Immunological Impacts of Diabetes on the Susceptibility of Mycobacterium tuberculosis

The interaction between diabetes and major world infections like TB is a major public health concern because of rapidly rising levels of diabetes. The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health problem. Diabetes mellitus is a major risk factor for the development of active and latent tuberculosis. Immune mechanisms contributing to the increased susceptibility of diabetic patients to TB are due to the defects in bacterial recognition, phagocytic activity, and cellular activation which results in impaired production of chemokines and cytokines. The initiation of adaptive immunity is delayed by impaired antigen-presenting cell (APC) recruitment and function in hyperglycemic host, which results in reduced frequencies of Th1, Th2, and Th17 cells and its secretion of cytokines having a great role in activation of macrophage and inflammatory response of tuberculosis. In addition, impaired immune response and killing of intracellular bacteria potentially increase bacterial load, chronic inflammation, and central necrosis that facilitate bacterial dissemination and miliary tuberculosis. Understanding of the immunological and biochemical basis of TB susceptibility in diabetic patients will tell us the rational development of implementation and therapeutic strategies to alleviate the dual burden of the diseases. Therefore, the aim of this review was focused on the association between diabetes and tuberculosis, focusing on epidemiology, pathogenesis, and immune dysfunction in diabetes mellitus, and its association with susceptibility, severity, and treatment outcome failure to tuberculosis.

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Exercise for the Management of Diabetes Mellitus: A Review of the Evidence

Journal of Enam Medical College ◽

10.3329/jemc.v3i2.16133 ◽

2013 ◽

Vol 3 (2) ◽

pp. 99-108

Author(s):

Md. Shahjamal Khan

Keyword(s):

Public Health ◽

Physical Activity ◽

Diabetes Mellitus ◽

Aerobic Exercise ◽

Public Health Problem ◽

Moderate Intensity ◽

Public Health Approach ◽

Diabetic Patients ◽

Published Evidence ◽

Exercise Programmes

Diabetes mellitus is a public health problem in both developed and developing countries and has increased alarmingly, giving the disease the dimension of an epidemic. The aetiology of diabetes is multifactorial involving genetic, environmental, and behavioural origins. Exercise is an important part for the management of diabetes mellitus. Regularly planned exercise reduces insulin resistance, improves glucose tolerance, improves lipid profile and increases cardiovascular and cardiopulmonary function. This article critically reviews the more relevant evidence on the interrelationships between exercise and diabetes mellitus. This study included bibliography research from both the review and the research literatures on exercise in diabetes mellitus. From this review it appears that the effects of aerobic exercise are well established, and interventions with more vigorous aerobic exercise programmes resulted in greater reductions in HbA1c, greater increase in oxygen consumption and greater increase in insulin sensitivity. Considering the available evidence, it appears that resistance training could be an effective intervention to help glycaemic control, especially considering that the effects of this form of intervention are comparable with what is reported with aerobic exercise. It is well established that physical activity produces general and specific health benefits for diabetic patients. The basic principles of an effective exercise programme are the intensity, duration and frequency of exercise in an appropriate environment. Usually, moderate-intensity and long-duration exercise programmes are considered most suitable for diabetic patients. As it is supported by published evidence, encouragement to adopt increased physical activity and reduction of sedentary behaviour is a successful public health approach for diabetes mellitus prevention and management. Journal of Enam Medical College; Vol 3 No 2 July 2013; Page 99-108 DOI: http://dx.doi.org/10.3329/jemc.v3i2.16133

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The efficacy of a diabetic educational program and predictors of compliance of diabetes mellitus patient’s

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00463 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0046

Author(s):

Kelly Stéfani ◽

Vinicius Borges ◽

Aldo Barbachan

Keyword(s):

Diabetes Mellitus ◽

Operative Procedure ◽

Public Health Problem ◽

Developed Countries ◽

The United States ◽

Diabetic Patients ◽

Global Public Health ◽

Charcot Arthropathy ◽

Specific Protocol ◽

Patients With Diabetes

Category: Diabetes Introduction/Purpose: Diabetes mellitus has become a global public health problem. Not only has its incidence remained high in developed countries such as Japan and the United States, but, also, the number of cases has been growing alarmingly in developing countries such as Brazil. The concept of detection and management of diabetes mellitus in primary care centers is widely practiced in Brazil by the general physician. The purpose of this study was to evaluate the efficacy of our educational diabetics program for patients with diabetes mellitus and to determine the predictors of compliance. Since our patient orientation protocols and the insensitive footwear we provide reduce our hospital admission costs. Methods: A prospective study (2005-2017) was performed in a quaternary hospital where patients with diabetes were referred to the outpatient clinic of the diabetic foot group. The epidemiological profile of these patients under treatment in a specialized multidisciplinary outpatient unit was evaluated. A specific protocol included notes on the age, body mass index, length of disease, use of insulin, degree of sensation as evaluated by the Semmes-Weinstein monofilament test, deformity in feet, palpation of peripheral pulses, cigarette smoking, and previous operative procedure in foot an ankle.The same specialist orthopedic doctors in foot and ankle completed the protocol and performed the specific physical examination (reports were made on deformities regarded as risky for the incursion of ulcers such as plantar callosities, alterations of the hallux and lesser toes, loss of the longitudinal plantar arch, and all those related to Charcot arthropathy) and performed the same a guidelines for foot care. Results: Out of the 578 diabetic patients, the mean age of was 67 years, 69% being of the female gender. There was 53% made use of insulin, the time of disease was 14 years, and 85% patients were obese. Evaluation of protective sensibility showed that 68% were significantly decreased (from the 4.0 g monofilament). The ulcers was found in 64 patients, 57% had degree 1 in the Wagner classification, and 63% was affected in the forefoot. Charcot neuroarthropathy was diagnosed in 54 patients, 52% had the phase 3 in the Eichenholz classification, and 61% was affected in the midfoot. Fifty-three patients had amputations at the time of their first appointment, 66% on toes. 127 patients required surgery resulted from clinical complications: ulcers, osteomyelitis, and Charcot arthropathy. Conclusion: The costs related to the disease increase greatly with the appearance of the complications, especially if there is need of hospitalization and surgical treatment. The prevention of injuries, with adequate glycemic control and supply of protective shoes is essential.

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PO 18146 - The efficacy of a diabetic educational program and predictors of compliance of patients with non-insulin dependent diabetes mellitus (type 2)

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1020 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. S31

Author(s):

Kelly Cristina Stéfani ◽

Aldo Barbachan Rodrigues ◽

Vinicius Quadros Borges ◽

Gabriel Ferraz Ferreira ◽

Leonardo Vinícius De Matos Moraes

Keyword(s):

Diabetes Mellitus ◽

Educational Program ◽

Public Health Problem ◽

The Body ◽

Dependent Diabetes Mellitus ◽

Diabetic Patients ◽

Foot And Ankle ◽

Global Public Health ◽

Specific Protocol ◽

Patients With Diabetes

Introduction: Diabetes mellitus (DM) has become a global public health problem. The concept of detection and management of diabetes mellitus in primary care centers is widely practiced in Brazil by the general practitioner. The aim of this study was to evaluate the efficacy of our educational program for diabetics for patients with diabetes mellitus and to determine the predictors of compliance. Methods: A cross-sectional prospective study was performed in a quaternary hospital where patients with diabetes were referred to the outpatient clinic of the diabetic foot group so that they were part of a multidisciplinary group (medical orthopedists specialists in foot and ankle, medical endocrinologists, physiotherapist and nurse) with a specific protocol for guidelines for foot care. Specialist orthopedic doctors of the foot and ankle completed the protocol and performed the specific physical examination. Results: Of the 578 diabetic patients, the mean age was 67 years, 69% were female, 53% used insulin to control the disease and the disease duration was 14 years. Obesity was diagnosed by calculation of the body mass index (BMI), and 85% patients were overweight. Evaluation of protective sensibility showed that 68% were significantly decreased, with sensation from the 4.0 g monofilament. One hundred and twenty seven patients required surgery resulting from clinical complications of the disease: 64 ulcers (Wagner classification 57% ulcers had a degree 1 Wagner classification, 63% affected forefoots), 54 Charcot arthropathies (52% Eichenholz in phase 3, 61% located in the mid-foot), and 9 cases of osteomyelitis. Fifty-three patients had one or more prior amputations at the time of their first appointment, mostly of the toes (66%). Conclusion: The costs related to the disease increased greatly with the appearance of complications, especially if there was a need for hospitalization and surgical treatment. The prevention of injuries with adequate glycemic control and the provision of protective shoes is essential.

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Anaemia - a pale ale?

South African Family Practice ◽

10.4102/safp.v59i3.4688 ◽

2017 ◽

Vol 59 (3) ◽

pp. 17-23

Author(s):

George L Muntingh ◽

M Viljoen

Keyword(s):

Public Health ◽

Pregnant Women ◽

Public Health Problem ◽

The Elderly ◽

Reproductive Age ◽

World Health ◽

Health Concern ◽

Global Public Health ◽

Women Of Reproductive Age ◽

Global Database

Despite some modest improvements described recently, anaemia remains a significant global public health concern affecting both developed and developing countries. It affects a quarter of the global population, including 293 million (47%) children who are younger than five years of age. A prevalence of 42% and 30% has been described in pregnant and non-pregnant women, respectively. Children and women of reproductive age are at high risk, partly because of physiological vulnerability, followed by the elderly. Africa and Asia are the most heavily affected regions, accounting for 85% of the absolute anaemia burden in highrisk groups. According to the World Health Organization global database on anaemia (1993–2005), this disorder was considered to be a moderate public health problem in South African preschool children, pregnant women and non-pregnant women of reproductive age. There has been an increased awareness of anaemia and its consequences on the health and development of women and children in the past few decades. The many underlying causes of the various types of anaemia seen in general practice means it is essential that practitioners’ clinical decisions be underpinned by a sound knowledge of the pathological processes involved. Thorough history-taking will guide practitioners to request specific tests to confirm or refute differential diagnoses. Management must be developed around the specific type of anaemia and the potential physical and psychological effects it may have on the individual.

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The Effect of Zumba Exercise to Women's Waist Hip Ratio

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v6i2.17449 ◽

2020 ◽

Vol 6 (2) ◽

pp. 67

Author(s):

Laksmi Indreswari ◽

Yunita Dewi Anggraeni ◽

Rena Normasari

Keyword(s):

Public Health ◽

Diabetes Mellitus ◽

Abdominal Obesity ◽

Public Health Problem ◽

Statistical Test ◽

Global Public Health ◽

Waist Hip Ratio ◽

High Prevalence ◽

Paired T Test ◽

Global Public Health Problem

Abdominal obesity is a global public health problem. The high prevalence of abdominal obesity triggers an increase in morbidity and mortality in chronic diseases such as diabetes mellitus, cardiovascular, and cancer. One of the causes of the high prevalence of abdominal obesity is the lack of physical activity. Prevention efforts are needed through the identification of risk factors such as measurement of waist hip ratios. The respondents of this study were divided into two groups: 28 respondents who did zumba exercise for four weeks and 28 control respondents. The statistical test performed was a paired t-test comparison test. The results of this study indicate the value of t-count > t-table value (7.184 > 2.052) and the significance of 0.000 < 0.05. These results indicate that there is a decrease in the waist hip ratio after doing zumba exercise for four weeks.

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Honour based violence as a global public health problem: a critical review of literature

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-10-2015-0032 ◽

2016 ◽

Vol 9 (3) ◽

pp. 198-215 ◽

Cited By ~ 3

Author(s):

Sadiq Bhanbhro ◽

Anna Cronin de Chavez ◽

Adelaide Lusambili

Keyword(s):

Public Health ◽

Research Policy ◽

Public Health Problem ◽

Well Being ◽

Health Concern ◽

Global Public Health ◽

Gender Based Violence ◽

Content Type ◽

Gender Based ◽

Health And Well Being

Purpose “Honour”-based violence (HBV), a form of gender-based violence (GBV), has received increasing interest from media, human rights organisations, academics and the public. A significant increase in the occurrence and reporting of HBV in many parts of the world and its detrimental impact on the health and well-being of women, girls, communities and wider society; marks it as a major public health concern. However, awareness and recognition of HBV in the field of public health is low in many countries and there is little known about its nature, roots and distribution. The paper aims to discuss these issues. Design/methodology/approach The literature was searched using the Scopus database and a series of search terms related to HBV, GBV and health and well-being. Findings Definition of HBV and its forms is varied across cultures. There is a lack of consensus on how HBV can be identified over other forms of violence and no explicit theoretical perspectives have been sufficiently developed to deepen the understanding of HBV. Although the findings from the review suggest that HBV forms and patterns may be regionally distinct, causes emanate from gender-based and socio-economic inequalities. Research limitations/implications This review has limitations in that it included only English and Spanish language papers and those accessed through Scopus; it therefore may have excluded papers from other languages, countries and databases. Another major weakness in this review was a lack of papers specifically dedicated to HBV. Despite these weaknesses the paper is an attempt to raise awareness and recognition of HBV in public health research, policy and practice domain. Originality/value The findings from the review highlight the complexity of tackling HBV in a globalised world. They also provide insights on how a public health model can be used to analyse both the causes and prevention of HBV. Further, a non-culturalised, unprejudiced and inclusive definition is required to flag-up and record HBV cases.

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Correlation between Anemia and Malaria Infection Severity in Patients with Type 2 Diabetes Mellitus in Nigeria

Althea Medical Journal ◽

10.15850/amj.v7n4.2085 ◽

2020 ◽

Vol 7 (4) ◽

Author(s):

Adedeji David Atere ◽

Henry Chijindu Okpoli ◽

Kelvin Aimuemwosa Uwumarogie ◽

Adebimpe Iyanuoluwa Moronkeji

Keyword(s):

Diabetes Mellitus ◽

Parasite Density ◽

Malaria Infection ◽

Public Health Problem ◽

Hemoglobin Level ◽

Control Group ◽

P Value ◽

Diabetic Patients ◽

Global Public Health ◽

Malaria Parasitemia

Background: Malaria and diabetes mellitus are still a significant global public health problem despite the phenomenal progresses in clinical sciences related to the diseases. Both anemia and malaria parasitemia are common in developing countries. It is therefore important to diagnose and determine the correlation between anemia level and malaria infection severity in diabetic patients for better management. Methods: Patients with diabetes mellitus (DM) infected with malaria were recruited (n=50) as subjects and non-diabetic patients were used as control in this study, who were further divided into two sub-group: non-DM infected with malaria (n=25) and non-DM without malaria parasitemia (n=25). Blood sample were collected to examine the fasting blood sugar (FBS) level, packed cell volume (PCV), hemoglobin (Hb) level, and malaria parasitemia. Statistical analysis was then performed using ANOVA with a p value of less than or equal to 0.05 considered statistically significant. Results: The parasite density in DM with malaria was significantly lower (p<0.05) than in the non-DM with malaria. Interestingly, there was a higher PCV and hemoglobin level (p<0.05) in DM with malaria when compared with non-DM with malaria. Conclusion: DM patients infected with plasmodium have low parasite density but higher hemoglobin level and PCV compared to the control group. There is no correlation between the severity of anemia and malaria parasitemia in DM patients infected with malaria when compared to non-diabetic subjects infected with malaria. Further studies are needed to explore the correlation between hemoglobin level in DM and plasmodium infection

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Influence of Race in the Association of Diabetes and Heart Failure

US Cardiology Review ◽

10.15420/usc.2017:24:2 ◽

2018 ◽

Vol 12 (1) ◽

pp. 17-21 ◽

Cited By ~ 1

Author(s):

Hou Tee Lu ◽

Rusli Bin Nordin ◽

Aizai Azan Bin Abdul Rahim ◽

◽

...

Keyword(s):

Public Health ◽

Diabetes Mellitus ◽

Risk Factors ◽

Heart Failure ◽

Racial Differences ◽

Race And Ethnicity ◽

Public Health Problem ◽

Racial Groups ◽

Global Public Health ◽

Readmission Rates

Heart failure is a global public health problem with high mortality and readmission rates. Race and ethnicity are useful concepts when attempting to understand differential health risks and health disparities. With cardiovascular diseases accounting for most deaths globally, eliminating racial disparities in cardiac care has become a new challenge in cardiology. Significant racial differences exist in patients with heart failure. African American patients in the US have a significantly higher incidence of heart failure, lower ejection fraction and are younger at presentation compared to White, Hispanic and Chinese American patients. These findings are explained by a higher burden of risk factors such as diabetes mellitus, hypertension, obesity and lower household incomes among African Americans. The authors believe that these findings are applicable to other racial groups across the globe. The prevalence of predisposing risk factors probably has a stronger influence on the incidence of heart failure than the racial factor alone. The interaction between race and diabetes mellitus has important public health implications for the management and prevention of heart failure.

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Application of Inherent Risk of Contagion (IRC) framework & modelling to aid local Covid-19 response & mitigation: Viewpoint (Preprint)

10.2196/preprints.19814 ◽

2020 ◽

Author(s):

Helmi Zakariah ◽

Fadzilah bt Kamaluddin ◽

Choo-Yee Ting ◽

Hui-Jia Yee ◽

Shereen Allaham ◽

...

Keyword(s):

Public Health ◽

Public Health Problem ◽

Analytical Framework ◽

Vulnerable Population ◽

Contact Tracing ◽

Global Public Health ◽

Inherent Risk ◽

Transmission Area ◽

Current Outbreak ◽

Novel Coronavirus

UNSTRUCTURED The current outbreak of coronavirus disease 2019 (COVID-19) caused by the novel coronavirus named SARS-CoV-2 has been a major global public health problem threatening many countries and territories. Mathematical modelling is one of the non-pharmaceutical public health measures that plays a crucial role for mitigating the risk and impact of the pandemic. A group of researchers and epidemiologists have developed a machine learning-powered inherent risk of contagion (IRC) analytical framework to georeference the COVID-19 with an operational platform to plan response & execute mitigation activities. This framework dataset provides a coherent picture to track and predict the COVID-19 epidemic post lockdown by piecing together preliminary data on publicly available health statistic metrics alongside the area of reported cases, drivers, vulnerable population, and number of premises that are suspected to become a transmission area between drivers and vulnerable population. The main aim of this new analytical framework is to measure the IRC and provide georeferenced data to protect the health system, aid contact tracing, and prioritise the vulnerable.

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Associations between gestational diabetes mellitus and the neurodevelopment of offspring from 1 month to 72 months: study protocol for a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-040305 ◽

2020 ◽

Vol 10 (11) ◽

pp. e040305

Author(s):

Chao Li ◽

Ping Zhou ◽

Yixi Cai ◽

Bin Peng ◽

Yongfang Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Public Health Problem ◽

Multiple Linear Regression Model ◽

Preschool Age ◽

Control Group ◽

Global Public Health ◽

Open Access Journals

IntroductionGestational diabetes mellitus (GDM) is a common gestational disease and an important global public health problem. GDM may affect the short-term and long-term health of offspring, but the associations between GDM and the neurodevelopment of offspring of mothers with GDM (OGDM) are still unclear, and studies based on the Chinese population are lacking. We aim to determine the associations between GDM and the neurodevelopment of OGDM by studying a cohort of OGDM and offspring of non-GDM mothers.Methods and analysisThe single-centre prospective cohort study is being conducted in China over 7 years. A total of 490 OGDM (GDM group) and 490 fromof healthy mothers (control group) will be enrolled during the same period. Baseline characteristics, neuropsychological development scores and clinical data at specific time points (at 0, 1, 3, 6, 12, 24, 36, 48, 60 and 72 months old) will be collected from the children in both groups until the age of 6 years. The associations between GDM and the neurodevelopment of OGDM from infancy to preschool age will be analysed using a multiple linear regression model adjusted for confounders. In addition, we will compare longitudinal data to further assess the effects of GDM on neurodevelopmental trajectories.Ethics and disseminationThe study has been approved by the Ethics Committee of the Children’s Hospital of Chongqing Medical University (Approval Number: (2019) Institutional Review Board (IRB) (STUDY) No. 85). The findings of this study will be disseminated through open access journals, peer-reviewed journals and scientific meetings.Trial registration numberNCT03997396.

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