No abstract available.
Diabetes Mellitus ; Mortality

No abstract available.
Depression* ; Diabetes Mellitus, Type 2* ; Mortality*

OBJECTIVES: To compare the rate of diabetes complications in young-onset type 2 diabetes (T2DM) with type 1 diabetes (T1DM) patients and to examine the relationship between diabetes complications with clinical and metabolic parameters.
METHODOLOGY: This is a retrospective,comparative study based on electronic medical records review. Young-onset T2DM patients defined as those with disease onset before the age of 40 and T1DM patients were included. Data was collected on demographic and clinical parameters, cardiovascular risks factors, macrovascular and microvascular complications.
RESULTS: There were 194 young-onset T2DM and 45 T1DM subjects. Despite similar glycemic profile, more subjects in the T2DM group hadunfavourable cardiovascular risk factors and developedmacro- or microvascular complications than the T1DM group (22 vs. 0%, p< 0.001for macrovascular, 68 vs. 40%, p< 0.001 for microvascular). Afteradjustment ofthe confounders, young-onset T2DM remained an independent predictor for both macrovascular and microvascular complications in the overall cohort (HR= 2.635, p= 0.022).
CONCLUSION: Young-onset T2DM appeared to be a more aggressive disease compared to T1DM. An aggressive approach should be adopted in treating young-onset T2DM to optimise the cardiovascular risk factors and glycemic control to prevent premature mortality and morbidity.

Introduction: Metformin has known mechanistic benefits on COVID-19 infection due to its anti-inflammatory effects and its action on the ACE2 receptor. However, some physicians are reluctant to use it in hypoxemic patients due to potential lactic acidosis. The primary purpose of the study was to determine whether metformin use is associated with survival. We also wanted to determine whether there is a difference in outcomes in subcategories of metformin use, whether at home, in-hospital, or mixed home/in-hospital use. Objectives: This study aimed to determine an association between metformin use and mortality among patients with type 2 diabetes mellitus hospitalized for COVID-19 infection. Methodology: This was a cross-sectional analysis of data acquired from the COVID-19 database of two tertiary hospitals in Cebu from March 1, 2020, to September 30, 2020. Hospitalized adult Filipino patients with type 2 diabetes mellitus who tested positive for COVID-19 via RT-PCR were included and categorized as either metformin users or metformin non-users. Results: We included 355 patients with type 2 diabetes mellitus in the study, 186 (52.4%) were metformin users. They were further categorized into home metformin users (n=109, 30.7%), in-hospital metformin users (n=40, 11.3%), and mixed home/in-hospital metformin users (n=37, 10.4%). Metformin use was associated with a lower risk for mortality compared to non-users (p=0.001; OR=0.424). In-hospital and mixed home/in-hospital metformin users were associated with lower mortality odds than non-users (p=0.002; OR=0.103 and p=0.005; OR 0.173, respectively). The lower risk for mortality was noted in metformin, regardless of dosage, from 500 mg to 2 g daily (p=0.002). Daily dose between ≥1000 mg to <2000 mg was associated with the greatest benefit on mortality (p≤0.001; OR=0.252). The survival distributions between metformin users and non-users were statistically different, showing inequality in survival (χ2=5.67, p=0.017). Conclusion Metformin was associated with a lower risk for mortality in persons with type 2 diabetes mellitus hospitalized for COVID-19 disease compared to non-users. Use of metformin in-hospital, and mixed home/in-hospital metformin use, was also associated with decreased risk for mortality. The greatest benefit seen was in those taking a daily dose of ≥1000 mg to <2000 mg.
Metformin ; Diabetes Mellitus ; COVID-19 ; Mortality

Introduction: Hypoglycemia is an important and harmful complication that often occurs in inpatient and outpatient settings. This study aims to assess the incidence of inpatient hypoglycemia and its related factors. We also assessed mortality and length of hospital stay. Methodology: We performed a retrospective cohort study among patients with type 2 diabetes mellitus admitted to a tertiary hospital in Indonesia. Using multivariate regression, we analyzed age, sex, body mass index, comorbidities, history of hypoglycemia, hyperglycemia treatment administered, nutritional intake, and medical instruction as the related risk factors for inpatient hypoglycemia. Results: From 475 subjects, 80 (16.8%) had inpatient hypoglycemia, of which, 7.4% experienced severe hypoglycemia. We found that patients with a history of hypoglycemia (RR: 4.6; 95% CI: 2.8-7.6), insulin and/or sulfonylurea treatment (RR 6.4; 95% CI: 1.6-26.5), and inadequate nutritional intake (RR 2.6; 95% CI: 1.5-4.3) were more likely to have hypoglycemic events compared to those who did not. The length of hospital stay for patients in the hypoglycemic group is significantly longer than those in the non-hypoglycemic group (13 vs 7 days, p<0.001), but their mortality rates did not differ (16% vs 10.9%, p=0.18). Conclusion Inpatient hypoglycemia may be affected by a history of hypoglycemia and inadequate nutritional intake. Patients who had inpatient hypoglycemia tend to have a longer median length of hospital stay.
Hypoglycemia ; Diabetes Mellitus ; Insulin ; Mortality ; Length of Stay

Atherothrombotic complications are important causes of morbidity and mortality in diabetic patients. Diabetes has been considered to be a prothrombotic status. Several factors contribute to the prothrombotic condition, such as increasing coagulation, impaired fibrinolysis, endothelial dysfunction, and platelet hyperreactivity. Among the factors that contribute to the prothrombotic status in diabetes, altered platelet function plays a crucial role. Although understanding platelet function abnormalities in diabetes still remains as a challenge, more attention should be focused on platelet function for effective management and the prediction of atherothrombotic events in diabetic patients. This review will provide an overview on the current status of knowledge of platelet function abnormalities and clinical marker of platelet hyperreactivity in patients with diabetes.
Biomarkers* ; Blood Platelets* ; Diabetes Mellitus* ; Fibrinolysis ; Humans ; Mortality

Mucormycosis occurs primarily in patients with severe underlying illness, especially leukemia, lymphoma, and uncontrolled diabetes mellitus. Cutaneous mucormycosis is somewhat less frequently associated with systemic illness than other forms of mucormycosis. The associated mortality is significantly less than that related to rhinocerebral form. More recent reports have shown that primary cutaneous mucormycosis has emerged as an important form of the disease. It develops where a break in the integrity of the skin has occurred as a result of surgery, bum, or other forms of trauma. We report a case of primary cutaneous mucormycosis in a healthy person without systemic illness, which was successfully treated with amphotericin B therapy for 2 weeks.
Amphotericin B ; Diabetes Mellitus ; Humans ; Leukemia ; Lymphoma ; Mortality ; Mucormycosis* ; Skin

Metabolically healthy obesity (MHO) is a new concept in which an individual may exhibit an obese phenotype in the absence of any metabolic abnormalities. There are a number of definitions of MHO that utilize a variety of components. The findings of clinical and basic studies indicate that subjects with MHO do not exhibit an increased mortality, an increased risk of cardiovascular disease, or an increased risk of type 2 diabetes mellitus, as compared to normal-weight controls. Although these findings imply that metabolic health is a more important factor than obesity, several studies have shown that subjects with MHO have a similar risk of metabolic or cardiovascular diseases as those with metabolically unhealthy obesity. Thus, there is still debate regarding not only the implications of the MHO phenotype but its very existence. Accordingly, future studies should focus on developing a unified definition of MHO and distinguishing subjects who will be at a high risk for metabolic and cardiovascular diseases.
Cardiovascular Diseases ; Diabetes Mellitus, Type 2 ; Mortality ; Obesity* ; Phenotype*

Glycemic variability comprises 'glucose variability' and 'hemoglobin A1c (HbA1c) variability.' Glucose variability relates to the within-day fluctuation of glucose level and may eventually reflect an increase in HbA1c level. Long-term glycemic variability, which is assessed by HbA1c fluctuation, reflects changes in glycemia over longer periods of time. Previous reports from several cohort studies have demonstrated that HbA1c variability is associated with the development or progression of microvascular complication in type 1 and 2 diabetes mellitus. However, data on the impact of HbA1c variability on macrovascular complications are controversial, and little is known about its impact on mortality. Further studies with a larger population including various ethnic groups are required to verify the impact of HbA1c variability on micro- and macrovascular complications of diabetes. Also, stabilized control of long-term glucose level should be emphasized based on these study results.
Cohort Studies ; Diabetes Mellitus ; Ethnic Groups ; Glucose ; Humans ; Mortality

More than 25% of Korean population aged ≥ 65 years has diabetes, and elderly diabetic patients show higher mortality, reduced functional activity, and increased risk of hospitalization. The care of elderly diabetic patients is complicated by their clinical, cognitive, and functional heterogeneity. Healthy patients with good functional status can be treated using therapeutic interventions and goals similar those for younger adults with diabetes. For patients with complications and reduced functionality, intensive glycemic control should be avoided. Glycemic goals for older patients might be individualized so that treatment can achieve the appropriate balance between glycemic control and risk of hypoglycemia.
Adult ; Aged ; Diabetes Mellitus ; Hospitalization ; Humans ; Hypoglycemia ; Mortality ; Population Characteristics