Prevalence of nephropathy among type two diabetes patients in Eastern Mediterranean Region: A systematic review and meta-analysis

Objectives: The global epidemic of Diabetes Mellitus exerts a substantial burden on health services. This high prevalence of diabetes leads to an increase in diabetic complications, especially diabetic nephropathy, a leading cause of end stage renal disease and renal replacement therapies. Due to its’ the high prevalence reported by Individual studies in EMR, we conducted a meta-analysis of relevant studies to estimate diabetic retinopathy in EMR.Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, Web of knowledge, and Gray literature from Jan 1st, 2000 to December 13, 2019. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment were performed. Results: Out of 3,225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. The prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04, 32%); and it was 30.42% (95% CI= 23.38, 37.94%) in males and 22.1% (95% CI= 16.05, 28.79%) in females. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators (p = .332, .725, .280, .220, and .468, respectively).Conclusions: Diabetic nephropathy high prevalence in EMR implicates the importance of diabetes screening, periodic examinations, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.

Optimal Type 2 Diabetes Mellitus Management and Active Ageing

Type two diabetes mellitus (T2DM) represents a chronic condition with increasing prevalence worldwide among the older population. The T2DM condition increases the risk of micro and macrovascular complications as well as the risk of geriatric syndromes such as falls, fractures and cognitive impairment. The management of T2DM in the older population represents a challenge for the clinician, and a Comprehensive Geriatric Assessment should always be prioritized, in order to tailor the glycated hemoglobin target according to functional and cognitive status comorbidities, life expectancy and type of therapy. According to the most recent guidelines, older adults with T2DM should be categorized into three groups: healthy patients with good functional status, patients with complications and reduced functionality and patients at the end of life; for each group the target for glycemic control is different, also according to the type of treatment drug. The therapeutic approach should always begin with lifestyle changes; after that, several lines of therapy are available, with different mechanisms of action and potential effects other than glucose level reduction. Particular interest is growing in sodium-glucose cotransporter-2 inhibitors, due to their effect on the cardiovascular system. In this review, we evaluate the therapeutic options available for the treatment of older diabetic patients, to ensure a correct treatment approach.

Isolated nerve palsy following insertion of a three-piece inflatable penile prosthesis

Case report of a 57 year-old male who underwent insertion of an inflatable penile prosthesis due to erectile dysfunction, secondary to poorly controlled Type two diabetes and Peyronie’s disease. The surgical procedure was uneventful and there were no immediate post-operative complications. During a routine follow up the patient described problems with the deflation of the implant and severe lower back and leg pain. Diagnostic MRI scans revealed reservoir migration, impingement of the obturator nerve and oedema in the adductor muscle group. The reservoir was initially repositioned, and later on removed due to on-going symptoms.

THE PREVALENCE OF CHRONIC DISEASES AMONG PATIENT WITH TYPE TWO DIABETES MELLITUS IN NATIONAL GUARD HOSPITAL ALHASA: RETROSPECTIVE STUDY

Background: Diabetes mellitus is the most common endocrine disorders encountered in clinical practice. Many chronic diseases like Hyper- and hypothyroidism, Hypertension, Dyslipidemia and Obesity have been associated with insulin resistance, which has been reported to be the major cause of impaired glucose metabolism in type II DM. Objective: The main aim of this study to investigate the prevalence of chronic diseases among patient with type two diabetes mellitus in National Guard hospital, AlHasa. Methods: A retrospective cross-sectional study was done on patients who diagnosed with type II DM and regularly attended the family medicine clinic at National Guard hospital, AlHasa, Saudi Arabia. Results: Out of 300 randomly selected type two diabetic patients with different chronic diseases. In addition, there was a statistically signicant association between HbA1C level and type of treatment received by our population but fasting blood glucose level was not signicant. Regarding the TSH level, out of 300 patients; 9.5% were diagnosed normal and 90.5% were diagnosed abnormal regarding to the TSH level. One hundred thirty-ve patients had hypertension with Dyslipidemia and the rest of the patients had another co morbidities. Vitamin D level deciency was observed in the majority of patients and insufciency in of patients. Conclusion: In our population, the prevalence of female diabetic patients with chronic diseases was 1.8 times higher than diabetic male. The prevalence of abnormal diagnosed level of TSH was 9.5 times higher than normal level.

Hypothetical molecular interconnection between type 2 diabetes and dyslexia

Background Dyslexia is one of the most common learning disabilities, especially among children. Type 2 diabetes is a metabolic disorder that affects a large population globally, with metabolic disorders. There have been several genes that are identified as causes of Dyslexia, and in recent studies, it has been found out that some of those genes are also involved in several metabolic pathways. For several years, it has been known that type 2 diabetes causes several neurodegenerative disorders, such as Alzheimer’s disease and Parkinson’s disease. Furthermore, in several studies, it was suggested that type 2 diabetes also has some associations with learning disabilities. This raises the question of whether “Is there a connection between type 2 diabetes and dyslexia?”. In this study, this question is elaborated by linking their developmental processes via bioinformatics analysis about these two diseases individually and collectively. Result The literature review for dyslexia and type two diabetes was completed. As the result of this literature review, the genes that are associated to type 2 diabetes and dyslexia were identified. The biological pathways of dyslexia, and dyslexia associated genes, type 2 diabetes, and type 2 diabetes associated genes were identified. The association of these genes, regarding to their association with pathways were analysed, and using STRING database the gene associations were analysed and identified. Conclusion The findings of this research included the interaction analysis via gene association, co-expression and protein–protein interaction. These findings clarified the interconnection between dyslexia and type 2 diabetes in molecular level and it will be the beginning of an answer regarding to the relationship between T2D and dyslexia. Finally, by improving the understanding this paper aims to open the way for the possible future approach to examine this hypothesis.

Association of CYP26C1 Promoter Hypomethylation with Small Vessel Occlusion in Korean Subjects

The risk factors for stroke, a fatal disease, include type two diabetes, hypertension, and genetic influences. Small vessel occlusion (SVO) can be affected by epigenetic alterations, but an association between SVO and the methylation of cytochrome P450 family 26 subfamily C member 1 (CYP26C1) has not been identified. In this study, we measured the level of DNA methylation in the CYP26C1 promoter and the 5′ untranslated region of 115 normal subjects and 56 patients with SVO in Korea. The DNA methylation level of each subject was measured by bisulfite amplicon sequencing, and statistical analysis was performed using the general linear model or Pearson’s correlation. The average level of DNA methylation was markedly lower in patients with SVO than in normal subjects (20.4% vs. 17.5%). We found that the methylation of CYP26C1 has a significant positive correlation with blood parameters including white blood cells, hematocrit, lactate dehydrogenase, and Na+ in subjects with SVO. We predicted that binding of RXR-α and RAR-β might be affected by CYP26C1 methylation at CpG sites −246–237 and −294–285. These findings suggest that CYP26C1 methylation in the promoter region may be a predictor of SVO.

Polycystic Ovarian Syndrome: Clinical Features, Genetics of Disease, and Diagnosis Criteria

Introduction: The polycystic ovary syndrome (PCOS) is a complex endocrine condition affecting 7-10% of women in reproductive age. PCOS is generally characterized by hirsutism, hyperandrogenism, and polycystic ovaries. Insulin resistance is the hallmark of PCOS with a considerable prevalence. Despite numerous studies, the etiology of PCOS haas not been cleared yet; PCOS is considered a multifactorial syndrome with a wide range of genetic, endocrine, molecular, and environmental abnormalities. Altered expression of several genes and miRNAs in PCOS patients has become a useful and non-invasive method in the characterization of PCOS in the last decades. On the other hand, altered secretion of sexual hormones like testosterone, progesterone, and estrogen can be a valid confirmation of PCOS. Several methods and drugs are used to treat PCOS like anti-androgens, insulin sensitizers, and bariatric surgery. Conclusion: Taken together, PCOS is a common abnormality among women and not only does affect fertility, but also influences different aspects of their life from anxiety to type two diabetes. Women, especially in third world countries should care about their lifestyle and diet, which has a vital role in the prevention of PCOS. New methods in the diagnosis of PCOS lead to declining the side effects of PCOS.