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African Health Sciences Jun 2023NASH or "Non-alcoholic Steatohepatitis" is related to non-alcoholic fatty liver disease (NAFLD). The simultaneous occurrence of NASH and type 2 diabetes is common....
INTRODUCTION
NASH or "Non-alcoholic Steatohepatitis" is related to non-alcoholic fatty liver disease (NAFLD). The simultaneous occurrence of NASH and type 2 diabetes is common. However, only a limited number of studies have focused on the characteristics of patients with diabetes with or without NASH.
OBJECTIVES
This systematic review summarises epidemiological evidence related to the prevalence and characteristics of NASH in patients with diabetes.
METHODS
Different electronic databases PubMed, Scopus, and Google Scholar were searched for the published articles. Original studies conducted in patients with diabetes published in English were included in this review.
RESULTS
Thirteen studies were eligible for inclusion in this review. In patients with diabetes, increased BMI, overweight/obesity, increased HbA1c, increased serum cholesterol, and elevated liver enzyme levels have been strongly linked with NASH. Other significant characteristics include increasing age, being female, race(white), low HDL, metformin use, increased ferritin, and increased albumin levels. The prevalence of NASH ranged from 12% to 93.8%, the highest percentage was found in studies in Romania (87.1), and lowest in studies in India (12.5).
CONCLUSION
The incidence of NASH increases with age. Gender differences as a risk factor for NASH still need to be fully understood. This systematic review provides insight and strong indication to all patients with diabetes to visit hepatologists and screen for fatty liver disease. If steatosis is found on baseline ultrasound, a liver biopsy should be performed for timely management. At present, no NAFLD/NASH-specific medication on the market helps in treating the disease. New development of the drugs and ongoing research is important for the cure and treatment of NASH, with specific attention being provided to involve populations at high-risk.
Topics: Humans; Female; Male; Non-alcoholic Fatty Liver Disease; Diabetes Mellitus, Type 2; Risk Factors; Metformin; Obesity
PubMed: 38223606
DOI: 10.4314/ahs.v23i2.59 -
American Journal of Physiology.... Sep 2022Diabetes is the eighth leading cause of death in the world and the prevalence is rising in low-income countries. Cardiovascular diseases are the leading cause of death... (Review)
Review
Diabetes is the eighth leading cause of death in the world and the prevalence is rising in low-income countries. Cardiovascular diseases are the leading cause of death worldwide, especially for individuals with diabetes. Although medications exist to treat symptoms of diabetes, lack of availability and high costs may deter their use by individuals with low incomes as well as those in low-income nations. Therefore, this systematic review was performed to determine whether genistein, a phytoestrogen found in soy products, could provide therapeutic benefits for individuals with diabetes. We searched PubMed and SCOPUS using the terms "genistein," "diabetes," and "glucose" and identified 33 peer-reviewed articles that met our inclusion criteria. In general, preclinical studies demonstrated that genistein decreases body weight and circulating glucose and triglycerides concentrations, whereas increasing insulin levels and insulin sensitivity. Genistein also delayed the onset of type 1 and type 2 diabetes. In contrast, clinical studies utilizing genistein generally reported no significant relationship between genistein and body mass, circulating glucose, glycated hemoglobin (A1C) concentrations, or onset of type 1 diabetes. However, genistein was found to improve insulin sensitivity and serum triglyceride concentrations and delayed the onset of type 2 diabetes. In summary, preclinical and clinical studies suggest that genistein may help delay the onset of type 2 diabetes and improve several symptoms associated with the disease. Although additional research is required to confirm these findings, the results highlighted in this review provide some evidence that genistein may offer a natural approach to mitigating some of the complications associated with diabetes.
Topics: Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Genistein; Glycated Hemoglobin; Humans; Insulin Resistance
PubMed: 35816719
DOI: 10.1152/ajpregu.00236.2021 -
BMJ Open Diabetes Research & Care Mar 2020Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes... (Review)
Review
Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case-control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM, significant association between GDM and nitrogen dioxide (NO) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NO) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO, NO, and SO, and the second trimester exposure of PM with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
Topics: Air Pollution; Case-Control Studies; Cohort Studies; Diabetes Mellitus, Type 2; Diabetes, Gestational; Female; Humans; Pregnancy; Prospective Studies; Retrospective Studies
PubMed: 32193198
DOI: 10.1136/bmjdrc-2019-000937 -
Sensors (Basel, Switzerland) Feb 2022(1) Background: The use of smart devices to better manage diabetes has increased significantly in recent years. These technologies have been introduced in order to make... (Review)
Review
(1) Background: The use of smart devices to better manage diabetes has increased significantly in recent years. These technologies have been introduced in order to make life easier for patients with diabetes by allowing better control of the stability of blood sugar levels and anticipating the occurrence of dangerous events (hypo/hyperglycemia), etc. That being said, the main objectives of the self-management of diabetes is to improve the lifestyle and life quality of patients with diabetes; (2) Methods: We performed a systematic review based on articles that focus on the use of smart devices for the monitoring and better management of diabetes. The search was focused on keywords related to the topic, such as "Diabetes", "Technology", "Self-management", "Artificial Intelligence", etc. This was performed using databases, such as Scopus, Google Scholar, and PubMed; (3) Results: A total of 89 studies, published between 2011 and 2021, were included. The majority of the selected research aims to solve a diabetes management problem (e.g., blood glucose prediction, early detection of risk events, and the automatic adjustment of insulin doses, etc.). In these studies, wearable devices were used in combination with artificial intelligence (AI) techniques; (4) Conclusions: Wearable devices have attracted a great deal of scientific interest in the field of healthcare for people with chronic conditions, such as diabetes. They are capable of assisting in the management of diabetes, as well as preventing complications associated with this condition. Furthermore, the usage of these devices has improved illness management and quality of life.
Topics: Artificial Intelligence; Diabetes Mellitus; Humans; Machine Learning; Quality of Life; Self-Management
PubMed: 35270989
DOI: 10.3390/s22051843 -
Advances in Nutrition (Bethesda, Md.) Jan 2024Evidence of associations between ultra-processed foods (UPF) and increased risk of cardiovascular disease is emerging, but it is unclear how much this is influenced by... (Meta-Analysis)
Meta-Analysis Review
Evidence of associations between ultra-processed foods (UPF) and increased risk of cardiovascular disease is emerging, but it is unclear how much this is influenced by the methodology used to assess the UPF intake or by the level of consumption. We conducted a meta-analysis to evaluate 1) the association between UPF consumption and risk of diabetes, hypertension, dyslipidemia, and obesity, using prospective cohort studies; 2) the differential associations depending on the methodology used to assess UPF intake and the level of UPF consumption and 3) the quality of evidence using the NutriGrade scoring system. A systematic literature search was conducted in PubMed/MEDLINE, ISI Web of Science, and Scopus through 1 April, 2023, on studies conducted in humans providing data for the highest compared with the lowest UPF consumption categories. Summary relative ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random-effects model. Out of 4522 articles retrieved from the literature search, 25 reports met the criteria for inclusion in the meta-analysis, 7 for diabetes, 5 for hypertension, 3 for dyslipidemia, and 13 for obesity. A consistently positive association between high UPF intake and increased risk of developing diabetes (37%), hypertension (32%), hypertriglyceridemia (47%), low HDL cholesterol concentration (43%), and obesity (32%) was observed, even if the quality of evidence was not satisfying. However, these risks varied significantly depending on the methodology used to assess UPF consumption, with a difference of more than 50% between the methods. Based on the level of intake, we did not observe significant differences in the results. These findings show that UPF consumption is associated with higher risk of diabetes, hypertension, dyslipidemia, and obesity, but the level of risk consistently changes depending on the methodology used to assess UPF intake. Therefore, caution should be used when interpreting and extrapolating the results.
Topics: Humans; Diabetes Mellitus; Diet; Dyslipidemias; Food, Processed; Hypertension; Obesity; Prospective Studies
PubMed: 38245358
DOI: 10.1016/j.advnut.2023.09.009 -
International Journal of Public Health 2023We report results of a systematic review on the health effects of long-term traffic-related air pollution (TRAP) and diabetes in the adult population. An expert Panel... (Meta-Analysis)
Meta-Analysis Review
We report results of a systematic review on the health effects of long-term traffic-related air pollution (TRAP) and diabetes in the adult population. An expert Panel appointed by the Health Effects Institute conducted this systematic review. We searched the PubMed and LUDOK databases for epidemiological studies from 1980 to July 2019. TRAP was defined based on a comprehensive protocol. Random-effects meta-analyses were performed. Confidence assessments were based on a modified Office for Health Assessment and Translation (OHAT) approach, complemented with a broader narrative synthesis. We extended our interpretation to include evidence published up to May 2022. We considered 21 studies on diabetes. All meta-analytic estimates indicated higher diabetes risks with higher exposure. Exposure to NO was associated with higher diabetes prevalence (RR 1.09; 95% CI: 1.02; 1.17 per 10 μg/m), but less pronounced for diabetes incidence (RR 1.04; 95% CI: 0.96; 1.13 per 10 μg/m). The overall confidence in the evidence was rated moderate, strengthened by the addition of 5 recently published studies. There was moderate evidence for an association of long-term TRAP exposure with diabetes.
Topics: Adult; Humans; Air Pollutants; Air Pollution; Environmental Exposure; Diabetes Mellitus; Incidence; Particulate Matter
PubMed: 37325174
DOI: 10.3389/ijph.2023.1605718 -
Tropical Medicine & International... Nov 2022To investigate the current status of the availability and affordability of specific essential medicines and diagnostics for diabetes in Africa. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the current status of the availability and affordability of specific essential medicines and diagnostics for diabetes in Africa.
METHODS
Systematic review and meta-analysis. Studies conducted in Africa that reported any information on the availability and affordability of short-acting, intermediate-acting, and premixed insulin, glibenclamide, metformin, blood glucose, glycated haemoglobin or HbA1c, and lipid profile tests were included. Random-effect model meta-analysis and descriptive statistics were performed to determine the pooled availability and affordability, respectively.
RESULTS
A total of 21 studies were included. The pooled availability of each drug was as follows: short-acting insulin 33.5% (95% CI: 17.8%-49.2%, I = 95.02%), intermediate-acting insulin 23.1% (95% CI: 6.3%-39.9%, I = 91.6%), premixed insulin 49.4% (95% CI: 24.9%-73.9%, I = 90.57%), glibenclamide 55.9% (95% CI: 43.8%-68.0%, I = 96.7%), and metformin 47.0% (95% CI: 34.6%-59.4%, I = 97.54%). Regarding diagnostic tests, for glucometers the pooled availability was 49.5% (95% CI: 37.9%-61.1%, I = 97.43%), for HbA1c 24.6% (95% CI: 3.1%-46.1%, I = 91.64), and for lipid profile tests 35.7% (95% CI: 19.4%-51.9%, I = 83.77%). The median (IQR) affordability in days' wages was 7 (4.7-7.5) for short-acting insulin, 4.4 (3.9-4.9) for intermediate-acting insulin, 7.1 (5.8-16.7) for premixed insulin, 0.7 (0.7-0.7) for glibenclamide, and 2.1 (1.8-2.8) for metformin.
CONCLUSION
The availability of the five essential medicines and three diagnostic tests for diabetes in Africa is suboptimal. The relatively high cost of insulin, HbA1c, and lipid profile tests is a significant barrier to optimal diabetes care. Pragmatic country-specific strategies are urgently needed to address these inequities in access and cost.
Topics: Humans; Diagnostic Tests, Routine; Glyburide; Glycated Hemoglobin; Health Services Accessibility; Drugs, Essential; Diabetes Mellitus; Costs and Cost Analysis; Insulin; Metformin; Insulin, Short-Acting; Lipids
PubMed: 36121433
DOI: 10.1111/tmi.13819 -
PloS One 2022Metformin has been suggested to reduce thyroid cancer incidence and to improve thyroid cancer prognosis. We aimed to evaluate the associations between metformin and... (Meta-Analysis)
Meta-Analysis
Metformin has been suggested to reduce thyroid cancer incidence and to improve thyroid cancer prognosis. We aimed to evaluate the associations between metformin and thyroid cancer incidence and prognosis (metastasis/recurrence/progression-free survival). Cochrane Library, PubMed, ClinicalTrials.gov, and U.S. National Library of Medicine Clinical Trials were searched through the end of December 2021. Data were collected from original observational studies or clinical trials on the incidence or prognosis of thyroid carcinoma outcomes in type 2 diabetes mellitus (T2DM) patients with and without metformin use. Risk of bias in non-randomized studies of interventions (ROBINS-I) tool and Grading of Recommendations, and Assessment, Development and Evaluations (GRADE) approach were used to evaluate the risk of bias and quality of the body of evidence, respectively. In general, 4 studies were related to the thyroid cancer incidence, including 1,705,123 participants metformin users and non-users and yielding a total of 3,238 thyroid cancer events; 3 studies reported the prognosis of thyroid carcinoma based on a total of 4,972 individuals with primary thyroid carcinoma and comorbid type 2 diabetes, and the number of thyroid cancer prognosis cases ranged from 3 to 79. The overall risk of bias of the included studies ranged from moderate to serious. In the random-effects model, the summary relative risk (SRR) for thyroid cancer incidence was 0.743 (95% CI: 0.453-1.220; I2 = 88.7%, low certainty) comparing metformin users to non-users; and SRR for the prognosis of thyroid cancer was 0.504 (95% CI: 0.178-1.430; I2 = 57.5%, low certainty). Non-statistically significant negative associations between metformin use and incidence and prognosis of thyroid cancer were found in the current analysis, although the quantity and quality of the evidence were limited. Futher investigation is needed to evaluate the clinical benefits of metformin on thyroid cancer prevention and treatments.
Topics: Diabetes Mellitus, Type 2; Humans; Hypoglycemic Agents; Incidence; Metformin; Thyroid Neoplasms
PubMed: 35901016
DOI: 10.1371/journal.pone.0271038 -
Environment International Jan 2022Cadmium exposure has been associated with increased diabetes risk in several studies, though there is still considerable debate about the magnitude and shape of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cadmium exposure has been associated with increased diabetes risk in several studies, though there is still considerable debate about the magnitude and shape of the association.
OBJECTIVE
To perform a systematic review and meta-analysis of observational studies investigating the relation between cadmium exposure and risk of type 2 diabetes and prediabetes, and to summarize data on the magnitude and shape of the association.
DATA SOURCE
After conducting an online literature search through October 1, 2021, we identified 42 eligible studies investigating the association between cadmium exposure and risk of diabetes and prediabetes.
STUDY ELIGIBILITY CRITERIA
We included studies that assessed cadmium exposure through biomarker levels; examined type 2 diabetes or prediabetes among outcomes; and reported effect estimates for cadmium exposure for meta-analysis only.
STUDY APPRAISAL AND SYNTHESIS METHODS
Studies were evaluated using ROBINS-E risk of bias tool. We quantitively assessed the relation between exposure and study outcomes using one-stage dose-response meta-analysis with a random effects meta-analytical model.
RESULTS
In the meta-analysis, comparing highest-versus-lowest cadmium exposure levels, summary relative risks (RRs) for type 2 diabetes were 1.24 (95% confidence interval 0.96-1.59), 1.21 (1.00-1.45), and 1.47 (1.01-2.13) for blood, urinary, and toenail matrices, respectively. Similarly, there was an increased risk of prediabetes for cadmium concentrations in both urine (RR = 1.41, 95% CI: 1.15-1.73) and blood (RR = 1.38, 95% CI: 1.16-1.63). In the dose-response meta-analysis, we observed a consistent linear positive association between cadmium exposure and diabetes risk, with RRs of 1.25 (0.90-1.72) at 2.0 µg/g of creatinine. Conversely for blood cadmium, diabetes risk appeared to increase only above 1 µg/L. Prediabetes risk increased up to approximately 2 µg/g creatinine above which it reached a plateau with RR of 1.42 (1.12-1.76) at 2 µg/g creatinine.
LIMITATIONS AND CONCLUSIONS
This analysis provides moderate-certainty evidence for a positive association between cadmium exposure (measured in multiple matrices) and risk of both diabetes and prediabetes.
Topics: Bias; Cadmium; Diabetes Mellitus, Type 2; Humans; Prediabetic State; Risk
PubMed: 34628255
DOI: 10.1016/j.envint.2021.106920 -
Respiratory Research Jun 2021Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial lung disease, of which the etiology has been poorly understood. Several studies have focused on the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is a chronic diffuse interstitial lung disease, of which the etiology has been poorly understood. Several studies have focused on the relationship between IPF and diabetes mellitus (DM) in the past years but have failed to reach a consensus. This meta-analysis aimed to examine the association between diabetes to IPF.
METHODS
We accumulated studies investigating the association between DM and IPF from databases including Medline, Cochrane Library, Embase, Web of Science, and China National Knowledge Infrastructure. RevMan 5.3 and the Newcastle-Ottawa Scale (NOS) were utilized to analyze the data and assess the quality of the included studies. The value of odds ratio (OR) with 95% confidence interval (CI) was used as the measure to estimate the risk of DM in IPF. Heterogeneity was assessed by I statistics. We also performed subgroup analysis, meta-regression, and Egger's test for bias analysis.
RESULTS
Nine case-control studies with 5096 IPF patients and 19,095 control subjects were included in the present meta-analysis, which indicated a positive correlation between DM and IPF (OR 1.65, 95% CI 1.30-2.10; P < 0.0001). Meta-regression and subgroup analysis negated the influence of covariates like cigarette smoking, age and gender, but the heterogeneity existed and could not be fully explained.
CONCLUSION
IPF and DM may be associated, but the causal relationship remains indeterminate till now. Further rigorously designed studies are required to confirm the present findings and investigate the possible mechanisms behind the effect of DM on IPF.
Topics: Comorbidity; Diabetes Mellitus; Global Health; Humans; Idiopathic Pulmonary Fibrosis; Incidence; Risk Factors
PubMed: 34103046
DOI: 10.1186/s12931-021-01760-6