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Clinical display of posterior cerebral artery occlusions : Medical reasoning to get a more intense therapeutic technique?
This study evaluated the use of the Medtronic MiniMed 670G system in adults with type 1 diabetes mellitus from a large endocrinology practice and its impact on glycemic control, quality of life (QoL), compliance and safety.

84 participants completed one site visit for data collection. Percentage of time in range (TIR 70-180mg/dL), hyperglycemia or time above range (TAB) (>180mg/dL), hypoglycemia or time below range (TBR) (<70mg/dL), HbA1c, average blood glucose (ABG), and other metrics were evaluated at the last visit using the system (LVMM) and compared between the last visit on previous insulin therapy (LVPT).

The mean percentage of TIR at the LVMM was 74.0±12.1%, with an increase of 27.1% (p<0.001) in TIR from the LVPT. The mean percentage of TAR was 22.9±11.8% and the mean percentage of TBR was 3.2±5.1%.

The use of the Medtronic MiniMed 670G system in our practice resulted in a TIR above the recommended target with a high degree of treatment satisfaction and compliance in adults with type 1 diabetes. Furthermore, the system may be a reasonable choice for patients struggling with significant amounts of hypoglycemia.
The use of the Medtronic MiniMed 670G system in our practice resulted in a TIR above the recommended target with a high degree of treatment satisfaction and compliance in adults with type 1 diabetes. Furthermore, the system may be a reasonable choice for patients struggling with significant amounts of hypoglycemia.There may be hesitancy in prescribing GLP-1RA in older adults. On pooling results from the CVOTs comparing GLP-1RA to placebo, there was a significantly lower incidence of MACE favoring GLP-1RA in both younger and older adults. GLP-1RA should be considered in high risk patients regardless of age.
Diabetic retinopathy (DR) is a serious complication of type 2 diabetes mellitus (T2DM) and is the most common cause of impaired vision for adults. DR is related to a number of risk factors. The aim of this study was to investigate the relationship between burden of coronary artery disease assessed by Syntax Score (SS) and DR in T2DM.

A total of 96 T2DM patients undergoing coronary angiography were prospectively included in the study. Presence and severity of DR were assessed by ocular fundus examination. DR was graded as no apparent retinopathy (NDR), non-proliferative (NPDR), and proliferative DR (PDR). The SS for each patient was calculated.

The mean age was 58.0±8.2years. SS gradually increased from NDR group to PDR group. PF-6463922 cost The median (IQR) value of SS was 10 (5-16) in patients with NDR, 22.8 (17-35.8) in those with NPDR, and 35.5 (28-37) in those with PDR (p<0.001). On multivariate analysis SS [odds ratio (OR) 1.145, p=0.001] and duration of diabetes (OR 1.753, p=0.031) were independent factors for DR.

The SS is independently associated with the occurrence of DR in T2DM. Ophthalmologists and cardiologists must cooperate when evaluating patients with DM because of possible complications.
The SS is independently associated with the occurrence of DR in T2DM. Ophthalmologists and cardiologists must cooperate when evaluating patients with DM because of possible complications.
To prospectively explore the association between sedentary time (SED-time) and the development of diabetic foot ulcer (DFU) in people with diabetic peripheral neuropathy (DPN).

175 DPN individuals who attended the annual evaluation for the SAMBA Study (2012-2019) were included. Main outcome measure was the first diagnosis of DFU. SED-time was measured by the PAS 2.1 questionnaire. Nerve function was evaluated by nerve conduction studies. Vascular function was assessed by Ankle-brachial index (ABI) and pedal pulses. Foot deformity and skin dryness were examined by visual inspection.

62 participants (35.5%) developed a DFU during the study. SED-time was significantly higher in people who developed DFUs (12.8±3.0 vs 9.4±3.1h/day). Logistic regression showed that among several nervous (motor amplitude, OR 0.33, 95% CI, 0.18-0.60; sensory amplitude, 0.85, 0.77-0.94) and vascular parameters (ABI, 0.23, 0.1-0.61; pedal pulses, 2.81, 0.12-0.63) and foot characteristics (deformity, 2.63, 1.30-5.32; skin dryness, 2.04, 0.95-4.37), SED-time was one of the strongest variables contributing to the development of DFUs (2.95, 1.45-6.44).

SED-time is an independent predictor of the risk of DFU in people with DPN. The monitoring of SED-time with strategies aimed at reducing it should be included in the standard care of diabetic patients.
SED-time is an independent predictor of the risk of DFU in people with DPN. The monitoring of SED-time with strategies aimed at reducing it should be included in the standard care of diabetic patients.
To investigate the relative contribution of previous gestational diabetes mellitus (GDM) and current type 2 diabetes (T2D) on the development of liver fibrosis, the strongest predictor of end-stage liver disease.

This is a population-based cross-sectional study based on data from the 2017-2018 cycle of the National Health and Nutrition Examination Survey. We included women age≥20years that had delivered at least one live birth and had available data on vibration-controlled transient elastography (VCTE). Liver steatosis and fibrosis were assessed by the median value of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively.

Among the 1699 women included in the study, 144 (10.1%, 95% CI 7.7-13.2) reported a previous diagnosis of GDM. Women with previous GDM were younger, had a higher BMI, a higher prevalence of T2D and were significantly older at the time they had the last live birth. Univariate analysis did not show a significant difference between women with and without a prior history of GDM in terms of both steatosis (44.8% vs 39.4%, p=0.464) and fibrosis (7.5% vs 7.6%, p=0.854). Multivariable logistic regression analysis showed that BMI, γ-glutamyltranspeptidase levels, T2D (OR 2.96, 95% CI 1.48-5.93, p<0.01), HBV and HCV infection were associated with higher odds of significant fibrosis, while previous GDM showed a neutral effect.

Women with previous GDM that do not develop overt T2D might not experience a poor hepatic prognosis.
Women with previous GDM that do not develop overt T2D might not experience a poor hepatic prognosis.
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