Employed females such as school teachers form a particularly vulnerable and overlooked population group, in terms of non-communicable diseases (NCDs), and despite their higher risk, research on female school teachers remains limited.

The current study aimed to assess NCDs related risk factors, and their knowledge in female secondary school teachers.

A cross-sectional baseline survey was conducted for a quasi-experimental mixed methods study on 130 female secondary school teachers, selected using two stage sampling, with the first stage involving purposive selection of 08 secondary federal government public schools of Islamabad, and the second stage involving simple random selection of female teachers employed at these schools. Data was collected using pre-validated questionnaires and analyzed using SPSS version 27. Chi-square/Fisher exact test and binary logistic regression were applied to determine associations between variables.

Out of the 130 participants, 63.8% were aged 41-45 years age group, 89.2% had a post-graduate degree, and 90% participants earned more than 150,000 PKR per month. About 38.5% consumed fruits every 3-4 days, 88.5% claimed they did not know how many servings of fruits and vegetables they consumed, and 16.2% participants said they often add salt to their foods before or while eating. About 63.8% participants said they walk for at least 30 min per day, while 31.5% spent more than 6 h while sitting or lying down. The mean BMI was reported to be 27.09 ± 4.94, mean waist circumference (WC) was 95.01 ± 10.05, while mean WtHR was 0.88 ± 0.04. The percentage of participants with moderate level of HTN, CVDs, and DM were 61.5, 76.9, and 64.6%, respectively. Household income (p = 0.022), servings of fruits and vegetables (p < 0.001), and moderate physical activity (p = 0.041) were significantly associated with DM.

This study's findings reflected high levels of moderate NCDs knowledge, however, participants exhibited increased behavioral and anthropometric NCDs risk factors. This reflects a lack of translational knowledge despite general NCDs awareness in the target population.

Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease and chronic kidney disease (CKD), yet the extent of longitudinal CKD screening in routine clinical practice remains unclear. This study aimed to assess long-term cardiorenal outcomes and CKD screening practices in patients with T2D managed across primary care and endocrinology settings, evaluating the feasibility of risk stratification in real-world practice.

We conducted a retrospective cohort study using anonymized data from the Telotrón database (2.2 million patients). Adults with T2D attended across primary and endocrinology care were followed from 1 January 2018 to 31 December 2022. Frequency of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) measurements, and cumulative proportion of kidney and cardiovascular events, hospitalizations, and mortality were assessed.

Among 13,600 individuals, 31.1% experienced a kidney event and 18.6% a cardiovascular event over 5 years. All-cause hospitalization occurred in 24.9% and 16.1% died. First occurrence of an abnormal eGFR or UACR measurement occurred in 37.0% of participants without baseline CKD, and 45.4% with baseline CKD showed progression. Annual monitoring was limited, with 39.1% and 16.6% undergoing at least one yearly assessment, and 2.9 and 1.5 mean number of measurements per patient for eGFR and UACR, respectively.

Despite receiving endocrinology care, kidney disease progression and cardiovascular events remain a major concern in T2D, and yet suboptimal albuminuria and eGFR assessment limit early detection and risk stratification, thereby hindering risk-directed management.

Background/Objectives: Peripheral arterial disease (PAD) and diabetes mellitus (DM) may produce different and overlapping plantar thermal patterns. This study descriptively characterized whole-foot temperature-distribution patterns in clinically defined healthy, PAD, DM, and combined PAD_DM cohorts. Methods: This single-center, exploratory, cross-sectional observational study included 73 participants: healthy controls (n = 21), isolated PAD (n = 13), isolated DM (n = 19), and combined PAD_DM (n = 20). Right- and left-foot temperature distributions were processed separately for each participant and interpreted as one paired bilateral thermal footprint using patient-level histograms, representative bilateral kernel density estimation (KDE) profiles, and a cohort-derived deterministic rule-based model. The model was developed from the present cohort and was not evaluated as an independent diagnostic classifier. Results: Among healthy controls, 11 of 21 participants (52.4%) were assigned to healthy and 8 of 21 (38.1%) to borderline healthy categories. In the DM cohort, 7 of 19 participants (36.8%) were assigned to DM, 3 of 19 (15.8%) to borderline healthy/suspected DM or controlled DM, 3 of 19 (15.8%) to DM suspected PAD, and 5 of 19 (26.3%) to PAD_DM. In the combined PAD_DM cohort, 15 of 20 participants (75.0%) were assigned to PAD_DM. The isolated PAD cohort was the most heterogeneous: 6 of 13 participants (46.2%) were assigned to PAD_DM, while none were assigned to the isolated PAD output. Conclusions: This exploratory, cross-sectional study demonstrated that whole-foot plantar temperature distributions can descriptively characterize differences among healthy individuals, patients with isolated DM, and those with combined PAD and DM. While healthy controls generally demonstrated symmetric thermal footprints, the DM cohort frequently exhibited globally elevated and compact temperature-distribution profiles, while mixed asymmetric patterns were common in participants with combined PAD and DM. In contrast, the isolated PAD cohort was characterized by pronounced thermal heterogeneity.

Background: Lipoprotein(a) [Lp(a)] has emerged as a key mediator of calcific aortic valve disease and is strongly linked to the development and progression of aortic stenosis (AS). Whether elevated Lp(a) influences disease severity, long-term prognosis, or both in patients undergoing transcatheter aortic valve implantation (TAVI) remains uncertain. Methods: This multicenter study included 213 patients with severe symptomatic AS undergoing TAVI between 2016 and 2018. Pre-procedural Lp(a) concentrations were measured using a standardized immunoturbidimetric assay. Associations with long-term all-cause mortality were evaluated using Kaplan-Meier analyses and Cox proportional hazards models. The relationship between Lp(a) and AS severity was assessed using correlation analyses, multivariable linear regression models, and restricted cubic spline analyses. Anatomical and hemodynamic measures included aortic valve calcium score (AVCS), peak aortic jet velocity (AV Vmax), and transvalvular pressure gradients. Results: During a median follow-up of 7.58 years (IQR 4.33-8.66 years), Lp(a) was not associated with all-cause mortality, irrespective of whether it was analyzed as a continuous variable, according to established clinical thresholds, or across quartiles. In contrast, higher Lp(a) concentrations were associated with greater valvular calcification and more severe hemodynamic obstruction. These associations remained significant after adjustment for age, sex, diabetes mellitus, and renal function. Restricted cubic spline analyses suggested predominantly linear associations without evidence of significant non-linearity. Conclusions: Elevated Lp(a) concentrations were associated with greater anatomical and hemodynamic severity of AS but not with long-term mortality after TAVI. These findings suggest that elevated Lp(a) is associated with greater anatomical and hemodynamic severity of calcific aortic valve disease but was not linked to long-term mortality after TAVI.

Background/Objectives: Gestational diabetes mellitus (GDM) is a metabolic disorder associated with an amplified risk of unfavorable pregnancy outcomes. This study aimed to compare clinical characteristics and pregnancy outcomes among GDM patients belonging to different ethnic groups. Patients and Methods: This retrospective analysis included n = 466 women with GDM (n = 167 Asian; n = 299 European). The impact of ethnicity on pregnancy outcomes was evaluated using multivariable logistic regression models, adjusting for confounding factors. Results: Asians were younger than Europeans (p < 0.001) and more frequently multiparous (p = 0.003). Fasting glucose at OGTT was higher in Asians, as well as HbA1c values at the end of pregnancy (p = 0.010 and p = 0.001, respectively). Asian ethnicity was associated with an increased likelihood of insulin therapy (OR = 3.36 [1.72-6.58] 95% CI, p < 0.001), in the adjusted model. The gestational week of delivery was lower in Asians compared to Europeans (p = 0.007). The Asian group had a higher occurrence of cesarean section (p = 0.048) and emergency cesarean section (p = 0.006) compared to the European group. Delivery complications were more frequent in the Asian cohort, adjusting for confounders (OR = 2.19 [1.11-4.32] 95% CI, p = 0.023). Newborns of the Asian group were more frequently small for gestational age (SGA) in adjusted models (OR = 2.36 [1.08-5.15] 95% CI, p = 0.031). Conclusions: Worse GDM outcomes were observed in the Asian cohort compared to the European cohort. Identifying risk factors for GDM-related complications is crucial for developing tailored interventions and reducing the overall disease burden.

Albuminuria is an important marker of kidney and cardiovascular risk in adults with type 2 diabetes mellitus (T2DM). Regional data from Mexico remain limited among patients with preserved estimated glomerular filtration rate (eGFR) and no previous diagnosis of diabetic kidney disease. This study aimed to describe albuminuria categories observed at a single screening assessment and to explore clinical factors associated with higher urinary albumin-to-creatinine ratio (uACR) categories in adults with T2DM receiving care at a regional hospital in western Mexico.

This exploratory single-center cross-sectional study included 119 adults with T2DM (mean age, 53.3 ± 11.7 years), preserved eGFR (≥60 mL/min/1.73 m²), and no previous diagnosis of diabetic kidney disease. Albuminuria was classified from a single first-morning uACR measurement as A1 (<30 mg/g), A2 (30-300 mg/g), or A3 (>300 mg/g). Exploratory multivariable ordinal logistic regression evaluated factors associated with higher uACR categories. A secondary exploratory binary model evaluated screen-detected uACR ≥ 30 mg/g (A2/A3 versus A1).

A1 was observed in 67 patients (56.3%), A2 in 40 (33.6%), and A3 in 12 (10.1%); 52 patients (43.7%) had uACR ≥ 30 mg/g at screening. The median uACR was 25.6 mg/g, the median HbA1c was 11.2%, and the median fasting glucose was 280 mg/dL. In the exploratory ordinal model, longer T2DM duration (OR 1.51 per 5 years; 95% CI 1.09-2.10; p = 0.012), higher HbA1c (OR 1.18 per 1% increase; 95% CI 1.01-1.38; p = 0.036), and lower eGFR (OR 0.69 per 10 mL/min/1.73 m² increase; 95% CI 0.55-0.88; p = 0.003) were associated with higher uACR categories after adjustment for the measured covariates. In the secondary binary model, longer T2DM duration and lower eGFR were associated with screen-detected uACR ≥ 30 mg/g.

A single screening assessment identified uACR ≥ 30 mg/g in 43.7% of this selected regional cohort. These findings represent screen-detected albuminuria and do not establish persistent albuminuria, diabetic kidney disease, temporality, or causality. Confirmation with repeated uACR measurements and validation in larger longitudinal multicenter studies with detailed medication data are required.

Simultaneous pancreas-kidney transplantation (SPKT) restores both renal function and endogenous insulin secretion in selected patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD). Whether SPKT provides superior patient survival, kidney graft outcomes and cardiovascular benefit compared with kidney transplantation alone (KTA) remains debated, particularly when KTA is performed from a living donor.

A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE was searched using a predefined strategy including terms related to pancreas transplantation, kidney transplantation alone, T1DM, and ESRD/chronic kidney disease. Eligible studies included adult T1DM/ESRD populations comparing SPKT with KTA, including living-donor kidney transplantation (LDKT) and deceased-donor kidney transplantation (DDKT) and reporting clinically relevant outcomes. Full texts were reviewed and categorized as core comparative evidence, secondary/supportive evidence or excluded records. A quantitative synthesis was additionally performed for studies reporting directly comparable adjusted hazard ratios for patient mortality and kidney graft failure in the SPKT versus LDKT comparison.

Nineteen observational studies met the inclusion criteria and were included in the qualitative synthesis. SPKT consistently provided superior metabolic control and insulin independence when pancreas graft function was maintained. Compared with deceased-donor or mixed KTA cohorts, SPKT was frequently associated with more favorable long-term patient survival and cardiovascular outcomes in selected recipients. However, comparisons with LDKT yielded less consistent results, with several registry-based analyses reporting equivalent or superior kidney graft and survival outcomes after living-donor transplantation. Quantitative synthesis of the two studies providing directly comparable adjusted hazard ratios demonstrated a higher risk of patient mortality (HR 1.30, 95% CI 1.10-1.54) and kidney graft failure (HR 1.43, 95% CI 1.24-1.66) following SPKT compared with LDKT. Formal meta-analysis of SPKT versus DDKT was not feasible because of substantial heterogeneity in outcome definitions, statistical reporting methods and follow-up duration across studies.

In adults with T1DM and ESRD, successful SPKT provides a durable metabolic advantage and may improve long-term outcomes compared with deceased-donor KTA in selected patients. Across analyses that included all transplanted recipients from the time of surgery (intent-to-treat), early perioperative risk is higher after SPKT but may be offset over time when pancreas graft function is maintained. Evidence does not support a universal survival superiority of SPKT over living-donor kidney transplantation. Our quantitative synthesis of intent-to-treat, transplant-date analyses indicates that LDKT is associated with lower risks of patient mortality and kidney graft failure compared with SPKT when a suitable living donor is available. Treatment decisions should be individualized, considering living-donor availability, anticipated waiting time and dialysis exposure, cardiovascular and surgical risk, and the likelihood of durable pancreas graft function, with greater weight given to contemporary cohorts.

Background: Hyperuricemia has long been linked to the progression of chronic kidney disease (CKD), although the role of serum uric acid (sUA) reduction in kidney preservation remains uncertain. Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower sUA levels and exert renoprotective effects, but it is unclear whether these findings are mechanistically related. Methods: Adult patients with type 2 diabetes mellitus and hyperuricemia were included from a retrospective cohort. Patients treated with empagliflozin (n = 70) or dapagliflozin (n = 78) were pooled into a single group and compared with an allopurinol-treated group (n = 66). Exploratory mediation-informed analysis models assessed associations between treatment, changes in sUA (ΔsUA), and changes in estimated glomerular filtration rate (ΔeGFR) at 12 and 36 months. Dose-response and nonlinear associations between ΔsUA and ΔeGFR were additionally examined. Results: At 12 months, SGLT2 inhibitor treatment was associated with greater ΔsUA compared with allopurinol (B = 22.62, p = 0.040); its direct association with ΔeGFR remained significant after adjustment for ΔsUA (B = -6.14, p < 0.001). At 36 months, the association of treatment with ΔsUA was no longer significant, whereas association with ΔeGFR persisted (B = -11.8, p < 0.001). No dose-response or nonlinear relationship was identified between ΔsUA and ΔeGFR, while treatment remained an independent predictor of ΔeGFR at both time points. Conclusions: Reductions in sUA do not appear to mediate the renoprotective effects of SGLT2 inhibitors. The preservation of kidney function associated with SGLT2 inhibitor therapy is likely driven by mechanisms independent of sUA lowering.

The escalating global prevalence of diabetes, marked by a troubling rise in younger demographics, imposes a substantial public health burden. Although current pharmacological interventions are effective, they are frequently constrained by adverse side effects and inherent pharmacological limitations. Microalgal bioactive peptides possess high protein content and sustainable production capacity. They exhibit a broad spectrum of bioactivities. Consequently, they are positioned as safe and effective candidates for glycemic regulation. Compared to conventional drugs, microalgal peptides present distinct advantages in sustainability and safety profiles. This review systematically consolidates current knowledge on microalgal hypoglycemic peptides, commencing with an overview of their resource superiority and potential for sustainable manufacturing. We then detail the evolving methodologies for peptide preparation, purification, and identification. A central focus is placed on elucidating their mechanisms of action, with particular emphasis on α-glucosidase inhibition, as revealed through advanced techniques such as molecular docking. Moreover, we critically assess the persistent challenges that currently impede full commercial translation. These include gaps in mechanistic understanding, bottlenecks in process optimization, and hurdles to industrial scale-up. Finally, future research directions aimed at overcoming these barriers are discussed. This review comprehensively synthesizes the research progress in this field, aiming to provide a reference for the development of microalgal-derived functional ingredients and to accelerate their translational application in diabetes intervention.

Background One of the main causes of end-stage renal disease and chronic kidney disease (CKD) in people with type 2 diabetes mellitus (T2DM) is diabetic nephropathy. The clinical value of the protein-creatinine ratio (PCR) and derived renal risk indices for comprehensive renal risk assessment has not been adequately investigated, despite microalbuminuria being a recognised indicator of early renal injury. Derived renal risk markers (novel renal indices, including the albumin-protein ratio (APR), albumin-creatinine ratio (ACR)/eGFR index (ACR/eGFR), protein/eGFR index (PCR/eGFR), and a composite renal risk score (RRS)) were calculated to comprehensively assess proteinuria relative to renal function and estimate the severity of renal impairment. Methods A one-year hospital-based cross-sectional study from January 2025 to January 2026 was conducted among 150 adults with T2DM individuals with T2DM who were enrolled in Vinayaka Mission Medical College & Hospital, Karaikal, and participated in the cross-sectional study. Blood pressure, body mass index (BMI), serum creatinine, HbA1c, and length of diabetes were among the clinical and biochemical markers that were noted. Spot urine PCR was calculated, and urinary microalbumin was quantified using an immunoturbidimetric technique. The CKD-EPI equation was used to determine the estimated glomerular filtration rate (eGFR). To evaluate renal involvement, derived renal indices such as the urine APR, ACR, albumin/eGFR index, and protein/eGFR index were computed. Associations between renal indices and clinical parameters were assessed using multivariable regression analysis and Pearson correlation, with statistical significance established at p < 0.05. Results Of the 150 individuals, 21.3% had macroalbuminuria, 38.7% microalbuminuria, and 40.0% had normoalbuminuria. As albuminuria worsened, PCR, APR, ACR/eGFR, PCR/eGFR, and renal risk score all significantly increased while eGFR decreased (p < 0.001). PCR and microalbuminuria had a significant positive connection (r = 0.72, p < 0.001). Renal impairment was substantially correlated with HbA1c, length of diabetes, hypertension, and BMI. HbA1c and PCR were found to be independent predictors of diabetic nephropathy using multivariable regression. Conclusion In individuals with T2DM, PCR and derived renal indices showed strong correlations with renal involvement and could be helpful supplements to traditional indicators for evaluating diabetic nephropathy.