The aim of this study was to develop a type 1 diabetes mellitus self-management scale for children and to assess its psychometric properties.

A methodological, descriptive, correlational, and cross-sectional study was conducted. The research sample comprised 212 children with diabetes aged 7-12 years. Content validity was evaluated by seven experts in pediatric endocrinology, pediatric nursing, public health nursing, and Turkish language. Descriptive statistics, correlation analyses, Cronbach's alpha, McDonald's omega, split-half reliability, and factor analyses were used.

The Cronbach's alpha for the overall scale was 0.893, and for the subscales, it ranged from 0.757 to 0.845. The item-total score correlations ranged from 0.408 to 0.660. Exploratory factor analysis revealed a four-factor structure that explained 57.730% of the total variance, with item loadings ranging from 0.380 to 0.863. Confirmatory factor analysis supported the four-factor structure, with factor loadings ranging from 0.52 to 0.87 and acceptable fit indices: χ2/df=1.461, goodness-of-fit index=0.901, comparative fit index=0.939, incremental fit index=0.941, Tucker-Lewis index=0.926, and root mean square error of approximation=0.066.

The validity and reliability analyses revealed that the scale is a valid and reliable measure in Turkish culture.

Risk of some diseases of cats increases with age, including chronic kidney disease (CKD) and hyperthyroidism, but clinical signs can be dismissed by caregivers as age-related changes.

Quantify the prevalence of disease and other major clinical findings in older cats.

Data from cats (≥8 years old) that underwent routine health screening at 2 United Kingdom (UK)-based primary care veterinary clinics over a 52-month period (October 2, 2018 to February 14, 2023) were analyzed.

At screening visits, history, physical examination, and blood tests for plasma biochemistry with or without plasma total thyroxine concentration were performed. When possible, systolic blood pressure measurement (97.1% of cases; Doppler method) and urinalysis (41.3% of cases; 98.2% by cystocentesis; and bacterial culture if indicated based on sediment examination) were performed.

A total of 549 cats were screened with a median age of 13.5 (IQR: 11.3-15.8) years old. Diagnoses of hyperthyroidism, azotemic CKD, and hypertension were made in 89/464 (19.2%; 95% CI, 15.9%-23.0%), 62/542 (11.4%; 95% CI, 9.0%-14.4%), and 37/524 (7.1%; 95% CI, 5.2%-9.6%) of cats, respectively. Severe dental disease was present in 32/522 (6.1%; 95% CI, 4.4%-8.5%) and bacteriuria was identified in 22/227 (9.7%; 95% CI, 6.5%-14.2%) of urine samples. Other diagnoses included suspected neoplasia (8 cats), diabetes mellitus (8 cats), and suspected primary gastrointestinal disease (4 cats).

Routine medical health screening in older cats is useful in detecting diseases, many of which would benefit from prompt veterinary intervention. These results can assist veterinarians in explaining the value of health screening to cat caregivers.

Shared decision making (SDM) is fundamental to patient-centered care, yet dominant frameworks have been developed within dyadic patient-provider models grounded in Western individualistic assumptions. Prior research from East Asian, Sub-Saharan African, and Latin American contexts has documented that medical decision making is frequently family-centered and that caregivers function as recognized actors in clinical encounters. Building on this evidence base, this study examines how caregiver participation is enacted and constrained within the Korean chronic care context, contributing a multilevel reinterpretation rather than a discovery of caregiver involvement.

We conducted four semi-structured focus group interviews between June and September 2024 with 20 family caregivers of patients diagnosed with hypertension, diabetes mellitus, chronic kidney disease requiring dialysis, or heart disease. Disease-specific groups were formed to enable contextually grounded discussion. Participants were recruited through a Seoul-based research agency and were, on average, highly educated. Using inductive qualitative content analysis, we identified key themes and interpreted the findings through the Social-Ecological Model. Interviews were conducted in Korean, and selected quotations were translated by bilingual researchers through consensus-based reconciliation. Analytic adequacy was assessed in terms of thematic sufficiency.

At the individual level, caregivers experienced emotional strain and decision-related uncertainty, prompting self-directed information seeking. At the interpersonal level, participation was shaped by hierarchical communication with physicians and role-based constraints with nonphysician staff. At the organizational level, fragmented care pathways and standardized information formats constrained access to guidance. At the societal level, culturally embedded deference to medical authority and normalized expectations of family responsibility framed involvement as obligation rather than a formally recognized role. Caregivers simultaneously described aspirations for participatory legitimacy.

Consistent with prior non-Western literature, caregiver involvement is not exceptional but routine; the contribution lies in jointly examining the individual, interpersonal, organizational, and societal conditions through which involvement is simultaneously expected and constrained.

Young-onset stroke represents a growing public health concern, yet data from the United Arab Emirates (UAE) remain limited. This study aimed to examine the risk factors and clinical outcomes associated with young-onset stroke in the UAE.

A retrospective chart review was conducted on 419 patients aged below 50 years who were admitted at Al Qassimi Hospital, Sharjah, UAE, with a diagnosis of stroke between 2016 and 2022. Data on demographics, comorbidities, stroke subtype, management, and outcomes were collected and analyzed using Python-based statistical libraries.

The study population comprised predominantly of male individuals (78.28%), with most patients originating from South Asia (63.96%) and the Middle East and North Africa region (19.33%). Ischemic stroke was the most common subtype (50.12%), followed by intracerebral hemorrhage (27.21%) and non-traumatic subarachnoid hemorrhage (22.67%). Hypertension (45.45%) and diabetes mellitus (24.42%) were the most prevalent comorbidities. Only 0.24% of patients underwent mechanical thrombectomy, and 9.41% received intravenous thrombolysis. The overall mortality rate was 12.68%, with coronary artery disease significantly associated with death (p < 0.001). South Asian patients were 2.19 times more likely to have large-artery atherosclerosis compared to non-South Asians (95% CI: 1.11-4.30, p = 0.02).

Young-onset stroke in the UAE is characterized by a high burden of modifiable cardiovascular risk factors, particularly hypertension and diabetes mellitus. Targeted preventive strategies and region-specific research are essential to reduce disease burden and improve patient outcomes.

Pregnancy-induced food cravings are associated with excessive gestational weight gain and gestational diabetes mellitus (GDM). This study aimed to measure brain responses to food pictures with varying fat and carbohydrate content during pregnancy in women with and without GDM.

To characterize brain-metabolism coupling, we recorded visual evoked potentials (VEPs) in pregnant individuals with and without GDM (24-36 weeks gestation) while they viewed food pictures varying in fat and carbohydrate content. Eighteen women with untreated GDM and 21 healthy pregnant controls participated. HbA1c levels were obtained from blood samples. Statistical analyses assessed group differences and interactions.

Within the initial ~150 ms post-stimulus onset, VEPs exhibited Group × Fat (p = 0.047, ηp² = 0.103), but no Group × Carb, interactions: Healthy pregnant controls showed stronger responses to images of high- versus low-fat foods, whereas individuals with GDM did not. Source estimations localized these effects to brain regions associated with control, attention, and reward. Moreover, brain responses correlated with HbA1c levels in GDM (p = 0.01, ηp² = 0.351), but not with pre-pregnancy BMI in either group.

These results provide evidence of links between spatiotemporal brain responses to visual food cues and metabolic health in pregnancy.

To investigate vestibular function, postural stability, and fall risk in individuals with type 2 diabetes mellitus (T2DM) with and without diabetic polyneuropathy (DPN), compared with healthy controls.

A cross-sectional study.

University hospital outpatient clinic.

A total of 128 adults participated: 51 with T2DM and DPN, 38 with T2DM without DPN, and 39 healthy controls. Participants were consecutively recruited and classified based on clinical and electrophysiologic evaluation of DPN.

Not applicable.

Vestibular function was assessed using the video head impulse test (vHIT). Postural stability was measured by computerised posturography (F2-F4 sway, Stability Index, Fall Risk Index). Fall concern was assessed by questionnaire, and fall history within the past year was self-reported.

Abnormal vHIT findings were rare (7%) and there were no group differences. Participants with T2DM and DPN demonstrated significantly higher F2-F4 sway compared with both T2DM without DPN and controls. A similar pattern was observed for the Stability Index, while the Fall Risk Index did not differ between groups. Participants with a heightened fall concern and paticipants reporting falls within the past year had greater F2-F4 sway . Logistic regression analysis confirmed an independent association between F2-F4 sway and fall history.

Computerised posturography, particularly F2-F4 sway, identified balance impairment and increased fall risk in individuals with T2DM, especially those with DPN. Abnormal vHIT findings were rare and unrelated to falls, suggesting a limited role of vHIT-detectable vestibular dysfunction in this population.

This study aimed to characterize differences in clinical presentation, metabolic parameters and cytokine profiles between STEMI and NSTE-ACS patients and identify potential biomarkers of disease severity and inflammation.

An exploratory study was conducted on 60 ACS patients (30 STEMI, 30 NSTE-ACS) experiencing their first episode. Clinical characteristics, routine laboratory parameters and multiplex cytokine analysis (GM-CSF, IFN-γ, IL-1β, IL-4, IL-6, IL-8, IL-9, IL-10, IL-12P70, IL-18, MCP-1, M-CSF, TNF-α) were compared. Normality was assessed using the Shapiro-Wilk test and statistical comparisons were made using t-tests or Mann-Whitney U tests for continuous variables and chi-square tests for categorical variables. Multivariable logistic regression and Benjamini-Hochberg false-discovery-rate (FDR) correction were applied.

Chest pain was more frequent in STEMI (28/30 [93.3%] vs 15/30 [50.0%]; p = 0.0006) with higher prevalence of diabetes mellitus (24/30 [80.0%] vs 6/30 [20.0%]; p < 0.0001), worse lipid profile and increased inflammation (CRP 126.48 [44.63 - 169.75] mg/L vs 15.98 [3.75 - 39.49] mg/L; p = 0.0001). Cytokine analysis revealed significantly higher levels of IL-6, IL-8, IL-1β, IL-18, and M-CSF in STEMI after FDR correction (all FDR < 0.05). These differences persisted in non-diabetic sensitivity analysis and after multivariable adjustment for diabetes, HbA1c and CRP. The composite cytokine panel showed modest discriminatory capacity (AUC 0.69, 95% CI 0.55 - 0.83).

STEMI is characterized by greater inflammation, dyslipidemia and diabetes burden compared to NSTE-ACS. These differences persist after sensitivity analysis, multivariable adjustment and FDR correction revealing distinct inflammatory profiles that support the hypothesis of subtype-specific immune activation and pathways.

To evaluate the effect of levothyroxine therapy on renal outcomes in patients with type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SCH) with background SGLT2 inhibitor therapy.

In this hypothesis generating open-label, randomized controlled pilot trial, adults with T2DM and SCH were assigned (1:1) to levothyroxine or no levothyroxine therapy and followed for 6 months. Primary outcomes were changes in urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR).

Sixty participants were randomized (30 per group); 24 and 27 completed follow-up in the treatment and control groups respectively. UACR decreased with levothyroxine (-13.09 mg/g) and increased in controls (31.84 mg/g). The difference was significant in per-protocol (PP)(-44.93 mg/g; 95% CI -77.6 to 12.26; p = 0.008) but insignificant in intention to treat (ITT)(-35.61 mg/g; 95% CI -77.31 to 6.08; p = 0.092). eGFR changes were statistically insignificant in both ITT(4.65 mL/min/1.73 m²; 95% CI -8.3 to 17.6; p = 0.472) and PP(7.35 mL/min/1.73 m²; 95% CI -1.68 to 16.37; p = 0.108). Thyroid-stimulating hormone decreased significantly in treatment arm in comparison to control arm (p < 0.001) in ITT and PP. No adverse event was reported.

Levothyroxine treatment showed trend toward improving albuminuria and eGFR without reaching statistical significance, suggesting possible renoprotective effect warranting further studies.

This trial is registered with Clinical Trial Registry of India (CTRI/2025/06/089606).

This study evaluated the clinical value of a "immuno-metabolic co-management" strategy by investigating the association between glucose-lowering agents (metformin, insulin, and acarbose) and readmission risk in patients with rheumatoid arthritis (RA) and comorbid type 2 diabetes mellitus (T2DM). This study included up to 10 years of longitudinal follow-up data from 616 patients with RA and comorbid T2DM. A shared Gamma frailty model was utilized to analyze unplanned readmission. Furthermore, inverse probability of treatment weighting (IPTW) was employed to control for confounding, followed by validation. Subgroup interaction tests and sensitivity analyses were conducted to evaluate model robustness. In the weighted multivariable analysis, metformin and insulin use were significantly associated with a lower risk of readmission (metformin: HR = 0.56, 95%CI: 0.46-0.70, P < 0.001; insulin:HR = 0.65, 95%CI: 0.52-0.81, P < 0.001), respectively, whereas acarbose showed no statistically significant correlation on the readmission risk (HR = 0.97, P = 0.790). Subgroup interaction analyses indicated that the observed associations were largely consistent across clinical strata. Notably, the inverse association with metformin was more pronounced among patients receiving concomitant glucocorticoids (P for interaction = 0.003). These primary findings remained robust in multiple sensitivity analyses. In conclusion, metformin and insulin are associated with a lower risk of unplanned readmission in patients with RA and comorbid T2DM. These findings highlight the potential clinical relevance of "immuno-metabolic co-management", although future prospective studies are needed to validate these observations.

Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases, whose prevalence is increasing worldwide. There is a great demand for an effective cure that attains a normal glucose level. The differentiation of mesenchymal stem cells into insulin-producing cells (IPCs) for pancreatic regeneration represents a promising anti-diabetic therapeutic approach. However, the pathogenic milieu of T2DM may affect their differentiation potential.

This study aimed to investigate the impact of the T2DM milieu on the pancreatic differentiation potential of human adipose-derived stem cells (ASCs) in vitro.

We isolated and cultured ASCs from T2DM (dASCs) and non-diabetic (nASCs) subjects, then we differentiated the cells into IPCs. We evaluated the differentiation potential using dithizone staining, immunofluorescence staining, and gene expression analysis. We examined the functionality of generated cells via glucose challenge assay.

Our results revealed that both dASCS and nASCs could be committed to an early endocrine-like phenotype with comparable potential. However, the glucose-stimulated insulin secretion of dASCs-derived IPCs was significantly less than that derived from nASCs.

T2DM does not affect the pancreatic commitment potential of dASCs. However, ASCs-derived from diabetic patients displayed a reduced capacity to acquire glucose-responsive endocrine characteristics following pancreatic differentiation, exhibiting a limited β-like functionality.