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Prediction of Type 2 Diabetes Remission after Bariatric or Metabolic Surgery

  • Park, Ji Yeon
    • Journal of Obesity & Metabolic Syndrome
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    • v.27 no.4
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    • pp.213-222
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    • 2018
  • Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

Wellness Prediction in Diabetes Mellitus Risks Via Machine Learning Classifiers

  • Saravanakumar M, Venkatesh;Sabibullah, M.
    • International Journal of Computer Science & Network Security
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    • v.22 no.4
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    • pp.203-208
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    • 2022
  • The occurrence of Type 2 Diabetes Mellitus (T2DM) is hoarding globally. All kinds of Diabetes Mellitus is controlled to disrupt over 415 million grownups worldwide. It was the seventh prime cause of demise widespread with a measured 1.6 million deaths right prompted by diabetes during 2016. Over 90% of diabetes cases are T2DM, with the utmost persons having at smallest one other chronic condition in UK. In valuation of contemporary applications of Big Data (BD) to Diabetes Medicare by sighted its upcoming abilities, it is compulsory to transmit out a bottomless revision over foremost theoretical literatures. The long-term growth in medicine and, in explicit, in the field of "Diabetology", is powerfully encroached to a sequence of differences and inventions. The medical and healthcare data from varied bases like analysis and treatment tactics which assistances healthcare workers to guess the actual perceptions about the development of Diabetes Medicare measures accessible by them. Apache Spark extracts "Resilient Distributed Dataset (RDD)", a vital data structure distributed finished a cluster on machines. Machine Learning (ML) deals a note-worthy method for building elegant and automatic algorithms. ML library involving of communal ML algorithms like Support Vector Classification and Random Forest are investigated in this projected work by using Jupiter Notebook - Python code, where significant quantity of result (Accuracy) is carried out by the models.

Desmopressin responding female nephrogenic diabetes insipidus: a case report

  • Juyeon Lee;Hae Il Cheong;Jung Won Lee;Ki Soo Pai
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.107-110
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    • 2022
  • Nephrogenic diabetes insipidus, decreased ability to concentrate urine, with production of large amounts of urine, is caused by the refractory response of renal tubules to the action of antidiuretic hormone. This rare disorder, known as X-linked nephrogenic diabetes insipidus, is caused by a mutation in the AVPR2 gene. Because it is hereditary, most patients are male. This report highlights a case of nephrogenic diabetes insipidus in a 3-year 5-month-old female; upon presentation to the hospital, her symptoms included frequent urinationand consumptionof a significant amount ofwater,which had begun2 years ago. The results of blood tests showed increased levels of serum antidiuretic hormone, and sellar magnetic resonance imaging showed no abnormality. The results of the water restriction test and the desmopressin administration test confirmed the diagnosis of nephrogenic diabetes insipidus showing a partial response to desmopressin. The results of genetic testing indicated the presence of an AVPR2 mutation, a heterozygous missense mutation (p.Val88Met), suggesting inheritance of X-linked nephrogenic diabetes insipidus. This report describes a significant case of symptomaticX-linked nephrogenic diabetes insipidus in a female patient who showed a partial response to desmopressin.

A Study of Total Medical Cost and Hospitalization Risk of Patients with Schizophrenia and Type 1 Diabetes Mellitus (제1형 당뇨병을 동반한 조현병 환자의 총 의료비용 및 입원 위험)

  • Lee, Sang-Uk;Kim, You-Seok
    • Korean Journal of Schizophrenia Research
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    • v.22 no.1
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    • pp.8-13
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    • 2019
  • Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

The art of diabetes care: guidelines for a holistic approach to human and social factors

  • Muhammad Jawad Hashim
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.218-222
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    • 2023
  • A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

Healthcare coaching program for youth with type 1 diabetes in South Korea: a pilot study

  • Dae Eun Lee;Haejung Lee;Chong Kun Cheon;Ju Young Yoon
    • Child Health Nursing Research
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    • v.30 no.1
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    • pp.17-30
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    • 2024
  • Purpose: This pilot study aimed to assess the feasibility, preliminary efficacy, and effects of a mobile app healthcare coaching program developed based on self-regulation theory among youths with type 1 diabetes. Methods: A mixed-method design was utilized. Participants were randomly assigned into intervention (n=23, 12-week coaching program) or control groups (n=16, usual care). Pre- and post-intervention assessments included self-efficacy, diabetes management behavior, and health outcomes (quality of life, depression, and HbA1c). Quantitative data were analyzed with SPSS/WIN ver. 26.0. The narrative information from the participants in the healthcare coaching program underwent content analyzed. Results: The intervention group had significantly lower depression scores (t=2.57, p=.014) than the control group. No significant differences were observed in self-efficacy, diabetes management behavior, and health outcomes between the two groups. The average frequency of health behavior monitoring per week among the participants was 1.86±1.60. The qualitative findings indicated that participants perceived improved diabetes self-management with the intervention; however, challenges during vacations, dietary control difficulties, and a lack of disease awareness were identified. Conclusion: The healthcare coaching program improved psychological aspects for youth with type 1 diabetes. Further research is needed to develop and implement mobile app interventions aimed at enhancing compliance with diabetes management in pediatric and adolescent populations.

Diabetes Mellitus as a Risk Factor for High Grade Renal Cell Carcinoma

  • Otunctemur, Alper;Ozbek, Emin;Sahin, Suleyman;Dursun, Murat;Besiroglu, Huseyin;Koklu, Ismail;Erkoc, Mustafa;Danis, Eyyup;Bozkurt, Muammer;Gurbuz, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3993-3996
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    • 2014
  • Background: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. Results: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p<0.05 in both cases). Conclusions: Renal cancer appears more aggressive in patients with diabetes. In this study lifestyle and risk factors with diabetes regulation were observed to be important for renal cancer patients. Multicenter studies are needed in larger series for more accurate results.

The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population

  • Yeom, Hyungseon;Lee, Jung Hyun;Kim, Hyeon Chang;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.2
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    • pp.108-117
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    • 2016
  • Objectives: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. Methods: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ${\geq}30mg/g$) or low estimated glomerular filtration rate ($<60mL/min/1.73m^2$). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. Results: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). Conclusions: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Relationship between Body image and Depression of Diabetes Mellitus Patients (당뇨병환자의 신체상과 우울과의 관계)

  • Lee, Myung-Hwa;Song, Myung-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.1
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    • pp.49-59
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    • 2002
  • The purpose of study was to identify relationship between body image and depression of diabetes mellitus patients. The subjects of study were 120 diabetes mellitus patients who were B hospital in Pusan. Data were collected from 15th April to 20th August, 1998. The instrument used for this study were Osgood's body image scale and Zung's depression scale. The collected data were analyzed frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, Pearson's correlation coefficients. The results were as follows: 1. The mean score of body image was $68.91{\pm}18.04$, and the mean score of depression was $56.18{\pm}11.58$. 2. The score of body image according to marital status(t=-2.434, p=.016), economic status (F=6.252, p=.001), reason of different regular hospital visiting(F=3.017, p=.014), treatment method of diabetes mellitus(F=3.048, p=.013) were significantly difference. ere significantly difference. 3. The score of depression according to sex(t=2.353, p=.020), occupational status(F=4.657, p=.002), marital status(t=-2.325, p=.022), economic status(F=5.536, p=.001), regular hospital visiting(t=2.081, p=.040), reason of different regular hospital visiting(F=3.352, p=.007), treatment method of diabetes mellitus(F=3.102, p=.012), paticipation of diabetes mellitus(t=3.726, p=.000), paticipation of diabetes mellitus visiting(F=4.819, p=.003) were significantly difference. 5. Body image and depression was a significant negative correlation(r=-.679. p=.000). Conclusion: From this study, a relationship between body image and depression inpatients with diabetes mellitus was idetified. Therefore, nursing intervention are needed to promote body image and depression in patients with diabetes mellitus.

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Streptozotocin Diabetes Attenuates the Effects of Nondepolarizing Neuromuscular Relaxants on Rat Muscles

  • Huang, Lina;Chen, Dan;Li, Shitong
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.461-467
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    • 2014
  • The hypothesis of this study was that diabetes-induced desensitization of rat soleus (SOL) and extensor digitorum longus (EDL) to non-depolarizing muscle relaxants (NDMRs) depends on the stage of diabetes and on the kind of NDMRs. We tested the different magnitude of resistance to vecuronium, cisatracurium, and rocuronium at different stages of streptozotocin (STZ)-induced diabetes by the EDL sciatic nerve-muscle preparations, and the SOL sciatic nerve-muscle preparations from rats after 4 and 16 weeks of STZ treatment. The concentration-twitch tension curves were significantly shifted from those of the control group to the right in the diabetic groups. Concentration giving 50% of maximal inhibition ($IC_{50}$) was larger in the diabetic groups for all the NDMRs. For rocuronium and cisatracurium in both SOL and EDL, $IC_{50}$ was significantly larger in diabetic 16 weeks group than those in the diabetic 4 weeks group. For SOL/EDL, the $IC_{50}$ ratios were significantly largest in the diabetic 16 weeks group, second largest in the diabetic 4 weeks group, and smallest for the control group. Diabetes-induced desensitization to NDMRs depended on the stage of diabetes and on the different kind of muscles observed while was independent on different kind of NDMRs. The resistance to NDMRs was stronger in the later stage of diabetes (16 versus 4 weeks after STZ treatment). Additionally, when monitoring in SOL, diabetes attenuated the actions of neuromuscular blockade more intensely than that in EDL. Nonetheless, the hyposensitivity to NDMRs in diabetes was not relevant for the kind of NDMRs.