Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, a...Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, and Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and practices (KAP) around diabetic eye disease in the general population including patients with DM and non-diabetic people in Medina City, Saudi Arabia. Methods: This is a cross-sectional study involving 385 participants via a self-administered online Questionnaire started in January 2023 in Medina, Saudi Arabia. Results: In total, 339 participants with ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed the questionnaire. The majority were females (74.6%), singles (67.8%), and had a university level of education (54.6%). Most of the study participants were found to have poor knowledge levels (67%) in comparison to 33% who had an overall good knowledge of diabetic eye diseases. Knowledge level was found to be higher among old-aged participants and those with a family history of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ attitudes and practices, the study showed good attitudes toward eye care practice for diabetics with half of the participants (50%) reporting self-awareness as a reason that made them undergo the first eye screening. Conclusion: Participants in the present study have poor knowledge and awareness level of diabetic eye disease. Furthermore, positive attitudes and perceptions have been revealed by the participants toward the practice of providing eye care for diabetics. .展开更多
BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with ...BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.展开更多
BACKGROUND A number of recent studies indicate a transformation in the natural course of chronic kidney disease(CKD)in type 2 diabetes(T2D)patients:an increasing prevalence of declined renal function without proceedin...BACKGROUND A number of recent studies indicate a transformation in the natural course of chronic kidney disease(CKD)in type 2 diabetes(T2D)patients:an increasing prevalence of declined renal function without proceeding to the accompanying elevation of albuminuria.It has been suggested that albuminuric and nonalbuminuric CKD patterns could be different in their phenotypes and pathogenic mechanisms.AIM To identify the risk factors and biomarkers of albuminuric and non-albuminuric patterns of CKD in patients with T2D.METHODS Three hundred sixty patients with T2D duration≥10 years were included in this observational cross-sectional study.The associations of a panel of demographic and clinical characteristics,complications,comorbidities,and metabolic and hematology parameters with albuminuric and non-albuminuric CKD patterns were analyzed.The urinary excretion of nephrin and podocin,two podocytespecific markers,and WAP-four-disulfide core domain protein 2(WFDC-2),a marker of tubulointerstitial fibrosis,was determined by ELISA in comparison with healthy controls.RESULTS Non-albuminuric CKD was associated with age≥65 years(P=0.0001),female sex(P=0.04),diabetes duration≥15 years(P=0.0009),and the use of diuretics(P=0.0005).Male sex(P=0.01),smoking(P=0.01),waist-to-hip ratio>1.0(P=0.01)and hemoglobin A1c(HbA1c)>8.0%(P=0.005)were risk factors for elevated albuminuria not accompanied by a decrease in estimated glomerular filtration rate(eGFR).Duration of diabetes≥15 years and the use of calcium channel blockers were risk factors for albuminuria with decreased eGFR(both P=0.01).In multivariate logistic regression analysis,age,HbA1c,female sex and diuretics were significant predictors for reduced eGFR,while waist-to-hip ratio,HbA1c and male sex were associated with elevated urinary albumin-to-creatinine ratio(UACR).Excretion of nephrin and podocin was increased in patients with albuminuria,regardless of decline in renal function(P<0.001),correlating positively with UACR.The urinary excretion of WFDC-2 was markedly higher in men than in women(P<0.000001).Men with T2D demonstrated increased WFDC-2 levels independently of the CKD pattern(all P<0.05).In T2D women,WFDC-2 excretion was increased in those with reduced renal function(P≤0.01),correlating negatively with eGFR.CONCLUSION The data provide further evidence that albuminuric and non-albuminuric CKD phenotypes correspond to different pathways of diabetic kidney disease progression.展开更多
Background The equations for estimating glomerular filtration rate （GFR） based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C ...Background The equations for estimating glomerular filtration rate （GFR） based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease （CKD） and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease （MDRD） equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes. Methods A total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams （Stevens, Ma, Rule, Macisaac and Perkins）. The plasma clearance of ^99mTc-DTPA was determined as measured GFR （mGFR）.Results For CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2-5. The differences between Macisaac and mGFR in CKD stages 2-4 were significantly less than those in CKD stage 1 or 5.Stevens and Rule＇s formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3-5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR≥90 ml·min^-1·1.73 m^-2 stage, in GFR 60-89 ml·min^-1·1.73 m^-2 stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR 〈60 ml·min^-1·1.73 m^-2 stages. The MDRD formula had a greater accuracy within 50% of mGFR than the equations based on cystatin C in diabetic patients. Perkins formula showed a large positive bias and low accuracy, therefore it may not be suitable for assessing GFR in patients with CKD and diabetes. Conclusions The formulae for estimating GFR based on cystatin C or creatinine have different trends and accuracies in patients with CKD and diabetes, especially in patients with various GFR levels. The equations based on cystatin C provide less accurate results than MDRD formulae, at least in the diabetic patients. Therefore, whether the formulae based on cystatin C are superior to MDRD formula requires further investigation in large diverse populations.展开更多
Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinar...Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinary albumin excretion rate and the incidence and severity of coronary heart disease in elderly type 2 diabetes mellitus patients. Methods A total of 612 hospitalized type 2 diabetes mellitus patients aged 60 years or older, who were given coronary angiography for diagnosis of possible coronary heart disease, participated. Their urinary albumin excretion rate was measured, and the severity of coronary artery stenosis was quantified with the Gensini scoring system to analyze the incidence of coronary heart disease and the severity of coronary artery stenosis. The optimal urinary albumin excretion rate predictive value for coronary heart disease incidence in elderly type 2 diabetes mellitus patients was determined. Results The incidence of coronary heart disease, the number of patients with coronary vascular disease and the Gensini scores were significantly different between the microalbuminuria group and the normal atbuminuria group （P 〈0.05）. The urinary albumin excretion rate was independently correlated with the occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients （odds ratio （OR） =1.058, P 〈0.0001,95% confidence interval （CI）： 1.036-1.080）. Urinary albumin excretion rate and the Gensini score were independently correlated in elderly type 2 diabetes mellitus patients （β=0.476, P 〈0.0001）. The best predictive value of urinary albumin excretion rate was 10.45 tJg/min for elderly type 2 diabetes mellitus patients. The area under the curve was 0.764, with a sensitivity and specificity of 70.0% and 72.2%, respectively. Conclusions The occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients with microalbuminuria was higher than that in patients with normal albuminuria, and the severity of the disease also increased in patients with microalbuminuria. In elderly type 2 diabetes mellitus patients, urinary albumin excretion rate was positively correlated with the incidence and severity of coronary heart disease and was also an independent factor contributing to coronary heart disease.展开更多
文摘Background: Diabetic eye disease is known as a group of eye problems that diabetic patients may develop as a complication of diabetes and can lead to blindness. They may include Diabetic retinopathy (DR), Cataracts, and Glaucoma. Objectives: This study aims to assess the knowledge, attitude, and practices (KAP) around diabetic eye disease in the general population including patients with DM and non-diabetic people in Medina City, Saudi Arabia. Methods: This is a cross-sectional study involving 385 participants via a self-administered online Questionnaire started in January 2023 in Medina, Saudi Arabia. Results: In total, 339 participants with ages ranged from 18 to more than 60 years with a mean age of 26.8 ± 12.6 years old completed the questionnaire. The majority were females (74.6%), singles (67.8%), and had a university level of education (54.6%). Most of the study participants were found to have poor knowledge levels (67%) in comparison to 33% who had an overall good knowledge of diabetic eye diseases. Knowledge level was found to be higher among old-aged participants and those with a family history of DM (P = 0.001, P = 0.049) respectively. Regarding participants’ attitudes and practices, the study showed good attitudes toward eye care practice for diabetics with half of the participants (50%) reporting self-awareness as a reason that made them undergo the first eye screening. Conclusion: Participants in the present study have poor knowledge and awareness level of diabetic eye disease. Furthermore, positive attitudes and perceptions have been revealed by the participants toward the practice of providing eye care for diabetics. .
基金Supported by Basic scientific research industry of Heilongjiang Provincial undergraduate universities in 2019,No.2019-KYYWF-1213.
文摘BACKGROUND Cerebrovascular disease(CVD)poses a serious threat to human health and safety.Thus,developing a reasonable exercise program plays an important role in the long-term recovery and prognosis for patients with CVD.Studies have shown that predictive nursing can improve the quality of care and that the information–knowledge–attitude–practice(IKAP)nursing model has a positive impact on patients who suffered a stroke.Few studies have combined these two nursing models to treat CVD.AIM To explore the effect of the IKAP nursing model combined with predictive nursing on the Fugl–Meyer motor function(FMA)score,Barthel index score,and disease knowledge mastery rate in patients with CVD.METHODS A total of 140 patients with CVD treated at our hospital between December 2019 and September 2021 were randomly divided into two groups,with 70 patients in each.The control group received routine nursing,while the observation group received the IKAP nursing model combined with predictive nursing.Both groups were observed for self-care ability,motor function,and disease knowledge mastery rate after one month of nursing.RESULTS There was no clear difference between the Barthel index and FMA scores of the two groups before nursing(P>0.05);however,their scores increased after nursing.This increase was more apparent in the observation group,and the difference was statistically significant(P<0.05).The rates of disease knowledge mastery,timely medication,appropriate exercise,and reasonable diet were significantly higher in the observation group than in the control group(P<0.05).The satisfaction rate in the observation group(97.14%)was significantly higher than that in the control group(81.43%;P<0.05).CONCLUSION The IKAP nursing model,combined with predictive nursing,is more effective than routine nursing in the care of patients with CVD,and it can significantly improve the Barthel index and FMA scores with better knowledge acquisition,as well as produce high satisfaction in patients.Moreover,they can be widely used in the clinical setting.
文摘BACKGROUND A number of recent studies indicate a transformation in the natural course of chronic kidney disease(CKD)in type 2 diabetes(T2D)patients:an increasing prevalence of declined renal function without proceeding to the accompanying elevation of albuminuria.It has been suggested that albuminuric and nonalbuminuric CKD patterns could be different in their phenotypes and pathogenic mechanisms.AIM To identify the risk factors and biomarkers of albuminuric and non-albuminuric patterns of CKD in patients with T2D.METHODS Three hundred sixty patients with T2D duration≥10 years were included in this observational cross-sectional study.The associations of a panel of demographic and clinical characteristics,complications,comorbidities,and metabolic and hematology parameters with albuminuric and non-albuminuric CKD patterns were analyzed.The urinary excretion of nephrin and podocin,two podocytespecific markers,and WAP-four-disulfide core domain protein 2(WFDC-2),a marker of tubulointerstitial fibrosis,was determined by ELISA in comparison with healthy controls.RESULTS Non-albuminuric CKD was associated with age≥65 years(P=0.0001),female sex(P=0.04),diabetes duration≥15 years(P=0.0009),and the use of diuretics(P=0.0005).Male sex(P=0.01),smoking(P=0.01),waist-to-hip ratio>1.0(P=0.01)and hemoglobin A1c(HbA1c)>8.0%(P=0.005)were risk factors for elevated albuminuria not accompanied by a decrease in estimated glomerular filtration rate(eGFR).Duration of diabetes≥15 years and the use of calcium channel blockers were risk factors for albuminuria with decreased eGFR(both P=0.01).In multivariate logistic regression analysis,age,HbA1c,female sex and diuretics were significant predictors for reduced eGFR,while waist-to-hip ratio,HbA1c and male sex were associated with elevated urinary albumin-to-creatinine ratio(UACR).Excretion of nephrin and podocin was increased in patients with albuminuria,regardless of decline in renal function(P<0.001),correlating positively with UACR.The urinary excretion of WFDC-2 was markedly higher in men than in women(P<0.000001).Men with T2D demonstrated increased WFDC-2 levels independently of the CKD pattern(all P<0.05).In T2D women,WFDC-2 excretion was increased in those with reduced renal function(P≤0.01),correlating negatively with eGFR.CONCLUSION The data provide further evidence that albuminuric and non-albuminuric CKD phenotypes correspond to different pathways of diabetic kidney disease progression.
文摘Background The equations for estimating glomerular filtration rate （GFR） based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease （CKD） and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease （MDRD） equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes. Methods A total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams （Stevens, Ma, Rule, Macisaac and Perkins）. The plasma clearance of ^99mTc-DTPA was determined as measured GFR （mGFR）.Results For CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2-5. The differences between Macisaac and mGFR in CKD stages 2-4 were significantly less than those in CKD stage 1 or 5.Stevens and Rule＇s formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3-5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR≥90 ml·min^-1·1.73 m^-2 stage, in GFR 60-89 ml·min^-1·1.73 m^-2 stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR 〈60 ml·min^-1·1.73 m^-2 stages. The MDRD formula had a greater accuracy within 50% of mGFR than the equations based on cystatin C in diabetic patients. Perkins formula showed a large positive bias and low accuracy, therefore it may not be suitable for assessing GFR in patients with CKD and diabetes. Conclusions The formulae for estimating GFR based on cystatin C or creatinine have different trends and accuracies in patients with CKD and diabetes, especially in patients with various GFR levels. The equations based on cystatin C provide less accurate results than MDRD formulae, at least in the diabetic patients. Therefore, whether the formulae based on cystatin C are superior to MDRD formula requires further investigation in large diverse populations.
基金The study was supported by a grant from the Beijing Municipal Natural Science Foundation of China （No. 7062059）.
文摘Background Coronary heart disease is the main complication of type 2 diabetes mellitus; its incidence is closely related to microalbuminuria. The aim of this study was to investigate the correlation between the urinary albumin excretion rate and the incidence and severity of coronary heart disease in elderly type 2 diabetes mellitus patients. Methods A total of 612 hospitalized type 2 diabetes mellitus patients aged 60 years or older, who were given coronary angiography for diagnosis of possible coronary heart disease, participated. Their urinary albumin excretion rate was measured, and the severity of coronary artery stenosis was quantified with the Gensini scoring system to analyze the incidence of coronary heart disease and the severity of coronary artery stenosis. The optimal urinary albumin excretion rate predictive value for coronary heart disease incidence in elderly type 2 diabetes mellitus patients was determined. Results The incidence of coronary heart disease, the number of patients with coronary vascular disease and the Gensini scores were significantly different between the microalbuminuria group and the normal atbuminuria group （P 〈0.05）. The urinary albumin excretion rate was independently correlated with the occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients （odds ratio （OR） =1.058, P 〈0.0001,95% confidence interval （CI）： 1.036-1.080）. Urinary albumin excretion rate and the Gensini score were independently correlated in elderly type 2 diabetes mellitus patients （β=0.476, P 〈0.0001）. The best predictive value of urinary albumin excretion rate was 10.45 tJg/min for elderly type 2 diabetes mellitus patients. The area under the curve was 0.764, with a sensitivity and specificity of 70.0% and 72.2%, respectively. Conclusions The occurrence of coronary heart disease in elderly type 2 diabetes mellitus patients with microalbuminuria was higher than that in patients with normal albuminuria, and the severity of the disease also increased in patients with microalbuminuria. In elderly type 2 diabetes mellitus patients, urinary albumin excretion rate was positively correlated with the incidence and severity of coronary heart disease and was also an independent factor contributing to coronary heart disease.
