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diabetes mellitus and adverse outcomes after carotid endarterectomy:A systematic review and meta-analysis

Chinese Medical Journal 2023年第12期136卷 1401-1409页

作者： Fengshi Li Rui Zhang Xiao Di Shuai Niu Zhihua Rong Changwei Liu Leng Ni Department of Vascular Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Breast Oncoplastic Surgery Hunan Cancer Hospital&The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangshaHunan 410031China

Background:There is still uncertainty regarding whether diabetes mellitus(DM)can adversely affect patients undergoing carotid endarterectomy(CEA)for carotid stenosis.The aim of the study was to assess the adverse impact of DM on patients with carotid stenosis treated by CEA.Methods:Eligible studies published between 1 January 2000 and 30 March 2023 were selected from the PubMed,EMBASE,Web of Science,CENTRAL,and ClinicalTrials databases.The short-term and long-term outcomes of major adverse events(MAEs),death,stroke,the composite outcomes of death/stroke,and myocardial infarction(MI)were collected to calculate the pooled effect sizes(ESs),95%confidence intervals(CIs),and prevalence of adverse outcomes.Subgroup analysis by asymptomatic/symptomatic carotid stenosis and insulin/noninsulin-dependent DM was performed.Results:A total of 19 studies(n=122,003)were included.Regarding the short-term outcomes,DM was associated with increased risks of MAEs(ES=1.52,95%CI:[1.15-2.01],prevalence=5.1%),death/stroke(ES=1.61,95%CI:[1.13-2.28],prevalence=2.3%),stroke(ES=1.55,95%CI:[1.16-1.55],prevalence=3.5%),death(ES=1.70,95%CI:[1.25-2.31],prevalence=1.2%),and MI(ES=1.52,95%CI:[1.15-2.01],prevalence=1.4%).DM was associated with increased risks of long-term MAEs(ES=1.24,95%CI:[1.04-1.49],prevalence=12.2%).In the subgroup analysis,DM was associated with an increased risk of short-term MAEs,death/stroke,stroke,and MI in asymptomatic patients undergoing CEA and with only short-term MAEs in the symptomatic patients.Both insulin-and noninsulin-dependent DM patients had an increased risk of short-term and long-term MAEs,and insulin-dependent DM was also associated with the short-term risk of death/stroke,death,and MI.Conclusions:In patients with carotid stenosis treated by CEA,DM is associated with short-term and long-term MAEs.DM may have a greater impact on adverse outcomes in asymptomatic patients after CEA.Insulin-dependent DM may have a more significant impact on post-CEA adverse outcomes than noninsulin-dependent DM.Whether DM manag

关键词： Carotid artery stenosis Carotid endarterectomy diabetes mellitus Meta-analysis

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diabetes mellitus promoted lymph node metastasis in gastric cancer: a 15-year single-institution experience

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Chinese Medical Journal 2022年第8期135卷 950-961页

作者： Xinhua Chen Yuehong Chen Tao Li Weiqi Liang Huilin Huang Hongtao Su Chuyang Sui Yanfeng Hu Hao Chen Tian Lin Tao Chen Liying Zhao Hao Liu Guoxin Li Jiang Yu Department of General Surgery&Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor Nanfang HospitalThe First School of Clinical MedicineSouthern Medical UniversityGuangzhouGuangdong 510515China

Background: Previous studies have revealed that diabetes mellitus (DM) promotes disease progress of gastric cancer (GC). This study aimed to further investigating whether DM advanced lymph nodes (LNs) metastasis in GC.Methods: The clinicopathologic data of GC patients with >15 examined LN (ELN) between October 2004 and December 2019 from a prospectively maintained database were included. The observational outcomes included the number (N3b status) and anatomical distribution (N3 stations) of metastatic LN (MLN).Results: A total of 2142 eligible patients were included in the study between October 2004 and December 2019. N3 stations metastasis (26.8% in DMvs. 19.3% in non-DM,P = 0.026) and N3b status (18.8% in DMvs. 12.8% in non-DM,P = 0.039) were more advanced in the DM group, and multivariate logistic regression analyses confirmed that DM was an independent factor of developing N3 stations metastasis (odds ratio [OR] = 1.771,P= 0.011) and N3b status (OR= 1.752,P= 0.028). Also, multivariate analyses determined DM was independently associated with more MLN (β = 1.424,P = 0.047). The preponderance of N3 stations metastasis (DMvs. non-DM, T1-2: 2.2%vs. 4.9%, T3: 29.0%vs. 20.3%, T4a: 38.9%vs. 25.8%, T4b: 50.0%vs. 36.6%;ELN16-29: 8.6%vs. 10.4%, ELN30-44: 27.9%vs. 20.5%, ELN ≥ 45: 37.7%vs. 25.3%), N3b status (DMvs. non-DM, T1-2: 0%vs. 1.7%, T3: 16.1%vs. 5.1%, T4a: 27.8%vs. 19.1%, T4b: 44.0%vs. 28.0%;ELN16-29: 8.6%vs. 7.9%, ELN30-44: 18.0%vs. 11.8%, ELN ≥ 45: 26.4%vs. 17.3%), and the number of MLN (DMvs. non-DM, T1-2: 0.4vs. 1.1, T3: 8.6vs. 5.2, T4a: 9.7vs. 8.6, T4b: 17.0vs. 12.8;ELN16-29: 3.6vs. 4.6, ELN30-44: 5.8vs. 5.5, ELN ≥ 45: 12.0vs. 7.7) of DM group increased with the advancement of primary tumor depth stage and raising of ELN.Conclusions: DM was an independent risk factor for promoting LN metastasis. The preponderance of LN involvement in the DM group was aggravated with the advancement of tumor depth.

关键词： diabetes mellitus Gastric cancer Lymph node Metastasis

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diabetes mellitus, revascularization and outcomes in elderly patients with myocardial infarction-related cardiogenic shock

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Journal of Geriatric Cardiology 2020年第10期17卷 604-611页

作者： Miquel Gual Albert Ariza-Solé María García Márquez Cristina Fernández JoséL Bernal Francesc Formiga María-Isabel Barrionuevo JoséC Sánchez-Salado Victòria Lorente Júlia Pascual Isaac Llaó Oriol Alegre Angel Cequier Javier Elola Hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para la Mejora de la Asistencia Sanitaria MadridSpain Hospital Clínico Universitario San Carlos MadridSpain Hospital Universitario 12 de Octubre MadridSpain

Background The prognostic role of diabetes mellitus(DM)in elderly patients with myocardial infarction-related cardiogenic shock(MI-CS)remains controversial.Little information exists about the impact of intensive cardiac care unit(ICCU)and revascularization on outcomes of elderly patients with MI-CS.We aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to analyze the impact ICCU management and revascularization on in-hospital mortality in MI-CS patients at older ages.Methods Discharge episodes with diagnosis of CS associated with MI were selected from the Spanish National Health System’s Basic Data Set.Centers were classified according to their availability of ICCU.Main outcome measured was in-hospital mortality.Results A total of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 years.The impact of DM on in-hospital mortality was different among age subgroups.While in younger patients,DM was associated to a higher mortality risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2<0.001),this association became non-significant in older patients(0.76 vs.0.81,χ^2=0.09).Adjusted mortality rate of MI-CS aged≥75 years was lower in patients admitted to hospitals with ICCU(adjusted mortality rate:74.2%vs.77.7%,P<0.001)and in patients undergoing revascularization(74.9%vs.77.3%,P<0.001).Conclusions Prognostic impact of DM in patients with MI-CS was different according to age,with a significantly lower impact at older ages.The availability of ICCU and revascularization were associated with better outcomes in these complex patients.

关键词： Cardiogenic shock diabetes mellitus Myocardial infarction Revascularization The elderly

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diabetes mellitus is associated with increased mortality during tuberculosis treatment:a prospective cohort study among tuberculosis patients in SouthEastern Amahra Region,Ethiopia

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Infectious Diseases of Poverty 2016年第1期5卷 198-207页

作者： Mahteme Haile Workneh Gunnar Aksel Bjune Solomon Abebe Yimer Institute of Health and Society Faculty of MedicineUniversity of OsloOsloNorway Amhara Regional State Health Bureau Bahir-DarEthiopia Department of Microbiology Oslo University HospitalOsloNorway Department of Bacteriology and Immunology Norwegian Institute of Public HealthOsloNorway

Background:There is growing evidence suggesting that diabetes mellitus(DM)affects disease presentation and treatment outcome in tuberculosis(TB)patients.This study aimed at investigating the role of DM on clinical presentations and treatment outcomes among newly diagnosed TB patients.Methods:A prospective cohort study was conducted in South-Eastern Amhara Region,Ethiopia from September 2013 till March 2015.Study subjects were consecutively recruited from 44 randomly selected health facilities in the study area.Participants were categorized into two patient groups,namely,patients with TB and DM(TBDM)and TB patients without DM(TBNDM).Findings on clinical presentations and treatment outcomes were compared between the two patient groups.Cox proportional hazard regression analysis was applied to identify factors associated with death.Results:Out of 1314 TB patients enrolled in the study,109(8.3%)had coexisting DM.TBDM comorbidity[adjusted hazard ratio(AHR)3.96;95%confidence interval(C.I.)(1.76–8.89)],and TB coinfection with human immunodeficiency virus(HIV)[AHR 2.59;95%C.I.(1.21–5.59)]were associated with increased death.TBDM and TBNDM patients did not show significant difference in clinical symptoms at baseline and during anti-TB treatment period.However,at the 2nd month of treatment,TBDM patients were more symptomatic compared to patients in the TBNDM group.Conclusions:The study showed that DM is associated with increased death during TB treatment.DM has no association with clinical presentation of TB except at the end of the intensive phase treatment.Routine screening of TB patients for DM is recommended for early diagnosis and treatment of patients with TBDM comorbidity.

关键词： Tuberculosis diabetes mellitus Association Symptoms Treatment outcome Amhara Region Ethiopia

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Prevalence of Anemia in Patients with diabetes mellitus:A Systematic Review and Meta-Analysis

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Biomedical and Environmental Sciences 2024年第1期37卷 96-107页

作者： Monireh Faghir-Ganji Narjes Abdolmohammadi Maryam Nikbina Alireza Amanollahi Alireza Ansari-Moghaddam Rozhan Khezri Hamidreza Baradaran Student Research Committee Iran University of Medical SciencesTehranIran Department of Epidemiology School of Public HealthIran University of Medical SciencesTehranIran Department of Epidemiology School of Public HealthTehran University of Medical SciencesTehranIran Department of Midwifery Shoushtar Faculty of Medical SciencesShoushtarIran Department of Epidemiology School of Public Health and SafetyShahid Beheshti University of Medical SciencesTehranIran Trauma and Injury Research Center Iran University of Medical SciencesTehranIran Health Promotion Research Center Zahedan University of Medical SciencesZahedanIran Endocrine Research Center Institute of Endocrinology and MetabolismIran University of Medical SciencesTehranIran

Objective Anemia is a common public health concern in patients with type 2 diabetes worldwide.This study aimed to identify the prevalence of anemia among patients with diabetes.Methods Electronic databases,including PubMed,Scopus,Web of Sciences,and Google Scholar,were searched systematically for studies published between 2010 and 2021.After removing duplicates and inappropriate reports,the remaining manuscripts were reviewed and appraised using theNewcastleOttawa Scale(NOS)tool.A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17.Heterogeneity of the studies was assessed using the Q statistic.Results A total of 51 articles containing information on 26,485 patients with diabetes were included in this study.The articles were mainly from Asia(58.82%)and Africa(35.29%).The overall prevalence of anemia was 35.45%(95%CI:30.30–40.76),with no evidence of heterogeneity by sex.Among the two continents with the highest number of studies,the prevalence of anemia in patients with diabetes was significantly higher in Asia[40.02;95%CI:32.72–47.54]compared to Africa[28.46;95%CI:21.90–35.50](P for heterogeneity=0.029).Moreover,there has been an increasing trend in the prevalence of anemia in patients with diabetes over time,from[15.28;95%CI:9.83–22.21]in 2012 to[40.70;95%CI:10.21–75.93]in 2022.Conclusion Globally,approximately 4 in 10 patients with diabetes suffer from anemia.Therefore,routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

关键词： Prevalence Diabetic foot Anemia diabetes mellitus

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A review of patent literature on the regulation of glucose metabolism by six phytocompounds in the management of diabetes mellitus and its complications

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Journal of Integrative Medicine 2023年第3期21卷 226-235页

作者： Anusree DasNandy Rajashri Virge Harsha V.Hegde Debprasad Chattopadhyay ICMR-National Institute of Traditional Medicine Belagavi 590010KarnatakaIndia

diabetes mellitus is a chronic disease,typified by hyperglycemia resulting from failures in complex multifactorial metabolic functions,that requires life-long medication.Prolonged uncontrolled hyperglycemia leads to micro-and macro-vascular complications.Although antidiabetic drugs are prescribed as the first-line treatment,many of them lose efficacy over time or have severe side effects.There is a lack of in-depth study on the patents filed concerning the use of natural compounds to manage diabetes.Thus,this patent analysis provides a comprehensive report on the antidiabetic therapeutic activity of 6 phytocompounds when taken alone or in combinations.Four patent databases were searched,and 17,649 patents filed between 2001 and 2021 were retrieved.0f these,139 patents for antidiabetic therapeutic aids that included berberine,curcumin,gingerol,gymnemic acid,gymnemagenin and mangiferin were analyzed.The results showed that these compounds alone or in combinations,targeting acetylcoenzyme A carboxylase 2,serine/threonine protein kinase,α-amylase,α-glucosidase,lipooxygenase,phosphorylase,peroxisome proliferator-activated receptor-γ(PPAR-γ),protein tyrosine phosphatase 1B,PPARγco-activator-1α,phosphoinositide 3-kinase and protein phosphatase 1 regulatory subunit 3C,could regulate glucose metabolism which are validated by pharmacological rationale.Synergism,or combination therapy,including different phytocompounds and plant extracts,has been studied extensively and found effective,whereas the efficacy of commercial drugs in combination with phytocompounds has not been studied in detail.Curcumin,gymnemic acid and mangiferin were found to be effective against diabetes-related complications.

关键词： Berberine Curcumin Gingerol Gymnemic acid Gymnemagenin Mangiferin diabetes mellitus Patents

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Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus:a systematic review and meta-analysis

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World Journal of Pediatrics 2023年第4期19卷 323-339页

作者： Yi Wu Yi-Yun Zhang Ya-Ting Zhang Hui-Jing Zhang Tian-Xue Long Qi Zhang Jing Huang Ming-Zi Li Peking University Health Science Center 38 Huayuan RoadHaidian DistrictBeijing100191China School of Nursing Peking UniversityBeijingChina Peking University Health Science Centre for Evidence-Based Nursing A Joanna Briggs Institute Affiliated GroupBeijingChina School of Nursing Jilin UniversityChangchunChina

Background This study aimed to analyze the efficacy of resilience-promoting interventions among adolescents and youth aged 10-24 years with any type of diabetes.Methods A systematic literature search was performed using the PubMed,Web of Science,Embase,Cochrane Library,CINAHL,and PsycINFO databases from inception to May 25,2022.The Cochrane risk of bias tool(version 2)was used to assess the quality of the included studies.A meta-analysis was performed to calculate the pooled effects of resilience-promoting interventions.Results Nineteen articles were included covering an overall sample of 2048 adolescents with diabetes.When analyzing the effectiveness of resilience-promoting interventions,hemoglobin A1c(HbA1c)at six months[mean difference=-0.47,95%confidence interval(CI)=-0.83 to-0.12,P=0.009]after the intervention was improved.However,long-term(≥12 months)improvement in HbA1c was not significant.In addition,comparing the control group,there were significant differences in the effect size for stress[standardized mean difference(SMD)=-0.87,95%CI=-1.25 to-0.48,Pdiabetes management to improve HbA1c,stress,self-efficacy,and quality of life.Incorporating resilience-promoting components into diabetes education and re-enforcing these contents every six months are recommended for implementation in clinical practice.

关键词： Adolescents diabetes mellitus Intervention Meta-analysis Resilience

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Effectiveness and safety of Shexiang Baoxin Pill(MUSKARDIA)in patients with stable coronary artery disease and concomitant diabetes mellitus:a subgroup analysis of a randomized clinical trial

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Chinese Medical Journal 2023年第1期136卷 82-87页

作者： Jingmin Zhou Haiming Shi Fusui Ji Yang Wu Yulan Zhao Jun Qian Junbo Ge Department of Cardiology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Cardiology Huashan HospitalFudan UniversityShanghai 200040China Department of Cardiology Beijing HospitalBeijing 100005China Department of Cardiology Dongfang Hospital Affiliated to Beijing University of Chinese MedicineBeijing 100078China Department of Cardiology The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450014China Department of Cardiology The Center Hospital of Ma’anshanMa’anshanAnhui 243099China

Background:Preliminary studies have indicated that Shexiang Baoxin Pill(MUSKARDIA)has a coronary artery dilation effect and increases the coronary blood flow,relieving the symptoms of angina.This study aimed to evaluate the benefit of MUSKARDIA on patients with stable coronary artery disease(CAD)and diabetes mellitus(DM).Methods:This was a subgroup analysis of a multicenter,randomized,placebo-controlled phase IV trial.CAD patients with a medical history of DM or baseline fasting blood glucose(FBG)≥7.0 mmol/L were grouped according to the treatment(standard therapy plus MUSKARDIA or placebo).The primary outcome was major adverse cardiovascular events(MACEs),which was the composite outcome of cardiovascular death,non-fatal myocardial infarction,and non-fatal stroke.The secondary outcome was the composite outcome of all-cause death,non-fatal myocardial infarction,non-fatal stroke,hospitalization for unstable angina or heart failure,and coronary angioplasty.Results:MACEs occurred in 2.6%(9/340)and 4.8%(18/376)of patients in the MUSKARDIA and placebo groups,respectively(P=0.192).Secondary composite outcome was significantly less frequent with MUSKARDIA than with placebo(15.3%[52/340]vs.22.6%[85/376],P=0.017).Risk of MACEs(hazard ratio[HR]=0.69,95%confidence interval[CI]:0.31-1.57)was comparable between two groups.In patients with uncontrolled DM(≥4 measurements of FBG≥7 mmol/L in five times of follow-up),the risk of secondary outcome was significantly lower with MUSKARDIA(5/83,6.0%)than with placebo(15/91,16.5%)(HR=0.35,95%CI:0.13-0.95).Conclusion:As an add-on to standard therapy,MUSKARDIA shows a trend of reduced MACEs in patients with stable CAD and DM.Furthermore,MUSKARDIA may reduce the frequency of all-cause death,hospitalization,and coronary angioplasty in this population,especially in those with uncontrolled DM.Trial Registration:***,ChiCTR-TRC-12003513.

关键词： Shexiang Baoxin Pill MUSKARDIA Coronary artery disease Angina diabetes mellitus Major adverse cardiovascular events

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diabetes mellitus in patients with type 1 autoimmune pancreatitis at diagnosis and after corticosteroid therapy

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Hepatobiliary and Pancreatic Diseases International 2024年第4期23卷 393-398页

作者： Li M.-Z. Guo T. Feng Y.-L. Zhang S.-Y. Bai X.-Y. Wu X. Xu K. Yang A.-M. Department of Gastroenterology State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China Department of Radiology Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China

Background: A high prevalence of diabetes mellitus (DM) coexisting with autoimmune pancreatitis (AIP) is observed. However, evidence on the circumstances under which corticosteroid therapy (CST) for AIP improves or worsens DM is scarce. This study aimed to demonstrate and identify predictors of DM control under the influence of CST. Methods: Patients diagnosed with type 1 AIP were enrolled from a prospectively maintained cohort and were classified into three groups according to the chronology in which AIP and DM were diagnosed: pre-existing DM (pDM), concurrent DM (cDM), and non-DM (nDM). The responses of DM to CST were assessed when corticosteroid was ceased or tapered to a maintenance dose and classified as ‘improvement’ and ‘non-improvement’ (including ‘no change’ and ‘exacerbation’). Results: Among 101 patients with type 1 AIP, 52 (51.5%) patients were complicated with DM at the time of AIP diagnosis, with 36 patients in the cDM group and 16 patients in the pDM group. The incidences of diffuse pancreatic swelling (72.2%) and pancreatic body/tail involvement (91.7%) were significantly higher in the cDM group than in both the pDM and nDM groups. Of the 52 patients with DM, CST was administered in 48 cases. Multivariate logistic analysis identified that elevated serum gamma-glutamyl transferase (GGT) level at AIP diagnosis [odds ratio (OR) = 0.032, 95% confidence interval (CI): 0.003-0.412, P = 0.008] and pancreatic atrophy after CST (OR = 0.027, 95% CI: 0.003-0.295, P = 0.003) were negatively associated with DM control improvement. Conclusions: Patients with diffuse pancreatic swelling and pancreatic body/tail involvement in pancreatitis tended to be complicated with cDM at AIP diagnosis. CST exerted a beneficial effect on the clinical course of DM in nearly half of the AIP patients complicated with DM at diagnosis, particularly in those without elevated serum GGT levels at diagnosis and who did not experience pancreatic atrophy after CST. © 2023 First Affiliated Hospital, Zhejiang University School of Medicine

关键词： Corticosteroid therapy diabetes mellitus Pancreatic atrophy Predictive factor Type 1 autoimmune pancreatitis

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Parkinson’s disease and diabetes mellitus: common mechanisms and treatment repurposing

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Neural Regeneration Research 2022年第8期17卷 1652-1658页

作者： Carmen M.Labandeira Arturo Fraga-Bau David Arias Ron Elena Alvarez-Rodriguez Pablo Vicente-Alba Javier Lago-Garma Ana I.Rodriguez-Perez Department of Clinical Neurology Hospital Alvaro CunqueiroUniversity Hospital ComplexVigoSpain Laboratory of Cellular and Molecular Neurobiology of Parkinson’s Disease Research Center for Molecular Medicine and Chronic Diseases(CIMUS)IDISUniversity of Santiago de CompostelaSantiago de CompostelaSpain Department of Clinical Oncology University Hospital ComplexOurenseSpain Department of Endocrinology Hospital MeixoeiroUniversity Hospital ComplexVigoSpain Networking Research Center on Neurodegenerative Diseases(CiberNed) MadridSpain

In the last decade,attention has become greater to the relationship between neurodegeneration and abnormal insulin signaling in the central nervous system,as insulin in the brain is implicated in neuronal survival,plasticity,oxidative stress and neuroinflammation.diabetes mellitus and Parkinson’s disease are both aging-associated diseases that are turning into epidemics worldwide.diabetes mellitus and insulin resistance not only increase the possibility of developing Parkinson’s disease but can also determine the prognosis and progression of Parkinsonian symptoms.Today,there are no available curative or disease modifying treatments for Parkinson’s disease,but the role of insulin and antidiabetic medications in neurodegeneration opens a door to treatment repurposing to fight against Parkinson’s disease,both in diabetic and nondiabetic Parkinsonian patients.Furthermore,it is essential to comprehend how a frequent and treatable disease such as diabetes can influence the progression of neurodegeneration in a challenging disease such as Parkinson’s disease.Here,we review the present evidence on the connection between Parkinson’s disease and diabetes and the consequential implications of the existing antidiabetic molecules in the severity and development of Parkinsonism,with a particular focus on glucagon-like peptide-1 receptor agonists.

关键词： antidiabetic diabetes mellitus dopamine exenatide glucagon-like peptide-1 insulin neurodegeneration neuroinflammation Parkinson’s disease repurposing

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