Frontiers in clinical diabetes and healthcare最新文献

{"title":"Gestational diabetes mellitus in Cameroon: prevalence, risk factors and screening strategies","authors":"E. Sobngwi, Joelle Sobngwi-Tambekou, J. Katte, J. B. Echouffo-Tcheugui, E. Balti, A. Kengne, L. Fezeu, C. Ditah, A. Tchatchoua, M. Dehayem, Nigel C. Unwin, Judith Rankin, J. Mbanya, R. Bell","doi":"10.3389/fcdhc.2023.1272333","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1272333","url":null,"abstract":"The burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population.We carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies.GDM prevalence was 5·9%, 17·7%, and 11·0% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3·14, 95%CI: 1·27-7·76)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5·9 mmol/L for RPG (c-statistic 0·62) and 7·1 mmol/L for 1-hour 50g GCT (c-statistic 0·76). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6·5 mmol/L (c-statistic 0·61) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66·9 and 41·0% of the cases.GDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"54 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139441908","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":"Exploring the progress of artificial intelligence in managing type 2 diabetes mellitus: a comprehensive review of present innovations and anticipated challenges ahead","authors":"Farwa Tahir, Muhammad Farhan","doi":"10.3389/fcdhc.2023.1316111","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1316111","url":null,"abstract":"A significant worldwide health issue, Type 2 Diabetes Mellitus (T2DM) calls for creative solutions. This in-depth review examines the growing severity of T2DM and the requirement for individualized management approaches. It explores the use of artificial intelligence (AI) in the treatment of diabetes, highlighting its potential for diagnosis, customized treatment plans, and patient self-management. The paper highlights the roles played by AI applications such as expert systems, machine learning algorithms, and deep learning approaches in the identification of retinopathy, the interpretation of clinical guidelines, and prediction models. Examined are difficulties with individualized diabetes treatment, including complex technological issues and patient involvement. The review highlights the revolutionary potential of AI in the management of diabetes and calls for a balanced strategy in which AI supports clinical knowledge. It is crucial to pay attention to ethical issues, data privacy, and joint research initiatives.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"296 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138996826","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":"Factors associated with diabetes concordant comorbidities among adult diabetic patients in Central Ethiopia: a cross-sectional study","authors":"Y. Negussie, Mihiret Shawel Getahun, Nardos Tilahun Bekele","doi":"10.3389/fcdhc.2023.1307463","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1307463","url":null,"abstract":"Diabetes comorbidities are a serious public health issue that raises the risk of adverse health effects and complicates diabetes management. It also harms emotional health, medication adherence, self-management, and general quality of life. However, evidence is scarce in Ethiopia, particularly in the study area. Thus, this study aimed to estimate the prevalence of diabetes concordant comorbidities and identify factors associated with the presence of concordant comorbidities among adult diabetic patients in central Ethiopia.A health facility-based cross-sectional study was conducted among 398 adult diabetic patients. A computer-generated simple random sampling was used to select study participants. Data were collected using a structured data extraction checklist. The collected data were entered into Epi info version 7.2 and exported to SPSS version 27 for analysis. A binary logistic regression model was used to analyze the association between dependent and independent variables. An adjusted odds ratio with the corresponding 95% confidence interval was used to measure the strength of the association and statistical significance was declared at a p-value < 0.05.The prevalence of diabetes-concordant comorbidities was 41% (95% CI: 36.2-46.0). The multivariable logistic regression model showed that age 41–60 (AOR = 2.86, 95% CI: 1.60–5.13), place of residence (AOR = 2.22, 95% CI: 1.33–3.70), having type two diabetes (AOR = 3.30, 95% CI: 1.21–8.99), and having positive proteinuria (AOR = 2.64, 95% CI: 1.47–4.76) were significantly associated with diabetes concordant comorbidities.The prevalence of diabetes-concordant comorbidities was relatively high. Age, place of residence, type of diabetes, and positive proteinuria were factors associated with diabetes-concordant comorbidities. Prevention, early identification, and proper management of diabetes comorbidities are crucial.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"42 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139005025","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 benefits of GLP1 receptors in cardiovascular diseases","authors":"L. Ferhatbegović, Denis Mršić, Amra Macić-Džanković","doi":"10.3389/fcdhc.2023.1293926","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1293926","url":null,"abstract":"Glucagon like peptide-1 (GLP-1) receptor agonists are well established drugs for the treatment of type 2 diabetes (T2D). In addition to glycemic control, GLP-1 receptor agonists have beneficial other effects. They act by binding to GLP-1 receptors, which are widely distributed in the body, including cardiomyocytes and blood vessels. The aim of this article is to provide a comprehensive review of GLP-1 receptor agonists impact on cardiovascular outcomes and risk reduction. In the last decade, several cardiovascular outcomes trials (CVOT) have been conducted in order to explore cardiovascular benefit of GLP-1 receptor agonists. CVOTs primarily proved cardiovascular safety and tolerability of different GLP-1 receptor agonists, but also showed cardiovascular benefit of specific drugs. CVOTs have shown that GLP-1 receptor agonists reduce MACE in patients with T2D compared to placebo. In addition, they have positive impact on several cardiovascular risk factors such as obesity by promoting weight loss, blood pressure and blood lipid levels. Also, they stimulate the endothelium to produce nitric oxide, reduce oxidative stress, and have antiatherogenic and antiinflammatory effects. Studies have shown their positive impact on kidney outcomes in patients with T2D compared to placebo. The results of previous trials are encouraging in terms of multiple positive effects of GLP-1 receptor agonists. However, further research is needed to understand their full potential and all details of their mechanism of action, which will enable to expand the therapeutic indications and to determine their optimal use in clinical practice.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586536","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":"Evaluating consistency of physical activity and exercise prescription in the UK for people with diabetes – a Delphi study","authors":"Clare Strongman, Francesca Cavallerio, Matthew A. Timmis, Andrew Morrison","doi":"10.3389/fcdhc.2023.1278597","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1278597","url":null,"abstract":"Increased physical activity is recommended as a cost-effective measure to tackle long-term management of people with diabetes, but research on interventions lacks consistency in terms of effective duration and modality. The aim of this study was to evaluate expert consensus on exercise and physical activity prescription via a three-round Delphi study conducted with 45 UK-based health and fitness professionals experienced in prescribing exercise or physical activity to people with diabetes.The majority of items put forward to the panel reached consensus with 70% or above voting these items as important, but the details of the type, duration and/or modality of exercise or physical activity prescription within these items often contradicted each other, suggesting that patients are receiving inconsistent advice. The range of different exercise prescription found in this study suggests that patients are being given inconsistent and potentially confusing advice, which may affect their participation in exercise and long-term lifestyle change.More consistent promotion of advice from healthcare and fitness professionals may help with increasing physical activity in this participant group and achieving long term behavior change, reducing patient symptoms as well as reducing the cost to the National Health Service (NHS).","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590314","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":"Editorial: Current understanding of complications associated with diabetes","authors":"S. Srivastava","doi":"10.3389/fcdhc.2023.1338656","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1338656","url":null,"abstract":"","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"2 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595719","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":"A co-designed, community-based intensive health behavior intervention promotes participation and engagement in youth with risk factors for type 2 diabetes","authors":"Julie M Pike, Kathryn M Haberlin-Pittz, Basmah S. Alharbi, Susan M. Perkins, Tamara S. Hannon","doi":"10.3389/fcdhc.2023.1264312","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1264312","url":null,"abstract":"Obesity among youth (children and adolescents) is associated with increased risk for youth-onset type 2 diabetes. Lifestyle change can delay or prevent the development of type 2 diabetes, yet real-world implementation of health behavior recommendations is challenging. We previously engaged youth with risk factors for type 2 diabetes, their caregivers, and professionals in a human-centered design study to co-design a lifestyle change program. Here we report the outcomes for this 16-week co-designed lifestyle change program for youth at risk for T2D and their caregivers.This single-arm family-based cohort study included youth aged 7-18 years, with BMI ≥85th percentile (overweight or obese) and at least one additional risk factor for type 2 diabetes, and their caregivers. Clinical (BMI, HbA1c), self-reported physical activity, and quality of life outcomes were evaluated at baseline (B), post-intervention (M4), and 1 year (M12) following the intervention.Seventy-eight youth (mean age 12.4 ± 2.7y, 67% female, 37.8% white) and 65 caregivers were included in the data analysis. Youth baseline BMI z-scores (2.26 ± 0.47) and HbA1c (5.3 ± 0.3) were unchanged at follow up time points [BMI z-scores M4 (2.25 ± 0.52), M12 (2.16 ± 0.58), p-value 0.46], [HbA1c M4 (5.3 ± 0.3), M12 (5.2 ± 0.3), p-value (0.04)]. Youth reported increased physical activity at M4 (p = 0.004), but not at M12. Youth quality of life scores increased at M12 (p=0.01). Families who attended at least one session (n=41) attended an average of 9 out of 16 sessions, and 37 percent of families attended 13 or more sessions.A co-designed, community-based lifestyle intervention promotes increased physical activity, improved quality of life, maintenance of BMI z-scores and HbA1c, and engagement in youth with risk factors for T2D.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612238","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":"Poor glycaemic control: prevalence, factors and implications for the care of patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.","authors":"Jean-Pierre Fina Lubaki, Olufemi Babatunde Omole, Joel Msafiri Francis","doi":"10.3389/fcdhc.2023.1241882","DOIUrl":"10.3389/fcdhc.2023.1241882","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes is a significant problem in sub-Saharan Africa and achieving glycaemic control poses a health challenge among patients living with type 2 diabetes. There are limited data on glycaemic control in Kinshasa, Democratic Republic of the Congo. This study assessed the prevalence and factors associated with glycaemic control to inform potential interventions to improve glycaemic control in Kinshasa.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted between November 2021-September 2022 among patients recruited from 20 randomly selected health facilities in Kinshasa. Participants were asked to complete a structured questionnaire and to provide two millilitres of blood for Hb1AC assay. Poor glycaemic control was defined as HbA1c ≥7%. Univariate and multivariable logistic regressions were performed to identify factors associated with poor glycaemic control.</p><p><strong>Results: </strong>A total of 620 participants were recruited for this study. Study participants had a median age of 60 (IQR=53.5-69) years with the majority being female (66.1%), unemployed (67.8%), having income below the poverty line (76.4%), and without health insurance (92.1%). About two-thirds of the participants (420; 67.6%) had poor glycaemic control. Participants on monotherapy with insulin (AOR=1.64, 95%CI [1.10-2.45]) and those on a treatment duration ≥7 years (AOR=1.45, 95%CI [1.01-2.08]) were associated with increased odds of poor glycaemic control while being overweight (AOR= 0.47, 95%CI [0.26-0.85]) and those with uncontrolled blood pressure (AOR=0.65, 95% CI [0.48-0.90]) were protective for poor glycaemic control.</p><p><strong>Conclusion: </strong>Poor glycaemic control is prevalent among patients with type 2 diabetes in Kinshasa, DRC. Being on insulin alone and a duration of diabetes treatment equal or more than 7 years predisposed to poor glycaemic control. By contrary, having uncontrolled blood pressure and being overweight had protective effect against poor glycaemic control. These links between uncontrolled blood pressure and overweight on the one hand, and glycaemic control on the other are unusual. These reflect, among other things, the specific characteristics of diabetes in sub Saharan Africa.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"4 ","pages":"1241882"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138814133","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 role of neighborhood inequalities on diabetes prevention care: a mini-review.","authors":"Francesco Frigerio, Luca Muzzioli, Alessandro Pinto, Lorenzo Maria Donini, Eleonora Poggiogalle","doi":"10.3389/fcdhc.2023.1292006","DOIUrl":"10.3389/fcdhc.2023.1292006","url":null,"abstract":"<p><p>An emerging research niche has focused on the link between social determinants of health and diabetes mellitus, one of the most prevalent non-communicable diseases in modern society. The aim of the present mini-review is to explore and summarize current findings in this field targeting high-income countries. In the presence of disadvantaged neighborhood factors (including socioeconomic status, food environment, walkability and neighborhood aesthetics), diabetes prevention and care are affected at a multidimensional level. The vast majority of the included studies suggest that, besides individual risk factors, aggregated neighborhood inequalities should be tackled to implement effective evidence-based policies for diabetes mellitus.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"4 ","pages":"1292006"},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479667","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 GAD65 and IA2 autoantibodies on islet allograft survival","authors":"Joana R. N. Lemos, Raffaella Poggioli, Jonathan Ambut, Nujen C. Bozkurt, Ana M. Alvarez, Nathalia Padilla, Francesco Vendrame, Camillo Ricordi, David A. Baidal, Rodolfo Alejandro","doi":"10.3389/fcdhc.2023.1269758","DOIUrl":"https://doi.org/10.3389/fcdhc.2023.1269758","url":null,"abstract":"Introduction Islet transplantation (ITx) shows promise in treating T1D, but the role of islet autoantibodies on graft survival has not been clearly elucidated. We aimed to analyze the effect of GAD65 and IA2 autoantibody status on graft survival and attainment of insulin independence in subjects with T1D who underwent ITx. Method We conducted a retrospective cohort study on 47 ITx recipients from 2000 to 2018. Islet infusion was performed via intrahepatic portal (n=44) or onto the omentum via laparoscopic approach (n=3). Immunosuppression involved anti-IL2 receptor antibody, anti-TNF, and dual combinations of sirolimus, tacrolimus, or mycophenolate mofetil (Edmonton-like) in 38 subjects (80.9%). T-cell depletion induction with Edmonton-like maintenance was used in 9 subjects (19%). GAD65 and IA2 autoantibodies were assessed pre-transplant and post-transplant (monthly) until graft failure, and categorized as persistently negative, persistently positive, or seroconverters. Graft survival was analyzed using U-Mann-Whitney test, and Quade’s nonparametric ANCOVA adjusted for confounders. Kaplan-Meier and Log-Rank tests were employed to analyze attainment of insulin independence. P value &amp;lt;0.05 indicated statistical significance. Results ITx recipients with persistent autoantibody negativity (n = 21) showed longer graft function (98 [61 – 182] months) than those with persistent autoantibody positivity (n = 18; 38 [13 – 163] months), even after adjusting for immunosuppressive induction protocol (P = 0.027). Seroconverters (n=8) had a median graft survival time of 73 (7.7 – 167) months, which did not significantly differ from the other 2 groups. Subjects with persistently single antibody positivity to GAD65 (n = 8) had shorter graft survival compared to negative islet autoantibody (GAD65/IA2) subjects (n = 21; P = 0.016). Time of graft survival did not differ in subjects with single antibody positivity to IA2. The proportion of insulin independence attainment was similar irrespective of autoantibody status. Conclusion The persistence of islet autoantibodies, as markers of islet autoimmunity, may represent an underappreciated contributing factor to the failure of transplanted β cells. Whether induction with T-cell depletion may lead to improved graft survival, independent of islet autoantibody status, could not be evaluated in our cohort. Larger prospective studies are needed to further address the role of islet autoantibody status on islet graft survival.","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"45 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136282239","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}