Survival Analysis on Time-To-Recovery of Diabetic Patients at Minlik Referral Hospital, Ethiopia: Retrospective Cohort Study

AimThe study aimed to determine the time to recovery of diabetic patients who have been treated in the hospital under follow-up. Subject and MethodsA retrospective cohort study design was carried out. The fast blood glucose level of diabetic patients who are under follow-up in the hospital was measured from 2016 to 2020. One thousand seven hundred diabetic patients were included in the study. Kaplan-Meier, Log-rank test, global test, Schoenfeld residuals, and Cox-PH model were used for statistical analysis.ResultsOut of the total of 1278 patients, 27.4% were censored (withdrawal from follow-up) and 72.6% recovered from the diabetic disease. For sex, the expected hazard is 1.322 times higher in males than female diabetic patients or there is a 32.2% increase in the expected hazard in males relative to female diabetic patients. For Spdrt, The expected hazard is 1.164 times higher in the patients who had taken leute than diabetic patients who took doanied. For regimen, the expected hazard is 1.495 times higher in the patients who had been treated by insulin agent only than diabetic patients who were treated by oral agents only ConclusionThe intensive-therapy regimen, Spdrt, and gender differences were statistically significant and critically contribute to the survival time to recovery of diabetic patients.

Gastric bypass prevents diabetes in genetically modified mice and chemically induced diabetic mice

Obese subjects have increase probabilities of developing type 2 diabetes (T2D). In this study, we sought to determine whether gastric bypass prevents the progression of prediabetes to overt diabetes in genetically modified mice and chemically induced diabetic mice. Roux-en-Y gastric bypass (RYGB) was performed in C57BL/KsJ-db/db null (BKS-db/db,) mice, high-fat diet (HFD)-fed NONcNZO10/LtJ (NZO) mice, C57BL/6 db/db null (B6-db/db) mice and streptozotocin (STZ)-induced diabetic mice. Food consumption, body weight, fat mass, fast blood glucose level, circulating insulin and adiponectin and glucose tolerance test were analyzed. The liver and pancreatic tissues were subjected to H&E and immunohistochemistry staining and islet cells to flow cytometry for apoptotic analysis. RYGB resulted in sustained normoglycemia and improved glucose tolerance in young prediabetic BKS-db/db mice (at the age of 6 weeks with hyperglycemia and normal insulinemia) and HFD-fed NZO and B6-db/db mice. Remarkably, RYGB improved liver steatosis, preserved the pancreatic β-cells and reduced β-cell apoptosis with increases in circulating insulin and adiponectin in young prediabetic BKS-db/db mice. However, RYGB neither reversed hyperglycemia in adult diabetic BKS-db/db mice (12 weeks old) nor attenuated hyperglycemia in STZ-induced diabetic mice. These results demonstrate that gastric bypass improves hyperglycemia in genetically modified prediabetic mice; however, it should be performed prior to β-cells exhaustion.

Diabetic retinopathy, visual impairment and the risk of six-year death: a cohort study of a rural population in China

Purpose: To explore the association between diabetic retinopathy (DR) and the risk of six-year death, as well as the association between visual impairment (VI) and the risk of six-year death, in a rural Chinese population of age≥30 years. Methods: This was a population-based cohort study. In 2006-2007, 6,830 subjects aged ≥30 years were recruited from 13 villages in northern China through clustered randomization. In 2012-2013, a six-year follow-up was further done. Six different proportional hazards models, with different confounders adjusted, were used to explore the association between baseline DR and risk of death. Results: 5,570 subjects were included in this study by our inclusion and exclusion criteria. 410 (7.36%) subjects died by follow-up. The median ages of the dead subjects and survived subjects were 67 (interquartile range, IQR: 58-72) years and 52 (IQR: 42-58) years (Z=21.979, p<0.001). Male accounted for 62.20% and 44.92% among the dead and survived subjects (p<0.001). Besides, compared with those survived, the dead were found to be with lower education (p<0.001), lower marriage rate (p<0.001), lower income (p<0.001), higher proportion of smoking (p=0.003), higher systolic blood pressure (Z=10.411, p<0.001), lower body mass index (Z=-3.302, p=0.001), larger spherical equivalent error (Z=4.248, p<0.001), lower intraocular pressure (Z=-4.912, p<0.001), smaller anterior chamber depth (Z=-9.186, p<0.001), larger length thickness (Z=11.069, p<0.001), higher fast blood glucose level (Z=5.650, p<0.001), higher total cholesterols (Z=2.015, p=0.044), higher low-density lipoprotein (Z=2.024, p=0.043), higher proportion of drug usage (p<0.001). Besides, the dead subjects were more likely to be with VI, glaucoma, cataract, age-related macular degeneration, diabetes and DR. 148 subjects were diagnosed with DR at baseline, 33 (22.30%) of them were dead before follow-up. By adjusting all relative confounders in a proportional hazards model, DR was found to be a risk factor of six-year death, the hazard ratio (HR) was 1.739 (95% confidence intervals: 1.080, 2.803). Another five different statistical models with different confounders adjusted also revealed a statistically significant association between DR and six-year death. The association between VI and six-year death was not statistically significant. Conclusions: DR increased the risk of six-year death in a rural Chinese population aged ≥30 years, while VI not.

Influence of snoring on in incidence of metabolic syndrome: a community-based prospective cohort study in rural Northeast China

Background: There is increasing trend of metabolic syndrome (MetS) in rural areas of China in recent years. It is necessary to figure out the possible risk factors of MetS for better intervention. This community-based prospective cohort study was performed to assess the relationship between snoring status and incidence of MetS.Methods: We conducted a cohort study among residents aged ≥ 35 years without MetS in 2012-2013. Among 5,691 residents who met the inclusion criteria, 4,980 residents (2,586 men and 2394 women; follow-up proportion: 87.5%) remained available for follow-up examinations during 2015-2017. The main outcome was the incidence of MetS, defined by the unify criteria in 2009. We divided residents by snoring status and compared outcome between groups. Using a logistic regression model, we estimated the odds ratio (OR) for incidence for MetS, adjusting for confounders, ages, gender, exercise habit, sleep duration, alcohol and smoke consumption. Results: With a median follow up of 4.6 years, incidence of MetS was higher in snorers (men 26.2%, women 33.5%) than in non-snorers (men 19.7%, women 23.2%). Diastolic blood pressure increased in follow-up compared with baseline in male snorers but decreased in male non-snorers. Similarly, fast blood glucose level increased in female snorers at follow-up but decreased in female non-snorers. We found a significant association between snoring and incidence of MetS (adjusted OR=1.51, 95%CI=1.32-1.74). Besides, as the degrees of the snoring increased, the incidence of MetS increased simultaneously. And the OR for the very severe snoring was double compared with non-snorers (adjusted OR=2.10, 95%CI=1.38-3.20). Conclusion: Snoring is associated with higher incidence of MetS in rural Northeast Chinese. More emphasis should be paid to residents with snoring problem.