Background and Aims

The study aimed to determine the changes in the shoulder muscle mechanical properties in patients with diabetes-induced adhesive capsulitis when the different dose of Radial Extracorporeal Shock Wave Therapies (rESWT) applied.

Methods

The randomized clinical trial conducted at Okan University Research Hospital (Istanbul). Participants were≥ 45years (mean 53.49±5.81 years), had T2D for≥3 years (mean duration 9.92±5.70 years), and had HbA1c≤9.0% (mean 7.38±0.76%); were being treated with inadequately basal insulin (20.5%) and oral antidiabetic drugs (79.5%) were enrolled. The rESWT was applied with Enraf ​​Nonius Endoplus device with a 25mm applicator, at 8Hz, and with 2000 beats. The participants were randomly assigned to three groups as follows: high dose rESWT (n=13), moderate dose rESWT (n=13) or placebo rESWT group (n=13). The primary outcome was biceps brachialis, infraspinatus, deltoideus, trapezius upper muscle properties evaluations with calibrated,MyotonPro device for over the 4th, and 6th week of the trial. Analyses were performed according to intention to treat.

Results

In the hrESWT group biceps brachialis, infraspinatus muscles tone and stiffness decreased together and the trapezius upper only has reduced tone at 4th week (p˂0.05). Only biceps brachialis muscle tone decreased (mean change:1.38±0.38, p˂0.001) in hrESWT group at the 6th week. In the mrESWT group, the tone of the deltoideus muscle decreased and biceps brachialis and deltoideus muscle stiffness decreased in the sixth week (p˂0.001).

Conclusions

In the diabetes-induced adhesive capsulitis the rESWT seems like an effective treatment intervention because of reduces the tone of the muscles around the shoulder joint and causes increased muscle compliance.

Background and Aims

The study aimed to determine the changes in the shoulder pain and muscle strength in patients with diabetes-induced adhesive capsulitis (DIAC) when the different dose of Radial Extracorporeal Shock Wave Therapies (rESWT) applied.

Methods

This double-blind randomized clinical trial conducted at Okan University Research Hospital (Istanbul) with patients referred from multiple centers. Participants were≥ 45years (mean 53.49±5.81 years), had T2D for≥ 3 years (mean duration 9.92±5.70 years), had DIAC, had HbA1c≤ 9.0% (mean 7.38±0.76%); were being treated with inadequately basal insulin (20.5%) and oral antidiabetic drugs (79.5%) were enrolled. The rESWT was applied with Enraf ​​Nonius Endoplus device with a 25mm applicator, at 8Hz, and with 2000 beats. The participants were randomly assigned to three groups as follows: high dose rESWT (hrESWT, n=13), moderate dose rESWT (mrESWT, n=13) or placebo rESWT group (prESWT, n=13). The primary outcomes were Visual Analog Scale (VAS) for pain and dynamometer evaluations for shoulder muscle strength for over the 4th and 6th week of the trial.

Results

Without the group differences (p˃0.05) pain decreased in 4th and 6th week in all three treatment groups (p<0.001). Increased strength of shoulder flexor, extensor and rotator muscles were observed in both groups receiving active rESWT(p˂0.05). Strength of abductor's muscles did not change in all three groups (p˃0.05). There was no increase in the strength of the evaluated muscles of the prESWT group (p˃0.05).

Conclusions

Different doses of rESWT were effective in improving muscle strength in the diabetes-induced adhesive capsulitis. In pain reduction, rESWT was effective without being different from placebo application.

Background and Aims

The foot is the most commonly affected body part among diabetic patients leading to peripheral vascular disease. Contact based NIRS device is known to have high sensitivity and low spatial resolution. The aim is to do the 3D reconstruction of vessels in the dorsum of the foot focused on spatiotemporal features during ischemia and reactive hyperemia.

Methods

In a room with controlled temperature, the 3 healthy volunteers were asked to sit comfortably in a chair with feet flat on the floor. A pad consisting of 8 sources and detectors was placed on the right dorsum of the foot. Initial NIR signals were collected for 30 seconds with a cuff around the right leg at 0 mm Hg. After, a cuff was inflated (ischemic) at 60 mm Hg for 10 seconds (s). The pressure was maintained for 50 s before deflation (reactive hyperemia) at 0 mm Hg. The signals were collected for 3 consecutive days for each patient in a dark room and processed to obtain the spatiotemporal features. A 3D reconstruction of vessels was done to show the different responses in cuff pressure.

Results

The result showed that intensity changes with time and on the temporal plots, it showed that as cuff pressure increases, the intensity detected also increases. In relation to the image, better vessel structures are reconstructed since more scattering and less absorption from chromophores happened.

Conclusions

The method allowed the extraction of spatiotemporal features. Moreover, the presentation of results in 3D reconstruction showed the effect of pressure on vessel oxygenation.

Background and Aims

Background: A sustained increase in bodily glucose levels is associated with several chronic illnesses, such as diabetes. Currently, no single test is globally affordable, innocuous and predictable at measuring glucose levels. We tested earwax as a viable option to measure short and long-term glucose levels in comparison with Glycated Haemoglobin (HbA_1c) in healthy individuals.

Methods

Methods: 37 participants provided standard glucose blood samples, HbA_1c and earwax on two occasions, one month a part. The samples measured baseline fasting glucose, a follow-up postprandial glucose level and a between sample long term glucose concentration estimation calculated using the mean value at the two time points. The baseline earwax sample was extracted with a conventional procedure and the follow-up with earwax self-sampling device.

Results

Results: The earwax extraction time using the self-sampling device was considerably faster than the conventional method. Earwax proved to be a reliable method to measure glucose concentrations at both time points with stronger correlations compared to HbA_1c which ranged in the low to moderate spectrum. Earwax methods were approximately 60% more predictable than HbA_1c in measuring chronic glucose levels. Follow-up postprandial concentrations were larger than their respective fasting baseline levels. Earwax showed to be unaffected by a range of confounders contrary to glycaemic and HbA_1c samples.

Conclusions

Conclusion: Earwax measurements proved to be more predictable than HbA_1c in measuring fasting, postprandial and long term glucose measurements and unaffected by confounders. Earwax may be a suitable method for measuring glucose concentration by using the earwax self-sampling device .

Background and Aims

A new test kit, GTT@home, uses finger-prick blood samples to perform a standard OGTT procedure and record test data for cloud-based analysis. The procedure is self-administered conveniently at home. Data captured by the disposable GTT@home device can be sent by smartphone to the cloud for analysis, with results available electronically for interpretation. Performance of GTT@home was compared to corresponding venous plasma samples measured by the YSI 2300 reference analyser - the "gold standard" - for identification of glucose intolerance and diabetes.

Methods

100 women underwent a standard 2-hour OGTT procedure using a 75-gram glucose load. Corresponding finger prick and venous plasma samples were taken. Finger prick blood was added to the GTT@home device and venous plasma was analysed in the YSI analyser.

Results

Compared to YSI venous plasma, sensitivity of GTT@home for glucose intolerance was 100% (fasting glucose) and 90% (2-hour glucose); for type 2 diabetes, 2-hour sensitivity was 93%. Specificity was 99%. There was a slight negative bias; fasting -1.4%, 2-hour -0.5%. Correlation to YSI was excellent, with combined (fasting and 2-hour values) R² = 0.93 and kappa statistics of 0.96 (fasting) and 0.90 (2-hour).

Conclusions

GTT@home shows excellent correlation and low bias compared to laboratory YSI venous plasma, making it an effective replacement for laboratory based OGTT. Ease of use, patient acceptability increased test uptake have been demonstrated elsewhere. For detecting prediabetes and all forms of diabetes, GTT@home offers substantial improvements in sensitivity and specificity over the commonly used HbA1c test, with implications for the effectiveness of diabetes prevention programmes.

Background and Aims

Cardio-metablic risks have been reported to be most prevalent among Americans of African origin. However, there are inconsistencies among studies on the topic from Africans residents of sub-Saharan Africa. This study aimed at assessing the reliability and validity of a new non-invasive cardio-metabolic risk tool for usage among African elderly population.

Methods

A cross-sectional, community-based study was done among Ubungo Msewe residents in Dar es Salaam, Tanzania. Information on weight, height, fasting glycaemia, 2-hours post-prandial glycaemia, resting electrocardiogram, sitting systolic and diastolic blood pressures were performed. Continuous data were summarized using median (IQR) while categorical data were summarized using frequency (%). Generalised linear model was used to ascertain association among variables. Chronbach’s alpha coefficient was used to estimate the reliability index. Variables were assessed for their construct validity. A verbal informed consent was sought from each participant prior to inclusion into the study

Results

We recruited 472 black Africans. Median age was 67 (IQR: 63-71) years. Waist-circumference, female gender, age>65, fasting glycaemia as well as systolic blood pressure were the largest determinant of a cardio-metabolic risk in this study population ( chronbach’s α = .719, p=0.000). Waist -circumference correlated well with BMI ( γ = 0.81, p=.000). Cardio-metabolic risk index increased by a unit for each tenth-increase in systolic BP (p=.02), 3-unit increase in BMI (p=.05), 1.5 unit increase in fasting glycaemic level (p=.000). Majority (68.9%) of study participants had early repolarisation pattern on their resting electrocardiograms.

Conclusions

Non-invasive variables had appreciable reliability and validity in this study population.

Background and Aims

To determine aqueous cytokines association with macular edema after cataract surgery in patients with or without diabetic retinopathy (DR).

Methods

Undiluted aqueous humor samples were obtained from 64 patients with diabetes who underwent cataract surgery, among them 32 patients had a non-proliferative stage of diabetic retinopathy (NPDR) and 32 patients had no DR. A Bio-Plex multiplex assay system (Bio-Rad, Hercules, USA) was used to measure the concentrations of 6 human aqueous humor cytokines: interleukin-1β (IL-1β), IL-8, IL-10, monocyte chemotactic protein-1 (MCP-1), vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1 (ICAM-1).

Results

There was no significant difference in levels of IL-1β, IL-10, MCP-1 between groups. Levels of IL-8, VEGF, and ICAM-1 were significantly elevated in NPDR group (p = 0.009, p < 0.001 and p < 0.001, respectively). Meanwhile, the mean MCP-1, IL-8, VEGF and ICAM-1 concentrations of the ME (+) subgroup were higher than that of the ME (−) subgroup in both NPDR and no DR groups. Multivariate logistic regression analysis showed that MCP-1 was the only factor associated with ME after cataract surgery in patients without DR, whereas MCP-1, VEGF and ICAM-1 contributed to the development of ME in patients with NPDR.

Conclusions

The analysis of the aqueous humor may provide the basis for therapeutic approaches to the treatment of ME in patients with diabetes following uncomplicated phacoemulsification cataract surgery according to the presence or absence of DR.

Background and Aims

The aim of this study is to evaluate the pregnant women with gestational diabetes(GDM) during a 5 year period in SUOGJ "Mbreteresha Geraldine ",the way of delivery with Sectio cesarea or vaginal delivery and percentage of S/C,weight of birth.

Methods

This is a retrospective cohort study done for a 5 year period from 2012 to 2016.In our study are included only women with Gestational diabetes. The data are obtained from clinical birth charts.

Results

During our study done for a 5 year period 2012-2016 with data obtained from clinical birth charts we found 29 pregnant women with GDM.In 2012 were 6 women,in 2013 were 4,in 2014 were 3,in 2015 were 6,in 2016 were 10.28 of 29 women with GDM have given birth by S/Cesarea feto vivo,only one by vaginal delivery feto vico 4400 gr.To express in %,97%of these women has given birth to theor babies by S/Cesarea.22 of their babies have been over 4000 gr in weight,one of them 2900 gr delivered in the 34 week of pregnancy,one other was 3200gr and 5 of them were 3500-4000gr.11 of these 29 pregnant women were pregnant for the first time.7 of the others refered GDM in the previous pregnancy.17 of 29 gave birth in 38-38 week of pregnancy,7 in 37-38,1in 40 week,4 before 37 week.

Conclusions

GDM and % of S/C is increased.In 28 of 29 women was performed S/C. 22 of their babies have been over 4000 gr which favors birth with S/C.We must try to prevent,to detect early and to control GDM.

Background and Aims

Peripheral Arterial Diseases (PAD) have been a recurring issue on Diabetes Treatment. The best solution, as has been reported by physicians and researchers worldwide is a timely diagnosis. Currently, the best non-invasive method for PAD diagnosis is measuring the Ankle Brachial Index, which is based on the ratio between systolic pressure on the superior and inferior limbs. It is a time-consuming method that requires, generally, a sphygmomanometer and a Vascular Doppler device. In patients with Diabetes, detection of the blood wave pulse with the Doppler device can be difficult for non-experienced physicians and the high cost of proper equipment leads many clinics to not investing in their acquisition. An alternative device is therefore needed. We present in this work a solution for this issue, by means of an automatic measuring device for diagnosing PAD in a short time period and exempting the user from the necessity of the Doppler device.

Methods

We developed a non-invasive device made of low-cost components for diagnosing PAD. It is remotely controlled by cellphone (trough Bluetooth connection) and, by using a Pulse Sensor, it records the pulse waves and performs the pressure measurement, automatically presenting on the smartphone screen the final ABI result and diagnosis.

Results

The device is currently on the validation phase and has presented accurate results. The interface is easy to use and self-explanatory, as shown in the following figures. The average measuring time is 5 minutes.

Conclusions

Our device is presenting correct measurements and practicality of use. Further clinical tests must be performed.

Background and Aims

Diabetes complication arises mostly in the foot and worst scenarios leading to amputation. The aim is to do a 3-dimensional reconstruction of foot vessels during cuff inflation and deflation through a signal collection using remote NIRS having high spatial resolution and low sensitivity. The images could be of use for non-ionizing and non-invasive assessment of blood flow.

Methods

Diabetes complication arises mostly in the foot and worst scenarios leading to amputation. The aim is to do a 3-dimensional reconstruction of foot vessels during cuff inflation and deflation through a signal collection using remote NIRS having high spatial resolution and low sensitivity. The images could be of use for non-ionizing and non-invasive assessment of blood flow.

Results

The comparison of temporal features was consistent. At 0 mm Hg, there is greater blood flow which resulted in greater absorption of optical light, therefore, lesser NIR intensity detected. However, better vessel structures were reconstructed in lesser blood flow with higher scattering and less absorption.

Conclusions

The processing of signals allowed the extraction of spatiotemporal features and 3D image reconstruction. These images could be of use as biomedical evidence in the assessment of foot vessels that could improve patients’ quality of life.

Background and Aims

Scientific evidence for digital health applications (apps) which claim to help in the prevention and management of diabetes (T2D) is meagre. We aimed to evaluate currently available health apps for prevention of T2D amongst South Asians.

Methods

Using the key words diabetes prevention, healthy lifestyle and fitness, two independent reviewers selected apps only if they were commercially available in India, in English, updated in last 6 months, had an average user rating of ≥3, 10,000+ downloads and at least 50 user reviews. The apps were rated on a scale of 1 to 4 (max. score 16) based on above mentioned criteria by a third reviewer. App size was also rated but had reverse scoring. Apps were excluded if they offered medical treatment, unconventional diets, pharma delivery, promoted a brand/device or were in beta testing mode.

Results

Using the key words from over 740 apps, 47 met the eligibility criteria. Using the rating system,16 apps with an overall score of 9 were selected. Of which 87%(14) apps had a rating of 4 and above and 50,000 plus downloads, 81%(13) apps had size below 30MB and 50% (8) had user reviews above 10,000. Further, these apps will be downloaded and evaluated using a scientifically established tool called the Mobile App Rating Scale (MARS).

Conclusions

Many health apps are currently available in the market however robust evaluation of these apps is lacking. It is crucial we develop a standard evaluation methodology that rate these apps for their quality and evaluate their efficacy as a health tool.

Background and Aims

ABSTRACT

1-T2DM is dominantly transmitted disease

use Oral Glucose Tolerance Test (OGTT),

4- the treatment is normal life style if not wanted the only medication useful is insulin’s (basal or fast action)

AIMS

1-to digose hyperglycemia 2- treat with normal life style and rapid insulin 3- to emphasize that DMT2 is a dominantly inherited disease t

Methods

Method

all subjects studied were volunteers

The Oral Glutcose Tolerance test was used

1-300 subjects were fastin the rest with their usuall daily beakfast

2- blood gucose measure with a glucometer and blood was taken from the cubital vein. subjects took orally a 75 gr glucose solution. Fast acting insulin injetetd if the blood glucose was higher than 200mg/d

3-one hourr after the intake of the glucose solution blood glucose was measured again with the glucometer and blood was taken from the cubital vein

4-insulin, glucose, glucagon, cholesterol, triglycerides, HDL,were measured when the study was done in Brownsville Texas in Bogota no glucagon was measure

5-Hemoglobin A1c (HbA1c), is meassure now

Results

RESULTS

1-6% of the total volunteer studie were normal and they did not have family memebers with DMT2

2-94% have abnormal blood gluose: I-13% had hyperinsulinemia. II-48% had Impaiered Glucose Tolerance IGT-III-32% had prediabetes without symptoms.IV- 2% had hypoglycemia, without symptoms

Conclusions

CONCLUSIONS

1-DMT2 is a dominantly inherited disease

2-DMT2 begins with normal glucose and glucagon, if the patient has a normal life style. If the person does not normal life style develops hyperlycemia, or prediabetes, or diabetes

Background and Aims

The purpose of this analysis with the results from all performed clinical studies was to evaluate the CoG NI performance compared to the YSI 2300STATPlus reference method.

Methods

Data collected from 224 participants from four clinical studies were included into this analysis (52% male / 48% female, 26.3% type 1, 56.3% type 2, and 17.4% healthy subjects). The results were collected during in-clinic visits (standardized meal tests) and during 12 weeks of home use with comparisons to YSI during rapid glucose changes and stable glucose levels.

Results

Meta-analysis provided 3,798 paired NI/YSI data points from the in-clinic meal tests and 18,654 non-invasive measurements from the 12 weeks of in-home use. More than 99% of the noninvasive readings were in the A and B zones of the Consensus Error Grid. The total MARD (vs. YSI) of the entire meta-analysis data set of NI measurements was 15.2%. Forty-three possible interfering factors were tested, and no interference was detected. Fifty-four percent fewer hypoglycemic episodes were detected (p<0.01) with stable glycemic control (no change in HbA1c) during the three-month home use period. Patients were testing more frequently with the non-invasive module at home and reported a high level of treatment satisfaction.

Conclusions

The CoG device showed the acceptable performance and may help to improve routine care of patients with type 1 and type 2 diabetes.