Showing papers in "Journal of diabetes and metabolic disorders in 2020"
TL;DR: All research carried out on the mental health status of health care workers (HCWs) to bring policymakers and managers’ attention is reviewed to recommend the supportive, encouragement & motivational, protective, and training & educational interventions.
Abstract: The novel coronavirus 2019 (COVID-19) is widely spreading all over the world, causing mental health problems for most people. The medical staff is also under considerable psychological pressure. This study aimed to review all research carried out on the mental health status of health care workers (HCWs) to bring policymakers and managers’ attention. A literature search conducted through e-databases, including PubMed, EMBASE, Scopus, and Web of Science (WoS) from December 2019 up to April 12th 2020. All cross- sectional studies published in English which assessed the health workers’ psychological well-being during the SARS-CoV-2 pandemic included. Study quality was analyzed using NHLBI Study Quality assessment tools. One hundred relevant articles were identified through systematic search; of which eleven studies were eligible for this review. Their quality score was acceptable. The lowest reported prevalence of anxiety, depression, and stress among HCWs was 24.1%, 12.1%, and 29.8%, respectively. In addition, the highest reported values for the aforementioned parameters were 67.55%, 55.89%, and 62.99%, respectively. Nurses, female workers, front-line health care workers, younger medical staff, and workers in areas with higher infection rates reported more severe degrees of all psychological symptoms than other health care workers. Moreover, vicarious traumatization in non-front-line nurses and the general public was higher than that of the front-line nurses. During SARS-CoV-2 outbreak, the health care workers face aggravated psychological pressure and even mental illness. It would be recommended to the policymakers and managers to adopt the supportive, encouragement & motivational, protective, and training & educational interventions, especially through information and communication platform.
364 citations
TL;DR: A methodology for diabetes prediction using a diverse machine learning algorithm using the PIMA dataset is presented to develop a novel automatic prognosis tool that can be helpful in early detection of the disease.
Abstract: International Diabetes Federation (IDF) stated that 382 million people are living with diabetes worldwide. Over the last few years, the impact of diabetes has been increased drastically, which makes it a global threat. At present, Diabetes has steadily been listed in the top position as a major cause of death. The number of affected people will reach up to 629 million i.e. 48% increase by 2045. However, diabetes is largely preventable and can be avoided by making lifestyle changes. These changes can also lower the chances of developing heart disease and cancer. So, there is a dire need for a prognosis tool that can help the doctors with early detection of the disease and hence can recommend the lifestyle changes required to stop the progression of the deadly disease. Diabetes if untreated may turn into fatal and directly or indirectly invites lot of other diseases such as heart attack, heart failure, brain stroke and many more. Therefore, early detection of diabetes is very significant so that timely action can be taken and the progression of the disease may be prevented to avoid further complications. Healthcare organizations accumulate huge amount of data including Electronic health records, images, omics data, and text but gaining knowledge and insight into the data remains a key challenge. The latest advances in Machine learning technologies can be applied for obtaining hidden patterns, which may diagnose diabetes at an early phase. This research paper presents a methodology for diabetes prediction using a diverse machine learning algorithm using the PIMA dataset. The accuracy achieved by functional classifiers Artificial Neural Network (ANN), Naive Bayes (NB), Decision Tree (DT) and Deep Learning (DL) lies within the range of 90–98%. Among the four of them, DL provides the best results for diabetes onset with an accuracy rate of 98.07% on the PIMA dataset. Hence, this proposed system provides an effective prognostic tool for healthcare officials. The results obtained can be used to develop a novel automatic prognosis tool that can be helpful in early detection of the disease. The outcome of the study confirms that DL provides the best results with the most promising extracted features. DL achieves the accuracy of 98.07% which can be used for further development of the automatic prognosis tool. The accuracy of the DL approach can further be enhanced by including the omics data for prediction of the onset of the disease.
133 citations
TL;DR: The existence of such a high prevalence and severity of psychiatric disorders among hospitalized patients with COVID-19 underscores the need for serious attention to the mental health status of these patients, and health policymakers need to have coherent plans for screening cases and managing related situations.
Abstract: COVID-19, a disease that can be transmitted from person to person and with serious health problems, can be associated with mental health disorders. In this study, we evaluated the prevalence and severity of depression, anxiety, stress, and stress perception among a group of patients with COVID-19 who were hospitalized. In this cross-sectional study, 106 inpatients with COVID-19 who had stable clinical conditions were evaluated psychologically by two questionnaires: Depression, Anxiety and Stress Scales-21 (DASS-21) and Perceived Stress Scale (PSS-4). More than one third of patients had underlying disease. Overall, 97.2% of patients with COVID-19 had some degree of depression. Severity of depression, according to the DASS questionnaire, was 85.8%. All patients (100%) had severe (0.9%) and very severe (99.1%) anxiety. Regarding to stress levels, 97.1% of patients had some degree of stress. In the severity of stress category, 84.9% of patients had severe and very severe stress. In terms of perceived stress, 73.6% of patients had high levels and 22.6% had moderate levels. A positive strong correlation was found between depression and perceived stress (Coefficient: 0.33, P-value: 0.001). Correlation between anxiety and perceived stress was statistically significant (Coefficient: 0.2, P-value: 0.04). The existence of such a high prevalence and severity of psychiatric disorders among hospitalized patients with COVID-19 underscores the need for serious attention to the mental health status of these patients. It seems that health policymakers need to have coherent plans for screening cases and managing related situations.
83 citations
TL;DR: The prevention and management of childhood obesity should be set as a priority at an individual, community and population level during this pandemic.
Abstract: Obesity is a global epidemic based on three major pillars of (i) genetic (ii) behavioural and (iii) environmental determinants. The latter two pillars have been challenged during the course of the COVID-19 pandemic across all population age groups including children. The closure of schools resulted in decreased organised physical activity, increase in sedentary lifestyle and screen time with the possibility of stress-induced indulgence in high calorie dense and sugary foods, resulting in higher susceptibility to weight gain. The uncertainty faced by many Northern Hemisphere governments as the new scholastic year looms closer whether to open schools again or not further enhances the stress on the children and their family. Re-opening of schools is beneficial for children's mental and physical health, and general wellbeing including the 'combating' of the childhood obesity epidemic. The family unit has also been challenged during this pandemic especially if the parent/s suffered redundancy. There have been attempts at seeing a silver lining as some families have embraced lockdowns as a means to strengthen their family bonds, increase homemade meals apart from the various virtual opportunities that were streamed on social media to encourage children to perform physical activity at home or in safe environments. However, curbing the viral spread while protecting population health will remain top priority until an effective COVID-19 vaccine is available. It is imperative to address other co-existing problems such as childhood obesity, which if uncontrolled may have a long-term profound health and economic consequence of higher eminence than the actual COVID-19 infection. The prevention and management of childhood obesity should be set as a priority at an individual, community and population level during this pandemic.
50 citations
TL;DR: Five proteins of COVID-19 and 18 drugs that have either been used currently as antiviral or have been reported to possess antiviral effects are selected as target proteins for drug repositioning and shown highly favorably free binding energies with all tested target proteins.
Abstract: Recently, the world has been dealing with a new type of coronavirus called COVID-19 that in terms of symptoms is similar to the SARS coronavirus. Unfortunately, researchers could not find a registered therapy to treat the infection related to the virus yet. Regarding the fact that drug repurposing is a good strategy for epidemic viral infection, we applied the drug repurposing strategy using virtual screening to identify therapeutic options for COVID-19. For this purpose, five proteins of COVID-19 (3-chymotrypsin-like protease (3CLpro), Papain-Like protease (PLpro), cleavage site, HR1 and RBD in Spike protein) were selected as target proteins for drug repositioning. First, five proteins of COVID-19 were built by homology modeling. Then FDA-approved drugs (2471 drugs) were screened against cleavage site and RBD in Spike protein via virtual screening. One hundred and twenty-eight FDA-approved drugs with the most favorable free-binding energy were attached to the cleavage site and RBD in Spike protein. Of these 128 drugs, 18 drugs have either been used currently as antiviral or have been reported to possess antiviral effects. Virtual screening was then performed for the 18 selected drugs with ACE2, 3CLpro and PLpro and HR1 and TMPRSS2. According to the results, glecaprevir, paritaprevir, simeprevir, ledipasvir, glycyrrhizic acid, TMC-310911, and hesperidin showed highly favorably free binding energies with all tested target proteins. The above-mentioned drugs can be regarded as candidates to treat COVID-19 infections, but further study on the efficiency of these drugs is also necessary.
48 citations
TL;DR: It is suggested that MLR could serve as a predictive and effective marker for DKI in diabetic subjects due to its strong correlation with MA and inexpensive and readily available nature.
Abstract: Inflammation is a cardinal pathogenetic mechanism in diabetic kidney injury (DKI). The detection of microalbuminuria (MA) is very important in preventing end-stage renal failure in diabetic subjects. A combination of high monocyte and low lymphocyte counts are used as a marker of inflammation. Monocyte to lymphocyte ratio (MLR) is considered as a marker in inflammatory diseases. We aimed to evaluate the MLR levels in diabetic subjects as a predictive marker in detecting MA. A total of 212 patients with type 2 diabetes mellitus (T2DM) were included in the study. Patients with T2DM were divided into two groups as MA and normoalbuminuria (NA). MLR of the groups were compared. There were 72 patients in MA and 140 patients in NA group. MLR of the MA and NA groups were 0.247 (0.131–0.540) and 0.211 (0.052–0.390), respectively (p < 0.001). There was a statistically significant correlation between MLR and MA (r = 0.228, p = 0.001). In multivariate backward logistic regression analysis, MLR, fasting blood glucose, HbA1c and presence of comorbid clinical diseases were determined as independent predictors of DKI. We suggest that MLR could serve as a predictive and effective marker for DKI in diabetic subjects due to its strong correlation with MA and inexpensive and readily available nature.
46 citations
TL;DR: Overall, available data from observational and clinical studies indicated a trend for the relationship between MD and hepatic steatosis and improvement in the most important risk factors of NAFLD, i.e. BMI, serum triglycerides, and insulin resistance.
Abstract: Mediterranean diet (MD) is a healthful dietary pattern with benefits for prevention of metabolic diseases including non-alcoholic fatty liver disease (NAFLD). In the current meta-analysis, we assessed the association between MD and liver steatosis and cardiometabolic risk factors in patients with NAFLD. PubMed, Scopus, and Embase were searched to find observational and clinical studies on the issue. No restriction on date and language was made. Outcomes included body mass index (BMI), waist circumference, blood pressure, triglycerides (TG), cholesterol fractions, glucose, insulin, insulin resistance, and liver transaminases. Seven observational reports and 6 trials met our inclusion criteria and entered in the meta-analysis. In observational studies, there was an inverse association between MD and NAFLD (effect size (ES) = 0.95; 95% CI: 0.90, 1.00; P = 0.05). In trials, subgroup analysis based on the method of liver examination showed effectiveness of MD on steatosis examined by magnetic resonance spectroscopy (P < 0.002; n = 2) but not by ultrasound (P = 0.08; n = 2). MD also showed a significant decreasing effect on BMI (ES = −1.23 kg/m2; 95% CI: −2.38, −0.09), plasma triglycerides (ES = −33.01 mg/dL; 95% CI: −52.84, −13.18), and HOMA-IR (ES = -0.94; 95% CI: −1.29, −0.58) but no significant effect was observed in waist circumference, cholesterol fractions, glucose and insulin, and liver transferases. Overall, available data from observational and clinical studies indicated a trend for the relationship between MD and hepatic steatosis. Improvement in the most important risk factors of NAFLD, i.e. BMI, serum triglycerides, and insulin resistance, may be involved in such relationship.
32 citations
TL;DR: In both genders, getting older and high-fat mass were positively associated with sarcopenia, and BMI had a significant inverse association in both genders and all defintions.
Abstract: This study proposed to compare the prevalence and risk factors for sarcopenia by EGWSOP-1 and EWGSOP-2 diagnostic criteria in Iran. This cross-sectional study was conducted based on the data collected during the Bushehr Elderly Health (BEH) Program, stage II. Sarcopenia was defined as 3 definitions: EWGSOP-1(with Iranian cut off), EWGSOP-2(with Iranian cut off), EWGSOP-2(with European cut off) definition. We evaluated the age-standardized prevalence of sarcopenia in both genders. Regression analysis was used to show the associations in the adjusted models. Among 2426 participants, age-standardized prevalence of sarcopenia, and severe sarcopenia by EWGSOP-1 were 19.7%, and 12.9%, in men and 13.6%, and 16.7% in women, respectively. When we used EWGSOP-2 (with Iranian cut-off) criteria, these values were 10.5%, and 12.7% among men and 7.13% and 16.5% in women, respectively. The prevalence sarcopenia and severe sarcopenia by EWGSOP-2 (with European cut-off) were 12.7%, and 13.4% in men and 5.42%, and 13.7% in women, respectively. In both genders, getting older and high-fat mass were positively associated with sarcopenia, and BMI had a significant inverse association in both genders and all defintions. Results showed that a prevalence of sarcopenia varied largely by using different criteria, in both sexes. EWGSOP2- defined sarcopenia prevalence was lower than that defined using EWGSOP-1 criteria due to different diagnostic factors to detect sarcopenia. Some adverse outcomes should be considered for evaluating sarcopenia to compare the accuracy of EWGSOP-1 and EWGSOP-2.
31 citations
TL;DR: It is found that burdens of cardiovascular diseases and asthma are shifting toward greater YLDs than YLLs and this profile calls policymakers for the development of more rehabilitation centers for patients with ischemic heart disease, stroke, and respiratory diseases to mitigate their disabilities.
Abstract: Iran, as an in-transition country, tackled communicable diseases and now is confronting emerging challenges of non-communicable diseases (NCDs) in the path to reach health for everyone at all ages by 2030. Across Iran, death-averting treatments of NCDs have been expanded recently which might cause a shift toward a greater share of years lived with disability (YLDs) compared to years of life lost (YLLs) in the disability-adjusted life years of NCDs. Since the management of disability differs from the reduction of mortality in terms of public health policies, depicting the current picture of the burden of NCDs is principal for policymakers in achieving health for all. In this communication, we briefly reviewed our current knowledge about the burden of NCDs in Iran and found that burdens of cardiovascular diseases and asthma are shifting toward greater YLDs than YLLs. In addition to expanding preventive measures and maintenance of the current system, this profile calls policymakers for the development of more rehabilitation centers for patients with ischemic heart disease, stroke, and respiratory diseases to mitigate their disabilities. The consistent increase in the age-standardized YLD rate of neoplasms necessitates providing rehabilitation centers as well. Morbidity and mortality of diabetes have increased robustly which warrant extensive preventive and control measures. It should be noted that the estimates of the Global Burden of Disease study offer us invaluable insights on the burden of diseases in Iran; nonetheless, efforts for gathering nationally-representative data, e.g., National and Subnational Burden of Diseases, Injuries, and Risk Factors study, are strongly encouraged in the future.
29 citations
TL;DR: The use of probiotic supplements (individually or in combination with cinnamon) leads to a reduction in blood glucose and an increase in antioxidant enzymes in people with type 2 diabetes.
Abstract: The aim of this study was to investigate the effect of probiotic bacteria of Lactobacillus acidophilus, cinnamon powder and their combinations on the glycemic and antioxidant indices in patients with type 2 diabetes. A total of 136 patients randomized with type 2 diabetes entered the study and were randomly divided into four groups who were matched for age and gender. Thereafter, alongside their routine pharmacotherapy, each group followed one of the following diets: Group A: Lactobacillus acidophilus 108 cfu and 0.5 g of powdered cinnamon (synbiotic). Group B: Lactobacillus acidophilus (probiotic), Group C: powdered cinnamon. Group D: rice flour powder as placebo. At the beginning and end of the intervention, fasting blood sugar (FBS), HbA1c, advance glycation end products (AGE), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and antioxidant enzymes of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were measured. Following 3 months of treatment, the mean FBS level was decreased significantly in probiotic, cinnamon, and synbiotic supplementation groups compared with control (P < 0.01). FBS levels in probiotic, cinnamon, and synbiotic groups were significantly decreased compared with the control group (P = 0.001, P = 0.063 and P = 0.001, respectively). The mean HbA1C in probiotic, cinnamon, and synbiotic groups were also decreased (P = 0.001, P = 0.001 and P = 0.04, respectively). The mean AGE in synbiotic group was significantly decreased (P = 0.037). Probiotic, cinnamon and synbiotic all could improve antioxidant enzyme activity modestly. However, the most significant effect was seen in probiotic group. According to the current results, the use of probiotic supplements (individually or in combination with cinnamon) leads to a reduction in blood glucose and an increase in antioxidant enzymes in people with type 2 diabetes.
28 citations
TL;DR: The findings provide major clues for how to design and use probiotics with more efficient compositions in obesity and IR management and may bring new insights into how host-microbe interactions contribute to such protective effects.
Abstract: сomparative animal study of effectiveness of intermittent administration of lyophilized single-, three- and alive multistrain probiotic in short courses on insulin resistance (IR) in rats with experimental obesity. 70 rats were divided into 7 groups (n = 10 in each). Rats of group I were left intact. Newborn rats in groups II-VII were administered monosodium glutamate (MSG) (4 mg/g) by injection. Rats in group II (MSG-obesity group) were left untreated. The rats in groups III-V received lyophilized mono-probiotics B.animalis VKL, B.animalis VKB, L.casei IMVB-7280 respectively. The rats in group VI received all three of these probiotic strains mixed together. Group VII was treated with multi-probiotic “Symbiter”, containing 14 different live probiotic strains (Lactobacillus, Bifidobacterium, Propionibacterium, Acetobacter genera). Treatment of newborn rats with MSG lead to the development of obesity in all MSG-obesity rats and up to 20–70% after probiotic administration. Additions to probiotic composition, with preference to alive strains (group VII), led to significantly lower rates of obesity, decrease in HOMA-IR (p < 0.001), proinflammatory cytokines levels – IL-1β (p = 0.003), IL-12Bp40 (p < 0.001) and elevation of adiponectin (p = 0.003), TGF-β (p = 0.010) in comparison with MSG-obesity group. Analysis of results in groups treated with single-strain probiotics (groups III-V) shows significant decrease in HOMA-IR, but changes were less pronounced as compared to mixture groups and did not achieve intact rats level. Other metabolic parameters were not affected significantly by single strains. Our findings provide major clues for how to design and use probiotics with more efficient compositions in obesity and IR management and may bring new insights into how host-microbe interactions contribute to such protective effects.
TL;DR: Gut microbial alterations have been observed among patients suffering from type 1 and type 2 diabetes mellitus and healthy control adults and modulating approaches of gut microbiota composition could be helpful in diabetes management.
Abstract: Regarding the role of gut microbial dysbiosis in hyperglycemia, we aimed to compare the main gut bacterial composition among type 1 and type 2 diabetic patients and healthy non-diabetic adults. A total of 110 adult subjects (49 patients diagnosed with type 2 diabetes, 21 patients diagnosed with type 1 diabetes and 40 healthy persons) were included in this case-control study. The intestinal microbiota composition was investigated by quantitative real-time polymerase chain reaction (qPCR) method targeting bacterial 16S rRNA gene. Comparison between three groups was done using one-way analysis of variance. The participants’ mean age in the type 1 diabetes, type 2 diabetes and control groups was 35.4, 57.2 and 38.0 years, respectively. Higher level of Escherichia, Prevotella and Lactobacillus was observed in both type 1 and type 2 diabetic patients compared with the healthy group (P ˂0.001). In contrast, bacterial load of Bifidobacterium, Roseburia and Bacteroides was higher in healthy control group (P < 0.05). Faecalibacterium was significantly lower in type 1 diabetic patients compared with the other two groups (P ˂0.001). No significant difference was found in Akkermansia level among three groups. Gut microbial alterations have been observed among patients suffering from type 1 and type 2 diabetes mellitus and healthy control adults. Butyrate producing genera including Roseburia and Faecalibacterium decreased while Escherichia, Prevotella and Lactobacillus increased in diabetic patients compared to healthy subjects. Modulating approaches of gut microbiota composition could be helpful in diabetes management.
TL;DR: Iran has had a significant scientific contribution in various areas of the disease, however, the network of studies has not been sufficiently cohesive, and more coherent collaboration between researchers at the national and international levels should be on the agenda of research policymakers in the country.
Abstract: Iran is fighting heroically against COVID-19. Due to the importance of scientific publications in better dealing with this stubborn virus, this study was conducted aiming at reviewing COVID-19 publications by Iranian scientists. We searched for COVID-19 and all its related keywords in the Web of Science (WOS), Scopus and PubMed databases to find documents published by Iranian authors until July 10, 2020. Duplicates documents were excluded, and bibliographic parameters were evaluated. Co-authorship matrix was calculated using Bibexcel, and visualizations were done using VOSviewer. A total of 849 documents from 3450 Iranian researchers (5.5 authors per document) were retrieved from WOS, PubMed, and Scopus and Iran ranked 12th and 13th in WOS and Scopus in terms of the number of publications. The average citation per document was 2.2 with the h-index of 18. Original articles and letters were the most common formats for Iranian publications. The Journal of Military Medicine has published the highest number of documents. Iranian authors have mostly collaborated with researchers from the United States, Italy, the UK, and Canada, respectively. The co-occurrence network for keywords represented five publication clusters in the collection, and the largest clusters were related to epidemiological studies and public health, followed by clinical studies on COVID-19. Iranian researchers have had a significant scientific contribution in various areas of the disease. However, the network of studies has not been sufficiently cohesive, and more coherent collaboration between researchers at the national and international levels should be on the agenda of research policymakers in the country.
TL;DR: The results of the subgroup analysis showed that RPM is more effective for patients who are residents of cities, having intervention lengths less than 6 months, getting the orders from the physician and using the websites as their intervention type.
Abstract: The objective of this study is to conduct an assessment of Remote Patient Monitoring (RPM) systems compared to usual care for controlling glycosylated hemoglobin in type 2 diabetes. The study was a systematic review with meta-analysis and meta-regression. A systematic search was performed via the most important electronic databases of medical resources, such as PubMed, Scopus and Cochrane library. The main outcome was HbA1C. The heterogeneity sources were examined using Chi-square (Q) and I2 tests. Meta-analyses were done using Stata version 11 software. Statistical significance was defined as P < 0.05. Random effects model was used in meta-analysis, and the heterogeneity more than 50% was considered as significant. The results of the systematic review and meta-analysis indicated that the effect size index (Difference of Pre-test/Post-test Control Design-2nd method “using pooled pretest SD” (DPPC2)) among users of RPM for type 2 diabetic patients was −0.32 with a confidence interval of 95% (from −0.45 to −0.19) as compared to the control group. The current study declared a vital role of RPM technology in reduction of hemoglobin glycogen levels. The results of the subgroup analysis showed that RPM is more effective for patients who are residents of cities, having intervention lengths less than 6 months, getting the orders from the physician and using the websites as their intervention type. The current study indicted the efficacy of RPM in reducing HbA1c among type 2 diabetic patients, which could be a base for policymakers to decide on the introduction of this technology in Iran.
TL;DR: In this article, the α-amylase inhibitors from Duranta repens were identified via in silico and in vitro and predict their role in the modulation of multiple pathways involved in diabetes mellitus.
Abstract: Although α-amylase is the choice of target to manage postprandial hyperglycemia, inhibitors of this enzyme may get absorbed into the systemic circulation and modulate proteins involved in the pathogenesis of diabetes mellitus. Hence, the present study aimed to identify α-amylase inhibitors from Duranta repens via in silico and in vitro and predict their role in the modulation of multiple pathways involved in diabetes mellitus. α-amylase inhibitory activity of hydroalcoholic extract/fractions (s) and pure compounds from D. repens was performed using in vitro enzyme inhibitory assay. Multiple open-source databases and published literature were used to retrieve reported phytoconstituents present in D. repens and their targets. The network was constructed between α-amylase inhibitors, modulated proteins, and expressed pathways. Further, hit molecules were also confirmed for their potency to inhibit α-amylase using in silico molecular docking and in vitro enzyme inhibitory assay. The glucose uptake assay was performed to assess the effect of hydrolcoholic extract/fraction(s) using rat hemidiaphragm. Fraction rich in flavonoids showed the highest α-amylase inhibitory activity with a IC50 of 644.29 ± 4.36 µg/ml compared to other fractions. PI3K-Akt signaling pathway and p53 signaling pathway were predicted to be primarily modulated in the compound-protein-pathway network. Similarly, scutellarein was predicted as lead hit based on α-amylase inhibitory action, binding affinity, and regulated pathways. Further, α-amylase inhibitors were also predicted to modulate the pathways involved in diabetes complications like AGE-RAGE and FoxO signaling pathway. Fraction rich in flavonoids showed the highest glucose uptake in rat hemidiaphragm with an effective concentration of 534.73 ± 0.79 µg/ml. The α-amylase inhibitors from D. repens may not be limited within the gastrointestinal tract to inhibit α-amylase but may get absorbed into the systemic circulation and modulate multiple pathways involved in the pathogenesis of diabetes mellitus to produce synergistic/additive effect.
TL;DR: N. gaditana supplementation was shown effective in lowering the levels of glucose, HbA1c and improving the renal and hepatic function and also in attenuating the oxidative stress and inflammation in diabetic rats.
Abstract: This study aims to evaluate the anti-inflammatory and antioxidant effects of N. gaditana on streptozotocin (STZ)-induced diabetes mellitus in Wistar rats. Diabetes was induced in male Wistar rats by single intraperitoneal injection of STZ (45 mg/kg). Male rats were fed on control diet supplemented or not with N. gaditana (10%) for a period of 2 months. At the end of the experiment, biochemical parameters and oxidant/antioxidant markers in liver and pancreas tissues, as well as mitochondria isolated from liver of rats, were determined. It was notice that levels of glucose, glycated hemoglobin (HbA1c), lipid profile, kidney functions and liver enzymes in addition to markers of the inflammatory reactions interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) increased significantly (P < 0.05) in diabetic rats. Moreover, undesirable alterations of oxidative stress markers of tissue and mitochondria isolated from the liver were noted in these rats. N. gaditana supplementation was shown effective in lowering the levels of glucose, HbA1c and improving the renal and hepatic function and also in attenuating the oxidative stress and inflammation in diabetic rats. N. gaditana possesses antioxidant properties that might have beneficial effect in treatment of diabetes.
TL;DR: The literature review suggests that ethnic-specific genetic associations are involved between vitamin D deficiency and metabolic diseases, and some positive associations showing potential effects on obesity and T2D in specific ethnic groups were identified.
Abstract: Given that the relationship between vitamin D status and metabolic diseases such as obesity and type 2 diabetes (T2D) remains unclear, this review will focus on the genetic associations, which are less prone to confounding, between vitamin D-related single nucleotide polymorphisms (SNPs) and metabolic diseases. A literature search of relevant articles was performed on PubMed up to December 2019. Those articles that had examined the association of vitamin D-related SNPs with obesity and/or T2D were included. Two reviewers independently evaluated the eligibility for the inclusion criteria and extracted the data. In total, 73 articles were included in this review. There is a lack of research focusing on the association of vitamin D synthesis-related genes with obesity and T2D; however, the limited available research, although inconsistent, is suggestive of a protective effect on T2D risk. While there are several studies that investigated the vitamin D metabolism-related SNPs, the research focusing on vitamin D activation, catabolism and transport genes is limited. Studies on CYP27B1, CYP24A1 and GC genes demonstrated a lack of association with obesity and T2D in Europeans; however, significant associations with T2D were found in South Asians. VDR gene SNPs have been extensively researched; in particular, the focus has been mainly on BsmI (rs1544410), TaqI (rs731236), ApaI (rs7975232) and FokI (rs2228570) SNPs. Even though the association between VDR SNPs and metabolic diseases remain inconsistent, some positive associations showing potential effects on obesity and T2D in specific ethnic groups were identified. Overall, this literature review suggests that ethnic-specific genetic associations are involved. Further research utilizing large studies is necessary to better understand these ethnic-specific genetic associations between vitamin D deficiency and metabolic diseases.
TL;DR: The CREATE (Community deRivEd AutomaTEd insulin delivery) trial is an open-labelled, randomised, parallel 24-week, multi-site trial comparing sensor augmented pump therapy (SAPT) to the AnyDANA-loop, a so-called "do it yourself" (DIY) approach to AID.
Abstract: Commercialised automated insulin delivery (AID) systems have demonstrated improved outcomes in type 1 diabetes (T1D), however, they have limited capacity for algorithm individualisation, and can be prohibitively expensive if an individual is without access to health insurance or health funding subsidy. Freely available open-source algorithms, which have the ability to individualise algorithm parameters paired with commercial insulin pumps, and continuous glucose monitoring make up the so-called "do it yourself" (DIY) approach to AID. Limited data on the open-source approach have shown promising results, but data from a large randomised control trial are lacking. The CREATE (Community deRivEd AutomaTEd insulin delivery) trial is an open-labelled, randomised, parallel 24-week, multi-site trial comparing sensor augmented pump therapy (SAPT) to our AnyDANA-loop. The three components of AnyDANA-loop are: 1) OpenAPS algorithm implemented in a smartphone (a version of AndroidAPS), 2) DANA-i™ insulin pump and, 3) Dexcom G6R continuous glucose monitor (CGM). The primary outcome measure is the percentage of time in target sensor glucose range (3.9 -10mmol/L). Secondary outcomes include psycho-social factors and platform performance. Analysis of online collective learning, characteristic of the open-source approach, is planned. 100 participants with T1D aged 7 – 70 years (age stratified into children/adolescents 7–15 years and adults 16–70 years), will be recruited from four sites in New Zealand. A 24-week continuation phase follows, to assess long-term safety.
TL;DR: Mitochondrial dysfunction contributes to the oxidative stress and systemic inflammation leading to insulin resistance (IR), hence, mitochondria are important players in the pathogenesis of T2DM.
Abstract: Type 2 diabetes mellitus (T2DM) is global health problem. An estimated 425 million people in the world had diabetes in 2017. It is a major cause of morbidity and mortality worldwide. Although, pathogenesis of T2DM and its complications have been focus of medical research for long, much remains to be learned. A better understanding of molecular pathogenesis is essential for more effective preventive and therapeutic interventions. Role of mitochondria in pathogenesis of metabolic problems such as obesity, metabolic syndrome, and T2DM is the focus of many recent research studies. Mitochondrial dysfunction contributes to the oxidative stress and systemic inflammation leading to insulin resistance (IR). Mitochondria are also essential for pancreatic beta cell insulin secretion. Hence, mitochondria are important players in the pathogenesis of T2DM. In this article, pathogenesis of T2DM is examined from a mitochondrial perspective.
TL;DR: L-carnitine supplementation was associated with lowering of CRP, IL-6, TNF-α, and MDA, and increasing SOD levels, but did not affect other inflammatory and oxidative stress biomarkers.
Abstract: Several trials investigated the efficacy of L-carnitine administration on markers of inflammation and indicators of oxidative stress; however, their findings are controversial. The aim of this study was to conduct a comprehensive meta-analysis and a critical review, which would analyze all randomized controlled trials (RCTs) in order to determine the effects of L-carnitine supplementation on inflammatory markers and oxidative stress. An electronic search was performed using Scopus, Cochrane Library, PubMed, Google scholar and Web of Science databases on publications from 1990 up to May 2020. Human RCTs conducted in healthy subjects or participants with certain disorders which investigating the efficacy of L-carnitine supplementation compared to control (placebo, usual treatment or no intervention) on inflammation and oxidative markers were included. Data were pooled applying a random-effects model and as the overall effect size, weighted mean difference (WMD) was presented. Between heterogeneity among studies was computed using Cochran’s Q test and I-square (I2). Quality of studies assessed using the Jadad scale. Dose-response analysis was measured using meta-regression. The funnel plot, as well as the Egger’s regression test was applied to determine the publication bias. 44 trials (reported 49 effect sizes for different outcomes of interest) met the inclusion criteria for this meta-analysis. According to the findings, L-carnitine supplementation resulted in a significant reduction in C-reactive protein (CRP) (WMD: -0.10; 95% CI: -0.14, -0.06), interleukin 6 (IL-6) (WMD: -1.87; 95% CI: -2.80, -0.95), tumor necrosis factor-α (TNF-α) levels (WMD: -1.43; 95% CI: -2.03, -0.84), and malondialdehyde (MDA) (WMD: -0.47; 95% CI: -0.76, -0.18) levels, while there was a significant increase in superoxide dismutase (SOD) (WMD: 2.14; 95% CI: 1.02, 3.25). However, no significant effects of L-carnitine on glutathione peroxidase (GPx) (WMD: 0.02; 95% CI: -0.01, 0.05) and total antioxidant capacity (TAC) (WMD: 0.14; 95% CI: -0.05, 0.33) were found. L-carnitine supplementation was associated with lowering of CRP, IL-6, TNF-α, and MDA, and increasing SOD levels, but did not affect other inflammatory and oxidative stress biomarkers.
TL;DR: It is concluded that miR-29b regulates the expression of HDAC4 which plays a role in controlling renal fibrosis and podocytes’ impairment in DN.
Abstract: As epigenetic modifications like chromatin histone modifications have been suggested to play a role in the pathophysiology of Diabetic Nephropathy (DN) and are also found to be regulated by microRNAs. Our main purpose was to explore the role of microRNA in histone modulations associated with DN. There is downregulation of miR-29b due to advanced glycation end products in diabetes. Histone Deacetylase-4 (HDAC4) is amongst the histone modulators which promotes podocytes’ impairment and upregulates transforming growth factor-1 (TGF-β1) leading to renal fibrosis. Moreover, macrophage infiltration causes podocytes’ apoptosis and IL-6 mediated inflammation. As miR-29b is downregulated in diabetes and HDAC4, TGF-β1 and IL-6 could be the possible therapeutic targets in DN, our study was focussed on unveiling the role of miR-29b in modulation of HDAC4 and hence, in podocyte dysfunction and renal fibrosis in DN. In silico analysis and luciferase assay were done to study the interaction between miR-29b and HDAC4. In-vitro DN model was developed in podocytes and miR-29b mimics were transfected. Also, podocytes were co-cultured with macrophage and miR-29b mimics were transfected. At the end, in-vivo DN model was generated in C57BL/6 J male mice and the effect of miR-29b mimics was reconfirmed. It was found that miR-29b targets the 3′ untranslated region of HDAC4. In both in-vitro and in-vivo DN model, downregulation of miR-29b and subsequent increase in HDAC4 expression was observed. The miR-29b mimics suppressed podocytes’ inflammation mediated through macrophages and attenuated HDAC4 expression, glomerular damage and renal fibrosis. This study concludes that miR-29b regulates the expression of HDAC4 which plays a role in controlling renal fibrosis and podocytes’ impairment in DN.
TL;DR: The effect of plasma irradiation on infectious diabetic foot ulcer was decreased bacterial load then accelerated wound healing by effecting on inflammatory phase in diabetic foot Ulcers.
Abstract: The healing process is impaired in diabetic wounds like the other types of chronic wounds. Cytokines, and growth factors are valuable candidates for determination of wound vitality or duration. The aim of this study is to introduce a beneficial method to stop the inflammatory phase and infection in the wound healing process for accelerating the treatment of diabetic foot ulcers. As a randomized controlled trial, 44 patients with diabetic foot ulcers were selected and randomized. Twenty-two patients received standard care and rest of them received SC (standard care) + CAP (cold atmospheric plasma), n = 22). Clinical examination was performed to assess the status of peripheral nerves and arteries for all patients. Cold plasma jet was used as a source of helium gas plasma generator. Plasma was irradiated on the wound 5 min, 3 times a week for 3 consecutive weeks. Applying a plasma jet was effective in wound healing. The level of inflammatory cytokines was changed. Moreover, after applying plasma the mean expression of these variables was significantly decreased (P = 0.001). Following the plasma treatment, the level of cytokines such as IL-1 (39.44 ± 7.67), IL-8 (368.30 ± 82.43), INF-γ (17.03 ± 2.62), TNFα (22.75 ± 4.02) has decreased, inflammatory factors have ameliorated over three weeks, and accelerate wound healing. After CAP exposure, the mean of the mean fraction of bacterial load counts was significantly decreased. The effect of plasma irradiation on infectious diabetic foot ulcer was decreased bacterial load then accelerated wound healing by effecting on inflammatory phase in diabetic foot ulcers.
TL;DR: The process of beta-cell destruction, the role of genes in contributing to the fast increase in the progression of T2DM in detail, and an inventory of presently used therapeutic tools and a review of novel therapeutic approaches like incretin-based therapies or sodium-glucose transporter-2 inhibitors are discussed.
Abstract: Type 2 diabetes mellitus (T2DM) is a heterogeneous condition that is related to both defective insulin secretion and peripheral insulin resistance. Beta cells are the major organ for secreting insulin hence, it is important to maintain an adequate beta-cell mass in response to various changes. Insulin resistance is a major cause of T2DM leads to elevated free fatty acid (FFA) levels which increases beta-cell mass and insulin secretion to compensate for insulin insensitivity. Chronic increase of plasma FFA levels results in disturbances in lipid metabolism, which contributes to decreased beta-cell function and lipotoxicity thus promoting T2DM. In the present review, we have discussed the process of beta-cell destruction, the role of genes in contributing to the fast increase in the progression of T2DM in detail. More than 130 variants in various T2DM susceptibility and candidate genes have been discovered to be associated with T2DM. Still, these variants elucidate only a small amount of total heritability of T2DM. Further, there is also an inventory of presently used therapeutic tools and a review of novel therapeutic approaches like incretin-based therapies or sodium-glucose transporter-2 inhibitors. Additionally, providing a concise but comprehensive update, this review will be essential to every clinician involved in the treatment of diabetes mellitus.
TL;DR: Decisive evidence emerged from numerous in-depth studies have clearly demonstrated that fasting can produce therapeutic effects in many noncommunicable disorders such as obesity, diabetes, cardiovascular disease, cancers, and neurodegenerative diseases.
Abstract: The ritual of fasting, which includes complete refraining from food or drink, dates back to antiquity, and is observed in different religions such as Islam and Judaism. Islamic fasting is observed during the lunar month of Ramadan every year, and approximately 2 billion Muslims practice it all across the globe. [1] During Ramadan, all healthy Muslim adults (without any particular adverse health condition) need to fast from dawn to dusk and abstain from eating, drinking, smoking, intercourse, and several other activities. This can potentially last for more than 18 h a day depending on the latitude. [2] Nonetheless, there are several exemptions to this divine obligation, and travelers, menstruating women and those with certain diseases (or at increased risk for contracting a disease) can be exempted from the obligation. [3] For many Muslims, depending on the school of Islam they follow, these certain diseases or increased risks should be officially announced as Fatwas or religious edicts. Nonetheless, ultimately, these decisions need to be made on an individual basis according to the physicians’ recommendations. In some schools of Islam, such Fatwas are issued through an intricate collaborations amongst high-ranking Islamic jurisprudence scholars, academics, and medical practitioners on a virtually annual basis prior to the commencement of the holy month. [1, 4, 5] Health benefits of different patterns of fasting are very diverse and are described in details in the literature. [6] Initially, it was believed that reduction in the production of oxygen free radicals is the sole responsible mechanism of the wide range of health benefits observed in fasting. [6] Later, solid evidence emerged from comprehensive studies demonstrated that not all health benefits of different fasting regimens (such as intermittent fasting) can be attributed to reduced free-radical production. [7] Recently, it was brought to light that fasting can activate certain adaptive cellular responses which can improve glucose regulation, increase resistance to stress, and suppress inflammatory reactions. [8] Today, it is demonstrated that fasting can activate different cellular pathways which foster intrinsic defense mechanisms against metabolic and oxidative stress, and this can lead to removal of damaged cells and molecules. [9] Decisive evidence emerged from numerous in-depth studies have clearly demonstrated that fasting can produce therapeutic effects in many noncommunicable disorders such as obesity, diabetes, cardiovascular disease, cancers, and neurodegenerative diseases. [8] Fasting can also play a protective role against aging. A comprehensive meta-analysis study which was recently conducted has demonstrated that the average life expectancy can significantly increase by fasting. [10] Moreover, fasting can improve physical composition, function, and endurance. [11, 12] Fasting can also enhance cognitive functions in terms of spatial memory, associative memory and working memory, and can reverse neurotoxic effects of obesity, diabetes, and neuroinflammation. [13] This dietary intervention can even facilitate amelioration of cognitive deficits in traumatic brain injury. [14] Moreover, results of an study we conducted in 2012 demonstrated that fasting has a remarkable influence in promotion of psychologic health and regulation of sleep pattern. [15] These evidence and similar findings indicate that the effects of Ramadan Fasting are not merely confined those related to refraining from eating and drinking, and they include a diverse range of physical, psychological, and spiritual health. Considering diverse benefits of fasting, this ancient dietary alternation has been recently bought to light as a therapeutic clinical intervention. In clinical settings, caloric restriction and fasting has been documented to improve several cardiometabolic risk factors in nonobese humans. [16] This healing effect is medicated through a wide range of mechanisms such as modification of blood pressure, resting heart rate, levels of high-density and low-density lipoprotein (HDL and LDL) cholesterols, triglycerides, glucose, and insulin concentration, * Bagher Larijani larijanib1340@gmail.com
TL;DR: The outcome of this review is to bring the pros and cons of chromium supplementation along with is safety and toxicity concern beside molecular pathways, biochemistry and clinical trials, all in one comprehensive review.
Abstract: Chromium (Cr) is an essential trace element which found naturally in a daily diet and available in the form of supplementary tablets to boost disorders like diabetes mellitus (DM) and functions like lipid metabolism and beneficial on depression too. Diabetes is one of the most prevalent endocrine diseases or in other words, the most severe metabolic syndrome (MS), which associated with high production of free-radicals which is out of bodies detoxifying machine capacity or high oxidative stress (HOS), vasculitis and elevated lipid profile. many research papers and clinical trials published about the significance of chromium on biological activities, pre and post clinical. For this review research articles, clinical trials, from 1st Jan'10 to 31st Dec'18 and refer literature for the biochemical, pharmacological and biological activity of Chromium. Primarily articles gathered from the above search engines. Then precisely according to our aim and goal and regarding designed objectives dismisses similar articles and finally came to 84 articles for the above said period. This review trying to cover the entire picture from what chromium is to the recent updates on their greater role in increasing insulin sensitivity of cells and enhancing lipid metabolism and even recent findings suggest its positive effects including prevention and ameliorating properties on depression. The biological activities, pharmacological features, clinical implications including efficacy and role of chromium compounds on the glycaemic index will be discussed. The outcome of this review is to bring the pros and cons of chromium supplementation along with is safety and toxicity concern beside molecular pathways, biochemistry and clinical trials, all in one comprehensive review.
TL;DR: This study can help scientists to recognize some risk factors related to the aging process and also aware policymakers about the necessity to create heath care services at regional and even national levels.
Abstract: The pace of population aging is growing rapidly around the world. Aging is associated with the emergence of different health status including geriatric syndrome such as frailty, diabetes, cardiovascular diseases, and dementia. These conditions are the most prominent challenges for health care systems and also elderly people. Therefore, understanding these changes can help scientists to prevent and treat significant health issues and also improve the functional ability of older adults. This is a protocol of the first wave of Birjand Longitudinal Aging Study that is an ongoing community-based prospective cohort study with a following up at least 10 years. This study carries out on aged population ≥ 60 years which were residents in Birjand County (urban and rural older subjects). The selection of the participants of this study in urban areas is based on an age group weighted multistage stratified random sample while in the rural region the sample was selected from all ten rural regions of Birjand County by simple random sampling. The rural region sampling was based on the list of the aged population which were under the coverage of the rural health center. Sociodemographic, past medical history, lifestyle, sleep, activities of daily living, cognitive function, quality of life, and social capital were evaluated by interviewing with the participants and one of the informants. Anthropometric measures, electrocardiography, and interpretation of ophthalmologic examination were carried out by experts. Fasting Blood samples were collected and bio-banked in − 80 °C. then finally biochemical and hematologic markers were measured. This is the protocol of stage one baseline of Birjand Longitudinal Aging Study (BLAS). The BLAS is an enjoining study, the first phase of its baseline was carried out on a community- dwelling aged population sample ≥ 60 years who were residents in urban and rural regions of Birjand County. This is a community based prospective cohort study with at least 10 years follow up of participants. The data for 65% of older subjects (response rate = 65%) that lived in clusters were collected. This study can help scientists to recognize some risk factors related to the aging process and also aware policymakers about the necessity to create heath care services at regional and even national levels.
TL;DR: The results indicated that most patients referred to healthcare centers and diabetes clinics affiliated to Shiraz University of Medical Sciences had moderate spiritual well-being, high hope, and low adherence to treatment regimen, and a significant reverse correlation was observed between hope and adherence toreatment.
Abstract: Adherence to treatment regimen is one of the behaviors related to diabetes, which has predicted successful control of the disease and reduced its intensity as well as negative consequences. This study aimed to determine the relationship between spiritual well-being and hope, and adherence to treatment regimen in patients with type II diabetes referred to diabetes clinics. In this descriptive-correlational study, 227 diabetic patients referred to healthcare centers and diabetes clinics affiliated to Shiraz University of Medical Sciences were selected via cluster sampling (clinics) followed by convenience sampling (patients). The study data were collected using a demographic information form, spiritual well-being scale developed by Ellison and Paloutzian, Herth hope scale, and adherence to treatment regimen questionnaire. Then, the data were entered into the statistical software and were analyzed using descriptive and inferential statistics. The results indicated that most participants had moderate spiritual well-being, high hope, and low adherence to treatment regimen. Additionally, spiritual well-being was directly associated with hope and reversely related to adherence to treatment. A significant reverse correlation was also observed between hope and adherence to treatment. Considering the fact that spiritual well-being and hope were reversely associated with adherence to treatment regimen, further studies should be done in this field. Also patients’ image of God and their interpretations of being sick might not be appropriate and need correction.
TL;DR: Prevalence of dyslipidemia seems to be very high in Pakistan, necessitating an urgent call for early screening and effective management through lifestyle intervention and appropriate lipid lowering drugs to prevent this important cardiovascular risk factor.
Abstract: Dyslipidemia is a major risk issue for the development of cardiovascular disease. The aim of our study was to observe the pattern and prevalence of dyslipidemia in Pakistani population. This is a sub analysis of a population based second National Diabetes Survey of Pakistan (NDSP) 2016–2017 in adults aged 20 years or above, carried out from February 2016 to August 2017 across Pakistan. Multi stage sampling technique was used for the stratification of population, based on rural and urban domains. District wise clusters and sub clusters were selected i.e. 27 and 46 in number. Subjects, consented to participate were requested to come after an overnight fast for anthropometric measurements, oral glucose tolerance test and fasting lipid profile (except for subjects with self-reported diabetes). Dyslipidemia was identified using Adult Treatment Panel III guidelines. A total of 10,834 subjects (43.8% male and 56.2% female) having mean age of 43.8 ± 14.0 years, participated in the survey. Of the subjects studied, 39.3% had hypercholesterolemia, 48.9% had hypertriglyceridemia, 39.7% had high LDL-C levels while 83.9% men and 90% women had low HDL levels. High cholesterol and triglyceride levels were highest in 50–59 years age group, while high LDL and low HDL was most common in 40–49 years age group. Diabetes, obesity and hypertension were found to be the significant determinants for dyslipidemia. Prevalence of dyslipidemia seems to be very high in Pakistan, necessitating an urgent call for early screening and effective management through lifestyle intervention and appropriate lipid lowering drugs to prevent this important cardiovascular risk factor.
TL;DR: Diabetic patients with age 65 years or older,Comorbidity CKD, “other comorbidities”, as well as neutrophil count ≥8.0 × 109/L, Hb level, and creatinine level, were more likely to dead after COVID-19, and some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation.
Abstract: Diabetic’s patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determine factors predicting poor outcomes in hospitalized diabetic patients with COVID-19. This retrospective cohort study included all adult diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records. Diagnosis of diabetes mellitus was self-reported. Comorbidities including cancer, rheumatism, immunodeficiency, or chronic diseases of respiratory, liver, and blood were classified as “other comorbidities” due to low frequency. The assessed poor outcomes were in-hospital mortality, need to ICU care, and receiving invasive mechanical ventilation. Self-reported. Multivariate logistic regression models were fitted to quantify the predictors of in-hospital mortality from COVID-19 in patients with DM. Of 455 included patients, 98(21.5%) received ICU care, 65(14.3%) required invasive mechanical ventilation, and 79 (17.4%) dead. In the multivariate model, significant predictors of “death of COVID-19” were age 65 years or older (OR (95% CI): 2.0 (1.16–3.44), chronic kidney disease (CKD) (2.05 (1.16–3.62), presence of “other comorbidities” (2.20 (1.04–4.63)), neutrophil count ≥8.0 × 109/L)6.62 (3.73–11.7 ((, Hb level < 12.5 g/dl (2.05 (1.13–3.72) (, and creatinine level ≥ 1.36 mg/dl (3.10 (1.38–6.98)). (All p –values <0.05). Some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation. Diabetic patients with age 65 years or older, comorbidity CKD, “other comorbidities”, as well as neutrophil count ≥8.0 × 109/L, Hb level < 12.5 g/dl, and creatinine level ≥ 1.36 mg/dl, were more likely to dead after COVID-19. Presence of hypertension and cardiovascular disease were associated with none of the poor outcomes.
TL;DR: It was concluded that the occurrence of metabolic syndrome was dreadfully high among the diabetic population, especially among female subjects, and when compared to diabetes patients without metabolic syndrome, all the metabolic risk elements were significantly higher in diabetes patients with metabolic syndrome.
Abstract: Lifestyle changes in diabetes mellitus leads to metabolic syndrome, thus resulting in a hike in micro and macrovascular complications in diabetes mellitus patients. The main objective of the study was to identify the occurrence of metabolic syndrome and to evaluate the gender-associated difference in each component of metabolic syndrome by using International Diabetic Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)criteria. This is a cross-sectional study conducted in 350 type II diabetes mellitus patients. All the study participants within 30–80 years were enrolled. Subjects with type I DM and pregnant women were excluded from the study. The occurrence of metabolic syndrome among the diabetic population was found to be 42.28% and 28.85% using the IDF and the NCEP ATP III criteria respectively. It was observed that the prevalence was found to be higher in females than males as per IDF and NCEP ATP III criteria and was found to be statistically significant (p < 0.001). Central obesity elevated blood pressure, and reduced high-density lipoprotein was significantly higher in female patients. The most frequently occurring risk factor in this study population was central obesity followed by hypertension. A comparative analysis of IDF and NCEP ATP III criteria implies that when compared to diabetes patients without metabolic syndrome, all the metabolic risk elements were significantly higher in diabetes patients with metabolic syndrome. This study concluded that the occurrence of metabolic syndrome was dreadfully high among the diabetic population, especially among female subjects.