Endocrinology, Diabetes, and Metabolism Commons^™

Assessing Medication Compliance And The Usage Of Complementary Therapies Effecting Hba1c Among Patients With Type 2 Diabetes Mellitus In A Tertiary Care Hospital In Karachi, Pakistan, Neelam Nasruddin

Theses & Dissertations

Background: Diabetes Mellitus is a chronic illness. It remains to be a major public health matter and a financial burden on the medical system worldwide. This condition can be managed and better treatment strategies and compliance can reduce the risk of complications. In 2022, there will be around 33,000,000 new cases of diabetes worldwide, with 26.7% of the adults in Pakistan being affected, predicts the (International Diabetes Federation, 2022). However, it is observed that most individuals turn to complementary and alternative methods (CAM)/Traditional medicine because of the rising cost of therapy, adverse effects of anti-diabetic medications, and accessibility concerns.
Purpose: …

Utility Of Bariatric Surgery In The Remission Of Type 2 Diabetes Mellitus, Christine Ercoline, Alyssa Bower, Corinne Singh

Physician Assistant Capstones, 2020-current

Objective: Assess whether bariatric surgery is more effective than lifestyle modification and medication in the long-term reduction of hemoglobin A1c (HbA1c) and fasting plasma glucose among obese adults with type 2 diabetes mellitus. Design: Systematic literature review. Methods: A PubMed search was performed utilizing the terms bariatric surgery, type 2 diabetes and remission. In PubMed the following limits and terms were used: published in the last 10 years, humans, full text, clinical trial, randomized control trial, and English. Results: An analysis of three randomized control trials (RCTs) supports bariatric surgery as a modality to induce the remission of type 2 …

Decreasing Surgical Complications In Diabetic Patients, Bandana Mahato

DNP Qualifying Manuscripts

Executive Summary

Objective: This manuscript aims to determine if controlling diabetes prior to undergoing low back surgery could decrease complications and disability.

Contexts: Despite the overwhelming information on the complications of uncontrolled diabetes, patients continue to have elevated HgA1C before having surgery. Furthermore, there is a plethora of data showing uncontrolled diabetic patients will have higher complications after surgery, yet patients continue to have elective surgery despite having unchecked diabetes. There are no clear guidelines for primary care providers or surgeons on when they should allow patients to have elective surgery. Therefore, it is vital that HgA1c needs to be …

Covid-19 Breakthrough Infections In Type 1 Diabetes Mellitus: A Cross-Sectional Study By The Covid-19 Vaccination In Autoimmune Diseases (Covad) Group, Suhrud Panchawagh, Naveen Ravichandran, Bhupen Barman, Arvind Nune, Mahnoor Javaid, Abraham Edgar Gracia-Ramos, Jessica Day, Mrudula Joshi, Masataka Kuwana, Sreoshy Saha

Medical College Documents

To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on patients suffering from various autoimmune diseases including T1DM. We performed a subgroup analysis on this cohort to investigate COVID-19 BI characteristics in patients with T1DM. Logistic regression with propensity score matching analysis was performed. A total of 9595 individuals were included in the analysis, with 100 patients having T1DM. Among the fully vaccinated …

Combined Effect Of Adiposity And Elevated Inflammation On Incident Type 2 Diabetes: A Prospective Cohort Study, Dan Wu, Yulong Lan, Shuohua Chen, Xiong Ding, Guanzhi Chen, Chutao Wu, Lois Balmer, Wencan Xu, Shouling Wu, Wei Wang

Research outputs 2022 to 2026

Background: Adiposity and elevated inflammation are two hallmarks of hyperglycemia. However, it is unknown whether clustering of elevated inflammation and adiposity interact act on diabetogenesis and lead to a greater risk for incident type 2 diabetes (T2D). Methods: Adiposity was indicated by body mass index, waist circumference and ultrasonography-measured fatty liver degrees. Elevated inflammation was indicated as high-sensitivity C-reactive protein levels ≥ 2 mg/L. Time-to-event survival analyses were conducted to investigate the joint effect of adiposity and inflammation on incident T2D on both multiplicative and additive scales. Results: Among 82,172 non-diabetic participants from a prospective cohort in China, 14,278 T2D …

Supra-Additive Effect Of Chronic Inflammation And Atherogenic Dyslipidemia On Developing Type 2 Diabetes Among Young Adults: A Prospective Cohort Study, Yulong Lan, Dan Wu, Zhiwei Cai, Yuancheng Xu, Xiong Ding, Weiqiang Wu, Shaocong Lan, Lan Chen, Zheng Guo, Lois Balmer, Xingang Li, Manshu Song, Shouling Wu, Jingli Gao, Wei Wang, Youren Chen

Research outputs 2022 to 2026

Background: Both elevated inflammation and atherogenic dyslipidemia are prominent in young-onset diabetes and are increasingly identified as biologically intertwined processes that contribute to diabetogenesis. We aimed to investigate the age-specific risks of type 2 diabetes (T2D) upon concomitant chronic inflammation and atherogenic dyslipidemia. Methods: Age-stratified Cox regression analysis of the risk of incident diabetes upon co-exposure to time-averaged cumulative high-sensitivity C-reactive protein (CumCRP) and atherogenic index of plasma (CumAIP) among 42,925 nondiabetic participants from a real-world, prospective cohort (Kailuan Study). Results: During a median 6.41 years of follow-up, 3987 T2D developed. Isolated CumAIP and CumCRP were significantly associated with incident …

Pseudocystic Myxoid Liposarcoma Of The Posterior Chest Wall - A Rare Case Report, Saad Shakil, Sareema Eman Akhtar, Mahum Zaidi, Rizwan Ajmal, Abdulla K. Alsubai, Rahul Ramtohul, Absam Akbar, Aysa Tabassi, Aylin Tabassi, Talal Almas

Medical College Documents

Introduction and importance: Liposarcoma (LPS) is a common soft-tissue sarcoma predominantly diagnosed in adults, arising from malignant adipose cells. Among its various subtypes, myxoid LPS (MLPS) stands out as the second most frequent, accounting for ~30% of all LPS cases. This particular subtype typically manifests in males between the ages of 40 and 50 and is commonly found in the lower extremities. Although rare, MLPS may also occur in the head, neck, and infrequently in the back. Chest wall LPS cases are also sparsely reported.
Case presentation: In this report, we present a case of MLPS in a 69-year-old male …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Enhancing Diabetes Care In Lmics: Insights From A Multinational Consensus, Jose Carlos Miranda, S Abbas Raza, Babatope Kolawole, Jahanzeb Kamal Khan, Atiba Alvi, Fariha Sadiq Ali, Ejim Emmanuel Chukwudi, Nanik Ram, Amira Oluwatoyin

Section of Diabetes, Endocrinology and Metabolism

The International Cardio-Metabolic Forum held a plenary session to establish a multinational consensus on the challenges faced in diabetes management within lower-middle-income countries (LMICs) and their potential solutions. Stakeholders, including patients, family/caretakers, healthcare professionals, and healthcare policymakers & organizations, participated in discussions. The audience of 280 doctors from 15 different countries (Pakistan, Qatar, Sri Lanka, Kenya, Myanmar, Georgia, Nigeria, Philippines, Uzbekistan, Iraq, Tanzania, Cambodia, Kazakhstan, South Sudan and Libya) was divided into 4 groups led by Group Leaders to represent each stakeholder group. Questionnaires addressing key challenges and solutions specific to each group were used to facilitate consensus development. Participants …

Prevalence Of Comorbidities And Survival Analysis Of Covid-19 Patients – An Observational Study From A Tertiary Healthcare Center In North West Romania, Mihaela Simona Popoviciu, Lorena Paduraru, Roxana Adriana Stoica, Anca Pantea Stoian, Claudiu Teodorescu, Simona Cavalu

Journal of Mind and Medical Sciences

Objectives. The experience accumulated in the last two years shows that the prevention of COVID-19 in people with comorbidities (protective measures, vaccination, etc.) still remains a public health priority. In this context, the aim of our study was to perform a retrospective, observational study in order to assess the time-to-death and risk factors of mortality among COVID-19 patients. Materials and Methods. The study was conducted on 177 patients admitted to Oradea Emergency County Hospital, Bihor, Romania, between October and December 2021. Inclusion criteria were patients over 18 years positive for COVID-19 in upper respiratory tract samples using real-time PCR test. …

Follow-Up Care After Metabolic Surgery – A Prospective Study In The North-Eastern Region Of Romania, Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei

Journal of Mind and Medical Sciences

Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. …

Diabetes Mellitus: Interdisciplinary Medical, Surgical And Psychological Therapeutic Approach, Bogdan Socea, Adrian Silaghi, Laura Florentina Rebegea, Daniela Gabriela Balan, Cristian Balalau, Tiberiu Ștefăniță Tenea-Cojan, Doina Andrada Mihai, Ioana Paunica

Journal of Mind and Medical Sciences

Diabetes mellitus is a complex and widespread metabolic disease, having extremely complex implications (biological, psychological, social) for patients. Understanding the pathophysiology of diabetes (majorly influenced by various factors such as genetic predisposition, age, lifestyle choices, etc.) is essential for the prevention of this condition and the establishment of effective treatment strategies. The latest and relevant literature data related to the epidemiology, pathophysiology, and treatment of diabetes are presented, after an exhaustive review of the articles published on this topic and indexed in the WOS, PubMed, Scopus and Google Scholar databases. Preventing or delaying the onset of diabetes can be achieved …

Prevalence Of Liver Cirrhosis And Its Association With Obesity Among Mexican Americans: An Evidence Synthesis, Alexa Perlick, Abaigeal Thompson, Colton Wayne, Angel Rendon, Jose E. Campo Maldonado

Research Colloquium

Introduction: Chronic liver disease is the 6^th and 7^th leading cause of death in Hispanic men and Hispanics, respectively.¹ In contrast to other causes of liver disease, the prevalence of nonalcoholic liver disease has been growing as is diabetes and obesity.²

Objective: There is a paucity of data regarding the prevalence of cirrhosis for Mexican Americans in South Texas. The aim of this evidence synthesis is to investigate the prevalence of cirrhosis in Hispanic populations and its relationship with obesity.

Methods: PubMed was used to perform a thorough literature search on September10, 2020. The terms “liver …

Severe Hyponatremia Associated With Partial Empty Sella Syndrome, Lily Chen, Shyama Appareddy, Laura Garcia

Research Colloquium

Hyponatremia, serum sodium concentration < 135 mmol/L, is further classified by patient volume status. Symptoms are dependent on the acuity of sodium loss. Acute onset hyponatremia can present with confusion, disorientation, headache, agitation, vomiting, and lethargy. Patients with hyponatremia warrant a thorough workup and can be a leading manifestation of hypopituitarism in the geriatric population. A 77 year old patient, history of pituitary adenoma, presented with generalized symptoms of fatigue, gait instability, poor appetite and confusion associated with severe hyponatremia and hypoglycemia. The patient has a history of pituitary adenoma treated with cabergoline, hypothyroidism treated with levothyroxine and gonadal insufficiency treated with testosterone, with no reported history of diuretic use. On admission, the patient had a sodium level of 116 mmol/L. While the patient reported improvement in symptoms, patient’s confusion was noted to persist despite appropriate correction of sodium and glucose. Patient had an AM cortisol of 4 mcg/dL. Cosyntropin test was conducted and noted to be negative. MRI Brain with Gadolinium revealed empty sella turcica with a small amount of enhancing pituitary tissue, which may indicate a response to previous cabergoline therapy. Despite negative cosyntropin results, the patient was suspected to have relative adrenal insufficiency due to multiple acute stressors including illness, hospitalization, disruption of routine and abrupt smoking cessation. Patient was given a trial of hydrocortisone with improvements noted in his mental status, strength and appetite. Thus, careful consideration should be given towards adrenal insufficiency secondary to hypopituitarism as an etiology for severe hyponatremia.

Penile Calciphylaxis In An End Stage Renal Disease Patient., Juan Enrique Garcia Lopez, Alain Velazquez Blanco, Aileen Aguilar, Sareena Siyas, Daniel Ibarias Paz, Mays Abdulazeez, Jesus Garza-Tamez, Desmond Adamu

Research Colloquium

Background: Penile Calciphylaxis occurs in about 1–4% of hemodialysis patients worldwide. Associated mortality rates are very high, and hyperparathyroidism is the second most frequently associated disorder. Addressing the resulting metabolic imbalance, and surgical intervention guided by findings of radiological studies may improve quality of life. The pathogenesis is thought to be mediated by vascular smooth muscle cells which differentiate into osteoblast-like cells. Decrease in vascular calcification inhibitory proteins fetuin-A and matrix Gla is found in patients on dialysis causing systemic medial calcification of arterioles, leading to epidermal ischemia, tissue infarction, and ulceration.

Case presentation: 47-year-old male with history of coronary …

A Reflection Of Experiences Of Adults With Type 1 Diabetes In Integrated Physical Education Classes, Kalleigh West

Human Movement Sciences Theses & Dissertations

The purpose of this study was to gain an understanding of the experiences of type 1 diabetics in integrated physical education classes. In this study, we interviewed young type 1 diabetic adults and asked them to reflect on their school-based physical education experiences. An interpretative phenomenological analysis (IPA) approach was adopted to guide data collection, analysis, and interpretation for this retrospective study. Eight participants (ages 19 to 32) were enrolled in this study, and semi-structured interviews focused on their physical education experiences acted as the primary data. Transcribed interview data were analyzed using an IPA approach. Three interrelated themes emerged …

Vitamin D Deficiency Among Children And Adolescents Living In Sunny South Texas, Yoscelina E. Martinez-Lopez, Margarita Faz, Beatriz Tapia, Juan C. Lopez-Alvarenga, Francisco J. Cervantes

Research Symposium

Background: Exposure to sunlight is essential to produce Vitamin D (ViD). Recent studies suggest obesity is associated with low ViD concentration. Living in South Texas with 220 sunny days a year should be enough to maintain adequate ViD levels. We aimed to analyze ViD levels and obesity in children and adolescents.

Methods: We included 1239 pediatric (1.5 to 18.8 years old) participants (primary care clinic from Laredo) with registered CDC percentiles of BMI (pBMI) and serum concentrations of ViD (Atellica™). Data are described as median (p25, p75), Loess correlation between pBMI and ViD, ANCOVA to adjust by age, sex, and …

A Case Of Osteogenesis Imperfecta In A Patient Diagnosed In Adulthood, Khalid Sheikh, M. Lastovica, N. S. Appareddy, R. Wagner, E. Luna

Research Symposium

Background: Osteogenesis imperfecta (OI) is an extremely rare inherited connective tissue disorder, with an incidence of 1 in 20,000 births in the United States. Our aim is to assist other providers in diagnosing and managing patients with OI and concurrent medical morbidities.

Case Presentation: A 21 year old male with a BMI of 34 and a lifetime history of over 10 fractures presented to the Emergency department after a complex seizure at home. The seizure was witnessed by his mother and lasted less than one minute. He had another seizure two weeks prior to presentation. In the ED, the patient …

Progression Of Comorbidities In Youth With Overweight Or Obesity During The Covid-19 Pandemic., Erica Wee, Ashley K. Sherman, Safa Farrukh, Mark A. Clements, Kelsee Halpin, Yun Yan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Childhood obesity rates have continued to increase with the COVID-19 pandemic. However, data are limited on the impact of increasing obesity on associated comorbidities.

METHODS: We evaluated the progression of overweight- or obesity-associated comorbidities by investigating change in laboratory results pre-COVID-19 pandemic and post-COVID-19 pandemic onset in youth with overweight or obesity. We defined progression of comorbidities based on increase in category rather than absolute change in value.

RESULTS: HbA1c progression was seen in 19%, and LDL cholesterol progression was seen in 26%, as defined by categories. HbA1c progression and LDL cholesterol progression were significantly correlated. HbA1c and LDL …

Type 2 Diabetes Mellitus Burden Of Disease In Brazil Between 1990 To 2019: A Nationwide Descriptive Analysis Of The Global Burden Of Disease Study 2019, Lucas Helal, Paula Portal Teixeira, Lucas Scotta Cabral, Tiago Montes, Rita Mattiello, Bárbara Niégia Garcia De Goulart, Bruce Bartholow Duncan

AMNET XX Conferencia Internacional

This is a Brazilian nationwide analysis of the burden of type 2 diabetes mellitus along the 26 states and federal district, between 1990 up to 2019. In summary, through spatiotemporal Gaussian regression methods, we estimated the attributable share of T2DM for prevalence, deaths, DALYs, YLLs and YLDs in Brazilian population. Moreover, we sought to investigate the behavior of top risk factors for T2DM and the attributable impact in burden of disease outcomes accordingly. We also investigated whether the geolocation and time, as well as the socio demographic index, would have any ecological relationship with different levels of disease and risk …