Prevention of diabetic eye disease: the commonest cause of blindness in individuals younger than 65 years

There has been a considerable advancement in the treatment of diabetes and understanding of the biochemical mechanisms underlying diabetic complications in the last 20 years. However, this advancement has not translated into a consistent reduction in diabetic retinopathy, one of the most frightening complications of diabetes mellitus. It is probable that greater attention to preventive intervention will help reduce the damage load in the next future, and that several drugs for the treatment of more advanced stages of diabetic retinopathy will become available. Competent strategies targeting prevention based on screening programs should be proposed to reduce the burden and to improve the clinical outcome of this devastating diabetes complication

Diabetes-Specific Nutrition Algorithm: A Transcultural Program to Optimize Diabetes and Prediabetes Care

Type 2 diabetes (T2D) and prediabetes have a major global impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. To mitigate this disease burden, interventions of proven effectiveness must be used. Evidence shows that nutrition therapy improves glycemic control and reduces the risks of diabetes and its complications. Accordingly, diabetes-specific nutrition therapy should be incorporated into comprehensive patient management programs. Evidence-based recommendations for healthy lifestyles that include healthy eating can be found in clinical practice guidelines (CPGs) from professional medical organizations. To enable broad implementation of these guidelines, recommendations must be reconstructed to account for cultural differences in lifestyle, food availability, and genetic factors. To begin, published CPGs and relevant medical literature were reviewed and evidence ratings applied according to established protocols for guidelines. From this information, an algorithm for the nutritional management of people with T2D and prediabetes was created. Subsequently, algorithm nodes were populated with transcultural attributes to guide decisions. The resultant transcultural diabetes-specific nutrition algorithm (tDNA) was simplified and optimized for global implementation and validation according to current standards for CPG development and cultural adaptation. Thus, the tDNA is a tool to facilitate the delivery of nutrition therapy to patients with T2D and prediabetes in a variety of cultures and geographic locations. It is anticipated that this novel approach can reduce the burden of diabetes, improve quality of life, and save lives. The specific Southeast Asian and Asian Indian tDNA versions can be found in companion articles in this issue of Current Diabetes Reports

Sleep apnea, sleep disturbance, and fasting glucose variability: a pilot study

3Background: Disturbed sleep and nocturnal altered breathing are related to disturbances of glucose metabolism. The present uncontrolled observational study explores the role of these factors on the variability of fasting glycemia. Methods: The number and duration of nocturnal awakenings and the fasting glycemia of 97 patients with type 2 diabetes treated with diet, metformin, or gliptins were recorded over seven consecutive days. During the same time period, the main respiratory indexes - oxygen disturbance index, apnea/hypopnea index, and respiratory disturbance index - were recorded for one night. Results: The three respiratory indexes and the number of nocturnal awakenings are highly correlated with the coefficient of variation of the fasting blood glucose recorded over the 7-day period at p < .005 level. A multiple regression analysis showed that the variables in the model explained 86% of the variability. Discussion: Respiratory/sleep disturbances appear to be modulators superimposed on blood glucose levels determined by other factors. © Diabetes Technology Society.nonenoneTatti, Patrizio; Strollo, Felice; Passali, DesiderioTatti, Patrizio; Strollo, Felice; Passali, Desideri

Is it fair to hope that patients with Type 1 Diabetes (autoimmune) may be spared by the infection of Covid-19?

The CoV-19 infection appears to be unusual among patients with type 1 Diabetes Mellitus, although they are considered a fragile population. We think that this in part due to the peculiar immune condition that leads to the destruction of the Beta cells.The CoV-19 infection appears to be unusual among patients with type 1 Diabetes Mellitus, although they are considered a fragile population. We think that this in part due to the peculiar immune condition that leads to the destruction of the Beta cells

Changes in ghrelin, leptin and pro-inflammatory cytokines after therapy in Obstructive Sleep Apnea Syndrome (OSAS) patients

The correlations between the levels of cytokines, apnea, and obesity are not well understood. The aim of this study was to investigate the relationship between sleep apnea, body mass index (BMI) and plasma levels of leptin, ghrelin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α)