Global diabetes burden: analysis of regional differences to improve diabetes care.

peer reviewed[en] INTRODUCTION: The current evaluation processes of the burden of diabetes are incomplete and subject to bias. This study aimed to identify regional differences in the diabetes burden on a universal level from the perspective of people with diabetes. RESEARCH DESIGN AND METHODS: We developed a worldwide online diabetes observatory based on 34 million diabetes-related tweets from 172 countries covering 41 languages, spanning from 2017 to 2021. After translating all tweets to English, we used machine learning algorithms to remove institutional tweets and jokes, geolocate users, identify topics of interest and quantify associated sentiments and emotions across the seven World Bank regions. RESULTS: We identified four topics of interest for people with diabetes (PWD) in the Middle East and North Africa and another 18 topics in North America. Topics related to glycemic control and food are shared among six regions of the world. These topics were mainly associated with sadness (35% and 39% on average compared with levels of sadness in other topics). We also revealed several region-specific concerns (eg, insulin pricing in North America or the burden of daily diabetes management in Europe and Central Asia). CONCLUSIONS: The needs and concerns of PWD vary significantly worldwide, and the burden of diabetes is perceived differently. Our results will support better integration of these regional differences into diabetes programs to improve patient-centric diabetes research and care, focused on the most relevant concerns to enhance personalized medicine and self-management of PWD

Neuroprotection in glaucoma: A model for nouroprotection in optic neuropathies

Purpose of review: Efforts to discover modalities and pathophysiologies that might afford successful neurorescue, neurorestoration, and neuroprotection of cells of the central nervous system have focused on processes that affect the central nervous system proper, that is, the brain. Often overlooked in the search for neural protection is the fact that the mammalian optic nerve behaves in many ways as an integral part of the central nervous system. As such, the eye-the optic nerve and retina-affords an ideal clinical model for neuroprotection and neuroprotective agents. Glaucomatous optic neuropathy is the most prevalent of all adult optic neuropathies, and offers an ideal primate and lower mammalian animal model for investigations of neuroprotection. Recent findings: This is especially compelling because while recent studies in glaucoma have shown reduction of intraocular pressure (IOP) to be an effective modality in the treatment of glaucomatous opt c neuropathy, not all patients respond to or can achieve meaningful IOP reductions. Therefore much attention has now been focused on neuroprotection as a strategy in therapies for glaucomatous optic neuropathy as a means of preserving retinal ganglion cells and their axonal projections. Summary: This review discusses the latest studies on various mechanisms of neuroprotection in the treatment of glaucomatous optic neuropathy. © 2003 Lippincott Williams & Wilkins