The role of calcium metabolism-related genes (CMRGs) in gestational diabetes mellitus (GDM) is unclear, and potential biomarkers remain unidentified. This study aims to identify CMRGs as potential biomarkers for GDM and explore their functional roles, diagnostic performance, and associations with immune infiltration and signaling pathways in the pathogenesis of GDM. We conducted a retrospective transcriptomic and experimental validation study, integrating bioinformatics analyses from GEO datasets and quantitative real-time polymerase chain reaction (qRT-PCR) validation. Candidate genes were identified by intersecting differentially expressed genes from 2 GDM-related GEO datasets (GSE154414 and GSE9984) with 178 known CMRGs. Biomarker potential was assessed through receiver operating characteristic curve analysis, consistency of gene expression across datasets, and functional enrichment analysis. Expression of selected genes was validated by qRT-PCR. Further mechanistic insights were obtained through immune infiltration analysis, regulatory network construction, drug prediction, and gene-disease association studies. Eight candidate genes were identified from the intersection of 649 differentially expressed genes and CMRGs. Among these, AGTR1 and ADCY4 were consistently downregulated in placental tissues of GDM patients and demonstrated strong diagnostic performance (area under the curve > 0.7). qRT-PCR validation confirmed significantly decreased expression levels of both genes. Functional enrichment analysis indicated involvement in ribosomal, lysosomal, and calcium signaling pathways. Immune infiltration analysis revealed a significant increase in activated B cells in GDM placentas, which were negatively correlated with AGTR1 (r = -0.738) and ADCY4 (r = -0.881) expression. Regulatory network analysis associated these genes with pathways including cAMP metabolism and vascular smooth muscle contraction. A total of 59 potential therapeutic compounds were identified. AGTR1 and ADCY4 are promising biomarkers for GDM, likely contributing to disease progression through dysregulation of calcium signaling and the immune microenvironment. These findings offer a theoretical foundation for further mechanistic studies and targeted therapeutic development for GDM.

To evaluate the association between cataract surgery and diabetic retinopathy (DR) progression in the Thai population. This was a retrospective analysis of 200 eyes of 100 patients with diabetes who underwent cataract surgery in one eye, using the non-operated fellow eye as a control to minimize confounding factors. Outcomes were assessed at 12 months postoperatively. Potential risk factors were explored using logistic regression analysis. DR progression occurred more frequently in the operated eyes than it did in the non-operated eyes (21% vs 13%, P = .004). However, the progression of macular edema was not significant between the groups (10% vs 9%, P = .740). Higher hemoglobin A1c levels and preexisting DR were identified as significant risk factors for retinopathy progression (P = .044 and .038, respectively). Cataract surgery might be associated with DR progression, particularly in patients with poor glycemic control or preexisting DR. Careful preoperative evaluation and close postoperative monitoring are essential to optimize visual outcomes and minimize complications in patients with diabetes undergoing cataract surgery.

We aimed to develop a generic questionnaire for use in routine clinical practice to identify barriers and levers to medication adherence, particularly for patients with chronic disease, in order to implement targeted interventions.

To generate items we conducted a narrative literature review and qualitatively analyzed semi-structured interviews of patients with chronic diseases (type 2 diabetes, chronic obstructive pulmonary disease and heart failure). Items were classified according to the five dimensions that influence medication adherence proposed by the WHO. Qualitative reduction of the number of items was conducted by a panel of experts. This long questionnaire was tested on ambulatory patients and analysis of responses enabled quantitative item reduction. Validation of the short questionnaire and stability over time was tested on an independent cohort of patients, and again 15 days later.

The 194 items extracted from the literature review (validated in several pathologies) and/or from analysis of 45 interviews, spanned all five dimensions of medication adherence according to the WHO. The expert panel reduced the number of items to 62. The analysis of responses from 112 patients using factorial component analysis reduced the final questionnaire to 14 questions each scored on a 7-point Likert-type scale. A validated visual analogue scale (0-100) was added to evaluate medication adherence in general. The final version was well accepted by patients and took 5-10 minutes to complete, with little missing data. In an independent community pharmacy population (n = 55) concordance of the results between day 0 and day 15 was acceptable.

This generic questionnaire (initially developed in French) for the identification of barriers and levers to medication adherence in patients with chronic disease could help care teams to structure and propose help-with-adherence visits to their patients and personalize interventions to improve patient outcomes.

Cardiometabolic multimorbidity (CMM) refers to a cluster of metabolic and cardiovascular diseases, including stroke, diabetes, and cardiovascular diseases. Glycated hemoglobin (HbA1c) and high-density lipoprotein cholesterol (HDL-C) are widely used to assess glucose metabolism and lipid metabolism disorders, respectively, given their close association with the onset of diabetes and cardiovascular diseases. This study aimed to investigate the association between the HbA1c/HDL-C ratio and the incidence of newly diagnosed CMM in individuals aged 45 and older, using data from the China Health and Retirement Longitudinal Study (CHARLS) database.

Our study utilized data from the CHARLS database from 2011 to 2018. A multivariate logistic regression model was established to determine the association between the cumulative average HbA1c/HDL-C (2011-2015) and the incidence of newly diagnosed CMM (2015-2018). Besides, a multivariable-adjusted restricted cubic spline (RCS) curve, stratified analysis, and interaction tests were conducted to evaluate the relationship between HbA1c/HDL-C and CMM.

Our longitudinal analysis included 4,225 participants, with 716 new cases of CMM identified over a 7-year follow-up period. A positive association was observed between the HbA1c/HDL-C ratio and the incidence of CMM. In the fully adjusted model, the highest quartile of HbA1c/HDL-C (Q4) exhibited the highest risk of CMM (OR = 1. 08, 95% CI: 1. 04-1. 12). The association between the HbA1c/HDL-C ratio and CMM incidence was consistent in all subgroups except for education level. Stratified analysis showed no significant interaction between the HbA1c/HDL-C ratio and factors such as age, gender, marital status, education level, residence, smoking status, drinking status, and body mass index (BMI).

A significant linear relationship exists between the HbA1c/HDL-C ratio and the risk of CMM. Accordingly, the HbA1c/HDL-C ratio may be an independent risk factor for CMM. Among middle-aged and older adults, monitoring and managing HbA1c/HDL-C levels may aid in identifying individuals at high risk of developing CMM.

This study aimed to explore the relationship between a body shape index (ABSI) and diabetes, and to assess the robustness of this relationship across different population subgroups.

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) database, this study employed multivariate linear regression analysis to evaluate the association between ABSI and the likelihood of having diabetes. This research further explored non-linear issues in gender stratification through smooth curve fitting and two-part linear regression models, analyzing different subgroups including gender, race, hypertension, and stroke.

A total of 34,693 participants were involved in the study, with a diabetes prevalence of 11.60%. The prevalence increased with higher tertiles of ABSI. After comprehensive adjustment, ABSI was positively correlated with diabetes (OR = 1.42, 95% CI: 1.33, 1.52). Participants in the highest quartile of ABSI had a 96% higher odds of having diabetes (OR = 1.96, 95% CI: 1.69, 2.26), than did those in the lowest quartile. Smooth curve fitting analysis revealed a non-linear, inverse L-shaped relationship between ABSI and diabetes, with a breakpoint at 9.54. Subgroup analyses indicated that the association between ABSI and diabetes remained stable across different populations, except for those with a history of stroke.

Our findings suggest that there is a positive correlation between diabetes and increased ABSI. ABSI may serve as an effective alternative indicator to other obesity indices, such as BMI.

To understand the need for self-management among adolescents with type 2 diabetes mellitus (T2DM) and provide a reference for developing tailored management programmes.

Descriptive-qualitative.

Purposive sampling was used to recruit 10 adolescents with T2DM from a paediatric and adolescent diabetes clinic at a tertiary hospital in Bangkok. Semi-structured, in-depth interviews were conducted from January to March 2023, and the data were thematically analysed.

Five key themes were coded: (1) understanding T2DM diagnoses; (2) seeking support for diabetes self-management (DSM); (3) self-managing T2DM; (4) understanding barriers to DSM; and (5) seeking T2DM telehealth.

Adolescents with T2DM mostly receive adequate DSM understanding from healthcare providers. However, although they are strongly willing to manage their condition, they face significant challenges (e.g., limited knowledge, stress, and social pressure). Support from family, healthcare providers, and peers is crucial in fostering effective DSM. Medical staff should provide personalised care based on each patient's status and needs, encouraging the development of self-managing behaviours while helping prevent complications.

Enhanced cultural sensitivity training can improve patient trust and plan adherence.

Key insights are provided for healthcare providers regarding the early management of adolescents with T2DM and designing prevention programmes. Guidance for tailored interventions is provided, addressing adolescents' unique needs and focusing on improving their knowledge, emotional well-being, and support channels.

Guidance for tailored interventions is provided, addressing adolescents' unique needs and focusing on improving their knowledge, emotional well-being, and support channels.

Emphysematous cystitis (EC) is a rare, potentially life-threatening infection characterized by gas formation within the bladder wall or lumen, most commonly caused by Escherichia coli or Klebsiella pneumoniae. It is typically associated with diabetes mellitus, immunosuppression, or urinary tract abnormalities. We present a case of EC in a 67-year-old immunocompromised female with advanced-stage ovarian cancer, undergoing chemotherapy with carboplatin and paclitaxel at the time of diagnosis. Her additional risk factors included diabetes mellitus and chronic corticosteroid use. Diagnosis was established via CT angiography, which revealed extensive gas within the bladder wall. Urine culture grew Klebsiella pneumoniae sensitive to ceftriaxone, which was administered intravenously. The patient was managed conservatively with antibiotics, bladder decompression, and supportive care, resulting in resolution of the infection. To our knowledge, this is the first reported case of EC in a patient receiving carboplatin and paclitaxel chemotherapy for ovarian cancer, underscoring the diagnostic complexity and management considerations of EC in oncology patients with compounding immunosuppressive risk factors.

Raoultella planticola (R. planticola) is a gram-negative environmental bacterium rarely implicated in human infections. Urinary tract infections (UTIs) caused by R. planticola remain rare, particularly in outpatient settings. We present a 64-year-old female with a history of type 2 diabetes mellitus and recurrent UTIs who presented to the outpatient clinic with dysuria and increased urinary frequency. Urine culture subsequently grew >100,000 CFU/mL of R. planticola. The patient was successfully treated with a five-day course of nitrofurantoin. This case highlights a rare instance of community-acquired UTI due to R. planticola in an immunocompetent outpatient. It underscores the importance of accurate microbiological identification and the consideration of atypical pathogens in patients with recurrent UTIs. This report contributes to the limited literature on R. planticola as a uropathogen and supports nitrofurantoin as an effective treatment option.

Background Effective management of type 2 diabetes mellitus (T2DM) requires not only appropriate pharmacological therapy but also consistent adherence to prescribed regimens. However, data on how different treatment regimens and adherence levels influence glycemic control in local populations are limited. Objective This study aimed to evaluate the impact of different medication regimens and adherence levels on glycemic control, as measured by glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) in T2DM patients at a tertiary care hospital in Lahore. Methods This retrospective study was conducted at Combined Military Hospital, Lahore, Pakistan, from May 2023 to May 2025, including 355 patients with T2DM. Patients were categorized by regimen type: Group 1 (oral therapy), Group 2 (injectable therapy), and Group 3 (combination therapy). Medication adherence was classified into three groups based on compliance with prescription refill data and follow-up documentation: High (≥80%), Medium (50-79%), and Low (<50%). Clinical and demographic data were extracted from electronic health records. Outcomes included HbA1c, FBG, and body mass index (BMI) at six months. Statistical analyses included chi-square for categorical outcomes and analysis of variance (ANOVA) for continuous outcomes. A p-value <0.05 was considered significant. Results By regimen, Group 3 (combination therapy) demonstrated the greatest reductions in HbA1c (-2.0% ± 1.3%), FBG (-54.3 ± 40.2 mg/dL), and BMI (-1.4 ± 1.5 kg/m²), compared to Group 2 (-1.7% ± 1.1%, -42.7 ± 34.0 mg/dL, -1.1 ± 1.3 kg/m²) and Group 1 (-1.3% ± 0.9%, -35.2 ± 27.4 mg/dL, -0.6 ± 0.9 kg/m²) (p < 0.05). By adherence, high-adherence patients achieved lower mean HbA1c (7.0% vs. 7.8% vs. 8.6%), FBG (140 vs. 160 vs. 180 mg/dL), and BMI (29.2 vs. 30.5 vs. 32.0 kg/m²) compared with medium- and low-adherence groups. Adverse events were more common in the injectable and combination groups. Conclusion Both the choice of antidiabetic regimen and patient adherence significantly influence glycemic control. Combination therapy was associated with the greatest improvements in HbA1c, FBG, and BMI, particularly in patients with high adherence. Interventions targeting adherence improvement are essential to optimize therapeutic outcomes in T2DM.

This study explores the importance of social factors, Social Determinants of Health (SDOH), particularly poverty, on patients with type 2 diabetes mellitus (T2DM), who developed gastroparesis. The analysis aimed to correlate social variables such as income, education, occupation, and loneliness with clinical outcomes and their association with clinical outcomes and healthcare utilization, using hospitalization frequency and symptom burden as proxy indicators of quality of life.

This retrospective observational study analyzed a subgroup of 50 patients with diabetic gastroparesis, selected from a larger cohort of 250 patients diagnosed with gastroparesis. Diabetic gastroparesis was confirmed via gastric scintigraphy. Demographic, clinical, and social variables were analyzed, and data collection was facilitated through a structured instrument using the software EpiInfo.

In this retrospective observational study, the majority of patients were obese females over 60 years of age, retired, and residing in rural areas. Loneliness emerged as a significant aggravating factor. Low income was associated with increased complications, frequent hospitalizations, and higher overall healthcare expenditure.

Diabetic gastroparesis is an underdiagnosed complication of T2DM, frequently worsened by social vulnerability. In this study, low income, rural residence, obesity and loneliness were identified as key social determinants modulating disease severity and healthcare utilization. Greater emphasis on addressing these SDOH is necessary to optimize outcomes and reduce hospitalization rates, insurance expenses, and overall healthcare burden (used herein as proxy indicators of reduced quality of life).