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Long-term quality-of-care score for predicting the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus

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World Journal of diabetes 2023年第7期14卷 1091-1102页

作者： Pi-I Li How-Ran Guo Department of Family Medicine Chi Mei Medical CenterTainan 710TaiwanChina Department of Pharmacy Chia Nan University of Pharmacy and ScienceTainan 717TaiwanChina Department of Environmental and Occupational Health College of MedicineNational Cheng Kung UniversityTainan 704TaiwanChina Department of Occupational and Environmental Medicine National Cheng Kung University HospitalTainan 704TaiwanChina

BACKGROUND Cardiovascular disease(CVD)is the leading cause of death globally,and diabetes mellitus(DM)is a well-established risk factor.Among the risk factors for CVD,DM is a major modifiable factor.In the fatal CVD outcomes,acute myocardial infarction(AMI)is the most common cause of death.AIM To develop a long-term quality-of-care score for predicting the occurrence of AMI among patients with type 2 DM on the basis of the hypothesis that good quality of care can reduce the risk of AMI in patients with DM.METHODS Using Taiwan’s Longitudinal Cohort of diabetes Patients Database and the medical charts of a medical center,we identified incident patients diagnosed with type 2 DM from 1999 to 2003 and followed them until 2011.We constructed a summary quality-of-care score(with values ranging from 0 to 8)with process indicators(frequencies of HbA1c and lipid profile testing and urine,foot and retinal examinations),intermediate outcome indicators(low-density lipoprotein,blood pressure and HbA1c),and co-morbidity of hypertension.The associations between the score and the incidence of AMI were evaluated using Cox regression models.RESULTS A total of 7351 patients who had sufficient information to calculate the score were enrolled.In comparison with participants who had scores≤1,those with scores between 2 and 4 had a lower risk of developing AMI[adjusted hazard ratio(AHR)=0.71;95% confidence interval(95%CI):0.55-0.90],and those with scores≥5 had an even lower risk(AHR=0.37;95%CI:0.21-0.66).CONCLUSION Good quality of care can reduce the risk of AMI in patients with type 2 DM.The quality-of-care score developed in this study had a significant association with the risk of AMI and thus can be applied to guiding the care for these patients.

关键词： Acute myocardial infarction Cardiovascular disease diabetes mellitus Quality-of-care Score

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Leech-Centipede Granules Suppress EndMT to Improve Erectile Dysfunction in Rats with diabetes mellitus via TGF-β/Smad Pathway

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Chinese Journal of Integrative Medicine 2023年第1期29卷 28-36页

作者： ZHANG Hui FENG Chu-hui HE Shan DENG Ming-xia MENG Hao CHEN Ming LIU Hong Department of Urology the First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510000China Department of Urology the Third Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510000China The First Clinical Medical College of Guangzhou University of Chinese Medicine Guangzhou510000China

Objective:To investigate whether Leech-Centipede(LC) Granules can improve erectile function in rats with diabetes mellitus-associated erectile dysfunction(DMED) through endothelial-to-mesenchymal transition(EndMT) inhibition.Methods:Components of LC Granules were identified via ultra-high-performance liquid chromatography.Thirty male Sprague Dawley rats were injected with streptozotocin and fed continuously for 8weeks to establish the DMED rat model.Rats with erectile dysfunction symptoms diagnosed using apomorphine were divided into DMED and low-,medium-,and high-doses LC groups(n=6 in each).The negative control(NC, n=6) and DMED groups were given 5 mL of deionized water via intragastric gavage,and the low-,mediumand the high-doses LC groups were administered LC at 1.6,3.2,and 6.4 g/kg,respectively,via intragastric gavage for 4 weeks.The intracavernous pressure(ICP),mean arterial pressure(MAP),and nitric oxide(NO) levels in cavernous tissue were measured for each group.Quantitative reverse transcription-polymerase chain reaction and Western blot were used to detect mRNA and protein expressions of endothelial and mesenchymal markers.Immunofluorescence staining was used to observe α-SMA, and Masson’s trichrome staining was performed to determine the myofiber/collagen ratio.Results:A total of 474 active components were identified.After treatment,the ICP/MAP value and NO level were significantly higher in the medium-and high-dose LC groups than in the DMED group(Pdiabetes onset but reduced following LC intervention(P0.05).α-SMA expression was significantly higher in the DMED group and was reduced in all LC intervention groups(P>0.05).The myofiber/collagen ratio in the LC groups was higher than that in the DMED group but lo

关键词： Leech-Centipede Granules erectile function diabetes mellitus endothelial cell endothelial-to-mesenchymal transition tumor growth factor-beta/Smad pathway

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Cognitive disorder and dementia in type 2 diabetes mellitus

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World Journal of diabetes 2022年第4期13卷 319-337页

作者： Genaro G Ortiz Miguel Huerta Héctor A González-Usigli Erandis D Torres-Sánchez Daniela LC Delgado-Lara Fermín P Pacheco-Moisés Mario A Mireles-Ramírez Blanca MG Torres-Mendoza Roxana I Moreno-Cih Irma E Velázquez-Brizuela Department of Philosophical and Methodological Disciplines University Health Sciences CenterUniversity of GuadalajaraGuadalajara 44340JaliscoMexico Department of Neurology Movement Disorders ClinicSub-Specialty Medical UnitNational Western Medical CenterMexican Social Security Institute(IMSS)Guadalajara 44340JaliscoMexico University Biomedical Research Center University of ColimaColima 28040Mexico Department of Medical and Life Sciences University Center of‘La Ciénega’University of GuadalajaraOcotlán 47810JaliscoMexico Department of Chemistry University Center of Exact Sciences and EngineeringUniversity of GuadalajaraGuadalajara 44340JaliscoMexico Division of Neurosciences Western Biomedical Research CenterMexican Social Security Institute(IMSS)Guadalajara 44340JaliscoMexico Gerontology Postgraduate Program Public Health DepartmentUniversity Health Sciences CenterUniversity of GuadalajaraGuadalajara 44340JaliscoMexico

Insulin,a key pleiotropic hormone,regulates metabolism through several signaling pathways in target tissues including skeletal muscle,liver,and brain.In the brain,insulin modulates learning and memory,and impaired insulin signaling is associated with metabolic dysregulation and neurodegenerative diseases.At the receptor level,in aging and Alzheimer’s disease(AD)models,the amount of insulin receptors and their functions are decreased.Clinical and animal model studies suggest that memory improvements are due to changes in insulin levels.Furthermore,diabetes mellitus(DM)and insulin resistance are associated with age-related cognitive decline,increased levels ofβ-amyloid peptide,phosphorylation of tau protein;oxidative stress,pro-inflammatory cytokine production and dyslipidemia. Recent evidence shows that deleting brain insulin receptors leads to mildobesity and insulin resistance without influencing brain size and apoptosis development.Conversely, deleting insulin-like growth factor 1 receptor (IGF-1R) affects brain size anddevelopment, and contributes to behavior changes. Insulin is synthesized locally in the brain andis released from the neurons. Here, we reviewed proposed pathophysiological hypotheses toexplain increased risk of dementia in the presence of DM. Regardless of the exact sequence ofevents leading to neurodegeneration, there is strong evidence that mitochondrial dysfunctionplays a key role in AD and DM. A triple transgenic mouse model of AD showed mitochondrialdysfunction, oxidative stress, and loss of synaptic integrity. These alterations are comparable tothose induced in wild-type mice treated with sucrose, which is consistent with the proposal thatmitochondrial alterations are associated with DM and contribute to AD development. Alterationsin insulin/IGF-1 signaling in DM could lead to mitochondrial dysfunction and low antioxidantcapacity of the cell. Thus, insulin/IGF-1 signaling is important for increased neural processing andsystemic metabolism, and could be a specific target for therapeutic st

关键词： Alzheimer´s disease diabetes mellitus Insulin Vascular dementia Cognitive decline

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Predictors of permanent pacemaker implantation following transcatheter aortic valve replacement-the search is still on!

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World Journal of Cardiology 2024年第3期16卷 104-108页

作者： Sudesh Prajapathi Akshyaya Pradhan Department of Cardiology King George's Medical UniversityLucknow 226003Uttar PradeshIndia

Several anatomical,demographic,clinical,electrocardiographic,procedural,and valve-related variables can be used to predict the probability of developing con-duction abnormalities after transcatheter aortic valve replacement(TAVR)that necessitate permanent pacemaker(PPM)implantation.These variables include calcifications around the device landing zone and in the mitral annulus;pre-existing electrocardiographic abnormalities such as left and right bundle branch blocks(BBB),first-and second-degree atrioventricular blocks,as well as bifas-cicular and trifascicular blocks;male sex;diabetes mellitus(DM);hypertension;history of atrial fibrillation;renal failure;dementia;and use of self-expanding valves.The current study supports existing literature by demonstrating that type 2 DM and baseline right BBB are significant predictors of PPM implantation post-TAVR.Regardless of the side of the BBB,this study demonstrated,for the first time,a linear association between the incidence of PPM implantation post-TAVR and every 20 ms increase in baseline QRS duration(above 100 ms).After a 1-year follow-up,patients who received PPM post-TAVR had a higher rate of hospital-ization for heart failure and nonfatal myocardial infarction.

关键词： Bundle branch block Self expanding aortic valve Atrioventricular node diabetes mellitus QRS duration

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Multi Head Deep Neural Network Prediction Methodology for High-Risk Cardiovascular Disease on diabetes mellitus

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Computer Modeling in Engineering & Sciences 2023年第12期137卷 2513-2528页

作者： B.Ramesh Kuruva Lakshmanna School of Information Technology and Engineering Vellore Institute of TechnologyVelloreTamilnadu632014India

Major chronic diseases such as Cardiovascular Disease(CVD),diabetes,and cancer impose a significant burden on people and healthcare systems around the globe.Recently,Deep Learning(DL)has shown great potential for the development of intelligentmobile Health(mHealth)interventions for chronic diseases that could revolutionize the delivery of health care anytime,anywhere.The aimof this study is to present a systematic review of studies that have used DL based on mHealth data for the diagnosis,prognosis,management,and treatment of major chronic diseases and advance our understanding of the progress made in this rapidly developing field.Type 2 diabetes mellitus(T2DMs)is a regular chronic disorder that is caused by the secretion of insulin,which leads to serious death-related issues and the most complicated ones.Coronary Heart Disease(CHD)is the most frequent issue related to T2DM patients.The major concern is recognizing the high possibility of CHD complications,yet the model is not available to identify it.This work introduces a deep learning technique that can predict heart disease effectively using a hybrid model,which integrates DNNs(Deep Neural Networks)with a Multi-Head Attention Model called MADNN.The scheme canbedesignedtoautomatically learnthe best-quality features fromElectronic Health Records(EHRs),and effectively combine heterogeneous and time-sequencedmedical data for predicting the risk of CVD.The analysis is done using the Kaggle dataset.The outcomes prove that the MADNN has improved accuracy by about 95%and indicates the precise accuracy is higher for the disease compared with SVM,CNN and ANN.

关键词： diabetes mellitus cardiovascular diseases deep learning coronary heart disease deep neural networkwith amultihead attention model

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Analysis of the management and therapeutic performance of diabetes mellitus employing special target

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World Journal of diabetes 2023年第12期14卷 1721-1737页

作者： Hong-Yan Sun Xiao-Yan Lin Department of Endocrine and Metabolic Diseases Yantaishan HospitalYantai 264003Shandong ProvinceChina

diabetes mellitus (DM) is a chronic metabolic condition characterized predominantlyby hyperglycemia. The most common causes contributing to the pathophysiologyof diabetes are insufficient insulin secretion, resistance to insulin’stissue-acting effects, or a combination of both. Over the last 30 years, the globalprevalence of diabetes increased from 4% to 6.4%. If no better treatment or cure isfound, this amount might climb to 430 million in the coming years. The major fact-ors of the disease’s deterioration include age, obesity, and a sedentary lifestyle.Finding new therapies to manage diabetes safely and effectively without jeopardizingpatient compliance has always been essential. Among the medicationsavailable to manage DM on this journey are glucagon-like peptide-1 agonists,thiazolidinediones, sulphonyl urease, glinides, biguanides, and insulin-targetingreceptors discovered more than 10 years ago. Despite the extensive preliminarystudies, a few clinical observations suggest this process is still in its early stages.The present review focuses on targets that contribute to insulin regulation andmay be employed as targets in treating diabetes since they may be more efficientand secure than current and traditional treatments.

关键词： diabetes mellitus Hyperglycemia Therapeutic performance Management Special target Literature review

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Cellular and molecular overview of gestational diabetes mellitus:Is it predictable and preventable?

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World Journal of diabetes 2023年第11期14卷 1693-1709页

作者： Pei-Qi Lim Yen-Ju Lai Pei-Ying Ling Kuo-Hu Chen Department of Obstetrics and Gynecology Taiwan Adventist HospitalTaipei 105TaiwanChina School of Medicine George Washington UniversityWashingtonDC 20052United States Department of Obstetrics and Gynecology Taipei Tzu-Chi General HospitalTaipei 231TaiwanChina

BACKGROUND In contrast to overt diabetes mellitus(DM),gestational DM(GDM)is defined as impaired glucose tolerance induced by pregnancy,which may arise from exaggerated physiologic changes in glucose metabolism.GDM prevalence is reported to be as high as 20%among pregnancies depending on the screening method,gestational age,and the population studied.Maternal and fetal effects of uncontrolled GDM include stillbirth,macrosomia,neonatal diabetes,birth trauma,and subsequent postpartum hemorrhage.Therefore,it is essential to find the potential target population and associated predictive and preventive measures for future intensive peripartum care.AIM To review studies that explored the cellular and molecular mechanisms of GDM as well as predictive measures and prevention strategies.METHODS The search was performed in the Medline and PubMed databases using the terms“gestational diabetes mellitus,”“overt diabetes mellitus,”and“insulin resistance.”In the literature,only full-text articles were considered for inclusion(237 articles).Furthermore,articles published before 1997 and duplicate articles were excluded.After a final review by two experts,all studies(1997-2023)included in the review met the search terms and search strategy(identification from the database,screening of the studies,selection of potential articles,and final inclusion).RESULTS Finally,a total of 79 articles were collected for review.Reported risk factors for GDM included maternal obesity or overweight,pre-existing DM,and polycystic ovary syndrome.The pathophysiology of GDM involves genetic variants responsible for insulin secretion and glycemic control,pancreaticβcell depletion or dysfunction,aggravated insulin resistance due to failure in the plasma membrane translocation of glucose transporter 4,and the effects of chronic,low-grade inflammation.Currently,many antepartum measurements including adipokines(leptin),body mass ratio(waist circumference and waist-to-hip ratio),and biomarkers(microRNA in extracellular vesicles)have been studied and confirme

关键词： Gestational diabetes mellitus Overt diabetes mellitus Insulin resistance diabetes mellitus

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Considerations for management of patients with diabetes mellitus and acute COVID-19

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World Journal of diabetes 2022年第10期13卷 802-808页

作者： Efterpi Mougakou Maria Kyziroglou Alexandra Tsankof Evangelos Cholongitas Konstantinos Tziomalos First Department of Internal Medicine Medical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthens 11527Greece First Propedeutic Department of Internal Medicine Medical SchoolAristotle University of ThessalonikiAHEPA HospitalThessaloniki 54636Greece

diabetes mellitus(DM)is an independent risk factor for admission to intensive care unit and death in patients with coronavirus disease 2019(COVID-19).On the other hand,medications used in the management of COVID-19 are potentially associated with increases in blood glucose levels and a higher incidence of infections.Accordingly,care of patients with DM and acute COVID-19 requires careful consideration of both diseases.Hyperglycemia and hypoglycemia are associated with adverse outcomes and therefore frequent measurement of blood glucose levels and a basal-bolus insulin regimen are required in most patients.Regarding the management of COVID-19,dexamethasone increases blood glucose levels and might also increase the risk for infections.On the other hand,limited data suggest that antiviral and immunomodulatory agents used in COVID-19 are not strongly associated with higher incidence of infections in this population.As knowledge evolves in this field,optimization of the management of both DM and COVID-19 will hopefully improve the outcome of these patients。

关键词： diabetes mellitus COVID-19 Insulin Antidiabetic agents Dexamethasone Tocilizumab Remdesivir

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Effect of dates on blood glucose and lipid profile among patients with type 2 diabetes

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World Journal of diabetes 2024年第6期15卷 1079-1085页

作者： Hyder Osman Mirghani Internal Medicine University of TabukSaudi ArabiaTabuk 51941TabukSaudi Arabia

Poor fruit and vegetable consumption is one of the 10 major risk factors for mortality.There is a misconception regarding the consumption of dates among patients with diabetes.This manuscript assessed the effects of date consumption on fasting and postprandial blood glucose,glycated hemoglobin,total cholesterol,triglycerides,low-density lipoproteins,high-density lipoproteins,and microbial markers.Four literature databases were searched for relevant articles.Of the 595 studies retrieved,24 assessed the effects of dates on glycemic control and lipids.Overall,the evidence suggests that dates have a lowering effect on blood glucose.Dates reduce total cholesterol and triglyceride levels and increase high-density lipoprotein levels.Dates also promote the abundance of beneficial gut microbiota.Therefore,patients with diabetes and dyslipidemia can consume dates to reduce their blood glucose,cholesterol,and triglycerides.

关键词： Dates Lipid profile Blood glucose diabetes mellitus Microbial contamination

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Intraocular lens selection in diabetic patients:How to increase the odds for success

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World Journal of diabetes 2024年第6期15卷 1199-1211页

作者： Arvind Kumar Morya Prateek Nishant Prasanna Venkatesh Ramesh Sony Sinha Aarti Heda Sarika Salodia Ripunjay Prasad Department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia Department of Ophthalmology ESIC Medical CollegePatna 801113BiharIndia Department of Glaucoma and Research Mahathma Eye Hospital Private LimitedTrichy 620017Tamil NaduIndia Department of Ophthalmology-Vitreo-Retina Neuro-Ophthalmology and OculoplastyAll India Institute of Medical SciencesPatnaPatna 801507BiharIndia Department of Ophthalmology National Institute of OphthalmologyPune 411000MaharashtraIndia Department of Safety Global Medical SafetyLundbeckSingapore 307591Singapore Department of Ophthalmology RP Eye InstituteDelhi 110001India

The incidence of cataracts is significantly higher in diabetic individuals,particularly in younger age groups,with rates quadrupled in those under 65 and doubled in those over 65 compared to non-diabetics.Cataract surgery in diabetic patients poses many challenges:Poor epithelial healing,decreased corneal sensitivity,increased central corneal thickness,decreased endothelial cell count,variable topography,poor pupillary dilatation,anterior capsular phimosis,posterior capsular opacification(PCO),chances of progression of diabetic retinopathy(DR),zonular weakness,and vitreous prolapse and diabetic macular edema.Selection of an appropriate intraocular lens(IOL)is crucial for visual rehabilitation and monitoring DR.The choice of IOL in diabetic cataract patients is a challenging scenario.Square-edge IOLs are favored for their capacity to mitigate PCO,whereas hydrophilic counterparts may incur calcification in the setting of proliferative DR.The advisability of premium IOLs for achieving spectacle independence warrants judicious evaluation,particularly in the presence of advanced retinopathy.Optimal IOL placement within the capsular bag is advocated to minimize postoperative complications.Rigorous preoperative assessment and informed patient counseling regarding IOL options are indispensable for optimizing surgical outcomes.This review article covers various aspects regarding the choice of IOLs in different case scenarios and complications in the diabetic population.

关键词： Diabetics Cataract Intraocular lens Diabetic retinopathy diabetes mellitus

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