Introduction: Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes (T2D) and a major cause of blindness. DR awareness is important for early identification and management in patients with T2D. This study aimed to estimate the level of awareness of DR and its risk factors among patients with T2D in Saudi Arabia.

Methods:We conducted a cross-sectional study to analyze data collected from 291 patients with T2D attending outpatient clinics in the General Hospital in Rabigh during 2020-2021. We collected demographic information and level of awareness about T2D and DR.

Results:Among 291 patients with T2D, 42.3% had T2D for more than five years, and 37.8% had T2D for two to five years. In our study population, 32.3% of participants obtained high school education, and 42.3% had moderate income. Over half of respondents (56.4%) had their last eye exam within the past year, and 68.4% of participants believed high blood glucose levels might cause vision problems. The mean standard deviation of the DR awareness score was 7.23 2.74. Most participants had moderate level of awareness (39.5% of participants), 31.6% had good level of awareness, and 28.9% had poor level of awareness about T2D and DR. Participantswithout DR or who had DR for less than two years and those who had their eyes checked by a doctor last year had a significantly higher DR awareness level.

Conclusion:We asked patients with T2D to assess their level of DR awareness. Most patients had moderate awareness levels, indicating a need for improved awareness ofT2D complication on retina and treatment options. Patients should also be motivated for retinal screening to reduce the risk of visual complications. Furthermore, DR screening programs should not be limited to eye care centers. Improved awareness and access to screening programs will help patients and their healthcare providers achieve optimal outcomes in prevention of DR.

Diabetesmellitus is characterized by chronic hyperglycemia and impaired carbohydrate metabolism due to a complete or partial lack of insulin secretion and/or action[1]. Type 2 diabetes (T2D) is the most common type of diabetes, accounting for 90%-95% of all patients with diabetes[2]. Global estimates indicate that 439 million people will be diagnosed with T2D by 2030[3]. Most cases of T2D are caused by the interplay of genetic, environmental, and behavioral risk factors[4].

Diabetes is becoming more common in high- and low-income countries[5]. Saudi Arabia was rated seventh out of 10 highestcountries inprevalence of diabetes in 2013, with 24% of adults aged 20-79 years diagnosed with diabetes, and the incidence is expected to climb[6]. Diabetes can damage organ systems resulting in serious problems over time, such as retinopathy, neuropathy, and nephropathy[1]. Because of its ocular consequences, T2D is a leading cause of blindness worldwide[7].

Diabetic retinopathy (DR) is one of the diabetic complications causingblindness around the world[8]. DR consists of early nonproliferative DR (NPDR) and advanced proliferative DR (PDR). The clinical features classify NPDR, such as retinal hemorrhages, microaneurysms, venous caliber changes, and intraretinal microvascular abnormalities. PDR is differentiated by pathologic preretinal neovascularization[9]. Studies in Saudi Arabia reported that the prevalence of DR is 16.7%-31%[10-11].

The duration of diabetes, poor blood glucose management, and the presence of other systemic disorders such as hypertension (HTN) are risk factors for DR[12-13]. Early screening, detection, and treatment of DR among patients with T2D require a strong awareness of DR and its risk factors to avoid potential visual damage[13-14]. Lack of knowledge regarding T2D, DR, the need for routine eye exams, and treatment advantages can result in poor adherence to recommendations, referral delays, and presentation with advanced DR[15-16]. This study aimed to assess the level of DR awarenessand its associated risk factors among patients with T2D in Rabigh, Saudi Arabia.

We conducted a cross-sectional study in the general hospital in Rabigh having patients with T2D diagnosed at least one year before the study started. The study included any Saudi adults age 25 or older with any degree of education, male or female. The study excluded patients with type 1 diabetes, patients younger than age 25, or pregnant patients. This study was approved by the institutional review board of King Abdulaziz University (Reference No 568-19).Wemet the patientsin person in the clinic and used a self-constructedquestionnaire from previous study which validated by revision of two community medicine and one internal medicine consultant to collect the data. The questionnaire was divided into two sections; the first concerned patient demographic information (e.g., age, gender, nationality, place of residence, and education level), and the second measured personal level of awareness of T2D and DR.

Twelve questions assessed participant level of awareness regarding DR using Likert-Type Scales[17]. Each right or positive answer was given a score of 1, and a score of 0 was given for the wrong and I dont care answers. The highest possible score is 12. Participants were classified according to their level of awareness into those having a poor level of awareness (i.e., scores < 6), a fair level of awareness (scores of 6-9), and a good level of awareness (scores of 10-12).

The data were coded, entered, cleaned, and analyzed using IBM SPSS Statistics for Windows, Version 22.0. (IBM Corp., Armonk, NY). Qualitative variables were presented using frequencies and percentages, while quantitative variables were shown as the mean standard deviation. A Chi-squared test was used to compare between two qualitative variables. We used a 95% confidence interval, and p<0.05 was considered statistically significant. And there was no multivariate analysis test.

Table1presents the distribution of 291 participants according to demographic data. The most common age range was 46-55 years (31.6%), 56.4% of the study population was male, 91.1% had a Saudi nationality, and 74.2% were from the Rabigh region. Approximately one-third (32.3%) of the participants had a high school education, 74.9% were married, 42.3% had a monthly income of 5000-10000 Saudi Riyals (SR), and 56.4% were employed. Also, 10% of participants were current smokers, and 10% engaged in regular physical activity. Most of them (60.8%) had chronic diseases, the most common of which was HTN; 44.7%. Approximately 43% of the participants were overweight [mean body mass index (BMI): 26.88 4.57 kg/m2].

Table1also presents the distribution of the participants according to conditions related to T2D, DR, and last eye exam. Approximately 42.3% of the participants had T2D for more than five years, 83.8% were on oral antihyperglycemic agents for T2D control, 61.2% had a history of vitamin B12 intake, and 59.5% took oral vitamin B12. Under half the population (45%) had a history of hospitalization for high blood glucose, and 58.8% reported checking their blood glucose daily. The most common T2D complications reported by the participants were nerve damage (49.5%) and foot damage (16.5%). Over half of all participants (56.4%) had their last eye exam within the past year, 41.6% had DR, and 57.7% had their eyes checked by a doctor in the last year.

Regarding the participants responses to DR awarenessitems, 81.8% heard about general complications of T2D, 73.2% heard about eye complications of T2D, and 35.1% knew the relationship between retinopathy and T2D. Approximately 45.4% of the participants knew what DR is, 39.5% knew factors leading to DR, 68.4% knew that vision could be affected due to high blood glucose levels, and 55.3% thought that T2D might lead to blindness. About one-third (30.6%) of them knew that a person with diabetes should undergo an eye checkup yearly or every two years, and 41.2% reported that when they are first diagnosed with T2D, they must screen their eyes at the time of diagnosis. Most participants (60.8%) thought DR is a treatable condition, 56.7% thought they needed regular eye screening for DR if their eyes were healthy, and 71.1% thought that good control of T2D might prevent DR (Table2). The mean level of awareness score was 7.23 2.74, and 28.9% of the population had poor awareness, 29.5% had moderate awareness, and 31.6% had good awareness of DR.

Table3shows that participants who are aged 46-55 years, female, reside in Rabigh, have a masters degree, earn >10000 SR monthly, regularly practice physical activity, and have no history of chronic diseases had a significantly higher DR level of awareness score than others (p<0.05). A nonsignificant relationship was found between participants nationality, marital status, occupation, smoking status, and BMI categories and the level of knowledge about DR (p>0.05).

Table3also showed that participants without DR or who had DR for less than two years and those who had their eyes checked by a doctor last year had a significantly higher DR level of awareness score (p<0.05). We found a nonsignificant relationship between the level of participants DR level of awareness and duration of T2D, type of T2D treatment, history of vitamin B12 intake, history of hospitalization for high blood glucose, and frequency of checking blood glucose (p>0.05).

Participants who had their last eye examination less than one year ago had a significantly higher level of awareness regarding DR (Figure1; p<0.05).

Our study explored patient awareness of DR and related risk factors in patients visiting an outpatient clinic in the general hospital in Rabigh. We found that 39.5% of patients with T2D had moderate levels of awareness regarding DR, 31.6% had good levels of awareness, and 28.9% had poor levels of awareness. Several studies have documented the levels of awareness of T2D patients regarding DR. In a study in Tabuk, 47.1% had poor levels of awareness, 27.7% had moderate levels of awareness, and 25.1% had good levels of awareness[18]. In another study in Jeddah, 82.6% were aware of DR[19]. This difference could be related to a range of socioeconomic factors and geographic location. Most of the patients in our study (n=213; 73.2%) were aware that T2D could impair the eyes, and 55.3% thought DR could lead to blindness. In Tabuk, 86.9% of patients were aware that diabetes could affect the eyes, and 78.5% reported that DR could lead to blindness[18]. These results were similar to a study conducted in Jordan in which 88.2% of patients with diabetes were aware that diabetes could affect the eyes, and 81% thought DR could lead to blindness[20].

The differences in awareness are often due to different educational levels. Most patients in our study believed that good control of their diabetes would prevent DR, but our population had relatively lower awareness than other studies done in Tabuk (94%) and Jordan (82.7%); this indicates a lack of awareness and the necessity for programs to improve awareness in our population[18, 20]. Patients were asked how often they thought their eyes should be checked after being diagnosed with diabetes, and 41.9% said every six months, while 30.6% answered yearly or every two years, and 17.5% said only when vision is affected. Nearly half of respondents in Jordan (50.6%) answered every six months, 20.7% answered every year, 5.1% answered every two years, and 23.6% answered that retinal assessment is important only when vision is affected[20]. Some 60.8% were aware of the existence of the treatment of DR. These findings were lower in comparison to the studies done in Malaysia (72.3%) and Tabuk (86.1%)[18, 21]. These variances could be due to differences in sample size and sampling procedure.

Our study had some limitations, being a single-center study with small number of patients. This impacts the generalizability of our results to other populations. We assess the level of awareness only in one type of diabetes. Moreover, there was no tools or education session to improve the level of awareness.

In this study, asample of patients with T2Dwere studied to assess their level of DR awareness. Most patients reported moderate levels of awareness. This result emphasizes the need for increased awareness about T2D, DR,and its prevention. Strategies to develop and implement awareness initiatives are crucial, and patients need to be motivated for retinal screening to reduce the risk of visual complications. To reach undiagnosed people, DR screening programs should not be limited to eyecare centers; screening campaigns should be implemented near their homes. Future nationalmulti-center studies having larger number of patientsare recommended.

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Awareness of Diabetic Retinopathy Among Patients With Type 2 Diabetes Attending the Outpatient Clinic in the General Hospital in Rabigh, Saudi Arabia:...

Diabetic socks refer to looser-fitting socks that prevent skin irritation and protect the feet. They are different than compression socks, which are generally tight-fitting and aim to prevent swelling and fluid retention.

People living with diabetes may experience complications from the condition, which can include problems with their feet. These individuals have an increased risk of blisters, ulcers, and infections, so they may wish to wear diabetic socks to help protect their feet.

These socks differ from compression socks, which people use purely for the purposes of reducing swelling and boosting circulation.

This article explains the uses and features of diabetic and compression socks. It also provides foot care tips for people with diabetes.

There are several differences between these types of socks.

Diabetic socks are a form of protective footwear that aims to protect the feet and reduce foot injuries, including wounds and blisters. Choosing appropriate footwear can help a person with diabetes keep their feet clean, dry, and healthy. As diabetes can impair wound healing, it is important to protect the feet and reduce the likelihood of injuries.

Socks for people with diabetes may vary slightly in their characteristics, but the features typically include:

Compression socks are a tighter-fitting form of footwear that applies gentle pressure to the legs and feet to encourage blood flow and alleviate swelling and discomfort. These socks may be useful for people with conditions such as varicose veins, lymphedema, and plantar fasciitis. They may also be useful during sports recovery, travel, and pregnancy.

Although people living with diabetes may experience circulation problems, many compression socks carry warnings that they are not suitable for people with diabetes. As these socks may restrict blood flow, they could further impede the healing process. Therefore, it is advisable for a person with diabetes to consult a doctor before wearing compression socks.

Both diabetic and compression socks are widely available at many stores and from a range of online retailers. A person may wish to ask a doctor for their recommendations regarding particular features and brands.

A person can also explore whether diabetic and compression socks are available through their health insurance. However, in most cases, Medicare and other medical insurance plans do not cover either type of sock.

Anecdotal evidence suggests that diabetic and compression socks usually last for about 6 months. To care for diabetic and compression socks, it is advisable to wash them after each use. People can also consider using a mesh laundry bag to protect the socks during the wash and allow them to air dry.

People with diabetes must regularly check their socks for tears and holes, replacing them if necessary. They can also look out for and remove pilling. Any damage to the sock can increase the risk of a foot injury.

Similarly, people may wish to replace compression socks if they are too thin or show signs of wear. Socks in this condition may not provide adequate pressure.

People with diabetes may experience foot-related issues due to nerve damage and poor circulation. As such, it is vital to take good care of the feet to prevent potential complications, including infections and gangrene. Severe complications can make amputation necessary. Foot care tips for people with diabetes include:

Some questions that people often ask about diabetes and foot health include:

Diabetic socks aim to protect the feet and reduce the risk of injury or irritation. Features that help achieve this include being seamless, moisture-wicking, and padded. Compressions socks are tighter-fitting socks that apply gentle pressure to the legs and feet to help reduce swelling and discomfort.

Diabetes may result in high blood sugar levels, which can lead to blood vessel damage. This damage can reduce blood flow to the legs and feet, which can lessen the bodys ability to prevent infection and heal wounds.

People with diabetes can do this by exercising regularly, keeping their feet warm, and managing their cholesterol, blood pressure, and blood sugar. It is also advisable to avoid smoking.

Socks for people with diabetes are designed to protect the feet and reduce foot problems, such as blisters, ulcers, and infections. They have a seamless design with extra padding and moisture-wicking features.

These socks differ from compression socks, which are tight-fitting and apply gentle pressure to boost circulation and alleviate fluid retention.

It may be advisable for people living with diabetes to avoid using compression socks unless a doctor recommends them as part of the treatment plan.

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What are the differences between diabetic and compression socks? - Medical News Today

KABUL (Pajhwok): Physicians says patients with diabetes should be under treatment for several weeks after being infected with coronavirus because the disease can raise their blood sugar.

Dr. HashmatullahFaizi, in charge of quality control and trainer at the Afghan-Japan hospital, told Pajhwok Afghan News that people suffering from diabetes or heart diseases when contract Covid-19 their blood sugar level and heart problem increase.

He added statistics recorded in their hospital showed that patients with diabetes, when infected with Covid-19, their blood sugar levels increase and remain high for several weeks because the body of the person becomes weak and the immunity decreases as well.

Diabetes is a disease on which immunity has a great effect and if the immune system is low, blood sugar rises and becomes uncontrollable, he added.

He said if a diabetic person recovered from Covid-19, still it would take several weeks for the person to be under treatment.

Meanwhile, Dr Faridullah Omari, a trainer and specialist at Antani Hospital, told Pajhwok: Covid-19 disease not only affects respiratory system, but also the whole system of the body, including heart and digestive system.

He added the virus had negative impact on individuals suffering from diabetes and their sugar level became very high and even uncontrollable.

He explained: When a person gets infected with Covid-19, the virus also reaches his/her pancreas as it produces insulin and insulin lowers blood sugar and as a result the blood sugar level rises.

Dr. Omari added Covid-19 patients also develop mental and emotional pressure and as a result of fear and mental pressure, hormones develop anti-insulin effects. He added the certain hormones caused blood sugar to rise in a person.

He said research showed the rise of diabetes was not permanent after contracting the virus and it returned to normal within a few weeks, but only if the person was under treatment of a doctor.

He also advised diabetes patients to use their medicine under the supervision of a doctor and have a regular diet until the condition returns to normal.

Meanwhile, Dr. Mohammad BasirKhabri, an internal medicine specialist at Mazar-i-Sharif Covid-19 hospital, told Pajhwok that diabetes affected all the internal organs of the human body.

He added diabetic persons after being infected with the virus their diabetes level surges and if they did not pay attention, it would get out of control.

He also advised patients to be under treatment and follow a regular diet so their sugar level did not become uncontrollable.

sa/ma

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Mirroring a finding in humans, diabetes diagnoses in dogs are significantly more likely to occur in the winter and in the northern US compared to any other season or region, a new study shows.

For the study in PLOS ONE, researchers looked at 960 pet dogs with diabetes mellitus living across the United States. Though the findings dont explain the underlying cause of this correlation, the link with cold weather hints at future possibilities to pursue.

I was surprised we found this connection, even though it had been hinted at before.

This link is something that has been discussed in regard to humans with type 1 diabetes, but its never been rigorously looked at in dogs, says Rebecka Hess, a professor of internal medicine in the University of Pennsylvania School of Veterinary Medicine, and senior author of the study.

Its important to explore because dogs and people live in the same world. If the environmentcold temperatures and seasonalityare important in this disease in both species, it gives us something to look at with further research.

To investigate the relationships between geography, seasonality, and diabetes, Hess and Penn Vet colleagues recruited dogs with the condition from across the US, reaching out to all of the nations veterinary schools, the American Kennel Club, and breed clubs and leveraging social media to gain the broadest sample possible.

Owners filled out surveys about their pets, including their dogs age, date and age at the time of diabetes diagnosis, and state of residence.

For 669 dogs, the date of diabetes diagnosis was known. Of those, 33% were diagnosed in the winter, compared to 24% in the spring, 24% in the summer, and 19% in the fall.

When the researchers looked at geographic regions of the US, the North stood out, with 46% of diagnoses occurring in dogs in this region, compared to 27% in the South, 15% in the central US, and 12% in the West. This is despite the fact that many more dogsmore than 31 millionreside in the South compared to about 24 million in the North and about 13 million each in the central and West regions.

To be honest, I was surprised we found this connection, even though it had been hinted at before. I was always skeptical of the data, says Hess. But when I saw our results, it was quite clear. The findings were strengthened by the fact that diabetes diagnoses were more prevalent in both the winter and the North. Results would have been more difficult to interpret if, for example, we had found increased prevalence in the winter but also in the South.

Of the dogs in the study, 3% developed diabetes before they were 1 year of age. Like the diagnoses made in adulthood, these juvenile-onset cases were also more common in colder months and in the North but did not correlate to any particular breed, the researchers say.

Hypotheses about the connection between colder and more northerly climates and diabetes diagnoses in humans include links to vitamin D deficiency, diet, lifestyle, and viral infections. In dogs, the diet connection seems unlikely, Hess says, as most dog owners feed their pets a commercially available kibble, no matter their location or the season.

In addition, she says, overweight and obese dogs arent at higher risk of developing diabetes, so a connection with exercise, or lack thereof, seems unlikely.

In Hess view, the culprits are more likely to involve how the body processes either vitamin D or insulin. In human studies, lower levels of vitamin D have been connected with an increased likelihood of diabetes. And lower temperatures lead to declines in insulin sensitivity. Hess also says some researchers have floated a connection to a viral infection that may be more prevalent in cold weather.

In future work, Hess says she hopes to delve into the vitamin D connection, perhaps exploring how genetic variability in the vitamin D receptor correlates with diabetes risk. A study that examines a prior history of viral infection could also be revealing, she says.

Given the close relationship between humans and dogs, and the parallels we see when it comes to diabetes, it behooves us to look.

Source: Penn

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More dogs are diagnosed with diabetes in winter - Futurity: Research News

Yii presents a lucky draw prize to a young winner at the event, witnessed by Dr Fam (second left).

MIRI (Aug 22): The 2019 National Health and Morbidity Survey (NHMS) showed an increasing prevalence of diabetes among adults, of which almost half were undiagnosed.

In stating this, Deputy Minister for Tourism, Creative Industry and Performing Arts Datuk Sebastian Ting said according to the survey, almost five per cent of young Malaysians between 18 to 29 years old are diagnosed as diabetics.

It is worrying to see this trend, he said in a text speech read by Miri mayor Adam Yii who represented him at the opening of Miri Diabetes Camp 2022yesterday.

Pointing out that diabetes is a lifestyle disease, Ting said it is primarily affected by ones lifestyle which includes daily activities, dietary choices, eating pattern and the presence of other chronic diseases such as hypertension and dyslipidemia.

Diabetes is a disease that affects many organs, namely the heart, kidneys, eyes and wound healing. Nonetheless, it is reassuring to know that we now have a wide array of treatments for diabetes, available in most healthcare facilities in Miri, he noted.

It is my wish to look forward to more public educational, awareness events such as this to empower the community in the battle against diabetes. I must applaud Diabetes Malaysia for hosting the annual Miri Diabetes Camp, he said.

Ting also expressed his appreciation to the staff of Miri Hospital for their tireless efforts in treating diabetic patients and managing their complications, as well as the government health clinics in playing the role of primary and preventive care for the community.

The one-day Diabetes Camp which took place at Pullman Hotel was jointly organised by Diabetes Malaysia Association Miri branch and Miri Hospital.

Also present was Miri Hospital director Dr Jack Wong and event organising chairperson, Consultant Physician Dato Dr Fam Tem Lom.

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A new drug that reboots how fat cells use insulin could revolutionise type 2 diabetes treatment and improve the outlook of hundreds of millions of patients globally.

A new drug that reboots how fat cells use insulin could revolutionise type 2 diabetes treatment and improve the outlook of hundreds of millions of patients globally.

The drug, called PATAS, is in development after a team of international researchers, including Monash University, decoded what causes insulin resistance in fat tissue cells. This has been a major stumbling block in treating and preventing type 2 diabetes.

PATAS, which is being developed by AdipoPharma, could be delivered by simple injection and possibly a patch. It may also have the potential to prevent type 2 diabetes, a major global epidemic, largely driven by obesity.

Type 2 diabetes involves high blood sugar levels and is caused by the resistance of body cells such as fat cells (adipocytes) to the action of insulin, the hormone that enables glucose to be properly utilised in the adipocytes and in the rest of the body.

Published in the American Diabetes Association journal Diabetes, the French, UK, USA and Australian teams research found an inability by fat cells to regulate metabolism using glucose causes insulin resistance.

The research was led by Inserm, Frances National Institute of Health and Medical Research, in collaboration with Monash University and the University of Birmingham (UK).

Dr Vincent Marion, the Inserm study coordinator and deputy director at the Laboratory of Medical Genetics in Strasbourg, France, along with his team, designed the breakthrough peptide drug PATAS and has shown that it was able to fix this problem by enabling glucose to be used in fat cells.

Co-researcher Paul Zimmet AO, Professor of Diabetes at Monash University, said the discovery could improve metabolic control of diabetes and reduce the risk of the serious complications of diabetes including heart, kidney, liver and eye disease.

PATAS corrects an abnormality in fat cells by separating two proteins, ALMS1 and PKC alpha, that are associated with insulin resistance by blocking insulin from initiating glucose uptake.

In rodent studies, PATAS reduced the insulin resistance, glucose intolerance and fat build up in the liver (steatosis). Beneficial effects were also observed in glucose intolerant animal models. Similarly, when used on cultured human fat cells in the laboratory and independent contract research organisations, the drug reactivated glucose uptake in the fat cells.

Professor Zimmet said the discovery was potentially one of the most important he had seen in his 45 years of diabetes research. Human clinical trials are likely to start in 2023.

This is a very exciting discovery that could have enormous health benefits, not just for people with type 2 diabetes, but also for patients with other chronic medical disorders caused by insulin resistance including cardiac diseases, and fatty liver and the Metabolic Syndrome, Professor Zimmet said.

Current drugs for type 2 diabetes mainly focus on lowering the high blood sugar level rather than targeting insulin resistance, the underlying cause.

This research study has for the first time, identified the root cause of insulin resistance in adipocytes, a precursor of type 2 diabetes, and developed a drug that reduces insulin resistance and restores normal glucose uptake.

Type 2 diabetes is very costly for global economies and diagnoses are rising and patients are becoming younger, with the disease now frequently detected in adolescents and children.

Diabetes affects 537 million people worldwide, most of whom have type 2 diabetes. The International Diabetes Federation says the annual global cost of diabetes treatment was USD$966 billion in 2021 up more than 300 per cent in the past 15 years.

This diabetes breakthrough emerged following research into Alstrom Syndrome, an ultra-rare genetic disease in children. It is associated with obesity and severe insulin resistance that leads to type 2 diabetes and an accelerated form of liver steatosis and fibrosis. The researchers found that insulin resistance was linked to the dysfunctional protein, ALMS1.

Building on this previous research, the multinational team next discovered that in normal fat cells and upon insulin signalling, a protein called PKC alpha is released from ALMS1 to trigger glucose uptake. With insulin resistance, PKC alpha is no longer released from ALMS1 and hence glucose is no longer absorbed by the fat cells to be utilised.

Dr Marion said that in cultured human adipocytes as well as in most relevant animal models, PATAS was able to separate the proteins and restore normal function of glucose uptake and utilisation in the fat cells.

Thanks to PATAS, which rescues the adipocytes (fat cells) that could no longer access glucose, they were once again able to take up glucose and metabolise it to synthesise and secrete healthy lipid metabolites which are beneficial to the entire body for maintaining insulin sensitivity and overall metabolic health, he said.

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Innovative drug could improve type 2 diabetes treatment - Medicine, Nursing and Health Sciences - Monash University

Katherine R. Tuttle, MD, FASN, FACP, FNKF, a nephrologist from the University of Washington and Providence Health Care, discussed new consensus guidelines that call for the early use of sodium glucose cotransporter 2 (SGLT2) inhibitors, GLP-1 receptor agonists, and finerenone in the care of patients with both chronic kidney disease (CKD) and diabetes.

Rising rates of type 2 diabetes (T2D) worldwide are driving up incidence of chronic kidney disease (CKD), but these patients can reduce their risk of early death if physicians make better use of available therapies, starting with sodium glucose cotransporter 2 (SGLT2) inhibitors.

Katherine R. Tuttle, MD, FASN, FACP, FNKF, clinical professor of medicine, Division of Nephrology at the University of Washington, and executive director for research, Providence Health Care, called for a more holistic approach to addressing glucose control while also protecting the heart and the kidney late last month, as she addressed the American Society for Preventive Cardiology, meeting in Louisville, Kentucky.

Despite all that is known about prevention, Tuttle said, Today, 4 out of 10 people with type 1 (diabetes) and 3 out of 10 with type 2 will still develop kidney disease. This is half of all chronic kidney disease worldwide, she said. With 537 million people having diabetes in 2021, that translates into 200 million developing CKD; and the numbers with diabetes are forecast to reach 783 million by 2040.

So, for the foreseeable future, all of us will be seeing more and more people with chronic kidney disease, she said.

Tuttle offered additional data highlighting the interconnected nature of diabetes, heart failure, and CKD, noting the majority of patients with end-stage renal disease have diabetes. Cardiologists treat many of these patients, and they may be the first clinicians in a position to prescribe newer therapies that can halt renal progression. These are the highest risk patients who have the most to gain from what you have to offer, she said.

Not that its been easy to sort through conflicting advice. Guidelines from groups such as the American Diabetes Association (ADA) and nephrology professional society may not have been well harmonized, Tuttle explained, leading to confusion for treating physicians. To that end, she was part a joint effort by the American Diabetes Association and KDIGO (Kidney Disease: Improving Global Outcomes) that presented a consensus statement in June. The statement called for renin-angiotensin system inhibitors and statins to be used as first-line treatment for all CKD patients, including those with type 1 diabetes (T1D). But significantly, multiple other new therapies were included in first-line treatment, even ahead of metformin.

Over the past decade, she said, trials involving SGLT2 inhibitors, glucagon-like peptide-1 receptor agonists, have demonstrated significant benefits to the heart, kidney, and all-cause mortality in patients with diabetes.

Although SGLT2 inhibitors were developed to treat T2D, many other benefits have been discovered because of cardiovascular outcomes trials, which were required by the FDA to rule out any safety issues. When the drug class was shown to have benefits in heart failure and prevention of renal decline, manufacturers launched dedicated trials in these areas; some are still awaiting results.

Tuttle highlighted both a meta-analysis and 2 dedicated kidney studies that had been published this far (EMPA-KIDNEY for empagliflozin is due to report results). Importantly, both the heart and kidney benefits are present, even in this very high risk group of patients with established kidney disease, she said.

Kidney outcomesmeasures of estimated glomerular filtration rate (eGFR) that track kidney decline, showing the need for dialysis or transplanthave shown 40% risk reduction, while composites for heart failure, hospitalization for heart failure, and cardiovascular outcomes have declined 25%. Both are enormous, Tuttle said. Remember, especially people with kidney disease, these are the two major risks in this population. This is really a breakthrough moment for us.

She made special note of the historic significance of the DAPA-CKD study, which led to dapagliflozin receiving fast track breakthrough therapy designations in 2020firsts in nephrology. Results showed a 39% risk reduction for a composite measure of worsening renal function or risk of cardiovascular or renal death among CKD patients already receiving standard of care. Reductions in all-cause death or hospitalization for cardiovascular disease or heart failure were also impressive.

More recently, Tuttle said, trials involving the nonsteroidal mineralocorticoid antagonist (MRA) finerenone, have shown that the potent anti-inflammatory effects have produced positive renal outcomes. (Last year, results presented at the European Society of Cardiology showed finerenone cut hospitalization 29% in the highest-risk patients.)

So, were beginning to build the concept of combination therapy, because these drugs work very differently, she said.

Its extremely important, Tuttle said, for cardiologists to not rely solely on eGFR but also to screen for albuminuria, because that can help catch CKD in its earliest stages, when its treatable. She highlighted trial results that showed how finerenones results are not adversely affected by SGLT2 use, and then presented a case study about their concurrent use. So, the beautiful thing about this is, is not only may these drugs be providing complementary efficacy, but it may be that using and SGLT2 inhibitor mitigates hyperkalemia and allows us to deliver finerenone safely.

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SGLT2 Inhibitors, Combination Therapy Needed to Stem the Tide of CKD in Diabetes - AJMC.com Managed Markets Network

One of the most nuanced areas of diabetes management has become a focal point for diabetes care and education specialists: use of new technologies to improve care. With many in patient-facing roles, optimal uptake and dissemination of information, and the technologies themselves, have led to diabetes technology becoming a main topic of discussion at the Association of Diabetes Care and Education Specialists (ADCES) annual meeting and for good reason. In just the first half of 2022, major regulatory decisions have been made related to Omnipod 5, Eversense E3, and the FreeStylen Libre 3 devices.

With an interest in learning more about the real-world need for diabetes care and education specialists in advancing use of continuous glucose monitoring and other diabetes-centric technology, EndocrinologyNetwork sat down Gary Scheiner, MS, CDE, owner and clinical director of Integrated Diabetes Services, at the ADCES 2022 annual meeting for his perspective on the ever-changing landscape. That conversation is the subject of the video found below:

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The Role of Diabetes Care and Education Specialists on Leveraging Technology in Diabetes, with Gary Scheiner, MS, CDE - Endocrinology Network

Camp Kudzu is having their Kudzu One Day to educate families and kids with diabetes and spreading awareness in Central Georgia.

WARNER ROBINS, Ga. Camp Kudzu is hosting their 1st Kudzu One Day event on Saturday from 10 a.m. - 4 p.m. at Green Acres Baptist Church in Warner Robins.

Families with kids that have type 1 diabetes and are insulin-dependent can register today on the Camp Kudzu website.

There will be educational classes with health experts, camp activities, and snacks and drinks provided.

Check-in time starts at 9:45 AM.

The day will start with Dr. Stephen Ponder who will speak to parents about diabetes education.

Then, Jessica Hutchins, a pediatric endocrinologist with Atrium Health Navicent Medical Center in Macon, will discuss diabetes and mental health.

While the parents are attending classes, the campers and their siblings will create arts and crafts, play camp games, and learn about diabetes.

Families and kids will participate in color wars and a snow cone social.

Camp Kudzu asks that families bring their own lunch food for the picnic.

If you have questions or want more information, you can contact Community Coordinator Caroline Tallman by email at caroline.tallman@campkudzu.org.

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Camp Kudzu hosts event for families and kids with diabetes - 13WMAZ.com

Teachers and school staff of children with type 1 diabetes are being urged by the HSE and Diabetes Ireland to follow new guidelines about their care.

According to Diabetes Ireland, for children living with diabetes, a return to or starting school for the first time also means adapting to their diabetes management, sometimes changing insulin regimes, and thinking about blood glucose monitoring and safety in school.

Diabetes is a disease that occurs when a persons blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy.

It is caused by the bodys own immune system destroying the insulin-making cells (beta-cells) of the pancreas.

Ireland has a high incidence rate of type 1 diabetes in children and adolescents with on average 285 new cases of type 1 diabetes in those under 15 years diagnosed annually. Our country is in the top 25 per centfor diabetes incidence worldwide, according to Diabetes Ireland.

Up to five children and teenagers are diagnosed each week with Type 1 diabetes in Ireland.

There can be an added concern for parents, as well as for the teacher if a child with diabetes is starting school for the first time or changing to a new class or school with a teacher who may not be yet familiar with diabetes.

The younger the child, the greater the involvement in the diabetes management and care of school staff it is, often including special needs assistants.

To help make the transition as easy as possible for everyone, new guidelines have been published by the HSE in an effort to provide useful information and a number of tools and easy-to-follow actions to help school staff to understand type 1 diabetes and the needs of such pupils.

The document sets out clear guidelines that will help structure the conversation and preparations between the family, diabetes team, and school staff. It explains diabetes and diabetes management to teachers and school staff and sets out clear lines of responsibility for all partners.

The document also includes a Personal Pupil Plan to agree on current diabetes management and the needs of a child. This includes information such as personal hypoglycemia symptoms, what to eat during hypoglycemia, and when to check glucose levels and deliver insulin.

The school can have a personalised information pack for all their pupils with type 1 diabetes.

Dr Kate Gajewska, Diabetes Ireland Research and Advocacy Manager explained that for parents, the challenge of leaving a child on their own or under the care of others can be very stressful so good preparations and effective communication with school staff is vital and will help to reduce the feeling of uncertainty.

Dr Gajewska added: We hope this online resource will be helpful and we strongly recommend involving the childs diabetes team early in the planning and communication process and the guidelines will be of great help to everyone involved.

The online resource has separate sections for parents and carers, and the teachers and school staff. The first section includes tips on how to start planning for back to school early, explains how to prepare the school and what to expect, provides information on special needs assistance and requires non-teaching support, gives tips on healthy lunchtime snacks, and how to support the child from the mental health and well-being side.

In the section for teachers, SNAs and other staff educational materials about type 1 diabetes, hypo and hyperglycemia and diabetes management are provided, as well as information on how important it is for their mental health and well-being to be included in school life.

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Teachers and school staff of children with type 1 diabetes urged to follow new guidelines - BreakingNews.ie