Type 2 diabetes mellitus (T2DM) is associated with increased skeletal fragility despite normal or elevated bone mineral density (BMD), suggesting impaired bone quality and remodeling. Bone turnover markers (BTMs), including procollagen type I N-terminal propeptide (P1NP) and β-C-terminal telopeptide of type I collagen (β-CTX), reflect bone formation and resorption, respectively. This study evaluated serum P1NP and β-CTX concentrations in patients with T2DM from North India and their associations with clinical and biochemical parameters.

This hospital-based case-control study included 80 patients with T2DM and 20 age- and sex-matched healthy controls. Anthropometric measurements, glycemic indices, lipid profile, serum calcium, 25-hydroxyvitamin D, BMD and serum BTMs were assessed.

Patients with T2DM had significantly higher body mass index, blood pressure, fasting glucose, HbA1c and adverse lipid profiles than controls (all p<0.05). Serum β-CTX (0.735±0.302 vs. 0.356±0.171 pg/mL; p<0.001) and P1NP (33.11±16.49 vs. 26.39±10.92 ng/mL; p=0.033) were elevated in T2DM. Vitamin D levels were lower and osteoporosis was present in 76.3% of patients. β-CTX showed a weak inverse correlation with age (r=-0.233, p=0.038) and age remained its only independent predictor.

Patients with T2DM exhibited increased bone turnover with predominant bone resorption, supporting the clinical utility of BTMs beyond BMD assessment.

Achieving sustained blood-pressure control remains difficult in routine care, particularly in referral settings where patients often have longer di sease duration and multiple comorbidities. Cross-sectional clinical data can identify correlates of poor control, but such associations should not be interpreted as causal effects.

To describe the clinical characteristics of adults with treated hypertension and to examine factors associated with uncontrolled blood pressure in a tertiary-care population.

This cross-sectional observational study included 100 consecutively recruited adults with previously diagnosed hypertension at Government Medical College, Bhadradri Kothagudem, Telangana, India, from February to November 2025. Demographic, clinical, lifestyle, treatment, adherence, follow-up and office blood-pressure data were recorded. Controlled hypertension was defined as office blood pressure <140/90 mm Hg and uncontrolled hypertension as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg. Bivariate associations were summarized with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs), followed by multivariable logistic regression.

The mean age was 56.8 ± 11.4 years and 58.0% of participants were men. Uncontrolled hypertension was observed in 62.0% of the cohort. In bivariate analysis, body mass index (BMI) ≥25 kg/m², hypertension duration > five years, diabetes mellitus, high salt intake, physical inactivity, poor medication adherence, and missed follow-up visits were associated with uncontrolled blood pressure. After adjustment, poor medication adherence [adjusted OR (aOR) 6.84, 95% CI 2.02-23.15], BMI ≥25 kg/m² (aOR 3.49, 95% CI 1.11-10.99), physical inactivity (aOR 3.21, 95% CI 1.12-9.18), high salt intake (aOR 2.94, 95% CI 1.05-8.27) and hypertension duration > five years (aOR 2.88, 95% CI 1.02-8.15) remained statistically significant. The wide CIs indicate limited precision.

Several behavioural and clinical characteristics were associated with uncontrolled office blood pressure in this tertiary-care sample. Because this was a cross-sectional single-centre study based on a single-visit office assessment, its findings indicate associations rather than causal relationships and should not be extrapolated to the general hypertensive population.

Diabetes mellitus (DM) is a major modifiable risk factor for coronary artery disease, and cardiovascular events can represent the first clinical manifestation of undiagnosed DM. Our study aims to determine the incidence of newly detected cardiovascular risk factors, including DM, prediabetes, dyslipidemia, hypertension, and smoking, among patients presenting with acute coronary syndrome (ACS) in Qatar.

This cross-sectional observational study was included all patients admitted with ST-or non-ST-elevation myocardial infarction (MI) to Heart Hospital, Qatar, between March 1, 2015, and December 31, 2020. Data were extracted from electronic records, including newly diagnosed DM was defined as hemoglobin A1c (HbA1c) ≥6.5%; prediabetes as HbA1c 5.6%-6.4%; dyslipidemia as low-density lipoprotein (LDL) ≥3.3 mmol/L; and familial hyperlipidemia as LDL ≥4.9 mmol/L with a family history. Smoking and hypertension were also recorded.

Among 10,450 patients, the mean age of ACS was 51 ± 11 years, and 92.4% were male, 13.2% had newly diagnosed DM, and 21.2% met prediabetes criteria. Dyslipidemia, hypertension, and smoking were newly identified in 30.3%, 38.9%, and 27.3%, respectively. These findings suggest that ACS onset occurred at a markedly younger age compared to international cohorts.

Undiagnosed cardiovascular risk factors, particularly DM and prediabetes, are highly prevalent and may be associated with earlier MI. Thus, early screening and preventive strategies should be more targeted and tailored to reflect the distinct cardiometabolic risk profiles of Middle Eastern populations.

Ossifying fibroma is a benign, well-demarcated fibro-osseous neoplasm that most commonly affects the mandible and maxilla. Involvement of the paranasal sinuses is rare, and ethmoid sinus localization is particularly uncommon. Because sinonasal ossifying fibroma may mimic other fibro-osseous and osseous lesions radiologically, histopathologic confirmation and complete excision are important for diagnosis and disease control.

A 43-year-old Saudi man with well-controlled type 2 diabetes mellitus presented with a 6-month history of progressive right-sided nasal obstruction and frontal headache. He reported no history of epistaxis, visual disturbance, or anosmia. Computed tomography demonstrated a well-defined 2.5 × 1.6 × 2.3 cm sclerotic lesion with ground-glass matrix occupying the right posterior ethmoid air cells and abutting the skull base. Histopathology confirmed ossifying fibroma. The patient underwent complete endoscopic transnasal resection with skull base repair using a free autologous cartilage graft. The clinical course is summarized in Table 1. Recovery was uneventful, and he was discharged on postoperative day two.

Ethmoidal ossifying fibroma is rare and may present with nonspecific sinonasal symptoms. Complete excision is recommended for symptomatic sinonasal disease because incomplete removal is associated with recurrence. In selected cases, an endoscopic approach can provide direct visualization, avoid external approach-related morbidity, and allow skull base reconstruction when required. However, 4-month follow-up is insufficient to make definitive statements about long-term recurrence.

Posterior ethmoid ossifying fibroma is an uncommon presentation of a benign fibro-osseous tumor. Accurate diagnosis requires clinical, radiologic, and histopathologic correlation. Complete endoscopic resection with appropriate skull base repair can achieve favorable short-term outcomes in selected cases, but prolonged surveillance is necessary.

Medication adherence is critical for achieving optimal glycemic control and preventing diabetes-related complications. However, poor adherence remains a major barrier to effective diabetes management worldwide. Evidence regarding factors associated with medication adherence among adults with diabetes in Saudi Arabia remains limited. This study aimed to assess medication adherence among adults with diabetes and examine associations of sociodemographic, clinical, pharmacist-related, and digital health factors with adherence levels.

A cross-sectional study was conducted among adults with type 1 or type 2 diabetes attending a specialized diabetes center in Jazan, Saudi Arabia, during February-March 2025. Participants were recruited using non-probability convenience sampling. Of 489 patients approached, 388 completed the questionnaire, yielding a response rate of 79.3%. Data were collected using a bilingual (Arabic/English) electronic questionnaire. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Descriptive statistics, bivariate analyses, correlation analysis, and multinomial logistic regression were performed using IBM SPSS Statistics version 27.

Overall, 77.1% of participants demonstrated low medication adherence, while 16.5% and 6.4% demonstrated moderate and high adherence, respectively. In the adjusted multinomial logistic regression model, higher satisfaction with the current diabetes management plan was significantly associated with greater odds of moderate adherence (OR=1.650, 95% CI: 1.212-2.245, P=0.001) and high adherence (OR=2.038, 95% CI: 1.165-3.565, P=0.013) compared with low adherence. Insulin use was associated with moderate vs low adherence (OR=2.175, 95% CI: 1.008-4.692, P=0.048), but not with high adherence. Participants who did not use mobile applications or digital health tools had higher odds of high vs low adherence than those who used such tools (OR=2.685, 95% CI: 1.007-7.154, P=0.048). Age and comorbid conditions were not significantly associated with adherence level in the adjusted model. Frequency of pharmacist consultation was significant overall (P=0.001), although individual category comparisons did not demonstrate a consistent pattern across adherence levels. Multicollinearity diagnostics indicated no problematic collinearity (VIF=1.04-1.34; tolerance ≥0.75).

Medication adherence was predominantly low among study participants. Higher satisfaction with diabetes management was consistently associated with greater adherence, while insulin use and digital health tool use showed category-specific associations. The unexpected association between digital-tool non-use and high adherence should be interpreted cautiously and does not establish a causal effect of digital technology on adherence. Further longitudinal and prospective studies are warranted to clarify these associations and determine how structured pharmacist engagement and personalized digital-health strategies can be optimally incorporated into patient-centered diabetes care.

Omentin-1 is an adipokine predominantly secreted by visceral adipose tissue (VAT) and is abundant in human plasma. Circulating omentin-1 levels are significantly reduced in patients with obesity, type 2 diabetes mellitus (T2DM), hypertension, and coronary artery disease (CAD). However, the associations between circulating omentin-1 levels and cardiovascular risk and prognosis appear heterogeneous across populations and disease stages. Accumulating evidence indicates that omentin-1 exerts multiple cardioprotective effects. These effects include anti-atherosclerotic activity, improved insulin sensitivity, anti-inflammatory and antioxidant effects, enhanced endothelial function, and myocardial protection. Through these mechanisms, omentin-1 contributes to vascular and cardiometabolic homeostasis. This review summarizes the biological characteristics of omentin-1 and its protective roles and molecular mechanisms in CVD. It also highlights recent advances in clinical research. We further highlight emerging evidence that commonly used cardiometabolic drugs can modulate omentin-1 levels, supporting its potential as both a biomarker and a therapeutic target. A clearer understanding of its pleiotropic actions may facilitate the development of translational strategies for CVD prevention and treatment.

Aortoiliac occlusive disease (AIOD) often requires urgent revascularization to prevent chronic limb-threatening ischemia (CLTI). The coexistence of autoimmune hemolytic anemia (AIHA) complicates surgical planning due to increased transfusion risks and unstable hemoglobin levels. Understanding the interplay between AIHA and AIOD is crucial, as delayed intervention can lead to irreversible ischemic damage.

A 72-year-old man presented with leg pain and bilateral lower-limb weakness. His medical history included type 2 diabetes mellitus and suspected AIHA. Physical examination revealed necrosis in the first, second, and fourth toes of the left foot, consistent with CLTI classified as Fontaine stage IV. Laboratory findings showed severe anemia, hyperglycemia, leukocytosis, and hypoalbuminemia. CT angiography confirmed aortoiliac occlusion. Despite a suboptimal hemoglobin response to transfusion with leukodepleted packed red blood cells due to suspected AIHA, urgent revascularization was performed. The patient underwent aortoiliac endarterectomy followed by an aortobifemoral bypass using a Y-graft. Postoperative examination revealed good bilateral femoral pulses, indicating successful revascularization.

The management of AIOD with AIHA presents a clinical dilemma. AIHA may reduce the effectiveness of perioperative transfusions, yet delaying surgery risks the progression of ischemia. Anatomical bypass to the femoral arteries restores proximal blood flow and addresses the dual concerns of thrombus progression and limb salvage.

Despite the hematologic challenges posed by the suspicion of AIHA, revascularization through aortobifemoral bypass remains a viable and effective treatment for CLTI caused by AIOD. This case highlights the importance of timely intervention and careful perioperative management in patients with complex comorbidities.

This study aimed to investigate the impact of diabetes mellitus (DM) on the risk of mortality in patients with giant cell arteritis (GCA).

This Danish nationwide cohort study included patients diagnosed with both GCA and DM, who were matched 1:3 with patients with only GCA or DM, on sex and year of birth. The Pseudo-observation method and Cox regression were used to evaluate the cumulative incidence proportion (CIP), risk difference (RD), and relative risk of mortality after 6 months and 5 years. Also, time-dependent hazard ratios (HR) were made to assess the impact of predefined HbA1c categories on the risk of mortality.

Among 3674 cases, the CIP of mortality was 8.1% (7.1-9.1) at 6 months and 34.6% (32.7-36.4) at 5 years. Compared with patients with GCA only (n = 10,311), the RD was 5.5% (4.5-6.5) at 6 months and 15.1% (13.3-17.0) at 5 years. Compared with patients with DM only (n = 11,020), the RD was 4.9% (3.9-5.9) and 6.5% (4.7-8.3). The adjusted HR for mortality was significantly higher in patients with elevated HbA1c, especially after 5 years of follow-up.

Having both GCA and DM was associated with a higher mortality risk compared with either condition alone, especially in the initial phase after diagnosis. High HbA1c increased the risk of 5-year mortality in both patients with GCA and DM and GCA alone, suggesting glycaemic control could be relevant in this population.

Postmenopausal women with type 2 diabetes mellitus (T2DM) are at increased risk of fragility fractures, emphasizing the importance of selecting antidiabetic agents that support glycemic control and bone health. Most dipeptidyl peptidase-4 inhibitors have shown neutral or favorable effects on bone metabolism; however, data specifically on evogliptin remain limited. This study evaluated the effects of evogliptin and dapagliflozin on bone metabolism and glycemic parameters in postmenopausal women with T2DM.

This multicenter, randomized clinical trial enrolled postmenopausal women with T2DM assigned to receive evogliptin or dapagliflozin for 48 weeks. The primary outcome was change in bone mineral density (BMD). Glycemic indices were the secondary endpoints.

Sixty participants were included in the final analysis, with 30 in each group. After 48 weeks, the change in BMD at the L1-L4 spine and total hip did not differ significantly between groups. Femoral neck BMD decreased significantly in the dapagliflozin group compared with the evogliptin group, although the absolute between-group difference was small (0.00 ± 0.02 vs -0.02 ± 0.04 g/cm², p = 0.0402). After adjustment for baseline femoral neck BMD and 25OHD, the between-group difference was attenuated (p = 0.0763). The body mass index (BMI) decreased more in the dapagliflozin group than in the evogliptin group. In analyses of factors associated with femoral neck BMD change, no statistically significant predictors were identified, although decreasing BMI showed a trend toward association. Glycemic indices did not differ significantly between the groups.

In postmenopausal women with T2DM, BMD remained stable with evogliptin, whereas dapagliflozin was associated with a small reduction in femoral neck BMD, although this finding was weakened after adjustment. These findings provide preliminary evidence regarding the skeletal effects of evogliptin and dapagliflozin and warrant confirmation in larger studies.

ClinicalTrials.gov (NCT04706637).

Diabetic nephropathy (DN) is a significant complication of diabetes mellitus (DM) and a primary driving force for renal failure. The development of DN is influenced by immunological dysregulation, and chronic inflammation. Despite the promise of mesenchymal stromal cell-conditioned media (MSCs-CM) as a beneficial intervention for various diseases, its clinical application is hindered by insufficient studies and a limited understanding of the underlying mechanisms. This study examines the beneficial effects and potential mechanisms through which MSCs-CM attenuates early diabetic renal injury in a streptozotocin (STZ)-induced diabetic rat model, targeting oxidative stress-induced inflammation response, and renal damage triggered by hyperglycemia, via compare the therapeutic impact and associated anti-inflammatory modulatory profiles of intravenous versus pancreatic-targeted MSCs-CM delivery in STZ-induced early diabetic renal injury. Forty male Wistar rats were randomly allocated to five groups (n = 8/group) including: Control, DN (rats that had fasted overnight, 50 mg/kg b.wt. STZ was dissolved in cold citrate buffer (pH 4.5) and administered intraperitoneally fifteen minutes after 110 mg/kg b.wt. of nicotinamide (NA) prepared in normal physiological saline and injected intraperitoneally), DN+ Amaryl (800 µg/kg body weight per day), DN+ intravenous MSCs-CM (0.5 mL MSCs-CM was given intravenously (IV) through the tail vein) & DN+ pancreatic MSCs-CM (0.5 mL MSCs-CM was locally administered going straight into the pancreas). All treatments continued for 28 days. The treatment regimens led to a significant decline in serum insulin, HbA1c, and blood glucose levels. Additionally, the treatments reduced oxidative stress and increased antioxidant enzyme activities/concentrations, as demonstrated by the kidney's decreased lipid peroxidation marker (MDA), NO as a marker of nitric oxide/oxidative-nitrosative stress and elevated antioxidant markers (catalase, superoxide dismutase, and glutathione). The inflammatory mediator NF-κB, COX-2, and iNOS expression were significantly reduced by MSCs-CM in conjunction with the significant decrease in IL-1β, PGE2, TNF-α, and IL-6. These findings suggest that infusing MSCs-CM into T1DM rat model support further investigation of MSCs-CM as a potential therapeutic approach.