Trends in Receipt of American Diabetes Association Guideline-Recommended Care Among U.S. Adults With Diabetes: NHANES 2005–2018

<b>Objective: </b>To characterize national trends and characteristics of adults with diabetes receiving American Diabetes Association (ADA) guideline-recommended care. <div><p><b>Research Design and Methods: </b>We performed serial cross-sectional analyses of 4,069 adults aged≥20 years with diabetes who participated in the 2005-2018 National Health and Nutrition and Examination Survey (NHANES)</p> <p><b>Results: </b>Overall, the proportion of US adults with diabetes receiving ADA guideline-recommended care (meeting all five criteria (self-report) in the past year: having a primary doctor for diabetes and number of visits for this doctor≥1; HbA1c testing; an eye exam; a foot exam; and cholesterol testing)<b> </b>increased from 25.0% in 2005-2006 to 34.1% in 2017-2018 (P-trend=0.004). For participants with age≥65 years, it increased from 29.3% in 2005-2006 to 44.2% in 2017-2018 (P-trend=0.001), whereas for participants with age 40-64 and 20-39 years, it did not change significantly during the same time period: 25.2% to 25.8% (P-trend=0.457) and 9.9% to 26.0% (P-trend=0.401), respectively. Those who were not receiving ADA guideline-recommended care were more likely to be younger, of lower socioeconomc status, uninsured, newly diagnosed with diabetes, not on diabetes medication, and free of hypercholesterolemia. </p> <p><b>Conclusions: </b>Receipt of ADA guideline-recommended care increased only among adults with diabetes aged ≥65 years in the past decade. In 2017-2018, only 1 out of 3 US adults with diabetes reported receiving ADA guideline-recommended care, with even a lower receipt of care among those<65 years of age. Efforts are needed to improve healthcare delivery and equity in diabetes care. Insurance status is an important modifiable determinant of receiving ADA guideline-recommended care. </p></div>

Trends in Receipt of American Diabetes Association Guideline-Recommended Care Among U.S. Adults With Diabetes: NHANES 2005–2018

<b>Objective: </b>To characterize national trends and characteristics of adults with diabetes receiving American Diabetes Association (ADA) guideline-recommended care. <div><p><b>Research Design and Methods: </b>We performed serial cross-sectional analyses of 4,069 adults aged≥20 years with diabetes who participated in the 2005-2018 National Health and Nutrition and Examination Survey (NHANES)</p> <p><b>Results: </b>Overall, the proportion of US adults with diabetes receiving ADA guideline-recommended care (meeting all five criteria (self-report) in the past year: having a primary doctor for diabetes and number of visits for this doctor≥1; HbA1c testing; an eye exam; a foot exam; and cholesterol testing)<b> </b>increased from 25.0% in 2005-2006 to 34.1% in 2017-2018 (P-trend=0.004). For participants with age≥65 years, it increased from 29.3% in 2005-2006 to 44.2% in 2017-2018 (P-trend=0.001), whereas for participants with age 40-64 and 20-39 years, it did not change significantly during the same time period: 25.2% to 25.8% (P-trend=0.457) and 9.9% to 26.0% (P-trend=0.401), respectively. Those who were not receiving ADA guideline-recommended care were more likely to be younger, of lower socioeconomc status, uninsured, newly diagnosed with diabetes, not on diabetes medication, and free of hypercholesterolemia. </p> <p><b>Conclusions: </b>Receipt of ADA guideline-recommended care increased only among adults with diabetes aged ≥65 years in the past decade. In 2017-2018, only 1 out of 3 US adults with diabetes reported receiving ADA guideline-recommended care, with even a lower receipt of care among those<65 years of age. Efforts are needed to improve healthcare delivery and equity in diabetes care. Insurance status is an important modifiable determinant of receiving ADA guideline-recommended care. </p></div>

SIRT1 promotes macrophage polarization to enhance efferocytosis by regulating TXNIP/NLRP3 inflammasome pathway

Objects: This study aimed to determine if SIRT1couldenhance efferocytosis and inhibit apoptosis by modulating cell polarization through the TXNIP/NLRP3 inflammasome pathway in murine peritoneal macrophages.Methods and Results: The effects of SIRT1in peritoneal macrophages were detected using adenovirus-mediated overexpression and knockdown of SIRT1. The apoptotic rate was determined by Annexin V/propidium iodide staining. LDLcholesterol levels were tested by Oil Red O staining and cholesterol testing. Efferocytosisof peritoneal macrophages was determined by fluorescence staining and macrophage markers were determined by flow cytometry, western blot, and ELISA.SIRT1 decreased cholesterol intake andthe apoptotic rate stimulated with ox-LDL in macrophages, which was consistent with upregulation of Bcl-2 and caspase-3 and downregulation of Bax and cleaved caspase-3. SIRT1 increased efferocytosis in macrophages. Expression levels of the M1 macrophage markers IL-6, TNF-α, iNOS, and CD16/32 were decreased, and levels of the M2 markers Dectin-1, IL-10, Arg-1, and CD206 were increased by SIRT1. Moreover, SIRT1 inhibited the ox-LDL stimulated increase in expression of TXNIP and NLRP3 proteins. The effects of SIRT1 were similar to those of TXNIP/NLRP3 inflammasome pathway inhibitor MCC950.Conclusions: These results indicated that SIRT1 exerted an anti-atherosclerosis effect by regulating macrophage polarization to enhance efferocytosis and inhibit apoptosis. Specifically, these effects were generated by downregulation of the TXNIP/NLRP3inflammasome pathway.

Microfluidic Point-of-Care Testing: Commercial Landscape and Future Directions

Point-of-care testing (POCT) allows physicians to detect and diagnose diseases at or near the patient site, faster than conventional lab-based testing. The importance of POCT is considerably amplified in the trying times of the COVID-19 pandemic. Numerous point-of-care tests and diagnostic devices are available in the market including, but not limited to, glucose monitoring, pregnancy and infertility testing, infectious disease testing, cholesterol testing and cardiac markers. Integrating microfluidics in POCT allows fluid manipulation and detection in a singular device with minimal sample requirements. This review presents an overview of two technologies - (a.) Lateral Flow Assay (LFA) and (b.) Nucleic Acid Amplification - upon which a large chunk of microfluidic POCT diagnostics is based, some of their applications, and commercially available products. Apart from this, we also delve into other microfluidic-based diagnostics that currently dominate the in-vitro diagnostic (IVD) market, current testing landscape for COVID-19 and prospects of microfluidics in next generation diagnostics.

CHOLESTEROL LOWERING EFFECT OF CHITOSAN NANOPARTICLES USING PARIJOTO FRUITS EXTRACT

Parijoto (Medinilla speciosa Reinw. ex Blum) fruit is known to have pharmacological activity as cholesterol lowering levels. Its activity needs to be increased with nanoparticle system so that the active substance can bind 100% to the action target. This study aims to determine the formation of nanoparticles from parijoto fruit (NEBP) and activity test as a decrease in cholesterol levels. The formation of nanoparticles used variations of concentration and volume of chitosan and NaTPP. Anti-cholesterol testing is based on the amount of free cholesterol in the sample that reacted with Lieberman-Burchard into complex green compounds. The best formation of NEBP was 0.2% chitosan, 0.1% NaTPP and volume ratio 5:1. The particle size showed an average size of 269.3 nm (10-1000 nm). The result of the percent transmittance and polydispersity index were 99,379 (close to 100%) and 0.378 (PDI <0.5). The functional group-specific of NEBP was –OH, N-H, PO3. The morphology was round and non-uniform particles. NEBP can decrease 50% cholesterol levels with a smaller EC50 value was 89.08 compared to the extract (EC50 259.98 ppm). Nanoparticles of parijoto fruit is a potential candidate for anti-cholesterol drug.

Use of Point Of Care Cholesterol Testing in Population Based Non-Communicable Disease Surveillance: Caveats and Challenges

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