Exploring the therapeutic potential of functional foods for diabetes: A bibliometric analysis and scientific mapping.

The incidence of diabetes is increasingly becoming a global health burden. Meanwhile, in recent years, functional foods have been intensively investigated for diabetes management. These foods provide health benefits due to their bioactive compounds that enhance the metabolism and lower the risk of chronic diseases, such as diabetes. The aim of this study was to explore the keywords, countries/territories, publication numbers, institutions, authors, and journals associated with functional foods for the management of diabetes using a comprehensive bibliometric analysis method. Scopus database was used to compile the information, followed by VOSviewer for comprehensive bibliometric data analysis. A total of 1,226 Scopus articles that met the inclusion criteria were analyzed. The results showed that the greatest expansion in research occurred in 2012, and China was identified as the most productive nation in this field. In addition, Food and Function was found as the most recognized journal in this area, and Singh, R.B. as well as Zengin, G. made the greatest contribution. The bibliometric data also illustrated several mechanisms of functional foods for diabetes management, including antioxidant activity, effect on the gastrointestinal microbiomes, and inhibitor α-amylase. These results underscore the immense potential of functional foods in the diabetes management and provide guidance for future research on this subject.

Monogenic diabetes in a Chinese population with young-onset diabetes: A 17-year prospective follow-up study in Hong Kong.

AIMS: Asians have a high prevalence of young-onset diabetes, but the pattern of monogenic diabetes is unknown. We aimed to determine the prevalence of monogenic diabetes in Chinese patients with young-onset diabetes and compare the clinical characteristics and outcome between patients with and without monogenic diabetes. MATERIALS AND METHODS: We sequenced a targeted panel of 33 genes related to monogenic diabetes in 1021 Chinese patients with non-type 1 diabetes diagnosed at age ≤40 years. Incident complications including cardiovascular disease (CVD), end-stage kidney disease (ESKD) and all-cause death were captured since enrolment (1995-2012) until 2019. RESULTS: In this cohort (mean ± SD age at diagnosis: 33.0 ± 6.0 years, median[IQR] diabetes duration 7.0[1.0-15.0] years at baseline, 44.9% men), 22(2.2%, 95% confidence interval[CI] 1.4%-3.2%) had monogenic diabetes. Pathogenic (P) or likely pathogenic (LP) variants were detected in GCK (n = 6), HNF1A (n = 9), HNF4A (n = 1), PLIN1 (n = 1) and PPARG (n = 2), together with copy number variations in HNF1B (n = 3). Over a median follow-up of 17.1 years, 5(22.7%) patients with monogenic diabetes (incidence rate 12.3[95% CI 5.1-29.4] per 1000 person-years) versus 254(25.4%) without monogenic diabetes (incidence rate 16.7[95% CI 14.8-18.9] per 1000 person-years) developed the composite outcome of CVD, ESKD and/or death (p = 0.490). The multivariable Cox model did not show any difference in hazards for composite events between groups. CONCLUSIONS: In Chinese with young-onset non-type 1 diabetes, at least 2% of cases were contributed by monogenic diabetes, over 80% of which were accounted for by P/LP variants in common MODY genes. The incidence of diabetes complications was similar between patients with and without monogenic diabetes.

Federally Qualified Health Centers' Screening for Social Risk Factors and Health Outcomes.

Federally Qualified Health Centers (FQHCs) are ideally positioned to identify and address health-related social needs, but little is understood about the relationship between social risk factor (SRF) screening and health outcomes. We studied 1352 FQHCs from the 2019 Uniform Data System. Ordinary least squares regression was used to estimate the relationship between SRF screening and the percentage of patients with adequately controlled diabetes and hypertension. Results show 71% of the FQHCs in the sample collected SRFs. FQHCs' screened for SRFs had higher percentages of patients with adequately controlled diabetes (69.5% vs 67.0%, P < .001) and hypertension (63.8% vs 59.4%, P < .001) relative to FQHCs not collecting SRFs.

CVD incidence and mortality among people with diabetes and/or hypertension: Results from the English longitudinal study of ageing.

BACKGROUND AND AIMS: Diabetes and/or hypertension are the most common conditions in older people, and also related to higher cardiovascular disease (CVD) incidence and mortality. This study aims to explore the risk of CVD incidence and mortality among older people with diabetes and/or hypertension over a 16 years follow-up period and investigates the role of depression and obesity in these relationships. METHODS: 6,855 participants aged 50+ from the English Longitudinal Study of Ageing (ELSA). The main exposure is having diabetes and/or hypertension at baseline (2002/2003) compared to not having, but excluded those with coronary heart disease (CHD) and/or stroke (CVD). Survival models are used for CVD incidence and mortality up to 2018, adjusted for socio-demographic, health, health behaviours, cognitive function, and physical function characteristics. RESULTS: 39.3% of people at baseline had diabetes and/or hypertension. The risk of CVD incidence was 1.7 (95%CI: 1.5; 1.9) higher among people with diabetes and/or hypertension compared to those without and was independent of covariates adjustment. People with diabetes and/or hypertension were also 1.3 (95%CI: 1.1; 1.8) times more likely to die from CVD than those without. We did not find evidence for an elevated risk of CVD incidence and mortality among people with obesity nor among those with depression. CONCLUSIONS: In order to effectively reduce the risk of CVD incidence and mortality among older people, treatment as well as management of hypertension and diabetes should be routinely considered for older people with diabetes and/or hypertension.

Visual impairment among diabetes patients in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: The increased prevalence of visual impairment among diabetes patients has become a major global public health problem. Although numerous primary studies have been conducted to determine the prevalence of visual impairment and its associated factors among diabetes patients in Ethiopia, these studies presented inconsistent findings. Therefore, this review aimed to determine the pooled prevalence of visual impairment and identify associated factors among diabetes patients. METHODS: An extensive search of literature was done on PubMed, Google Scholar, and Web of Sciences databases. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to calculate the pooled prevalence of visual impairment. RESULTS: A total of 34 eligible primary studies with a sample size of 11,884 participants were included in the final meta-analysis. The pooled prevalence of visual impairment was 21.73% (95% CI: 18.15, 25.30; I2 = 96.47%; P<0.001). Diabetes mellitus with a duration of diagnosis ≥10 years [AOR = 3.18, 95% CI: 1.85, 5.49], presence of co-morbid hypertension [AOR = 3.26, 95% CI: 1.93, 5.50], poor glycemic control [AOR = 4.30, 95% CI: 3.04, 6.06], age ≥56 years [AOR = 4.13, 95% CI: 2.27, 7.52], family history of diabetes mellitus [AOR = 4.18 (95% CI: 2.61, 6.69], obesity [AOR = 4.77, 95% CI: 3.00, 7.59], poor physical activity [AOR = 2.46, 95% CI: 1.75, 3.46], presence of visual symptoms [AOR = 4.28, 95% CI: 2.73, 6.69] and no history of eye exam [AOR = 2.30, 95% CI: 1.47, 3.57] were significantly associated with visual impairment. CONCLUSIONS: The pooled prevalence of visual impairment was high in Ethiopia. Diabetes mellitus with a duration of diagnosis ≥10 years, presence of co-morbid hypertension, poor glycemic control, age ≥56 years, and family history of diabetes mellitus, obesity, poor physical activity, presence of visual symptoms, and no history of eye exam were independent predictors. Therefore, diabetic patients with these identified risks should be screened, and managed early to reduce the occurrence of visual impairment related to diabetes. Moreover, public health policy with educational programs and regular promotion of sight screening for all diabetes patients are needed.

Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center.

INTRODUCTION: Diabetes mellitus (DM) is a risk factor of infection. Although DM has been associated with worse functional outcomes after acetabular fracture, literature regarding the effect of DM on surgical site infection and other early complications is lacking. METHODS: A 20-year registry from a level 1 trauma center was queried to identify 134 patients with DM and 345 nondiabetic patients with acetabular fractures. RESULTS: The diabetic patient population was older (57.2 versus 43.2; P < 0.001) and had higher average body mass index (33.6 versus 29.5; P < 0.001). Eighty-three patients with DM and 270 nondiabetics were treated surgically (62% versus 78%; P < 0.001). Diabetic patients who were younger (54.6 versus 61.4; P = 0.01) with fewer comorbidities (1.7 versus 2.2; P = 0.04) were more frequently managed surgically. On univariate analysis, patients with DM more commonly developed any early infection (28.4% versus 21%; P = 0.049) but were no more likely to develop surgical site infection, or other postoperative complications. Older patient age, length of stay, baseline pulmonary disease, and concurrent abdominal injury were independent predictors of postoperative infection other than surgical site infection. Diabetics that developed infection had more comorbidities (2.4 versus 1.5; P < 0.001) and higher Injury Severity Score (24.1 versus 15.8; P = 0.003), and were more frequently insulin-dependent (72.7% versus 41%; P = 0.01). DISCUSSION: Independent of management strategy, diabetic patients were more likely to develop an infection after acetabular fracture. Insulin dependence was associated with postoperative infection on univariate analysis. Optimal selection of surgical candidates among patients with DM may limit postoperative infections.

A national audit of facilities, human and material resources for the comprehensive management of diabetes in Ghana-A 2023 update.

INTRODUCTION: The human and material resources as well as the systems for managing diabetes in Africa are inadequate. This study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana. METHODS: We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant. RESULTS: Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin, respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones. Majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Fifteen facilities (12.3%) had Diabetes Support Groups in their locality and catchment areas. CONCLUSION: An urgent multisectoral collaboration, including prioritisation of resources at the facility level, to promote and achieve acceptable comprehensive diabetes care is required.

Exploring the path to optimal diabetes care by unravelling the contextual factors affecting access, utilisation, and quality of primary health care in West Africa: A scoping review protocol.

BACKGROUND: The prevalence of diabetes in West Africa is increasing, posing a major public health threat. An estimated 24 million Africans have diabetes, with rates in West Africa around 2-6% and projected to rise 129% by 2045 according to the WHO. Over 90% of cases are Type 2 diabetes (IDF, World Bank). As diabetes is ambulatory care sensitive, good primary care is crucial to reduce complications and mortality. However, research on factors influencing diabetes primary care access, utilisation and quality in West Africa remains limited despite growing disease burden. While research has emphasised diabetes prevalence and risk factors in West Africa, there remains limited evidence on contextual influences on primary care. This scoping review aims to address these evidence gaps. METHODS AND ANALYSIS: Using the established methodology by Arksey and O'Malley, this scoping review will undergo six stages. The review will adopt the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) guidelines to ensure methodological rigour. We will search four electronic databases and search through grey literature sources to thoroughly explore the topic. The identified articles will undergo thorough screening. We will collect data using a standardised data extraction form that covers study characteristics, population demographics, and study methods. The study will identify key themes and sub-themes related to primary healthcare access, utilisation, and quality. We will then analyse and summarise the data using a narrative synthesis approach. RESULTS: The findings and conclusive report will be finished and sent to a peer-reviewed publication within six months. CONCLUSION: This review protocol aims to systematically examine and assess the factors that impact the access, utilisation, and standard of primary healthcare services for diabetes in West Africa.

Computed Tomography Angiography Characteristics of Thin-Cap Fibroatheroma in Patients With Diabetes.

BACKGROUND: It was recently reported that thin-cap fibroatheroma (TCFA) detected by optical coherence tomography was an independent predictor of future cardiac events in patients with diabetes. However, the clinical usefulness of this finding is limited by the invasive nature of optical coherence tomography. Computed tomography angiography (CTA) characteristics of TCFA have not been systematically studied. The aim of this study was to investigate CTA characteristics of TCFA in patients with diabetes. METHODS AND RESULTS: Patients with diabetes who underwent preintervention CTA and optical coherence tomography were included. Qualitative and quantitative analyses were performed for plaques on CTA. TCFA was assessed by optical coherence tomography. Among 366 plaques in 145 patients with diabetes, 111 plaques had TCFA. The prevalence of positive remodeling (74.8% versus 50.6%, P<0.001), low attenuation plaque (63.1% versus 33.7%, P<0.001), napkin-ring sign (32.4% versus 11.0%, P<0.001), and spotty calcification (55.0% versus 34.9%, P<0.001) was significantly higher in TCFA than in non-TCFA. Low-density noncalcified plaque volume (25.4 versus 15.7 mm3, P<0.001) and remodeling index (1.30 versus 1.20, P=0.002) were higher in TCFA than in non-TCFA. The presence of napkin-ring sign, spotty calcification, high low-density noncalcified plaque volume, and high remodeling index were independent predictors of TCFA. When all 4 predictors were present, the probability of TCFA increased to 82.4%. CONCLUSIONS: The combined qualitative and quantitative plaque analysis of CTA may be helpful in identifying TCFA in patients with diabetes. REGISTRATION INFORMATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04523194.

HbA1c changes in a deprived population who followed or not a diabetes self-management programme, organised in a multi-professional primary care practice: a historical cohort study on 207 patients between 2017 and 2019.

BACKGROUND: Diabetes self-management (DSM) helps people with diabetes to become actors in their disease. Deprived populations are particularly affected by diabetes and are less likely to have access to these programmes. DSM implementation in primary care, particularly in a multi-professional primary care practice (MPCP), is a valuable strategy to promote care access for these populations. In Rennes (Western France), a DSM programme was designed by a MPCP in a socio-economically deprived area. The study objective was to compare diabetes control in people who followed or not this DSM programme. METHOD: The historical cohort of patients who participated in the DSM programme at the MPCP between 2017 and 2019 (n = 69) was compared with patients who did not participate in the programme, matched on sex, age, diabetes type and place of the general practitioner's practice (n = 138). The primary outcome was glycated haemoglobin (HbA1c) change between 12 months before and 12 months after the DSM programme. Secondary outcomes included modifications in diabetes treatment, body mass index, blood pressure, dyslipidaemia, presence of microalbuminuria, and diabetes retinopathy screening participation. RESULTS: HbA1c was significantly improved in the exposed group after the programme (p < 0.01). The analysis did not find any significant between-group difference in socio-demographic data, medical history, comorbidities, and treatment adaptation. CONCLUSIONS: These results, consistent with the international literature, promote the development of DSM programmes in primary care settings in deprived areas. The results of this real-life study need to be confirmed on the long-term and in different contexts (rural area, healthcare organisation).

Hematological Parameters and Comorbidities in COVID-19: Insights into Clinical Profiles and Outcome Predictors.

BACKGROUND: The global pandemic, known as the coronavirus disease 2019 (COVID-19) and caused by the severe acute respiratory syndrome, coronavirus 2 (SARS-CoV-2), poses a significant threat, particularly to individuals with comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), diabetes, HIV, cardiovascular disease (CVD), and cancer. METHODS: This descriptive retrospective study investigates the impact of comorbidities on COVID-19-positive patients. The study includes individuals that were tested positive for SARS-CoV-2 via polymerase chain reaction at the Security Forces Hospital, Makkah, KSA, between February, 2022, and June, 2022. A total of 208 patients (107 males, 101 females) were examined, and the laboratory results revealed normal parameters. RESULTS: An analysis indicates that 86.5% of the patients were discharged, 2.9% remained hospitalized, and 10.6% succumbed to the disease, indicating a 10.6% mortality rate among comorbid COVID-19-positive patients. Notably, the study identifies specific comorbidities (chronic kidney disease, diabetes mellitus, hypertension) and changes in laboratory parameters (red blood cells, hemoglobin, C-reactive protein, white blood cells, ferritin, D-dimer, ALT, troponin, LDH, neutrophils) associated with ICU admission during hospitalization. CONCLUSIONS: This study underscores the critical impact of comorbidities, such as chronic kidney disease, diabetes, and hypertension, on the clinical outcomes of COVID-19-positive patients. The identification of specific laboratory parameters linked with ICU admission provides valuable insights for risk stratification and tailored management strategies.

Diabetes, life course and childhood socioeconomic conditions: an empirical assessment for Mexico.

BACKGROUND: Demographic and epidemiological dynamics characterized by lower fertility rates and longer life expectancy, as well as higher prevalence of non-communicable diseases such as diabetes, represent important challenges for policy makers around the World. We investigate the risk factors that influence the diagnosis of diabetes in the Mexican population aged 50 years and over, including childhood poverty. RESULTS: This work employs a probabilistic regression model with information from the Mexican Health and Aging Study (MHAS) of 2012 and 2018. Our results are consistent with the existing literature and should raise strong concerns. The findings suggest that risk factors that favor the diagnosis of diabetes in adulthood are: age, family antecedents of diabetes, obesity, and socioeconomic conditions during both adulthood and childhood. CONCLUSIONS: Poverty conditions before the age 10, with inter-temporal poverty implications, are associated with a higher probability of being diagnosed with diabetes when older and pose extraordinary policy challenges.

Epidemiology and Comorbidities of Vestibular Disorders: Preliminary Findings of the AVOCADO Study.

INTRODUCTION: Studies on incidence and prevalence of vestibular disorders tend to focus on small pockets of patients recruited from specialized clinics and often exclude measures of vestibular function. The objectives of the study were to characterize patients with common vestibular disorders, estimate the prevalence of common vestibular disorders, and ascertain whether patients with vestibular disorders experience increased risks of falls and morbidity. MATERIALS AND METHODS: This retrospective cohort study includes both inpatient and outpatient routine clinical care data culled from a nationally representative, population-based sample. Patients were included if their record in the TriNetX Diamond Cohort comprised at least one vestibular function test or vestibular diagnosis. The main outcome measures were diagnosis with a vestibular disorder, a fall, or a common medical comorbidity (e.g., diabetes, cerebrovascular disease). RESULTS: The cohort includes n = 4,575,724 patients, of which 55% (n = 2,497,136) had a minimum of one vestibular diagnosis. Patients with vestibular diagnoses were 61.3 ± 16.6 years old (mean ± standard deviation), 67% women, 28% White race (69% unknown race), and 30% of non-Hispanic or Latino ethnicity (66% unknown ethnicity). The prevalence of vestibular disorders was estimated at 2.98% (95% confidence interval [CI]: 2.98-2.98%). Patients with vestibular diagnoses experienced a significantly greater odds of falls (odds ratio [OR] = 1.04; 95% CI: 1.02-1.05), cerebrovascular disease (OR = 1.42; 95% CI: 1.40-1.43), ischemic heart disease (OR = 1.17; 95% CI: 1.16-1.19), and diabetes (OR = 1.14; 95% CI: 1.13-1.15), among others. DISCUSSION: Vestibular disorders affect an estimated 3% of the U.S. population, after weighting. Patients with these disorders are at greater risk for many common, consequential medical conditions.

The association between the triglyceride-glucose index and the risk of cardiovascular disease in US population aged ≤ 65 years with prediabetes or diabetes: a population-based study.

BACKGROUND: The relationship between the triglyceride-glucose (TyG) index and the risk of cardiovascular disease (CVD) in the U.S. population under 65 years of age with diabetes or prediabetes is unknown. The purpose of this study was to investigate the relationship between baseline TyG index and CVD risk in U.S. patients under 65 years of age with diabetes or prediabetes. METHODS: We used data from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). Multivariate regression analysis models were constructed to explore the relationship between baseline TyG index and CVD risk. Nonlinear correlations were explored using restricted cubic splines. Subgroup analysis and interaction tests were also conducted. RESULTS: The study enrolled a total of 4340 participants with diabetes or pre-diabetes, with a mean TyG index of 9.02 ± 0.02. The overall average prevalence of CVD was 10.38%. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 7.35%; Quartile 2: 10.04%; Quartile 3: 10.71%; Quartile 4: 13.65%). For CVD, a possible association between the TyG index and the risk of CVD was observed. Our findings suggested a linear association between the TyG index and the risk of CVD. The results revealed a U-shaped relationship between the TyG index and both the risk of CVD (P nonlinear = 0.02583) and CHF (P nonlinear = 0.0208) in individuals with diabetes. Subgroup analysis and the interaction term indicated that there was no significant difference among different stratifications. Our study also revealed a positive association between the TyG index and comorbid MetS in the U.S. population under 65 years of age with prediabetes or diabetes. CONCLUSIONS: A higher TyG index was linked to an increased likelihood of CVD in the U.S. population aged ≤ 65 years with prediabetes and diabetes. Besides, TyG index assessment will contribute to more convenient and effective screening of high-risk individuals in patients with MetS. Future studies should explore whether interventions targeting the TyG index may improve clinical outcomes in these patients.

Impact of Comprehensive Primary Care in Patients With Complex Chronic Diseases: Nationwide Cohort Database Analysis in Korea.

BACKGROUND: More comprehensive healthcare services should be provided to patients with complex chronic diseases to better manage their complex care needs. This study examined the effectiveness of comprehensive primary care in patients with complex chronic diseases. METHODS: We obtained 2002-2019 data from the National Health Insurance Sample Cohort Database. Participants were individuals aged ≥ 30 years with at least two of the following diseases: hypertension, diabetes mellitus, and hyperlipidemia. Doctors' offices were classified into specialized, functional, and gray-zone based on patient composition and major diagnostic categories. The Cox proportional hazard model was used to examine the association between office type and hospital admission due to all-causes, severe cardiovascular or cerebrovascular diseases (CVDs), hypertension, diabetes mellitus, or hyperlipidemia. RESULTS: The mean patient age was 60.3 years; 55.8% were females. Among the 24,906 patients, 12.8%, 38.3%, and 49.0% visited specialized, functional, and gray-zone offices, respectively. Patients visiting functional offices had a lower risk of all-cause admission (hazard ratio [HR], 0.935; 95% confidence interval [CI], 0.895-0.976) and CVD-related admission (HR, 0.908; 95% CI, 0.844-0.977) than those visiting specialized offices. However, the admission risks for hypertension, diabetes mellitus, and hyperlipidemia were not significantly different among office types. CONCLUSION: This study provides evidence of the effectiveness of primary care in functional doctors' offices for patients with complex chronic diseases beyond a single chronic disease and suggests the need for policies to strengthen functional offices providing comprehensive care.

Diabetes mellitus, systemic inflammation and overactive bladder.

Background: Increasing evidence emphasizes the potential relationship between diabetes and OAB (overactive bladder). However, large population epidemiology is still lacking. Methods: This cross-sectional study included six cycle NHANES surveys, with a total of 23863 participants. Logistic regression models were constructed to analyze the association between diabetes mellitus, diabetes-related markers, and inflammatory biomarkers with OAB. Restricted cubic splines were used to analyze the non-linear associations. Mediating analysis was performed to test the effect of inflammatory biomarkers on the relationship between diabetes-related markers and OAB. Finally, machine learning models were applied to predict the relative importance and construct the best-fit model. Results: Diabetes mellitus participants' OAB prevalence increased by 77% compared with non-diabetes. As the quartiles of diabetes-related markers increased, the odds of OAB monotonically increased in three models (all p for trend < 0.001). Glycohemoglobin exhibited a linear association with OAB (p for nonlinearity > 0.05). White blood cells significantly mediated the associations between diabetes-related markers (glycohemoglobin, fasting glucose, and insulin) with OAB, and the proportions were 7.23%, 8.08%, and 17.74%, respectively (all p < 0.0001). Neutrophils partly mediated the correlation between (glycohemoglobin, fasting glucose, and insulin) and OAB at 6.58%, 9.64%, and 17.93%, respectively (all p < 0.0001). Machine learning of the XGBoost model constructs the best fit model, and XGBoost predicts glycohemoglobin is the most important indicator on OAB. Conclusion: Our research revealed diabetes mellitus and diabetes-related markers were remarkably associated with OAB, and systemic inflammation was an important mediator of this association.

Deciphering mortality risk of diabetes medications in heart failure patients with diabetes mellitus under triple guideline-directed medical therapy.

BACKGROUND: Scientific evidence regarding the impact of different combinations of diabetes medications in heart failure patients with diabetes mellitus (HFwDM) remains limited. AIM: We aimed to investigate the effect of monotherapy and combination therapy for DM on all-cause mortality in HFwDM under triple guideline-directed medical therapy (GDMT). METHOD: This nationwide retrospective cohort study included adult HFwDM under triple GDMT between January 1, 2016 and December 31, 2022.We collected the data from the National Electronic Database of the Turkish Ministry of Health.We created various combination including different diabetes medications based on the current guidelines for DM.The primary endpoint was all-cause mortality. RESULTS: A total of 321,525 HFwDM under triple GDMT (female:49%, median age:68[61-75] years) were included. The highest rate of prescribed combination therapy was metformin and sulfonylureas (n = 55,266). In Cox regression analysis, insülin monotherapy had the highest risk for all-cause mortality (HR:2.25, 95CI%:2.06 - 2.45), whereas combination therapy including metformin, SGLT2i, and sulfonylureas provided the most beneficial effect on survival (HR:0.29, 95CI%:0.22-0.39) when compared to patients not receiving diabetes medication. Among patients taking diabetes medications, the inclusion of SGLT2i demonstrated a survival benefit (p < 0.05), despite concurrent use of volume-retaining medications such as insulin and thiazolidinediones. Conversely, combinations of diabetes medications without SGLT2i did not demonstrate any survival benefit compared to patients not taking diabetes medication (p > 0.05). CONCLUSION: This study underscored the use of SGLT2i as monotherapy or as a part of combination diabetes medications to improve survival among HFwDM, while also highlighting that combinations lacking SGLT2i did not confer any survival benefit.

Knowledge level and health information-seeking behavior of people with diabetes in rural areas: a multicenter cross-sectional study.

Introduction: There is a lack of research on the current level of diabetes knowledge and health information-seeking behaviors among patients with diabetes in rural areas of China's economically underdeveloped regions during COVID-19, as well as a lack of up-to-date evidence on glycemic control and the incidence of complications among rural patients with diabetes. Objectives: To investigate the prevalence of glycemic control and complications among patients with diabetes in rural areas, to explore the current status and correlation of diabetes knowledge level and health information-seeking behavior, and to analyze the factors affecting diabetes knowledge level. Methods: From January 2022 to July 2022, we conducted a screening on diabetic complications and a questionnaire survey among 2,178 patients with diabetes in 15 county hospitals in rural areas of Guangxi Zhuang Autonomous Region. The patients' knowledge level and health information-seeking behavior were investigated. Spearman correlation analysis was used to assess the correlation between diabetes knowledge and health information-seeking behavior. Multiple linear regression analysis was used to test how demographic information and health information-seeking behavior influenced the level of diabetes knowledge. Results: Of 2,178 patients with diabetes in rural areas, 1,684 (77.32%) had poor glycemic control, and the prevalence of diabetic complications was estimated to be 72.13%. Patients with diabetes had poor diabetes knowledge and health information-seeking behavior, and there is a strong positive correlation between them. Diabetes knowledge level was influenced by per capita household disposable income, occupational status, gender, age, ethnicity, family history of diabetes, insulin use, glycated hemoglobin, education level, number of complications and health information-seeking behavior. Conclusion: Patients with diabetes in rural areas have poor glycemic control and a high incidence of diabetic complications. Patients with diabetes in rural areas have poor knowledge and inadequate health information-seeking behavior. Systematic and standardized education should be provided to improve patients' diabetes knowledge and thus improve their self-management ability.

Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020.

BACKGROUND: Noncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions. METHODS: A state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI). RESULTS: Due to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension. CONCLUSION: The burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.

Joint effect of abnormal systemic immune-inflammation index (SII) levels and diabetes on cognitive function and survival rate: A population-based study from the NHANES 2011-2014.

OBJECTIVE: The purpose of this study was to investigate whether the combination of abnormal systemic immune-inflammation index (SII) levels and hyperglycemia increased the risk of cognitive function decline and reduced survival rate in the United States. METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014 and enrolled 1,447 participants aged 60 years or older. Restricted cubic splines (RCS), linear regression and kaplan-meier(KM) curve were employed to explore the combined effects of abnormal SII and hyperglycemia on cognitive function and survival rate, and subgroup analysis was also conducted. RESULTS: The RCS analysis revealed an inverted U-shaped relationship between lgSII levels and cognitive function. Linear regression analysis indicated that neither abnormal SII nor diabetes alone significantly contributed to the decline in cognitive function compared to participants with normal SII levels and blood glucose. However, when abnormal SII coexisted with diabetes (but not prediabetes), it resulted to a significant decline in cognitive function. After adjusting for various confounding factors, these results remained significant in Delayed Word Recall (ß:-0.76, P<0.05) and Digit Symbol Substitution tests (ß:-5.02, P<0.05). Nevertheless, these results showed marginal significance in Total Word Recall test as well as Animal Fluency test. Among all subgroup analyses performed, participants with both abnormal SII levels and diabetes exhibited the greatest decline in cognitive function compared to those with only diabetes. Furthermore, KM curve demonstrated that the combination of abnormal SII levels and diabetes decreased survival rate among participants. CONCLUSION: The findings suggest that the impact of diabetes on cognitive function/survival rate is correlated with SII levels, indicating that their combination enhances predictive power.