Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

First Report of Glyphosate-Resistant Biotype of Eleusine Indica (L.) Gaertn. in Europe

Glyphosate-resistant biotypes of Eleusine indica (L.) Gaertn. have been detected in Asia, the Americas but not in Europe. The aim of this study was to evaluate resistance levels and possible target site resistance mechanisms of an E. indica biotype (19-1) collected from a plant nursery in Southern Italy where poor glyphosate efficacy was reported. Two dose-response experiments were conducted to evaluate the sensitivity of biotype 19-1 to glyphosate in comparison with two susceptible checks. 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) sequencing was performed to identify possible mutations conferring the resistance. The susceptible biotypes were completely controlled at the glyphosate recommended field dose of 360 g ae ha(-1), while 50% of the plants of biotype 19-1 survived at 1440 g ae ha(-1). The resistance index of biotype 19-1 ranged between 5.8 and 7.3 for the response variables of fresh weight reduction and plant survival, respectively. All the plants surviving glyphosate application and sampled for DNA analyses had the point mutation P106A. The biotype 19-1 can be confirmed as glyphosate-resistant, representing the first glyphosate-resistant population of E. indica in Europ

Evaluation of a Fixed Spraying System for Phytosanitary Treatments in Heroic Viticulture in North-Eastern Italy

Modern viticulture cannot be practiced without the use of plant protection products to control diseases like downy mildew, powdery mildew, and pests. In severely sloping vineyards, where mechanization is not possible, pesticide application is realized using spray guns, which is a laborious, expensive, and dangerous application technique. In these vineyards, where viticulture is defined as “heroic viticulture,” vine-growers could seriously take advantage of innovation in spray-technique applications. For this reason, several prototypes of a fixed spraying system (FSS) were realized in recent years. Two prototypes of a fixed spraying system were built in 2019 in two different vineyards in the Veneto region (north-eastern Italy). In both vineyards, the fixed spraying systems were used to perform pesticide application during the 2020 season to control downy mildew, powdery mildew, and pests. With this solution, both vineyards were successfully protected, resulting in comparable infection degrees and yields as the ones protected with airblast sprayers and spray guns. This study contributes to assert fixed spraying systems as an innovation that could improve working conditions, safety, timing, and performances of plant protection products’ application in heroic viticulture areas

Efficacy of a "contact center-based communication" in optimizing the care of inflammatory bowel diseases

Telephone helplines are a useful vehicle for the management of chronic diseases even though data on how these can ease management of inflammatory bowel disease (IBD) is still scarce

Bowel Damage in Crohn's Disease: Direct Comparison of Ultrasonography-based and Magnetic Resonance-based Lemann Index

Background: The Lémann index (LI), calculated by magnetic resonance (MR) or computed tomography enterography in association with endoscopy, was developed to assess bowel damage (BD) in Crohn’s disease (CD). Our aim was to investigate the concordance between ultrasonography-based Lèmann index (US-LI) and magnetic resonance–based Lèmann index (MR-LI). Methods: We prospectively evaluated all consecutive patients with CD referred to our IBD Unit. All patients had undergone endoscopy, US and MR within 1 month. US-LI and MR-LI were calculated by scoring previous surgery, location, extension, and intestinal complications. Furthermore, we evaluated the association between LI and: CD duration, Harvey–Bradshaw index, and other relevant clinical features. In accordance with recent literature, an LI .4.8 was considered indicative of BD. Results: Seventy-one patients with CD were examined. About CD location, 36% showed ileal disease (L1), 10% showed colonic CD (L2), whereas 54% had an ileocolonic disease (L3). Moreover, 27% of patients presented a noncomplicated behavior (B1), 45% had almost one stricture (B2), whereas 28% showed penetrating CD (B3). Perianal CD was observed in 16% of subjects, whereas 40% had undergone previous surgery. MR-LI and US-LI were 6.62 (95% confidence interval, 4.2–9.7) and 6.04 (95% confidence interval, 3.6–9.2), respectively (r 1⁄4 0.90; P , 0.001), with 35 patients (49%) showing an LI indicative of BD. No significant correlation was evident between LI and Harvey–Bradshaw index (P 1⁄4 0.9), whereas a significant correlation was found between both US-LI/MR-LI and CD duration (P 1⁄4 0.01). Conclusions: US-LI shows high concordance with MR-LI and could be considered a good option for assessing BD in CD by using a highly available and relatively inexpensive procedure