Liver metabolism is closely linked to glucose levels. Studies have shown that the aspartate aminotransferase to platelet ratio index (APRI), as a marker of liver fibrosis, is associated with type 2 diabetes mellitus (T2DM). However, the existing evidence remains insufficient to establish this association definitively. Furthermore, no prior studies have investigated the potential relationship between APRI and diabetic retinopathy (DR). This study aimed to investigate the association of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to platelet ratio index (APRI) scores with dysglycemia and DR.

This cross-sectional study analyzed data from 5828 participants aged 50 and older. All participants underwent laboratory blood tests, ophthalmological examinations, and interviews using questionnaires. Multiple linear regression models and receiver operating characteristic (ROC) curves explored the association between ALT and AST APRI scores and dysglycemia. Binary logistic regression was used to analyze the association between ALT and AST APRI scores and DR. Analyses were conducted for males and females separately to examine sex-specific effects.

In the multiple linear regression models, ALT and AST APRI scores were associated with fasting blood glucose after adjusting various potential confounders in the whole population or subgroup analysis (all P <0.05). ALT APRI score was superior to AST APRI score in the discrimination of hyperglycemic participants. In the univariate analysis, the ALT and AST APRI scores were associated with DR in the female participants with diabetes (P = 0.043, P=0.022). However, binary logistic regression models found no evident significant association between the ALT and AST APRI scores and DR in the female participants with diabetes (all P>0.05).

ALT and AST APRI scores are potential markers for the diagnosis of hyperglycemia, and ALT APRI score is superior to AST APRI score. ALT and AST APRI scores are not independent risk factors for DR.

Diabetes mellitus has become one of the major pandemics of the 21st century. In this scenario, nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus. Nursing interventions are crucial for managing the disease and preventing complications.

To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.

This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables, such as glycated haemoglobin and fasting plasma glucose.

After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables, a descriptive analysis of the studies with the most significant changes was conducted. Based on this, an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient's technological skills.

The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.

To date, there is a lack of information on the use of flash glucose monitoring system (fCGM) in low-middle income countries, such as Brazil, as well as on digital health platforms most used to calculate the bolus insulin dose. In this study, we aimed to describe the population characteristics, prescription patterns and glycemic control of fCGM users compared to blood glucose monitoring (BGM) system in those who use Glic™, a digital health platform in Brazil, and to assess factors associated with better glycemic control in this population.

This study is a cross-sectional retrospective study using anonymized aggregated data manually inputted by Glic™ users who self-reported a diagnosis of type 1 diabetes (T1DM), type 2 diabetes (T2DM), gestational diabetes (GDM) and latent autoimmune diabetes in adults (LADA).

Of the 12,727 individuals included in this study, 11,007 (86.5%) reported their glucose monitoring method to be BGM, while 1720 (13.5%) reported using fCGM. Most individuals (70.5%) had T1DM. Compared to BGM, fCGM users were significantly younger, had a higher proportion of males, resided more frequently in the Southeast region of Brazil, had a lower BMI, a longer time since diagnosis, and used Glic™ platform more frequently. fCGM users were prescribed significantly more ultra-long and ultra-rapid acting insulins as their basal and bolus insulin, respectively, and less oral anti-diabetics drugs compared to BGM users. Considering only the T1DM and LADA individuals and their manual glucose inputs, fCGM users had non-significant lower glucose levels than BGM. Use of Glic™ platform and a higher percentage of basal insulin dose were associated with a better glycemic control.

This is the first and largest real-world evidence study that describe and compare fCGM and BGM in users of a digital health patient support platform in Brazil. fCGM users were significantly different from those who perform BGM, in terms of population characteristics and treatment patterns. Glycemic control was better in fCGM users, although not statistically significant due to a restricted sample size. Importantly, a higher frequency of Glic™ use was associated with a higher glucose time in range.

Type 2 diabetes mellitus is a disease with a rising prevalence worldwide. Person-centered treatment factors, including comorbidities and treatment goals, should be considered in determining the pharmacological treatment of type 2 diabetes. ChatGPT-4 (Generative Pre-trained Transformer), a large language model, holds the potential performance in various fields, including medicine. We aimed to examine the reliability, quality, reproducibility, and readability of ChatGPT-4's responses to clinical scenarios about the medical treatment approach and management of type 2 diabetes patients.

ChatGPT-4's responses to 24 questions were independently graded by two endocrinologists with clinical experience in endocrinology and resolved by a third reviewer based on the ADA(American Diabetes Association) 2023 guidelines. DISCERN (Quality Criteria for Consumer Health Information) Measurement Tool was used to evaluate the reliability and quality of information.

Responses to questions by ChatGPT-4 were fairly consistent in both sessions. No false or misleading information was found in any ChatGPT-4 responses. In terms of reliability, most of the answers showed good (87.5%), followed by excellent (12.5%) reliability. Reading Level was classified as fairly difficult to read (8.3%), difficult to read (50%), and very difficult to read (41.7%).

ChatGPT-4 may have a role as an additional informative tool for type 2 diabetes patients for medical treatment approaches.

The authors evaluated whether an electronic health record clinical decision support system improves diabetes screening across a health system.

Study population included adults without diabetes attending a visit at 27 primary care clinics. Outcomes included the monthly screening laboratory order rate and completion rate among eligible patient visits. The authors performed logistic regression using a generalized estimating equations model and interrupted time series analysis to evaluate the change in the outcome from baseline to implementation and postimplementation periods.

From the baseline to postimplementation period, screening laboratory order rates increased from 53% to 66%, and completion rates increased from 46% to 54%, respectively. The odds of laboratory order and completion increased significantly from the baseline to postimplementation period (test order: OR=3.7; 95% CI=3.4, 4.1, p<0.001; test completion: OR=2.1; 95% CI=2.0, 2.3, p<0.001). In the interrupted time series analysis, laboratory order and completion rates increased significantly from the baseline period (p<0.001 for both).

The authors developed and implemented a clinical decision support system alert that automatically identifies eligible patients and facilitates single-click ordering of a diabetes screening test. An easily implementable and scalable clinical decision support system alert can improve diabetes screening.

Background: Type 2 diabetes mellitus (T2DM) is the most common type of diabetes, accounting for around 90% of all diabetes. Studies have found that dietary habits and biochemical metabolic changes are closely related to T2DM disease surveillance, but early surveillance tools are not specific and have lower accuracy. This paper aimed to provide a reliable artificial intelligence model with high accuracy for the clinical diagnosis of T2DM. Methods: A cross-sectional dataset comprising 8981 individuals from the First Affiliated Hospital of Guangxi Medical University was analyzed by a model fusion framework. The model includes four machine learning (ML) models, which used the stacking method. The ability to leverage the strengths of different algorithms to capture complex patterns in the data can effectively combine questionnaire data and blood test data to predict diabetes. Results: The experimental results show that the stacking model achieves significant prediction results in diabetes detection. Compared with the single machine learning algorithm, the stacking model has improved in the metrics of accuracy, recall, and F1-score. The test set accuracy is 0.90, and the precision, recall, F1-score, area under the curve, and average precision (AP) are 0.91, 0.90, 0.90, 0.90, and 0.85, respectively. Additionally, this study showed that HbA1c (P < 0.001,OR = 2.203), fasting blood glucose (FBG) (P < 0.001,OR = 1.586), Ph2BG (P < 0.001,OR = 1.190), age (P < 0.001,OR = 1.018), Han nationality (P < 0.001,OR = 1.484), and carbonate beverages (P = 0.001,OR = 1.347) were important predictors of T2DM. Conclusion: This study demonstrates that stacking models show great potential in diabetes detection, and by integrating multiple machine learning algorithms, stacking models can significantly improve the accuracy and stability of diabetes prediction and provide strong support for disease prevention, early diagnosis, and individualized treatment.

Fatty acid metabolism is pivotal for lipid synthesis, cellular signaling, and maintaining cell membrane integrity. However, its diagnostic significance in type 2 diabetes mellitus (T2DM) remains unclear.

Three datasets and fatty acid metabolism-related genes were retrieved. Differential expression analysis, WGCNA, machine learning algorithms, diagnostic analysis, and validation were employed to identify key feature genes. Functional analysis, ceRNA network construction, immune microenvironment assessment, and drug prediction were conducted to explore the underlying molecular mechanisms.

Six feature genes were identified with strong diagnostic performance and were involved in processes such as ribosome function and fatty acid metabolism. Immune cells, including dendritic cells, eosinophils, and neutrophils, may play a role in the progression of T2DM. ceRNA and drug-target network analysis revealed potential interactions, such as RP11-miR-29a-YTHDF3 and BPA-MSANTD1. The expression patterns of the feature genes, except for YTHDF3, were consistently upregulated in T2DM, aligning with trends observed in the training set.

This study investigated the potential molecular mechanisms of six fatty acid metabolism-related genes in T2DM, offering valuable insights that may guide future research and therapeutic development.

Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by reduced responsiveness of body cells to insulin, leading to elevated blood sugar levels. CNOT6L is involved in glucose metabolism, insulin secretion regulation, pancreatic beta-cell proliferation, and apoptosis. These functions may be closely related to the pathogenesis of T2D. However, the exact molecular mechanisms linking CNOT6L to T2D remain unclear. Therefore, this study aims to elucidate the role of CNOT6L in T2D.

The T2D datasets GSE163980 and GSE26168 profiles were downloaded from the Gene Expression Omnibusdatabase generated by GPL20115 and GPL6883.The R package limma was used to screen differentially expressed genes (DEGs). A weighted gene co-expression network analysis was performed. Construction and analysis of the protein-protein interaction (PPI) network, functional enrichment analysis, gene set enrichment analysis, and comparative toxicogenomics database (CTD) analysis were performed. Target Scan was used to screen miRNAs that regulate central DEGs. The results were verified by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), western blotting (WB), and blood glucose measurements in mice.

A total of 1951 DEGs were identified. GO and KEGG enrichment analysis revealed that differentially expressed genes were mainly enriched in the insulin signaling pathway, ECM-receptor interaction, and PPAR signaling pathway. Metascape analysis indicated enrichment primarily in the cAMP signaling pathway and enzyme-linked receptor protein signaling pathway. WGCNA analysis yielded 50 intersecting genes. PPI network construction and algorithm identification identified two core genes (CNOT6L and GRIN2B), among which CNOT6L gene was associated with multiple miRNAs. CTD analysis revealed associations of core genes with type 2 diabetes, diabetic complications, dyslipidemia, hyperglycemia, and inflammation. WB and RT-qPCR results showed that in different pathways, CNOT6L protein and mRNA levels were upregulated in type 2 diabetes.

CNOT6L is highly expressed in type 2 diabetes mellitus, and can cause diabetes complications, inflammation and other physiological processes by regulating miRNA, PPAR and other related signaling pathways, with poor prognosis. CNOT6L can be used as a potential therapeutic target for type 2 diabetes.

To evaluate the impact of a pharmaceutical intervention on treatment optimization in patients with type 2 diabetes mellitus.

Before-after intervention study. SITE: Health centers of the Primary Care Department of Camp de Tarragona.

Patients aged ≥ 18 years, diagnosed with type 2 diabetes mellitus and under treatment with antidiabetic drugs.

Review of pharmacological treatment for type 2 diabetes mellitus and issuance of proposals for its adequacy.

Demographic and clinical variables were collected to assess the adequacy of antidiabetic treatment. A consensus meeting was arranged with the patients' primary care physician to evaluate the proposals for improvement. The implementation of the proposals and the variation in postintervention glycemic control were assessed.

A total of 907 patients (59% men) were included. A total of 782 proposals for intervention were made in 65.8% of the patients reviewed. Of the proposals, 43.5% corresponded to drug discontinuation, 16% to intensification of dosing and 12.6% to exchange for a therapeutic equivalent. Of the consensual proposals, 54.7% were implemented. HbA1c was reduced by 0.2% after the intervention (7.4 vs 7.2%).

Review of the pharmacological treatment of patients with type 2 diabetes mellitus by a pharmacist or pharmacologist facilitates its optimization.

We aimed to report the latest and largest pooled analyses and evidence updates to assess the effectiveness of telemedicine interventions for self-management (DSM) in patients with type 2 diabetes mellitus (T2DM).

A systematic literature search was conducted using PubMed, Cochrane, Embase, and Web of Science in December 2023. We included randomized controlled trials (RCTs) of adults (≥18 years of age) diagnosed with T2DM where the intervention was the application of telemedicine. The Cochrane Risk of Bias Assessment was used to evaluate quality. The study's main outcome indicators were glycosylated hemoglobin (HbA1c) and diabetes self-management (DSM) capacity.

A total of 17 eligible articles, comprising 20 studies and 1,456 patients (734 in the intervention group and 722 in the control group), were included in the evidence synthesis. The baseline characteristics of both groups were similar in all outcomes. Comprehensive analyses showed post-intervention decreases in HbA1c, 2-h postprandial glucose, systolic and diastolic blood pressure, increases in Diabetes Self- Care activities, DSM competencies based on dietary and medication adherence, and improvements in overall DSM scores, all of which were statistically significant. While no statistically significant differences were observed in body mass index, lipids, and other DSM dimensions. Based on subgroup analyses, app-based experimental interventions targeting under 60 years old populations in Asia and North America were found to be more effective and less heterogeneity in the short term (<6 months of intervention).

Telemedicine interventions may assist patients with T2DM in enhancing their DSM and improving their HbA1c levels. Clinician can use various telemedicine interventions to enhance DSM in T2DM patients, considering local circumstances.

https://www.crd.york.ac.uk/PROSPERO/, CRD42024508522.

Undiagnosed type 2 diabetes (T2D) is a global problem. Current strategies for diagnosis in Sweden include screening individuals within primary healthcare who are of high risk, such as those with hypertension, obesity, prediabetes, family history of diabetes, or those who smoke daily. In this study, we aimed to estimate the proportion of individuals with undiagnosed T2D in Stockholm County and factors associated with T2D being diagnosed by healthcare. This information could improve strategies for detection.

We used data from the Stockholm Diabetes Prevention Programme (SDPP) cohort together with information from national and regional registers. Individuals without T2D aged 35-56 years at baseline were followed up after two ten-year periods. The proportion of diagnosed T2D was based on register information for 7664 individuals during period 1 and for 5148 during period 2. Undiagnosed T2D was assessed by oral glucose tolerance tests at the end of each period. With logistic regression, we analysed factors associated with being diagnosed among individuals with T2D.

At the end of the first period, the proportion of individuals with T2D who had been diagnosed with T2D or not was similar (54.0% undiagnosed). At the end of the second period, the proportion of individuals with T2D was generally higher, but they were less likely to be undiagnosed (43.5%). The likelihood of being diagnosed was in adjusted analyses associated with overweight (OR=1.85; 95% CI 1.22-2.80), obesity (OR=2.73; 95% CI 1.76-4.23), higher fasting blood glucose (OR=2.11; 95% CI 1.67-2.66), and self-estimated poor general health (OR=2.42; 95% CI 1.07-5.45). Socioeconomic factors were not associated with being diagnosed among individuals with T2D. Most individuals (>71%) who developed T2D belonged to risk groups defined by having at least two of the prominent risk factors obesity, hypertension, daily smoking, prediabetes, or family history of T2D, including individuals with T2D who had not been diagnosed by healthcare.

Nearly half of individuals who develop T2D during 10 years in Stockholm County are undiagnosed, emphasizing a need for intensified screening of T2D within primary healthcare. Screening can be targeted to individuals who have at least two prominent risk factors.

Age is a significant risk factor of diabetes mellitus (DM). With the develop of population aging, the incidence of DM remains increasing. Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.

To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.

A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed. The prevalence of DM among the elderly was calculated. The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure (DBP) and systolic blood pressure (SBP), fasting blood glucose, body mass index (BMI), waist-to-hip ratio (WHR) and incidence of hypertension (HT), coronary heart disease (CHD), and chronic kidney disease (CKD).

DM was diagnosed in 32.70% of the 4816 elderly people. The BMI of the DM group (25.16 ± 3.35) was greater than that of the non-DM group (24.61 ± 3.78). The WHR was 0.90 ± 0.04 in the non-DM group and 0.90 ± 0.03 in the DM group, with no significant difference. The left SBP and SBP in the DM group were 137.9 mmHg ± 11.92 mmHg and 69.95 mmHg ± 7.75 mmHg, respectively, while they were 126.6 mmHg ± 12.44 mmHg and 71.15 mmHg ± 12.55 mmHg, respectively, in the non-DM group. These findings indicate higher SBP and lower DBP in DM patients than in those without DM. In the DM group, 1274 patients were diagnosed with HT, accounting for 80.89%. Among the 3241 non-DM patients, 1743 (53.78%) were hypertensive and 1498 (46.22%) were nonhypertensive. The DM group had more cases of HT than did the non-DM group. There were more patients with CHD or CKD in the DM group than in the non-DM group. There were more patients who drank alcohol more frequently (≥ 3 times) in the DM group than in the non-DM group.

Older adults in the Lugu community are at a greater risk of DM. In elderly individuals, DM is closely related to high BMI and HT, CHD, and CKD. Physical examinations should be actively carried out for elderly people to determine their BMI, SBP, DBP, and other signs, and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes.

Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods.

The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors.

This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study's conclusions.

Objective: This study aimed to understand the public's expectations regarding type 2 diabetes prevention and to identify factors associated with willingness to participate in preventive activities among adults in Poland. Methods: A cross-sectional survey was carried out using a computer-assisted web interview (CAWI) on a representative sample of 1,046 adults in Poland. A non-probability quota sampling method was used. A study tool was a self-prepared questionnaire. Results: Most respondents (77.3%) declared willingness to participate in preventive activities. Consultation with a diabetologist (75.1%) or family doctor consultation (74.9%) were the most often selected. Lifestyle interventions in the form of dietary and culinary workshops (58.1%) were the least chosen. Having higher education (OR = 3.83, 1.64-8.94, p = 0.002), chronic diseases (OR = 1.36, 1.01-1.85, p = 0.04), and a history of diabetes in the family (OR = 1.67, 1.21-2.30, p = 0.002) were significantly associated with a higher interest in type 2 diabetes prevention. Conclusion: The adults in Poland are keen on participating in diabetes prevention programs, mostly those based on medical counselling rather than lifestyle-oriented interventions. Educational level was the most important factor associated with willingness to participate in type 2 diabetes prevention.

Integrated Knowledge Translation (IKT) is a key strategy for contextualising, tailoring, and communicating research for policy and practice. In this viewpoint, we provide examples of how partners from five countries in sub-Saharan Africa used IKT to advance interventions for curbing non-communicable diseases in their contexts and how these strategies were magnified during the COVID-19 pandemic in some cases. The stories highlight the importance of deliberate and reinforced capacity building, authentic relationship enhancement, adaptable and user-informed stakeholder engagement, and agile multi-sectoral involvement.

Type 2 diabetes is one of the most important widespread diseases worldwide. In Germany, nearly one in five persons over age 65 has type 2 diabetes. The German National Disease Management Guideline for Type 2 Diabetes (NDMG; in German: Nationale Versorgungsleitlinie, NVL) contains updated recommendations for the diagnostic evaluation and pharmacotherapy of this disease as well as information about specific groups of people for whom early detection may be useful.

The guideline has been updated, chapter by chapter, since 2018. Its recommendations are based on systematically searched and evaluated scientific evidence, the clinical expertise of a multidisciplinary panel of experts, and patient perspectives.

The new chapter on shared decision making includes a description of a structured approach that can be used when individual treatment goals have not been achieved. The diagnosis of diabetes newly requires at least two abnormally elevated laboratory values: e.g., fasting plasma glucose ≥ 126 mg/dL (≥ 7.0 mmol/L), HbA1c ≥ 6.5 % (≥ 48 mmol/mol) and/or casual plasma glucose ≥ 200 mg/dL (≥ 11.1 mmol/L). Cardiovascular and renal risks are to be considered in the choice of drug. Studies have shown that, in persons with cardiovascular disease, treatment with GLP-1 receptor agonists (GLP-1, glucagon-like peptide-1) or SGLT2 inhibitors (SGLT2, sodium-glucose co-transporter-2) was less likely than the comparison intervention to lead to certain patient-relevant endpoints, including all-cause mortality (OR = 0.88 and 0.84, respectively), hospitalization for heart failure (SGLT2 inhibitors: OR = 0.65), and worsening of renal function (OR = 0.61 and 0.59, respectively).

Current evidence continues to support the recommendations on pharmacotherapy of the 2021 guideline. The Guideline Group did not find evidence of adequate certainty to inform recommendations about the screening of persons at risk, HbA1c target values, or screening for sequelae and comorbidities. Better evidence on these matters would be desirable.

The aim of this study was to identify what nurses working in primary care settings perceive as necessary to support the life needs of people with type 2 diabetes. Articulate these needs with the needs expressed by people with diabetes in a previous study. Finally, illustrate the potential of the used method.

A highly structured qualitative group method for brainstorming and idea sharing was used to generate a participant-owned concept map that can support and evaluate practice change.

Data were collected between April and May 2022 in two public primary healthcare centres in Sacaba, Bolivia, with 33 professional nurses, technical nurses, nurse trainees and one physician. The concept mapping process by Trochim was used to generate, share and structure ideas, maximizing equality of input.

The nurses identified 73 unique needs that were structured in 11 conceptual clusters related to four different stakeholders or domains: organization of care and health policy, strengthening knowledge, skills and attitudes of healthcare providers, empower people living with diabetes and their family, and community-level health promotion and diabetes education.

The needs and domains identified by nurses and people with type 2 diabetes are very similar and inform a multisectoral and transdisciplinary action plan to jointly monitor and evaluate progress towards people-centred care for people with diabetes.

This study demonstrates nurses' important contribution to analysing and designing people-centred care in their community. They identify and act upon social determinants of health related to schools, safety and legislation. Besides global relevance, results inform the municipal health plan and an ongoing research project on cardiometabolic health.

Data from prior patient consultations were included in the study design, and study results inform the municipal health plan.

Several dietary factors are associated with an increased risk of diabetes in Saudi Arabia. The increasing consumption of processed and sugary foods, including fast food and sugary beverages, in recent decades along with the rising prevalence of diabetes indicate the necessity of exploring the influence of eating habits on diabetes in Saudi Arabia. That is why the association between eating habits and diabetes in Saudi Arabia has become a topic of increasing interest. Therefore, this systematic literature review aimed to explore the influence of eating habits on the prevalence of diabetes in Saudi Arabia by providing a comprehensive synthesis of existing evidence from studies conducted on this topic in Saudi Arabia. A systematic search was conducted using predefined search terms in electronic databases, including PubMed, Embase, Medline, Google Scholar, and Scopus. Studies investigating the relationship between eating habits and diabetes prevalence among the Saudi Arabian population were included. Data extraction was performed, and the quality of included studies was assessed using appropriate tools. The findings were synthesized and discussed. Understanding the association between eating habits and diabetes in Saudi Arabia is crucial for developing effective preventive and management strategies for diabetes and other non-communicable diseases and promoting healthier eating habits in Saudi Arabia.

During the COVID-19 pandemic, patients with diabetes are among the most vulnerable. Our purpose is to research the dynamics of morbidity, mortality, and survival of patients with diabetes in Kazakhstan before and during the current pandemic.

The indicators were calculated taking into account gender and nosological forms (E10-E14, according to ICD-10).The survival analysis was performed by the method of constructing survival tables and the Kaplan-Meier method. Based on methods, the official reporting data of 1,903,243 cases of diabetes and 20,605 deaths from diabetes were analyzed for the period 2018-2021.

In Kazakhstan, during the COVID-19 pandemic, there has been an increase in the absolute frequency of all cases of diseases by 1.8 times (716,048 in 2021 against 396,990 in 2018) and newly detected by 2.0 times (from 38,396 to 75,027), also prevalence by 1.7 times (3743.9 in 2021 against 2142.2 in 2018) and incidence E10-E14 by 1.9 times (392.3 in 2021 against 207.2 in 2018). Mortality from E10-E14 in Kazakhstan increased during the pandemic by more than 1.5 times (34.1 per 100,000 in 2021 against 22.3 per 100,000 in 2018), and the average survival time at E10-E14 shifted (from 69.8 to 70.5 years) (P = 0.001).

To a greater extent, the increase in diseases and terminal outcomes occurred due to non-insulin-dependent type (E11) diabetes, mainly in the female population.

Noninvasive risk prediction models have been widely used in various settings to identify individuals with undiagnosed diabetes.

We aimed to evaluate the discrimination, calibration, and clinical usefulness of the Finnish Diabetes Risk Score (FINDRISC) and Australian Diabetes Risk Assessment (AUSDRISK) to screen undiagnosed diabetes in Kerman, Iran.

We analyzed data from 2014 to 2018 in the second round of the Kerman Coronary Artery Disease Risk Factors Study (KERCADRS), Iran. Participants aged 35 - 65 with no history of confirmed diabetes were eligible. The area under the receiver operating characteristic curve (AUROC) and decision curve analysis were applied to evaluate the discrimination power and clinical usefulness of the models, respectively. The calibration was assessed by the Hosmer-Lemeshow test and the calibration plots.

Out of 3262 participants, 145 (4.44%) had undiagnosed diabetes. The estimated AUROCs were 0.67 and 0.62 for the AUSDRISK and FINDRISC models, respectively (P < 0.001). The chi-square test results for FINDRISC and AUSDRISC were 7.90 and 16.47 for the original model and 3.69 and 14.61 for the recalibrated model, respectively. Based on the decision curves, useful threshold ranges for the original models of FINDRIS and AUSDRISK were 4% to 10% and 3% to 13%, respectively. Useful thresholds for the recalibrated models of FINDRISC and AUSDRISK were 4% to 8% and 4% to 9%, respectively.

The original AUSDRISK model performs better than FINDRISC in identifying patients with undiagnosed diabetes and could be used as a simple and noninvasive tool where access to laboratory facilities is costly or limited.

Chronic non-communicable diseases (NCD) are the major reason for death, morbidity, loss of independency and public health cost. NCD prevalence could be significantly reduced by adopting a healthy lifestyle. This cross-sectional cohort study (online survey) in 221 women aimed to assess NCD awareness, knowledge about NCD prevention and willingness to adopt a healthier lifestyle in women. Overall, NCD awareness level was quite high with, however, information mainly originating from lay media, probably being one reason for false estimations of age groups mainly affected by NCD, impact of NCD on quality of life, NCD mortalities, and the extent of NCD prevention by lifestyle interventions, respectively. Furthermore, also due to mainly lay media, half of women knew online NCD risk calculators, most of them would like to know their NCD risk, but only few had been offered NCD risk calculation by their physician. The mean threshold for willing to adopt a healthier lifestyle was a roughly calculated 37% 5-10 years risk to develop a certain NCD. Acceptance of non-pharmacological interventions for NCD prevention was high, however, major barriers for not implementing a healthier lifestyle were lack of expert information and lack of time. In conclusion, future public health strategies should focus on distributing better understandable and correct information about NCD as well as meeting the individuals' request for personalized NCD risk calculation. Furthermore, physicians should be better trained for personalized NCD prevention counseling.

Health screens are the cornerstones for health promotion and preventive interventions at a community level. This study investigated the barriers and facilitators to the uptake of diabetes health screening in the general population of Singapore.

In this mixed methods study, participants without diabetes were recruited from the general population. The quantitative phase (n = 2459) included face to face survey of participants selected through disproportionate stratified random sampling. Those who participated in the quantitative survey were then randomly chosen for a one-to-one semi-structured interview (n = 30).

Among the survey respondents, 73.09% (n = 1777) had attended a diabetes health screening in their lifetime whilst 42.36% (n = 1090) and 57.64% (n = 1328, p < 0.0001) attended the health screens regularly (every 12 months) and irregularly, respectively. A significantly higher proportion of older adults (≥ 40 years) attended regular diabetes health screening compared to younger adults (less than 40 years; 55.59% vs 24.90%, p < 0.001). The top 3 reasons for attending regular health screens were to detect diabetes early, to make lifestyle changes in case of a diagnosis and being health conscious. Qualitative interviews identified similar issues and complex nuances that influenced the uptake of regular diabetes health screening. Several personal factors (laziness, self-reliance, psychological factors, etc.), competing priorities, fatalistic beliefs, affordability, misconceptions about the screens, and appointment related factors (inconvenient location, time, etc.) were identified as barriers, while affordable screens, sense of personal responsibility, perception of susceptibility /risk, role of healthcare team (e.g. reminders and prescheduled appointments) and personal factors (e.g. age, family, etc.) were facilitators. Age, household income, ethnicity and educational level were associated with the uptake of regular diabetes health screening.

The uptake of regular diabetes health screening can be improved. Several barriers and enablers to the uptake of diabetes health screening were identified which should be addressed by the policy makers to alleviate misconceptions and create greater awareness of the importance of the programme that will improve participation.

To assess the effect of adding an oral glucose tolerance test (OGTT) to fasting plasma glucose (FPG) in terms of detection of type 2 diabetes (T2D) and impaired glucose tolerance (IGT).

Retrospective analysis of serial cross-sectional screening study.

Population-based health examinations within primary care in Västerbotten County, Sweden.

Individuals aged 40- 50 and 60 years with participation from 1985 to 2017. Those with previously diagnosed diabetes and FPG≥7 mmol/L were excluded.

Prevalence of hyperglycaemia on the OGTT (IGT and T2D defined as 2-hour postload capillary plasma glucose of 8.9-12.1 mmol/L and ≥12.2 mmol/L, respectively). Analyses were further stratified by age, sex and risk factor burden to identify groups at high or low risk of IGT and T2D on testing. The numbers needed to screen (NNS) to prevent one case of T2D through detection and treatment of IGT was estimated, combining prevalence numbers with average progression rates and intervention effects from previous meta-analyses.

The prevalence of IGT ranged from 0.9% (95% CI 0.7% to 1.1%) to 29.6% (95% CI 27.4% to 31.7%), and the prevalence of T2D ranged from 0.06% (95% CI 0.02% to 0.11%) to 7.0% (95% CI 5.9% to 8.3%), depending strongly on age, sex and risk factor burden. The estimated NNS to prevent one case of T2D through detection and lifestyle treatment of IGT ranged from 1332 among 40-year-old men without risk factors, to 39 among 60-year-old women with all risk factors combined.

The prevalence of hyperglycaemia on OGTT is highly dependent on age, sex and risk factor burden; OGTT should be applied selectively to high-risk groups to avoid unnecessary testing in the general population.

Post-transplant diabetes mellitus (PTDM) reduces allograft and recipient life span. Polygenic risk scores (PRSs) show robust association with greater risk of developing type 2 diabetes (T2D). We examined the association of PTDM with T2D PRS in liver recipients (n = 1,581) and their donors (n = 1,555), and kidney recipients (n = 2,062) and their donors (n = 533). Recipient T2D PRS was associated with pre-transplant T2D and the development of PTDM. T2D PRS in liver donors, but not in kidney donors, was an independent risk factor for PTDM development. The inclusion of a combined liver donor and recipient T2D PRS significantly improved PTDM prediction compared with a model that included only clinical characteristics: the area under the curve (AUC) was 67.6% (95% confidence interval (CI) 64.1-71.1%) for the combined T2D PRS versus 62.3% (95% CI 58.8-65.8%) for the clinical characteristics model (P = 0.0001). Liver recipients in the highest quintile of combined donor and recipient T2D PRS had the greatest risk of PTDM, with an odds ratio of 3.22 (95% CI 2.07-5.00) (P = 1.92 × 10^-7) compared with those in the lowest quintile. In conclusion, T2D PRS identifies transplant candidates with high risk of PTDM for which pre-emptive diabetes management and donor selection may be warranted.

To investigate the epidemiology of diabetes diagnosis and screening in Australian general practice.

Cross-sectional study using electronic health records of 1,522,622 patients aged 18+ years attending 544 Australian general practices (MedicineInsight database). The prevalence of diagnosed diabetes and diabetes screening was explored using all recorded diagnoses, laboratory results, and prescriptions between 2016 and 2018. Their relationship with patient sociodemographic and clinical characteristics was also investigated.

Overall, 7.5% (95% CI 7.3, 7.8) of adults had diabetes diagnosis, 0.7% (95% CI 0.6, 0.7) prediabetes, and 0.3% (95% CI 0.3, 0.3) unrecorded diabetes/prediabetes (elevated glucose levels without a recorded diagnosis). Patients with unrecorded diabetes/prediabetes had clinical characteristics similar to those with recorded diabetes, except for a lower prevalence of overweight/obesity (55.5% and 69.9%, respectively). Dyslipidaemia was 1.8 times higher (36.2% vs. 19.7%), and hypertension was 15% more likely (38.6% vs. 33.8%) among patients with prediabetes than with diabetes. Diabetes screening (last three years) among people at high risk of diabetes was 55.2% (95% CI 52.7, 57.7), with lower rates among young or elderly males.

Unrecorded diabetes/prediabetes is infrequent in Australian general practice, but prediabetes diagnosis was also lower than expected. Diabetes screening among high-risk individuals can be improved, especially in men, to enhance earlier diabetes diagnosis and management.

Right now, a tuberculosis (TB) and diabetes mellitus (DM) syndemic is re-emerging worldwide. Given the contradictory results of the impact of DM on the natural history of pulmonary TB (PTB), this study was undertaken to shed light on the precision of this hypothesis from a community with a substantial caseload of both diseases.

The present 5-year, retrospective, cohort study involved 487 (60.8% males, and 39.2% females) adult PTB patients (mean age 53.71 ± 15.78 years) selected from Dr. Soliman Fakeeh Hospital (DSFH), Jeddah, Kingdom of Saudi Arabia (KSA). The relevant patients' clinical, radiological and microbiological data were extracted from the hospital medical and laboratory database.

In our study, the cumulative prevalence of DM among PTB subjects was 27.1%. Both diabetic and non-diabetic groups were matched with regard to gender (p = 0.46); however, diabetic patients were significantly older (p = 0.0001). Patients with concomitant DM displayed higher frequency of the classic clinical presentations of PTB and were 1.8 times more likely to have cavitary lesions on imaging studies (p = 0.012). Furthermore, diabetic patients showed higher initial sputum acid-fast bacillus (AFB) smear grade (p = 0.0001) and were more prone to have delayed culture conversion as compared to their non-diabetic counterparts (77.55 ± 37.74 versus 54.95 ± 27.67 days, respectively; p = 0.0001) which points out to less favorable treatment outcome.

DM showed an impact on different aspects of PTB. Accordingly, integrated bi-directional screening programs for both diseases in the KSA need to be implemented to upgrade health-care services of patients with dual diagnosis.

Type 2 diabetes (T2D) is a clinically common cardiovascular disease that can lead to kidney damage and adversely affect male fertility and sperm quality. Resveratrol (Res) is a natural product that has a wide range of effects in animals and cell models.

This research is designed to observe the effect of resveratrol (Res) intervention on renal pathologic injury and spermatogenesis in mice with type 2 diabetes (T2D).

Sixty healthy male SD mice without specific pathogens (SPF grade) were selected, and numbered by statistical software to randomize into control group (CG; n=20), model group (MG; n=20) and research group (RG; n=20). Mice in CG were given regular diet, while those in MG and RG were fed with high fat diet. Subsequently, RG was given Res intervention while MG received no treatment. Biochemical indexes [triglyceride (TG), total cholesterol (TC), fasting blood glucose (FBG), 24-hour urinary albumin excretion rate (24h-UAER)] of mice in the three groups before and after intervention were observed and recorded. The effect of Res on oxidative stress, kidney histopathological structure, spermatogenic function, sperm density and viability of mice, as well as spermatogenic cell cycle of testis were determined.

Res reduced hyperlipidemia and hyperglycemia in T2D mice. By reducing malondialdehyde (MDA) and increasing superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), Res relieved oxidative stress and alleviated kidney tissue damage. In addition, Res improved the spermatogenic function of T2D mice by increasing the sperm density and survival rate and restoring the percentage of spermatogenic cells at all levels.

Res intervention in T2D mice can reduce kidney tissue damage, lower blood glucose (BG), and improve spermatogenic function by increasing sperm density and restoring the percentage of spermatogenic cells at all levels.

To explore the therapeutic value of sodium-dependent glucose transporters 2 (SGLT-2) inhibitor in type 2 diabetes mellitus (DM).

A total of 131 patients with type 2 DM admitted to our hospital from October 2017 to November 2019 were recruited as research objects, including 58 patients treated with insulin + metformin + acarbose as the control group (CG), and 73 patients treated with SGLT-2 inhibitor on the basis of control group as the study group (SG). The levels of blood glucose, serum creatinine (Scr), 24-hour urinary protein quantity, serum uric acid, and the incidence of adverse events were compared between the two groups.

After treatment, fasting blood glucose (FPG), 2 hours postprandial blood glucose (2hPG), body mass index (BMI), hemoglobin A1c (HbA1c), type IV collagen (CIV), procollagen type III (PCIII), serum creatinine (Scr), 24-hour urinary protein quantity and blood uric acid (UA) decreased significantly (P > 0.05), and they were lower in SG than in CG (P < 0.05). Besides, the total effective rate of SG was 95.89%, which was notably higher than that of CG (84.48%, P < 0.05). The adverse reaction rate (ADR) of patients in SG was notably lower than that in CG (P < 0.05).

SGLT-2 inhibitor can effectively control the blood glucose level of DM patients, and can reduce the incidence of renal injury and adverse events.

Prevention of and early treatment for noncommunicable diseases such as hypertension, hyperglycemia, and dyslipidemia are important, as these diseases are asymptomatic in early stages but can lead to critical conditions such as macro- and microvascular disorders later on. While screening is conducted worldwide, low rates of hospital visits after screening is a common issue. We aimed to investigate the effect of reminder letters on the consultation behavior of screened participants.

We used administrative claims data from a database managed by JMDC Inc for participants of health checkups in 2014, 2015, 2016, and 2017, who belonged to a health insurance society. Reminder letters were sent regularly 6 months after checkups to improve participant consultation behavior. Participants who screened positive for hypertension, hyperglycemia, and dyslipidemia, and who were not taking medication for any of these diseases at the time of health checkups, were included in the analyses.

A total of 1739 participants in 2014, 1693 in 2015, 2002 in 2016, and 2144 in 2017 were included in the analysis for hypertension. The cumulative proportion of hospital visits gradually increased over the course of 12 months after checkups in all years. After 2015, spikes, albeit very small ones, were observed at 6 months after checkups in accordance with the timing of reminder letters. Similar trends were observed for hyperglycemia and dyslipidemia.

Sending reminder letters is a potentially effective approach to increase hospital visits, but further improvements (ie, multiple reminders) may be necessary to affect enhancements in participant consultation behavior.

There is limited evidence on whether screening for type 2 diabetes mellitus affects health outcomes. A recent systematic review of randomised clinical trials found only one trial that met their inclusion criteria; therefore, current guidelines for screening interventions for type 2 diabetes mellitus are based on expert opinions and best practice rather than synthesised evidence. This systematic review seeks to collate evidence from non-randomised studies to investigate the effect of screening for adults with type 2 diabetes on outcomes including diabetes-related morbidity, mortality (all-cause and diabetes-related) and harms.

This systematic review will follow Effective Practice and Organisation of Care (EPOC) guidelines for the synthesis of non-randomised studies. We will search PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Academic Search Premier and Health Source Nursing Academic (from inception onwards). We will include non-randomised trials, controlled before-after studies, interrupted time-series studies, repeated measures studies and concurrently controlled prospective cohort studies. The primary outcome will be diabetes-related morbidity (microvascular complications of diabetic retinopathy, nephropathy or neuropathy or macrovascular complications of non-fatal myocardial infarction, peripheral arterial disease or non-fatal stroke). The secondary outcomes will be mortality (all-cause and diabetes-related) and harms of screening strategies to patients (including psychological harms or adverse events following treatments) or to health care system (including resource allocation for false-positives or overdiagnosis). Two reviewers will independently screen all citations and full-text articles. Data will be abstracted by one reviewer and checked by a second. The risk of bias of individual studies will be appraised using the ROBINS-I tool. GRADE will be used to determine the quality of the scientific evidence. If feasible, we will conduct random effects meta-analysis where appropriate. If necessary, analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, sex, socio-economic status, rural versus urban or low-middle income versus high-income country). We will disseminate the findings via publications and through relevant networks.

The protocol outlines the methods for systematically reviewing and synthesising evidence of screening strategies for type 2 diabetes mellitus and their effect on health outcomes associated with the disease. The potential impact of this systematic review is improved evidence-informed decision-making for policies and practice for screening of type-2 diabetes.

PROSPERO CRD42020147439.