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Diabetes & Metabolic Syndrome 2019Complications among patients with type 2 diabetes mellitus (T2DM) have increased dramatically through two past decades. Thus, the aim of this updated systematic review... (Meta-Analysis)
Meta-Analysis
Complications among patients with type 2 diabetes mellitus (T2DM) have increased dramatically through two past decades. Thus, the aim of this updated systematic review and meta-analysis was to estimate the pooled prevalence of T2DM complications in Iranian patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words, international databases including PubMed, ISI/WOS, Scopus, Iran Medex, SID, Magiran, Irandoc, Medlib, domestic databases were searched from January 1990 till January 2018 reporting prevalence of any complications of type 2 diabetes in Iran. All the keywords were searched electronically by two Boolean operators through the explained search strategy, separately. Relevant additional articles were identified from the lists of the retrieved articles. Random and fixed effect meta-analysis was used to estimate the pooled prevalence of complications in Iranian patients with T2DM. Through searching steps, among 1238 publications retrieved from literature search, finally 45 studies met the inclusion criteria for meta-analysis, with number of 30679 participants. According to random effect, the estimated pooled prevalence of diabetic foot ulcer, cardiovascular disease, retinopathy, neuropathy and nephropathy in Iranian patients with T2DM were 3%(95% CI: 1-5%), 33%(95% CI: 16-49%), 36%(95% CI: 27-45%), 38% (95% CI: 14-63%), and 43% (95% CI: 27-60%), respectively. This updated meta-analysis shows that prevalence of major microvascular complications of T2DM in Iran is high. Our findings provide practical evidence for better planning and clinical decision making.
Topics: Diabetes Complications; Diabetes Mellitus, Type 2; Humans; Iran; Prevalence; Risk Factors
PubMed: 31235172
DOI: 10.1016/j.dsx.2019.05.018 -
The Journal of Sexual Medicine Apr 2013Sexual dysfunction is reported in diabetic women (female sexual dysfunction [FSD]). (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Sexual dysfunction is reported in diabetic women (female sexual dysfunction [FSD]).
AIM
To examine the frequency of FSD in diabetic women, and its clinical or metabolic correlates, through meta-analysis of available studies.
METHODS
We searched in MEDLINE, EMBASE, Cochrane Library, and in reference lists of articles and systematic reviews; we considered human clinical studies published as full articles reporting on FSD in diabetic and control women. In total, we considered 26 studies, including 3,168 diabetic and 2,823 control women.
MAIN OUTCOME MEASURES
Frequency of FSD and score of Female Sexual Function Index (FSFI) as a function of study size, patient details (age, body mass index [BMI], duration of diabetes, metabolic control [HbA1c], chronic complications, Beck Depression Inventory [BDI] score).
RESULTS
Frequency of FSD was higher in type 1 (OR [95%CI] 2.27 [1.23, 4.16]), in type 2 diabetes (2.49 [1.55, 3.99]), and in "any diabetes" (type 1 and 2) women (2.02 [1.49, 2.72]) than in controls for any duration of diabetes. FSFI was lower in type 1 (-0.27 [-0.41, -0.12]), in type 2 diabetes (-0.65 [-0.75, -0.54]), and in "any diabetes" women (-0.80 [-0.88, -0.71]) than in controls. Depression was significantly more frequent in diabetic than in control women. At meta-regression only BMI was significantly associated with effect size (P = 0.005). At weighed regression, the only significant association was found between age and FSFI (P = 0.059). The limitations were as follows: only studies of observational nature were available, and heterogeneity was seen among studies.
CONCLUSIONS
FSD is more frequent in diabetic than in control women, but it is still poorly understood; low FSFI is associated with high BMI. Further studies are necessary to better understand risk factors for FSD in diabetic women.
Topics: Age Factors; Body Mass Index; Depression; Diabetes Complications; Female; Humans; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 23347454
DOI: 10.1111/jsm.12065 -
PloS One 2015Abundant evidence suggests an association between subclinical hypothyroidism (SCH) and type 2 diabetes mellitus (T2DM), but small sample sizes and inconclusive data in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Abundant evidence suggests an association between subclinical hypothyroidism (SCH) and type 2 diabetes mellitus (T2DM), but small sample sizes and inconclusive data in the literature complicate this assertion.
OBJECTIVE
We measured the prevalence of SCH in T2DM population, and investigated whether T2DM increase the risk of SCH and whether SCH was associated with diabetic complications.
METHODS
We conducted a meta-analysis using PubMed, EMBASE, Web of Science, Wan Fang, CNKI and VIP databases for literature search. We obtained studies published between January 1, 1980 to December 1, 2014. The studies were selected to evaluate the prevalence of SCH in T2DM subjects, compare the prevalence of SCH in T2DM subjects with those non-diabetics, and investigate whether diabetic complications were more prevalent in SCH than those who were euthyroid. Fixed and random effects meta-analysis models were used, and the outcome was presented as a pooled prevalence with 95% confidence interval (95% CI) or a summary odds ratio (OR) with 95% CI.
RESULTS
Through literature search, 36 articles met the inclusion criteria and these articles contained a total of 61 studies. Funnel plots and Egger's tests showed no publication bias in our studies, except for the pooled prevalence of SCH in T2DM (P = 0.08) and OR for SCH in T2DM (P = 0.04). Trim and fill method was used to correct the results and five potential missing data were replaced respectively. The adjusted pooled prevalence of SCH in T2DM patients was 10.2%, meanwhile, T2DM was associated with a 1.93-fold increase in risk of SCH (95% CI: 1.66, 2.24). Furthermore, SCH might affect the development of diabetic complications with an overall OR of 1.74 (95% CI: 1.34, 2.28) for diabetic nephropathy, 1.42 (95% CI: 1.21, 1.67) for diabetic retinopathy, 1.85 (95% CI: 1.35, 2.54) for peripheral arterial disease, and 1.87 (95% CI: 1.06, 3.28) for diabetic peripheral neuropathy.
CONCLUSIONS
T2DM patients are more likely to have SCH when compared with healthy population and SCH may be associated with increased diabetic complications. It is necessary to screen thyroid function in patients with T2DM, and appropriate individualized treatments in addition to thyroid function test should be given to T2DM patients with SCH as well.
Topics: Diabetes Mellitus, Type 2; Diabetic Nephropathies; Diabetic Neuropathies; Diabetic Retinopathy; Humans; Hypothyroidism; Odds Ratio; Prevalence; Risk Factors
PubMed: 26270348
DOI: 10.1371/journal.pone.0135233 -
Current Diabetes Reviews 2014Diabetes mellitus has been increasing rapidly worldwide, making it a huge health pressure on society in both the developed and developing countries. During the last... (Review)
Review
Diabetes mellitus has been increasing rapidly worldwide, making it a huge health pressure on society in both the developed and developing countries. During the last thirty years, diabetes mellitus, a chronic metabolic disease characterized by hyperglycemia is proving itself to be fatal. Periodontitis was considered as one of the main, oral health problems encountered in patients with diabetes mellitus. There exists a direct relation between the risk of complications of diabetes and periodontitis over time. The present review gives an outline of the features that govern the interrelationship between zinc and diabetes mellitus with periodontal disease, including the physiologic mechanisms and clinical studies, and presents scientific evidences. The disturbance in the zinc micronutrient and increased oxidative stress in type 2 diabetes may bring about insulin resistance and the creation of diabetic complications. The progression of diabetes mellitus may bring about perturbation in micronutrient metabolism and status.
Topics: Diabetes Complications; Diabetes Mellitus, Type 2; Disease Progression; Humans; Insulin Resistance; Oxidative Stress; Periodontitis; Risk Factors; Trace Elements; Tumor Necrosis Factor-alpha; Zinc
PubMed: 25413995
DOI: 10.2174/1573399810666141121161514 -
BMJ Open Diabetes Research & Care May 2020Mouse models are frequently used to study diabetes-associated ulcers, however, whether these models accurately simulate impaired wound healing has not been thoroughly... (Meta-Analysis)
Meta-Analysis Review
Mouse models are frequently used to study diabetes-associated ulcers, however, whether these models accurately simulate impaired wound healing has not been thoroughly investigated. This systematic review aimed to determine whether wound healing is impaired in mouse models of diabetes and assess the quality of the past research. A systematic literature search was performed of publicly available databases to identify original articles examining wound healing in mouse models of diabetes. A meta-analysis was performed to examine the effect of diabetes on wound healing rate using random effect models. A meta-regression was performed to examine the effect of diabetes duration on wound healing impairment. The quality of the included studies was also assessed using two newly developed tools. 77 studies using eight different models of diabetes within 678 non-diabetic and 720 diabetic mice were included. Meta-analysis showed that wound healing was impaired in all eight models. Meta-regression suggested that longer duration of diabetes prior to wound induction was correlated with greater degree of wound healing impairment. Pairwise comparisons suggested that non-obese diabetic mice exhibited more severe wound healing impairment compared with mice, streptozotocin-induced diabetic mice or high-fat fed mice at an intermediate stage of wound healing (p<0.01). Quality assessment suggested that the prior research frequently lacked incorporation of key clinically relevant characteristics. This systematic review suggested that impaired wound healing can be simulated in many different mouse models of diabetes but these require further refinement to become more clinically relevant.
Topics: Animals; Diabetes Complications; Diabetes Mellitus, Experimental; Disease Models, Animal; Mice; Ulcer; Wound Healing
PubMed: 32467222
DOI: 10.1136/bmjdrc-2019-000982 -
Journal of Clinical Periodontology Jun 2017This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis). (Review)
Review
AIM
This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis).
MATERIALS AND METHODS
Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.
RESULTS
Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29).
CONCLUSIONS
Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.
Topics: Databases, Factual; Dental Implants; Dental Restoration Failure; Diabetes Complications; Diabetes Mellitus; Humans; Hyperglycemia; Meta-Analysis as Topic; Mucositis; Peri-Implantitis; Risk Factors; Smoking
PubMed: 28346753
DOI: 10.1111/jcpe.12724 -
Diabetologia Nov 2021The aim of this work was to quantify racial/ethnic differences in risk for future diabetic complications and all-cause mortality by performing a meta-analysis of... (Meta-Analysis)
Meta-Analysis
Racial differences in all-cause mortality and future complications among people with diabetes: a systematic review and meta-analysis of data from more than 2.4 million individuals.
AIMS/HYPOTHESIS
The aim of this work was to quantify racial/ethnic differences in risk for future diabetic complications and all-cause mortality by performing a meta-analysis of prospective studies.
METHODS
A systematic search in PubMed and EMBASE was performed from inception to May 2021. Prospective cohort studies that reported HRs and associated 95% CIs of diabetes complications and all-cause mortality among racial/ethnic groups, with White people as the reference group, were included. Study characteristics and HR estimates were extracted from each study. Estimates were pooled using random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman variance estimator.
RESULTS
A total of 23 studies were included, comprising 2,416,516 individuals diagnosed with diabetes (White 59.3%, Black 11.2%, Asian 1.3%, Hispanic-American 2.4%, Native American 0.2%, East Asian 1.9%, South Asian 0.8%, Pacific Islander 2.3%, Māori 2.4% and others 18.2%). Compared with White individuals with diabetes, individuals of Māori ethnicity were at higher risk for all-cause mortality (HR 1.88 [95% CI 1.61, 2.21]; I = 7.1%), Hispanic-American individuals had a significantly lower risk for CVD (HR 0.66 [95% CI 0.53, 0.81]; I = 0%) and Black individuals had higher risk for end-stage renal disease (HR 1.54 [95% CI 1.05, 2.24]; I = 95.4%). No significant higher risk for diabetes complications was found in other racial/ethnic groups relative to White people.
CONCLUSIONS/INTERPRETATION
Racial/ethnic differences exist in the risk for future diabetic complications and all-cause mortality. Our results support the use of such categories for international diabetes clinical guideline recommendations until better predictors become available. Efforts to identify high-risk groups and to better control cardiovascular risk factors across ethnically diverse populations are therefore needed.
REGISTRATION
PROSPERO registration ID CRD42021239274.
Topics: Cause of Death; Diabetes Complications; Diabetes Mellitus; Ethnicity; Humans; Prospective Studies; Race Factors; Racial Groups; Risk Factors
PubMed: 34455457
DOI: 10.1007/s00125-021-05554-9 -
PloS One 2014Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Previous studies suggested that diabetes mellitus was associated with cancer risk and prognosis, but studies investigating the relationship between diabetes mellitus and survival in patients with hepatocellular carcinoma (HCC) reported inconsistent findings. To derive a more precise estimate of the prognostic role of diabetes mellitus in HCC, we systematically reviewed published studies and carried out a meta-analysis.
METHODS
Eligible articles were identified in electronic databases from their inception through September 16, 2013. To evaluate the correlation between diabetes mellitus and prognosis in HCC, the pooled hazard ratios (HR) and their 95% confidence intervals (95% CI) for poorer overall and disease-free survivals were calculated by standard meta-analysis techniques with fixed-effects or random-effects models.
RESULTS
21 studies with a total of 9,767 HCC patients stratifying overall survival and/or disease-free survival in HCC patients by diabetes mellitus status were eligible for meta-analysis. 20 studies with a total of 9,727 HCC cases investigated the overall survival, and 10 studies with a total of 2,412 HCC patients investigated the disease-free survival. The pooled HRs for overall survival and disease-free survival were 1.46 (95% CI, 1.29 to 1.66; P<0.001) and 1.57 (95% CI, 1.21 to 2.05; P = 0.001), respectively. The adjusted HRs for overall survival and disease-free survival were 1.55 (95% CI, 1.27 to 1.91; P<0.001) and 2.15 (95% CI, 1.75 to 2.63; P<0.001), respectively. In addition, for patients receiving hepatic resection, diabetes mellitus was associated with both poorer overall survival and poorer disease-free survival, and for patients receiving non-surgical treatment or patients receiving radiofrequency ablation, diabetes mellitus was associated with poorer overall survival. There was no evidence for publication bias.
CONCLUSION
Diabetes mellitus is independently associated with both poorer overall survival and poorer disease-free survival in HCC patients.
Topics: Carcinoma, Hepatocellular; Diabetes Complications; Diabetes Mellitus; Disease-Free Survival; Humans; Liver; Liver Neoplasms; Prognosis; Risk Factors; Treatment Outcome
PubMed: 24830459
DOI: 10.1371/journal.pone.0095485 -
Current Diabetes Reviews 2020This article presents a scoping review and synthesis of research findings investigating the toxic cellular accumulation of dysregulated inorganic phosphate-phosphate...
This article presents a scoping review and synthesis of research findings investigating the toxic cellular accumulation of dysregulated inorganic phosphate-phosphate toxicity-as a pathophysiological determinant of diabetes and diabetic complications. Phosphorus, an essential micronutrient, is closely linked to the cellular metabolism of glucose for energy production, and serum inorganic phosphate is often transported into cells along with glucose during insulin therapy. Mitochondrial dysfunction and apoptosis, endoplasmic reticulum stress, neuronal degeneration, and pancreatic cancer are associated with dysregulated levels of phosphate in diabetes. Ectopic calcification involving deposition of calcium-phosphate crystals is prevalent throughout diabetic complications, including vascular calcification, nephropathy, retinopathy, and bone disorders. A low-glycemic, low-phosphate dietary intervention is proposed for further investigations in the treatment and prevention of diabetes and related diabetic pathologies.
Topics: Cell Physiological Phenomena; Cells; Diabetes Complications; Diabetes Mellitus; Glucose; Humans; Micronutrients; Phosphates
PubMed: 31686640
DOI: 10.2174/1573399815666191104113236 -
Diabetes/metabolism Research and Reviews Feb 2012Studies of diabetes and hepatocellular carcinoma (HCC) yielded inconsistent findings. This meta-analysis was conducted to examine the association between diabetes and... (Meta-Analysis)
Meta-Analysis Review
Studies of diabetes and hepatocellular carcinoma (HCC) yielded inconsistent findings. This meta-analysis was conducted to examine the association between diabetes and risk of HCC. Studies were identified by searching PUBMED and MEDLINE database up to February 2011. Pooled risk estimates were calculated using the random-effects model. Potential sources of heterogeneity were explored by subgroup analyses. A total of 17 case-control studies and 32 cohort studies were included in the meta-analysis. The combined risk estimate of all studies showed a statistically significant increased risk of HCC prevalence among diabetic individuals (RR = 2.31, 95% CI: 1.87-2.84). The pooled risk estimate of 17 case-control studies (OR = 2.40, 95% CI: 1.85-3.11) was slightly higher than that from 25 cohort studies (RR = 2.23, 95% CI: 1.68-2.96). Metformin treatment was potentially protective. On the contrary, long duration of diabetes and sulfonylureas or insulin treatment possibly increase HCC risk. Also meta-analysis of 7 cohort studies found a statistically significant increased risk of HCC mortality (RR = 2.43, 95% CI: 1.66-3.55) for individuals with (versus without) diabetes. This meta-analysis shows that diabetes is associated with moderately increased risk of HCC prevalence, as well as HCC mortality. Considering the rapidly increasing prevalence of diabetes mellitus, the study underlines the need for cancer prevention in diabetic individuals. Further investigation is needed to focus on the potential mechanism for the pathogenesis of HCC and the link between HCC and different types, severity, treatment and duration of diabetes.
Topics: Carcinoma, Hepatocellular; Case-Control Studies; Cohort Studies; Diabetes Complications; Diabetes Mellitus; Humans; Insulin; Liver Neoplasms; Metformin; Risk; Sulfonylurea Compounds
PubMed: 21898753
DOI: 10.1002/dmrr.1291