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Erratum: Correlation analysis between foot deformity and diabetic foot with radiographic measurement. 勘误:足部畸形与糖尿病足的影像测量相关性分析。
Pub Date : 2024-03-06 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1392508

[This corrects the article DOI: 10.3389/fcdhc.2023.1121128.].

[此处更正了文章 DOI:10.3389/fcdhc.2023.1121128.]。
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引用次数: 0
Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes 确保忠实性:为服务不足的西班牙裔/拉美裔 2 型糖尿病患者推广糖尿病远程管理计划时应考虑的关键因素
Pub Date : 2024-02-16 DOI: 10.3389/fcdhc.2024.1328993
Sabrina Martinez, C. Nouryan, Myia S. Williams, Vidhi H. Patel, Paulina Barbero, Valeria Correa Gomez, Jose Marino, Nicole Goris, Edgardo Cigaran, Dilcia Granville, Lawrence F. Murray, Yael T. Harris, Alyson Myers, Josephine Guzman, A. Makaryus, Samy I. McFarlane, R. Zeltser, Maria Pena, Cristina Sison, M. Lesser, Myriam Kline, Ralph J DiClemente, R. Pekmezaris
The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated.This study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient’s preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices.Key elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D.
西班牙裔/拉美裔人群罹患 2 型糖尿病(T2D)的风险更高(估计大于 50%),而且发病年龄更小。据美国糖尿病协会估计,2017 年确诊糖尿病的费用为 3270 亿美元;医疗费用是无糖尿病患者的 2.3 倍。本手稿旨在介绍一项随机对照试验中使用的方法,该试验旨在评估糖尿病远程管理(DTM)项目对西班牙裔/拉美裔 T2D 患者的疗效。本研究是一项随机对照试验,共有 240 名参与者。符合条件的患者(西班牙裔/拉丁裔,18 岁以上,患有 T2D)被随机分配到综合门诊管理 (COM) 或 DTM。DTM 由常规护理组成,包括每三个月一次的常规门诊,以及生物测量(平板电脑、血糖仪、血压计和体重秤);每周视频访视(以患者偏好的语言进行);教育视频(包括符合其文化背景的糖尿病自我管理教育和测验)。COM 包括常规护理,包括每三个月一次的常规门诊。在本研究中,COM 患者获得了血糖仪、血糖试纸和柳叶刀。建立治疗性护患关系是我们对两组患者进行研究的基本要素。首次接触(注册后)的重点是确保患者和护理人员了解该计划、建立信任和融洽关系、营造非评判性环境、确定语言偏好以及确定时间安排(包括晚上和周末)。DTM 配备了平板电脑,可通过视频和每周视频访问进行自定进度的教育。研究小组和社区咨询委员会确定了适当的教育视频内容,并将其纳入糖尿病教育主题。通过视频访问,我们可以评估患者的参与度、积极性和非语言沟通能力。用西班牙语进行交流以及了解不同的西班牙/拉美裔背景至关重要,因为使用相关的常用术语可以提高患者的依从性并改善治疗效果。上述讨论的关键要素为今后推广循证 DTM 干预提供了框架,以满足服务不足的西班牙裔/拉美裔 T2D 患者的需求。
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引用次数: 0
Post-transplant diabetes mellitus: risk factors and outcomes in a 5-year follow-up. 移植后糖尿病:5 年随访的风险因素和结果。
Pub Date : 2024-01-30 eCollection Date: 2024-01-01 DOI: 10.3389/fcdhc.2024.1336896
Matheus Rizzato Rossi, Marilda Mazzali, Marcos Vinicius de Sousa

Introduction: Kidney transplantation is associated with an increased risk of posttransplant diabetes mellitus (PTDM), impacting recipient and graft survivals. The incidence of PTDM ranges from 15% to 30%, with most cases occurring in the first year post-transplant. Some clinical and laboratory characteristics pre- and post-transplant may be associated with a higher PTDM incidence in a more extended follow-up period. This study aimed to analyze the prevalence of PTDM among renal transplant recipients without previous DM diagnosis during a five-year post-transplant follow-up, as well as clinical and laboratory characteristics associated with a higher incidence of PTDM during this period.

Material and methods: Single-center retrospective cohort including kidney transplant recipients older than 18 years with a functioning graft over six months of follow-up between January and December 2018. Exclusion criteria were recipients younger than 18 years at kidney transplantation, previous diabetes mellitus diagnosis, and death with a functioning graft or graft failure within six months post-transplant.

Results: From 117 kidney transplants performed during the period, 71 (60.7%) fulfilled the inclusion criteria, 18 (25.3%) had PTDM diagnosis, and most (n=16, 88.9%) during the 1st year post-transplant. The need for insulin therapy during the hospital stay was significantly higher in the PTDM group (n=11, 61.1% vs. n=14, 26.4%, PTDM vs. non-PTDM). Other PTDM risk factors, such as older age, high body mass index, HLA mismatches, and cytomegalovirus or hepatitis C virus infections, were not associated with PTDM occurrence in this series. During 5-year post-transplant follow-up, the graft function remained stable in both groups.

Conclusion: The accumulated incidence of PTDM in this series was similar to the reported in other studies. The perioperative hyperglycemia with the need for treatment with insulin before hospital discharge was associated with PTDM.

导言:肾移植会增加移植后糖尿病(PTDM)的风险,影响受者和移植物的存活率。PTDM 的发病率为 15%-30%,大多数病例发生在移植后的第一年。在更长的随访期内,移植前后的一些临床和实验室特征可能与较高的 PTDM 发生率有关。本研究旨在分析在移植后五年随访期间,既往未确诊DM的肾移植受者中PTDM的发病率,以及在此期间与PTDM较高发病率相关的临床和实验室特征:单中心回顾性队列,包括2018年1月至12月间随访6个月以上、年龄大于18岁、移植物功能正常的肾移植受者。排除标准为肾移植时受者年龄小于18岁、既往诊断为糖尿病、移植后6个月内移植肾功能正常或移植肾衰竭死亡:在此期间进行的 117 例肾移植中,71 例(60.7%)符合纳入标准,18 例(25.3%)确诊为 PTDM,且大多数(16 例,88.9%)是在移植后第一年。PTDM组患者在住院期间需要胰岛素治疗的比例明显更高(n=11,61.1% vs. n=14,26.4%,PTDM vs. non-PTDM)。其他 PTDM 风险因素,如年龄大、体重指数高、HLA 不匹配、巨细胞病毒或丙型肝炎病毒感染等,与 PTDM 的发生无关。在移植后5年的随访中,两组患者的移植物功能均保持稳定:结论:本系列研究中PTDM的累计发生率与其他研究中的报道相似。结论:本系列研究中PTDM的累积发生率与其他研究报告相似,围手术期的高血糖以及出院前需要使用胰岛素治疗与PTDM有关。
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引用次数: 0
Type 1 diabetes mellitus in the context of high levels of rural deprivation: differences in demographic and anthropometric characteristics between urban and rural cases in NW Ethiopia. 农村高度贫困背景下的 1 型糖尿病:埃塞俄比亚西北部城市和农村病例在人口和人体测量特征方面的差异。
Pub Date : 2024-01-29 eCollection Date: 2023-01-01 DOI: 10.3389/fcdhc.2023.1298270
Shitaye A Balcha, David I Phillips, Elisabeth R Trimble

Background: While there is increasing evidence for an altered clinical phenotype of Type 1 diabetes in several low-and middle-income countries, little is known about urban-rural differences and how the greater poverty of rural environments may alter the pattern of disease.

Objective: Investigation of urban-rural differences in demographic and anthropometric characteristics of type 1 diabetes in a resource-poor setting.

Research design and methods: Analysis of a unique case register, comprising all patients (rural and urban) presenting with Type 1 diabetes over a 20 yr. period in a poor, geographically defined area in northwest Ethiopia. The records included age, sex, place of residence, together with height and weight at the clinical onset.

Results: A total of 1682 new cases of Type 1 diabetes were registered with a mean age of onset of 31.2 (SD 13.4) yr. The patients were thin with 1/3 presenting with a body mass index (BMI) <17kg/m2. There was a striking male predominance of cases when clinical onset was between 20 and 35 yr., this was more marked in the very poor rural dwellers compared to the urban population. While most patients with Type 1 diabetes presented with low BMIs and reduced height, stunting preferentially affected rural men.

Conclusions: These data have led to the hypothesis that complex interactions among poor socioeconomic conditions in early life affect both pancreatic function and the development of autoimmunity and provide a possible explanation of the unusual phenotype of Type 1 diabetes in this very poor community.

背景:尽管有越来越多的证据表明,在一些中低收入国家,1 型糖尿病的临床表型发生了改变,但人们对城乡差异以及农村环境更加贫困可能如何改变疾病模式知之甚少:研究设计与方法:对埃塞俄比亚西北部一个地理位置明确的贫困地区 20 年间所有 1 型糖尿病患者(农村和城市)的独特病例登记进行分析。记录包括年龄、性别、居住地以及临床发病时的身高和体重:结果:共登记了 1682 例 1 型糖尿病新病例,平均发病年龄为 31.2(标准差 13.4)岁。临床发病年龄在 20 至 35 岁之间的病例中,男性明显占多数,与城市人口相比,这种情况在非常贫困的农村居民中更为明显。虽然大多数 1 型糖尿病患者的体重指数较低且身高降低,但发育迟缓主要影响农村男性:这些数据提出了一个假设,即早年贫困的社会经济条件之间复杂的相互作用会影响胰腺功能和自身免疫的发展,并为这个非常贫困的社区中 1 型糖尿病的异常表型提供了可能的解释。
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引用次数: 0
Association of pancreatitis with risk of diabetes: analysis of real-world data 胰腺炎与糖尿病风险的关系:真实世界数据分析
Pub Date : 2024-01-09 DOI: 10.3389/fcdhc.2023.1326239
Djibril M. Ba, Vernon M. Chinchilli, Anna M. Cozzi, David P. Bradley, Ariana R. Pichardo-Lowden
Diabetes is a major cause of disease burden with considerable public health significance. While the pancreas plays a significant role in glucose homeostasis, the association between pancreatitis and new onset diabetes is not well understood. The purpose of this study was to examine that association using large real-world data.Utilizing the IBM® MarketScan® commercial claims database from 2016 to 2019, pancreatitis and diabetes regardless of diagnostic category, were identified using International Classification of Diseases, Tenth Revision [ICD-10] codes. We then performed descriptive analyses characterizing non-pancreatitis (NP), acute pancreatitis (AP), and chronic pancreatitis (CP) cohort subjects. Stratified Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) of diabetes across the three clinical categories.In total, 310,962 individuals were included in the analysis. During 503,274 person‐years of follow‐up, we identified 15,951 incident diabetes cases. While men and women had higher incidence rates of CP and AP-related diabetes, the rates were significantly greater in men and highest among individuals with CP (91.6 per 1000 persons-years (PY)) followed by AP (75.9 per 1000-PY) as compared to those with NP (27.8 per 1000-PY). After adjustment for diabetes risk factors, relative to the NP group, the HR for future diabetes was 2.59 (95% CI: 2.45-2.74) (P<0.001) for the CP group, and 2.39 (95% CI: 2.30-2.48) (P<0.001) for the AP group.Pancreatitis was associated with a high risk of diabetes independent of demographic, lifestyle, and comorbid conditions.
糖尿病是造成疾病负担的主要原因之一,对公众健康具有重大意义。虽然胰腺在葡萄糖稳态中发挥着重要作用,但胰腺炎与新发糖尿病之间的关联却不甚了解。本研究的目的是利用大型真实世界数据来研究这种关联。我们利用 2016 年至 2019 年的 IBM® MarketScan® 商业索赔数据库,使用《国际疾病分类》第十版 [ICD-10] 代码确定了胰腺炎和糖尿病(无论诊断类别)。然后,我们对非胰腺炎(NP)、急性胰腺炎(AP)和慢性胰腺炎(CP)队列受试者的特征进行了描述性分析。我们使用分层 Cox 比例危险回归模型来估计三个临床类别中糖尿病的危险比 (HR) 和 95% 置信区间 (CI)。在 503,274 人年的随访中,我们发现了 15,951 例糖尿病病例。虽然男性和女性的 CP 和 AP 相关糖尿病发病率都较高,但与 NP(27.8/1000-PY)相比,男性的发病率明显更高,CP 患者的发病率最高(91.6/1000 人-年),其次是 AP 患者(75.9/1000-PY)。经糖尿病风险因素调整后,相对于 NP 组,CP 组未来糖尿病的 HR 为 2.59(95% CI:2.45-2.74)(P<0.001),AP 组为 2.39(95% CI:2.30-2.48)(P<0.001)。
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引用次数: 0
Gestational diabetes mellitus in Cameroon: prevalence, risk factors and screening strategies 喀麦隆的妊娠糖尿病:发病率、风险因素和筛查策略
Pub Date : 2024-01-09 DOI: 10.3389/fcdhc.2023.1272333
E. Sobngwi, Joelle Sobngwi-Tambekou, J. Katte, J. B. Echouffo-Tcheugui, E. Balti, A. Kengne, L. Fezeu, C. Ditah, A. Tchatchoua, M. Dehayem, Nigel C. Unwin, Judith Rankin, J. Mbanya, R. Bell
The burden of gestational diabetes (GDM) and the optimal screening strategies in African populations are yet to be determined. We assessed the prevalence of GDM and the performance of various screening tests in a Cameroonian population.We carried out a cross-sectional study involving the screening of 983 women at 24-28 weeks of pregnancy for GDM using serial tests, including fasting plasma (FPG), random blood glucose (RBG), a 1-hour 50g glucose challenge test (GCT), and standard 2-hour oral glucose tolerance test (OGTT). GDM was defined using the World Health Organization (WHO 1999), International Association of Diabetes and Pregnancy Special Group (IADPSG 2010), and National Institute for Health Care Excellence (NICE 2015) criteria. GDM correlates were assessed using logistic regressions, and c-statistics were used to assess the performance of screening strategies.GDM prevalence was 5·9%, 17·7%, and 11·0% using WHO, IADPSG, and NICE criteria, respectively. Previous stillbirth [odds ratio: 3·14, 95%CI: 1·27-7·76)] was the main correlate of GDM. The optimal cut-points to diagnose WHO-defined GDM were 5·9 mmol/L for RPG (c-statistic 0·62) and 7·1 mmol/L for 1-hour 50g GCT (c-statistic 0·76). The same cut-off value for RPG was applicable for IADPSG-diagnosed GDM while the threshold was 6·5 mmol/L (c-statistic 0·61) for NICE-diagnosed GDM. The optimal cut-off of 1-hour 50g GCT was similar for IADPSG and NICE-diagnosed GDM. WHO-defined GDM was always confirmed by another diagnosis strategy while IADPSG and GCT independently identified at least 66·9 and 41·0% of the cases.GDM is common among Cameroonian women. Effective detection of GDM in under-resourced settings may require simpler algorithms including the initial use of FPG, which could substantially increase screening yield.
妊娠糖尿病(GDM)在非洲人口中的负担和最佳筛查策略尚待确定。我们开展了一项横断面研究,对 983 名怀孕 24-28 周的妇女进行了妊娠糖尿病筛查,筛查方法包括空腹血浆 (FPG)、随机血糖 (RBG)、1 小时 50 克葡萄糖挑战试验 (GCT) 和标准 2 小时口服葡萄糖耐量试验 (OGTT)。GDM的定义采用世界卫生组织(WHO,1999年)、国际糖尿病与妊娠特别小组协会(IADPSG,2010年)和美国国家卫生保健卓越研究所(NICE,2015年)的标准。使用逻辑回归评估了 GDM 相关性,并使用 c 统计量评估了筛查策略的效果。根据 WHO、IADPSG 和 NICE 标准,GDM 患病率分别为 5-9%、17-7% 和 11-0%。既往死产[几率比:3-14,95%CI:1-27-7-76]是 GDM 的主要相关因素。诊断 WHO 定义的 GDM 的最佳临界值为 RPG 5-9 mmol/L(c-统计量 0-62)和 1 小时 50g GCT 7-1 mmol/L(c-统计量 0-76)。RPG的临界值同样适用于IADPSG诊断的GDM,而NICE诊断的GDM的临界值为6-5 mmol/L(c-统计量0-61)。对于 IADPSG 和 NICE 诊断的 GDM,1 小时 50g GCT 的最佳临界值相似。WHO定义的GDM总能通过另一种诊断策略得到证实,而IADPSG和GCT至少能独立发现66-9%和41-0%的病例。在资源匮乏的环境中有效检测 GDM 可能需要更简单的算法,包括最初使用 FPG,这可以大大提高筛查率。
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引用次数: 0
Participation in a multicomponent lifestyle intervention for people with obesity improves glycated hemoglobin (HbA1c) 参与针对肥胖症患者的多成分生活方式干预可改善糖化血红蛋白 (HbA1c)
Pub Date : 2023-12-22 DOI: 10.3389/fcdhc.2023.1274388
Mathias Høgsholt, Signe Kierkegaard-Brøchner, U. Sørensen, Lene Bastrup Lange, L. S. Mortensen, Jens Meldgaard Bruun
Obesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA1c. The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA1c.Patients with a BMI≥30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA1c and body weight a clinically relevant change of 5≥mmom/mol and 5%≥, respectively, was chosen. Participants were divided into groups according to their baseline HbA1c level: “Diabetes”: HbA1c of ≥6.5% (≥48 mmol/mol), “Prediabetes”: HbA1c of 5.7% to 6.4% (39-47.99 mmol/mol) or “Normal” HbA1c <5.7% (<39 mmol/mol).180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25th;75th quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA1c was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA1c (<39) and 30% patients with diabetes reduced their HbA1c <48. All groups had clinically relevant (≥5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA1c reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01).In this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA1c after 6-months. More than 1/3 of patients with prediabetes normalized their HbA1c.
肥胖与糖代谢受损有关。因此,研究 LIBRA 队列中使用的生活方式干预措施(不仅旨在减轻体重,还旨在改善患者健康)是否也能通过降低 HbA1c 的证据帮助肥胖患者改善糖代谢是很有意义的。这项研究的目的是回顾性调查因肥胖而接受生活方式干预的患者是否能够改变 HbA1c。BMI 指数≥30 的患者接受了为期 6 个月的生活方式干预,同时还完成了身体和心理健康调查,并提供了基线和 6 个月的血液样本,这些患者都被纳入了分析范围。HbA1c 和体重的临床相关变化分别为 5≥mmom/mol 和 5%≥。根据参与者的 HbA1c 基线水平将其分为几组:"糖尿病组HbA1c≥6.5%(≥48 mmol/mol),"糖尿病前期":180 名患者符合规定的纳入标准,这些患者被分为几组(年龄中位数(第 25 分位;第 75 分位):糖尿病:47 人,年龄 54(43;60)岁,51% 为女性;糖尿病前期:68 人,年龄 60(50;66)岁,71% 为女性;正常:65 人,中位年龄 61(50;66)岁,85% 为女性。所有三组患者的 HbA1c 均有显著降低,特别是糖尿病组,从基线到干预结束,HbA1c 降低了(平均值[95%CI])-5[-8;-2] mmol/mol。此外,35% 的糖尿病前期患者 HbA1c 降至正常值(<39),30% 的糖尿病患者 HbA1c 降至 <48。所有组别的体重都有临床意义上的(≥5%)下降(p<0.01)。在糖尿病组,体重减轻与 HbA1c 降低之间存在关联(p<0.01)。在这项回顾性队列研究中,所有患者在参与生活方式干预后都实现了临床相关的体重减轻,肥胖糖尿病患者在 6 个月后实现了临床相关的 HbA1c 降低。超过 1/3 的糖尿病前期患者 HbA1c 恢复正常。
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引用次数: 0
Exploring the progress of artificial intelligence in managing type 2 diabetes mellitus: a comprehensive review of present innovations and anticipated challenges ahead 探索人工智能在管理 2 型糖尿病方面的进展:对当前创新和未来预期挑战的全面回顾
Pub Date : 2023-12-15 DOI: 10.3389/fcdhc.2023.1316111
Farwa Tahir, Muhammad Farhan
A significant worldwide health issue, Type 2 Diabetes Mellitus (T2DM) calls for creative solutions. This in-depth review examines the growing severity of T2DM and the requirement for individualized management approaches. It explores the use of artificial intelligence (AI) in the treatment of diabetes, highlighting its potential for diagnosis, customized treatment plans, and patient self-management. The paper highlights the roles played by AI applications such as expert systems, machine learning algorithms, and deep learning approaches in the identification of retinopathy, the interpretation of clinical guidelines, and prediction models. Examined are difficulties with individualized diabetes treatment, including complex technological issues and patient involvement. The review highlights the revolutionary potential of AI in the management of diabetes and calls for a balanced strategy in which AI supports clinical knowledge. It is crucial to pay attention to ethical issues, data privacy, and joint research initiatives.
2 型糖尿病(T2DM)是一个重大的全球健康问题,需要创造性的解决方案。这篇深度综述探讨了 T2DM 日益严重的问题以及对个性化管理方法的需求。它探讨了人工智能(AI)在糖尿病治疗中的应用,强调了人工智能在诊断、定制治疗计划和患者自我管理方面的潜力。论文强调了专家系统、机器学习算法和深度学习方法等人工智能应用在识别视网膜病变、解释临床指南和预测模型方面发挥的作用。文章还探讨了个体化糖尿病治疗的困难,包括复杂的技术问题和患者参与。综述强调了人工智能在糖尿病管理中的革命性潜力,并呼吁采取平衡的策略,让人工智能为临床知识提供支持。关注伦理问题、数据隐私和联合研究计划至关重要。
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引用次数: 0
Factors associated with diabetes concordant comorbidities among adult diabetic patients in Central Ethiopia: a cross-sectional study 埃塞俄比亚中部成年糖尿病患者糖尿病并发症的相关因素:一项横断面研究
Pub Date : 2023-12-13 DOI: 10.3389/fcdhc.2023.1307463
Y. Negussie, Mihiret Shawel Getahun, Nardos Tilahun Bekele
Diabetes comorbidities are a serious public health issue that raises the risk of adverse health effects and complicates diabetes management. It also harms emotional health, medication adherence, self-management, and general quality of life. However, evidence is scarce in Ethiopia, particularly in the study area. Thus, this study aimed to estimate the prevalence of diabetes concordant comorbidities and identify factors associated with the presence of concordant comorbidities among adult diabetic patients in central Ethiopia.A health facility-based cross-sectional study was conducted among 398 adult diabetic patients. A computer-generated simple random sampling was used to select study participants. Data were collected using a structured data extraction checklist. The collected data were entered into Epi info version 7.2 and exported to SPSS version 27 for analysis. A binary logistic regression model was used to analyze the association between dependent and independent variables. An adjusted odds ratio with the corresponding 95% confidence interval was used to measure the strength of the association and statistical significance was declared at a p-value < 0.05.The prevalence of diabetes-concordant comorbidities was 41% (95% CI: 36.2-46.0). The multivariable logistic regression model showed that age 41–60 (AOR = 2.86, 95% CI: 1.60–5.13), place of residence (AOR = 2.22, 95% CI: 1.33–3.70), having type two diabetes (AOR = 3.30, 95% CI: 1.21–8.99), and having positive proteinuria (AOR = 2.64, 95% CI: 1.47–4.76) were significantly associated with diabetes concordant comorbidities.The prevalence of diabetes-concordant comorbidities was relatively high. Age, place of residence, type of diabetes, and positive proteinuria were factors associated with diabetes-concordant comorbidities. Prevention, early identification, and proper management of diabetes comorbidities are crucial.
糖尿病并发症是一个严重的公共卫生问题,它增加了不良健康影响的风险,并使糖尿病管理复杂化。它还会损害情绪健康、服药依从性、自我管理和总体生活质量。然而,在埃塞俄比亚,尤其是在本研究地区,相关证据还很少。因此,本研究旨在估算埃塞俄比亚中部成年糖尿病患者中糖尿病并发症的患病率,并确定与并发症相关的因素。研究采用计算机生成的简单随机抽样来选择参与者。使用结构化数据提取清单收集数据。收集到的数据被输入 Epi info 7.2 版,并导出到 SPSS 27 版进行分析。采用二元逻辑回归模型分析因变量和自变量之间的关联。用调整后的几率和相应的 95% 置信区间来衡量相关性的强弱,当 p 值小于 0.05 时即为统计学意义。糖尿病合并症的患病率相对较高。年龄、居住地、糖尿病类型和蛋白尿阳性是糖尿病并发症的相关因素。预防、早期识别和妥善处理糖尿病合并症至关重要。
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引用次数: 0
Dysregulated coagulation system links to inflammation in diabetic kidney disease 凝血系统失调与糖尿病肾病的炎症有关
Pub Date : 2023-12-08 DOI: 10.3389/fcdhc.2023.1270028
Mengyun Xiao, D. Tang, Shaodong Luan, Bo Hu, Wenyu Gong, Wolfgang Pommer, Yong Dai, Lianghong Yin
Diabetic kidney disease (DKD) is a significant contributor to end-stage renal disease worldwide. Despite extensive research, the exact mechanisms responsible for its development remain incompletely understood. Notably, patients with diabetes and impaired kidney function exhibit a hypercoagulable state characterized by elevated levels of coagulation molecules in their plasma. Recent studies propose that coagulation molecules such as thrombin, fibrinogen, and platelets are interconnected with the complement system, giving rise to an inflammatory response that potentially accelerates the progression of DKD. Remarkably, investigations have shown that inhibiting the coagulation system may protect the kidneys in various animal models and clinical trials, suggesting that these systems could serve as promising therapeutic targets for DKD. This review aims to shed light on the underlying connections between coagulation and complement systems and their involvement in the advancement of DKD.
糖尿病肾病(DKD)是世界范围内终末期肾脏疾病的重要贡献者。尽管进行了广泛的研究,但其发展的确切机制仍然不完全清楚。值得注意的是,糖尿病和肾功能受损的患者表现出高凝状态,其特征是血浆中凝血分子水平升高。最近的研究表明,凝血酶、纤维蛋白原和血小板等凝血分子与补体系统相互关联,引起炎症反应,可能加速DKD的进展。值得注意的是,在各种动物模型和临床试验中,研究表明抑制凝血系统可以保护肾脏,这表明这些系统可以作为DKD的有希望的治疗靶点。这篇综述旨在阐明凝血和补体系统之间的潜在联系及其在DKD进展中的参与。
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引用次数: 0
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Frontiers in clinical diabetes and healthcare
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