The study, a cross sectional survey, was carried out at the Changing Diabetes in Children (CDiC) Outpatient Department of CDiC, BIRDEM-2 Hospital over a 1-year period from July 2018 to June 2019. Diabetes mellitus was diagnosed according to WHO, ISPAD and Mohan's criteria. Height, weight and waist circumference were recorded and body mass index (BMI) scores were calculated as weight (kg)/height (m²). BMI was classified using the cutoff points (<5th percentile underweight, 5th - 85th percentile normal, 85th - <95th percentile overweight and ≥95th percentile as obese) using the Center for Disease control and Prevention growth chart. To determine microalbuminuria, urine microalbumin and spot urine creatinine were measured by Immunoturbidimetry method using 2000 DCA plus analyzer and Albumin Creatinine Ratio (ACR) was calculated. Microalbuminuria was defined when two consecutive samples of spot urine were positive. Statistical analysis was performed with the help of software SPSS for Windows (statistical package for social science), 20.0 version. Association between the two groups was evaluated by using Students chi square test. Of the total participant 512, type 1 diabetes mellitus were 61.9% and type 2 diabetes mellitus 38.1% were observed that microalbuminuria was 88.7% and macroalbuminuria was 3.6% in diabetes mellitus children and adolescents. The study revealed that overweight and obesity were high in microalbuminuria than other parameters of BMI and that were statistically significant (p<0.001). Early diagnosis and screening of these diabetic children and adolescents with obesity can regress microalbuminuria and also prevent further progression.

Microvascular and macrovascular or both types of complications is much more common in patients with longstanding diabetes mellitus. However, very few studies focused on the complication rate among newly detected type 2 diabetes mellitus patient. The objective of the study was to assess the frequency of micro and macrovascular complications among newly detected type 2 diabetes mellitus patients attending the Department of Endocrinology of BIRDEM General Hospital, Dhaka, Bangladesh. This cross-sectional study was conducted from January 2019 to December 2019. All study participants were screened according to inclusion and exclusion criteria and informed written consent was taken. Out of 311 respondents, the mean age was 53.28±8.84 years. Males were 63.7% and females were 36.3%. Among 311 respondents 52.7% (164) had complications and 47.3% (147) had no complication. Considering the total respondents (311), 40.2% respondents had microvascular complications, 7.7% had macrovascular complications and 4.8% had both micro and macrovascular complications. The frequency of Diabetic Neuropathy, Retinopathy, Nephropathy, CVD, CAD and PAD were 20.6%, 8.03%, 16.4%, 3.5%, 6.4% and 2.6% respectively. Considering risk factors 16.1% of respondents had a smoking habit, 47.9% were overweight and 29.9% were obese, besides 28.9% had hypertension. Hypertension, fasting plasma glucose, HbA1c, total cholesterol and LDL were significantly associated with neuropathy. Hypertension, fasting plasma glucose, HbA1c, LDL and urine for ACR were significantly associated with retinopathy. Hypertension, HbA1c, total cholesterol, LDL and urine for ACR were significantly associated with nephropathy. Smoking habits, HTN, fasting plasma glucose, 2 hours PG after OGTT, HbA1c, total cholesterol and LDL were significantly associated with CVD. Among the newly detected type 2 diabetes mellitus patients both micro and macrovascular complications were substantially found. Neuropathy was the predominant microvascular complication where was coronary artery disease was the most common macrovascular complication.

End-stage renal disease (ESRD) patients receiving maintenance hemodialysis are at high risk of hepatitis B virus (HBV) infection and demonstrate inadequate immune response to vaccination. The objective of the study was to assess the antibody response (anti-HBs levels) of hepatitis B vaccinated maintenance hemodialysis patients. This cross-sectional observational analytical study was conducted at Marine City Medical College Hospital, Chittagong, Bangladesh for 34 months of period among 50 patients receiving maintenance hemodialysis for more than 4 months. Demographic and clinical data were collected and post-vaccination anti-HBs titers were measured. Patients were classified as high responders (anti-HBs ≥100 mIU/ml), poor responders (anti-HBs ≥10 to <100 mIU/ml) and non-responders (anti-HBs <10 mIU/ml). The mean age of participants was 52±10 years; 60.0% were male. The mean duration of dialysis was 19.7±7.7 months. The common causes of ESRD were diabetic nephropathy (58.0%), glomerulonephritis (24.0%), hypertension (12.0%) and others (6.0%). Overall, 38.0% were high responders, 26.0% poor responders and 36.0% non-responders, seroconversion rate was 64.0%. Mean anti-HBs titers were 663±463 mIU/ml in high responders, 31.55±23.24 mIU/ml in poor responders and 3.23±1.98 mIU/ml in non-responders. Age >50 years, presence of diabetes mellitus and lower serum albumin were significantly associated with poor or non response (p<0.05). Development of protective antibody levels after hepatitis B vaccination in maintenance hemodialysis patients was inadequate. Older age, diabetes and low serum albumin were important predictors of poor response. Strategies such as booster dosing and revaccination may improve seroconversion rates in this population.

Arteriovenous grafts (AVGs) are important vascular access options for maintenance hemodialysis. Late AVG failure is commonly attributed to venous anastomotic stenosis, thrombosis, infection, or pseudoaneurysm formation. In contrast, intraluminal calcification is rarely recognized as a direct cause of access dysfunction. We report a 78‑year‑old woman with end‑stage kidney disease secondary to obstructive nephropathy and a history of hypertension, but without diabetes mellitus (BMI 24.65 kg/m²), who had undergone left forearm AVG implantation in October 2016. The graft had been used for maintenance hemodialysis for 9 years and 8 months (from October 2016 to April 2026). During follow‑up, she underwent eight endovascular interventions for recurrent graft thrombosis and insufficient access flow, with one non‑tunneled central venous catheter placement. She had Chronic kidney disease-mineral and bone disorder (CKD-MBD) and was receiving calcimimetic therapy. In April 2026, she was admitted because of recurrent insufficient dialysis blood flow and progressive cannulation difficulty, characterized by marked resistance during needle insertion and a gritty sensation, often requiring multiple attempts to access the lumen. Ultrasound showed hyperechoic stenotic lesions within the graft, suggesting calcified graft stenosis. Surgical exploration revealed extensive firm whitish material adherent to the inner wall of the original graft, occupying approximately 80% of the lumen as estimated by gross visual inspection of the resected specimen. The diseased graft segment was resected, and a new prosthetic graft was tunneled along a revised subcutaneous route and anastomosed to the original anastomotic site. Histopathological examination confirmed calcium salt deposition within fibrous collagenous tissue. One month after surgery, the reconstructed AVG was successfully used for hemodialysis. This case highlights intraluminal calcification as a potential structural cause of late AVG failure in patients with CKD‑MBD.

Both short and long interpregnancy intervals (IPIs) have been associated with adverse maternal outcomes, including uterine rupture, gestational diabetes mellitus (GDM), gestational hypertension and postpartum haemorrhage (PPH). However, the strength and consistency of these relationships remain uncertain, and there is limited information on how these associations differ according to country income status. This review is designed to examine the impact of the income status of a country on the relationship between IPI and maternal complications of pregnancy.

CINAHL, MEDLINE, EMBASE via Ovid, Global Health, LILACS and African Index Medicus will be searched using combinations of MeSH and Emtree terms with keywords. Studies included are expected to be observational studies; existing systematic reviews with no new data will be excluded. The study population will consist of women with two or more singleton births and the exposure assessed will be short IPI (<24 months, <18 months and <12 months between the birth of a child and conception of the next pregnancy) and long IPI (>60 months). The comparator group will be an IPI of 24-60 months, as recommended by several international organisations. The co-primary outcomes are preterm pre-labour rupture of membranes, PPH, pre-eclampsia, gestational hypertension, GDM, uterine rupture and maternal mortality. The income status will be categorised according to the World Bank income-based classifications for low-, middle and high-income countries. Two reviewers will independently perform study screening, data extraction and risk of bias assessment using the Newcastle-Ottawa Score. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework will be used to assess the certainty of evidence. A random effects model will be used to calculate pooled ORs with 95% CIs.

Ethics approval is not applicable for this study as no original data will be collected. The results will be disseminated through peer-reviewed publication and conference presentations.

CRD420251075283.Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251075283.

To determine the pooled prevalence of sarcopenia phenotypes and synthesise the evidence on factors associated with sarcopenia among adults with type 2 diabetes mellitus (T2DM) in India.

Systematic review and meta-analysis.

PubMed, Embase, Scopus and Web of Science were searched from inception to 14 January 2026, supplemented by reference list and citation searching.

Cross-sectional studies of Indian adults (≥18 years) with T2DM reporting sarcopenia prevalence using Asian Working Group for Sarcopenia (AWGS) diagnostic criteria.

Two reviewers independently screened and extracted data. Methodological quality was assessed using the Joanna Briggs Institute prevalence checklist. Proportions were logit-transformed and pooled using random-effects models with Hartung-Knapp CIs and prediction intervals. Associated factors were synthesised narratively within a tiered framework separating adjusted from unadjusted ORs.

Seven studies (n=1359) were included. Pooled confirmed sarcopenia prevalence (AWGS 2019, k=6) was 27.4% (95% Hartung-Knapp CI 18.9% to 37.9%) but highly imprecise: I²=91.7% and the 95% prediction interval ran from 6.9% to 65.6%. Subgroup analysis showed 20.2% for dual-energy X-ray absorptiometry versus 31.7% for bioelectrical impedance analysis (Qbetween p=0.011). Severe sarcopenia was 11.0% (k=5) and sarcopenic obesity 25.2% (k=4); possible sarcopenia (65.6%, k=3; I²=98.6%) was too heterogeneous to interpret. In the two studies reporting adjusted estimates, hypertension (both studies) and diabetes duration ≥10 years (one study) were positively but imprecisely associated with sarcopenia. Certainty was very low for all prevalence outcomes (Grading of Recommendations Assessment, Development and Evaluation (GRADE)).

Sarcopenia appears common among Indian adults with T2DM, at approximately one in four, but certainty is very low and the plausible prevalence in a new cohort spans roughly 7% to 66%. These estimates are not a sufficient basis for a screening recommendation, but justify greater clinical awareness and, above all, community-based, dual-energy X-ray absorptiometry-standardised prospective studies, including from South India.

CRD420251251024.

The prevalence of cardiometabolic diseases like obesity, hypertension, diabetes, and dyslipidaemia is increasing rapidly, particularly in low- and middle-income countries (LMICs). Informal workers in Ghana, who account for the majority of the national workforce, contribute significantly to the country's socioeconomic growth. Often, their work predisposes them to cardiometabolic diseases. This study examines the cardiometabolic burden, its associated factors, and the diagnostic heterogeneity among this unique population.

This study used cross-sectional data on 948 informal workers (traders, fisherfolk, artisans, farmers, and drivers) in the Cape Coast Metropolis, Ghana. Sociodemographic, lifestyle, anthropometric, and biochemical data were obtained in accordance with standard procedures. Multiple diagnostic criteria were used to characterise diabetes, prediabetes, and obesity. Diagnostic concordance was evaluated using Venn diagrams and UpSet plots, and independent associated factors were identified using multivariate logistic regression.

The prevalence of obesity, hypertension, prediabetes, and diabetes was 45.46%, 40.19%, 29.54%, and 13.40%, respectively. Women and middle-aged adults (45-59 years) were most impacted. There was significant heterogeneity in classification criteria, with just 9.28% of obese participants and 2.36% of diabetic participants being diagnosed by all diagnostic criteria. While the absence of childhood obesity was associated with lower odds of obesity (aOR = 0.43, 95% CI: 0.30-0.61), diabetes (aOR = 0.64, 95% CI: 0.42-0.99), and hypertension (aOR = 0.63, 95% CI: 0.46-0.88), older age (≥60 years) was strongly associated with obesity (aOR = 2.54, 95% CI: 1.51-4.32) and hypertension (aOR = 4.82, 95% CI: 3.06-7.68). Low physical activity was significantly linked to hypertension (aOR = 1.73, 95% CI: 1.16-2.62), and elevated triglycerides were associated with diabetes (aOR = 2.16, 95% CI: 1.21-3.75) and hypertension (aOR = 1.84, 95% CI: 1.13-3.04).

The burden of cardiometabolic diseases among Ghana's informal workers is disproportionately high and diagnostically diverse. The findings emphasise the critical need for sex- and occupation-sensitive health interventions, life-course prevention strategies, and context-specific diagnostic guidelines to reduce cardiometabolic disease risk among informal workers in LMICs.

Liver steatosis is increasingly recognized as a major comorbidity in people living with HIV (PLWH), with growing evidence suggesting an increased risk of progression to advanced liver disease. We assessed predictors of liver steatosis progression over 36 months in PLWH from low- and middle-income countries.

Between 2020 and 2023, we enrolled PLWH aged ≥40 years who had been on antiretroviral therapy (ART) for ≥6 months at nine HIV clinics in the IeDEA Sentinel Research Network (SRN) across the Asia-Pacific, the Americas and African IeDEA regions, and followed them prospectively for 36 months. Participants with available and reliable controlled attenuation parameter (CAP) measurements at both enrolment and the 36-month visits were included in the analysis. Steatosis progression was defined as incident steatosis (CAP ≥248 dB/m) or a transition to a higher steatosis grade (moderate ≥268 dB/m; severe ≥280 dB/m) among those with a lower steatosis grade at enrolment. Logistic regression was used to assess predictors of progression.

We included 923 participants (63% female; median age 50 years, interquartile range 45-55) in this analysis. At enrolment, 51% were overweight or obese, 10% had type 2 diabetes mellitus (T2DM), 94% had HIV RNA <1000 copies/mL and 72% were on integrase strand inhibitor (INSTI)-based ART. During the 36-month follow-up, 190 (20%) participants showed steatosis progression, including 147 (74%) with incident steatosis and 49 (26%) with worsening of steatosis grades. The progression rate was significantly higher in Asia-Pacific (33% [95% CI, 24-44]) and the Americas (36% [95% CI, 26-46]) compared to the African regions (17% [95% CI, 14-20]). Independent predictors of steatosis progression were overweight/obesity (aOR: 2.97, 95% CI: 2.03-4.40), T2DM (aOR: 2.41, 95% CI: 1.45-3.96) and dyslipidaemia (aOR: 1.46, 95% CI: 1.01-2.12). In females, INSTI use for ≥2 years at enrolment was additionally associated (aOR 3.19, 95% CI: 1.35-8.01).

Metabolic disorders-including T2DM, overweight/obesity and dyslipidaemia-were associated with steatosis progression in PLWH in our cohort. These findings underscore the need for targeted monitoring and prevention strategies to address this significant public health issue.

Ecological momentary assessment (EMA) is a tool that captures emotional states, experiences, and behaviors in real or near-real time. Concurrent EMA and continuous glucose monitoring (CGM) data can provide an in-depth understanding of the impacts of psychosocial factors on momentary glucose levels. However, study methodology varies widely for EMA and CGM data collection and analysis.

This scoping review aims to summarize the objectives, methodologies, and outcomes of studies analyzing concurrent biopsychosocial EMA and CGM data in diabetes.

This study was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Original research studies evaluating participants with diabetes, with concurrent collection and analysis of EMA and CGM data, were included in this review. A total of 782 studies were identified from PubMed, Embase, and EBSCOhost from May 2009 to December 2025. From these, duplicates, non-original research articles, and articles not measuring concurrent EMA and CGM data were excluded, resulting in a total of 19 studies included in this review. Methodological data were abstracted and summarized, including study characteristics, EMA protocols and outcomes, CGM outcomes, and integrated EMA and CGM study objectives. Methodological gaps across the included studies were identified and summarized.

Of the 19 studies, 16 primarily recruited adult populations, and the majority of these studies (n=14, 74%) included participants with type 1 diabetes. The median EMA delivery duration was 14 days (range 3-18 days), with a median of 5.5 prompts delivered per day (range 1-28). EMA outcomes included a variety of biopsychosocial factors (emotion, self-care behaviors, interpersonal interactions, symptoms, and cognition). Seventy-four percent analyzed blinded CGM data over a median of 14 (range 3-18) days. Forty-two percent used nonstandardized CGM glucose outcomes (postprandial glucose, eating patterns, and hypoglycemic events). Integrated EMA and CGM data analysis answered a broad array of study objectives, including the impact of psychosocial factors on momentary glucose metrics; the influence of momentary glucose on emotional states, mood, personal behaviors, sleep, and cognition, or vice versa; and study protocol or mobile app optimization, among others. Methodological gaps included lack of standardization of EMA and CGM outcomes, duration of data capture, reporting of statistical analyses, and study population.

This review provides a detailed summary of the methodology and outcomes of original research articles using combined EMA and blood glucose data measured via CGM. These combined methods allow for an opportunity to elucidate relationships between psychosocial factors and momentary glucose, an understanding of which is imperative for the development of future psychological and behavioral interventions in diabetes. However, standardization of protocols and expansion of participant populations for future EMA and CGM data collection and analysis are needed to ensure data accuracy, reproducibility, and generalizability.

This systematic review sought to synthetize recent studies on psychological interventions aiming to address parental psychosocial factors in families of children and adolescents with Type 1 Diabetes (T1D). Particularly, its purpose was to characterize intervention designs, frameworks, and delivery modalities, as well as to examine their findings on both parental psychosocial and youth glycemic outcomes.

Twenty-six manuscripts from 2019 to 2025 were selected, including randomized controlled trials, quasi-experimental designs, pilot, feasibility, and protocol studies. Most interventions were grounded in cognitive-behavioral frameworks and implemented through a range of diverse delivery formats. Overall, the available evidence indicates that the interventions are associated with improvements across a range of parental psychosocial factors (e.g., diabetes distress, depressive and anxiety symptoms, fear of hypoglycemia, and quality of life), while findings regarding glycemic outcomes were heterogeneous across studies. Interventions targeting parents of youth with T1D appear effective in enhancing psychosocial adjustment. The diversity of study designs, theoretical frameworks, and intervention approaches reflects both heterogeneity and a robust scientific evidence base, with potential for adaptation and replication across different contexts.