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Diabetes is sweeping the world as a silent epidemic, posing a growing threat to public health. Modeling diabetes is an effective method to monitor the increasing prevalence of diabetes and develop cost-effective strategies that control the incidence of diabetes and its complications. This paper focuses on a mathematical model known as the diabetes complication (DC) model. The DC model is analyzed using different numerical methods to monitor the diabetic population over time. This is by analyzing the model using five different numerical methods. Furthermore, the effect of the time step size and the various parameters affecting the diabetic situation is examined. The DC model is dependent on some parameters whose values play a vital role in the convergence of the model. Thus, parametric analysis was implemented and later discussed in this paper. Essentially, the Runge–Kutta (RK) method provides the highest accuracy. Moreover, Adam–Moulton’s method also provides good results. Ultimately, a comprehensive understanding of the development of diabetes complications after diagnosis is provided in this paper. The results can be used to understand how to improve the overall public health of a country, as governments ought to develop effective strategic initiatives for the screening and treatment of diabetes.

The global pandemic of the novel Coronavirus infection 2019 (COVID-19) challenged the care of comorbid patients. The risk imposed by COVID-19 on diabetes patients is multisystemic, exponential, and involves glucose dysregulation. The increased burden for diabetes patients infected with COVID-19 is substantial in countries with a high prevalence of diabetics, such as the United Arab Emirates (UAE). This study aims to explore the prevalence of diabetes, clinical characteristic, and outcomes of patients admitted for COVID-19 treatment with or without a concurrent preadmission diagnosis of diabetes. A prospective study was performed on 1199 adults admitted with confirmed COVID-19 from December 2020 to April 2021 to a single hospital in the UAE. The study compared the demographics, clinical characteristics, and outcomes in COVID-19-infected patients with diabetes to patients without diabetes. The study endpoints include the development of new-onset diabetes, admission to ICU, trends in the blood glucose levels, and death. A total of 1199 patients (390 with diabetes) were included in the study. A diabetes prevalence was detected among 9.8% of the study population. Among the diabetes group, 10.8% were morbidly obese, 65.4% had associated hypertension, and 18.9% had coronary artery disease. Diabetes patients showed higher rates of ICU admission (11.1% vs. 7.1%), NIV requirement (9.6% vs. 6.4%), and intubation (5.45% vs. 2%) compared to the non-diabetes group. Advanced age was a predictor of a worsening COVID-19 course, while diabetes (p < 0.050) and hypertension (p < 0.025) were significant predictors of death from COVID-19. Nearly three-fourths (284 (73.4%)) of the diabetic patients developed worsened hyperglycemia as compared to one-fifth (171 (20.9%)) of the nondiabetic patients. New-onset diabetes was detected in 9.8% of COVID-19 patients. COVID-19 severity is higher in the presence of diabetes and is associated with worsening hyperglycemia and poor clinical outcomes. Preexisting hypertension is a predictor of COVID-19 severity and death.

BACKGROUND. One of the priority directions in the development of the health care system is to reduce the medical and social damage caused by the increase in the prevalence of diabetes mellitus (DM). From this point of view, the development of a diabetes register is very important as the main information and analytical platform for clinical and epidemiological monitoring of diabetes in the Russian Federation (RF).AIMS. The aim of our study was to analyze a dynamic (2016–2020) of the epidemiological characteristics of diabetes mellitus in the Russian Federation (prevalence, morbidity, mortality), the prevalence of complications, the level of HbA1c and the dynamics of the structure of glucose-lowering therapy (GLT) according to the Federal Diabetes Register (FDR).MATERIALS AND METHODs. The database of FRD (http://diaregistry.ru) 84 regions of the RF. The data are presented in dynamics 2016→2020.RESULTS. The total number of DM patients in the RF as of 01.01.2021 was 4,799,552 (3.23% of the population), including: Type 1 (T1) — 5.5% (265.4 ths) , T2 — 92.5% (4.43 million), other DM types — 2.0% (99.3 ths). The dynamics of prevalence was 168.7→180.9/100 ths people with T1, and 2709 → 3022/100 ths people with T2; morbidity in T1 10.5→7.7/100 ths population, in T2 219.6→154.2/100 ths population. Age and sex characteristics: the proportion of men in T1 — 54%, in T2 — 30%; the max proportion of patients with T1 at the age of 30–39 years, T2 65–69 years. Mortality: T1 3.0 → 2.7/100 ths population, T2 87.7→93.9/100 ths of the population, the main cause of death was cardiovascular: in T1 38,1% cases, in T2 — 52,0%. Life expectancy (average age of death of patients): T1 was 53.2years, the dynamics in males 50.7 → 50.5years, ­females 58.7→55.2years; in T2 — 73.5 years, males 70.2→70.1years, females 75.7→75.4 years. The dynamic of DM duration until the death: in T1 17.4→19.0 years; in T2 11→11.4 years. The incidence of diabetic complications in T1 and T2 patients: neuropathy 43.3% and 24.4%, nephropathy (CKD) 25.9% and 18.4%, retinopathy 31.7% and 13.5%, respectively. The ­proportion of ­patients with HbA1c CONCLUSIONS. The performed analysis demonstrates the importance of dynamic assessment of epidemiological characteristics and monitoring of clinical data on patients with diabetes through a registry for assessing the quality of diabetes care and the prospects for its development.

BACKGROUND: Diabetes mellitus (DM) is a leading contributor to morbidity and mortality in the United States (US). Prior DM prevalence estimates in Asian Americans are predominantly from Asians aggregated into a single group, but the Asian American population is heterogenous. OBJECTIVE: To evaluate self-reported DM prevalence in disaggregated Asian American subgroups to inform targeted management and prevention. DESIGN: Serial cross-sectional analysis. PARTICIPANTS: Respondents to the US Behavioral Risk Factor Surveillance System surveys who self-identify as non-Hispanic Asian American (NHA, N=57,001), comprising Asian Indian (N=11,089), Chinese (N=9458), Filipino (N=9339), Japanese (N=10,387), and Korean Americans (N=2843), compared to non-Hispanic White (NHW, N=2,143,729) and non-Hispanic Black (NHB, N=215,957) Americans. MAIN MEASURES: Prevalence of self-reported DM. Univariate Satterthwaite-adjusted chi-square tests compared the differences in weighted DM prevalence by sociodemographic and health status. KEY RESULTS: Self-reported fully adjusted DM prevalence was 8.7% (95% confidence interval 8.2–9.3) in NHA, compared to 14.3% (14.0–14.6) in NHB and 10.0% (10.0–10.1) in NHW (p

Diabetes mellitus has a significant impact on people's lives and drugs financial burden. On the other hand, diabetes also has substantial economic effects on countries and national health systems. Most countries spend between 5% and 20% of their total health expenditures on diabetes. This is due to the increased use of health services, lack of productivity, and the long-term demand for complications associated with diabetes, such as kidney failure, blindness, and heart problems. This is why diabetes poses a significant challenge to healthcare systems and hinders sustainable economic development. This work is concerned with proposing mathematical models characterized by accuracy and ease in predicting the number of diabetics type 2 in the Sultanate of Oman. By analyzing the proposed mathematical models of the current work (1, 2, and 3), it was found that the proposed mathematical model in Equation 6 can accurately predict the number of diabetics in Oman up to 2050. In order to test the model's accuracy and validity, we revised it with actual data. The results prove the accuracy of the proposed model in predicting future data of 99%. Lastly, several recommendations were recorded that could help to reduce the prevalence of diabetes type 2 in Oman.

Background: Over the last decades, the number of new diabetic cases and the prevalence of diabetes have tended to increase. The diabetes prevalence rate in Indonesia in 2020 reached 6.20%. Purpose: The aim of this study is to examine the relationship between the variables of age, level of education, smoking status, and Body Mass Index (BMI) and the prevalence of diabetes in the urban areas. Methods: This was a cross-sectional study and used secondary data from the Indonesia Family Life Survey (IFLS 5) in 2015. The data was analyzed using descriptive analysis and simple logistic regression. The dependent variable in this study was Diabetes Mellitus (DM); the independent variables were age, education level, smoking status, and BMI. Results: In terms of the respondents’ characteristics, individuals were mainly over 35 years of age (130 respondents, 83.87%). The highest level of education was attained by 93 respondents (60.00%). There was a correlation between respondents who were over 35 years of age, with p=0.01; prevalence ratio (PR)=5.60; 95%Cl=3.64–8.62) and the level of education (p=0.01; PR=1.69; 95%Cl=1.22–2.34) with the incidence of diabetes in urban areas in Indonesia. There was no correlation between the smoking status (p=0.55; PR=0.67; 95%Cl=0.01–2.73) and the BMI of respondents with the prevalence of diabetes in urban areas in Indonesia. Conclusion: The age and the level of education were linked to the incidence of diabetes in urban areas in Indonesia.

To compare prevalence of self-reported diabetes between U.S. state-born, Puerto Rico-born, Mexico-born, Cuba-born, and South/Central America-born Hispanic groups, and examine whether risk for diabetes differs by country of origin and experiences with discrimination when accounting for BMI. Data from 6223 Hispanic respondents from the nationally representative NESARC-III study was used. Sociodemographic characteristics were compared across nativity groups, and adjusted odds of self-reported diabetes diagnosis (past year) tested. Differences by perceived discrimination (using endorsement of individual items assessing specific experiences) and by nativity were examined when accounting for sociodemographic characteristics, acculturation, and BMI. Prevalence of self-reported diabetes diagnosis was significantly higher among the Puerto Rico-born Hispanics, and remained significantly elevated when adjusting for perceived discrimination, acculturation, and health risk behaviors. When adjusting further for BMI, there were no significant differences in the odds of diabetes by nativity. Prevalence of lifetime perceived discrimination was significantly lower among Cuba-born Hispanics. Mean BMI was significantly lower in South/Central America-born Hispanic individuals relative to U.S. state-, Mexico-, and Puerto Rico-born Hispanic groups. Higher BMI was associated with significantly greater risk of diabetes diagnosis across groups. Marked heterogeneity exists in prevalence and in factors associated with diabetes risk and weight status across Hispanic groups in the U.S. Experiences with discrimination may play an important role in accounting for these differences. This should be considered when planning future research to inform the most optimal patient-centered prevention efforts. Level III, Evidence obtained from well-designed cohort analytic study.

Background : The World Health Organization (WHO) states, the number of people with diabetes has increased from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years has increased from (4.7%) in in 1980 to (8.5%) in 2014. Diabetes prevalence is increasing faster in middle and low income countries. In 2015, an estimated 1.6 million deaths were directly caused by Diabetes. 2.2 million other deaths were caused by high blood glucose in 2012. Nearly half of all deaths due to high blood glucose occurred before the age of 70 years. Research Objectives : To determine the factors related to the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Bekasi Hospital in 2019. Research Methods : This research method uses Analytical Quantitative Design with Cross Sectional Approach, with Independent Variables, Heredity, Diet and Sports Habits while the Dependent Variable is Diabetes Mellitus, with a population of 300 patients during the last 6 months July-December 2019, for sampling using accidental sampling as many as 35 respondents, the type of statistical test used is chi square. Research Results : The results showed that there was a significant relationship between heredity, diet, exercise habits with the incidence of diabetes mellitus in the Internal Medicine Clinic of Budi Lestari Hospital in Bekasi with a P.Value value of 0.014 or P.Value ≤ a (0.05) with OR (Odds Ratio) = 0.050. Suggestion : It is expected that hospitals can provide maximum health services for patients seeking treatment and input for nurses in providing health education to patients with Diabetes Mellitus about Factors Related to Diabetes Mellitus.

The surge in diabetes prevalence has seized the increasing attention of Physicians, Patients, Healthcare Support Systems, as well as policymakers. Telemedicine is a frugal intervention in diabetes ...

Purpose The increasing diabetes prevalence and advent of new treatments for its major visual-threatening complications (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]), which require frequent life-long follow-up, have increased hospital demands markedly. Subsequent delays in patient's evaluation and treatment are causing sight loss. Strategies to increase capacity are needed urgently. The retinopathy (EMERALD) study tested diagnostic accuracy, acceptability, and costs of a new health care pathway for people with previously treated DME or PDR. Design Prospective, multicenter, case-referent, cross-sectional, diagnostic accuracy study undertaken in 13 hospitals in the United Kingdom. Participants Adults with type 1 or 2 diabetes previously successfully treated DME or PDR who, at the time of enrollment, had active or inactive disease. Methods A new health care pathway entailing multimodal imaging (spectral-domain OCT for DME, and 7-field Early Treatment Diabetic Retinopathy Study [ETDRS] and ultra-widefield [UWF] fundus images for PDR) interpreted by trained nonmedical staff (ophthalmic graders) to detect reactivation of disease was compared with the current standard care (face-to-face examination by ophthalmologists). Main Outcome Measures Primary outcome: sensitivity of the new pathway. Secondary outcomes: specificity; agreement between pathways; costs; acceptability; proportions requiring subsequent ophthalmologist assessment, unable to undergo imaging, and with inadequate images or indeterminate findings. Results The new pathway showed sensitivity of 97% (95% confidence interval [CI], 92%–99%) and specificity of 31% (95% CI, 23%–40%) to detect DME. For PDR, sensitivity and specificity using 7-field ETDRS images (85% [95% CI, 77%–91%] and 48% [95% CI, 41%–56%], respectively) or UWF images (83% [95% CI, 75%–89%] and 54% [95% CI, 46%–61%], respectively) were comparable. For detection of high-risk PDR, sensitivity and specificity were higher when using UWF images (87% [95% CI, 78%–93%] and 49% [95% CI, 42%–56%], respectively, for UWF versus 80% [95% CI, 69–88%] and 40% [95% CI, 34%–47%], respectively, for 7-field ETDRS images). Participants preferred ophthalmologists’ assessments; in their absence, they preferred immediate feedback by graders, maintaining periodic ophthalmologist evaluations. When compared with the current standard of care, the new pathway could save £1390 per 100 DME visits and between £461 and £1189 per 100 PDR visits. Conclusions The new pathway has acceptable sensitivity and would release resources. Users’ suggestions should guide implementation.

The Hmong, an ethnic group in Laos, immigrated to the United States at the end of the Vietnam War. Minnesota and California have the largest Hmong populations. Hmong were historically farmers and hunter-gatherers with inadequate food supply in Laos. Here in America, with a surplus of food and a sedentary lifestyle, the Hmong are at increased risk for diabetes, hence the Thrifty Gene Hypothesis. This retrospective study compares the prevalence and control of diabetes mellitus-type 2 between the Hmong and other ethnic and racial groups at the Health And Life Organization (HALO) clinic in Sacramento, California. A total of 9,285 charts were reviewed. The Hmong had the highest prevalence but poorest control of diabetes mellitus when compared with the Laotian, Vietnamese, Blacks, Whites, and Hispanics (chi-square p-value

Background. The number of people with diabetes increases every year, both in Poland and worldwide. In Poland, the exact number is not known, and the latest data comes from 2014. The aim of the study was to assess basic epidemiological indicators regarding diabetes in Poland in 2014–2017. Methods. Division into types of diabetes and other analyzes was carried out on the basis of data prepared by a team of experts and employees of the Department of Analysis and Strategy of the Ministry of Health. The NHF databases were used, concerning realized medical interventions and refunded prescriptions. Results. The number of people with diabetes in Poland in 2014 was 2.113 million (1.167 million women and 0.946 million men). This number increased in subsequent years and in 2017 amounted to 2.533 million (1.408 million women and 1.124 million men), which constituted 6.58% of the population. Using the adopted methodology, the number of patients in whom the type of diabetes could not be determined was large and ranged from 39.57% to 32.75% in individual years. Conclusions. Diabetes prevalence in Poland is increasing. The adopted methodological assumptions regarding the division criteria for type 2 and type 1 diabetes do not allow an accurate determination of the epidemiology of diabetes by type (incidence rate and morbidity), but they allow to determine “specific” subpopulations of patients with a given type of disease.

Sinopsis La incidencia de la úlcera de pie diabético (UPD) ha incrementado en la última década, tanto en Chile como en el mundo, como resultado de un aumento progresivo en la prevalencia de la diabetes mellitus. Frente a esta compleja situación, y dado que las UPD están asociadas con un alto riesgo de infección y amputación, es necesario optar por tratamientos cuya evidencia demuestre efectividad en el manejo de este tipo de úlceras. Un apósito con tecnología lípido coloide y factor nano oligosacárido (TLC–NOSF), con un alto nivel de evidencia, ha demostrado ser efectivo en el manejo local de UPD, y podría ayudar a combatir esta problemática. El objetivo de este artículo es revisar la evidencia en relación con la TLC–NOSF y su implementación en la práctica clínica. Conflicto de interés: FSS recibió pagos personales de Laboratorios UrgoMedical por ponencias y actividades. RCG es empleada de Laboratorios UrgoMedical. APP declara no tener conflicto de interés.

Diabetes prevalence has been rapidly increasing worldwide, and there is a need for searching natural compounds to prevent and treat it. Bioactive peptides derived from insect protein would be an interesting sustainable option. However, the potential of insects such as mealworms (Tenebrio molitor) as source for antidiabetic peptides has not been widely studied. In this work, the influence of ultrasound and the sequential hydrolysis with subtilisin and trypsin hydrolysis were analysed for the release α-glucosidase inhibitory peptides. Short time of ultrasound improved the following releasing of bioactive peptides but longer ultrasound treatment time limited their production. Subtilisin hydrolysis did not allow the release of α-glucosidase inhibitory peptides, but it is needed to cleave the protein before trypsin releases these peptides. These high-bioactive hydrolysates could be used as ingredient regulating the glycaemic index in food formulation.

Cancer patients with diabetes experience a poorer prognosis, yet the population burden of this multimorbidity remains unknown. This study aimed to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. We used projection of cancer incidence and latest survival data from population‐based cancer registries. The incidence of cancer associated with diabetes was estimated separately for patients with pre‐existing diabetes and those without diabetes, and used to estimate the 5‐year cancer prevalence for those with and without diabetes. The prevalence of pre‐existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Among cancer sites, diabetes prevalence was high in patients with liver and pancreatic cancers in both sexes. In conclusion, our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy‐makers., This study aimed to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. The prevalence of pre‐existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy‐makers.

The diabetes epidemic is expanding rapidly in India, with 69.2 million people living with diabetes in 2015. This study assessed the spatial pattern and determinants of diagnosed diabetes prevalence in the districts of six states and one union territory (UT) in southern India – a region that has a high prevalence of diabetes. Using cross-sectional population-based survey data from the 2012–13 District Level Household and Facility Survey-4, the prevalence and magnitude of diagnosed diabetes at district level for the population aged 18 years and above were computed. Moran’s I was calculated to explore the spatial clustering of diagnosed diabetes prevalence. Ordinary Least Square (OLS) and Spatial Lag (SL) regression models were carried out to investigate the spatial determinants of diagnosed diabetes prevalence. The prevalence of diagnosed diabetes was found to be substantially higher than that of self-reported diabetes in southern India (7.64% vs 2.38%). Diagnosed diabetes prevalence in the study area varied from 10.52% in Goa to 4.89% in Telangana. The Moran’s I values signified positive moderate autocorrelation. Southern India had 14.15 million individuals with diagnosed diabetes in 2012–13. Bangalore had the highest number of persons with diagnosed diabetes, and Palakkad had the smallest number. In the OLS and SL models, the proportion of people with secondary education and above, wealthy and Christian populations were found to be significant determinants of diagnosed diabetes prevalence. In addition, in the OLS model, the proportion of Scheduled Tribe population showed a negative relationship with diagnosed diabetes prevalence. In order to prevent or postpone the onset age for diabetes, there is a need to raise awareness about diabetes in India.

To address the public health and economic burden of type 2 diabetes, the Centers for Disease Control and Prevention (CDC) began dissemination of the National Diabetes Prevention Program (NDPP) in the United States in 2010. Based on the intensive lifestyle intervention from a large efficacy trial, the NDPP aims to reduce incidence through lifestyle change and weight loss. This narrative review summarizes evidence on reach, effectiveness, and sustainability of the NDPP, while highlighting opportunities to overcome challenges in these areas. Major successes include reaching hundreds of thousands of at-risk individuals across the nation, with notable effectiveness upon full participation and widespread insurance coverage. Yet, more work is needed to ensure greater public health impact, particularly among priority populations at heightened risk who also experience disparities in program outcomes. Preliminary evidence suggests a number of strategies may improve reach and effectiveness of the NDPP, often with more rigorous study needed prior to widespread uptake. Updating the NDPP to better match the current evidence-base may also be important, such as directly targeting glycemia with a patient-centered approach and promoting metformin as an adjunct or second-line treatment. Finally, revisiting pay-for-performance reimbursement models may be critical to sustainability by ensuring adequate availability of suppliers and ultimately reducing diabetes prevalence.

This study aimed to investigate the independent and synergistic effects of childhood and adult social class, as well as the effect of social mobility, on type 2 diabetes (T2D) risk in later life. Cross-sectional data from The Irish Longitudinal Study of Ageing (TILDA) (n = 4,998), a nationally representative probability sample of adults aged 50 and older, were analysed. Prevalent diabetes was defined using subjective (self-reported doctor’s diagnosis) and objective data (medications usage and glycated haemoglobin testing). Social class was classified as a three-level variable based on fathers’ occupation in childhood and respondents’ primary occupation in adulthood. A five-level social mobility variable was created from cross-classification of childhood and adulthood social class. Logistic regression was employed to assess the relationship between social class variables and T2D. Mean (SD) age of the sample was 63.8y (9.9) and 46.4% were male. Incidence of T2D was 11.6% of men and 7.7% of women. Some 57.4% of the sample were classified as Manual social class in childhood. Compared to those in Professional/Managerial occupations, belonging to the Manual social class in childhood was associated with an increased risk of T2D in men (Odds Ratio (OR): 1.36, 95% CI: 0.88, 2.10) and women (OR: 2.16, 95% CI: 1.21, 3.85). This association was attenuated in women when controlled for adulthood social class (OR: 1.84, 95% CI: 1.00–3.37), suggesting that the effect of childhood social class may be modified by improving social circumstance over the life course.

OBJECTIVE Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample. RESEARCH DESIGN AND METHODS We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7% to ≥9%). OGTT screening costs were estimated using Medicare fee schedules. RESULTS Diabetes prevalence was 15.7% (∼5.0 million) using the Endocrine Society’s approach and 7.3% (∼2.3 million) using the standard approach. Treatment eligibility ranged from 5.4% to 0.06% and 11.8% to 1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c CONCLUSIONS Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.

BACKGROUND: South Asians generally have an unfavourable metabolic phenotype compared with white Caucasians, including central obesity and insulin resistance. The Wnt protein family interacts with insulin signaling, and impaired Wnt signaling is associated with adiposity and type 2 diabetes mellitus. We aimed to investigate Wnt signaling in relation to insulin signaling in South Asians compared with white Caucasians.METHODS: Ten Dutch South Asian men with prediabetes and overweight or obesity and 10 matched Dutch white Caucasians were included. Blood samples were assayed for the Wnt inhibitor sclerostin. Subcutaneous white adipose tissue (WAT) and skeletal muscle biopsies were assayed for Wnt and insulin signaling gene expression with quantitative reverse transcription polymerase chain reaction (Clinicaltrials.gov NCT02291458).RESULTS: Plasma sclerostin was markedly higher in South Asians compared with white Caucasians (+65%, PCONCLUSION: South Asian men with overweight or obesity and prediabetes have higher plasma sclerostin and lower Wnt signaling gene expression in WAT compared with white Caucasians. We interpret that reduced Wnt signaling could contribute to impaired insulin signaling in South Asians.

In recent years, the diabetes mellitus in Indonesia has become a health problem in the community because its population has increased 2-3 times faster than other countries. Diabetes prevalence in Indonesia ranks 4th highest in the world after China, India and the United States. People can prevent complications and premature death if they detect early symptoms of diabetes. However, people do not know that they are at risk of diabetes, not had knowledge about the symptoms of diabetes, complexity of the process diagnosis and the high cost of examinations. Therefore, we need an application that can provide the results of the type of diabetes and its management solutions as practiced by experts. The aim of this research is to develop an expert system for detection types of diabetes such as: type one diabetes, type two diabetes, neuropathy diabetes, diabetes retinopathy, and diabetes nephropathy. The object of this research is diabetes carried out in March to April 2019 in the Klinik Pratama Desa Putera. This study uses primary data from patients who had a history of diabetes at Klinik Pratama Desa Putra and secondary data in the form of literature, research journals, and data documents needed to compile this study. In addition, we generated a knowledge base using forward chaining. The test results show that the expert system meets the functional requirements and the system performance reaches an accuracy of 100%. This expert system helps people in Indonesia to detect diabetes early so that it can prevent complications.

BACKGROUND: Diabetes mellitus is an established health concern in First Nations communities and is associated with complex influences of colonization. This study, a partnership between First Nations and academic researchers, was undertaken to determine patterns of diabetes prevalence, incidence and mortality in Ontario. METHODS: Using health services and population data from Ontario for 1995 to 2014, linked with the federal Indian Register, we calculated age- and sex-adjusted annual estimates of diabetes prevalence, incidence and mortality for First Nations people (living within and outside First Nations communities) and other people in Ontario. We also examined age- and sex-specific crude diabetes prevalence. RESULTS: Between 1995 and 2014, the prevalence of diabetes increased and the incidence decreased somewhat in all populations. Both prevalence and incidence were substantially higher among First Nations people than among other people in Ontario. In particular, First Nations women had higher prevalence than other women (4.2% v. 1.6% for ages 20–34 yr and 17.6% v. 6.0% for ages 35–49 yr). The lifetime risk of diabetes was higher among First Nations people than among other people in Ontario (57.0%, 95% confidence interval [CI] 56.3%–57.6% v. 44.5%, 95% CI 44.4%–44.6%). Over time, all-cause mortality for those with diabetes declined but remained consistently higher for First Nations people than for other people in Ontario. INTERPRETATION: Diabetes is more common among First Nations people than among other people in Ontario, particularly at younger ages and in women. First Nations–led approaches to address the high prevalence of diabetes in younger First Nations women have the potential to improve metabolic health across generations.

Many people with diabetes do not achieve individualized treatment targets. Therapeutic inertia, the underuse of effective therapies in preventing serious clinical end points, is a frequent, important contributor to this failure. Clinicians, patients, health systems, payors, and producers of medications, devices, and other products for those with diabetes all play a role in the development of therapeutic inertia and can all help to reduce it.

Background. Diabetes is a public health problem worldwide, associated with increased morbidity and mortality. According to the International Diabetes Federation (IDF) 2017 data, around 425 million people worldwide suffer from diabetes. This number is expected to increase to 629 million in 2045. Various occidental studies reported the increased prevalence and lower control of diabetes among prisoners. However, there is no data on the characteristics of inmates with diabetes in sub-Saharan Africa. Methods. A cross-sectional study among incarcerated detainees from the Yaoundé Central Prison was conducted from January to July 2017. Diabetes was defined according to the American Diabetes Association (ADA) criteria. Analyzed variables included phenotypic characteristics, lifestyle, the reason for detention, the sentence severity, and the length of detention. Results. We recruited 437 inmates (344 men) with an average age of 37.0 (95% CI: 35.9-38.3) years. The most frequent age group was 20 to 39 years with 281 (64.7%) inmates, and the mean prison stay was 29.1 (95% CI: 25.7-32.8) months. The prevalence of diabetes in the Yaoundé Central Prison was 9.4%. The main cardiovascular risk factors were a sedentary lifestyle (91.1%), hypertension (39.6%), smoking (31.6%), and alcohol consumption (28.1%). Hypertension (p=0.005), obesity (p=0.0006), smoking (p=0.04), sedentary lifestyle (p=0.04), major crime (p=0.007), and minor crime (p=0.003) were associated with diabetes in univariate analysis. In multivariate analysis, only obesity and sedentary lifestyle were associated with diabetes. Conclusion. Diabetes prevalence in the Yaoundé Central Prison was high, at 9.4%, compared to that in the general population. It was associated with other classical cardiovascular risk factors and factors linked to the sentence (minor and major crimes). This trial is registered with CE00617/CRERSHC/2016.

Background:Diabetes prevalence is constantly rising, involving the eyes with damage including development of diabetic macular oedema. Since 2012, intravitreal anti-vascular endothelial growth factor medication is available for diabetic macular oedema treatment. Endocrinological studies have shown that fewer women are affected by diabetes. However, when affected, they exhibit more severe diabetic complications than men. We have investigated gender-related differences in diabetic macular oedema and outcome in an ophthalmological tertiary referral hospital.Methods:We included 88 patients (54 males and 34 females) with 112 eyes (68 male and 44 female) having clinically significant diabetic macular oedema, treated with anti-vascular endothelial growth factor medication. A 1 year follow-up was performed in all patients (visual acuity and optical coherence tomography). Previous retinal surgery was an exclusion criterion, as were other retinal pathologies.Results:The mean visual acuity and mean central retinal thickness at baseline were 0.53 logMAR (male 0.49 and female 0.595) and 469 μm (male 452 μm and female: 494 μm), respectively. After 360 days, mean visual acuity changed by −0.07 (±0.36) logMAR (male −0.11 and female +0.01) and mean central retinal thickness changed by −119 μm (male −113 μm and female −127 μm). For visual acuity, a significant difference was noted at baseline ( p = 0.02) and at 1 year ( p Conclusion:Our study showed that female patients with diabetic macular oedema were diagnosed with and treated for diabetic macular oedema at a stage when visual acuity and optical coherence tomography were worse than those in their male counterparts. This gender difference could not be reduced, despite similar numbers of injections. Female diabetic patients should therefore be assessed early for ophthalmological pathologies.

Background: Helicobacter pylori infection and hyperglycemia are associated with an increased risk of colorectal neoplasm, and may have a synergistic effect in combination. However, these 2 factors that affect colorectal neoplasm remain controversial. We aimed to carry out a meta-analysis to evaluate the study population diabetes prevalence rate and H pylori infection rate with colorectal adenoma risk for adults. Methods: We conducted systemic research through English databases for medical reports. We also recorded the diabetes prevalence and H pylori infection prevalence in each study. We classified these studies into 4 subgroups as their background population diabetes prevalence

Depression is associated with several chronic diseases such as diabetes. Diabetes is a long-term health disorder that have many health complications such as mental health problems, if left untreated. Our study aimed to determine the prevalence of depression among Qatari patients with diabetes, and to investigate the potential determinants of depression. Our results revealed that the prevalence of depression among the target population was 15.4%. Females, younger adults, smokers and patients with higher education had more depressive symptoms.

Type 2 diabetes affects an estimated 1.5 million Australians,1 with a current annual economic burden in excess of $15 billion.2 Diabetes prevalence rates follow those of obesity and increase with age,3 predicting further future increases in prevalence considering the continuing rising trend of obesity4 and the ever-increasing ageing population.5.

Background Increasing trend of diabetes is significant public health threats. This is a consecutive cross-sectional study aimed to estimate the attribution of overweight for diabetes prevalence in Japan. Methods We used individual data aged 20 years and older of National Health and Nutrition Survey in 1997 (2349 men and 3588 women), 2002 (2075 and 3087), 2007 (1614 and 2346), 2012 (5538 and 7981), and 2016 (4327 and 6270). Diabetes was defined as glycated haemoglobin (HbA1c) >6.5% or currently being treated. We estimated multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) for the association between diabetes and overweight (body mass index >25kg/m2) after adjusting for the number of steps per day, total energy intake (kcal/kg), fat energy ratio (%), smoking and drinking status by logistic regression. Results There was significant association between diabetes and overweight in all years: multivariable-adjusted OR (95%CI) were 1.78 (1.32-2.40) in 1997, 1.46 (1.10-1.93) in 2002, 1.77 (1.35-2.32) in 2007, 1.79 (1.55-2.07) in 2012, and 2.15 (1.82-2.54) in 2016 for men and 2.53 (1.92-3.32), 2.53 (1.87-3.42), 2.91 (2.15-3.95), 2.94 (2.51-3.45), and 2.72 (2.27-3.25), for women, respectively. The estimated population attribution on diabetes prevalence due to overweight was 14.8%, 11.9%, 18.1%, 18.0%, and 24.6% for men and 27.0%, 29.4%, 29.9%, 29.5%, and 26.7% for women. Conclusions Overweight was a risk factor for diabetes consistently for 20 years. That attribution was increasing among men but decreasing after peaking in 2007 among women. Key messages The present study suggested a high burden of diabetes due to overweight in Japan.

Objective To test the feasibility of reporting diabetes indicators at a regional and community level in order to provide feedback to local leaders on health system performance. Design Analysis of administrative data from hospital discharges and physician billings. Setting Sioux Lookout region of Ontario. Participants Residents from 30 remote communities served by the Sioux Lookout First Nations Health Authority. Main outcome measures Incidence and prevalence of diabetes and incidence of diabetes complications, including heart attack, stroke, retinopathy, amputations, end-stage kidney disease, diabetes-related hospitalizations, and death. Results Data were available for 18 542 residents from the 30 remote communities. Residents were almost entirely of First Nations descent. The prevalence of diabetes was 12.9%, the annual incidence was 1.0%, and the annual rate of complications was 5.4% in 2015-2016. Prevalence increased slightly over time. We had sufficient data to report prevalence in 25 of 30 communities (average population 738; range 234 to 2626). We reported statistically significant differences in prevalence by community; 8 were above average and 2 were below average. For diabetes complications, data were pooled over 5 years, and while community-level results could be reported, the variance was too high to allow detection of significant differences. Using 2-tailed t tests for difference of proportions, we determined that grouping communities into subregions of approximately 2000 persons would permit the detection of differences of 30% from the average 5-year complication rate. Conclusion This study demonstrates the possibility of reporting diabetes prevalence by individual First Nations reserve communities. Complication rates can be reported by individual community, but estimates are more useful for comparison if the smallest communities are grouped together. Such studies could be replicated across Canada to promote local use of these data for resource planning and monitoring long-term progress of diabetes programs and services.

ContextData-driven diabetes subgroups were proposed as an alternative to address diabetes heterogeneity. However, changes in trends for these subgroups have not been reported.ObjectiveHere, we analyzed trends of diabetes subgroups, stratified by sex, race, education level, age categories, and time since diabetes diagnosis in the United States.MethodsWe used data from consecutive NHANES cycles spanning the 1988-2018 period. Diabetes subgroups (mild obesity-related [MOD], severe insulin-deficient [SIDD], severe insulin-resistant [SIRD], and mild age-related diabetes [MARD]) were classified using validated self-normalizing neural networks. Severe autoimmune diabetes (SAID) was assessed for NHANES-III. Prevalence was estimated using examination sample weights considering bicyclic changes (BCs) to evaluate trends and changes over time.ResultsDiabetes prevalence in the United States increased from 7.5% (95% CI 7.1-7.9) in 1988-1989 to 13.9% (95% CI 13.4-14.4) in 2016-2018 (BC 1.09%, 95% CI 0.98-1.31, P < .001). Non-Hispanic Black people had the highest prevalence. Overall, MOD, MARD, and SIDD had an increase during the studied period. Particularly, non-Hispanic Black people had sharp increases in MARD and SIDD, Mexican Americans in SIDD, and non-Hispanic White people in MARD. Males, subjects with secondary/high school, and adults aged 40-64 years had the highest increase in MOD prevalence. Trends in diabetes subgroups sustained after stratifying time since diabetes diagnosis.ConclusionPrevalence of diabetes and its subgroups in the United States has increased from 1988 to 2018. These trends were different across sex, ethnicities, education, and age categories, indicating significant heterogeneity in diabetes within the US obesity burden, population aging, socioeconomic disparities, and lifestyle aspects could be implicated in the increasing trends of diabetes in the United States.

Diabetes affects approximately 12% of the U.S. adult population and approximately 25% of adults aged ≥65 years. From 2009 to 2017, there was no significant change in diabetes prevalence overall or among persons aged 65-79 years (1). However, these estimates were based on survey data with

INTRODUCTION: Cardiovascular diseases and stroke are steadily the leading causes of death in Latvia. Therefore, the greatest efforts should be given to recognize associative factors which may be modifiable to decrease the burden of ischemic events. OBJECTIVES: The aim of this study was to examine the frequency of aspirin and clopidogrel resistance and its associated risk factors in patients with acute cerebrovascular events. METHODS: The prospective, descriptive study included 204 patients. Patients were considered biochemical resistant to aspirin if platelet aggregation was ≥550 ARU, whereas biochemical clopidogrel resistance was defined when platelet inhibition was >230 PRU. RESULTS: Biochemical aspirin resistance was found in 27 (13%) patients, whereas clopidogrel resistance - in 44 (22%) patients. Five patients (2%) had resistance to both antiplatelet drugs. In the analysis of blood parameters, none were associated with aspirin resistance, except the level of triglycerides which were lower in the aspirin resistance group (p=0.001; r=0.26). In the analysis of clopidogrel sensitivity there was a difference in diabetes prevalence where it was more frequent in the clopidogrel resistance group (15.6% vs. 40.9%; p=0.001; r=0.255). Patients with clopidogrel resistance had higher levels of triglycerides 1.7 (1.3-2.6) than patients grouped as sensitive 1.4 ((1.1-2.0), p=0.033; r=0.16). CONCLUSION: Biochemical aspirin and clopidogrel resistance are quite common in patients with cerebrovascular diseases in Latvia. Our study found that patients with diabetes and elevated glycosylated hemoglobin level were more prone to clopidogrel biochemical resistance. However, the association between aspirin resistance and clinical, laboratory data remains inconclusive.

OBJECTIVE Leisure-time physical activity (LTPA) has been shown to prevent or delay the development of diabetes. However, little research exists examining how other domains of PA (e.g., occupation based [OPA] and transportation based [TPA]) are associated with diabetes prevalence across diverse racial/ethnic groups. We examined associations between OPA, TPA, and LTPA and diabetes prevalence and whether associations differed by race/ethnicity. RESEARCH DESIGN AND METHODS Participants in the 2011–2016 National Health and Nutrition Examination Survey (NHANES) self-reported domain-specific PA. Diabetes status was determined by self-reported doctor/health professional–diagnosis of diabetes or a glycosylated hemoglobin (HbA1c) measurement of ≥6.5% (48 mmol/mol). Multivariable log binomial models examined differences in diabetes prevalence by PA level in each domain and total PA among Latinos (n = 3,931), non-Latino whites (n = 6,079), and non-Latino blacks (n = 3,659). RESULTS Whites reported the highest prevalence of achieving PA guidelines (64.9%), followed by Latinos (61.6%) and non-Latino blacks (60.9%; P < 0.0009). Participants achieving PA guidelines were 19–32% less likely to have diabetes depending on PA domain in adjusted models. Diabetes prevalence was consistently higher among non-Latino blacks (17.1%) and Latinos (14.1%) compared with non-Latino whites (10.7%; P < 0.0001), but interaction results showed the protective effect of PA was similar across PA domain and race/ethnicity—except within TPA, where the protective effect was 4% greater among non-Latino whites compared with Latinos (adjusted difference in risk differences 0.04, P = 0.01). CONCLUSIONS PA policies and programs, beyond LTPA, can be leveraged to reduce diabetes prevalence among all population groups. Future studies are needed to confirm potentially differential effects of transportation-based active living on diabetes prevalence across race/ethnicity.

Objectives To determine the variation in diabetes prevalence across Asian countries and its relationship with the quality of health system and socioeconomic characteristics of the country. Methodology An ecological analysis was conducted using publicly available data from the World Bank, the World Health Organization and the International Diabetes Federation. Geographical variation in diabetes prevalence across countries was examined using control charts while the relationships between country-level determinants and diabetes prevalence were investigated using linear regression analysis. Results The control chart shows special-cause variation in diabetes prevalence in 21 (58%) of the Asian countries; nine countries were below the 99.8% control limits while twelve were above it. Fifteen (42%) countries suggest common-cause variation. Three country characteristics independently associated with diabetes prevalence were hypertension prevalence (OR 0.39, 95% CI 0.22 to 0.55; p-value

As diabetes prevalence increases in the US, critical care nurses need to be familiar with the acute hyperglycemic emergencies they may encounter in the ED or ICU. This article focuses on the diagnosis of, various treatments for, and nursing considerations associated with two acute hyperglyc

Aims To determine the long-term risk of diabetes in a cohort of children treated with recombinant human growth hormone in Israel, using data from the Israeli National Diabetes Register. Methods Between 1988 and 2009, 2513 children were approved for growth hormone treatment. They were assigned to one of two groups. The first group included children treated for isolated growth hormone deficiency and who were small for gestational age and the second included those treated for multiple pituitary hormone deficiency, chronic renal failure, Turner syndrome or Prader-Willi syndrome. The cohort was cross-linked with the Israeli National Diabetes Register for 2014 (mean follow-up duration 12.1±5.3 years), and prevalent cases of diabetes were identified. Standardized prevalence ratios for diabetes were calculated for people aged 10-29 years. Results In 2014, a total of 23 individuals were identified with diabetes (four with pre-existing diabetes, seven developed diabetes before age 17 years and 12 developed it at a later age). In the isolated growth hormone deficiency and small-for-gestational-age group there was no difference in the prevalence of diabetes compared with the general population (standardized prevalence ratio 2.05, 95% CI 0.94-3.89). In the group that included people with multiple pituitary hormone deficiency, chronic renal failure, Turner syndrome and Prader-Willi syndrome there was a significantly higher diabetes prevalence (standardized prevalence ratio 11.94, 95% CI 6.53-20.00) compared with the general population. Conclusions No difference in diabetes prevalence was found in the isolated growth hormone deficiency and small-for-gestational-age group, compared with the general population. Children treated with growth hormone with pre-existing risk factors had an increased prevalence of diabetes. It is advisable to monitor blood glucose levels closely during and after growth hormone treatment, especially in such children.

AIM The prevalence of diabetes has been increasing over the past few decades. The objective of this study is to assess the time trends in diabetes between 1994 and 2017 in Jordan. METHODS Surveys were conducted in 1994, 2004, 2009 and 2017 by the same investigators using generally similar methods. Fasting blood glucose was measured in all surveys. Variables were obtained using structured questionnaires designed specifically for the surveys. Crude and age-specific diabetes prevalence rates were derived for each sex, together with overall, crude and age-standardized prevalence rates. RESULTS The prevalence of diabetes in men aged ≥ 25 years increased from 14.2% in 1994 to 18.3% in 2004, 26.8% in 2009 and 32.4% in 2017. The corresponding prevalence rates in women were 12.3%, 16.9%, 18.8%, and 18.1%, respectively. The overall age-standardized prevalence rate increased from 13.0% in 1994 to 17.1% in 2004, 22.2% in 2009 and 23.7% in 2017. Known diabetes in the 2017 survey accounted for 82.6% of people with diabetes. A HbA1c of

While diabetes prevalence in U.S. adults has increased in the last three decades, less is known about trends in ocular complications of diabetes, particularly in adults aged Disclosure E. A. Lundeen: None. M. Kim: None. D. B. Rein: None. J. Wittenborn: None. C. Cai: None. J. B. Saaddine: None.

Objective: Rates for non-traumatic lower-extremity amputations (LEA) have been declining, but concerns exist over disparities in rates between races/ethnicities. Our objective is to track changes in major LEA (MLEA) rates before and after the Affordable Care Act (ACA) among Medicare beneficiaries residing in the Diabetes Belt compared to those in the surrounding areas. Methods: We used Medicare claims files for a sample of ~1 million Fee-for-Service beneficiaries in 2006 - 2015 to compute rates per 1000 patients with diabetes. The Diabetes Belt was identified by the CDC as 644 counties across Appalachian and southeastern counties in the US that had diabetes prevalence ≥ 11% in 2008. Results: MLEA rates for the Diabetes Belt and surrounding counties as well as rates for Non-Hispanic (NH) Black and NH White are in Figure. Patients in the Belt experienced one full MLEA more per 1000 patients than those in the surrounding area. Although amputation rates declined rapidly in both areas, NH blacks consistently had > 3 times higher rates than NH whites in the Belt. Trends did not show noticeable changes in MLEAs before and after the ACA. Discussion: Our data show persistent disparities in MLEA rates between the Diabetes Belt and surrounding counties. Racial disparities were much larger in the Belt. Targeted policies to prevent MLEAs among NH black patients are needed to reduce the disparities in this region. Disclosure J. M. Lobo: None. S. Kim: None. H. Kang: None. T. L. Mcmurry: None. M. Sohn: None. Funding National Institutes of Health (R01DK113295)

Overall prevalence of diabetes has increased since the year 2000 in the US, disproportionately affecting low-income populations. Recent changes in income-related inequalities (IRI) in diabetes prevalence are unknown. We estimated IRI in diagnosed diabetes in 2001−2018 among US adults aged ≥ 18 years using data from the National Health Interview Survey. We assessed IRI using the Concentration Index (CI). The CI ranges from -1 to 1, with negative values indicating diabetes was concentrated among low-income groups. Trends were assessed using Joinpoint regression. During 2001−2018, all CIs were negative (Figure). The degree of inequality (absolute value of CIs) decreased from 0.16 in 2001 to 0.12 in 2011 (annual percentage change [APC] -2.5, p=0.013), and then increased to 0.18 in 2018 (APC 4.7, p=0.004). The degree of IRI in diabetes differed by sex and age group. Diabetes was more concentrated in low-income groups among females than males. For females, the degree of inequality decreased during 2001−2012 (APC -2.5, p=0.024) and increased after 2012 (APC 4.7, p=0.097); for males, the trend of the inequality was not statistically significant. Among age groups, adults aged 45-64 years had the highest level of IRI in diabetes. Also, the degree of inequality increased in each age group during 2001−2018 (all p Disclosure Y. Chen: None. X. Zhou: None. K. M. Bullard: None. P. Zhang: None. G. Imperatore: None. D. B. Rolka: None.

Introduction: In the last decade, an increase in the prevalence and a reduction in the incidence of diabetes have been observed in many countries including Canada. Yet, some Canadian provinces depicted an elevation in incidence rates among younger age groups. Our objective was to document these trends in the province of Quebec from fiscal years 2001 to 2017. Hypothesis: Prevalence is increasing because of raising incidence in individuals aged Methods: Prevalence, incidence and all-cause mortality among cases of diabetes ≥20 years were assessed using the Quebec Integrated Chronic Disease Surveillance System (n=6,551,045 in 2017). Estimations were age-standardized or stratified by 10-year age groups. Results: In 2017, the crude prevalence and incidence of diabetes were 9.9% [99% confidence interval: 9.9-10.0] (n=651,370) and 6.0 per 1,000 inhabitants [5.9-6.0] (n=35,355), respectively. Between 2001 and 2017, the age-standardized prevalence increased by 43% (6.3% [6.3-6.3] to 9.0% [9.0-9.1]), while age-standardized incidence decreased by 29% (8.3 per 1,000 [8.2-8.4] to 5.9 per 1,000 [5.9-6.0]). In every age group, the prevalence increased steadily with progressive stabilization from 2011 and onward, except for the 60-69 years old group who depicted a reduction from 2012 to 2017. Incidence remained stable among Conclusions: The rise and stabilization of diabetes prevalence could be due to a reduction in incidence in patients aged ≥50 years and mortality among all age groups. Prevention of diabetes should be a priority among individuals aged

Although less muscle mass is associated with greater diabetes prevalence in cross-sectional studies, prospective data in middle-aged Black and White adults are lacking. Middle age is a critical window as accelerated muscle loss is yet to occur, and preventing diabetes reduces lifelong morbidity and mortality. We hypothesized that lower appendicular lean mass adjusted for body mass index (ALM/BMI) is associated with higher incident diabetes in middle-aged Black and White adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study. ALM/BMI was measured by dual x-ray energy absorptiometry (DXA) in 2005-06 among middle-aged US men (n=855) and women (n=1045) in CARDIA. Incident diabetes occurred if any of the following were met in 2010-11 or 2015-16 among persons without diabetes in 2005-06: fasting glucose ≥7 mmol/L (126 mg/dL), 2-hour glucose ≥11.1 mmol/L (200 mg/dL) on a 75-gram glucose tolerance test, HbA 1C ≥48 mmol/mol (6.5%), or use of glucose-lowering medications. We used logistic regression models with sex stratification given sex differences in ALM. In men, mean age was 45.0 ± 3.5 y, BMI 28.0 ± 4.3 kg/m 2 , and ALM/BMI 1.07 ± 0.14 m 2 . In women, mean age was 45.2 ± 3.6 years, BMI 28.4 ± 6.4 kg/m 2 , and ALM/BMI 0.73 ± 0.12 m 2 . Diabetes developed in 70 men (8.2%) and 72 women (6.9%). For each standard deviation increase in ALM/BMI (m 2 ), the risk of diabetes decreased by 22% in men and 29% in women (Table 1). After adjusting for age, race, smoking, education, physical activity, and waist circumference, the association of ALM/BMI with diabetes incidence was no longer significant. Associations were similar between race-ethnic groups. In conclusion, less relative skeletal muscle mass is associated with a greater risk of developing diabetes in middle-aged men and women over 10 years, which is largely explained by the relationship of ALM/BMI to other metabolic risk factors. Low skeletal muscle mass in middle age is a marker for greater diabetes risk and may be a target for preventative interventions.

Purpose: To examine whether social network characteristics of US-and foreign-born individuals are related to hypertension, diabetes and obesity prevalence. Design: Cross-sectional. Setting: Six San Francisco Bay Area counties. Participants: N = 1153 cohorts of young and older adults (21-30 and 50-70 years). Measures: Network structure and support measures were calculated using name elicitation and interpreter questions common in egocentric surveys. Hypertension and diabetes were self-reported, and overweight/obesity was determined using body mass index calculations. Foreign-birth status was based on country of birth. Analysis: Adjusted and unadjusted logistic regression models were used to examine associations between network characteristics and hypertension, diabetes and overweight/obesity. These relationships were tested for moderation by foreign-birth status, age and gender. Results: Higher percentages of family members (AOR = 4.16, CI: 1.61-10.76) and same-sex individuals (AOR = 3.41, CI: 1.25-9.35) in the composition of respondents’ networks were associated with overweight/obesity. Higher composition of family members (AOR = 3.54, CI: 1.09-11.48) was associated with hypertension. Respondents whose networks composed of higher numbers of advice individuals (AOR = 0.88, CI: 0.77-0.99), female respondents (AOR = 0.52, CI: 0.35-0.77) and foreign-born respondents (AOR = 0.54, CI: 0.32-0.92) were less likely to report overweight/obesity. Diabetes was associated with higher composition of individuals living within 5-minutes to respondents (AOR = 5.13, CI: 1.04-25.21). Conclusion: Family and network support members such as advice individuals could be potential targets for chronic disease prevention, particularly among older adults and immigrants.

Diabetes prevalence has been rising exponentially, increasing the need for reliable noninvasive approaches for glucose monitoring. Different biofluids have been explored recently for replacing current blood finger-stick glucose strips with noninvasive painless sensing devices. While sweat has received considerable attention, there are mixed reports on correlating the sweat results with blood glucose levels. Here, we demonstrate a new rapid and reliable approach that combines a simple touch-based fingertip sweat electrochemical sensor with a new algorithm that addresses for personal variations toward the accurate estimate of blood glucose concentrations. The new painless and simple glucose self-testing protocol leverages the fast sweat rate on the fingertip for rapid assays of natural perspiration, without any sweat stimulation, along with the personalized sweat-response-to-blood concentration translation. A reliable estimate of the blood glucose sensing concentrations can thus be realized through a simple one-time personal precalibration. Such system training leads to a substantially improved accuracy with a Pearson correlation coefficient higher than 0.95, along with an overall mean absolute relative difference of 7.79%, with 100% paired points residing in the A + B region of the Clarke error grid. The speed and simplicity of the touch-based blood-free fingertip sweat assay, and the elimination of periodic blood calibrations, should lead to frequent self-testing of glucose and enhanced patient compliance toward the improved management of diabetes.

Amaç: COVID-19 hastalarında diyabet prevalansını ve diyabetin COVID-19 hastalığının seyrine etkisini araştırmayı amaçladık.Gereç ve Yöntemler: Çalışmaya 01/06/2020-30/10/2020 tarihleri arasında İstanbul Sancaktepe Şehit Prof.Dr. İlhan Varank Eğitim ve Araştırma Hastanesi'nde COVID-19 tanısı alan hastalar dahil edildi.Hastane bilgi yönetim sisteminden hastaların tıbbi kayıtları araştırıldı.Hastaların tıbbi geçmişlerini,PCR test sonuçlarını,kan testi sonuçlarını,bilgisayarlı tomografi raporlarını,hastaneye yatış durumlarını ve tedavi sonuçlarını incelendi. Bulgular: Çalışmaya 1145 kadın ve 1269 erkek olmak üzere toplam 2414 hasta dahil edildi.Tüm gruptaki diyabet prevalansı % 18.6 saptandı. Diyabetiklerde; hastaneye yatış oranı ve yoğun bakıma yatış oranı diyabetik olmayanlara göre anlamlı olarak daha yüksekti. Diyabetik grupta, hastanede ve yoğun bakımda yatış süreleri anlamlı olarak daha yüksekti. Diyabetiklerde,tomografide pnömoni varlığı oranı anlamlı olarak daha yüksektiDiyabetik hastalarda ölüm oranı daha yüksekti.Sonuç: Diyabet, COVID-19 hastalarında daha kötü klinik sonuçlara yol açabilir. COVID-19, diyabetik hastalarda daha ölümcül olabilir., Aim: We aimed to investigate the prevalence of diabetes in COVID-19 patients and the effect of diabetes on the course of COVID-19 disease.Material and Methods: Patients diagnosed with COVID-19 disease in Istanbul Sancaktepe Martyr Prof. Dr. Ilhan Varank Training and Research Hospital between 01/06/2020 and 30/10/2020 were included in the study. Medical records of patients were analyzed from the hospital information management system. We examined medical history, PCR test results, blood test results, computerised tomographyreports, hospitalization and treatment results.Results: 2414 patients, 1145 females and 1269 males were included in the study. The diabetes prevalence in the whole group was 18.6%. The rate of hospitalization and the rate of admission to intensive care unit was significantly higher in diabetics than non-diabetics. In the diabetic group; total length of stay in hospital and intensive care unit was significiantly higher. The rate of presence of pneumonia ontomography was significantly higher in diabetics. The mortality rate was significiantly higher in diabetics than non-diabetics.Conclusion: We found the prevalence of diabetes in COVID-19 patients to be 18.6%. The rate of presence of pneumonia on thorax CT, the rate of hospitalization and the rate of admission to the intensive care unit were found to be significantly higher in diabetics. The mortality rate was found to be higher in COVID-19 patients with diabetes. Diabetes mellitus may lead to worse clinical outcomes inCOVID-19 patients. COVID-19 may be more mortal in diabetic patients.

INTRODUCTION AND OBJECTIVES Little is known about changes in cardiovascular risk factors (CVRF) profile over time in patients presenting with acute myocardial infarction (AMI). METHODS We assessed changes in age and CVRF profile in consecutive AMI patients enrolled in the Swiss nationwide AMIS Plus registry between January 1, 1997 and December 31, 2018. RESULTS A total of 57,995 AMI patients were included in the analysis. Mean age at presentation was 71.5±11.3 years for women and 63.9±12.8 years for men and did not change over time. Overall, the mean (standard deviation) number of CVRF increased from 1.76 (1.07) in 1997/98 to 2.26 (1.10) in 2017/18 in men (P$_{trend}$

OBJECTIVE To investigate the trends in diabetes prevalence, diagnosis, and management among Mexican adults who were participants in a long-term prospective study. RESEARCH DESIGN AND METHODS From 1998 to 2004, 159,755 adults from Mexico City were recruited to a prospective study, and from 2015 to 2019, 10,144 survivors were resurveyed. Diabetes was defined as self-reported diagnosis, glucose-lowering medication use, or HbA1c ≥6.5%. Controlled diabetes was defined as HbA1c RESULTS During 1998–2004 and 2015–2019, 99,623 and 8,986 participants were aged 45–84 years. Diabetes prevalence had increased from 26% in 1998–2004 to 35% by 2015–2019. Of those with diabetes, the proportion previously diagnosed had increased from 76% to 89%, and glucose-lowering medication use among them had increased from 80% to 94%. Median HbA1c among those with diabetes had decreased from 8.2% to 7.3%, and the proportion of participants with controlled diabetes had increased from 16% to 37%. Use of blood pressure–lowering medication among those with previously diagnosed diabetes had increased from 35% to 51%, and their use of lipid-lowering therapy had increased from 1% to 14%. The excess mortality risk associated with diabetes accounted for 34% of deaths at ages 35–74 years, of which 5% were attributable to controlled and 29% to inadequately controlled diabetes. CONCLUSIONS Inadequately controlled diabetes is a leading cause of premature adult death in Mexico. Improvements in diabetes management have increased diagnosis and control, but substantial opportunities remain to improve treatment, particularly with lipid-lowering therapy.

This paper studies the context of 39 different countries’ healthcare systems up to 2019 by applying the output-oriented variable return-to-scale model (VRS) of data envelopment analysis. 4 input variables (health expenditure per capita and beds, physicians, and nurses per thousand people) should result in the best 4 output results (life expectancy at birth, death rate per thousand people by communicable and non-communicable diseases, percentage of diabetes prevalence and mortality of cardiovascular diseases, cancer, diabetes or chronic respiratory disease). Efficient and super-efficient systems are identified and Mexico’s system is discussed as an example.