Predictors of Obesity among Type 2 Diabetes Mellitus Patients Attending a Tertiary Care Center of Province 1, Nepal

Background: Obesity and Diabetes Mellitus type 2 have a known association. Yet, the socio-demographic predictors of obesity in special populations like ours (Asian) who have DM remain unclear. The purpose of this study was to determine the socio-demographic predictors of obesity among newly diagnosed Diabetes Mellitus in adults. Materials and Methods: This was a descriptive cross-sectional study conducted in endocrine OPD of Nobel medical college. Total 124 subjects were enrolled who were newly diagnosed Diabetes Mellitus over a period of 1 year. Detailed history was taken for demographic and clinical variables. Height, weight, waist circumference and blood pressure were measured. Besides, Body Mass Index, the dependent variable, was calculated. Subjects were considered to have diabetes based on their fasting and postprandial blood sugar level for the first time. Results: The prevalence of obesity among the study population was 39.5%, overweight was 45.2%. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development. Conclusion: Obesity is a important risk factor for Diabetes Mellitus and higher prevalence of obesity among type 2 diabetes was observed. Predictors for this study for obesity were found as abnormal blood pressure and hospital visit after symptoms development

Case Report: Rhino-orbital Mucormycosis Related to COVID-19: A Case Series Exploring Risk Factors

There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk.

Acute aortic thrombosis in a patient with SARS-CoV-2 coronavirus disease (COVID-19)

One of the rare and life-threatening conditions is acute aortic thrombosis. We have described a case of thrombosis of the aorta and iliac arteries in a patient against the background of viral pneumonia COVID-19, with newly diagnosed diabetes mellitus and arterial hypertension.

Impaired fasting glucose: a risk factor for atrial fibrillation and heart failure

Background Dysglycaemia is associated with overall cardiovascular disease even at prediabetes levels. The aim of this study was to explore the association between glucose levels and future risk of developing atrial fibrillation and heart failure, respectively. Methods In this prospective cohort study subjects from the Swedish AMORIS-cohort with fasting glucose from health examinations 1985–1996 without previous cardiovascular disease (N = 294,057) were followed to 31 December 2011 for incident atrial fibrillation or heart failure. Cox proportional hazard models with attained age as timescale and adjustments for sex, cholesterol, triglycerides, and socioeconomic status were used to estimate hazard ratios by glucose categorized groups (normal glucose 3.9–6.0 mmol/L, impaired fasting glucose; 6.1–6.9 mmol/L, undiagnosed diabetes ≥ 7.0 mmol/L, and diagnosed diabetes). Results During a mean follow-up time of 19.1 years 28,233 individuals developed atrial fibrillation and 25,604 developed heart failure. The HR for atrial fibrillation was 1.19 (95% confidence interval 1.13–1.26) for impaired fasting glucose, 1.23 (1.15–1.32) for undiagnosed diabetes and 1.30 (1.21–1.41) for diagnosed diabetes. Corresponding figures for heart failure were; 1.40 (1.33–1.48), 2.11 (1.99–2.23), 2.22 (2.08–2.36) respectively. In a subset with BMI data (19%), these associations were attenuated and for atrial fibrillation only remained statistically significant among subjects with diagnosed diabetes (HR 1.25; 1.02–1.53). Conclusions Fasting glucose at prediabetes levels is associated with development of atrial fibrillation and heart failure. To some extent increased BMI may drive this association.

Association between antibiotics use and diabetes incidence in a nationally representative retrospective cohort among Koreans

Numerous studies have reported that antibiotics could lead to diabetes, even after adjusting for confounding variables. This study aimed to determine the causal relationship between antibiotics use and diabetes in a nationally representative cohort. This retrospective cohort study included adults aged 40 years or older who were enrolled in the Korean National Health Insurance Service-Health Screening Cohort. Antibiotic exposure was assessed from 2002 to 2005 and newly diagnosed diabetes mellitus was determined based on diagnostic codes and history of antidiabetic medication use from 2006 to 2015. Multivariate Cox proportional hazards model was used to assess the association between antibiotic use and diabetes incidence. The mean age of the 201,459 study subjects was 53.2 years. People who used antibiotics for 90 or more days had a higher risk of diabetes (adjusted hazard ratio [aHR] 1.16, 95% confidence interval [CI] 1.07–1.26) compared to non-users. Those who used five or more classes of antibiotics had a higher risk of diabetes than those who used one antibiotic class (aHR 1.14; 95% CI 1.06–1.23). The clear dose-dependent association between antibiotics and diabetes incidence supports the judicious use of antibiotics in the future.