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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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

In a nationwide study of 3818 charts from patients with fatal COVID-19, we found that geographical differences in Dipeptidyl peptidase 4 (DPP4) inhibitors use did not correlate with diabetes prevalence among COVID-19 deaths, thus not supporting the hypothesis of a clinically relevant involvement of DPP4 inhibition in COVID-19 development and progression.

In 2019, global diabetes prevalence was 463 million. Diabetes increases the risk of TB and adverse treatment outcomes including death and relapse. Diabetes also increases the risk of severe disease, multi-organ failure, coagulopathy and death in COVID-19. TB and COVID-19 share many features, suggesting opportunities to integrate prevention, diagnosis and care. Three areas for further work are highlighted: better infection control in diabetes clinics, easier and quicker diagnosis using similar technology platforms and optimal blood glucose control. The funding and resources for COVID-19 should be harnessed to improve TB and diabetes care and achieve their respective sustainable development goal targets.

IntroductionDiabetes prevalence continues to grow and there remains a significant diagnostic gap in one-third of the US population that has pre-diabetes. Innovative, practical strategies to improve monitoring of glycemic health are desperately needed. In this proof-of-concept study, we explore the relationship between non-invasive wearables and glycemic metrics and demonstrate the feasibility of using non-invasive wearables to estimate glycemic metrics, including hemoglobin A1c (HbA1c) and glucose variability metrics.Research design and methodsWe recorded over 25 000 measurements from a continuous glucose monitor (CGM) with simultaneous wrist-worn wearable (skin temperature, electrodermal activity, heart rate, and accelerometry sensors) data over 8–10 days in 16 participants with normal glycemic state and pre-diabetes (HbA1c 5.2–6.4). We used data from the wearable to develop machine learning models to predict HbA1c recorded on day 0 and glucose variability calculated from the CGM. We tested the accuracy of the HbA1c model on a retrospective, external validation cohort of 10 additional participants and compared results against CGM-based HbA1c estimation models.ResultsA total of 250 days of data from 26 participants were collected. Out of the 27 models of glucose variability metrics that we developed using non-invasive wearables, 11 of the models achieved high accuracy (ConclusionsThis study demonstrates the feasibility of using non-invasive wearables to estimate glucose variability metrics and HbA1c for glycemic monitoring and investigates the relationship between non-invasive wearables and the glycemic metrics of glucose variability and HbA1c. The methods used in this study can be used to inform future studies confirming the results of this proof-of-concept study.

Background The coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM) are at high risk of fatal outcomes. This meta-analysis quantifies the prevalence of mortality among (1) diabetic and (2) non-diabetic, and (3) the prevalence of DM, in hospitalized COVID-19 patients. Methods Published studies were retrieved from four electronic databases (PubMed, Embase, Scopus, and medRxiv) and appraised critically utilizing the National Heart, Lung, and Blood Institute’s tool. Meta-analyses were performed using the random-effects model. The measures of heterogeneity were ascertained by I- squared (I2) and Chi-squared (Chi2) tests statistics. Predictors of heterogeneity were quantified using meta-regression models. Results Of the reviewed 475 publications, 22 studies (chiefly case series (59.09 %)), sourcing data of 45,775 hospitalized COVID-19 patients, were deemed eligible. The weighted prevalence of mortality in hospitlized COVID-19 patients with DM (20.0 %, 95 % CI: 15.0–26.0; I2, 96.8 %) was 82 % (1.82-time) higher than that in non-DM patients (11.0 %, 95 % CI: 5.0–16.0; I2, 99.3 %). The prevalence of mortality among DM patients was highest in Europe (28.0 %; 95 % CI: 14.0–44.0) followed by the United States (20.0 %, 95 % CI: 11.0–32.0) and Asia (17.0 %, 95 % CI: 8.0–28.0). Sample size and severity of the COVID-19 were associated (p

Introduction: First Nations communities are known to have high rates of diabetes. The rural First Nations communities in northwest (NW) Ontario are particularly affected. Regional studies in 1985 and 1994 found a high prevalence of diabetes. More recently, they are estimated to have the highest prevalence in Ontario at 19%, double the provincial norm. The purpose of this study is to examine the epidemiology and prevalence of diabetes in the total population and cardiovascular comorbidities in the adult population of 25 First Nations communities in NW Ontario. Methods: This retrospective diabetes prevalence study used primary care electronic medical record data for a 3-year period, 1 August 2014–31 July 2017. Diabetes prevalence was calculated for both the total and the adult (18+) populations and comorbid hypertension and dyslipidaemia were identified in adults. Results: The age-adjusted diabetes prevalence for the total population was 15.1% versus a Canadian prevalence of 8.8%. The age-adjusted adult prevalence was 14.1%, double Canada's average of 7.1%. The average age of adults with diabetes was 52 years (±14.9); 57% were female. Comorbid hypertension (58%) and dyslipidaemia (73%) were common. Metformin was the most commonly used medication (58%), followed by insulin/analogues (23%) and sulphonylureas (13%). Conclusion: The diabetes prevalence in the First Nations population of NW Ontario is double Canada's norm. Addressing it will require addressing relevant social determinants of health, including poverty and food security.

Background: This study aimed to estimate the prevalence of diabetes and prediabetes in adults in Kuwait. Methods: The Kuwait Diabetes Epidemiology Program was a nationally representative, cross-sectional study of diabetes and obesity in Kuwait conducted between 2011 and 2014. The survey sampled 4937 adults in Kuwait aged 20 years or more and recorded participants&rsquo, demographics, behaviours, medical history, physical measurements and blood biochemical measurements. Prediabetes was defined as fasting plasma glucose between 6.1 and 6.9 mmol/L or HbA1c between 6 and 6.4% (42&ndash, 47 mmol/mol). Diabetes was defined as self-reported history with prescribed glucose-lowering medication or FPG &ge, 7mmol/L or HbA1c level &ge, 6.5% (&ge, 48 mmol/mol). Results: The overall adjusted prevalence of diabetes was 19.1%. The overall adjusted prevalence of prediabetes was 13.5%. Diabetes prevalence was 5.4%, 14.2%, 38.7% and 64.8% in adults aged 20&ndash, 29, 30&ndash, 44, 45&ndash, 59 and 60 years or more, respectively. Diabetes prevalence was 22.4% in men and 14.4% in women. Prediabetes prevalence was 14.8% in men and 11.5% in women. In Kuwaitis, diabetes and prediabetes prevalence was 21.8% and 11.1%, respectively, while prevalence in non-Kuwaitis was 18.2% for diabetes and 14.3% for prediabetes. Conclusion: These findings illustrate the severe public health challenge posed by diabetes in Kuwait.

Purpose of Review Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes. Recent Findings The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. Summary The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region.

To control and prevent the risk of diabetes, diabetes studies have identified the need to better understand and evaluate the associations between influencing indicators and the prevalence of diabetes. One constraint has been that influencing indicators have been selected mainly based on subjective judgment and tested using traditional statistical modeling methods. We proposed a framework new to diabetes studies using data‐driven and spatial methods to identify the most significant influential determinants of diabetes automatically and estimated their relationships. We used data from diabetes mellitus patients' health insurance records in Shandong province, China, and collected influencing indicators of diabetes prevalence at the county level in the sociodemographic, economic, education, and geographical environment domains. We specified a framework to identify automatically the most influential determinants of diabetes, and then established the relationship between these selected influencing indicators and diabetes prevalence. Our autocorrelation results showed that the diabetes prevalence in 12 Shandong cities was significantly clustered (Moran's I = 0.328, p, Key Points The significant spatial clusters of diabetes prevalence exist in the coastal northeast and northwest counties in Shandong Province, ChinaA methodological improvement combined data‐driven and spatial methods is proposed to identify automatically significant indicatorsSeveral economic, sociodemographic, education, and geographic environment indicators are found to be associated with diabetes prevalence

Background Despite Israel’s universal health coverage, disparities in health services provision may still exist. We aimed to assess socioeconomic disparities in diabetes prevalence and quality of care among Israeli children, and to assess whether these changed over time. Methods We used repeated cross-sectional analyses in the setting of the National Program for Quality Indicators in Community Healthcare. The data were derived from electronic medical records from Israel’s four health maintenance organizations. The study population included all Israeli children aged 2–17 years in 2011–2018 (2018: N = 2,404,856). Socio-economic position (SEP) was measured using Central Bureau of Statistics data further updated by a private company (Points Business Mapping Ltd), and grouped into 4 categories, ranging from 1 (lowest) to 4 (highest). We used logistic regression to assess the association of SEP with diabetes prevalence, diabetes clinic visits, hemoglobin A1C (HbA1C) testing, and poor glycemic control (HbA1c > 9%), and assessed whether these changed over time. Results Diabetes prevalence increased with age and SEP, with a total of 3019 children with diabetes. SEP was positively associated with visiting a specialized diabetes clinic (age and sex adjusted Odds Ratio (aORSEP 4 vs. 1 2.45, 95% Confidence Interval (CI) 1.67–3.69)). Although children in higher SEPs were less likely to undergo HbA1c testing (aORSEP 4 vs. 1 0.54, 95% CI 0.40–0.72), they were also less likely to have poor glycemic control (aORSEP 4 vs. 1 0.25, 95% CI 0.18–0.34). Disparities were especially apparent among children aged 2–9 (6.5% poor glycemic control in SEP 4 vs. 38.2% in SEP 1). Poor glycemic control decreased over time, from 44.0% in 2011 to 34.1% in 2018. Conclusions While poor glycemic control rates among children have improved, they remain high compared to rates in adults. Additionally, substantial socioeconomic gaps remain. It is eminent to study the causes of these disparities and develop policies to improve care provided to children in the lower SEP levels, to promote health equity.

Objective The objective of this study was to evaluate the pooled estimate of diabetes prevalence in young (50 years) COVID-19 cohorts. Methods Studies published between December-2019 and March-2020 reporting demographic and clinical characteristics of COVID-19 cases were identified. A total of 11 studies included accounting for 2084 COVID-19 patients. Results The overall prevalence of diabetes in COVID-19 patients with a mean age>50 years was 13.2%, whereas studies with relatively younger patients (mean age, Highlights • Prevalence of diabetes in the elderly (age >50 years) COVID-19 patients ranged from 10% to 17%. • Information about diabetes with other cardiovascular risk factors and the role of antidiabetic medicines remains limited in COVID-19 patients.

The IDF (International Diabetes Federation) Diabetes Atlas Committee has recently published the global estimates of diabetes prevalence for 2019 [...]

Introduction Diabetes is a major public health problem that is strongly influenced by lifestyle-related factors, with previous epidemiologic studies finding an inverse relationship between physical activity and the prevalence of diabetes. We aimed to quantify the prevalence of diabetes and determine whether a dose-response relationship is present between physical activity levels and diabetes. Methods Population characteristics were compared between diabetic and nondiabetic subjects. Multiple logistic regression models were used to assess the association between different levels of physical activity and diabetes. Restricted cubic spline analysis was used to examine the dose-response relationship between physical activity and diabetes prevalence. Results Compared with those in the lowest physical activity quartile, participants in the highest quartile had a 42% lower prevalence of diabetes (odds ratio = 0.58, 95% confidence interval = 0.44–0.75, p

Introduction: Diabetes is a critical health issue that impacts over 422 million people worldwide to include more than 500 000 children. Diabetes prevalence is higher in rural areas compared to urban areas and people living with diabetes in rural areas face significant challenges to care. Children with diabetes need appropriate care in the school setting to reduce the risk of short- and long-term complications. The inconsistencies of laws surrounding diabetes care in schools and lack of access to resources has resulted in insufficient training and poor provision of care to students, particularly in rural areas. The purpose of this study was to analyze the impact of the online diabetes education program Diabetes Care at School: Bridging the Gap on the diabetes knowledge and self-efficacy of school personnel in rural areas to administer care to students with diabetes. Methods: A total of 132 participants working in rural school districts throughout South Central Texas completed the program. A pretest-post-test design was used to measure knowledge and self-efficacy before and after completion of the 12-module online diabetes education program for school personnel. Knowledge and confidence to administer care change scores were compared, and user satisfaction with the online program was analyzed. Results: Results of this study showed a significant increase in the knowledge and confidence scores of the participants from pre- to post-test. Although the non-medical school personnel had baseline knowledge and confidence scores that were lower than the school nurses, they had significant change scores, resulting in similar post-test scores. Furthermore, those with no prior diabetes training had significant change in knowledge and confidence, resulting in post-test scores that were almost equivalent to those with prior diabetes training. Conclusion: As the prevalence of school-aged children with diabetes continues to increase, an important finding of this study is that online programs with up-to-date information on diabetes care may enhance the ability of school personnel to include both lay/non-medical individuals and school nurses to effectively manage the care of students with diabetes. With up-to-date diabetic information delivered in a user-friendly and accessible format, more school personnel in rural and remote areas can be trained. Ultimately, ensuring that staff receive adequate training on diabetes and possess the confidence to administer care should improve outcomes for students with diabetes in rural, remote and underserved areas.

Background: Diabetes prevalence continues to be a concern and the management of diabetes is important but costly. The prevalence of diabetes is greater among persons with a low income, including those who are uninsured or underinsured. Student-run free clinics (SRFC) are one resource to these patients who may otherwise lack access to medical care. Objective: The purpose of this study was to assess patient satisfaction with diabetes care at a SRFC in order to assist in identifying areas of improvement. Methods: A quality improvement survey was designed to assess patient satisfaction with overall care, as well as with routines and perception of care related to self-management, healthy eating, and exercise. Results: The survey was completed by 25 patients at a Toledo area SRFC. Established patients who were aged 18 years or older and diagnosed with diabetes, were invited to complete the survey. The majority of patients were satisfied with their diabetes care at the SRFC (88%). Fewer patients, however, reported satisfaction with the treatment for their diabetes (72%) and with their knowledge about diabetes (76%). Subanalyses of survey responses also showed significant differences when comparing sex, age, and length of diabetes diagnosis. Conclusions: The survey helped identify key areas in which the diabetes care provided at the SRFC could be improved. These areas included education about diabetes in general, as well as in understanding treatment, self-monitoring, and healthy eating and exercise options. Future research could explore survey results after specifying and implementing changes made to the education provided to the patients.

Importance: There was little data on the distribution of blood glucose levels and diabetes prevalence for centenarians and the oldest-old. Objective: The aim of this study is to analyzed the distribution of blood glucose and diabetes prevalence for centenarians and oldest-old in China:Based on the China Hainan Centenarian Cohort Study (CHCCS) and China Hainan Oldest-old Cohort Study (CHOCS). Design, setting and participants A total of 1002 centenarians and 798 oldest-old were enrolled from 18 cities and counties in Hainan Province (one of the longevity provinces). Main Outcomes and Measures: The fasting blood glucose was tested and prevalence of diabetes was calculated. Results: The average age of centenarians was 102.77±2.55 years old, 82.0% were women. The average age of the oldest-old was 84.99±4.01 years old, 59.9% were women. The average blood glucose of centenarians was 5.12±1.44mmol/L and 4.80±1.27mmol/L, and more than 70% were between 3.00mmol/L and 5.99mmol/L. There was no statistical difference between different genders and age groups. A total of 9.5% of centenarians had diabetes and 8.1% had IFG. A total of 11.4% of the oldest-old had diabetes and 4.4% had IFG. Abdominal obesity and TG levels may be associated with diabetes prevalence. The corresponding ORs were 1.517(1.083-2.125) and 1.473(1.089-1.943) respectively of abdominal obesity among centenarians and the oldest-old respectively, and corresponding ORs 1.182(1.081-1.316) and 1.162(1.009-1.699) respectively of abdominal obesity among centenarians and the oldest-old respectively Conclusions and Relevance: In summary, the results based on CHCCS with the largest sample among centenarians and CHOCS showed that the blood glucose level and the prevalence of diabetes were at a lower level than those of adults or younger elderly. Funding Statement: This work was supported by National Natural Science Foundation (81703285,81773502,81703308), Beijing Nova Program (Z181100006218085), Excellent youth project (2018-yqpy-003); "3+1" project; National Clinical Research Center for Geriatrics Diseases（NCRCG-PLAGH-2017017）,Medical big data research project of PLA General Hospital (2018MBD-029, 2018MBD-030); National key research and development project (2016YFC1303603, 2018YFC2000400); National Science and technology resource sharing service platform plan project (YCZYPT[2018]07) Declaration of Interests: The authors declare that there is no duality of interest associated with this manuscript. Ethics Approval Statement: This study was approved by the Biomedical Ethics Committee of Chinese PLA general hospital, and written informed consent with signature or fingerprint was obtained from each respondent.

Global diabetes prevalence is projected to rise from 382 million in 2013 to 592 million in 2030 with type 2 diabetes (T2D) accounting for 90–95% of cases(1,2). Approximately 4.7 million people in the UK had diabetes in 2018, this is estimated to rise to over 5 million by 2025(2) costing the NHS £15.1bn by 2035(3).Low-fat vegan (LFV) diets are associated with improvements in T2D biomarkers(4) however, to date no systematic review has evaluated the effectiveness of LFV diets in prevention and management of T2D. The aim of this study was to assess effects of LFV diets on T2D biomarkers in controlled trials for those with, or at risk of developing T2D.The review followed the PRISMA checklist for systematic reviews and used Cochrane Collaboration search strategies, which support the identification of randomised controlled trials (RCT's)(5). Searches were conducted and titles and abstracts screened for relevance by two independent review authors (AW or KEL). Studies that evaluated a LFV diet to reduce the risk of, or manage T2D using controlled trials were included with publication range from January 2003 to June 2018.Search criteria identified 130 articles, which reduced to 21 upon abstract and title screening. Further application of inclusion/exclusion criteria led to identification of six key studies. Four studies were RCT's, and two were cluster-controlled trials at corporate sites, one of which was randomised. In three of the studies participants were previously diagnosed with T2D, in two of the studies participants had a BMI ≥ 25 kg/m2 and/or were previously diagnosed with T2D, and one study had participants with BMI between 28 and 40 kg/m2. Four studies had a control group (non-intervention) two of which had a conventional diabetes diet (American Dietetic Association(6)) as a comparison group. Mean study length was 28.3 weeks; ranging from 16–74 weeks. An intention-to-treat and medication adjusted analysis was carried out; significant effects for BMI, body weight, HbA1c, fasting plasma glucose, LDL, HDL and total cholesterol were reported in most of the studies.Results from this systematic review demonstrate that a LFV diet is an effective alternative therapy to improve T2D biomarkers in those with, or at elevated risk of developing the disease. The LFV diet showed consistent positive effects on T2D biomarkers. Its effects are comparable to conventional T2D diets and energy restrictive diets, despite absence of restrictions on energy intake or portion sizes.

The diagnostic criteria for Diabetes mellitus have been modified from those previously recommended by the NDDG or WHO. Three ways to diagnose Diabetes are possible, and each must be confirmed, on a subsequent day, by any one of the three methods. For example, one instance of symptoms with casual plasma glucose >200 mg/dl (11.1 mmol/l), confirmed on a subsequent day by 1)^PG >126 mg/dl (7.0 mmol/l), 2) an OGTT with the 2- h postload value >200 mg/dl (11.1 mmol/l), or 3) symptoms with a casual plasma glucose >200 mg/dl (11.1 mmol/l), warrants the diagnosis of Diabetes.For epidemiological studies, estimates of Diabetes prevalence and incidence should be based on an FPG >126 mg/dl (7.0 mmol/l). This recommendation has been made in the interest of standardization and also to facilitate field-work, particularly where the OGTT may be difficult to perform and where the cost and demands on participants' time may be excessive.

We conducted three single-day point type 2 diabetes prevalence surveys of all inpatient clinical records in November 2013, 2014 and 2016. The prevalence of diabetes was 19.7-25.3%. The majority (63.4-76%) had type 2 diabetes. Twenty-one percent (n = 21) in 2013, 12% (n = 9) in 2014 and 22.6% (n = 21) in 2016 were diagnosed with diabetes during hospital admission; 41.8% (n = 41) in 2013, 46.7% (n = 35) in 2014 and 51.6% (n = 48) in 2016 required insulin. The high prevalence of diabetes among inpatients mandates active detection and specialist management of diabetes during the admission.

Objectives Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. Methods The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis were extracted or if possible calculated. Results From the 803 titles and abstracts that came out of the search, 29papers met the initial criteria. Prevalence of diabetes was 9.4% among subjects with periodontitis and 12.8%among subjects without periodontitis. Based on sub-analysis, for subjects with periodontitis, the prevalence of diabetes was 6.5%when diabetes was self-reported, compared to 17.3%when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries(17.2%,n=16647) and the lowest in studies describing populations from Europe(4.3%(n=7858). The overall odds ratio for diabetes patients to be among subjects with periodontitis as compared to those without periodontitis was 2.59(95%CI[2.12;3.15]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. Conclusions The overall prevalence and odds of having diabetes is higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe. This article is protected by copyright. All rights reserved.

The rates of obesity and type 2 diabetes (T2D) are much higher in patients with chronic mental illness compared to the general population1. Second-generation antipsychotic medications (SGA) are clearly contributory to these adverse metabolic phenotypes2. Thus, annual monitoring of fasting plasma glucose (FPG) levels is recommended to screen for T2D in patients on SGA3. Of note, FPG, and also HbA1c, have poor sensitivities in detecting T2D early, with nearly 50% of cases being missed using either of the above tests when compared to oral Glucose Tolerance Testing (oGTT,4). We thus screened patients with schizophrenia, schizoaffective or bipolar disorder on SGA per oGTT. We hypothesized that we would identify more patients with T2D per oGTT compared to FPG or HbA1c testing alone. To identify risk factors for T2D, we also assessed BMI, waist/hip ratio, blood pressure, dietary habits (UKDDQ = UK Diabetes and Diet Questionnaire), physical activity records (3d pedometer records), measures of psychopathology, cognition (PHQ-9 = Patient Health Questionnaire, SLUMS = Saint Louis University Mental Status exam) as well as HOMA IR (Homeostatic Model Assessment of Insulin Resistance), Matsuda index and lipid profile. Data were analyzed using SPSS, comparing normal and prediabetic patients to patients with T2D (per oGTT criteria). Thus far, we screened 22 patients per oGTT and newly identified 5 patients with T2D (23%), only one patient had T2D per HbA1c criterion, 4 were identified per elevated FPG, 3 patients had elevated 2h plasma glucose levels. Patients with T2D had significantly lower Matsuda indices (p

Type 2 diabetes mellitus is a major chronic disease worldwide. Over the next decade, the largest increase in diabetes prevalence is expected to be in those > 75 years old. Diabetes self-care and prevention of complications can be challenging, but, when combined with the demands of self-care for other chronic conditions, it can become overwhelming to patients and caregivers. The glycemic targets and treatment options are unique to older adults. Clinicians should treat elderly patients with diabetes based on comorbid conditions, functional status, and life expectancy using a person-centered, team-based approach.

ObjectiveBMI is a proxy for fat accumulation in the body. Increased diabetes and CVD risks have been observed for Asian populations at lower BMI than the WHO-recommended BMI cut-off points for overweight (≥25·0 kg/m2) and obesity (≥30·0 kg/m2). The current study aimed to quantify the increased hypertension (HTN) and type 2 diabetes mellitus (T2DM) prevalence in Bangladeshi adults with moderately increased BMI (23·0–24·9 kg/m2).DesignData from the most recent Bangladesh Demographic and Health Survey (2011) were analysed. Modified Poisson regression models with robust error variance were used to calculate prevalence ratios (PR) for HTN or T2DM by BMI category, considering BMI=18·5–22·9 kg/m2 as the reference. All analyses incorporated the complex sampling design of the survey.SettingBMI, blood pressure, blood sugar and related information were collected from a nationally representative sample.SubjectsAdults (n 7433) aged≥35 years.ResultsAbout 12 % of Bangladeshi adults, both male and female, were within the BMI range 23·0–24·9 kg/m2 or moderately overweight. Compared with the reference BMI group (18·5–22·9 kg/m2), they had an increased PR for HTN (1·55–1·77) and T2DM (1·54–1·93). These increased PR are similar to those for the WHO-defined overweight group (BMI=25·0–29·9 kg/m2).ConclusionsOur findings support the recommendation that calls for setting the optimum BMI for Asian populations to 18·5–23·0 kg/m2 for health promotion and for public health interventions like leisure-time physical activity. WHO cut-off points for overweight (≥25 kg/m2) should be used to facilitate international comparisons.

In 2019, global diabetes prevalence was 463 million. Diabetes increases the risk of TB and adverse treatment outcomes including death and relapse. Diabetes also increases the risk of severe disease, multi-organ failure, coagulopathy and death in COVID-19. TB and COVID-19 share many features, suggesting opportunities to integrate prevention, diagnosis and care. Three areas for further work are highlighted: better infection control in diabetes clinics, easier and quicker diagnosis using similar technology platforms and optimal blood glucose control. The funding and resources for COVID-19 should be harnessed to improve TB and diabetes care and achieve their respective sustainable development goal targets.

As diabetes prevalence in the UK continues to rise, primary care health professionals will need to be prepared to meet this demand. Anne Phillips, from the iDeal Advisory Group, explains how their new White Paper sets out plans to improve care pathways

Background In 2004, a survey in Yangon Region was conducted as the first STEP survey in Myanmar, which was repeated in 2014, assessing diabetes prevalence. Whether there have been any changes over time in the awareness, treatment and control status of diabetes is not known. The study aimed to assess changes in the prevalence, awareness, treatment and control of diabetes from 2004 to 2014, among adults in Yangon region. Methods The study was conducted in urban and rural areas of Yangon region, Myanmar, using two cross-sectional household based studies, in accordance with World Health Organization STEPS methodology. Men and women aged 25-74 years old participated in the studies (n = 4448 in 2004) and (n = 1372 in 2014). Logistic and linear regression were performed and outcome variables were diabetes and fasting plasma glucose. Results The overall age-standardized prevalence of diabetes were 8.3% (95% CI 6.5-10.6) in 2004 and 10.2% (7.6-13.6) in 2014 (p = 0.296). The diabetes prevalence increased from 2004 to 2014 only among participants aged ≥60 years, from 14.6% (11.7-18.1) to 31.9% (21.1-45.0) (p = 0.009). Awareness of having diabetes increased between 2004 and 2014 (44.3% (39.2, 49.6) to 69.4% (62.9-75.2)) (p < 0.001). Among participants who were aware of having diabetes, the proportion under treatment had increased between 2004 and 2014 from 55.1% (46.8-63.1) to 68.6% (61.5-74.8) (p = 0.015). There were no increase between 2004 and 2014 in the proportion of participants with controlled diabetes. After adjustments for age, sex and education, mean fasting plasma glucose levels in 2014 was 0.56 mmol/l (0.26-0.84) higher than in 2004. Conclusions The studies to monitor the development of diabetes prevalence in Myanmar are needed. Preventive measures to halt increases prevalence, to increase the detection rate of undiagnosed DM also treatment rate and to help people with diabetes to control their situation are needed. Key messages Mean plasma glucose levels were higher in 2014 than in 2004, but an increase in DM prevalence during this period was seen only among the oldest participants. The proportion of women being aware of having DM, as well as the proportion under treatment for most groups, had increased, however not the proportion under control.

Background Helicobacter pylori (H. Pylori) infection and hyperglycemia may be associated with an increased risk of colorectal neoplasm. However these two factors 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. Methods We conducted a 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 < 6%(Group 1); between 6 to 8%(Group 2); between 8 to 10 %(Group 3) and more than 10%(Group 4). The random effects model had used to calculate pooled prevalence estimates with 95% confidence interval [CI]. Results Twenty seven studies were finally eligible for meta-analysis. The random-effects model of meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.51 (95 % CI 1.39–1.63). The subgroup meta-analyses showed in Group 1 the H. pylori infection associated colorectal adenoma risk OR was 1.24 (95 % CI 0.86–1.78). As diabetes rate exceed 6%, the H. pylori infection became more significant increased risk of colorectal adenoma (Group 2: OR 2.16 (95 % CI 1.61–2.91); Group 3: OR 1.40 (95 % CI 1.24–1.57); Group 4: OR 1.52 (95 % CI 1.46–1.57)). Conclusions The results of this meta-analysis showed DM prevalence would affect the risk factor of colorectal adenoma with H. pylori infection.