Prevalence and Postpartum Screening Practice for Type 2 Diabetes following GDM in King Abdulaziz Medical City: A 3-Years Retrospective Cohort Study

Aim: GDM patients were associated to develop T2DM but mostly failed to undergo screening after delivery. This study aims to examine the practice of T2DM screening and prevalence of developing T2DM among women who had GDM in King Abdulaziz Medical City (KAMC), Saudi Arabia. Methods: Retrospective study involving 642 pregnant women with GDM. Medical records on screenings conducted, delivery mode, GDM and diabetes family history were collected and investigated. Statistical analysis was conducted. Frequencies and percentages were used for categorical variables while means and SD for continuous. Chi-square and t-test were used to establish relationship of categorical and comparing two group means, respectively. Results: Patients were 98.8% Saudi nationals, mean weight, height, parity and number of pregnancies were 76.96 kg, 2.74 m, 3.37 and 1.35, respectively. Majority were obese (56.9%), SVD (56.4%) mode of delivery and good lifestyle (91.4%) as management practice. OGTT was used for screening T2DM with 0 hr fasting and 2-hrs after consuming 75g of glucose, physician ordered 6 weeks after delivery. Only 20% had screening for T2DM and 3.9% developed postpartum diabetes with high number of women not returning for ordered OGTT screening (65.6%). Significant predictors identified were parity and mode of delivery for development of T2DM, while only mode of delivery for both screening for T2DM and management of GDM.Conclusion: Low prevalence of developing T2DM but high number of women failed to follow the ordered OGTT screening. Effort on the implementation of OGTT screening for T2DM needs improvement.

Use of SGLT-2 Inhibitors in Patients with Chronic Kidney Disease

KEY TAKEAWAYS • Chronic kidney disease (CKD) is common, occurring in 1 of 7 adults in the United States. • 9 out of 10 adults with CKD are unaware of it. • People with CKD have the same risk for cardiovascular (CV) death as people with known atherosclerotic heart disease. • The risk for CV events and death increases with worsening albuminuria and estimated glomerular filtration rate (eGFR). • Patients with risk factors for CKD (hypertension, diabetes, family history of CKD, or advancing age) should be screened by measuring both eGFR and urinary albuminto-creatinine ratio. • Sodium-glucose cotransporter-2 inhibitors are first-line agents for treatment of patients with type 2 diabetes mellitus and CKD or a history of atherosclerotic CV disease. • Dapagliflozin has demonstrated equivalent efficacy for reducing kidney events in patients with CKD irrespective of diabetes status, and a similar, ongoing trial with empaglifloz

The Risk and Influencing Factors of Hypertension in Jinchang Cohort

Background To investigate the incidence and influencing factors of hypertension in Jinchang cohort. Methods A prospective cohort study was conducted to collect the baseline and follow-up information of 22,826 employees from 2011 to 2015 based on the Jinchang cohort platform. The incidence of hypertension in the cohort was calculated and the influencing factors were analyzed by Cox proportional risk model. Results The subjects were followed up for an average of 22 years, and the incidence density of hypertension was 56.31/1000 person-years. Multivariate Cox regression results showed that the main risk factors for hypertension in the population included age ≥40 years, alcohol consumption, high-salt diet, history of diabetes, family history of hypertension, overweight and obesity, baseline systolic blood pressure ≥110 mm Hg and diastolic blood pressure ≥75 mm Hg, and higher education levels (middle school, high school, and above) were a protective factor. The incidence of grade 1 hypertension was related to age, drinking, history of diabetes, family history of hypertension and baseline blood pressure levels, and the incidence of grades 2 and 3 hypertension was related to high-salt diet, family history of hypertension, overweight or obesity, and baseline blood pressure levels. Conclusions The Jinchang cohort has a higher risk of hypertension. Age, unhealthy lifestyle, history of diabetes, family history of hypertension, obesity, and baseline blood pressure are strongly associated with the onset of hypertension. There are differences in the risk factors for the occurrence of grades 1, 2, and 3 hypertension.

Awareness on the Risk factors of Atherosclerosis among adults

Cardiovascular disease (CVD) is a main source of death for generally racial and ethnic gatherings of United States blacks and whites and represents 1 of every 4 passings. Atherosclerosis is a cardiovascular disease and it involves solidifying and narrowing of arteries. It can put the bloodstream into danger and supply routes get blocked. Self administrated questionnaire was designed based on risk factors of atherosclerosis. The questionnaire was distributed through an online survey link. The questionnaire was completed by 100 participants, and the data were analysed using SPSS software. Descriptive statistics and Pearson Chi square test were done to analyze the results of the survey. Majority of the participants are aware of the term atherosclerosis. Most of the participants were aware that hyper cholesterolemia, diabetes, family history and chronic stress are major risk factors associated with cardiovascular disease. The Chi square test showed that the respondents at the age group of 18-25 were more aware of the risk factors than the respondents of other age groups.

Pattern, Trend and Predictors of Adult-Onset Type 1 Diabetes in Uyo, Nigeria

<b><i>Background:</i></b> Unlike what obtains in childhood-onset type 1 diabetes, there remains a paucity of data on adult-onset type 1 diabetes in Nigeria. Hence, the current study aimed to determine the general characteristics of adult-onset type 1 diabetes among subjects (aged ≥18 years) presenting at the University of Uyo Teaching Hospital (UUTH) in Akwa Ibom State, South-south Nigeria. <b><i>Methods:</i></b> A 5-year (2014–2018) retrospective records review of subjects with type 1 diabetes was undertaken, using hospital medical records retrieved from the Department of Health Information Management of UUTH. Diagnosed adult cases of type 1 diabetes were meticulously identified and the relevant data at the point of initial diagnosis were acquired on a specially designed data acquisition template. <b><i>Results:</i></b> A total of 47,357 medical cases were identified of which 362 adults were diagnosed with type I diabetes (mean age 33.12 ± 4.40, range 20–51 years) and the females (<i>n</i> = 204; 56.4%) predominated among those diagnosed. The overall, male gender, and female gender prevalence was 7.4/1,000 (95% confidence interval [CI]: 6.89–7.98), 3.3/1,000 (95% CI: 2.52–4.08), and 4.3/1,000 (95% CI: 3.61–4.99), respectively. The females exhibited the highest trough, peak, annual, and overall prevalence during the study period. The female gender (OR: 2.334; 95% CI: 1.407–3.478; <i>p</i> = 0.010), age ≤30 years (OR: 1.976; 95% CI: 0.875–3.211; <i>p</i> &#x3c; 0.001), urban-dwelling (OR: 3.243; 95% CI: 2.3407.780; &#x3c;0.001), diabetes family history (OR: 1.365; 95% CI: 0.678–2.010; <i>p</i> = 0.033), and the rainy season (OR: 1.129; 95% CI: 0.401–1.910; <i>p</i> &#x3c; 0.001) were independent predictors among the overall adult type 1 diabetics. On gender-segregated analyses, age ≤30 years, urban-dwelling, diabetes family history, and the rainy season remained independent predictors among the male and female adult type 1 diabetics (<i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> The study demonstrated a high burden of type 1 diabetes among adult residents of Uyo, Akwa Ibom State, South-South Nigeria. The predictors of adult type 1 diabetes, identified in the present study, are valuable epidemiologic evidence for the design of type 1 diabetes-targeted preventive programs by various concerned stakeholders.

TYPE II DIABETES MELLITUS;

Objectives: To determine the frequency of asymptomatic elevation of liver function enzymes in type II diabetes mellitus patients using statins. Study Design: Cross sectional study. Setting and Period: Nishtar Hospital Multan, from February 2017 to February 2018. Material and Methods: A total of 335 patients were enrolled for this study. Sample size was calculated from the reference study.9 Clinical and biographical data was obtained from each patient in the form of previous medical records and patient interview such as, sex, age, height, weight, age at onset of diabetes, family history of diabetes, duration of diabetes, family history of liver diseases, medication history. All the data was measured and recorded by the researcher himself. Data thus obtained was subjected to statistical analysis by using computer software SPSS version 23. Mean and standard deviation was calculated for continuous variables while frequency and percentage was calculated for categorical variables. A p value of less than or equal to 0.05 was taken as significant for univariate test. ANOVA test was utilized to evaluate the relationship ALT and AST and other metabolic parameters. Results: Although the prevalence of elevated ALT increased with the increasing age, duration of diabetes, BMI, FBS and TG, but it was not statistically significant with (p=0.634), (p=0.759), (p=0.844), (p=0.400) and (p=0.246) respectively. Similarly, the prevalence of elevated AST increased with the increasing age, duration of diabetes, BMI, FBS and TG, but it was not statistically significant with (p=0.779), (p=0.945), (p=0.987), (p=0.199) and (p=0.933) respectively. (Table II). Conclusion: From this study it can be concluded that use of statins does not alter the usual finding of elevated liver enzymes among the patients with type two diabetes mellitus.

25-year-old man with chest pain

Clinical introductionA 25-year-old man presented with complaints of acute-onset chest pain for 2 hours associated with diaphoresis and generalised weakness. He had history of smoking for 10 years. There was no history of hypertension, diabetes, family history of premature coronary artery disease or drug abuse. On evaluation, his heart rate was 76/min, blood pressure 130/90 mm Hg and oxygen saturation 97% on room air. Cardiovascular examination was normal. The ECG is shown in figure 1.Figure 1