Thyroid dysfunction in pregnancy can adversely impact maternal and fetal outcomes. However, the association between thyroid status and specific adverse outcomes needs clarity, especially in understudied regions. This prospective cohort study aimed to illuminate the multifaceted associations between maternal thyroid dysfunction and feto-maternal outcomes in Gujarat, India. This hospital-based cohort study recruited and monitored 500 euthyroid, 250 hypothyroid, and 150 hyperthyroid pregnant women until delivery. Maternal thyroid status was determined by serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels. Adverse fetal outcomes included preterm birth, neonatal intensive care unit (NICU) admission, respiratory issues, and low APGAR scores. Maternal outcomes included preeclampsia, haemorrhage, hypertension, postpartum thyroiditis, and thromboembolism. Relative risks quantified associations between thyroid dysfunction and outcomes. Compared to euthyroid women, hypothyroid women had a higher RR for preterm birth (RR 1.8, 95
Abstract Aims The ICMR INDIAB-17 study revealed a diabetes prevalence of 11.4% in India, emphasizing the need for effective treatment for glycemic control. A Phase IV study was conducted to evaluate the safety and efficacy of a Fixed Dose Combination (FDC) of Remogliflozin, Metformin and Vildagliptin (RMV) in Type 2 Diabetes Mellitus (T2DM) patients uncontrolled on Metformin plus SGLT2 inhibitor or Metformin plus DPP4 inhibitor dual therapy. Methods A total of 215 patients (mean age: 46.4 years; 64% male, 36% female) were enrolled across multiple centers in India. The study population included patients with a baseline HbA1c ≥ 8% at the time of screening. The primary objective was to assess safety based on treatment-emergent adverse events (TEAEs), while the secondary. aim was to evaluate effectiveness in terms of glycemic (HbA1c, fasting plasma glucose, postprandial glucose) and extra-glycemic measures (renal and lipid parameters). Statistical analysis was conducted using paired t-tests and the Wilcoxon signed-rank test for within-group comparisons, and the Bonferroni correction was applied to adjust for multiple comparisons. Effectiveness was evaluated at baseline, week 12, and week 24. Results The study demonstrated statistically significant reductions in mean HbA1c levels from baseline to both week 12 and week 24 (p < 0.00001). At 24, weeks, 45.1% of patients achieved target HbA1c levels of ≤ 7%. Significant reduction was also observed in fasting plasma glucose (FPG) and postprandial glucose (PPG) levels. Renal parameters remained stable or improved, and lipid profile parameters, including LDL-C and triglycerides, showed favorable changes. Adverse events of special interest, including hypoglycemia and urinary tract infections, were reported in 4.7% of patients, with no serious adverse event recorded. Conclusions The twice daily triple FDC of RMV was well tolerated, safe and effective in patients with Type 2 Diabetes Mellitus uncontrolled on dual drug therapy of Metformin plus SGLT2i or Metformin plus DPP4i. The treatment led to significant improvements in glycemic control and other metabolic parameters over 24 weeks, without compromising renal function or causing serious adverse events. Trial registration CTRI, CTRI/2022/05/042581. Registered 17 May 2022, https//ctri.nic.in/Clinicaltrials/rmaindet.php? trialid=68,757&EncHid=36127.16500&modid=1&compid=19.
This meta-analysis study aims to evaluate the Diabetes Self-Management Education and Support (DSMES) online application for reducing glycated hemoglobin levels among patients with type 1 diabetes mellitus (T1DM) patients. The Web of Science (WoS), Cochrane Library, PubMed, Scopus, PROSPERO, and EMBASE databases were searched with Medical Subject Headings (MeSH) terms without minimum time limitation until February 2024. To be eligible, all the following predefined inclusion criteria must have been met in the original randomized controlled trial (RCT) studies without language limitation including T1DM, patients, online digital interventions such as web-based, mobile health applications, or e-health, 3 or more months follow-up, and measuring HbA1c. Finally, 10 studies were conducted, 1195 T1DM patients were included in this study of which 421 (35.2
This study aimed to determine the prevalence of Normal Weight Obesity (NWO) and evaluate its association with cardiometabolic risk factors among patients with Type 2 Diabetes Mellitus (T2DM) in Gujarat, India. This cross-sectional study included 432 adults with T2DM attending a Non-Communicable Disease clinic. Anthropometric measurements, body composition analysis using bioelectrical impedance, and clinical parameters were assessed. NWO was defined as normal BMI (18.5–24.9 kg/m²) with high body fat percentage (≥ 25
Abstract Background The management of diabetic foot osteomyelitis (DFO) is complex. The targeted use of adjuvant local antibiotics, in the form of biocomposite bone void filler, in DFO, can enhance patient outcomes while minimising the adverse effects associated with systemic antibiotic therapy and its shortcomings. Methods We reviewed a series of 105 consecutive patients who underwent surgical management for diabetic foot osteomyelitis. In the NLAB group, (no adjuvant local antibiotic use), 49 patients, received the current standard of care treatment with no use of adjunctive local antibiotic therapy. In group LAB, (adjuvant use of local antibiotics), 56 patients received additional adjuvant local antibiotic therapy. Patient outcomes were compared between both groups. Results Infection healing was demonstrated in 10 (20.41%) patients from group NLAB and 41 (73.21%) from group LAB (p < 0.0001). Persistence of infection with no evidence of wound healing, 6 months from surgery, was observed in 15 (30.61%) patients in group NLAB. Among the LAB group, only 4 (7.14%) patients demonstrated infection persistence (p = 0.00183). Reinfection was observed in 24 of 49 patients in group NLAB (49%) and in only 11 out of 56 patients in group LAB (20%) (p = 0.001466). 7 (6.67%) patients required major amputation with 6 (12.24%) belonging to group NLAB. Only 1 (1.78%) patient in group LAB underwent major amputation. A higher 5-year mortality rate was noted within patients in group NLAB, 27 (55.1%). The mortality rate in group LAB was (12.5%). Conclusion The adjuvant use of antibiotic loaded bio-composite bone void filler locally was associated with increased infection clearance rates regarding diabetic foot osteomyelitis when compared with the standard care of treatment while achieving lower rates of infection persistence and recurrence. It also has the potential to reduce amputation and mortality rates with further research.
Abstract Background Metabolic-associated fatty liver disease (MAFLD) is a major public health problem worldwide. This study aimed to determine the prevalence of MAFLD and evaluate the diagnostic accuracy of the Fatty Liver Index (FLI) compared to ultrasonography for detecting fatty liver in adults attending a tertiary care hospital in Gujarat, India. Methods This cross-sectional study included 500 adults visiting the outpatient department between January 2023 and December 2023. MAFLD was diagnosed on ultrasound. FLI was calculated using body mass index, waist circumference, triglycerides, and gamma-glutamyl transpeptidase levels. FLI ≥ 60 indicated fatty liver. Logistic regression analysis identified factors associated with fatty liver. Results MAFLD prevalence was 32.2% on ultrasound. High FLI (≥ 60) was present in 26.2%. Male sex, higher BMI, waist circumference, night shift work, diabetes, and triglycerides were independent predictors of fatty liver. FLI showed excellent diagnostic accuracy with a sensitivity of 96%, specificity of 92.5%, and AUC of 0.92 for detecting fatty liver on ultrasound. Conclusion MAFLD prevalence among adults was high in this hospital-based sample. FLI can serve as an accurate non-invasive tool for identifying individuals with a high probability of MAFLD. These findings emphasize the need for larger population-based studies and the implementation of regular MAFLD screening programs in high-risk groups.
To evaluate the specular microscopy findings in patients with diabetes mellitus (DM) through a systematic review and meta-analysis. A systematic search with the appropriate keyword was done in the online databases including PubMed, Scopus, and Web of Sciences. The records were imported into EndNote software and duplicated records were removed. The title, abstract, and full text of the articles were evaluated carefully. STATA software also was used for all data analyses. The mean difference (MD) and 95
Diabetes distress “refers to the negative emotional or affective experiences resulting from the challenge of living with the demands of diabetes.” Despite recommendations to screen for distress at regular intervals, it usually remains undiagnosed. This study aimed to determine the prevalence of diabetes distress among adults living with diabetes, determine the factors associated with distress, the association between selfcare and distress, glycemic control and distress and compare the health-related quality of life among those with and without distress. This cross-sectional, community-based study was conducted in an urban colony in Delhi, India. The participants were selected using simple random sampling and included adults diagnosed with diabetes mellitus. The sample size calculated was 390. The questionnaire included the Diabetes Distress Scale 17, Diabetes Self-Management Questionnaire and Healthy Days measure. Factors associated with distress were tested using bivariate followed by multivariable logistic regression. Multivariable logistic regression was used to find the association between selfcare and distress and glycemic control and distress. Mean number of unhealthy days and health rating were compared between distressed and non-distressed diabetics using Wilcoxon rank sum test and chi square test respectively. A total of 412 adults were included in the study, of which 35.4
Abstract Background Type 2 diabetes mellitus (T2DM) is a major global non-communicable disease, leading to increased morbidity and mortality. Its prevalence in Nigeria is driven by various risk factors. This review assesses the national and regional prevalence and risk factors of T2DM in Nigeria. Methods Following PRISMA guidelines, electronic databases (PubMed, Scopus, Google Scholar, African Journals Online) and gray literature were searched for English-language studies. The quality of the included studies was assessed using the Newcastle–Ottawa Scale. Data were extracted with Microsoft Excel and analyzed using Stata version 16 software. Random effect meta-regression analysis at 95% CI was used to assess pooled prevalence and risk factors. Heterogeneity was determined using the I2 statistic, and publication bias was evaluated with a funnel plot. Results Sixty studies from different Nigerian geopolitical zones met eligibility criteria, with a total sample size of 124,876 participants and a mean age of 48 ± 9.8 years. The pooled prevalence of T2DM in Nigeria was 7.0% (95% CI: 5.0-9.0%). Moderate publication bias was observed. The South-south zone had the highest prevalence at 11.35% (95% CI: 4.52-20.72%), while the North-central zone had the lowest at 2.03% (95% CI: 1.09-3.40%). Significant risk factors included family history (9.73), high socioeconomic status (6.72), physical inactivity (5.92), urban living (4.79), BMI > 25/m2 (3.07), infrequent vegetable consumption (2.68), and abdominal obesity (1.81). Conclusion The prevalence of T2DM in Nigeria (7.0%) nearly doubled the 2019 International Diabetes Federation estimate (3.7%) and shows a 21.3% increase from the 2019 review. Efforts should focus on modifying identified risk factors to reduce prevalence and prevent complications.
Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern and the risk of its development is connected with the increasing prevalence of metabolic syndrome (MetS) which occurs as a result of some complex obesity-induced metabolic changes. It is a common chronic liver disease characterized by excessive fat accumulation in the liver, the tendency to progress to more severe forms, and a corresponding increase in morbidity and mortality. Thus, effectively addressing the rising burden of the disease requires a thorough understanding of its complex interrelationship with obesity and MetS. Main Body MASLD results from complex interactions involving obesity, insulin resistance, and dyslipidaemia, leading to hepatic lipid accumulation, and is influenced by several genetic and environmental factors such as diet and gut microbiota dysbiosis. It has extensive metabolic and non-metabolic implications, including links to MetS components like hyperglycaemia, hypertension, and dyslipidaemia, and progresses to significant liver damage and other extra-hepatic risks like cardiovascular disease and certain cancers. Diagnosis often relies on imaging and histology, with non-invasive methods preferred over liver biopsies. Emerging biomarkers and OMIC technologies offer improved diagnostic capabilities but face practical challenges. Advancements in artificial intelligence (AI), lifestyle interventions, and pharmacological treatments show promise, with future efforts focusing on precision medicine and novel diagnostic tools to improve patient outcome. Conclusion Understanding the pathogenic mechanisms underlying the development of MASLD within the context of metabolic syndrome (MetS) is essential for identifying potential therapeutic targets. Advancements in non-invasive diagnostic tools and novel pharmacological treatments, hold promise for improving the management of MASLD. Future research should focus on precision medicine and innovative therapies to effectively address the disease and its consequences.
Monacolin-K, the active component of red yeast rice (RYR), reduces cholesterol by inhibiting HMG-CoA reductase. Following safety concerns, the European Food Safety Authority (EFSA) recommended limiting Monacolin-K intake to less than 3 mg/day due to adverse effects at higher doses. : A study comparing Armolipid Plus® and LopiGLIK® found LopiGLIK® more effective in lowering LDL cholesterol, possibly due to slightly higher dosages of Berberine and Monacolin-K. Despite reducing Monacolin-K content to 2.99 mg following EFSA guidelines, LopiGLIK® maintained its cholesterol-lowering efficacy. Taken together, our results indicate that other ingredients, such as Morus alba, may contribute to LopiGLIK®’s enhanced effectiveness, challenging the notion that minor differences in Monacolin-K dosage account for the observed efficacy.
Propylthiouracil is an antithyroid medication that is associated with ANCA positivity, often in the absence of clinically overt vasculitis. Propylthiouracil-induced ANCA-associated vasculitis (AAV) is characterized by multiple antigenicity and presents similarly to other forms of drug-induced vasculitis. We report a case of a 49-year-old woman who developed propylthiouracil-induced AAV after 31 years of intermittent therapy. The patient presented with progressive respiratory and generalized symptoms. She was diagnosed with propylthiouracil-induced AAV with alveolar hemorrhage based on detection of ANCA and anti-MPO antibodies, exclusion of primary vasculitis, and symptom resolution following propylthiouracil withdrawal. The patient was treated with intravenous methylprednisolone, followed by oral prednisolone. Her symptoms resolved, and her laboratory and radiological tests improved within one week. Research linking the duration of propylthiouracil use to the development of vasculitis is restricted by multiple methodological limitations. Maintaining a high index of clinical suspicion is a more reliable approach to detecting propylthiouracil-induced AAV than regular laboratory monitoring, given that patients with Graves’ disease may show ANCA positivity in the absence of medication use. Therefore, clinicians should remain vigilant for the varied presentations of propylthiouracil-induced AAV. Moreover, further research is recommended to investigate the possible link between the duration of PTU use and the onset of clinically overt vasculitis.
Abstract Background Type 2 diabetes mellitus (T2DM) is a multifaceted metabolic disorder. Over the past decade, the potential role of Growth Hormone (GH) and Insulin-like Growth Factor-1 (IGF-1) in the pathogenesis and progression of T2DM has garnered scientific interest. These hormones, while interrelated, exert differential effects on glucose homeostasis; GH elevates blood glucose levels, whereas IGF-1 sustains insulin secretion and augments insulin sensitivity. Objective The study aimed to investigate the impact of insulin resistance and glycaemic control on IGF-1 levels and to assess other risk factors influencing IGF-1 in T2DM. Methods A cross-sectional study was conducted at the National Diabetes Centre, Baghdad, Iraq, from May 2020 to May 2021. Sixty patients with T2DM were evaluated for fasting plasma glucose (FPG), GH, IGF-1, HbA1c, HOMA-IR, HOMA-B, and anthropometric measures following a comprehensive history and physical examination, focusing on any variables that could influence their metabolic profile. Patients with Type 1 diabetes mellitus, thyroid disease, pituitary disease, chronic kidney disease, hepatic disease, and pregnancy were excluded from the study. Results Patients with poorly controlled diabetes (HbA1c > 8) exhibited significantly elevated IGF-1 levels compared to those with HbA1c < 8 (166 vs. 134, P = 0.016). The mean IGF-1 was significantly lower in patients with insulin resistance (IR) compared to those without IR (143 vs. 192, P = 0.001), with a significant negative correlation with Body Mass Index (BMI) and a significant positive correlation with HbA1c and Quantitative Insulin Sensitivity Index (QUICKI). Elevated IGF-1 levels were observed with increasing age, duration of T2DM, higher HbA1c, higher QUICKI, and lower BMI. No significant difference was found in IGF-1 values with regards to HOMA-B, fasting insulin, and waist-hip ratio. Conclusion Patients with poorly controlled T2DM exhibit higher IGF-1 levels, while those with obesity and high insulin resistance demonstrate lower IGF-1 levels. Further prospective studies are warranted to evaluate the potential of using IGF-1 to reduce insulin resistance and improve metabolic and glycaemic measures in individuals with T2DM and obesity or insulin resistance.
Abstract Background We present one of only seven reported cases of a catecholamine-secreting adrenal neuroblastoma in an adult. The case is used as a platform to discuss key biochemical, genomic and imaging considerations that are central to the successful, targeted management of catecholamine-secreting adrenal tumours. Case presentation A 63-year-old male was urgently reviewed at a tertiary hospital endocrinology outpatient clinic for a 12 cm right-sided adrenal incidentaloma. Plasma normetanephrine and 3-methoxytyramine levels were approximately 10 times the upper limit of normal at 9272 pmol/L (< 900) and 1023 pmol/L (< 110), respectively. The adrenal mass appeared to be inseparable from the liver on imaging, and thus was suspected to be an invasive malignant phaeochromocytoma. FDG positron emission tomography (PET)/CT demonstrated moderate to intense metabolic activity within the right adrenal mass. [68 Ga]Ga-DOTATATE (Ga-TATE) PET-CT demonstrated patchy, heterogenous somatostatin receptor (SSTR) expression in the adrenal lesion, at most Krenning 3 (intensity above liver). The patient underwent a right adrenalectomy and segment 6/7 liver resection. Histopathology revealed a 130 mm diameter neuroblastoma of the differentiating subtype with a low Mitosis-Karyorrhexis Index. There was lymphovascular invasion and tumour focally present at the resection margin, but no tumour in one periadrenal lymph node, and no tumour invasion in the adherent liver. Immunohistochemistry revealed ALK positivity (+ 3) and wild type ATRX. At nine months following adrenalectomy, the plasma normetanephrine level has reduced to 991 pmol/L (< 900). Post-operative GaTate PET/CT shows no definite abnormal SSTR-expressing lesions in the surgical bed or elsewhere. The patient has completed adjuvant radiotherapy and is a candidate for ALK-targeted therapy if required for recurrence in the future. Conclusions Neuroblastomas may be misdiagnosed as phaeochromocytomas given the ability to secrete catecholamines and similarities in radiological appearance. Differentiating neuroblastomas from phaeochromocytomas and paragangliomas (PPGL) is critical, but clinically difficult. Genomics are central for management; diagnosing ALK-positive neuroblastoma triggers consideration of ALK-targeted therapy, which is not relevant for PPGL. A critical eye is required for the accurate diagnosis and management of malignant adrenal incidentalomas.
Abstract Background Osteomyelitis of the diabetic foot is a common and challenging complication affecting patients with diabetic foot ulcers and infections. The complexity of these infections lies in their polymicrobial nature, high rates of persistence and recurrence. This study examined the microbiological profile of diabetic foot osteomyelitis from a teaching hospital in Northwest England and their resistance patterns to understand its impact on infection persistence and to direct effective treatment. Methods A retrospective review of 105 patients who underwent surgical management for diabetic foot osteomyelitis between 2019 and 2024. We analysed three consecutive culture samples for each patient to assess for the microbiological profile and resistance patterns of these infections and to monitor infection recurrence and persistence rates. Results A total of 105 patients were identified. Infection eradication was noted in 42% of the cohort, infection persistence in 18%, and late infection recurrence in 40%. Polymicrobial growth was evident in 72% of our study sample. Gram-positive bacteria made up the majority of the bacterial isolates in all 3 culture samples, 74.81% in sample 1, 69.31% in sample 2, and 55.1% in sample 3. Staphylococcus aureus was the most prevalent gram-positive bacteria, at 52.38% in sample 1, 36.19% in sample 2, and 18.09% in sample 3, followed by Haemolytic Streptococcus, Enterococcus and Corynebacterium. The frequently identified gram-negative bacteria were Pseudomonas in sample 1 (7.61%), E. coli and Proteus in sample 2 (5,71%), Pseudomonas and Proteus in sample 3 (2.85%). Gram-positive bacteria were resistant to penicillin and macrolides with resistance of staphylococcus aureus to clarithromycin identified among all 3 culture samples. Gram-negative bacteria were most resistant to amoxicillin. Staphylococcus aureus was responsible for infection persistence in most of our cohort (12/19) 63.15%. Among those patients, Staphylococcus was resistant to clarithromycin in 6 of the cases. The 5-year mortality rate for our study sample was 32.38%. Conclusion This study highlights the prevalence of polymicrobial growth and multi-drug resistant pathogens in the scope of diabetic foot osteomyelitis. It highlights the predominance of Staphylococcus aureus and its resistant strains among patients affected by diabetic foot osteomyelitis in Greater Manchester.
Abstract Introduction Sarcopenia is defined by low measures of muscle quantity, quality and reduced physical performance. It is associated with higher levels of frailty. Individuals with diabetes mellitus (DM) undergo sarcopenia at an accelerated rate resulting in structural changes potentially culminating in limb loss. Aims To review the evidence on methods of detecting and measuring sarcopenic changes on magnetic resonance imaging (MRI) in the foot in patients with diabetes. Methods A literature review was conducted in accordance with PRISMA guidelines. We searched Embase and Medline (via Ovid), CINAHL (via Ebsco Host), Web of Science and Scopus as well as the grey literature. The MeSH terms “sarcopenia” AND “diabetes mellitus” AND “magnetic resonance imaging” were employed in the primary search string. Results 874 studies were identified. 404 articles were excluded in the title and abstract screening. 33 studies were assessed for eligibility after abstract and title screening was completed by two reviewers. 7 studies evaluating sarcopenia in the foot were included in the final review. Conclusion Sarcopenic changes are evident on MRI of the foot in patients with diabetes and is profound in patients with diabetic neuropathy. The general extent and severity of sarcopenia seems to correlate with clinical scores to assess neuropathy and is implicated in the development of diabetic foot disease.
Abstract Background Effective diabetic retinopathy screening (DRS) programmes are important in preventing vision impairment and blindness caused by diabetes. This study focuses on identifying the factors affecting attendance or non-adherence to DRS among children and young adults with diabetes mellitus (DM) in Bangladesh. Methods A mixed-methods approach was used, which included patients diagnosed with DM aged 12–26 years from Bangladesh who were registered at BIRDEM Women and Children hospital in Dhaka. Data collection occurred between July 2019 and July 2020, mainly through telephone and email due to restrictions imposed by the COVID-19 pandemic. Statistical analyses, including chi-squared tests, t-tests, and logistic regression, were used to assess the demographic and clinical factors influencing attendance at DRS. Results The study reported a high 88% attendance rate for DRS among children and young adults in Bangladesh. However, some barriers to attendance were identified. Children under 15 years of age showed a higher tendency to attend their last DRS appointment when compared to older age participants (16–26 years), P < 0.05. Male participants demonstrated a lower likelihood of attending their DRS appointments than females (OR 0.29, CI: 0.17 to 0.50), P < 0.001. Additionally, participants with higher HbA1c levels (mean 9.1%, IQR 2.5) attended their last DRS appointment compared to those with lower levels (mean 8.0%) (p < 0.05). The primary barriers leading to missed DRS appointments were distance to the hospital (15, 31.9%), financial limitations (19, 40.4%), and busy schedules (14, 29.8%). Conclusions Compliance with DRS was high in this setting especially among younger patients, females, and those with higher HbA1c levels, highlighting the effectiveness of current DRS initiatives in Bangladesh. Addressing barriers such as cost, service accessibility and transportation could improve attendance rates further, and strategies such as flexible scheduling, transport subsidies, telemedicine, and use of artificial intelligence may help overcome these challenges.
Abstract Background Constipation, which affects 16% of adults worldwide, is a chronic health problem characterized by unsatisfactory frequency of bowel movements, causing pain, bloating or incomplete bowel movements. The study aims to assess the magnitude of chronic constipation and associated factors among T2DM patients attending the endocrinology outpatient clinic at Hiwot Fana Comprehensive Specialized University Hospital from January 1 to May 30, 2023. Methods Hospital-based cross-sectional study design was carried out to assess the magnitude and associated factors of chronic constipation among T2DM patients at Hiwot Fana Comprehensive Specialized University Hospital. Using a single population formula 300 T2DM patients were enrolled in this study. The data was analyzed by using the Epi-Data 4.6 and SPSS version 25. Descriptive, bivariate, multivariate, and logistic regression were used. P < 0.05 was used to declare association. Results 300 T2DM patients participated in this survey. Of these 137 (45.7%) were male and 163 (54.3%) were female and the mean age was 58.57 ± 11.09 SD years, the range from 35 to 85 years. The prevalence of constipation was 73 (24.3%) (95% CI: 0.196–0.296). Education status above high school (AOR: 0.151.95% CI: 0.032–0.718), less than 7 h of sleep per day (AOR: 12.39.95% CI: 2.712–56.69), frequent depression (AOR: 6, 84, 95% CI: 2.639–17.743), parents with constipation (AOR: 6.843.95% CI: 2.639–17.743), daily water intake < 1300 ml (AOR: 4.760.95% CI: 1.146–19.773), TAG levels below 150 mg/dl (AOR: 0.050, 95% CI: 0.015–0.166), HbAlc between 6 and 7% (AOR: 0.013.95% CI: 0.001–0.132) ,HbAlc between 7.1 and 8% (AOR: 0.006, 95% CI: 0.001–0.067), and LDL levels were significantly associated with chronic constipation in T2DM patients. Conclusions The prevalence of chronic constipation was considerable in T2DM patients. Education level above high school, less than 7 h of sleep per day, frequent depression, parents with constipation, daily water intake < 1300 ml, TAG and HbAlc play a significant role in the development of chronic constipation in T2DM patients. T2DM patients can reduce the extent of constipation by treating the above problem in a timely and timely manner.
Abstract Background There are scant data relating to prognostic biomarkers for chronic kidney disease (CKD) complicating type 1 diabetes. The aim of this study was to assess the performance of the plasma protein biomarker-based PromarkerD test developed and validated for predicting renal decline in type 2 diabetes in the context of type 1 diabetes. Methods The baseline PromarkerD test score was determined in 91 community-based individuals (mean age 46.2 years, 56.5% males) with confirmed type 1 diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II. The performance of the PromarkerD test in predicting the risk of incident CKD (estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 in people without CKD at baseline) or an eGFR decline of ≥ 30% over the next four years was determined. The score can range from 0 to 100%, and is categorized as representing low (< 10%), moderate (10% to < 20%) or high (≥ 20%) risk. Results The area under the receiver operating characteristic curve was 0.93 (95% confidence interval 0.87–0.99) for the composite renal endpoint, indicating strong predictive accuracy. The positive and negative predictive values at moderate (10% to < 20%) and high (≥ 20%) risk PromarkerD cut-offs were 46.7–50.0% and ≥ 92.0%, respectively. Conclusions These preliminary data suggest that PromarkerD is at least as good a prognostic test for renal decline in type 1 as type 2 diabetes.
Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age, characterised by its multifactorial nature and intricate interplay of genetic, hormonal, and environmental factors. As the search for reliable biomarkers intensifies, serum kisspeptin emerges as a promising candidate due to its central role in regulating the hypothalamic-pituitary-gonadal (HPG) axis. This review aims to consolidate the evolving understanding of kisspeptin as a potential PCOS biomarker, comprehensively exploring its physiological basis, diagnostic challenges in PCOS, and clinical implications. Diagnostic challenges in PCOS are addressed, underscoring the limitations of current criteria and the need for objective and standardised biomarkers. Kisspeptin’s introduction as a potential biomarker brings forth both promises and challenges in terms of its diagnostic utility. The review recognises the importance of standardisation in research methodologies and emphasises the exploration of genetic polymorphisms to enhance kisspeptin’s robustness as a diagnostic tool.
