Accuracy and precision of non-invasive continuous haemoglobin concentration monitoring in diabetic patients

Background Accuracy and precision of non-invasive continuous haemoglobin concentration (SpHb) provided by Masimo device in diabetic patients is poorly studied. This retrospective analysis aimed to provide data on SpHb accuracy and precision in diabetic patients. Results The sample size population consisted of 14 patients, with 56 SpHb/Lab data pairs. Lab value showed a mean ± standard deviation (SD) of 13.2 ± 1.2 g/dL, whilst SpHb showed a mean ± SD of 11.8 ± 1.1 g/dL. Linear regression analysis between Lab/SpHb data pairs showed a r of 0.8960 (CI95% 0.8281-0.9379, p value < 0.0001). SpHb underestimated the real Hb values provided by Lab. Bland-Altman analysis showed that SpHb accuracy was −1.37 g/dL (CI95% −1.51 to −1.22 g/dL, p value < 0.0001), precision of 0.55 g/dL, lower LOA −2.45 g/dL (CI95% −2.71 to −2.20 g/dL) and upper LOA −0.28 g/dL (CI95% −0.53 to −0.02 g/dL). Conclusions For the first time, we provided data on SpHb accuracy and precision in the diabetic population. SpHb showed a high correlation coefficient when compared with Lab values, but the wide LOA limits its accuracy.

Novel Targets and Interventions for Cognitive Complications of Diabetes

Diabetes and cognitive dysfunction, ranging from mild cognitive impairment to dementia, often coexist in individuals over 65 years of age. Vascular contributions to cognitive impairment/dementia (VCID) are the second leading cause of dementias under the umbrella of Alzheimer’s disease and related dementias (ADRD). Over half of dementia patients have VCID either as a single pathology or a mixed dementia with AD. While the prevalence of type 2 diabetes in individuals with dementia can be as high as 39% and diabetes increases the risk of cerebrovascular disease and stroke, VCID remains to be one of the less understood and less studied complications of diabetes. We have identified cerebrovascular dysfunction and compromised endothelial integrity leading to decreased cerebral blood flow and iron deposition into the brain, respectively, as targets for intervention for the prevention of VCID in diabetes. This review will focus on targeted therapies that improve endothelial function or remove iron without systemic effects, such as agents delivered intranasally, that may result in actionable and disease-modifying novel treatments in the high-risk diabetic population.

The Association Between Diabetes Mellitus and Risk of Sarcopenia: Accumulated Evidences From Observational Studies

AimWe performed a meta-analysis of observational studies to evaluate the association between the presence of sarcopenia and HbA1c, prediabetes, diabetes and diabetic complications.MethodThe PubMed, Embase, Cochrane and Web of Science databases were searched from inception to May 2021. We included full-text English language articles that reported the prevalence of sarcopenia in patients with and without diabetes. Quality assessment was performed according to the Newcastle- Ottawa scale for observational studies.ResultsSixteen studies were included in the meta-analysis. Three studies showed that high HbA1c levels lead to loss of muscle mass, and one study involving prediabetes showed that people with prediabetes had lower muscle mass, strength, and performance than non-diabetic population. Seven studies showed that people with diabetes had a higher risk of sarcopenia than those without diabetes (combined OR: 2.09, 95% CI:1.62-2.70). The remaining five studies suggested that diabetic complications increased the risk of sarcopenia (combined OR: 2.09,95% CI:1.62-2.70).ConclusionHigh HbA1c levels, prediabetes, diabetes and diabetes complications were associated with an increased risk of sarcopenia. Therapeutic strategies addressed to avoid the conversion of IGT to diabetes and to optimize glycemic control are warranted to prevent or arrest sarcopenia in the diabetic population

Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020

(1) Background: In this work, we aim to describe influenza vaccine uptake among the diabetic population in Spain to assess the time trend from 2011 to 2020 and identify predictors of vaccine uptake among diabetes patients. (2) Methods: We conducted a descriptive cross-sectional study using the European Health Interview Survey for Spain (2014 and 2020) and the Spanish National Health Surveys (2011 and 2017). The independent variables analysed included socio-demographic characteristics, health-related variables and lifestyle variables. We matched each participant with diabetes with a non-diabetic participant based on age, sex, place of residence and year of survey. (3) Results: The overall coverage among diabetic adults was 52.1% compared to 40.6% for matched participants without diabetes (p < 0.01). The vaccine uptake among adults with diabetes was 52.6% in 2011, 54.38% in 2014 and 53.4% in 2017. The adjusted OR of having been vaccinated in 2020, with respect to 2011, was not significant at 0.87 (95% CI: 0.72–1.06). Factors such as being male, higher age, being affected by respiratory disease or cancer and being physically active were identified as positive predictors for influenza vaccination uptake, while smoking was a negative predictor. (4) Conclusions: The influenza vaccine uptake is below desirable levels among the adult diabetic population in Spain and has not improved from 2011 to 2020. More efforts should be made to increase influenza vaccine uptake in this high-risk group, especially for women, those aged 18–64 years, without other high-risk conditions and smokers.

A Review of Lactoferrin Inflammatory Role in Type 2 Diabetes Mellitus with Neutrophil Dysfunction

Lactoferrin (LF) is a protein that plays important roles in many diseases including diabetes mellitus (DM). DM is one of the most challenging health concerns of the 21st century. At least 30% of the diabetic population is undiagnosed at any one time, so effective and early diagnosis is of critical concern. Several of the body’s chemicals, such as enzymes, electrolytes, and proteins, have been used as biomarkers in the diagnosis of diabetic diseases. Detection of LF is considered an important sign of type 2 diabetes (T2DM), due to its activity as an anti-inflammatory agent and in the down-regulation of pro-inflammation. LF is produced by glandular epithelial cells and neutrophils, and a decrease in its concentration is linked with the dysfunction of neutrophils in many diseases. Neutrophils are the first line of defence against pathogens that invade the human body during inflammation. Therefore, the health of neutrophils can be employed as a biomarker in the diagnosis of diseases such as diabetes. A decrease in LF concentrations in T2DM could result in increased levels of inflammatory markers that are associated with the inflammation activity. Increased understanding of the link between LF concentration and development of T2DM should improve early diagnosis and treatment outcomes. LF is identified through use of various techniques such as immunoassay, proteomics, and spectrometry. The aim of this review is to summarise each pathway and some of the most relevant LF biomarkers that may be used to monitor the development or progression of diabetes and its complications, and the link between levels of LF and neutrophil dysfunction in T2DM. Moreover, the objective of this review is to show the most common LF analysis that may be useful in the clinical diagnosis of T2DM and discuss to what extent this analysis method can be a tool for prognostic and diagnostic work.

Diabetic COVID -19 Patients are prone to Respiratory Distress Syndrome as compared to Non-Diabetic COVID -19 Patients.

Background: COVID-19 is the alarming problem for all over the world due to its fast spread infection mode and uncertainty in mortality rate. The diabetic population is prone for comorbidity with COVID-19 due to injurious fashion develops in respiratory system. Aim: To compare the serum Lactate dehydrogenase levels in diabetic patients with COVID-19 & non diabetic patients with COVID-19. Methodology: This comparative study was done at Ali medical center Hala New District Matiari Sindh. 42 diabetic & non diabetic clinically suspected cases COVID -19 with fever, cough, shortness of breath, non-pneumonic opacities on digital X.ray with raised TLC, ESR & CRP. The data analyzed for significance on SPSS 19 by applying student t test. Results: The serum LDH levels was significantly raised (p<0.001) in group A contained COVID-19 patients with diabetes as compared to COVID-19 patients with no diabetes mellitus. Conclusion: COVID -19 diabetic population will be more prone to develop the respiratory complications. Keywords: COVID-19, Serum LDH, Diabetes Mellitus, Respiratory Distress Syndrome.