Relationship of Inflammatory Markers and Metabolic Syndrome in Postmenopausal Women

The increased deposition of visceral fat in the postmenopause period increases the production of inflammatory cytokines and the release of tumor necrosis factor- α (TNF-α), interleukin-6 (IL-6), and decrease in IL-10. This study investigated the relationship between inflammatory biomarkers and metabolic syndrome (MS) in postmenopausal women considering different diagnostic criteria. We conducted a cross-sectional observational study based on STROBE. Data were collected regarding the diagnostic criteria for MS (International Diabetes Federation; NCEP (International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III), and Harmonized criteria), body composition, comorbidities, time without menstruation, values of IL-6, IL-10, and TNF-α. ANOVA, Kruskal–Wallis, Levene tests, ROC, and odds ratio were performed to analyze the data. The results showed no significant difference between the methods and no interaction between the method and the presence of MS. However, for the values of WC, body fat percentage, TNF-α, and IL-10/TNF-α ratio, a significant effect of MS was observed. In subjects with MS, lower values of body fat percentage and TNF-α and higher values of the IL-10/TNF-α ratio were also observed. The higher IL-10/TNF-α ratio in the MS group is related to the greater anti-inflationary action of IL-10. The IL-10/TNF-α ratio showed significant accuracy to discriminate patients with MS according to the NCEP-ATP III criteria.

Identification of biomarkers related to metabolically unhealthy obesity in Korean obese adolescents: A cross-sectional study

BackgroundObesity is classified as metabolically unhealthy obesity (MUO) and metabolically healthy obesity (MHO). The current study aimed to screen for relationships and different potential metabolic biomarkers involved between MHO and MUO in adolescents.MethodsThe study included 148 obese adolescents aged between 14 and 16. The study participants were divided into MUO and MHO groups based on the age-specific adolescent metabolic syndrome (MetS) criteria of the International Diabetes Federation. The current study was conducted to investigate the clinical and metabolic differences (AbsoluteIDQ™ p180 kit) between adolescents in the MHO group and those in the MUO group. Multivariate analyses were conducted to investigate the metabolites as independent predictors for the odds ratio and the presence of the MetS in adolescents.ResultsThere were significant differences in the 3 acylcarnitines, 5 amino acids, glutamine/glutamate ratio, 3 biogenic amines, and 2 glycerophospholipids between the obese adolescents in the MUO group and those in the MHO group. Moreover, several metabolites were associated with the prevalence of MUO in adolescents. Additionally, several metabolites were inversely correlated with MHO in adolescents of the MUO group.ConclusionsWe observed that histidine, lysine, PCaaC34:1, and several clinical factors in adolescents of the MUO group were reverse correlated with the results in adolescents of the MHO group. In addition, the triglyceride-glucose index was related to MUO in adolescents, compared with the homeostasis model assessment of insulin resistance. Thus, the biomarkers found in this study have a potential to reflect the clinical outcomes of MUO in adolescents. These biomarkers will lead to a better understanding of MetS in obese adolescents.

Systematic review on diabetes mellitus and dental implants: an update

Purpose Dental implant surgery was developed to be the most suitable and comfortable instrument for dental and oral rehabilitation in the past decades, but with increasing numbers of inserted implants, complications are becoming more common. Diabetes mellitus as well as prediabetic conditions represent a common and increasing health problem (International Diabetes Federation in IDF Diabetes Atlas, International Diabetes Federation, Brussels, 2019) with extensive harmful effects on the entire organism [(Abiko and Selimovic in Bosnian J Basic Med Sci 10:186–191, 2010), (Khader et al., in J Diabetes Complicat 20:59–68, 2006, 10.1016/j.jdiacomp.2005.05.006)]. Hence, this study aimed to give an update on current literature on effects of prediabetes and diabetes mellitus on dental implant success. Methods A systematic literature research based on the PRISMA statement was conducted to answer the PICO question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?”. We included 40 clinical studies and 16 publications of aggregated literature in this systematic review. Results We conclude that patients with poorly controlled diabetes mellitus suffer more often from peri-implantitis, especially in the post-implantation time. Moreover, these patients show higher implant loss rates than healthy individuals in long term. Whereas, under controlled conditions success rates are similar. Perioperative anti-infective therapy, such as the supportive administration of antibiotics and chlorhexidine, is the standard nowadays as it seems to improve implant success. Only few studies regarding dental implants in patients with prediabetic conditions are available, indicating a possible negative effect on developing peri-implant diseases but no influence on implant survival. Conclusion Dental implant procedures represent a safe way of oral rehabilitation in patients with prediabetes or diabetes mellitus, as long as appropriate precautions can be adhered to. Accordingly, under controlled conditions there is still no contraindication for dental implant surgery in patients with diabetes mellitus or prediabetic conditions.

Epidemiology, diagnosis, and assessment of diabetes mellitus in the elderly population: a purposive review

The elderly population with diabetes mellitus is rapidly growing worldwide and has become a major social burden with significant impact on health and economics. This social category requires considerations that are not traditionally associated with diabetes mellitus management. Several epidemiological studies have shown that the prevalence of diabetes mellitus increases with advancing age. According to the recent International Diabetes Federation (IDF) published data, the number of people with diabetes mellitus among those 65 and over has reached 136 million (19.3%) with more frequent diabetes mellitus complications and co-morbidities compared to the young counterparts. Cardiovascular complications are the leading cause of death and the quality of life is strongly impacted by geriatric syndromes such as poor vision, dementia and functional dependence. The elderly diabetic population is classified into three categories; the robust, the fragile and the patient at the end of life. In practical terms, they can also be classified into two categories: the autonomous patients and the dependent patients, requiring support and assistance. Keywords: diabetes mellitus, elderly, epidemiology, geriatric syndromes, geriatric evaluation.

TATALAKSANA TERKINI INFEKSI KAKI DIABETES

Laporan dari International Diabetes Federation Tahun 2019 menyebutkan bahwa tingkat kejadian Diabetes Melitus (DM) meningkat setiap tahunnya dan diperkirakan sekitar 629 Juta orang di seluruh dunia menderita DM pada tahun 2045. Hal ini tentunya berdampak pada peningkatan dari komplikasi yang ditimbulkan oleh DM salah satunya adalah Diabetic Foot Infection (DFI) atau Infeksi Kaki Diabetes (IKD). IKD merupakan komplikasi lanjutan dari kaki diabetik yang ditandai oleh adanya proses invasi mikroorganisme yang berkembang di jaringan dalam seperti kulit, otot, tendon, sendi, tulang pada ekstremitas bawah, tepatnya di bawah malleoli. IKD dapat menimbulkan morbiditas dan mortalitas yang signifikan, termasuk kecacatan, mobilitas berkurang, penurunan kualitas hidup pada aspek fisik dan mental, serta ancaman kehilangan anggota tubuh oleh karena amputasi. Selain itu, penyakit ini juga dikaitkan dengan komplikasi DM lainnya seperti komplikasi neuropati perifer, Peripheral Arterial Disease (PAD), dan infeksi pada pasien DM. Dalam melakukan tatalaksana terhadap pasien DM dengan ataupun berisiko IKD, diperlukan perawatan lebih lanjut yang harus didasari dengan tingkat keparahan infeksi. Sebagian besar kasus IKD memiliki kecenderungan amputasi sehingga penting untuk dilakukan penatalaksanaan dan pencegahan secara komprehensif dengan melibatkan manajemen multidisiplin dengan ahli bedah (umum, vaskular, ortopedi), penyakit dalam, dan perawat luka, sehingga dapat mengurangi waktu penyembuhan luka, tingkat, dan keparahan amputasi.

Prediabetes Burden in Nigeria: A Systematic Review and Meta-Analysis

Prediabetes is a borderline glycemic status associated with both higher incidence of cardiovascular disease as well as higher risk of progression to diabetes. There is a rising burden of diabetes and prediabetes globally. This study aims to estimate the burden of prediabetes in Nigeria. Online searches of Google Scholar, PubMed, and Scopus were conducted and studies were selected based on predefined criteria. A total of 15 studies consisting of 14,206 individuals conducted between 2000 and 2019 were included in the meta-analysis with studies using American Diabetic Association (ADA) and World Health Organization (WHO) criteria pooled separately. The pooled prevalence of prediabetes in Nigeria was found to be 13.2% (95% CI: 5.6–23.2%, I2 = 98.4%) using the ADA criteria and 10.4% (95% CI: 4.3–18.9%, I2 = 99.2%) using the WHO criteria. According to the latest data by the United Nations, this translates to an estimated 15.8 and 12.5 million adult prediabetic individuals in Nigeria using the ADA and WHO criteria, respectively. The prevalence rates for women and men were similar at 12.1% (95% CI: 5–21%). The pooled prevalence rates for urban and rural settlements were also similar at 9% (95% CI: 2–22%). In conclusion, the prevalence of prediabetes in Nigeria was almost two times higher than the 7.3% estimate by the International Diabetes Federation in 2003. The similar rates of prediabetes between men and women and between urban and rural settlements points toward narrowing of cardiovascular risk burden between the two sexes and the two settlements. This represents higher future cardiovascular disease burden in the country further pressurizing the overstretched healthcare system.

Hubungan Lama Menderita Dengan Kejadian Neuropati Diabetikum Pada Pasien Diabetes Melitus

Organisasi Internasional Diabetes Federation (IDF) memperkirakan terdapat 463 juta orang pada usia 20-79 tahun di dunia menderita diabetes mellitus (DM) tahun 2019 atau setara dengan angka 9,3% dari total penduduk pada usia yang sama. Berdasarkan jenis kelamin, IDF memperkirakan prevalensi DM tahun 2019 yaitu 9% pada perempuan dan 9,65% pada laki-laki. Prevalensi diabetes meningkat seiring penambahan umur menjadi 19,9% atau 111,2 juta orang (umur 65-79 tahun). Angka diprediksi meningkat hingga 578 juta di tahun 2030 dan 700 juta di tahun 2045. Pusat Data dan Informasi PERSI (Perhimpunan Rumah Sakit Indonesia), prevalensi penderita DM dengan komplikasi neuropati sebesar lebih dari 50%. Tujuan untuk mengetahui hubungan lama menderita dengan kejadian neuropati diabetikum pada pasien diabetes melitus Metode secara deskriptif analitik dengan pendekatan cross sectional dan tehnik pengambilan sampel menggunakan purposive sampling sejumlah 84 responden/ pasien diabetes melitus tipe 1 dan tipe 2. Instrumen menggunakan kuesioner dan monofilament test dan data dianalisa dengan uji statistik chi-square. Hasil didapatkan 71 responden (84,5 %) yang lama menderita DM < 5 tahun, 46 responden (54,8%) mengalami neuropati diabetikum dan nilai Asymp Sig 0,942 (P-value = 0,005). Karena nilai 0,942 > 0,005, maka disimpulkan tidak ada hubungan yang signifikan antara lama menderita dengan kejadian neuropati diabetikum.Kata kunci : diabetes melitus; lama menderita; neuropati diabetikumThe Relationship Of Long Suffering With The Event Of Diabetic Neuropaty In Diabetes Mellitus PatientsAbstractThe International Diabetes Federation (IDF) estimates that there are 463 million people aged 20-79 years in the world suffering from diabetes mellitus (DM) in 2019, equivalent to 9.3% of the total population at the same age. Based on gender, IDF estimates that the prevalence of DM in 2019 is 9% in women and 9.65% in men. The prevalence of diabetes increases with increasing age to 19.9% or 111.2 million people (aged 65-79 years). The figure is predicted to increase to 578 million in 2030 and 700 million in 2045. According to the PERSI Data and Information Center (Indonesian Hospital Association), the prevalence of DM sufferers with neuropathic complications is more than 50%. The purpose of this study was to determine the relationship between length of stay and the incidence of diabetic neuropathy in patients with diabetes mellitus. Descriptive analytical method with a cross sectional approach and sampling technique used purposive sampling with a total of 84 respondents/patients with type 1 and type 2 diabetes mellitus. The instrument used a questionnaire and monofilament test and data. analyzed by chi-square statistical test. The results showed that 71 respondents (84.5%) had long suffered from DM < 5 years, 46 respondents (54.8%) had diabetic neuropathy and the Asymp Sig value was 0.942 (P-value = 0.005). Because the value is 0.942 > 0.005, it is concluded that there is no significant relationship between the length of suffering and the incidence of diabetic neuropathy.Keywords: diabetes mellitus; long suffering; diabetic neuropathy

Correction of eating habits in patients with carbohydrate metabolism disorders

The International Diabetes Federation estimates that approximately 10 % of the adult population in Ukraine has prediabetes. According to many studies, prediabetes is observed in every second obese patient, and later prediabetes can progress to type 2 diabetes mellitus. Therefore, timely detection of early disorders of carbohydrate metabolism is very important, as well as implementation of recommendations for lifestyle changes, the use of modern drugs to prevent type 2 diabetes and cardiovascular diseases. In recent years, increasing attention is drawn to dietary fibers as an integral part of a healthy diet. They help prevent obesity, metabolic syndrome and adverse changes in the gut, and also help increase the population of beneficial bacteria in the gut. That is why nutritionists recommend that obese people include dietary fibers in their diet. One of the most famous dietary fibers is psyllium, which comes from the husk of plantain seeds (Plantago ovata). Numerous studies show that psyllium has a positive effect on the functioning of many organs and systems, including the pancreas, intestines and heart muscle. Psyllium also lowers glucose and cholesterol and is an effective way to lose weight for people who are overweight. Fibolex® plant complex contains dietary fibers (psyllium and natural wheat fibers) and green tea extract. Due to the combined herbal composition, Fibolex® can be used in obese people, patients with prediabetes, metabolic syndrome, type 2 diabetes and other metabolic disorders for the correction of eating habits in order to improve carbohydrate and lipid metabolism.

Understanding Patients Experiences Living with Diabetes Mellitus: A Qualitative Study, Gujarat, India

Introduction: Diabetes mellitus is leading health problem in India. India is experiencing the burden of communicable disease as well as non-communicable disease. It is believed due to unhealthy life style and faulty food habits. The International Diabetes Federation estimated that 72.9 million adults in India were living with diabetes in last four years. The study overviews the different factors like personal, familial, social, and financial affecting the life style and management of the disease. Thus, diabetes mellitus affects all the dimensions of health of an individual. The aims of the study to assess quality of life and experiences faced by the patients who are suffering from diabetes mellitus and how the progressive stage of the diseases altered the all the dimensions. Objectives: To explore the lived in experiences of diabetes mellitus patients. To explore the various dimensions of the lived in experiences of diabetes mellitus patients. Materials and Methods: A qualitative, exploratory and descriptive design was used to explore and describe the experiences lived by participants suffering from diabetes in the selected areas of Kheda district Gujarat. The investigator used the phenomenological approach of the qualitative paradigm. The study conducted among 10 samples who are suffering from Diabetes Mellitus more than 07 years, sampling technique used was non-probability. Semi structured interview questions were used to conduct the detail history from the participants, where investigator has attain at least 6 to 8 sitting, (duration 30-45 Min.) with each participants. The investigator used local language for the interview and recorded in mobile, later all the recorded session has been verbatim according to the themes and sub-themes. Results: The study resulted in the extraction of six themes, which reflect the experiences of the study participants. The themes are: 1) lived time; 2) lived body; 3) lived relationship; 4) lived economical; 5) lived vocational and 6) lived spiritual. It was found that diabetes still causes participants to suffer from fear, depression and anxiety along with they hate to have modification in dietary pattern in which they cannot have sweets and sweet products. Although emotional support was provided by the family members and friends. Participant’s absence from work in their early diagnosis was due to both their health conditions and emotional embarrassment. There are evidences that diabetes has psychological damage to patient’s life and so they feel more anxious and fatigue. Conclusion: The study attempted to explore the lived in experiences of Diabetes Mellitus Patients and it was found that DM has affected all the dimensions of health especially in physical, psychological and economical dimensions. 1) In Physical dimension the patients were having common complaints of giddiness, weakness and headache which was leading them to certain problems. 2) In psychological dimension the patients were having more anxiety, fear regarding the disease and long term treatment along with depression. 3) In economical dimension some patients were having good family income so there were no issues related to expenses on diet and medication 4) In social dimension all the participants were having good relation with their everyone. 5) In vocational dimension all were having difficulty at work place to concentrate in their work but after starting the treatment their health was improved so later they continued their work properly. 6) In spiritual dimension only two participants were not having belief in God rest all were having faith in God and prayed daily.

INFLUÊNCIA DA DIABETES GESTACIONAL NO DESENVOLVIMENTO DO FETO

Introdução: O diabetes mellitus gestacional (DMG) é definido como qualquer grau de intolerância à glicose desencadeado durante a gravidez, sendo um problema comum na gravidez em que a hiperglicemia se desenvolve durante a gestação, podendo acarretar complicações para o gestante e para o feto. Objetivos: entender as principais complicações relacionadas a diabetes gestacional, elucidar a incidência da diabetes gestacional. Material e Métodos: Este estudo foi desenvolvido com o auxílio de uma revisão narrativa, que consiste em publicações amplas, apropriadas para descrever e discutir o desenvolvimento ou de um determinado assunto, sob ponto de vista teórico ou contextual. Foram realizadas pesquisas nas bases de dados BVS, PubMed, e Scielo. Foram utilizadas publicações entre os anos de 2005 até 2020, nas línguas Português e Inglês, incluindo no trabalho artigos e livros que abordavam o tema de forma pertinente. Resultados: Em estudos mais recentes do International Diabetes Federation (IDF), a DMG afeta 14% das grávidas de todo o mundo, representando 18 milhões anualmente. Mesmo sendo um problema comum pode acarretar vários problemas tanto para mãe quanto para o feto, como: parto prematuro, maior risco da mãe desenvolver diabetes tipo 2 pós-parto, predisposição de doenças cardiovasculares, crescimento excessivo do feto, podendo resultar em uma macrossomia, riscos de hipoglicemia nos bebês devido a dependência formada pela hiperglicemia materna, podendo contribuir com lesões na região cerebral caso não seja tratado. Alguns fatores que podem desencadear a DMG incluem sobrepeso, dieta desregulada com deficiência de micronutrientes, idade materna avançada e histórico familiar. Até então não são conhecidos tratamentos amplamente aceitos ou estratégia de prevenção que não sejam interferência no estilo de vida e eventualmente terapia com insulina. Conclusão: A diabetes gestacional é uma doença preocupante que pode acarretar problemas sérios caso não seja diagnosticada previamente, é de extrema importância o acompanhamento médico adequado para todas as gestantes, a fim de detectar a DMG previamente e garantir um tratamento de qualidade, reforçando assim uma segurança para a mãe e o feto. Com isso para que haja desenvolvimento de novos métodos para o tratamento da doença é de extrema importância o entendimento das principais complicações da diabetes gestacional.