Romanian Journal of Diabetes Nutrition and Metabolic Diseases https://rjdnmd.org/index.php/RJDNMD <p>The <strong>Romanian Journal of Diabetes Nutrition and Metabolic Diseases</strong> is the journal of the <strong>Romanian Society of Diabetes Nutrition and Metabolic Diseases</strong>.</p> <p>It appeared for the first time in 1992, in Romanian language and beginning with 2006 it was published entirely in English. It is a peer reviewed journal, therefore the accepted articles were peer-reviewed by <strong>at least two scientific experts</strong> in the field.</p> <p>It contains <strong>original papers</strong>, including fundamental and clinical research, <strong>literature reviews</strong>, <strong>clinical reports</strong>, <strong>editorials</strong>, articles that contain the <strong>results of the most important clinical studies</strong>, reports from the important congresses and <strong>book reviews</strong>.&nbsp;</p> <p>In Romanian Journal of Diabetes Nutrition and Metabolic Diseases there may be published only papers exclusively sent to this journal, not published previously. The authors should include possible conflicts of interest and financing sources. The laws of copyright and international rules of scientific research are respected.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases <strong>strictly requires</strong> for all the scientific work published <strong>to be 100% compliant</strong> with the&nbsp;<a title="ICMJE.ORG" href="http://www.icmje.org/icmje-recommendations.pdf" target="_blank" rel="noopener">Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals</a>&nbsp;and with the&nbsp;<a title="Best Practices" href="http://doaj.org/bestpractice" target="_blank" rel="noopener">Principles of Transparency and Best Practice in Scholarly Publishing</a> (joint statement by COPE, DOAJ, WAME, and OASPA).</p> <p>This journal appears trimestrially (four numbers/year). 650-800 copies are printed on each number.</p> <p>ILEX Printing House, Bucharest, has the exclusivity for the typesetting, printing and distribution of the Romanian Journal of Diabetes, Nutrition and Metabolic Diseases.</p> <p>Our journal is recognized by the Romanian National University Research Council (CNCSIS - 2009) to be part in the B+ category, Code 322.</p> <p>The Romanian Journal of Diabetes Nutrition and Metabolic Diseases is currently indexed in:</p> <p>- Index Copernicus<br>- Get Cited<br>- SCOPUS<br>- Scirus<br>- Celdes<br>- CNKI Scholar (China National Knowledge Infrastucture)<br>- CNPIEC<br>- EBSCO - TOC Premier<br>- EBSCO Discovery Service<br>- Google Scholar<br>- J-Gate<br>- Naviga (Softweco)<br>- Primo Central (ExLibris)<br>- SCImago (SJR)<br>- Summon (Serials Solutions/ProQuest)<br>- TDOne (TDNet)<br>- Ulrich's Periodicals Directory/ulrichsweb<br>- WorldCat (OCLC)</p> en-US journal@sanatateapress.ro (Dragoș Crețoiu) journal@sanatateapress.ro (Dragoș Crețoiu) Mon, 28 Mar 2022 15:00:35 +0300 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 Assessment of sleep quality, depression and nutrition habits of adults with insulin resistance https://rjdnmd.org/index.php/RJDNMD/article/view/929 <p><strong>Background and aims:</strong> The aim of this study was to evaluate sleep quality, depression status and nutrition habits of adults with insulin resistance.</p> <p><strong>Material and method:</strong> <em>The study was completed with 121 insulin resistance patients, 74 women and 47 men, aged between 18-65 years. The researcher applied to the participants a questionnaire including the Pittsburgh Sleep Quality Index (PSQI), CES Depression Scale (CES-D), Night Eating Questionnaire (NEQ) and 24-Hour Food Consumption Registration Form.</em></p> <p><strong>Results:</strong> The mean age of the insulin resistance patients was found to be 38.64 ± 12.71 years and 2.47 ± 2.82 years. It has been determined that 50.7% of the participants follow a low-carb diet. 54.5% of individuals had poor sleep quality and 52.9% had high depression levels; It was determined that 11.5% of them had night eating syndrome.</p> <p><strong>Conclusions:</strong> This study shows that individuals with insulin resistance should be monitored in terms of sleep quality, depression and night eating behavior. These results should be supported with new studies.</p> <div id="gtx-trans" style="position: absolute; left: 72px; top: 260.333px;">&nbsp;</div> İzan Işık, Pınar Altay ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/929 Mon, 28 Mar 2022 12:24:36 +0300 GLP-1R and IL-6 expression in the gastrointestinal tract of a murine model of metabolic syndrome https://rjdnmd.org/index.php/RJDNMD/article/view/1110 <p><strong>Background and aims:</strong> Glucose homeostasis is a critical cornerstone in both health and disease. It is described to be regulated by the balance of insulin and glucagon secretion but, this bi-hormonal perspective is long overdue, since glucose homeostasis is now known to be a multi-hormonal process. Metabolic syndrome (MetS) is a cluster of metabolic features which includes impaired glucose metabolism and obesity. Obesity promotes a low chronic inflammation state due to release of bioactive molecules like cytokines, ultimately contributing to cardiovascular disease, diabetes and cancer. The gastrointestinal tract (GIT), namely stomach and intestine, has a vital role not only in the food uptake and absorption, but also in the production of incretin hormones, such as GLP-1. We aim to evaluate the GLP-1 receptor (GLP-1R) in the GIT of a MetS animal model, and to assess whether it correlates with inflammatory levels.</p> <p><strong>Material and method:</strong> The expression of GLP-1R and Interleukin-6 (IL-6) was evaluated in the stomach and intestine of mice subjected to Normal Diet (ND) and High Fat Diet (HFD) by immunohistochemistry.</p> <p><strong>Results:</strong> We observed that HFD fed animals presented lower levels of GLP-1R in stomach and intestine when compared with animals fed with ND. Concomitantly, these mice expressed increased levels of IL-6.</p> <p><strong>Conclusions:</strong> GLP-1R expression is inversely correlated with the expression of the proinflammatory cytokine IL-6.</p> José Costa, Sofia Oliveira, Ana Cláudia Pereira, Raquel Soares, Pilar Baylina, Susana G Guerreiro, Rúben Fernandes, Carla Luís ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1110 Mon, 28 Mar 2022 12:29:03 +0300 Prevalence of syndrome Z among coronary artery disease patients attending a tertiary care hospital in south India https://rjdnmd.org/index.php/RJDNMD/article/view/1041 <p><strong><em>Abstract</em></strong></p> <p><strong><em>Introduction</em></strong><em>:</em></p> <p><em>Metabolic Syndrome (MS) and Obstructive Sleep Apnea (OSA) triggers the development of Coronary Artery Disease (CAD). This study aims to estimate the prevalence of syndrome Z (Metabolic syndrome + Obstructive Sleep Apnea) among CAD patients </em></p> <p><strong><em>Materials and Methods</em></strong><em>: OSA was assessed based on modified Berlin questionnaire and metabolic syndrome was identified based on </em><em>National Cholesterol Education Program Adult Treatment Panel</em><em> III guidelines. Anthropometric assessment and blood pressure were recorded. Serum triglyceride, high density lipoprotein level (HDL) and fasting blood glucose levels were estimated.</em></p> <p><strong><em>Results</em></strong><em>: </em></p> <p><em>Syndrome Z was prevalent among 51% of CAD subjects. The other groups were CAD only, CAD with MS and CAD with OSA. All data were compared using one-way ANOVA followed by Tukey’s multiple comparison. Blood pressure, triglyceride and HDL showed significant F test ratio. Post hoc test showed CAD subjects with syndrome Z had significantly higher mean levels of systolic BP (140.30± 17.94) (p=0.001), diastolic BP (89.09± 11.82) (p=0.003), triglyceride (232.73± 107.71) (p=0.000) and HDL levels (33.22± 6.46) (p=0.000) compared to other groups.</em></p> <p><strong><em>Conclusion</em></strong><em>:</em></p> <p><em>Concurrent presence of OSA and MS has adverse cardio-metabolic outcome. Identifying the presence of OSA and appropriate treatment at early stages can prevent the development of CAD to an extent</em></p> Narghis Bushra, Dr, Damal Chandrasekhar Mathangi, Dr; Nayar Pradeep, Dr; Remya Krishnan Jyothi ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1041 Mon, 28 Mar 2022 12:34:29 +0300 Multisystem inflammatory syndrome associated with SARS-COV-2 infection in an older adult: Case presentation https://rjdnmd.org/index.php/RJDNMD/article/view/1116 <p><em>Multisystem inflammatory syndrome (MIS) post SARS-COV-2 infection has been described in children. Few case reports of MIS in adults are available, the majority described in young previously healthy persons. Here we report the case of MIS that meets the Center for Disease Control definition of MIS in adults in an elderly patient with known type 2 diabetes with a recent history of COVID-19. As the number of COVID-19 cases continue to rise, we believe that more and more cases of adult MIS will be reported. Thus, investigations aiming to characterize the full spectrum of clinical manifestations, to clarify the pathogenetic mechanisms leading to adult MIS as well as long term consequences are needed.</em></p> Cosmina Cosma, Florina Pop Silvasan, Adriana Rusu, Cornelia Bala ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1116 Mon, 28 Mar 2022 12:36:24 +0300 The Early metabolic disorders among medical students https://rjdnmd.org/index.php/RJDNMD/article/view/768 <p><strong>Background and aims: </strong>People suffering from cardiovascular diseases (CVD), chronic kidney diseases (CKD) and/or diabetes mellitus (DM) type 2 or at high risk of such diseases need early detection and management.<strong> Purpose</strong> is to investigate early metabolic disorders among medical students. <strong>Material and Methods:</strong> investigated I group - Ukrainian medical students (n=31) with abdominal obesity and control group (n=12, healthy students). Methods: physical examination, medical history assessing, oral glucose tolerance test, HOMA-IR, blood lipids, urine albumin excretion (UAE), insulin, leptin, statistical methods. <strong>Results. </strong>Microalbuminuria is in 3 (9.7%) patients of I group. From I group 5 (16.1%) were active smokers, 26 (83.9%) - never smokers. The mean smoking index in I group was 5.0 (3.0; 7.0) packs/years, with correlation for UAE (r=+0.39; p=0.02). Hyperleptinemia was found in 30 (96.8%) patients in I group (p&lt;0.01), with correlation for UAE (r=+0.75; p&lt;0.001). In I group 8 (25.8%) patients had IFG and 9 (29.1%) IGT; 27 (87.1%) - hyperinsulinemia and 96.8% had IR (with correlation for UAE - r=+0.73; p&lt;0.001). Decreased HDL and elevated levels of TG was found in I group (p&lt;0.01). <strong>Conclusions:</strong> In medical students with abdominal obesity we found hyperleptinemia; dyslipidemia; prediabetic conditions and insulin resistance. Microalbuminuria was revealed only in 9.7% patients and indicates the early stages of glomerular kidney damage and the presence of endothelial dysfunction. Correlation analysis confirmed the predictive role of metabolic disorders for increasing UAE. Relationship between insulin resistance and urine albumin (r=+0.73, р˂0,001) indicates a predictive role in the development of renal dysfunction.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> Natalia Pertseva, Mariia Rokutova, Kateryna Malyar, Samir Shehadeh, Roder Saido ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/768 Mon, 28 Mar 2022 12:40:21 +0300 The barriers of diagnosis: A clinical case of Mauriac syndrome https://rjdnmd.org/index.php/RJDNMD/article/view/1138 <p>Mauriac syndrome is typically diagnosed in young patients with poorly controlled type 1 diabetes mellitus and is characterized by growth retardation, delayed puberty, cushingoid features, hypercholesterolemia and hepatomegaly. However, the sole presenting feature of Mauriac Syndrome can be hepatic glycogenosis (glycogen accumulation in hepatocytes) in both adults and children. This case reports an 18 -year-old patient with possible Mauriac syndrome. It was very difficult confirming Mauriac syndrome, due to lack of compliance and acknowledgement of his medical condition. Differential diagnosis is made with non-alcoholic fatty liver disease and with non-alcoholic steatohepatitis. These two, in time, can progress to cirrhosis and later to hepatocellular carcinoma, whereas Mauriac syndrome is potentially reversible with optimal diabetes control.</p> Anamaria Zah, Andrada Boanta, Adriana Rusu ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1138 Mon, 28 Mar 2022 12:46:00 +0300 Trans-cranial duplex and visfatin as markers for cerebrovascular complications in type 2 diabetes mellitus https://rjdnmd.org/index.php/RJDNMD/article/view/999 <p><strong><em>Background and aims:</em></strong> <strong>&nbsp;</strong>Transcranial Doppler (TCD) is a modern and sophisticated diagnostic procedure that enables recording the changes in cerebral perfusion in various states. We aimed to look into the role of TCD in studying the cerebral changes that occur in type 2 diabetic patients, as well as their relationship to visfatin and macro-and microvascular complications. <strong><em>Material and method:</em></strong> <strong><em>&nbsp;</em></strong>Twenty diabetic patients with no vascular complications were placed in group1, twenty diabetic patients with macrovascular complications were placed in group2, and forty diabetic patients with microvascular complications were placed in group 3. Serum visfatin level and TCD were performed on all patients. <strong><em>Results:</em></strong> The pulsatile index of the right and left middle cerebral arteries (PI RT &amp; LT MCA) have high sensitivity (69.2% and 64.1%, respectively) and specificity (75% and 95%) in predicting microvascular complications, with cut-off values of (1.005 and 1.035). A positive significant correlation between serum visfatin level and PI RT, and LT MCA with (p &lt;0.001, =0.035 respectively) among diabetics with no complications group, (p&lt;0.001) in both macro and micro-vascular complications group. <strong><em>Conclusion</em>:</strong> TCD is a non-invasive technique for determining brain circulation and predicting complications and prognosis in high-risk diabetics.</p> Samaa Ayman, Sahar Nassef, Nagwa Ramadan, Dina Sabry, Kareem Mohsen Moussa, Ahmed Fayed ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/999 Mon, 28 Mar 2022 12:49:22 +0300 Adherence to a Mediterranean dietary pattern in Moroccan type 2 diabetes patients https://rjdnmd.org/index.php/RJDNMD/article/view/1066 <p><strong>Background and aims:</strong> Adherence to the Mediterranean Diet (MED) improves the health and physical function of type 2 diabetes (T2D) patients. This study aimed to evaluate adherence to the MED in T2D patients, and identify the relationship with MED adherence, demographic, socioeconomic, and other lifestyle parameters. <strong>Material and method:</strong> This cross-sectional study concerned 343 T2D patients with complete dietary data. The survey was conducted from April to July 2019. Data collection was performed using a questionnaire including sociodemographic and lifestyle factors. The dietary intake was assessed by the Mediterranean Diet Adherence Screener (MEDAS). <strong>Results:</strong> Participants showed a moderate adherence to the Mediterranean dietary pattern (7.8 ± 1.2). Among 343 participants, high adherence to the MED was associated with elderly patients, suburban habitation, poor quality of life, physical activity, oral antidiabetic drugs, hypertension, and diabetes complications. Diabesity, diabetes phytotherapy, diabetes duration, controlled diabetes, and using honey are not associated with adherence to the MED. <strong>Conclusions:</strong> The application of the MEDAS makes it possible to identify which aspects require improvement and provides the opportunity to develop health education programs.</p> Youness El Achhab, Adel Tahraoui, Jaouad El-Hilaly, Badiaa Lyoussi ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1066 Mon, 28 Mar 2022 12:52:02 +0300 Levels of endothelial progenitor cells in children and adolescents with type 1 diabetes; an early marker for detection of cardiovascular complications https://rjdnmd.org/index.php/RJDNMD/article/view/966 <p><strong>Background: </strong>Type 1 Diabetes Mellitus (T1D) is a chronic metabolic disorder characterized by chronic hyperglycemia. T1D in children and adolescents is considered a high risk factor for the development of cardiovascular disease afterwards in adulthood. Endothelial&nbsp; progenitor cells (EPCs) number and function were found to influence endothelial function and vessels repair. Carotid intima medial thickness (CIMT) measurement has been a method to detect subclinical cardiovascular changes in children and adolescents with T1D, along with lipid profile and markers of glycemic control.</p> <p><strong>Methods: </strong>Sixty children and adolescents with T1D with disease duration exceeding 5 years were recruited from Diabetes clinic Ain Shams University Hospitals. They were compared to 60 age and sex matched healthy controls attending the outpatients’ clinics. All subjects were subjected to history taking, examination and blood sample withdrawal for: EPCs, lipid profile; total cholesterol, Triglycerides, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, as well as mean random blood sugar (RBS) and mean HBA1c. Also &nbsp;early morning samples of urine were collected for microalbumin, measurement of carotid intema media thickness was done and nerve conduction velocity study was performed to all patients as well as fundus examination.</p> <p><strong>Results:</strong> EPCs number and percentage were significantly lower in patients’ group (P = 0.001). The mean CIMT in patients’ group was significantly higher in patients’ group compared to control group (P = 0.003). Moreover, patients’ group had significantly higher levels of total serum cholesterol (p = 0.001) and LDL-cholesterol (0.015), and lower levels of HDL-cholesterol (p = 0.003) than the control group. There was a statistically significant negative correlation between EPCs percentage and mean RBS (p = 0.022), mean HbA1c% (p = 0.013), the presence of diabetic retinopathy (P = 0.001) but not with diabetic nephropathy nor diabetic neuropathy, total serum cholesterol (0.003), LDL cholesterol (p = 0.015) and mean CIMT (P = 0.021).</p> <p><strong>Conclusion:</strong> EPCs percentage is a good predictor for increased CIMT in children with T1D. Yet, further longitudinal studies are needed to confirm this relationship. Children and adolescents with T1D are at increased risk for atherosclerosis and macrovascular complications supported by the increased levels of harmful lipids (total serum cholesterol, triglycrides, LDL cholesterol) and increased mean CIMT. This may contribute to new strategies for early detection of diabtetes related complcations and intervention to prevent macrovascular complications.</p> Mona Salem, Abeer Abdelmaksoud, Hanan Issa, Mona Ismail, Osama Aboseri, Rasha Eladawy ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/966 Mon, 28 Mar 2022 12:55:03 +0300 The evolutionary profile of celiac disease via the compliance to the gluten-free diet in the western Algerian region https://rjdnmd.org/index.php/RJDNMD/article/view/1028 <p><strong><em>Background and aims:</em></strong> To assess the compliance to the gluten-free diet (GFD) of Algerian patients with celiac disease (CD) and to study the impact of long-term GFD on anthropometric, serological and histological parameters of these patients. <strong><em>Material and method:</em></strong> We conducted a retrospective study on 111 cases of CD patients followed up, from pediatric age until now, at the pediatrics department of the ORAN University Hospital Centre for many years. Two groups were made according to their adherence to the gluten-free diet. <strong><em>Results:</em></strong> The clinical presentation of the disease was typical (84.7%) and atypical (15.3%).. Two groups were selected group A and B for non-compliant diet (39.6%) and compliant diet (60.4%) respectively. There was a significant difference between the current age and the two groups of adherence (p=0.008) and with BMI (p &lt; 10<sup>-3</sup>). However, we noticed an excellent significant difference between a serology under diet and two groups (p=0.001) also with the grade of histology (p &lt; 10<sup>-3</sup>).&nbsp; Moreover, a significant reduction of IgA and IgG anti-t-TG in group B (p=0.001). <strong><em>Conclusions</em>:</strong> CD in Algeria is still characterized by a heterogeneous clinical symptoms and a good compliance to the GFD is a sign of the path to recovery.</p> Douniazad EL MEHADJI, Zouaoui Nadji, Khalida ZEMRI, Khedoudja KANOUN, Noria HARIR, Djamila YEKROU, Karim Bouziane NEDJADI, Latroche CHAREF, Siheme OUALI, Zahira BENAISSA, Walid Hassene HAMRI ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1028 Mon, 28 Mar 2022 13:24:41 +0300 The efficacy of isometric handgrip training on arterial stiffness and blood pressure in elevated and stage 1 hypertensive individuals – An interventional study https://rjdnmd.org/index.php/RJDNMD/article/view/1092 <p><strong>Objectives: </strong>Hypertension is considered as a risk factor for cardiovascular diseases.&nbsp; Various forms of exercises are recommended for pre-hypertensive stage as a prevention measure. The objective of the study was to evaluate the effect of isometric hand grip resistance exercise on blood pressure (BP) and arterial stiffness in elevated and stage 1 hypertensive individuals.</p> <p><strong>Methods: </strong>In this interventional study, 50 pre-screened pre-hypertensive individuals participated in the isometric hand grip exercise training. Participants were instructed to follow 40% maximum voluntary contraction (MVC) with 3 sessions per week for 8weeks. BP and vascular indices namely reflection and stiffness indices were measured and compared before and after the exercise.</p> <p><strong>Results: </strong>40 individuals participated in the program and were divided into two groups: Group I (n=21) with elevated BP and Group II (n=19) with stage 1 hypertension. Our study report indicates that the systolic BP was significantly decreased in both the groups (p&lt;0.001) while diastolic BP decreased only among the elevated BP group (p=0.01). Vascular indices did not report any significant change in both groups. Systolic (p=p&lt;0.001), diastolic (p=0.03), pulse pressure (p=0.001) and mean arterial pressure (p&lt;0.001) were significantly reduced when both the groups were taken together for the analysis. Heart rate was significantly positive correlation with the vascular indices (p&lt;0.001), similarly, diastolic BP was significantly positively correlated with stiffness index (p&lt;0.001).</p> <p><strong>Conclusion: </strong>Isometric hand grip exercise with 40% MVC with 3 sessions per week for 8weeks is effective in reducing the BP levels but has no effect on the arterial stiffness. Thus, this form of exercise can be recommended for the young pre-hypertensives.</p> <p><strong>Keywords:&nbsp;</strong></p> Deepika Velusami, Soundariya Krishnamurthy, Shivayogappa S Teli, Senthamil Selvi S, Mangani Mangalavalli S ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1092 Mon, 28 Mar 2022 13:32:41 +0300 Drivers of vildagliptin prescription for Romanian patients with type 2 diabetes, the TREND study https://rjdnmd.org/index.php/RJDNMD/article/view/1145 <p><strong><em>Background and aims: </em></strong><em>Vildagliptin is a dipeptidyl-peptidase-4 inhibitor, used in the treatment of Type 2 Diabetes Mellitus, associated with a slightly better HbA1c reduction compared to other molecules in its class, who may be used, in adjusted dose, irrespective the estimated glomerular filtration rate, including in end-stage kidney disease and which demonstrated an excellent safety profile. Vildagliptin is fully reimbursed in Romania within the National Diabetes Program. The main aim of this study was to evaluate which are the most important Vildagliptin’s prescription drivers. <strong>Material and methods: </strong>In this cross-sectional, non-interventional study data for 1918 patients in who Vildagliptin treatment was considered was collected in a consecutive-case population-based scenario. Data were collected from 106 diabetologists working in 61 cities from 36 Romanian counties. The median cases completed by a doctor was 18 (ranging from 1 to 31 responses, inter quartile range between 15 and 20).&nbsp;</em><strong><em>Results: </em></strong><em>The majority of Vildagliptin’s associations were to prior Metformin treatment (83.6% of the cases), among who in 48.7% of the cases Vildagliptin was added as early as possible to maximize the benefit according to the VERIFY study results. In 9.6% of the cases Vildagliptin was associated to sulfonylurea. In prescribing Vildagliptin, the most important driver was the improvement of glycemic control, considered by 72.6% of the responders as being extremely important, followed by the importance of cardiovascular protection (65.5% - extremely important), hypoglycemia avoidance (61.9% - extremely important) and the possibility of safely use in chronic kidney disease (59.1% - extremely important). 59.9% of the responders considered appropriate to intensify the diabetes therapy with Vildagliptin after 3 months of Metformin treatment and 31.2% considered adequate to add Vildagliptin right at the T2DM diagnosis alongside Metformin if this would have been possible in the reimbursement algorithm.<strong> Conclusions: </strong>Vildagliptin is considered a valuable intervention in the treatment of T2DM, its benefits being emphasized in case of its early use in the course of T2DM. The most important factor in considering Vildagliptin for a patient is the improvement of the glycemic control. The excellent safety profile and possibility to use irrespective of eGFR is considered a key advantage for Vildagliptin. </em></p> Bogdan Timar, Adina Braha, Laura Gaita, Alin Albai ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1145 Mon, 28 Mar 2022 13:34:32 +0300 Thyroid dysfunction and thyroid antibodies in a mild to moderate iodine deficiency area https://rjdnmd.org/index.php/RJDNMD/article/view/984 <p>Abstract</p> <p>Background and aims</p> <p>Albania &nbsp;is considered a region with mild-to-moderate iodine deficiency. The improved salt iodization program implemented in 2008 elevated the median urinary iodine excretion levels to the lower recommended level and reduced goiter prevalence in schoolchildren. Most of regions still remain with a mild or moderate iodine deficiency.Meanwhile there are no studies on prevalence of thyroid autoimmune disorders. The purpose of this study was&nbsp; to evaluate thyroid function and the presence of thyroid antibodies in a cohort&nbsp; of Albanian individuals not previously examined for thyroid diseases.</p> <p>Material and method:</p> <p>This is a cross-sectional study performed &nbsp;during a 2 year period (january 2019-january 2021). We assessed the prevalence of thyroid function disorders and presence of thyroid antibodies in 458 individuals&nbsp; (80% females and 20% males.Statistical analysis was performed to see the prevalence of thyroid dysfunction&nbsp; and presence of thyroid antibodies.</p> <p>Results:</p> <p>88.6 % (406) of&nbsp; subjects resulted euthyroid.We found a low prevalence of overt thyroid dysfunction (hyperthyroidism 1.1% and hypothyroidism&nbsp; 3.1%). The rates of subclinical hypothyroidism and hyperthyroidism were 5.5% and 1.7% respectively. The prevalence of positive thyroid antibodies, at least one of them was 26.5% in females and&nbsp; 11.8 % in males (2,2:1 ratio). 21 %&nbsp; (96&nbsp; individuals) from 458 examined,&nbsp; had normal thyroid function and resulted positive for anti TPO or anti TG</p> <p>Discussions:</p> <p>Undiagnosed biochemical thyroid dysfunctions were common in Albania, a country with&nbsp; mild to moderate iodine deficiency especially subclinical hypothyroidism. TSH level correlated well with the presence of antibodies. Measuring TPO antibodies in euthyroid subjects can be used to identify subjects with increased risk for hypothyroidism</p> <p>&nbsp;</p> Dorina Minxuri, Ridvana Mediu ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/984 Mon, 28 Mar 2022 13:36:23 +0300 Does TP53 gene polymorphism increase the risk of obesity and chronic pancreatitis comorbidities in type 2 diabetic patients? https://rjdnmd.org/index.php/RJDNMD/article/view/1082 <p><strong><em>Background and aims</em></strong><em>: </em>to establish the prevalence of genotype frequencies for <em>TP53</em> (rs1042522) alleles in type 2 diabetic patients with comorbid overweight/obesity and chronic pancreatitis (CP).<em> <strong>Material and methods</strong>:</em> The study involved 34 type 2 diabetic patients and 10 healthy individuals. Genomic DNA was extracted from peripheral blood leukocytes using a commercially available DNA isolation kit. The <em>TP53</em> gene rs1042522 C&gt;G polymorphism was genotyped using the Taq Man real-time PCR method.<em> <strong>Results</strong>:</em> We found a significant association between the C/C and C/G genotypes of <em>TP53 </em>rs1042522 SNP polymorphism in type 2 diabetic patients with normal body weight without CP and in type 2 diabetic patients with overweight/obesity. However, no significant difference was found between genotypes С/С, C/G and G/G of rs1042522 SNP in <em>TP53 </em>gene in type 2 diabetic patients with obesity and CP vs control group.<em> <strong>Conclusions</strong>: </em>The presence of the C allele of <em>TP53</em> SNP rs1042522 polymorphism in both homozygous and heterozygous states may indicate the increased risk of comorbid obesity development in type 2 diabetic population of Ternopil region, Ukraine. Small number of patients used in this study warrants further research.</p> Mariya Marushchak, Inna Krynytska ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1082 Mon, 28 Mar 2022 13:38:31 +0300 Telemedicine interventions in the management of diabetes mellitus in special epidemiological conditions https://rjdnmd.org/index.php/RJDNMD/article/view/1153 <p>The COVID-19 pandemic, an unprecedented epidemiological context, has brought multiple swift changes in public policies, healthcare facilities and the daily life of individuals worldwide. While the management of infections with SARS-CoV-2 have become a priority in most medical settings, a drastic reduction in the outpatient visits for noncommunicable diseases, an avoidance of hospitals and also a limitation in non-urgent medical appointments with delayed diagnosis and treatment have been reported.</p> <p>Diabetes mellitus (DM) is a lifelong condition that requires continuous non-pharmacological and pharmacological interventions to achieve and maintain an adequate control of glycaemic levels and of other cardiovascular risk factors. The COVID-19 pandemic has contributed to an increased difficulty in patients’ access to state-of-the-art diabetes care, situation that has found its solution through the inclusion of telemedicine into routine clinical practice. These interventions have been shown to improve glycaemic control, mental health and the communication between patients with DM and their healthcare providers, while also lowering the risk of potential infections with SARS-CoV-2. The aim of this review is to describe the epidemiological context that has led to the increased usage of telemedicine in diabetes and the diversity and benefits of these interventions.</p> Raul Patrascu, Laura Gaita, Adina Braha, Alin Albai, Sandra Lazar, Bogdan Timar ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1153 Mon, 28 Mar 2022 13:41:39 +0300 Diabetes mellitus and oral manifestations – An overview https://rjdnmd.org/index.php/RJDNMD/article/view/1050 <p>The global pandemic of diabetes mellitus is leaving a huge proportion of population debilitated. The hyperglycemic state along with the inflammatory and immune mediated changes result in long-term complications of diabetes. The quality of life of affected individuals are drastically reduced if the metabolic control is not achieved.&nbsp; The rate of progression of oral diseases is faster in a diabetic individual and this in turn can adversely affect the metabolic control of the disease. This review elaborates the oral manifestations of diabetes mellitus and mandates the need to educate non dental health care professionals involved in diabetic care about the complications.</p> Thara Chandran, Pushparaja Shetty, Audrey Madonna D’Cruz ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1050 Mon, 28 Mar 2022 13:44:12 +0300 Self-care behaviors in people living with type 2 diabetes https://rjdnmd.org/index.php/RJDNMD/article/view/987 <p><strong>Introduction:</strong> Type 2 diabetes is a chronic disease that impairs the body's ability to use carbohydrates in foods for energy. Self-care is an effective strategy to improve the status and control of chronic diseases, including type 2 diabetes. The present study aimed to identify self-care behaviors in people living with type 2 diabetes.</p> <p><strong>Methods:</strong> We carried out a narrative review in Februrary 2021 using the PubMed, Scopus, Science Direct, and Web of Science databases. After evaluating the title and abstract to select the most relevant studies based on inclusion and exclusion criteria, articles underwent quality assessment. The full text of selected articles was then thoroughly read to extract the essential findings.</p> <p><strong>Results: </strong>We identified 43 eligible records. In this study, a set of self-care behaviors was identified for individuals with type 2 diabetes in five main groups: diet, exercise, blood sugar monitoring, medication adherence, and other self-care behaviors. Based on the study's findings, the majority of reviewed studies (n=37, 86.0%) referred to diet and exercise as an effective self-care behavior for type 2 diabetes.</p> <p><strong>Conclusion:</strong> Refusal to engage with self-care increases the probability of complications of the disease, low quality of life, and also imposes high costs on the individual and the economy of society. Therefore, it is recommended to focus on self-care, especially behavior change and lifestyle modification of people with type 2 diabetes, rather than investing only in the clinical treatment of this disease.&nbsp;</p> Esmaeil Mehraeen, Mohammad Mehrtak, Amirali Karimi, Vahideh Aghamohammadi, Ali AkbarShekarchi, Jebraeil Farzi, Zahra Nazeri, Bagher Hayati, Khadijeh Nasiri ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/987 Mon, 28 Mar 2022 13:52:18 +0300 Diabetes and oral health: A review https://rjdnmd.org/index.php/RJDNMD/article/view/1104 <p>Diabetes mellitus is a common systemic disease whose incidence is currently rising in our contemporary world. In recent years, it has been well known that chronic periodontitis is listed as an important segment of the complications of diabetes mellitus. Along with chronic periodontitis several other oral manifestations such as increased incidence of dental caries, aphthous ulcers, xerostomia, burning mouth syndrome, etc. It has also been seen that those with diabetes mellitus are more prone to such oral conditions when compared to healthy individuals. Awareness regarding the bidirectional relationship between diabetes mellitus and general oral health, which is bidirectional in nature has shown to be unsatisfactory among the general public and those with diabetes whereas there is satisfactory awareness among physicians and dental practitioners.</p> Divine Nathalie Prato, Mamatha Shetty ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1104 Mon, 28 Mar 2022 13:56:32 +0300 The role of vitamin D deficiency and supplementation in onset and progression of diabetic nephropathy: A systematic review https://rjdnmd.org/index.php/RJDNMD/article/view/1093 <p>Diabetes mellitus (DM) and chronic kidney disease (CKD) are linked to Vitamin D deficiency in the realm of diabetic nephropathy. Vitamin D3 and Vitamin D analogues are increasingly assessed to hinder the progression of diabetic nephropathy. Hence, vitamin D supplementation in combating the progression of diabetic nephropathy was focussed. Pathogenesis of diabetic nephropathy is associated with oxidative stress and inflammation, regulated by nuclear receptors such as vitamin D receptor (VDR). Thus inhibiting progression underlies the molecular mechanistic mode of receptor based changes. Comprehensive analysis for mitigation of progression of diabetic nephropathy upon Vitamin D enrichment reveals potentiating benefits for retarding progression.</p> Ahmad shamim Khan, Muhammed Zubair; Shakeel Khan; Usman khalid, Khawar Sultan, Muhammad Kashif Khan ##submission.copyrightStatement## https://rjdnmd.org/index.php/RJDNMD/article/view/1093 Mon, 28 Mar 2022 14:01:10 +0300