Sousa","doi":"10.3389/fcdhc.2024.1336896","DOIUrl":"10.3389/fcdhc.2024.1336896","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney transplantation is associated with an increased risk of posttransplant diabetes mellitus (PTDM), impacting recipient and graft survivals. The incidence of PTDM ranges from 15% to 30%, with most cases occurring in the first year post-transplant. Some clinical and laboratory characteristics pre- and post-transplant may be associated with a higher PTDM incidence in a more extended follow-up period. This study aimed to analyze the prevalence of PTDM among renal transplant recipients without previous DM diagnosis during a five-year post-transplant follow-up, as well as clinical and laboratory characteristics associated with a higher incidence of PTDM during this period.</p><p><strong>Material and methods: </strong>Single-center retrospective cohort including kidney transplant recipients older than 18 years with a functioning graft over six months of follow-up between January and December 2018. Exclusion criteria were recipients younger than 18 years at kidney transplantation, previous diabetes mellitus diagnosis, and death with a functioning graft or graft failure within six months post-transplant.</p><p><strong>Results: </strong>From 117 kidney transplants performed during the period, 71 (60.7%) fulfilled the inclusion criteria, 18 (25.3%) had PTDM diagnosis, and most (n=16, 88.9%) during the 1<sup>st</sup> year post-transplant. The need for insulin therapy during the hospital stay was significantly higher in the PTDM group (n=11, 61.1% vs. n=14, 26.4%, PTDM vs. non-PTDM). Other PTDM risk factors, such as older age, high body mass index, HLA mismatches, and cytomegalovirus or hepatitis C virus infections, were not associated with PTDM occurrence in this series. During 5-year post-transplant follow-up, the graft function remained stable in both groups.</p><p><strong>Conclusion: </strong>The accumulated incidence of PTDM in this series was similar to the reported in other studies. The perioperative hyperglycemia with the need for treatment with insulin before hospital discharge was associated with PTDM.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139731216","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
Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia. 农村高度贫困背景下的 1 型糖尿病:埃塞俄比亚西北部城市和农村病例在人口和人体测量特征方面的差异。
Frontiers in clinical diabetes and healthcare Pub Date : 2024-01-29 eCollection Date: 2023-01-01 DOI: 10.3389/fcdhc.2023.1298270
Shitaye A Balcha, David I Phillips, Elisabeth R Trimble
{"title":"Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia.","authors":"Shitaye A Balcha, David I Phillips, Elisabeth R Trimble","doi":"10.3389/fcdhc.2023.1298270","DOIUrl":"10.3389/fcdhc.2023.1298270","url":null,"abstract":"<p><strong>Background: </strong>While there is increasing evidence for an altered clinical phenotype of Type 1 diabetes in several low-and middle-income countries, little is known about urban-rural differences and how the greater poverty of rural environments may alter the pattern of disease.</p><p><strong>Objective: </strong>Investigation of urban-rural differences in demographic and anthropometric characteristics of type 1 diabetes in a resource-poor setting.</p><p><strong>Research design and methods: </strong>Analysis of a unique case register, comprising all patients (rural and urban) presenting with Type 1 diabetes over a 20 yr. period in a poor, geographically defined area in northwest Ethiopia. The records included age, sex, place of residence, together with height and weight at the clinical onset.</p><p><strong>Results: </strong>A total of 1682 new cases of Type 1 diabetes were registered with a mean age of onset of 31.2 (SD 13.4) yr. The patients were thin with 1/3 presenting with a body mass index (BMI) <17kg/m<sup>2</sup>. There was a striking male predominance of cases when clinical onset was between 20 and 35 yr., this was more marked in the very poor rural dwellers compared to the urban population. While most patients with Type 1 diabetes presented with low BMIs and reduced height, stunting preferentially affected rural men.</p><p><strong>Conclusions: </strong>These data have led to the hypothesis that complex interactions among poor socioeconomic conditions in early life affect both pancreatic function and the development of autoimmunity and provide a possible explanation of the unusual phenotype of Type 1 diabetes in this very poor community.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725161","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
Association of pancreatitis with risk of diabetes: analysis of real-world data 胰腺炎与糖尿病风险的关系:真实世界数据分析
Frontiers in clinical diabetes and healthcare Pub Date : 2024-01-09 DOI: 10.3389/fcdhc.2023.1326239
Djibril M. Ba, Vernon M. Chinchilli, Anna M. Cozzi, David P. Bradley, Ariana R. Pichardo-Lowden
{"title":"Association of pancreatitis with risk of diabetes: analysis of real-world data","authors":"Djibril M. Ba, Vernon M. Chinchilli, Anna M. Cozzi, David P. Bradley, Ariana R. Pichardo-Lowden","doi":"10.3389/fcdhc.2023.1326239","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1326239","url":null,"abstract":"Diabetes is a major cause of disease burden with considerable public health significance. While the pancreas plays a significant role in glucose homeostasis, the association between pancreatitis and new onset diabetes is not well understood. The purpose of this study was to examine that association using large real-world data.Utilizing the IBM® MarketScan® commercial claims database from 2016 to 2019, pancreatitis and diabetes regardless of diagnostic category, were identified using International Classification of Diseases, Tenth Revision [ICD-10] codes. We then performed descriptive analyses characterizing non-pancreatitis (NP), acute pancreatitis (AP), and chronic pancreatitis (CP) cohort subjects. Stratified Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of diabetes across the three clinical categories.In total, 310,962 individuals were included in the analysis. During 503,274 person‐years of follow‐up, we identified 15,951 incident diabetes cases. While men and women had higher incidence rates of CP and AP-related diabetes, the rates were significantly greater in men and highest among individuals with CP (91.6 per 1000 persons-years (PY)) followed by AP (75.9 per 1000-PY) as compared to those with NP (27.8 per 1000-PY). After adjustment for diabetes risk factors, relative to the NP group, the HR for future diabetes was 2.59 (95% CI: 2.45-2.74) (P<0.001) for the CP group, and 2.39 (95% CI: 2.30-2.48) (P<0.001) for the AP group.Pancreatitis was associated with a high risk of diabetes independent of demographic, lifestyle, and comorbid conditions.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139445137","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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