Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献_第9页

Corrigendum to “Cardiometabolic disease and multiple long-term condition healthcare provision in Sub-Saharan Africa: Opportunities for new models of care in the post-COVID era” [Diabetes Metabol Syndr: Clin Res Rev 17 1 (January 2023) 102681] 对 "撒哈拉以南非洲的心脏代谢疾病和多种长期疾病医疗服务：后 COVID 时代新护理模式的机遇"[Diabetes Metabol Syndr: Clin Res Rev 17 1 (January 2023) 102681]的更正。

IF 4.3 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-05-01 DOI: 10.1016/j.dsx.2024.103061

Patrick J. Highton , Shabana Cassambai , Neusa Jessen , George N. Agot , Michelle Hadjiconstantinou , Melanie Davies , Samuel Seidu , Peter K. Njoroge , Joyce Muhenge Olenja , Pamela Godia , Albertino Damasceno , Roberta Lamptey , Kamlesh Khunti

引用次数: 0

Dose-dependent effect of tart cherry on selected cardiometabolic risk factors: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials 酸樱桃对某些心脏代谢风险因素的剂量依赖性影响：对随机对照试验进行 GRADE 评估的系统综述和剂量反应荟萃分析

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-05-01 DOI: 10.1016/j.dsx.2024.103026

Mostafa Norouzzadeh , Minoo Hasan Rashedi , Hossein Shahinfar , Seyedeh Tayebeh Rahideh

Aims

This study aimed to clarify the effectiveness of tart cherries on anthropometric, lipid, and glycemic indices. We also aimed to clarify the appropriate dosage for this effect and suggest directions for future studies.

Methods

PubMed, Scopus, and Web of Science were searched until May 2022. Twelve eligible trials were included. The pooled results were reported as weighted mean differences (WMD) and 95 % confidence intervals (CIs). The Cochrane risk of bias and GRADE tools were used to assess the risk of bias and certainty of the evidence, respectively.

Results

Tart cherry generally showed no significant effects on cardiometabolic risk factors. But subgroup analysis revealed that tart cherry significantly lowered total cholesterol (WMD: –0.33 mmol/l; 95 % CI: –0.55, –0.10), triglyceride (WMD: –0.19 mmol/l; 95 % CI: –0.26, –0.12), and low-density lipoprotein cholesterol (WMD: –0.36 mmol/l; 95 % CI: –0.58, –0.14), in unhealthy populations. Additionally, subgroup analysis indicated that the favorable effects of tart cherry were more pronounced in a single dose, longer duration, elderly, and obese individuals. Dose-response analysis revealed that 20 ml concentrate has the greatest effect in reducing total cholesterol (WMD: –0.40 mmol/l; 95 % CI: –0.61, –0.19), triglyceride (WMD: –0.23 mmol/l; 95 % CI: –0.33, –0.13), and elevating high-density lipoprotein cholesterol (WMD: 0.20 mmol/l; 95 % CI: 0.17, 0.22).

Conclusions

Tart cherry supplementation did not have significant effects on anthropometric and glycemic indices, but can improve lipid profile, especially in a single dose, longer duration, and in elderly, obese, and unhealthy individuals.

目的本研究旨在阐明酸樱桃对人体测量、血脂和血糖指数的影响。我们还旨在明确产生这种效果的适当剂量，并为今后的研究提出方向性建议。方法截至 2022 年 5 月，我们检索了 PubMed、Scopus 和 Web of Science。共纳入了 12 项符合条件的试验。汇总结果以加权平均差（WMD）和95%置信区间（CIs）的形式报告。科克伦偏倚风险和 GRADE 工具分别用于评估证据的偏倚风险和确定性。但亚组分析显示，在不健康人群中，酸樱桃能显著降低总胆固醇（WMD：-0.33 mmol/l；95 % CI：-0.55，-0.10）、甘油三酯（WMD：-0.19 mmol/l；95 % CI：-0.26，-0.12）和低密度脂蛋白胆固醇（WMD：-0.36 mmol/l；95 % CI：-0.58，-0.14）。此外，亚组分析表明，酸樱桃对单次剂量、持续时间较长、老年人和肥胖者的有利影响更为明显。剂量反应分析表明，20 毫升浓缩液对降低总胆固醇（WMD：-0.40 mmol/l；95 % CI：-0.61，-0.19）、甘油三酯（WMD：-0.23 mmol/l；95 % CI：-0.33，-0.13）和升高高密度脂蛋白胆固醇（WMD：0.结论补充酸樱桃对人体测量和血糖指数没有显著影响，但可以改善血脂状况，尤其是在单剂量、较长持续时间以及老年人、肥胖者和不健康人群中。

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引用次数: 0

The effects of anti-TNF-α biologics on insulin resistance and insulin sensitivity in patients with rheumatoid arthritis: An update systematic review and meta-analysis 抗肿瘤坏死因子-α生物制剂对类风湿性关节炎患者胰岛素抵抗和胰岛素敏感性的影响：最新系统综述和荟萃分析

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103001

Wei Shyann Lim , Seth En Teoh , Ansel Shao Pin Tang , Beatrice Jia Min Tan , Jasmine Yiling Lee , Chun En Yau , Julian Thumboo , Qin Xiang Ng

Background and aim

Increasing evidence demonstrates a link between the chronic inflammatory state in patients with rheumatoid arthritis (RA) and the development of insulin resistance. It is thought that anti-TNF-α biologic therapy may improve insulin sensitivity and ameliorate insulin resistance by the downregulation of inflammatory cytokines, however, pre-clinical and clinical studies have yielded conflicting results. A meta-analysis on this topic is necessary to summarize current evidence and generate hypotheses for future research.

Methods

Literature search was performed in four databases, namely PubMed, EMBASE, Scopus, and The Cochrane Library, from inception till April 9, 2023, querying studies reporting peripheral insulin resistance with and without anti-TNF-α use in patients with RA. Peripheral insulin resistance or sensitivity was quantified by the Homeostasis Model Assessment of Insulin Resistance (HOMA) index or the Quantitative Insulin Sensitivity Check Index (QUICKI) respectively. The difference in insulin resistance or sensitivity between the treatment and control group was calculated using standardized mean difference (SMD) for the purposes of the meta-analysis.

Results

Twelve articles were reviewed, with 10 longitudinal studies with a total of 297 patients included in the meta-analysis. The pooled standardized mean difference (SMD) from baseline HOMA was −0.82 (95% CI: −1.38 to −0.25) suggesting significant beneficial effects of anti-TNF-α therapy on insulin resistance.

Conclusion

Current evidence supports the significant clinical efficacy of anti-TNF-α biologics in alleviating insulin resistance and improving insulin sensitivity in patients with active RA.

背景和目的越来越多的证据表明，类风湿性关节炎（RA）患者的慢性炎症状态与胰岛素抵抗之间存在联系。人们认为，抗肿瘤坏死因子-α生物疗法可通过下调炎症细胞因子来改善胰岛素敏感性并减轻胰岛素抵抗，但临床前和临床研究的结果却相互矛盾。方法从开始到 2023 年 4 月 9 日，在 PubMed、EMBASE、Scopus 和 Cochrane 图书馆等四个数据库中进行文献检索，查询报告 RA 患者使用或未使用抗肿瘤坏死因子-α 的外周胰岛素抵抗的研究。外周胰岛素抵抗或敏感性分别通过胰岛素抵抗的稳态模型评估（HOMA）指数或胰岛素敏感性定量检查指数（QUICKI）进行量化。为了进行荟萃分析，采用标准化平均差（SMD）计算治疗组和对照组之间胰岛素抵抗或胰岛素敏感性的差异。与基线HOMA相比，汇总的标准化均值差（SMD）为-0.82（95% CI：-1.38至-0.25），表明抗TNF-α治疗对胰岛素抵抗有显著的益处。结论目前的证据支持抗TNF-α生物制剂对缓解活动性RA患者的胰岛素抵抗和改善胰岛素敏感性有显著的临床疗效。

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引用次数: 0

A new era for food in health? The FDA announces a qualified health claim for yogurt intake and type II diabetes mellitus risk reduction 健康食品的新时代？美国食品和药物管理局宣布酸奶摄入量和 II 型糖尿病风险降低的合格健康声明

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103006

Ronan Lordan

Introduction

Over the last two decades research has grown regarding dairy intake and health. It has been reported by many that yogurt intake may be associated with reduced risk of type 2 diabetes mellitus (T2D). In this report, the United States Food and Drug Administration (FDA) decision to announce a qualified health claim for yogurt products regarding reduced risk of T2D in response to a Danone North America petition is discussed.

Methods

Relevant literature cited in the petition along with supporting evidence from PubMed and Google Scholar databases until April 1st, 2024 were used. Literature was found using relevant keywords.

Results

On March 1st, 2024, the United States Food and Drug Administration (FDA) announced the first ever qualified health claim, stating that there that eating yogurt regularly may reduce the risk of T2D according to limited scientific evidence. The enforcement discretion letter was critically reviewed and discussed regarding its future implications for people with T2M and public health.

Conclusions

It is unclear how this FDA decision will affect public health and nutrition in the long-term. Limited scientific evidence suggests that at least 3 servings of yogurt per week may reduce the risk of T2D incidence for the general population. Yogurt will not cure or treat people with T2D.

导言：过去二十年来，有关乳制品摄入量与健康的研究不断增加。许多报告指出，酸奶的摄入可能与降低 2 型糖尿病（T2D）的风险有关。本报告讨论了美国食品和药物管理局（FDA）根据达能北美公司的请愿，决定宣布酸奶产品可降低2型糖尿病风险的合格健康声明。结果2024年3月1日，美国食品和药物管理局（FDA）宣布了有史以来第一个合格的健康声明，称根据有限的科学证据，经常食用酸奶可能会降低T2D的风险。结论目前尚不清楚食品及药物管理局的这一决定将对公众健康和营养产生怎样的长期影响。有限的科学证据表明，每周至少 3 份酸奶可降低一般人群患 T2D 的风险。酸奶不能治愈或治疗 T2D 患者。

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引用次数: 0

Impact of a diabetes-designed meal delivery service on changes in hemoglobin A1c and quality of life in patients with diabetes 糖尿病设计的送餐服务对糖尿病患者血红蛋白 A1c 和生活质量变化的影响

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103004

Bryan A. Farford , Brian J. Eglinger , Lindsey Kane , James N. Gilbert , Colleen T. Ball

Background

Over 34 million Americans have diabetes, and nutrition therapy is essential in self-management.

Aims

The primary aim of the study was to evaluate the impact of meals designed for patients with type 2 diabetes (T2D) through a meal delivery program. The primary outcome was a 3-month change in hemoglobin A_1c (HbA_1c). Secondary outcomes included a 3-month change in weight, blood pressure, high-density lipoprotein, low-density lipoprotein, and triglycerides. Furthermore, the study aimed to evaluate the impact of the meal delivery program on the participants' quality of life.

Methods

In this randomized crossover clinical trial, patients were allocated in a 1:1 fashion to treatment sequence AB or treatment sequence BA. In Phase 1, participants allocated to sequence AB received 10 meals per week for 3 months, followed by a 3-month washout period and a 3-month standard intervention period with no meals. Participants allocated to sequence BA received 3 months of standard intervention with no meals followed by a 3-month washout period and a 3-month period with 10 meals per week. A quality-of-life survey was obtained during weeks 0, 12, 24, and 36.

Results

The mean 3-month change in HbA_1c (primary outcome) was nearly a half point lower with meal delivery (−0.44% [95% CI: −0.85%, −0.03%]; P = 0.037). The estimated mean 3-month change in quality of life was approximately 2 points lower (better) with meal delivery (−2.2 points [95% CI: −4.2, −0.3]; P = .027). There were no statistically significant differences in secondary outcomes with meal delivery (all P ≥ 0.15).

Conclusions

A meal delivery system for patients with T2D improves glycemic control and quality of life.

背景超过 3400 万美国人患有糖尿病，而营养治疗对自我管理至关重要。主要结果是血红蛋白 A1c (HbA1c) 3 个月的变化。次要结果包括体重、血压、高密度脂蛋白、低密度脂蛋白和甘油三酯 3 个月的变化。此外，该研究还旨在评估送餐计划对参与者生活质量的影响。方法在这项随机交叉临床试验中，患者按 1:1 的比例被分配到治疗序列 AB 或治疗序列 BA。在第一阶段，被分配到AB序列的参与者在3个月内每周接受10次送餐，然后是3个月的冲洗期和3个月不送餐的标准干预期。被分配到BA序列的参与者接受3个月不进餐的标准干预，然后是3个月的冲洗期和3个月的每周10餐期。在第 0、12、24 和 36 周进行了生活质量调查。结果送餐后 3 个月的 HbA1c（主要结果）平均变化率降低了近半个百分点（-0.44% [95% CI：-0.85%, -0.03%]；P = 0.037）。送餐服务的生活质量在 3 个月内的平均变化估计要低约 2 个点（更好）（-2.2 个点 [95% CI：-4.2, -0.3]；P = 0.027）。结论 T2D 患者使用送餐系统可改善血糖控制和生活质量。

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引用次数: 0

Medical, pharmaceutical, and nutritional applications of 3D-printing technology in diabetes 三维打印技术在糖尿病医疗、制药和营养方面的应用

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103002

Reza Amin , Sayed Mahdi Hossaeini Marashi , Seyyed Mohammad Reza Noori , Zeinab Alavi , Elaheh Dehghani , Reyhaneh Maleki , Mehdi Safdarian , Arash Rocky , Enayat Berizi , Seyyed Mohammad Amin Alemohammad , Setayesh Zamanpour , Seyyed Mohammad Ali Noori

Aims

Despite numerous studies covering the various features of three-dimensional printing (3D printing) technology, and its applications in food science and disease treatment, no study has yet been conducted to investigate applying 3D printing in diabetes. Therefore, the present study centers on the utilization and impact of 3D printing technology in relation to the nutritional, pharmaceutical, and medicinal facets of diabetes management. It highlights the latest advancements, and challenges in this field.

Methods

In this review, the articles focusing on the application and effect of 3D printing technology on medical, pharmaceutical, and nutritional aspects of diabetes management were collected from different databases.

Result

High precision of 3D printing in the placement of cells led to accurate anatomic control, and the possibility of bio-printing pancreas and β-cells. Transdermal drug delivery via 3D-printed microneedle (MN) patches was beneficial for the management of diabetes disease. 3D printing supported personalized medicine for Diabetes Mellitus (DM). For instance, it made it possible for pharmaceutical companies to manufacture unique doses of medications for every diabetic patient. Moreover, 3D printing allowed the food industry to produce high-fiber and sugar-free products for the individuals with DM.

Conclusions

In summary, applying 3D printing technology for diabetes management is in its early stages, and needs to be matured and developed to be safely used for humans. However, its rapid progress in recent years showed a bright future for the treatment of diabetes.

目的尽管有许多研究涉及三维打印（3D 打印）技术的各种特点及其在食品科学和疾病治疗中的应用，但尚未有研究调查 3D打印技术在糖尿病中的应用。因此，本研究集中探讨了三维打印技术在糖尿病治疗的营养、药物和医疗方面的应用及其影响。结果3D打印技术在放置细胞方面的高精度实现了精确的解剖控制，并为胰腺和β细胞的生物打印提供了可能。通过三维打印微针（MN）贴片进行透皮给药有利于糖尿病的治疗。三维打印技术为糖尿病（DM）的个性化医疗提供了支持。例如，它使制药公司能够为每位糖尿病患者生产独特剂量的药物。总之，将 3D 打印技术应用于糖尿病管理尚处于早期阶段，需要不断成熟和发展才能安全地用于人类。然而，近年来3D打印技术的飞速发展为糖尿病治疗带来了光明的前景。

{"title":"Medical, pharmaceutical, and nutritional applications of 3D-printing technology in diabetes","authors":"Reza Amin , Sayed Mahdi Hossaeini Marashi , Seyyed Mohammad Reza Noori , Zeinab Alavi , Elaheh Dehghani , Reyhaneh Maleki , Mehdi Safdarian , Arash Rocky , Enayat Berizi , Seyyed Mohammad Amin Alemohammad , Setayesh Zamanpour , Seyyed Mohammad Ali Noori","doi":"10.1016/j.dsx.2024.103002","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103002","url":null,"abstract":"<div><h3>Aims</h3><p>Despite numerous studies covering the various features of three-dimensional printing (3D printing) technology, and its applications in food science and disease treatment, no study has yet been conducted to investigate applying 3D printing in diabetes. Therefore, the present study centers on the utilization and impact of 3D printing technology in relation to the nutritional, pharmaceutical, and medicinal facets of diabetes management. It highlights the latest advancements, and challenges in this field.</p></div><div><h3>Methods</h3><p>In this review, the articles focusing on the application and effect of 3D printing technology on medical, pharmaceutical, and nutritional aspects of diabetes management were collected from different databases.</p></div><div><h3>Result</h3><p>High precision of 3D printing in the placement of cells led to accurate anatomic control, and the possibility of bio-printing pancreas and β-cells. Transdermal drug delivery via 3D-printed microneedle (MN) patches was beneficial for the management of diabetes disease. 3D printing supported personalized medicine for Diabetes Mellitus (DM). For instance, it made it possible for pharmaceutical companies to manufacture unique doses of medications for every diabetic patient. Moreover, 3D printing allowed the food industry to produce high-fiber and sugar-free products for the individuals with DM.</p></div><div><h3>Conclusions</h3><p>In summary, applying 3D printing technology for diabetes management is in its early stages, and needs to be matured and developed to be safely used for humans. However, its rapid progress in recent years showed a bright future for the treatment of diabetes.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140550862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Performance of European prediction models for classification of type 1 and type 2 diabetes in Indians 欧洲预测模型在印度人 1 型和 2 型糖尿病分类中的表现

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103007

Ulagamadesan Venkatesan , Anandakumar Amutha , Angus G. Jones , Beverley M. Shields , Ranjit Mohan Anjana , Ranjit Unnikrishnan , Bagavandas Mappillairaju , Viswanathan Mohan

Aim

We aimed to determine the performance of European prediction models in an Indian population to classify type 1 diabetes(T1D) and type 2 diabetes(T2D).

Methods

We assessed discrimination and calibration of published models of diabetes classification, using retrospective data from electronic medical records of 83309 participants aged 18–50 years living in India. Diabetes type was defined based on C-peptide measurement and early insulin requirement. Models assessed combinations of clinical measurements: age at diagnosis, body mass index(mean = 26.6 kg/m²), sex(male = 64.9 %), Glutamic acid decarboxylase(GAD) antibody, serum cholesterol, serum triglycerides, and high-density lipoprotein(HDL) cholesterol.

Results

67955 participants met inclusion criteria, of whom 0.8 % had T1D, which was markedly lower than model development cohorts. Model discrimination for clinical features was broadly similar in our Indian cohort compared to the European cohort: area under the receiver operating characteristic curve(AUC ROC) was 0.90 vs. 0.90 respectively, but was lower in the subset of young participants with measured GAD antibodies(n = 2404): and an AUC ROC of 0.87 when clinical features, sex, lipids and GAD antibodies were combined. All models substantially overestimated the likelihood of T1D, reflecting the lower prevalence of T1D in the Indian population. However, good model performance was achieved after recalibration by updating the model intercept and slope.

Conclusion

Models for diabetes classification maintain the discrimination of T1D and T2D in this Indian population, where T2D is far more common, but require recalibration to obtain appropriate model probabilities. External validation and recalibration are needed before these tools can be used in non-European populations.

目的我们旨在确定欧洲预测模型在印度人群中对 1 型糖尿病（T1D）和 2 型糖尿病（T2D）进行分类的性能。方法我们利用印度 83309 名 18-50 岁参试者电子病历中的回顾性数据，对已发表的糖尿病分类模型的辨别和校准进行了评估。糖尿病类型是根据 C 肽测量值和早期胰岛素需求量确定的。模型评估了临床测量指标的组合：诊断年龄、体重指数（平均 = 26.6 kg/m2）、性别（男性 = 64.9%）、谷氨酸脱羧酶（GAD）抗体、血清胆固醇、血清甘油三酯和高密度脂蛋白胆固醇。结果67955名参与者符合纳入标准，其中0.8%患有T1D，明显低于模型开发队列。与欧洲队列相比，我们的印度队列对临床特征的模型判别大致相似：接收器操作特征曲线下面积（AUC ROC）分别为 0.90 和 0.90，但在测得 GAD 抗体的年轻参与者子集中（n = 2404），模型判别较低：将临床特征、性别、血脂和 GAD 抗体结合在一起时，接收器操作特征曲线下面积（AUC ROC）为 0.87。所有模型都大大高估了 T1D 的可能性，这反映出 T1D 在印度人群中的发病率较低。然而，通过更新模型截距和斜率进行重新校准后，模型表现良好。在非欧洲人群中使用这些工具之前，需要进行外部验证和重新校准。

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引用次数: 0

Enhancing outcome prediction by applying the 2019 WHO DM classification to adults with hyperglycemic crises: A single-center cohort in Thailand 将 2019 年世界卫生组织 DM 分类应用于成人高血糖危象，加强预后预测：泰国单中心队列

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103012

Chatchon Kaewkrasaesin , Weerapat Kositanurit , Phawinpon Chotwanvirat , Nitchakarn Laichuthai

Background and aims

Hyperglycemic crisis is a metabolic catastrophe which can occur in any type of diabetes. In 2019, the World Health Organization (WHO) revised the classification of diabetes mellitus (DM) and established two new hybrid forms, latent autoimmune diabetes in adults (LADA) and ketosis-prone type 2 diabetes (T2D). This study aimed to determine clinical outcomes after a hyperglycemic crisis event in people with diabetes classified subtypes by 2019 WHO DM classification.

Methods

A five-year (2015–2019) retrospective study of adult patients admitted with hyperglycemic crises was conducted. Types of diabetes were recategorized based on the 2019 WHO DM classification. Clinical characteristics, in-admission treatment and complications, long-term follow-up outcomes, and mortality were collected, analyzed, and compared.

Results

A total of 185 admissions occurred in 136 patients. The mean age was 50.6 ± 18.4 years (49.3 % men). The annual average incidence of hyperglycemic crises was 5.2 events/1000 persons. The proportion of type 1 diabetes, T2D, LADA, ketosis-prone T2D, and pancreatic DM were 15.4 %, 69.1 %, 2.2 %, 11 %, and 2.2 %, respectively. In-hospital mortality was 3.7 % while cumulative mortality totaled 19.1 %. During the 24-month follow-up, ketosis-prone T2D had the highest success of insulin discontinuation (HR 6.59; 95 % CI 6.69–319.4; p < 0.001), while T2D demonstrated the highest mortality compared to others (HR, 2.89; 95%CI 1.15–6.27; p = 0.02).

Conclusion

The reclassification of diabetes based on 2019 WHO DM classification helped elucidate differences in long-term outcomes and mortality among DM types. The new classification, which separates ketosis-prone T2D from standard T2D, should be encouraged in clinical practice for precise and individualized management.

背景和目的高血糖危象是一种代谢灾难，可发生于任何类型的糖尿病。2019年，世界卫生组织（WHO）修订了糖尿病（DM）的分类，并确立了两种新的混合形式，即成人潜伏性自身免疫性糖尿病（LADA）和酮症易发型2型糖尿病（T2D）。本研究旨在确定按2019年WHO DM分类法划分为亚型的糖尿病患者发生高血糖危象事件后的临床结果。方法对因高血糖危象入院的成年患者进行了为期五年（2015-2019年）的回顾性研究。根据 2019 年 WHO DM 分类对糖尿病类型进行了重新分类。收集、分析和比较了临床特征、入院治疗和并发症、长期随访结果和死亡率。平均年龄为 50.6 ± 18.4 岁（49.3% 为男性）。高血糖危象的年平均发生率为 5.2 次/1000 人。1型糖尿病、T2D、LADA、酮症易发T2D和胰腺DM的比例分别为15.4%、69.1%、2.2%、11%和2.2%。院内死亡率为3.7%，累计死亡率为19.1%。在24个月的随访期间，容易发生酮病的T2D患者停用胰岛素的成功率最高（HR 6.59；95%CI 6.69-319.4；p <；0.001），而T2D患者的死亡率与其他患者相比最高（HR，2.89；95%CI 1.15-6.27；p = 0.02）。新分类将易酮症化 T2D 与标准 T2D 区分开来，应在临床实践中加以推广，以便进行精确的个体化管理。

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引用次数: 0

Current status of hypertension care and management in the Philippines 菲律宾高血压护理和管理现状

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103008

Jared Gabriel L. Dela Rosa , Charlene Divine M. Catral , Nico Alexander Reyes , Danna Mae S. Opiso , Erika P. Ong , Eric David B. Ornos , Jerico R. Santos , Elgin Paul B. Quebral , Maria Llaine J. Callanta , Raymond V. Oliva , Ourlad Alzeus G. Tantengco

Aims

In this paper, we discuss the existing data on the burden of hypertension in the Philippines and present the status of management, prevention, and control of hypertension in the country.

Methods

A literature review was conducted to synthesize the status of hypertension care in the Philippines.

Results

Hypertension continues to contribute to the country's leading causes of death. Similar to the global trend, almost half of hypertensive Filipinos are still not aware of their condition, and only 27 % have it under control. The prevalence of hypertension has steadily increased from 22 % in 1993 to 25.15 % in 2013. The 2020 Philippine Society for Hypertension clinical practice guideline defines hypertension as an office BP of 140/90 mm Hg or above following the proper standard BP measurement. During the past decade, monotherapy has been the mode of treatment in more than 80 % of Filipino patients. This could also explain why the BP control rates have been low. The most prevalent complications of hypertension in the Philippines were stroke (11.6 %), ischemic heart disease (7.7 %), chronic kidney disease (6.30 %), and hypertensive retinopathy (2.30 %). Hypertension causes economic tolls on patients, from the cost of drugs to hospitalization and complications. Hospitalization from hypertensive complications can easily wipe out the savings of middle-class families and is catastrophic for lower-income Filipinos.

Conclusion

In this review, we summarize the existing data on the burden of hypertension among Filipinos and the risk factors associated with the disease. We present the current screening tools, diagnostics, treatment, and prevention strategies for hypertension in the Philippines. Lastly, we propose solutions to meet the global targets of hypertension management and help relieve the growing burden of this disease.

目的本文讨论了菲律宾高血压负担的现有数据，并介绍了菲律宾高血压的管理、预防和控制现状。结果高血压仍然是菲律宾的主要死因之一。与全球趋势相似，近一半的菲律宾高血压患者仍未意识到自己的病情，只有 27% 的患者病情得到控制。高血压患病率从1993年的22%稳步上升至2013年的25.15%。2020 年菲律宾高血压学会临床实践指南将高血压定义为：在进行适当的标准血压测量后，办公室血压达到或超过 140/90 mm Hg。在过去十年中，80% 以上的菲律宾患者采用单一疗法。这也可以解释为什么血压控制率一直很低。菲律宾最常见的高血压并发症是中风（11.6%）、缺血性心脏病（7.7%）、慢性肾病（6.30%）和高血压视网膜病变（2.30%）。高血压会给患者带来经济损失，包括药物费用、住院费用和并发症。高血压并发症导致的住院治疗很容易使中产阶级家庭的积蓄化为乌有，对低收入菲律宾人来说则是灾难性的。结论在本综述中，我们总结了菲律宾人高血压负担的现有数据以及与该疾病相关的风险因素。我们介绍了菲律宾目前的高血压筛查工具、诊断、治疗和预防策略。最后，我们提出了解决方案，以实现高血压管理的全球目标，帮助减轻这一疾病日益沉重的负担。

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引用次数: 0

Implementation of surface mechanomyography as a novel approach for objective evaluation of phasic muscle stretch reflexes in people with type 2 diabetes 采用表面机械肌电图作为一种新方法，对 2 型糖尿病患者的阶段性肌肉拉伸反射进行客观评估。

IF 1 Q1 Medicine

Diabetes & Metabolic Syndrome-Clinical Research & Reviews

Pub Date : 2024-04-01 DOI: 10.1016/j.dsx.2024.103022

Shaik Kareem , K. Dilara , K.N. Maruthy , Priscilla Johnson , A.V. Siva Kumar

Introduction

Diabetic peripheral neuropathy is the most common complication of diabetes producing metabolic disruptions in the peripheral nervous system. Alteration in the predictable nature of tendon reflexes is the most common indicator suggesting the possibility of diabetic neuropathy. Evaluation of tendon reflexes is a part of various clinical scoring systems that assess neuropathy. The conventional reflex grading scales are subjective, lack temporal data, and have high inter-rater variability. Hence, an indigenous quantification tool was developed to evaluate the tendon reflexes in order to assess diabetic peripheral neuropathy.

Materials and methods

A cross-sectional study was carried out in 140 healthy volunteers and 140 patients with type 2 diabetes. The mean age of controls and diabetics (49.1 ± 8.9, 50.7 ± 7.5) years, weight (66.9 ± 9.4, 69.8 ± 11.5) kilograms and BMI (24.5 ± 3.8, 26.1 ± 4.7), respectively. All of them are subjected to evaluation of tendon reflexes using the reflex quantification tool comprised of surface mechanomyography and electrogoniometry that can provide various static and dynamic variables of tendon reflex.

Results

The dynamic variables such as reflex amplitude, muscle velocity and angular velocity were significantly low in diabetic patients (p: <0.001) whereas latency and duration (p: <0.001) were prolonged. Furthermore, no significant difference was observed in the application of tendon striking force (p: 0.934) among the participants.

Conclusion

The current study demonstrates that the proposed reflex quantification tool provides several dynamic variables of patellar tendon reflex, which are significantly affected and altered in diabetic patients suggesting the involvement of peripheral neurons.

导言糖尿病周围神经病变是糖尿病最常见的并发症，会导致周围神经系统代谢紊乱。腱反射的可预测性改变是提示糖尿病神经病变可能性的最常见指标。腱反射评估是各种评估神经病变的临床评分系统的一部分。传统的反射分级量表比较主观，缺乏时间数据，而且评分者之间的差异很大。因此，我们开发了一种本土量化工具来评估腱反射，以评估糖尿病周围神经病变。材料和方法我们对 140 名健康志愿者和 140 名 2 型糖尿病患者进行了横断面研究。对照组和糖尿病患者的平均年龄分别为（49.1 ± 8.9，50.7 ± 7.5）岁，体重分别为（66.9 ± 9.4，69.8 ± 11.5）公斤，体重指数分别为（24.5 ± 3.8，26.1 ± 4.7）。结果糖尿病患者的腱反射动态变量，如反射幅度、肌速和角速明显偏低（p：<0.001），而潜伏期和持续时间则延长（p：<0.001）。结论目前的研究表明，拟议的反射量化工具提供了髌腱反射的几个动态变量，这些变量在糖尿病患者中受到明显影响和改变，表明外周神经元参与其中。

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