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Scientific Reports Mar 2021There is growing evidence for a role of maternal diabetes in the pathogenesis of neurodevelopmental disorders. However, the specific association between gestational... (Meta-Analysis)
Meta-Analysis
There is growing evidence for a role of maternal diabetes in the pathogenesis of neurodevelopmental disorders. However, the specific association between gestational diabetes (GDM), as opposed to pre-gestational diabetes, has been poorly isolated. Thus the aim was to systematically review and meta-analyse literature pertaining to prevalence and risk for two neurodevelopmental disorders: autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), when exposed to GDM. PubMed, Cochrane Library, EMBASE, PsycINFO and CINAHL were systematically searched for eligible literature, with forward and backward citation tracking. Screening for eligibility, risk of bias assessment and data extraction were performed by two independent reviewers. 18 studies measuring ASD and 15 measuring ADHD met inclusion criteria. On meta-analysis there was an increased risk of ASD (OR 1.42; 95% CI 1.22, 1.65) but not ADHD (OR 1.01; 95% CI 0.79, 1.28). We discuss potential mechanisms for these differing risks. Greater understanding of risk factors, including GDM, for these neurodevelopmental disorders and potential mechanisms may help inform strategies aimed at prevention of exposure to these adversities during pregnancy.
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Autism Spectrum Disorder; Child; Child, Preschool; Diabetes Complications; Diabetes, Gestational; Female; Humans; Male; Pregnancy; Risk Factors
PubMed: 33664319
DOI: 10.1038/s41598-021-84573-3 -
Archivio Italiano Di Urologia,... Dec 2020To investigate the incidence of diabetic cystopathy in relation to age, gender, type of diabetes, duration of diabetic disease and clinical evidence of peripheral...
OBJECTIVE
To investigate the incidence of diabetic cystopathy in relation to age, gender, type of diabetes, duration of diabetic disease and clinical evidence of peripheral neuropathy and to analyze the physiopathology of the various forms of diabetic cystopathy due to sensory impairment, motor-sensory impairment, motor impairment and hyperreflexia.
MATERIALS AND METHODS
In a retrospective multicenter cohort study the medical records of a cohort of 126 diabetic patients with (128 patients) or without (48 patients) urological symptoms were analyzed. Patients were observed at the Città di Alessandria Clinic of Policlinico di Monza and/or at the outpatient clinic of Alessandria Hospital from June 2018 to June 2020. The study excluded patients with central and/or peripheral neuropathy, spina bifida (mylomeningocele or meningocele) or spina bifida occulta; with persistent urinary infections; in anticholinergic treatment for enteric dysfunctions; in medical treatment for cervical-prostatic-urethral obstruction; with vaginal and/or rectal prolapse of II, III, IV degree; with previous spinal or pelvic surgery including radical prostatectomy, Wertheim hysterectomy or colorectal surgery. All the patients were studied with computed tomography (CT) scan of the urinary tract, voiding cystourethrography (VCUG), uroflowmetry, cystomanometry with intrinsic pressure assessment and compliance evaluation, electromyography (EMG) of the anal sphincter, pressure flow analysis, urethral pressure profile and, when advised, pharmacological tests.
RESULTS
Out of 126 diabetic patients, 48 did not show any signs or symptoms of urine voiding dysfunction; 30 were men and 18 women with an average age of 62.6 years; 20 had type I diabetes and were in treatment with insulin and 28 type II diabetes treated with oral hypoglycemic medication. The remaining 78 patients (48 men and 30 women), with an average age of 64.8 years, presented urological symptoms; 31 had type I diabetes and 47 had II type diabetes.
CONCLUSIONS
Diagnosis of the various forms of diabetic cystopathy and early treatment decreases complications and consequently accesses to outpatient facilities and hospital admissions, resulting in an improved quality of life.
Topics: Cohort Studies; Diabetes Complications; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Urinary Bladder Diseases
PubMed: 33348955
DOI: 10.4081/aiua.2020.4.314 -
Frontiers in Endocrinology 2020Diabetes mellitus is becoming more prevalent and even with new advancements which improve glycaemic control, complications of diabetes are common. Vascular complications... (Review)
Review
Diabetes mellitus is becoming more prevalent and even with new advancements which improve glycaemic control, complications of diabetes are common. Vascular complications of diabetes include the microvascular complications: retinopathy, nephropathy, and peripheral and autonomic neuropathy. Macrovascular complications are also common in patients with diabetes and arguably more concerning as they confer a high mortality risk yet are sometimes under-treated. Risk factors for diabetes complications start to occur in childhood and adolescents and some youths may be diagnosed with complications before transition to adult care. This article discusses the prevalence, risk factors, screening, and treatment recommendations for vascular complications in children and adolescents with diabetes.
Topics: Adolescent; Diabetes Complications; Humans; Risk Factors; Vascular Diseases
PubMed: 32582034
DOI: 10.3389/fendo.2020.00370 -
Journal of Diabetes Investigation Mar 2023Type 2 diabetes is no longer seen as being an irreversible natural course, accompanied by progressive beta cell failure and various chronic diabetes related...
Type 2 diabetes is no longer seen as being an irreversible natural course, accompanied by progressive beta cell failure and various chronic diabetes related complications. In contrast, remission can be achieved through a personalized approach. It is a paradigm shift in our understanding of type 2 diabetes and it may be necessary to change the concept of type 2 diabetes as an urgent condition requiring rapid intervention rather than a chronic progressive disease.
Topics: Humans; Diabetes Mellitus, Type 2; Diabetes Complications; Insulin-Secreting Cells
PubMed: 36625268
DOI: 10.1111/jdi.13948 -
TheScientificWorldJournal 2021Till date, there is no known antidote to cure diabetes mellitus despite the discovery and development of diverse pharmacotherapeutic agents many years ago. Technological... (Review)
Review
BACKGROUND
Till date, there is no known antidote to cure diabetes mellitus despite the discovery and development of diverse pharmacotherapeutic agents many years ago. Technological advancement in natural product chemistry has led to the isolation of analogs of vitexin and isovitexin found in diverse bioresources. These compounds have been extensively studied to explore their pharmacological relevance in diabetes mellitus. . The present review was to compile results from in vitro and in vivo studies performed with vitexin and isovitexin derivatives relating to diabetes mellitus and its complications. A systematic online literature query was executed to collect all relevant articles published up to March 2020.
RESULTS
In this piece, we have collected data and presented it in a one-stop document to support the multitargeted mechanistic actions of vitexin and isovitexin in controlling diabetes mellitus and its complications.
CONCLUSION
Data collected hint that vitexin and isovitexin work by targeting diverse pathophysiological and metabolic pathways and molecular drug points involved in the clinical manifestations of diabetes mellitus. This is expected to provide a deeper understanding of its actions and also serve as a catapult for clinical trials and application research.
Topics: Animals; Apigenin; Diabetes Complications; Diabetes Mellitus; Humans; Hypoglycemic Agents
PubMed: 33935599
DOI: 10.1155/2021/6641128 -
Frontiers in Endocrinology 2024
Topics: Humans; Comorbidity; Diabetes Mellitus; Diabetes Complications; Diabetes Mellitus, Type 2
PubMed: 38660511
DOI: 10.3389/fendo.2024.1406131 -
Journal of Immunology Research 2020Chlorogenic acid (CA) is a phenolic compound commonly found in human plant-based diets. CA is the main component of many traditional Chinese medicine preparations, and... (Review)
Review
Chlorogenic acid (CA) is a phenolic compound commonly found in human plant-based diets. CA is the main component of many traditional Chinese medicine preparations, and in recent years, it has been found to have hypoglycemic, hypolipidemic, anti-inflammatory, antioxidant, and other pharmacological properties. Specifically, CA relieves the effects of, and prevents, diabetes mellitus (DM). In addition, CA is also beneficial against complications arising from DM, such as diabetic nephropathy (DN), diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN). Herein, we review the use of CA in the prevention and treatment of DM and its complications, providing a background for further research and medical uses.
Topics: Animals; Antioxidants; Chlorogenic Acid; Diabetes Complications; Diabetes Mellitus; Gene Expression Regulation, Enzymologic; Glucose; Humans; Hypoglycemic Agents; Insulin; Insulin Resistance; Lipid Metabolism; Metabolic Networks and Pathways; Oxidative Stress
PubMed: 32566690
DOI: 10.1155/2020/9680508 -
Journal of Diabetes Science and... Jul 2020Diabetes is associated with poor clinical outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). During this pandemic, many hospitals have already...
Diabetes is associated with poor clinical outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). During this pandemic, many hospitals have already become overwhelmed around the world and are rapidly entering crisis mode. While there are global efforts to boost personal protective equipment (PPE) production, many centers are improvising care strategies, including the implementation of technology to prevent healthcare workers' exposures and reduce the waste of invaluable PPE. Not optimizing glycemic control due to clinical inertia driven by fear or lack of supplies may lead to poor outcomes in patients with diabetes and COVID-19. Individualized care strategies, novel therapeutic regimens, and the use of diabetes technology may reduce these barriers. However, systematic evaluation of these changes in care is necessary to evaluate both patient- and community-centered outcomes.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Critical Illness; Diabetes Complications; Diabetes Mellitus; Humans; Inpatients; Insulin; Pandemics; Pneumonia, Viral; Precision Medicine; SARS-CoV-2
PubMed: 32370606
DOI: 10.1177/1932296820923045 -
PloS One 2022Diabetes imposes a large burden on countries' healthcare expenditures. In Kuwait, diabetes prevalence in adults is estimated at 22.0%%-double the worldwide prevalence...
BACKGROUND
Diabetes imposes a large burden on countries' healthcare expenditures. In Kuwait, diabetes prevalence in adults is estimated at 22.0%%-double the worldwide prevalence (9.3%). There is little current data on pharmaceutical costs in Kuwait of managing diabetes and diabetes-related complications and comorbidities.
OBJECTIVES
Estimate the utilization and cost of drugs for diabetes and diabetes-related complications and comorbidities in Kuwait for year 2018, as well determinants of costs.
METHODS
This cross-sectional study used a multi-stage stratified sampling method. Patients were Kuwaiti citizens with diabetes, aged 18-80, recruited from all six governorates. Physicians collected demographic data, clinical data, and current drug prescription for each patient which was extrapolated for the full year of 2018. A prevalence-based approach and bottom-up costing were used. Data were described according to facility type (primary care vs. hospital). A generalized linear model with log function and normal distribution compared drug costs for patients with and without comorbidities/complications after adjustments for demographic and health confounders (gender, age group, disease duration, and obesity).
RESULTS
Of 1182 diabetes patients, 64.0% had dyslipidemia and 57.7% had hypertension. Additionally, 40.7% had diabetes-related complications, most commonly neuropathy (19.7%). Of all diabetes patients, 85.9% used oral antidiabetics (alone or in combinations), 49.5% used insulin alone or in combinations, and 29.3% used both oral antidiabetics and insulin. The most frequently used oral drug was metformin (75.7%), followed by DPP4 inhibitors (40.2%) and SGLT2 inhibitors (23.8%). The most frequently used injectables were insulin glargine (36.6%), followed by GLP-1 receptor agonists (15.4%). Total annual drug cost for Kuwait's diabetic population for year 2018 was US$201 million (US$1,236.30 per patient for antidiabetics plus drugs for comorbidities/complications).
CONCLUSIONS
Drug costs for treating diabetes and comorbidities/complications accounted for an estimated 22.8% of Kuwait's 2018 drug expenditures. Comorbidities and complications add 44.7% to the average drug cost per diabetes patient.
Topics: Adult; Cross-Sectional Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Drug Costs; Humans; Hypoglycemic Agents; Insulin Glargine; Kuwait
PubMed: 35653361
DOI: 10.1371/journal.pone.0268495 -
Frontiers in Endocrinology 2023Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels and has become the third leading threat to human health after cancer and... (Review)
Review
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels and has become the third leading threat to human health after cancer and cardiovascular disease. Recent studies have shown that autophagy is closely associated with diabetes. Under normal physiological conditions, autophagy promotes cellular homeostasis, reduces damage to healthy tissues and has bidirectional effects on regulating diabetes. However, under pathological conditions, unregulated autophagy activation leads to cell death and may contribute to the progression of diabetes. Therefore, restoring normal autophagy may be a key strategy to treat diabetes. High-mobility group box 1 protein (HMGB1) is a chromatin protein that is mainly present in the nucleus and can be actively secreted or passively released from necrotic, apoptotic, and inflammatory cells. HMGB1 can induce autophagy by activating various pathways. Studies have shown that HMGB1 plays an important role in insulin resistance and diabetes. In this review, we will introduce the biological and structural characteristics of HMGB1 and summarize the existing knowledge on the relationship between HMGB1, autophagy, diabetes, and diabetic complications. We will also summarize potential therapeutic strategies that may be useful for the prevention and treatment of diabetes and its complications.
Topics: Humans; Autophagy; Cell Death; Diabetes Complications; Diabetes Mellitus; HMGB1 Protein; Insulin Resistance
PubMed: 37065747
DOI: 10.3389/fendo.2023.1141516