International Journal of Diabetes in Developing Countries最新文献

Objective

Conducting diabetes screening programs in rural areas represents unique challenges with respect to participation of the rural residents. This study focussed on understanding the real-life challenges encountered and lessons learnt in the recruitment of rural residents for a population-based cross-sectional study in Tamil Nadu, South India.

Methods

In-depth interviews (IDIs) were conducted among a multidisciplinary research team comprised of field investigators (n = 8), field technicians (n = 8), telemedicine technicians (n = 2), and site coordinator (n = 1) who worked in the TREND study (Telemedicine PRoject for screENing Diabetes and its complications in rural Tamil Nadu). The IDIs explored the real-life challenges and potential strategies used to facilitate a high response rate in the recruitment of rural participants through a semi-structured guide. IDIs are conducted for 35–40 min and recorded after obtaining consent from each staff. The recordings were then transcribed into text, coded, and analysed using thematic analysis through NVIVO software version 10.0.

Results

A total of 10 IDIs were conducted. Seven major themes such as lack of awareness; transportation issues; stigma — fear of being diagnosed with diabetes; distrust on healthcare providers; cultural beliefs and practices; language barriers; and competing priorities were identified as the reasons for inactive participation. Building rapport and trust, patience and counselling skills aided the staff to handle non-respondents. Display of pamphlets in the public places, the village head’s support in campaigning, helped in the active participation of rural residents.

Conclusion

By identifying and addressing barriers to participation, healthcare providers and community stakeholders can work together to improve the health of rural communities.

Background

The incidence of type II diabetes mellitus (T2DM) has quadruplicated in the recent decades and Prevention of T2DM cases is possible by changing lifestyle practices. The process of diagnosis of diabetes is a tedious one. The advent and advancement in (AI) techniques presents a probable solution to this critical problem.

Objective

The study aims to assess the diverse attributes of the test sample population across Assam and enhance the early prediction of Type II Diabetes Mellitus by employing artificial neural networks.

Methods

The aim of this study is to design a suitable AI model that prognosticates the likelihood of diabetes in individuals with maximum accuracy based on the levels of liver enzymes. This work also analyzes the effect of fast food intake, sleeping patterns, and consumption of alcohol on healthy controls and contemplates their susceptibility to contract T2DM.

Results

The AI model accurately predicted T2DM likelihood and revealed significant links between unhealthy behaviors and increased T2DM risk among healthy individuals.

Conclusions

The study underscores lifestyle modifications for T2DM prevention, highlighting AI’s potential in diagnosis and the impact of unhealthy habits on T2DM susceptibility.

Background

Novel topical esmolol is shown to significantly improve wound healing than standard of care. Certain patient-related factors especially anemia and poor glycemic control may impede wound healing.

Objective

To study whether novel topical esmolol may circumvent patient-related factors to improve wound healing in diabetic foot ulcer (DFU).

Methods

The present study is a double-blind, vehicle (placebo)-controlled, randomized clinical trial in subjects with non-infected DFU of University of Texas grade 1A and 1C. Participants were randomized to receive either topical esmolol gel (Galnobax) with standard of care (SoC), SoC only, and vehicle (Placebo) with SoC in 3:3:1 proportion. The hematologic and biochemistry parameters were evaluated at the screening visit and at every 4 weeks after randomization during treatment phase and at the end of the study (EOS). Outcome was the proportion of complete ulcer closure with reference to baseline hemoglobin, albumin, and HbA1c during the 12-week treatment phase.

Results

A total of 176 subjects were included. Ninety-four out of 140 participants (67.1%) had anemia at baseline. Among anemic participants, 57.4% ulcers closed in the Galnobax group whereas 42.6% closed in the SoC only group during the 12-week treatment phase (p = 0.148, OR = 1.823, 95% CI = 0.80–4.13). One-third participants reported albumin < 4.0 g/dL. Among participants having albumin < 4.0 g/dL (one-third of participants), the proportion of ulcer closure was 60.9% in the Galnobax group compared to 42.1% in the SoC only group (p = 0.225, OR = 2.139, 95% CI = 0.62–7.37). The proportion of ulcer closure in Galnobax with the SoC group was higher (72.5%) compared to the SoC only group (43.5%) (p = 0.0067, OR = 3.427, 95% CI = 1.38–8.48) in participants with poor glycemic control (HbA1c > 8%).

Conclusions

Novel topical esmolol with SoC treatment exhibited significant DFU healing independent of patient-related factors including anemia, hypoalbuminemia, and poor glycemic control.

Background

Several studies have reported that increased pentraxin-3 (PTX3) levels are associated with impaired renal function in chronic kidney disease (CKD). PTX3 levels increase progressively with diabetic nephropathy (DN) and may be a biomarker for early diagnosis of DN.

Objective

The study evaluates serum PTX3 levels and their association with the development of DN. We also aim to find out whether serum PTX3 is a better marker than high-sensitive CRP (hs-CRP) for DN.

Methods

In this study, we evaluated serum PTX3 levels in 150 patients which were distributed into three groups that are 50 patients with DN, 50 patients with diabetes mellitus (DM) without DN and 50 controls (not any evidence of DM). DN patients were subdivided: 32 patients with microalbuminuria and 18 patients with macroalbuminuria. Serum PTX3 levels were evaluated using an enzyme-linked immunosorbent assay (ELISA) kit.

Results

DN group patients had a higher value of PTX3 (p < 0.001) as compared to DM without DN and control groups. hs-CRP levels were higher in DM without DN patients compared to DN patients and controls. PTX3 (p = 0.33) and hs-CRP (p = 0.10) levels among microalbuminuria and macroalbuminuria patients were statistically not significant.

Conclusion

This study concludes that serum PTX3 can be used as a diagnostic marker for DN before the development of apparent chronic kidney disease and PTX3 was found to be a better marker than hs-CRP for diagnosing DN.

Abstract

Abstract

Background

Diabetic retinopathy (DR) is an eye disease developed due to long-term diabetes mellitus, which affects retinal damage. The treatment at the right time supports people in retaining vision, and the early detection of DR is the only solution to prevent blindness.

Objective

The development of DR shows few symptoms in the early stage of progression; it is difficult to identify the disease to give treatment from the beginning. Manual diagnosis of DR on fundus images is time-consuming, costly, and liable to be misdiagnosed when compared to computer-aided diagnosis systems.

Methods

In this work, we proposed a deep convolutional neural network for the recognition and classification of diabetic retinopathy lesions to identify the severity of the disease. The performance evaluation of the proposed model was tested with other machine learning classifiers such as K-nearest neighbor (KNN), Naïve Bayes (NB), logistic regression (LR), support vector machine (SVM), decision tree (DT), and random forest (RF).

Results

Our proposed model achieves 98.5% accuracy for the recognition and classification of the severity level of DR stages such as no DR, mild DR, moderate DR, severe DR, and proliferative DR.

Conclusion

The training and testing of our model are carried out on images from the Kaggle APTOS dataset, and this work can act as a base for the autonomous screening of DR.

Abstract

Background

Diabetes self-care has been described as an evolutionary, sustainable process of knowledge development in chronic medical conditions. It has been discovered that there is a positive correlation between glycemic control and improvement in quality of life.

Objective

This study aims to evaluate the knowledge of self-care activities in type 2 diabetes mellitus(T2DM) and the effect of pharmacist-led intervention in glycemic control using Diabetes Self-Care Management Questionnaire-Revised (DSMQ-R).

Methods

The interventional study was conducted among diabetics in a tertiary care hospital for over 6 months. Baseline and follow-up data were analysed using t-tests and linear regression to assess changes in knowledge and their relationship with fasting blood sugar (FBS).

Results

This study recruited 179 participants, predominantly in the 56–65 age group and mostly male (53%). Importantly 85% with prior T2DM diagnoses, addressing a specific population. The study successfully investigated the link between self-care knowledge and blood sugar control in T2DM patients. While the initial correlation between questionnaire data and fasting blood sugar was moderate (r = 0.027, p = 0.358), a meaningful 30.46% improvement in participants’ knowledge was observed (p < 0.05). Notably, half achieved good glycemic control, highlighting the positive impact of education on self-care practices. This confirms the potential of such interventions to empower individuals with T2DM management tools.

Conclusion

By demonstrating a significant improvement in knowledge and observing good glycemic control in a substantial portion of participants, the study highlights its potential to empower individuals with T2DM.