Background Educating diabetic patients about their diseases encourages their families to learn as much as possible about the latest medical management and approaches, as well as informing healthy lifestyle choices, and supports their responsibility in improving their condition and quality of life through well-managed self-control. Goal To evaluate the outcomes of diabetes education in patients with T2DM. Materials and Methods The cohort survey was conducted at the Diabetes center of the State Central Clinical Hospital (SCCH) and District Health centers in Ulaanbaatar. Participants included 150 newly diagnosed patients with T2DM. Data collection was done by using internationally accepted questionnaire and anthropometric measurements and biomedical outcome measures such as Haemoglobin A1c levels, high density lipid (HDL), low density lipid (LDL), total cholesterol (TCh), triglyceride (TG), fasting blood glucose (FBG), blood pressure (BP), body weight (BW) at baseline and 3rd and 6th months of the follow ups. Statistical analyses were performed with the SPSS16 software. Results Diabetic patient’s knowledge (p=0.029) and self control of blood glucose (5.35±1.81 days in the last week) of newly diagnosed patients with T2DM improved statistically significantly (p=0.046) after 6 months diabetes education. Psychological problem areas in diabetes (PAID) score reduced in educated group 2.86% (95%CI 1.61 to 3.23) p=0.004 and points in illness perception questionnaire (IPQ) increased 8.95% (95%CI 5.31 to 10.1) p=0.001. After 6 months, the group of the newly diagnosed patients receiving diabetes education had decreased numbers in biomedical measurements: Systolic BP decreased 8mmHg (p=0.001), diastolic BP 2 mmHg (p=0.035), some anthropometric measurements including waist circumference (WC) decreased 2cm (p=0.014). Levels of HbA1C were 1.5% lower (p=0.001) in the diabetes educated group, LDL decreased 0.7 mmol/l (p=0.0001), and HDL increased 0.2% (p=0.036). Conclusion: 1. The data on the educated patients’ knowledge about diabetes, self control, psychosocial status, and illness perception are comparatively higher than those in the non-educated group. 2. The decrease in not only the levels of systolic and diastolic BP and WC of newly diagnosed patients with T2DM, but also levels of HbA1C and LDL together with the increase in levels of HDL indicates that the self control improves among educated patients.

Diabetes is known to be directly and indirectly associated with stress. Many researchers have reported that diabetes is actually induced by stress and several hormones includ¬ing cortisol are known to be involved.14 Though tight glycemic control is viewed as a primary indicator of favorable diabetes outcomes metabolic control , medication, and physical activity, contribute to a patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improves depressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI -1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

Diabetes is known to be directly and indirectly associated with stress. Many researchers havereported that diabetes is actually induced by stress and several hormones includ¬ing cortisolare known to be involved.14 Though tight glycemic control is viewed as a primary indicator offavorable diabetes outcomes metabolic control , medication, and physical activity, contribute toa patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improvesdepressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI-1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.

DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.

Background: In Mongolia, the prevalence of non-communicable diseases and their intermediate risk factors has continuously increased in recent years. From results of early detection and prevalence studies of non-communicable diseases in Mongolia, studies linking intermediate risk factors to insulin resistance are scarce. Aim: To identify the prevalence of insulin resistance among the population and study its connection with intermediate risk factors of non-communicable diseases. Materials and Methods: This study was approved by the MNUMS Ethics Committee on February 23, 2024 (2024/3- 02), and was conducted based on the data of participants who took part in the “Population-based Preventive and Early Detection Screening of Infectious and Non-Infectious Diseases” organized by the Mongolian government from 2022 to 2023. Insulin resistance was identified using the triglyceride-glucose index (TyG), calculated by the formula Ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL) / 2]. “Ln” refers to the natural logarithm, based on Euler’s number, approximately 2.71828. TyG levels were classified into low risk (<8.5), medium risk (8.5-9.0), and high risk (>9.0). Defined intermediate risk factors for non-communicable diseases according to stages of hypertension and diabetes. Results: The mean age of participants was 44.3±15.2 years, with 39.2% (n=49,270) male and 41.4% (n=49,749) residing in urban areas. Among the participants, 59.1% had overweight or obesity, 23.6% had diabetes or impaired fasting glucose, 61.4% had hypertension, and 19.7% had elevated triglycerides. Analyzing by levels of insulin resistance risk, 62.8% of the population had low risk, 22.5% medium risk, and 14.7% high risk. Comparing systolic blood pressure across levels of insulin resistance risk showed that even without central obesity or diabetes, as the level of insulin resistance increased, the level of systolic blood pressure also increased (low risk group: 117.0±11.7, medium risk group: 121.1±10.9, high risk group: 123.5±16.2 mmHg). Regression analysis of the risk of hypertension by insulin resistance risk level showed that the risk increased with higher levels of insulin resistance (medium risk group OR=1.35, p<0.0001; high risk group OR=1.63, p<0.0001). Conclusion 22.5% of the population is at medium risk and 14.7% at high risk of insulin resistance. The increase in hypertension risk with higher insulin resistance levels is statistically significant, independent of central obesity and diabetes stages.

Background: Complete blood count (CBC) is one of the most widely used clinical tests, offering a high-quality, inexpensive, and routine diagnostic tool for various diseases and for monitoring treatment outcomes. Due to modern technological advancements, blood cells are now measured in greater detail, with 36 parameters being evaluated. The prevalence of diabetes mellitus (DM) is rapidly increasing, not only globally but also in our country. This rise in prevalence leads to numerous adverse consequences, including delayed diagnosis, poor control, an increase in chronic complications, and treatment failure. Hyperglycemia is a predisposing factor for chronic inflammation, and a relatively new inflammatory marker, the neutrophil-to-lymphocyte ratio (NLR), may be useful for assessing diabetes control. In recent years, NLR has been studied as a composite biomarker that more effectively reflects systemic inflammation and is easier to detect compared to other inflammatory markers. An increase in neutrophil count and percentage indicates chronic, low-grade, toxic, and non-specific inflammation, while a decrease in lymphocyte count suggests insufficient immune regulation. Thus, an elevated NLR not only reflects the immune system’s functional state in chronic inflammation, but it is also studied as a reliable and selective marker of systemic inflammation in chronic diseases. NLR is considered more stable than the total leukocyte count, is less affected by physiological and pathological factors, is inexpensive, and can be incorporated into daily clinical practice. Aim: To study the relationship between the neutrophil-to-lymphocyte ratio in a complete blood count and diabetes control and complications Materials and Methods: A cross-sectional study was conducted involving 145 patients with type 2 diabetes mellitus, who were treated at the Endocrine Clinic of the Mongolian-Japanese Hospital, Mongolian National University of Medical Sciences. Data on the neutrophil-to-lymphocyte ratio (NLR), glycated hemoglobin (HbA1c), and diabetic complications, including retinopathy, neuropathy, and foot complications, were collected from the Carte-Hospital Management System. Based on the frequency distribution of the NLR parameter, the values were classified into three groups: low, medium, and high. These groups were subsequently compared with glycemic control and complications using correlation and linear regression analyses, with statistical significance set at p<0.05. Results: The mean age of the study participants (n=145) was 57.3±12.9 years, with 46.8% (n=131) being male. The mean duration of diabetes was 9.6 years (range: 1-31 years), and the mean HbA1c level was 8.6±2.47%. Among the participants, 59.3% (n=86) exhibited poor glycemic control. Regarding complications, 52.3% of participants experienced at least one diabetes-related complication. Of these, 25.2% had one complication, 13.3% had two, and 7.1% had three or more. The most common complications were retinopathy (25.7%), nephropathy (18.6%), and macrovascular complications (11.9%). A statistically significant increase in the mean HbA1c level was observed across groups stratified by NLR levels (p=0.003). Linear correlation analysis revealed a statistically significant positive correlation between HbA1c levels (r=0.194, p=0.001) and the number of chronic diabetes complications (r=0.162, p=0.002). Conclusion The NLR level is positively correlated with both diabetes control and the occurrence of chronic complications. As an inexpensive and easily accessible test, it can be used for daily monitoring and early detection of complications.

Introduction: PCOS prevalence is 5-10 percent among reproductive age women in worldwide. It is caused by imbalance of sex hormones which ultimately leads to menstrual irregularities, infertility, anovulation and other metabolic disturbances. Most women with chronic anovulation is caused by polycystic ovary syndrome [PCOS] The Rotterdam criteria is useful diagnostic tool for PCOS. In Mongolia there is almost no study on PCOS related infertility and there are increasing trend infertility among reproductive aged women with PCOS, lead us to conduct the study. Objective: The aim of this study was to estimate incidence of PCOS and to study clinical and biochemical characteristics of PCOS among infertility women. Material and Methods: We used the cross-sectional and case control study designs. Total 1334 infertility women enrolled in this study. The study was conducted after approval from the Ethical and research review board of the hospital, and written informed consent was taken from all the women. Among 114 women with PCOS were found by Rotterdam’s criteria at the Infertility and reproductive department, National Center for Maternal and Child Health, between December, 2018 - 2019. Total of 43 females with PCOS were screened among 1334 infertile women. All parameters were assessed either with ELISA in 43 infertile PCOS women and 17 age matched apparently healthy controls diagnosed according to Rotterdam consensus. IDF diagnostic criteria for MS was used. The PCOS patients divided into following groups: (1) with MS ( n=42) and (2) without MS (n=72). Results: The main age, body mass index (BMI), and duration of infertility were 28.7±4.1 years, 27.3±5.2 kg/ m² and 4.4±3.1y, respectively. Among patients 57.9% of them have oligomenorrhea, 22.8% with amenorrhea, primary infertility 57.0% and 51.9% with hirsutism and acne 50.8%. As a result of hormone assays were LH 9.3±3.5mIU/ml, LH/FSH 1.6 ±0.83 [0.1-3.6], AMH 6.1ng/ml ±3.6 /2.9-21.0/. The prevalence of MS was 36.8%. The variables including age (30.9±4.9), body mass (75.9±11.6kg) and also some metabolic parameters which is hypertension (133.6/88.4±13.6 mm Hg), WC (94.1±8.6 cm) and high triglyceride (1.8±1.0 mmol/l) were observed in MS group compared to without MS group. Conclusion Among 1334 women with infertility, the incidence of PCOS 8.7% (116), close to the prevalence in other countries. Considering the diagnose was confirmed of three criteria by the Rotterdam criteria. We found out that the prevalence of metabolic syndrome was 35.3% among infertility women with PCOS. Age, BMI, WC, amenorrhea, acne and acanthosis nigricans, were highly related to metabolic syndrome.