Impact of Nigella sativa oil on glycemic control in alloxan-induced diabetic Wistar rats

Background: To effectively manage diabetes, it is crucial to achieve optimal glycemic control by ensuring that A1C levels remain below 7.0%. This study aimed to investigate the impact of Nigella sativa oil (black seed oil, BSO) on glycemic control in alloxan-induced diabetic Wistar rats. Methods: Forty (40) male Wistar rats weighing 200-250 gm were randomly allocated into eight (8) groups of five (5) animals per group. Group 1 received normal saline as the normoglycemic control, while groups 2 to 8 were given alloxan monohydrate to induce hyperglycemia, following the method of Osikwe et al. Following the induction of hyperglycemia, group 2 received normal saline, group 3 received 200 mg/kg of metformin, group 4 received 2 mg/kg of glimepiride, group 5 received 2.5 ml/kg of BSO, group 6 received glimepiride and BSO, group 7 received metformin and BSO, and group 8 received BSO, glimepiride, and metformin. Results: The results showed that BSO significantly reduced fast blood glucose levels compared to the diabetic control group (p<0.05), lowered glycosylated hemoglobin to <7%, and improved pancreatic beta cell function. Conclusions: Black seed oil reduces fasting blood glucose, exhibits synergism with glimepiride, and improves pancreatic beta-cell function in alloxan-induced diabetic Wistar rats.

Relación entre diabetes mellitus y periodontitis apical de origen endodóntico. Revisión narrativa / Relationship between diabetes mellitus and apical periodontitis of endodontic origin. Narrative review

La diabetes mellitus es una enfermedad metabólica que se caracteriza por tener un aumento en los niveles de glucemia, causando un estado inflamatorio sistémico que puede afectar la cicatrización de las lesiones periapicales presentes en la periodontitis apical, una enfermedad inflamatoria crónica causada por una infección endodóntica cuyo desarrollo está regulado por la respuesta inmunitaria del huésped. La diabetes podría interactuar con la periodontitis apical al desencadenar la modulación inmunitaria, pudiendo afectar la respuesta clínica de las lesiones periapicales e interferir con la cicatrización después del tratamiento endodóntico. El objetivo de esta revisión de la literatura es analizar la evidencia respecto a la relación entre la diabetes mellitus y la presencia y severidad de la periodontitis apical de origen endodóntico. Se recopilaron artículos de las bases de datos PubMed, Scopus y Web of Science entre los años 2016 y 2021. Se eligieron 31 artículos pertinentes para el estudio. En el 41,6% de los estudios se encontró una mayor presencia de periodontitis apical en pacientes con diabetes asociada a una lesión apical más compleja y comprometida. Un 25% de los estudios encontró que los pacientes diabéticos mal controlados presentan mayor presencia de periodontitis apical. Un 25% de los estudios encontró que niveles altos de HbA1c se asocian a la presencia de periodontitis apical. Se encontró una relación entre la diabetes y la periodontitis apical, por lo que la diabetes debe ser considerada como un factor preoperatorio importante en el desarrollo y severidad de la periodontitis apical, sin embargo, se deben realizar estudios experimentales más estandarizados para poder determinar con mayor exactitud esta relación, además de poder indagar la bidireccionalidad entre ambos.(AU)

Diabetes mellitus is a metabolic disease that is characterized by an increase in blood glucose levels, causing a systemic inflammatory state that can affect the healing of periapical lesions present in apical periodontitis, a chronic inflammatory disease caused by an endodontic infection whose development is regulated by the host's immune response. Diabetes could interact with apical periodontitis by triggering immune modulation, being able to affect the clinical outcome of periapical lesions and interfering with healing after endodontic treatment. The objective of this literature review is to analyze the evidence regarding the relationship between diabetes mellitus and the presence and severity of apical periodontitis of endodontic origin. Articles were collected from the PubMed, Scopus and Web of Science databases between the years 2016 and 2021. 31 relevant articles were included for this study. In 41.6% of the studies a greater presence of apical periodontitis was found in patients with diabetes associated with a more complex and compromised apical lesion. 25% of the studies reported that poorly controlled diabetic patients had a greater presence of apical periodontitis. 25% of the studies reported high levels of HbA1c in association with apical periodontitis. A relationship was found between diabetes and apical periodontitis, which means diabetes should be considered as an important preoperative factor in the development and severity of apical periodontitis; however, more standardized experimental studies should be carried out to determine this relationship more accurately, in addition to being able to investigate a bidirectionality between the two.(AU)

Complicaciones vasculares en pacientes diabéticos con hemoglobina glicosilada alterada internados en el Centro Médico Nacional - Hospital Nacional periodo 2022 - 2023 / Vascular complications in diabetic patients with altered glycated hemoglobin admitted to Centro Médico Nacional - Hospital Nacional period 2022 ­ 2023

Introducción: la diabetes mellitus es una enfermedad crónica que, al no ser controlada, puede desencadenar en complicaciones macro y microvasculares. Uno de los indicadores de un adecuado control glucémico es la hemoglobina glicosilada. Objetivos: determinar la frecuencia de complicaciones macro y microvasculares en pacientes diabéticos tipo 2 con hemoglobina glicosilada alterada internados en el Hospital Nacional de Itauguá periodo 2022 - 2023 Metodología: estudio observacional, descriptivo de corte transversal que incluyó a 170 pacientes adultos internados en el servicio de clínica médica del Hospital Nacional (Itauguá, Paraguay) durante los años 2022 y 2023. Resultados: la edad media fue de 58 ± 12 años, con predominio del sexo femenino (51 %). La complicación más frecuentemente diagnosticada fue la enfermedad del pie relacionada a la diabetes con 83 pacientes (49 %), seguido por retinopatía diabética 23 (14 %). El valor promedio de hemoglobina glicosilada fue de 10 ± 2 %. Solamente 6 (4 %) del total de pacientes presentó un valor de HbA1C≥ 7,1 %. La comorbilidad asociada más frecuente fue la hipertensión arterial 87 (51 %). El 91 % de los pacientes conocía ser portador de la enfermedad, el 80 % recibía algún tipo de tratamiento. Conclusiones: el pie diabético fue la complicación vascular diagnosticada con mayor ,frecuencia, especialmente en pacientes con HbA1C≥ 7,1 %.

Introduction: diabetes mellitus is a chronic disease that, if not controlled, can lead to macro- and microvascular complications. One of the indicators of adequate glycemic control is glycosylated hemoglobin. Objectives: to determine the frequency of macro and microvascular complications in type 2 diabetic patients with altered glycosylated hemoglobin admitted to the Hospital Nacional from 2022 to 2023 Methodology: this was an observational, descriptive, cross-sectional study that included 170 adult patients admitted to the Internal Medicine service of the Hospital Nacional (Itauguá, Paraguay) during the years 2022 and 2023. Results: the mean age was 58 ± 12 years, with a predominance of the female sex (51 %). The most frequently diagnosed complication was foot disease related to diabetes with 83 patients (49 %), followed by diabetic retinopathy 23 (14 %). The average value of glycosylated hemoglobin was 10 ± 2 %. Only 6 (4 %) of the total patients had an HbA1C value ≤7 %. The most frequent associated comorbidity was arterial hypertension 87 (51 %). 91 % of the patients knew they were carriers of the disease, 80 % received some type of treatment. Conclusions: diabetic foot was the most frequently diagnosed vascular complication, especially in patients with HbA1C ≥7.1 %.

Correlation between serum HbA1c,LAG-3 and thyroid nodules in patients with type 2 diabetes mellitus / 国际检验医学杂志

Objective To explore the correlation between serum glycosylated hemoglobin(HbA1c),lym-phocyte activation gene-3(LAG-3)and thyroid nodules in patients with type 2 diabetes mellitus(T2DM).Methods A total of 120 T2DM patients with thyroid nodules admitted to the Third Hospital of Hebei Medi-cal University from July 2021 to July 2022 were included as the study group,and 100 simple T2DM patients(without thyroid nodules)were included as the control group during the same period.According to the patho-logical examination results of thyroid nodules,the study group was grouped into a benign nodule group(85 ca-ses)and a malignant nodule group(35 cases).Enzyme linked immunosorbent assay was applied to detect the serum LAG-3 level of all study subjects.Fully automated glycated hemoglobin analyzer was applied to detect HbA1c level in all study subjects.Spearman method was applied to analyze the correlation between serum HbA1c,LAG-3,and thyroid imaging report and data system(TI-RADS)scores in patients with T2DM and thyroid nodules.Multivariate Logistic regression was applied to analyze the influencing factors of T2DM with thyroid nodules.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of HbA1c and LAG-3 levels in T2DM with thyroid nodules.Results Compared with the control group,the level of HbA1c in the study group was obviously higher(P<0.05),while the level of LAG-3 was obviously lower(P<0.05).Compared with the benign nodule group,the serum LAG-3 level in the malignant nodule group was obviously lower(P<0.05),while the level of LAG-3 was obviously lower(P<0.05).Spearman analysis showed a positive correlation between HbA1c level and TI-RADS score in T2DM patients with thyroid nod-ules(r=0.378,P<0.001),while the serum LAG-3 level was negatively correlated with TI-RADS score(r=-0.472,P<0.001).The results of multivariate Logistic regression analysis showed that HbA1c was a risk factor for the occurrence of thyroid nodules in T2DM patients(P<0.05),and LAG-3 was a protective factor for the occurrence of thyroid nodules in T2DM patients(P<0.05).The combination of HbA1c and LAG-3 in the diagnosis of T2DM with thyroid nodules was superior to their individual diagnosis(Zcombination-HbA1c=2.542,P=0.011;Zcombination-LAG-3=3.098,P=0.002).Conclusion Patients with T2DM combined with thyroid nodules have obviously lower serum LAG-3 level and higher HbA1c level,and the two are related to the malignancy of thyroid nodules.

Influence of Medication Compliance of Type 2 Diabetes Chronic Disease Management Patients in Two Communities of Kunming on Disease Control / 昆明医科大学学报

Objective To analyze the influence of medication compliance of chronic type 2 diabetes management patients on disease control in two communities in Kunming.Methods A total of 138 patients with type 2 diabetes who were included in chronic disease management in Guandu and Xiaobanqiao communities of Kunming were selected from December 2021 to September 2022.Basic information collection and HbAlc and other related tests were improved.A questionnaire survey of 8-item Morisliy medication adherence scale(MMAS-8)was conducted to analyze the levels of HbAlc and other indexes of three groups with high(group A),medium(group B),and low(group C)adherence,and to conduct statistical analysis.Results Group A accounted for 22.5%,group B for 44.9%,and group C for 32.6%.There were significance differences in urinary albumin creatinine ratio(UACR),HbA1c and blood creatinine among the three groups(P<0.05).The levels of UACR,HbAlc and serum creatinine in group A were lower than those in group B and group C,and there was a negative correlation between UACR,HbAlc and serum creatinine and medication compliance rate(P<0.05).Conclusion In the Guandu Community and Xiaobanqiao community of Kunming,only 22.5%of patients with chronic type 2 diabetes had high medication compliance.The higher the compliance,the lower the level of UACR,HbAlc and serum creatinine,there is a correlation between the two,suggesting that medication compliance should be regarded as one of the key points in the management of chronic diabetes mellitus in the community,and the intervention of patients'medication compliance should be strengthened.

Effects of high-intensity interval training and moderate-intensity continuous training on body composition and glucose metabolism in overweight or obese patients with type 2 diabetes:a Meta-analysis / 中国组织工程研究

OBJECTIVE:To systematically evaluate the effects of high-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities,thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes. METHODS:The Cochrane Library,PubMed,EMbase,Web of Science,CNKI,CBM,WanFang,and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes.The search was conducted from database inception to June 2022.Meta-analysis of outcome indicators was performed using RevMan 5.4. RESULTS:(1)A total of 13 randomized controlled trials with 371 subjects were included,and the overall quality of the included studies was relatively high.(2)There was no significant difference in the improvement of body composition between HIIT and MICT[body mass:weighted mean difference(WMD)=2.44,95%confidence interval(CI):-3.01-7.89,P＞0.05;body mass index:WMD=0.28,95%CI:-1.21-1.77,P＞0.05;waist circumference:WMD=2.16,95%CI:-2.04-6.35,P＞0.05;body fat percentage:WMD=0.47,95%CI:-2.11-3.05,P＞0.05).(3)The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the"training cycle≥12 weeks"subgroup and the"training frequency≤3 times/week"subgroup(training cycle≥12 weeks subgroup:WMD=4.25,95%CI:0.90-7.59,P=0.01;WMD=2.71,95%CI:1.92-3.51,P＜0.000 01;training frequency≤3 times/week subgroup:WMD=5.14,95%CI:1.7-8.57,P=0.003;WMD=1.67,95%CI:0.66-2.67,P=0.001).(4)The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups(WMD=2.17,95%CI:1.20-3.14,P＜0.000 1),while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups(fasting blood glucose:WMD=0.31,95%CI:-0.17-0.79,P＞0.05;glycosylated hemoglobin:WMD=0.01,95%CI:-0.19-0.20,P＞0.05;insulin resistance index:WMD=-0.14,95%CI:-0.71-0.42,P＞0.05).(5)The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of"training frequency≤3 times/week"(WMD=0.92,95%CI:0.25-1.60,P=0.007)and glycosylated hemoglobin was significantly different in the"training frequency＞3 times/week"subgroup(WMD=-0.2,95%CI:-0.3 to-0.1,P＜0.000 1). CONCLUSION:Overall,there is no significant difference between HIIT and MICT in improving body composition such as body mass,body mass index,waist circumference,body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose,glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes.When the training period is≥12 weeks and the training frequency is≤3 times/week,MICT has a better effect on the improvement of body mass as well as body mass index.

Correlation between serum HbA 1c, γ-GT, ICAM-1 levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular diseases / 中华健康管理学杂志

Objective:To analyze the correlation between serum glycated hemoglobin (HbA 1c), γ-glutamyltranspeptidase(γ-GT) and intercellular adhesion factor-1 (ICAM-1) levels and cognitive impairment in elderly patients with hyperlipidemia complicated with cardiovascular disease. Methods:In this retrospective cohort study, 158 elderly patients who underwent examination and were diagnosed with hyperlipidemia complicated with cardiovascular disease at Beijing Anzhen Hospital Affiliated with Capital Medical University from January to December 2022 were selected as study subjects. The simple mental state scale (MMSE) was assessed in the subjects in combination with the subject′s level of education. Illiteracy≤17 points, primary school≤20 points, middle school and above≤24 points were classified as cognitive impairment group (67 cases), the rest were were classified into the non-cognitive impairment group (91 cases); and another 50 healthy elderly people who received physical examination in the same period were selected as the control group. The blood samples in the three groups were extracted to measure serum HbA 1c, γ-GT and ICAM-1. The correlation between HbA 1c, γ-GT and ICAM-1 levels with cognitive impairment were analyzed. Results:The serum levels of HbA 1c, γ-GT and ICAM-1 in the cognitive impairment group were all significantly higher than those in the non-cognitive impairment group and the control group [5.41%±1.04% vs 4.82%±0.95%, 4.39%±0.86%; (52.01±10.96) vs (41.28±9.23), (25.03±7.17) U/L; (336.61±85.36) vs (286.93±72.53), (143.52±64.20) g/ml], and the MMSE score was significantly lower [(20.19±2.85) vs (25.30±1.24), (27.14±1.56) points] (all P<0.05). Serum levels of HbA 1c, γ-GT and ICAM-1 were all significantly negatively correlated with MMSE score ( r=-0.512, -0.498, -0.563) (all P<0.05). The areas under the receiver operating characteristic curves (AUCs) for serum HbA 1c, γ-GT, and ICAM-1 levels in the assessment of cognitive dysfunction were 0.657, 0.816, and 0.691, respectively (all P<0.05). The optimal cut-off values were 5.115%, 47.65 U/L, and 304.58 g/ml, respectively. Conclusion:Serum HbA 1c, γ-GT and ICAM-1 levels in elderly patients with hyperlipidemia complicated with cardiovascular disease are negatively correlated with cognitive impairment, and have certain value for the evaluation and early diagnosis of cognitive impairment.

Influence of preoperative HbA1c level on posterior membrane opacity after phacoemulsification in diabetic patients and analysis of threshold effect / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the predictive value and threshold effect of preoperative glycated hemoglobin(HbA1c)level on posterior capsular opacification(PCO)in diabetic cataract patients.METHODS:Retrospective study. A total of 106 diabetic patients(106 eyes)with cataract treated in our hospital from September 2018 to September 2020 were collected. The patients were divided into PCO group(52 cases, 52 eyes)and non-PCO group(54 cases, 54 eyes)according to whether PCO occurred at 36 mo after surgery. The risk factors affecting postoperative PCO were analyzed. The threshold effect of HbA1c level on the occurrence of postoperative PCO was analyzed. The predictive value of preoperative HbA1c level in postoperative PCO was evaluated using the receiver operating characteristic(ROC)curve. The prediction model was constructed, and Bootstrap resampling was used to verify the prediction model, and the differentiation and accuracy of the model were evaluated.RESULTS: There were significant differences in diabetes course, diabetic retinopathy, fasting blood glucose, 2 h postprandial blood glucose, preoperative HbA1c, axial length and nuclear grade between PCO and non-PCO groups(P&#x003C;0.05). Duration of diabetes ≥12 a, presence of DR, fasting blood glucose ≥8 mmol/L, 2 h postprandial blood glucose ≥12 mmol/L, preoperative HbA1c ≥7%, axial length ≥30 mm, and nuclear grade Ⅲ or above were all influencing factors for postoperative PCO(P&#x003C;0.05). Curve fitting found that the probability of postoperative PCO showed an increasing trend with the increase of HbA1c level. Threshold effect analysis found that the incidence of postoperative PCO increased with the increase of HbA1c level when HbA1c≥7%. Sensitivity analysis showed that E value=2.129. The analysis of the correlation effect between preoperative HbA1c and the degree of PCO after phacoemulsification showed that the adjusted preoperative HbA1c level was an independent factor affecting the degree of PCO in diabetic patients(OR=1.65, 95% CI: 1.42-1.76, P=0.021). PCO outcome in diabetic cataract patients was indicated when the predictive model P=0.6, and the prediction accuracy of the model was 88.51%. Sensitivity and specificity were 86.33% and 86.82%, respectively.CONCLUSION:Duration of diabetes, presence of DR, fasting blood glucose, 2 h postprandial blood glucose, preoperative HbA1c, axial length, and nuclear grade were independent risk factors for postoperative PCO in diabetic patients, and preoperative HbA1c could be used as a sensitive index to evaluate postoperative PCO.

Role of Aahar and Panchakarma on restoration of euglycemia in known type II diabetes mellitus

Background: Diabetes mellitus, in particular, has emerged as a significant health concern, affecting millions of individuals and placing a considerable strain on the healthcare system. Promoting remission of diabetes, wherein patients achieve a state of sustained blood sugar control without the need for ongoing medication or with a reduced reliance on medication, can yield remarkable benefits. This study sought to understand the role of Aahar and Panchakarma on restoration of euglycemia in known type 2 diabetes patients. Methods: A retrospective, observational, cohort study was conducted at Madhavbaug Cardiac Care Clinic between April 2021 and April 2022 in Maharashtra, India. Patients aged 18 years and older with a diagnosis of type 2 diabetes mellitus with glycated haemoglobin level (HbA1c) >7% and had participated in the Comprehensive Diabetes Care (CDC) program were included in this study. Parameters such as HbA1c, body weight, body mass index (BMI), and dependence on conventional allopathic medication were assessed at the end of the CDC program. Follow-up was conducted at 90 days. Day 1 and day 90 data were compared. Results: Of the 45 patients, 17 (40.5%) patients had a negative glucose tolerance and 14 (33.3%) patients had impaired glucose tolerance. HbA1c, body weight, and BMI improved at the end of CDC program. Dependency on conventional allopathic medications was also reduced. Conclusions: Restoration of euglycemia in patients with type 2 diabetes mellitus is possible, however, further studies to understand the affecting factors are warranted.

Cross-sectional study to describe the severity, bio-chemical associations, and final outcomes of COVID-19-associated rhino-orbital-cerebral mucormycosis in a tertiary hospital of East India

Purpose: The second wave of coronavirus disease 2019 (COVID?19) pandemic triggered a mucormycosis epidemic in India. Diabetes mellitus and dysregulated immune response were contributors, and rhino?orbital?cerebral mucormycosis (ROCM) was the most common presentation. It is however not known whether bio?chemical parameters at presentation correlate with stage of ROCM or final outcome in terms of vision or mortality. Methods: This retrospective, hospital?based study included all in?patients of mucormycosis with ophthalmic manifestations at presentation admitted during June 1, 2021 to August 31, 2021. It aimed to evaluate the association between severity of infection, serum levels of HbA1c, ferritin, interleukin?6 (IL?6), C?reactive protein (CRP), and D?dimer levels at presentation and outcome. Results: There were altogether 47 eligible cases having a mean age of 48.8 ± 10.9 years with a male:female ratio of 2.6:1; forty?two (89.4%) had pre?existing diabetes, and five (10.6%) had steroid?induced hyperglycemia. The mean HbA1c among diabetics was 9.7 ± 2.1. HbA1c and serum CRP showed an increase over subsequent stages, which was not statistically significant (P = 0.31). IL?6 values for all stages were similar (P = 0.97). Only serum ferritin levels showed a statistically significant increase over stages (P = 0.04). IL?6 was significantly lower (P = 0.03) in patients who survived, whereas CRP levels were significantly lower in patients who had final visual acuity (VA) better than only perception of light (P = 0.03). Conclusion: Uncontrolled diabetes mellitus is a significant association of ROCM. Serum ferritin levels at presentation best correlate with extent of the disease. CRP levels are best to prognosticate cases that will have sufficient VA to carry on activities of daily living, whereas IL?6 levels are best associated with survival

Estrés psicológico y angustia por diabetes en adultos con diabetes mellitus tipo 2: una revisión sistemática / Psychological Stress and Diabetes Distress in Adults with Type 2 Diabetes Mellitus: A Systematic Review / Estresse psicológico e angústia causada por diabetes em adultos com diabetes mellitus tipo 2: uma revisão sistemática

Introducción: la diabetes mellitus tipo 2 es una enfermedad crónica que puede causar estrés psicológico en el desarrollo de la enfermedad y como suceso estresante, mientras que la angustia por la diabetes se asocia con estresores como el descontrol de las concentraciones de glucosa, presencia de complicaciones agudas o crónicas, disciplina y apego en el tratamiento integral. El objetivo del estudio fue analizar la literatura científica disponible sobre el estrés psicológico y angustia por diabetes en relación con el con- trol glucémico en adultos con diabetes mellitus tipo 2. Materiales y métodos: para la búsqueda de literatura se utilizaron las bases de datos Pubmed, Medline, Biblioteca Virtual en Salud, CINAHL, EBSCO, Wiley y Google Académico. Se incluyeron artículos indexados en bases de datos con idioma inglés, español y portugués, de diseños descriptivos, correlacionales y experimentales publicados en el periodo 2010-2020. Los artículos se evaluaron a través de la lista de revisión del Joanna Briggs Institute. Resultados: se encontró que el estrés psicológico ocurre mayormente en mujeres y que la angustia por diabetes es predictora del control glucémico pobre, provoca un manejo inadecuado de la glucosa, aumenta la hemoglobina glucosilada y también es una de las causas de mortalidad en hombres. Conclusiones: los hallazgos muestran que existe mayor relación entre la angustia por diabetes y el control glucémico en estos pacientes

Introduction: type 2 diabetes mellitus is a chronic disease that can cause psychological stress in the development of the disease and as a stressful event, while diabetes distress is associated to stressors such as uncontrolled diabetes, presence of acute or chronic complications, discipline and adherence in comprehensive treatment. The aim of the study is to analyze the available scientific literature on psychological stress and diabetes distress in relation to glycemic control in adults with type 2 diabetes mellitus. Materials and methods: For the literature search, Pubmed, Medline, Virtual Health Library, CINAHL, EBSCO, Wiley and Google databases were used. Articles indexed with English, Spanish and Portuguese languages, with descriptive, correlational and experimental designs published in the period 2010 to 2020. The articles were evaluated through the Joanna Briggs Institute Check list. Results: 10 articles that met the inclusion criteria were analyzed, some studies showed an associated of psychological stress and diabetes distress with glycated hemoglobin, in addition, it was found that psychological stress is mostly in women and diabetes distress is a predictor of poor glycemic control, it causes inadequate glucose management, increases glycated hemoglobin and is also one of the causes of mortality in men. Conclusions: The findings show that there is a relationship mainly between diabetes distress and glycemic control in these patients.

Introdução: A diabetes mellitus tipo 2 é uma doença crônica que pode causar estresse psicológico no surgimento da doença e ser um evento estressante, enquanto que a angústia por diabetes está associada a estressores como os níveis glicose descontrolados, presença de complicações agudas ou crônicas, disciplina e aderência a um tratamento integral. O objetivo do estudo foi analisar a literatura científica disponível sobre o estresse psicológico e a angústia por diabetes em relação ao controle glicêmico em adultos com diabetes mellitus tipo 2. Materiais e métodos: As bases de dados Pubmed, Medline, Biblioteca Virtual en Salud, CINAHL, EBSCO, Wiley e Google foram utilizadas para a pesquisa bibliográfica. Foram incluídos artigos indexados em bases de dados em inglês, espanhol e português, com desenhos descritivos, correlacionais e experimentais publicados no período de 2010 a 2020. Os artigos foram avaliados através do Check List do Instituto Joanna Briggs. Resultados: Foram analisados 10 artigos que cumpriram com os critérios de inclusão, alguns estudos mostraram associação do estresse psicológico e angústia por diabetes com a hemoglobina glicosilada, além disso, descobriu-se que o estresse psicológico apresenta principalmente nas mulheres e a angústia por diabetes é um preditor de controle glicêmico deficiente, provocando manejo inadequado da glicose, aumentando a hemoglobina glicosilada e também, é uma das causas de mortalidade nos homens. Conclusões: Os resultados mostraram que existe uma maior relação entre a angustia por diabetes e o controle glicêmico nestes pacientes

A cross sectional study to determine the correlation of blood glucose and HbA1C in type 2 diabetes mellitus patients

Background: Measurement of glycosylated hemoglobin (HbA1c) is considered the gold standard for monitoring chronic glycemic level of diabetes patients. HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. Levels of HbA1C represent the average blood glucose levels of diabetic patients over the previous 120 days. The objective of this study was to see the correlation between HbA1c levels and glucose levels. Methods: This cross-sectional study included 60 randomly selected subjects with known diabetes. Both fasting and post prandial blood glucose levels were measured by using venous blood samples. HbA1c levels were measured in venous blood by immunoturbidimetric method. Data were recorded on a proforma in MS-excel sheet. Pearson's coefficient of correlation was applied to find out any significant correlation between the HbA1c levels and the both fasting and postprandial blood glucose levels. Results: Results were obtained by statistical calculation and plotted with respect to scatter and bar diagram was done and a p<0.05 was considered significant (With 95% CI). Conclusions: A significant linear positive correlation exists between levels of HbA1C and fasting and post prandial blood glucose.

Retinopatía diabética y su relación con los niveles de hemoglobina glucosilada / Diabetic Retinopathy and its Relationship with Glycosylated Hemoglobin Levels

Introducción: La retinopatía diabética es la principal causa de ceguera en personas diabéticas de 20 a 64 años de edad, e incrementa su aparición frente a un mal control de la enfermedad, que se expresa con valores altos de hemoglobina glucosilada (HbA1C). Objetivo: Establecer la relación entre los niveles de hemoglobina glucosilada y la presencia de retinopatía en los pacientes con diabetes mellitus tipo 2. Métodos: Se llevó a cabo un estudio descriptivo, prospectivo y transversal, en el que se obtuvieron, mediante ficha de observación, datos sociodemográficos, de evaluación oftalmológica y niveles de HbA1C, de los pacientes atendidos en consulta externa del Hospital General Isidro Ayora de la ciudad de Loja, Ecuador, en el período febrero-junio de 2018. Se aplicaron medidas de frecuencia y asociación para el análisis estadístico. Resultados: Se incluyeron 160 pacientes: 108 mujeres y 52 hombres, todos de raza mestiza. Se identificó retinopatía en 26,8 por ciento (N = 43) de los pacientes, de quienes 41 por ciento (N = 18) tenía más de 65 años de edad. La media de HbA1C en pacientes sin retinopatía fue de 7,4 por ciento, y en aquellos con retinopatía de 9,8 por ciento en mayor porcentaje de pacientes con valores de HbA1C de 7 por ciento o más presentaron retinopatía diabética, en comparación con aquellos de HbA1C menores a 7 por ciento (p < 0,0001), la retinopatía no proliferativa moderada fue el principal diagnóstico realizado. Conclusiones: El mal control glucémico en las personas con diabetes mellitus tipo 2 se asocia con mayor probabilidad de aparición de lesiones retinianas(AU)

Introduction: Diabetic retinopathy is the main cause of blindness in diabetic people aged 20 to 64 years; it increases its occurrence due to poor control of the disease, expressed by high values of glycosylated hemoglobin (HbA1c). Objective: To establish the relationship between glycosylated hemoglobin levels and the presence of retinopathy in patients with type 2 diabetes mellitus. Methods: A descriptive, prospective and cross-sectional study was carried out, in which sociodemographic data, others from an ophthalmologic evaluation and HbA1c levels were obtained, by means of an observation card, from patients seen in the outpatient clinic of Hospital General Isidro Ayoraof the city of Loja, Ecuador, in the period February-June 2018. Frequency and association measures were applied for statistical analysis. Results: The study included 160 patients: 108 women and 52 men, all of mixed race. Retinopathy was identified in 26.8percent (N=43) of patients, of whom 41percent (N=18) were over 65 years of age. The mean HbA1c in patients without retinopathy was 7.4percent, and 9.8percent in those with retinopathy. A higher percentage of patients with HbA1c values of 7percent more had diabetic retinopathy, compared to those with HbA1C under 7percent (p<0.0001). Moderate nonproliferative retinopathy was the main diagnosis. Conclusions: Poor glycemic control in persons with type 2 diabetes mellitus is associated with increased likelihood of retinal lesions(AU)

Clinical characteristics among patients with pulmonary tuberculosis complicated by prediabetes mellitus / 中国基层医药

Objective:To analyze the clinical characteristics of pulmonary tuberculosis (PTB) in patients with prediabetes mellitus (PreDM) and improve the understanding and diagnosis of pulmonary tuberculosis complicated by prediabetes mellitus (PreDM-PTB).Methods:The clinical data of 109 inpatients with PTB who underwent glycated hemoglobin A1c (HbA1c) examination admitted to Beijing Chest Hospital, Capital Medical University from January 2015 to January 2016 were retrospectively analyzed. These patients were divided into the PreDM-PTB group ( n = 45) and the non-PreDM-PTB group (N-PreDMPTB group, n = 64) according to HbA1c test results. Patient demographic data, clinical features, imaging data, bacteriological results, and other laboratory results were collected from all patients. Results:The mean age and body mass index (BMI) were higher in the PreDM-PTB group than the N-PreDMPTB group. The proportion of patients having a smoking history was higher in the PreDM-PTB group than the N-PreDMPTB group (46.7% vs. 25.0%). The proportions of patients who had a cough (88.9%), fever (55.6%), anorexia (17.8%), chest tightness (31.1%), shortness of breath (28.9%), weight loss (40.0%), and pleural effusion (22.2%) were higher in the PreDM-PTB group than the N-PreDMPTB group. Patients with PreDM-PTB were more prone to develop anemia (55.6%), hypoproteinemia (55.6%), and increased low-density lipoprotein (26.7%) compared with patients with N-PreDMPTB. The levels of D-Dimer (93.2%), C-reactive protein (86.7%), and erythrocyte sedimentation rate (79.1%) were increased in the PreDM-PTB group compared with the N-PreDMPTB group. Sputum smear results showed that the positivity of mycobacterium tuberculosis was higher in the PreDM-PTB group (74.4%) compared with the N-PreDMPTB group. There was no significant difference in drug resistance between the two groups ( P > 0.05). The positivity of blood tuberculosis antibody and blood T-cell spot test for tuberculosis infection were 60.9% and 84.6% respectively in the PreDM-PTB group and they were 50.9% and 95.2% respectively in the N-PreDMPTB group. There were no significant differences in these two indices between the two groups ( P = 0.321, 0.066). Conclusion:Patients with Pre-DMPTB have different clinical manifestations and auxiliary examination characteristics compared with patients with N-PreDMPTB patients, which should be paid more attention to by clinicians. Early intervention should be actively adopted to prevent diabetes development from pre-DM.

Clinical study on dapagliflozin combined with metformin for the treatment of type 2 diabetes mellitus / 中国基层医药

Objective:To investigate the clinical effect of dapagliflozin combined with metformin on type 2 diabetes mellitus (T2DM).Methods:A total of 100 patients with T2DM who received treatment in The Second People's Hospital of Hefei from June 2019 to May 2021 were included in this study. They were randomly divided into a control group ( n = 50) and an experimental group ( n = 50). The control group was treated with metformin, and the experimental group was treated with dagglitazin combined with metformin. All patients were treated for 3 months. Blood glucose index, blood lipid level, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, fasting blood glucose, 2-hour post-prandial blood glucose, and glycosylated hemoglobin in the experimental group were (5.56 ± 0.37) mmol/L, (8.32 ± 0.23) mmol/L, and (6.17 ± 0.26)% respectively, which were significantly lower than (6.96 ± 0.48) mmol/L, (9.58 ± 0.39) mmol/L, and (7.27 ± 0.26)% respectively in the control group ( t = 3.59, 6.92, 5.03, all P < 0.05). The total cholesterol and triglyceride in the experimental group were (3.58 ± 0.53) mmol/L and (1.25±0.26) mmol/L, respectively, which were significantly lower than (4.94 ± 0.58) mmol/L and (1.93 ± 0.18) mmol/L in the control group ( t = 3.16, 4.25, both P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dapagliflozin combined with metformin can effectively control blood glucose and blood lipid in T2DM patients without increasing adverse reactions.

Therapeutic effects of insulin degludec/insulin aspart on type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs / 中国基层医药

Objective:To investigate the clinical efficacy of insulin degludec/insulin aspart on type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs.Methods:A total of 100 patients with type 2 diabetes mellitus in Tianfu Hospital of Chongqing Energy Investment Health Industry Company Limited from August 2020 to August 2021 were included in this study. They were randomly assigned to receive either insulin degludec/insulin aspart combined with Metformin (observation group, n = 50) or nsulin aspart 30 injection and Metformin (control group, n = 50). All patients were treated for 3 months. Changes in fasting plasma glucose level, 2-hour postprandial glucose level , and HbAlc after treatment relative to those before treatment as well as clinical efficacy were determined in each group. Results:Forty-eight patients in the observation group and forty-six patients in the control group completed the course of treatment. Fasting blood glucose level and 2-hour postprandial glucose level in the observation group were (6.24 ± 1.12) mmol/L and (8.34 ± 2.34) mmol/L, respectively and they were significantly lower than (6.91 ± 1.86) mmol/L and (10.72 ± 2.48) mmol/L, respectively in the control group ( t = 3.28, 4.76, both P < 0.05). The level of HbAlc was not significant between the two groups ( P > 0.05). The hypoglycemia rate in the observation group was significantly lower than that in the control group [2% (1/48) vs. 13% (6/46), χ2 = 4.09, P < 0.05]. The daily dose of insulin in the observation group was less than that in the control group [(13.5 ± 2.8) IU vs. (15.6 ± 3.1) IU, t = 3.28, P < 0.05)]. Conclusion:Compared with insulin insulin aspart 30, the insulin degludec/insulin aspart has a stronger hypoglycemic effect on fasting plasma glucose level and 2-hour postprandial glucose level in the treatment of type 2 diabetes mellitus in patients with poor efficacy of oral hypoglycemic drugs, leading to a less daily dose of insulin.

Relationship between serum iron metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus / 中国糖尿病杂志

Objective To explore the relationship between serum iron(SI)metabolism and glucose and lipid metabolism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 170 T2DM patients hospitalized in the Department of Endocrinology,Lanzhou University First Hospital from 2019 to 2021 were included.During the same period,30 healthy individuals from physical examination center were selected as the normal control(NC)group.Based on HbA1c control,T2DM patients were divided into subgroups with good blood glucose control(H1,HbA1c＜7%,n=39),poor glucose control(H2,7%＜HbA1c＜9%,n=63)and very poor glucose control(H3,HbA1c＞9%,n=68).According to the level of blood lipids,T2DM patients were divided into subgroups with normal blood lipids(L1,n=36)and high blood lipids(L2,n=134).Results Compared with NC group,age,SBP,DBP,BMI,serum ferritin(SF),FPG,FIns,HOMA-IR,TyG,TG,LDL-C and SUA increased inT2DM group(P＜0.05),while SI,TF,total iron binding capacity(TIBC),DI,HDL-C and eGFR decreased(P＜0.05).The levels of TF and TIBC in H3 subgroup were lower than those in H1 subgroup(P＜0.05).LDL-C of L2 subgroup was higher than that of L1 subgroup(P＜0.05),while HDL-C was lower than that of L1 subgroup(P＜0.05).Pearson correlation analysis showed that SF was positively correlated with HbA1c,TyG,TG and SUA(P＜0.05),and negatively correlated with HDL-C and eGFR(P＜0.05).TF was positively correlated with HDL-C and eGFR(P＜0.05),but negatively correlated with age,SBP,DBP,TyG and SUA(P＜0.05).Multiple linear regression analysis showed that SF and FPG were influencing factors for HbA1c in T2DM patients.Conclusion SI metabolism is closely related to glucose and lipid metabolism in T2DM patients.

Control status and influencing factors of glycated hemoglobin in children with type 1 diabetes in Tianjin 2020-2021 / 公共卫生与预防医学

Objective To analyze the control status and influencing factors of glycosylated hemoglobin (HbA1c) in children with type 1 diabetes mellitus (T1DM) in Tianjin from 2020 to 2021, and to provide a theoretical basis for controlling blood glucose in children with type 1 diabetes mellitus. Methods A total of 538 children with type 1 diabetes, including 275 males and 263 females, were selected from our hospital from January 2020 to June 2021. All the children were determined according to the level of HbA1c and divided into well-controlled group (HbA1c<7.0%, n=469) and poorly controlled group (HbA1c≥7.0%, n=69), 3ml fasting elbow venous blood was extracted from the two groups, and the levels of HbA1c, FPG, 2hPG, TC and LDL-C were compared between the two groups. Clinical data of the children were collected from the medical record system. The factors affecting the control of HbA1c in children with type 1 diabetes were analyzed by univariate analysis and logistic regression. Results The comparison of general data between the two groups showed no significant difference in age, sex and course of type 1 diabetes mellitus (P<0.05). The levels of HbA1c, FPG, 2hPG, TC and LDL-C in poorly controlled group were significantly higher than those in well controlled group (P<0.05). The blood glucose monitoring <60 times/month (OR=3.017), uncontrolled diet (OR=2.871), obesity (OR=2.623) were independent risk factors for poor control of HbA1c in children with type 1 diabetes (P<0.05). Conclusions Children with type 1 diabetes mellitus have a greater risk of poor control of HbA1c. It is necessary to strengthen publicity and education for parents of children with diabetes, regularly monitor blood glucose and control diet to effectively improve blood glucose control in children.

Eficacia del tratamiento con Bevacizumab intravítreo en pacientes diagnosticados de edema macular diabético en el Hospital Otorrino Oftalmológico de la Caja Nacional de Salud, La Paz ­ Bolivia / Effectiveness of treatment with intravitreous Bevacizumab in patients diagnosed with diabetic macular edema at the Hospital Otorrino Oftalmológico of the Caja Nacional de Salud, La Paz ­ Bolivia

Objetivo: determinar los cambios en el espesor macular establecido por Tomografía de Coherencia Óptica (OCT) posterior al tratamiento con Bevacizumab intravítreo en pacientes con Edema Macular Diabético, diagnosticados en el Hospital Otorrino Oftalmológico. Material y Métodos: es un estudio de serie de casos. Se realizo un muestreo por conveniencia de pacientes con edema macular diabético, la muestra obtenida fue de 106 casos de un universo de 146 pacientes con una confiabilidad del 95%, pero según criterios de inclusión y exclusión, la muestra se redujo a 24 pacientes. Resultados: disminución del espesor macular inicial de 493,8 µm a 287,6 µm. La agudeza visual mejora después del tratamiento con Bevacizumab en 79,2% de los pacientes, de los cuales el 62,5% mejoro hasta la 3era dosis de inyección intravítrea y en relación con la HbA1c (Hemoglobina Glicosilada) valores < a 7% da una frecuencia relativa de 66,7% y > a 7% un 33,3%. Existió mayor representatividad de edad entre un rango de 51 a 60 años en 9 pacientes 37,5%. Conclusiones: el tratamiento del edema macular diabético con Bevacizumab intravítreo produce mejorías significativas tanto anatómicas como funcionales. Los valores de HbA1Ac es influyente tanto para la mejora anatómica como funcional.

Objective: to determine the changes in macular thickness established by Optical Coherence Tomography (OCT) after treatment with intravitreal bevacizumab in patients with Diabetic Macular Edema, diagnosed at the Otorrino Ophthalmological Hospital. Material and Methods: it is a case series study. A convenience sampling of patients with diabetic macular edema was performed, the sample obtained was 106 cases from a universe of 146 patients with a reliability of 95%, but according to inclusion and exclusion criteria, the sample was reduced to 24 patients. Results: decrease in initial macular thickness from 493.8 µm to 287.6 µm. Visual acuity improved after treatment with bevacizumab in 79.2% of patients, of whom 62.5% improved to the 3rd dose of intravitreal injection and in relation to HbA1c (Glycosylated Hemoglobin) values < to 7% gives a relative frequency of 66.7% and > to 7% 33.3%. There was a greater representation of age between a range of 51 to 60 years in 9 patients, 37.5%. Conclusions: the treatment of diabetic macular edema with intravitreal bevacizumab produces significant anatomical and functional improvements. HbA1Ac values are influential for both anatomical and functional improvement.

Depression scores correlate with glycosylated hemoglobin a levels in type 2 diabetics from a mayan community / Los puntajes de depresión se correlacionan con los niveles de hemoglobina glucosilada en diabéticos tipo 2 de una comunidad maya

Abstract Objective: To assess whether depression and quality of life scores correlate with glycosylated hemoglobin A (HbA1c) levels in type 2 diabetes mellitus (T2DM) patients of predominant Mayan ethnicity, from a rural community in the state of Yucatán, Mexico. Materials and methods: Instruments: for depression, CES-D (cutoff ≥ 16); for quality of life, D-39; criterion for poor glycemic control, HbA1c ≥ 8%. Results: Depression was detected in 36.3% of 33 diabetic subjects (10 men, 23 women), and their HbA1c levels (mean ± SD) were higher (10.7 ± 2.5%) than for those without depression (8.6 ± 2.2%, p = 0.015; unpaired Student's t-test, two-tailed). Depression occurred in 33.3% of diabetics with HbA1c ≥8%, but only in 3.0% of those with HbA1c < 8% (p = 0.027, Fisher's exact test). HbA1c levels positively correlated with CES-D scores (r2 =0.135; p = 0.035; Pearson). D-39 "Anxiety-Worry" (AW) dimension scores were higher in diabetics with depression (43.3 ± 22.2) than in those without depression (17.7 ± 17.8; p = 0.005, Mann-Whitney U-test). A positive correlation was found between CES-D and AW scores (r2 = 0.304; p = 0.001; Pearson). Conclusions: Considering that depression and anxiety have been related to poor self-care for achieving a good glycemic control, we propose the concomitant use of CES-D and D-39, which are validated and easy-to-apply instruments, as screening tests to detect depression and anxiety in T2DM patients residing in rural communities. Therefore, if patients test positive on one or both instruments, they can be referred to a psychiatrist to confirm the diagnosis and provide appropriate therapy. This would help to promote adherence to diabetes control measures and improve their quality of life.

Resumen Objetivo: Evaluar si las puntuaciones de depresión y calidad de vida se correlacionan con los niveles de hemoglobina glucosilada (HbA1c) en pacientes con diabetes mellitus tipo 2 (DM2) de etnia maya predominante, de una comunidad rural en el estado de Yucatán, México. Materiales y Métodos: Instrumentos: para depresión, CES-D (punto de corte ≥ 16); para calidad de vida, D-39; criterio de mal control glucémico, HbA1c ≥ 8%. Resultados: Se detectó depresión en el 36.3% de 33 sujetos diabéticos (10 hombres, 23 mujeres), y sus niveles de HbA1c (media ± DE) fueron más altos (10.7 ± 2.5%) que para los que no tenían depresión (8.6 ± 2.2%, p = 0.015; prueba t de Student, no pareada). La depresión se presentó en el 33.3% de los diabéticos con HbA1c ≥ 8%, pero solo en el 3.0% de aquellos con HbA1c <8% (p = 0.027, prueba exacta de Fisher). Los niveles de HbA1c se correlacionaron positivamente con las puntuaciones CES-D (r2 = 0.135; p = 0.035; Pearson). Los puntajes de la dimensión "Ansiedad-Preocupación" (AW) del D-39 fueron más altos en diabéticos con depresión (43.3 ± 22.2) que en aquellos sin depresión (17.7 ± 17.8; p = 0.005, prueba U de Mann-Whitney). Se encontró una correlación positiva entre las puntuaciones CES-D y AW (r2 = 0.304; p = 0.001; Pearson). Conclusiones: Considerando que la depresión y la ansiedad han sido asociadas a autocuidados inadecuados para alcanzar un buen control glicémico, proponemos el uso concomitante de CES-D y D-39, que son instrumentos validados y de fácil aplicación, como pruebas de cribado para detectar depresión y ansiedad en pacientes con DM2 residentes en comunidades rurales. Por lo tanto, si los pacientes dan positivo en uno o ambos instrumentos, se les puede derivar a un psiquiatra para confirmar el diagnóstico y proporcionar la terapia adecuada. Esto ayudaría a promover el cumplimiento de las medidas de control de la diabetes y a mejorar su calidad de vida.