Malignant Insulinoma: Diagnostic Difficulties and Treatment Strategies in a Case of Persistent Hypoglycemia.

Hypoglycemia in non-diabetic individuals is a rare but critical condition that often signals an underlying pathology. Insulinoma, a rare neuroendocrine tumor of the pancreas, is a key differential diagnosis. As the most common functional pancreatic neuroendocrine tumors, insulinomas originate from pancreatic islet cells and are predominantly benign.

Economic Burden of Multimorbidity and Polypharmacy Among Geriatric Patients: A Single-Center Experience From Odisha, India.

Background Multimorbidity and polypharmacy are common in older adults and pose a considerable challenge to the health and social care system. They are complex and interrelated concepts in geriatric care that require early detection and patient-centered shared decision-making by multidisciplinary, team-led comprehensive geriatric assessment (CGA) across all health and social care settings. The primary objective of this study is to investigate the economic burden of multimorbidity and polypharmacy among geriatric patients.

Efficacy and Safety of Static Stretching and Daily Walking on the Cardio-Ankle Vascular Index in a Patient With Type 2 Diabetes Mellitus, Proliferative Retinopathy, and Lower-Extremity Peripheral Arterial Disease: A Case Report.

Proliferative diabetic retinopathy (PDR) and peripheral arterial disease (PAD) of the lower extremities are serious complications of type 2 diabetes mellitus (T2DM). Aerobic exercise has been shown to be primarily effective for glycemic control and gait disturbance owing to PAD. However, the safety and efficacy of exercise therapy in patients with PDR remain unclear.

Hepatic Glycogenosis: A Rare Complication of Type 1 Diabetes Mellitus.

Type 1 diabetes mellitus (T1DM) is a common autoimmune pathology requiring lifelong insulin therapy. We report the case of a 12-year-old girl with T1DM admitted to Department C of the National Institute of Nutrition of Tunis for diabetic ketosis. She had suffered from T1DM for five years, with poor glycemic control (hemoglobin A1C = 10%) and poor therapeutic adherence.

The Role of the Atherogenic Index of Plasma and the Castelli Risk Index I and II in Cardiovascular Disease.

Introduction: Metabolic syndrome (MS), identified by abdominal obesity, insulin resistance, hypertension, and/or dyslipidemia, occurs across all BMI (body mass index) ranges and increases the risk of atherosclerotic cardiovascular (CV) diseases and type II diabetes. The Atherogenic Index of Plasma (AIP) and Castelli Risk Index (CRI) I & II are ratios that can be calculated from a simple lipid profile test. These ratios are independent risk factors for CV diseases and have been shown to be increased in angiographically confirmed coronary artery disease (CAD) patients.

A Randomized Double-Blind Placebo-Controlled Study on the Safety and Efficacy of Probiotics for Insulin Resistance and Oxidative Stress Markers in Diabetic Patients With End-Stage Renal Disease on Hemodialysis.

Background: Chronic kidney disease (CKD) is a progressive loss of kidney function that can lead to end-stage renal disease (ESRD), requiring renal replacement therapy. Patients on chronic hemodialysis are at a higher risk of developing cardiovascular disease. This study aimed to investigate the effect of 12-week probiotic supplementation on insulin resistance, oxidative stress, and lipid profiles in diabetic patients with ESRD undergoing hemodialysis.

Assessing the Impact of Maitland Mobilization Combined With a Conventional Physiotherapy Regimen Using the Visual Analog Scale and Disability of the Arm, Shoulder and Hand Scale in Diabetic Frozen Shoulder With Moderate Tissue Irritability Level.

Background Patients suffering from diabetic frozen shoulder face particular challenges, including limited shoulder motion and excruciating pain. Although traditional physiotherapy methods are commonly used, it is important to investigate the effectiveness of combining Maitland mobilization with traditional treatments, especially considering patients' tissue irritability levels as often patients cannot tolerate mobilization and exercises due to tissue irritability. This study aimed to investigate the impact of Maitland mobilization combined with a conventional physiotherapy regimen on pain and functional ability using the Visual Analog Scale (VAS) and Disability of the Arm, Shoulder and Hand (DASH) scales in diabetic patients suffering from a frozen shoulder with moderate tissue irritability levels.

Diagnostic Challenges in Rhino-Orbito-Cerebral Mucormycosis With Diabetes Mellitus, Hypertensive Emergency, and Excess Alcohol Consumption.

A 72-year-old male with a history of excessive alcohol intake (35+ units of alcohol daily) presented to the emergency department with bilateral vision loss, periorbital swelling, headache, and sinus congestion with bloody nasal discharge. He was newly diagnosed with diabetes mellitus and presented with severe diabetic ketoacidosis and a hypertensive emergency (blood pressure of 240/90 mmHg). Despite initial normal brain and orbital imaging, the clinical presentation was complicated by multiple life-threatening conditions and a prior immunocompetent status, thereby delaying the early suspicion of mucormycosis.

The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus Remission: A Systematic Review.

Bariatric surgery has been shown to significantly affect type 2 diabetes mellitus (T2DM) remission, particularly in obese individuals. This systematic review aims to evaluate the effectiveness of bariatric surgical interventions in inducing remission of T2DM as well as to identify factors influencing surgical outcomes. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Serum C-peptide as a Predictor of Coronary Artery Disease in Middle-Aged Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Analytical Study.

Introduction Type 2 diabetes mellitus is a major public health problem. Coronary artery disease (CAD) is the major cause of morbidity and mortality due to diabetes. A subset of these patients develops this complication relatively early.

Effect of Furocyst on Lipid Profile and Insulin Resistance Across Different Categories of Body Mass Index in Women With Polycystic Ovarian Syndrome (PCOS).

Introduction Insulin resistance is a fundamental factor in the pathogenesis of polycystic ovarian syndrome (PCOS) and has been found to mediate a close association with obesity and dyslipidemia. While the anti-diabetic and anti-inflammatory properties of fenugreek seed extracts have been demonstrated, research on its anti-hyperlipidemic properties is still in its novice stage, with inconclusive evidence. The present study assessed the impact of fenugreek seed extracts rich in furostanolic saponins (Furocyst) on lipid profiles across different categories of body mass index (BMI) in women with PCOS.

Exploring Gamification and Serious Games for Mental Health: A Narrative Review.

The development of serious video games using gamification techniques and applying them to the management of mental health problems has emerged as one of the significant innovations in technology and mental health. However, various issues exist from the design stage of video games to the implementation stage, which can lead to problems with usability and accessibility and have non-beneficial effects on the individual. This review article provides an overview of various gamification technologies currently used in video games and virtual reality-based video games.

Newer Insulin Preparations and Insulin Analogs.

Diabetes mellitus represents a significant and growing global health challenge, with its prevalence steadily increasing. Insulin therapy remains a cornerstone of diabetes management. Since its discovery in 1921, insulin has undergone substantial advancements, evolving from crude animal extracts to highly refined recombinant formulations and biosimilars.

Diabetic Striatopathy: An Extremely Rare Form of Diabetes Mellitus End-Organ Lesions.

Diabetes mellitus is one of the most frequent endocrinopathies in the medical routine, appearing across different specialties. Although neurological involvement in the form of peripheral neuropathy is the most recurrent form acknowledged by physicians, the spectrum of neurological involvement can be more diverse. Here, we present a case of diabetic striatopathy, a rare neurological manifestation of diabetes mellitus with poor metabolic control, in a patient whose epidemiological group was not classically.

Pulmonary thromboembolism in adults: Experience from a tertiary care center.

Background: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). We aimed to analyze the risk factors, clinical presentations, evaluation and management strategies as well as outcomes of adult pulmonary thromboembolism cases at a tertiary care center.

Methods: In a retrospective observational study, all consecutive adult pulmonary thromboembolism cases admitted from January 2019 to September 2020 at our center were enrolled in this study.

Prevalence and impact of obstructive sleep apnea in type 2 diabetes mellitus: A descriptive cross-sectional study.

Background: Obstructive sleep apnea (OSA) has been reported to have a high prevalence in patients with type 2 diabetes mellitus. There is scarcity of literature on relationship between OSA and diabetes in Indian population.

Methods: A cross-sectional observational study was conducted at a tertiary care hospital and 80 consecutive and consenting patients with diabetes were enrolled over 24 months from 01 Sep 2014 to 31 Aug 2016.

Precision therapy for Developmental delay, Epilepsy and Neonatal Diabetes syndrome in the era of genomics.

Neonatal diabetes mellitus is a rare disorder with prevalence of one in 400,000 live births that's defined by persistent hyperglycaemia within the first six months of life. Neonatal diabetes is heterogeneous and can be transient or permanent. Developmental delay, Epilepsy and Neonatal Diabetes (DEND) syndrome is characterised by developmental delay, epilepsy, and neonatal diabetes.

External validation of Prediabetes Risk Test in Indian population for screening prediabetes.

Background: Prediabetes Risk Test (PRT) has been found valid in the Western population for screening prediabetes. However, ethnicity, race, geographical and other biological characteristics have been linked to the development of prediabetes. There is a dearth of literature on the external validity of PRT in the Indian population.

Importance of interprofessional collaboration in teaching diabetic foot self-management: Perceptions of health care professionals.

Background: Diabetes and associated diabetic foot ulcers require coordinated management, including several health care professional (HCPs). Therefore, an interprofessional (IP) team-based approach is essential for effectively managing and educating the population on diabetic foot self-management strategies. However, the perceptions of the HCPs related to the importance of IP teamwork in diabetic foot care and their readiness to work in an IP team are less explored.

Molecular and metabolic landscape of adenosine triphosphate-induced cell death in cardiovascular disease.

The maintenance of intracellular and extracellular adenosine triphosphate (ATP) levels plays a pivotal role in cardiac function. In recent years, burgeoning attention has been directed towards ATP-induced cell death (AICD), revealing it as a distinct cellular demise pathway triggered by heightened extracellular ATP concentrations, distinguishing it from other forms of cell death such as apoptosis and necrosis. AICD is increasingly acknowledged as a critical mechanism mediating the pathogenesis and progression of various cardiovascular maladies, encompassing myocardial ischemia-reperfusion injury, sepsis-induced cardiomyopathy, hypertrophic cardiomyopathy, arrhythmia, and diabetic cardiomyopathy.

Nocturnal sentry duty and cardiometabolic characteristics in armed forces personnel.

Background: Sleep deprivation can lead to increased body weight and blood pressure (BP), but the latent effects of partial sleep deprivation related to required night sentry duties within a short-term period on cardiometabolic characteristic changes in military personnel are unclear.

Aim: To investigate the association between night sentry duty frequency in the past 3 months and cardiometabolic characteristics in armed forces personnel.

Methods: A total of 867 armed forces personnel who were aged 18-39 years and did not take any antihypertensive medications in Taiwan in 2020 were included.

Sodium-dependent glucose transporter 2 inhibitors: Transforming diabetic cardiomyopathy management.

This article addresses the substantial findings of a study on sodium-dependent glucose transporter 2 inhibitors (SGLT2is) and their effects on myocardial function in patients with type 2 diabetes and asymptomatic heart failure. The editorial explores the broader implications of the study findings for clinical practice, thus highlighting the pivotal role of SGLT2is in improving cardiac function, reducing oxidative stress, and attenuating inflammation. It emphasizes the importance of early intervention with SGLT2is in preventing the progression of diabetic cardiomyopathy; hence, these inhibitors have the potential to transform the management of asymptomatic heart failure in patients with diabetes.

Stalking the stalk: Isolated pituitary stalk thickening and predictive factors for proliferative disease.

Background: Few studies have evaluated predictive factors of isolated pituitary stalk thickening (iPST) in children.

Methods: In this retrospective study, radiology, endocrinology, and neuro-oncology databases were interrogated to identify patients with iPST between January 2000 and June 2019. A blinded, longitudinal assessment of MRIs was performed using quantitative, semi-quantitative, and qualitative metrics.

Longitudinal trend in post-discharge estimated glomerular filtration rate in intensive care survivors.

Background: Acute kidney injury (AKI) within the intensive care unit (ICU) is common but evidence is limited on longer-term renal outcomes. We aimed to model the trend of kidney function in ICU survivors using estimated glomerular filtration rate (eGFR), comparing those with and without AKI, and investigate potential risk factors associated with eGFR decline.

Methods: This observational cohort study included all patients aged 16 or older admitted to two general adult ICUs in Scotland between 1st July 2015 and 30th June 2018 who survived to 30 days following hospital discharge.

Anesthesia management using remimazolam for coronary artery bypass grafting and aortic valve replacement in a patient with severe cardiac dysfunction: A case report.

Remimazolam, a short-acting benzodiazepine approved for use in general anesthesia in Japan in 2020, has cardiovascular stability superior to conventional anesthetics. Anesthesia management using remimazolam of a patient with impaired cardiac function and several complications is reported. A man in his 50s with hypertension, diabetes mellitus, and chronic kidney disease (G 5) on dialysis came to our hospital with a chief complaint of exertional dyspnea and chest tightness, and a close examination showed stenoses of three coronary arteries.