Diabetes-related molecular signatures in infrared spectra of human saliva

WOS: 000290261500001PubMed ID: 20630088Background: There is an ongoing need for improvements in non-invasive, point-of-care tools for the diagnosis and prognosis of diabetes mellitus. Ideally, such technologies would allow for community screening. Methods: In this study, we employed infrared spectroscopy as a novel diagnostic tool in the prediction of diabetic status by analyzing the molecular and sub-molecular spectral signatures of saliva collected from subjects with diabetes (n = 39) and healthy controls (n = 22). Results: Spectral analysis revealed differences in several major metabolic components - lipid, proteins, glucose, thiocyanate and carboxylate - that clearly demarcate healthy and diseased saliva. The overall accuracy for the diagnosis of diabetes based on infrared spectroscopy was 100% on the training set and 88.2% on the validation set. Therefore, we have established that infrared spectroscopy can be used to generate complex biochemical profiles in saliva and identify several potential diabetes-associated spectral features. Conclusions: Infrared spectroscopy may represent an appropriate tool with which to identify novel diseases mechanisms, risk factors for diabetic complications and markers of therapeutic efficacy. Further study into the potential utility of infrared spectroscopy as diagnostic and prognostic tool for diabetes is warranted

An index to prevent major limb amputations in diabetic foot

Objective. Besides the early detection and treatment of diabetic foot ulcers, being aware of the risk factors for major amputation plays a crucial role in preventing the major lower limb amputations. Major lower limb amputations are not just mentally and physically hard for patients, but also have an effect on patient's survival and are a financial burden on both patients and healthcare systems. Subjects and Methods. We defined 37 potential risk factors for major amputation and these risk factors were investigated among 507 patients who had ulcers in their feet and were seen by the diabetic foot ulcer council at Ege University Faculty of Medicine. In our study, 106 (20.9%) patients ended up undergoing major lower limb amputation. Results. The univariate analysis showed that 24 defined risk factors were statistically significant. In the multivariate analysis using the Cox regression model, 6 risk factors remained statistically significant. Multivariate-adjusted hazard ratios were 4.172 for hyperlipidemia, 3.747 for albumin 3.365 g/dL, 3.368 for C-reactive protein (CRP) >2.185 mg/L, 2.067 for presence of gangrenous Wagner stage, 1.931 for smoking tobacco >30 pack/year, and 1.790 for hematocrit (HCT) 31.5%. Most patients with major amputation presented with a neuroischemic foot (58%). Gender and age were not found to be risk factors for major amputation. Having less than 7% of hemoglobin A1c (HbA1c) levels had a direct proportion with major amputation numbers. The mortality rates in one year, two and three years after the major amputation operations were 24.6%, 30%, and 35.9%, respectively. Conclusion. Being familiar with these risk factors for major amputation is crucial for multi-disciplinary teams to take good care of patients with diabetic foot ulcers and to lower the need for major amputations. © 2023 Bugra Zengin et al., published by Sciendo

Adipokines and inflammatory mediators after initial periodontal treatment in patients with type 2 diabetes and chronic periodontitis

PubMed ID: 20059414Background: This studywas performedtoevaluate theeffects of initial periodontal treatment on clinical periodontal measurements, glycemic control, and systemic inflammatory mediator levels in patients with type 2 diabetes and chronic periodontitis. Methods: Thirteen well-controlled (glycated hemoglobin [HbA1c] 0.05). IL-6 levels decreased in well-controlled patients with diabetes and in the systemically healthy group (P < 0.05). Adiponectin levels increased in the systemically healthy group (P < 0.05). Leptin levels increased at 1 month in well-controlled patients with diabetes (P < 0.05). Conclusions:Within the limits of this study, patients with type 2 diabetes and chronic periodontitis exhibited similar clinical periodontal improvements as their systemically healthy counterparts. Initialperiodontal treatment appeared to improve glycemic control in poorly controlled patients with diabetes. Decreases in levels of IL-6, TNF-?, CRP, and leptin and an increase in adiponectin levels after periodontal therapy may be a function of glycemic control in patients with type 2 diabetes. J Periodontol 2010;81:24-33

Effect of an Educational Intervention Based on Bandura’s Theory on Foot Care Self-Efficacy in Diabetes: A Prospective Quasi-Experimental Study

2-s2.0-85089544312The purpose of this study is to evaluate the foot care self-efficacy of diabetic foot patients and the effect of an educational intervention for improving it. This study was of a semi-experimental design and was conducted between January and December 2019 in a diabetic foot council of a university hospital. After power analysis to determine sample size, 33 participants meeting the inclusion criteria were included in the study. A Patient Identification Form and Diabetic Foot Care Self-Efficacy Scale (DFCSES) were used to collect data. Of the patients, 51.5% were male and the mean age was 54.91 ± 16.61 years. The mean score of DFCSES was 50.18 ± 20.88 before education and 72.67 ± 20.74 after education. The educational intervention has large effects on self-efficacy (d = 1.233), perceived knowledge level on diabetic foot (d = 1.102), perceived health status (d = 0.859), and perceived quality of life (d = 0.807). Educational intervention was found to be an effective way to improve foot care self-efficacy, perceived knowledge level on diabetic foot, perceived health status, and perceived quality of life. © The Author(s) 2020

Effect of an Educational Intervention Based on Bandura’s Theory on Foot Care Self-Efficacy in Diabetes: A Prospective Quasi-Experimental Study

The purpose of this study is to evaluate the foot care self-efficacy of diabetic foot patients and the effect of an educational intervention for improving it. This study was of a semi-experimental design and was conducted between January and December 2019 in a diabetic foot council of a university hospital. After power analysis to determine sample size, 33 participants meeting the inclusion criteria were included in the study. A Patient Identification Form and Diabetic Foot Care Self-Efficacy Scale (DFCSES) were used to collect data. Of the patients, 51.5% were male and the mean age was 54.91 ± 16.61 years. The mean score of DFCSES was 50.18 ± 20.88 before education and 72.67 ± 20.74 after education. The educational intervention has large effects on self-efficacy (d = 1.233), perceived knowledge level on diabetic foot (d = 1.102), perceived health status (d = 0.859), and perceived quality of life (d = 0.807). Educational intervention was found to be an effective way to improve foot care self-efficacy, perceived knowledge level on diabetic foot, perceived health status, and perceived quality of life. © The Author(s) 2020

The Relationship Between Blood Hypoxia-Inducible Factor-1α, Fetuin-A, Fibrinogen, Homocysteine, and Amputation Level

Reduced life expectancy has resulted from an increased incidence of chronic complications in patients with diabetes. The diabetic foot is one of these complications and generally presents together with diabetic neuropathy and vascular insufficiency. Hypoxia-inducible factor-1α (HIF-1α) is important in developing the adaptation response to hypoxia and facilitates healing through regulation of keratinocyte migration and epithelium restoration in wounds. Fetuin-A is a transporter protein that is synthesized in the liver and inhibits vascular and ectopic calcifications. It has been observed that altered fetuin-A is associated with peripheral artery disease through vascular calcification and is associated with inflammation and metabolic syndrome occurrence in diabetic patients. Fibrinogen is an acute-phase reactant and has a major role in homeostasis, tissue repair, and wound healing. Increased fibrinogen blood level is one of the factors that facilitates the hypercoagulability in diabetics. Homocysteine has atherogenic features and causes vascular toxicity by enhancing low-density lipoprotein oxidation. We evaluated the association of serum HIF-1α, fetuin-A, fibrinogen, and homocysteine levels with amputation in 31 patients diagnosed with diabetes mellitus. According to our evaluation, a negative correlation was determined between fetuin-A and amputation level (P =.012, r = −0.450), which was statistically significant. Unfortunately, there was no significant correlation between HIF-1α, fibrinogen, homocysteine, and amputation level (P >.05). As a result, it was suggested that vascular calcification due to fetuin-A deficiency may be important in the diabetic foot pathogenesis and that fetuin-A levels may be a predictor for amputation level. © The Author(s) 2020.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Ege University Scientific Research Project Commission (Project No. 16-TIP-011).16-TIP-01

Turkish Adaptation of Diabetic Foot Ulcer Scale–Short Form

PubMed: 324891242-s2.0-85085976205The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Diabetic Foot Scale–Short Form (DFS-SF). The study was cross-sectional and conducted between January and October 2019 in a diabetic foot council of a university hospital. A total of 194 diabetic foot patients participated in the study. A Patient Identification Form and DFS-SF were used for data collection. Forward and backward translations were used in language validity. Expert opinions were obtained to determine the Content Validity Index. To determine construct validity, exploratory factor analysis and confirmatory factor analysis were used. Cronbach’s ? internal consistency coefficient, item-scale correlation, and test-retest reliability were used to evaluate reliability. It was found that Content Validity Index was 0.97 (0.86-1.00), the factor loading of scale varied from 0.378 to 0.982, Cronbach’s ? value varied from 0.81 to 0.94, and item-total correlations were between 0.30 and 0.75. The Turkish version of the DFS-SF was found valid and reliable to measure the quality of life of diabetic foot patients. © The Author(s) 2020

Chitotriosidase might be a diagnostic marker in patients with hashimoto thyroiditis

Objectives: Hashimoto’s thyroiditis (HT) is the most common organ-specific autoimmune disease. The aim of our study was to investigate a possible role of chitotriosidase (Chito) activity as a potential marker of inflammation in diagnosis of patients with HT. In addition, we aimed to determine the levels of inflammation markers such as YKL-40, high sensitivity C-reactive protein (hsCRP) and oxidative stress (OS) parameters such as thiobarbituric acid reactive substances (TBARS), catalase (CAT), superoxide dismutase (SOD), GSH-Px to evaluate an association between those inflammatory and OS markers in patients with HT. Methods: 42 patients with HT and 28 control cases were studied. All cases were euthyroid. Chito activity was measured fluorometrically based on Hollak et al’s. method. hsCRP and YKL-40 levels were measured using ELISA. TBARS, SOD, and CAT activities were determined in hemolyzates. GSH-Px activity was determined by a colorimetric assay. Results: Higher Chito concentrations were observed in patients with HT compared to the control group (p=0.002). YKL-40 levels were detected higher in HT but it was not statistically significant (p=0.810). Chito levels were positively correlated with age and negatively correlated with SOD (r=0.360, p=0.021; r=-0.368, p=0.018). YKL-40 levels were positively correlated with FT3 and SOD in HT (r=0.324, p=0.037; r=0.312, p=0.044) and negatively correlated with age (r=−0.463, p=0.002). SOD levels were negatively correlated with age and positively correlated with YKL-40 (r=−0.371, p=0.016, r=0.312, p=0.044). Conclusion: We revealed that Chito levels were higher among euthyroid HT patients. This result may point out that Chito levels could be used as a potential marker of inflammation in HT. © 2023, Kare Publishing. All rights reserved.received no financial support