Diabetes Physical Examination

Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data

This study aimed to examine comorbidity associations across age groups of inpatients with endocrine diseases as the primary diagnosis throughout the life cycle to develop an effective management strategy. Data were obtained from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS) from 2006 to 2021, involving 68,515 discharged patients aged ≥ 19 years with a principal diagnosis of endocrine disease. A database was constructed for analysis, extracting general characteristics and comorbidities. Employing R version 4.2.3, the Chi-squared test and the Apriori algorithm of ARM (association rule mining) were used for analyzing general characteristics and comorbidity associations. There were more women (53.1%) than men (46.9%) (p < 0.001, with women (61.2 ± 17.2) having a higher average age than men (58.6 ± 58.6) (p < 0.001). Common comorbidities include unspecified diabetes mellitus; essential (primary) hypertension; unspecified diabetes mellitus; and other disorders of fluid, electrolyte, and acid-base balance. Notably, type 2 diabetes mellitus, disorders of lipoprotein metabolism and other lipidemia, polyneuropathy in diseases classified elsewhere, retinal disorders in diseases classified elsewhere, and essential (primary) hypertension prevail across all age groups. Association rules further highlight specific comorbidities appearing selectively in certain age groups. In conclusion, establishing a management strategy for comorbidities in patients with a primary diagnosis of an endocrine disorder is necessary.

Comparison of Endocrinologists' Physical Examination Documentation for In-person vs Video Telehealth Diabetes Visits

Objective

Outpatient diabetes mellitus (DM) care over video telehealth (TH) requires modifications to how endocrinologists complete physical examinations (PEs). But there is little guidance on what PE components to include, which may incur wide variation in practice. We compared endocrinologists' documentation of DM PE components for in-person (IP) vs TH visits.

Methods

Retrospective chart review of 200 notes for new patients with DM from 10 endocrinologists (10 IP and 10 TH visits each) in the Veterans Health Administration between April 1, 2020, and April 1, 2022. Notes were scored from 0 to 10 based on documentation of 10 standard PE components. We compared mean PE scores for IP vs TH across all clinicians using mixed effects models. Independent samples t-tests were used to compare both mean PE scores within clinician and mean scores for each PE component across clinicians for IP vs TH. We described virtual care-specific and foot assessment techniques.

Results

The overall mean (SE) PE score was higher for IP vs TH (8.3 [0.5] vs 2.2 [0.5]; P < .001). Every endocrinologist had higher PE scores for IP vs TH. Every PE component was more commonly documented for IP vs TH. Virtual care-specific techniques and foot assessment were rare.

Conclusions

Our study quantifies the degree to which Pes for TH were attenuated among a sample of endocrinologists, raising a flag that process improvements and research are needed for virtual Pes. Organizational support and training could help increase PE completion via TH. Research should examine reliability and accuracy of virtual PE, its value to clinical decision-making, and its impact on clinical outcomes.

Diabetes mellitus research in Saudi Arabia: A bibliometric study (2010-2021)

Diabetes Mellitus (DM) causes global exhaustion, consumes economic resources, and has several risk factors. The bibliometric studies re-evaluate the research efforts on this illness using mathematical and statistical tools to indicate current research and future trends. This study examines KSA's DM research during 2010-2021. Data were acquired from Scopus and analyzed using VOSviewer and MS Excel. Several characteristics were examined to measure the quantity and quality of KSA-related DM articles. In total, 1,919 journal and conference papers were published. DM research included researchers from multidisciplinary sectors. Thirty-seven percent of them have ten or more scientific publications. Al-Daghri, N.M. (King Saud University) leads the pack. In total, 757 (39.44%) research projects got funding from 159 sources within and outside KSA. Memish, Z.A. is the most cited author. The Saudi Medical Journal has the most citations (1214). Al-Daghri, N.M. (KSU) collaborates the most. One hundred forty-one nations aided KSA's diabetes research. Egypt's High Institute of Public Health has the most scientific collaboration with KSA. Authors' and all Keywords analyses indicated a rich knowledge structure. Diabetes Care Journal has the most cocitations with 2,220 and a total link strength of 19,283, followed by The New England Journal of Medicine. The study results will be helpful to stakeholders to understand better the trends and performance of diabetes-related regional research, which will be beneficial.

Identification of a novel mutation in ALMS1 in a Chinese patient with monogenic diabetic syndrome by whole-exome sequencing

Alstrom syndrome (AS) is one type of monogenic diabetic syndromes caused by mutation in the ALMS1. Due to rare prevalence and overlaps of clinical symptoms, monogenic diabetes is often misdiagnosed. Here, we report a Chinese diabetes patient with poor blood glucose control and insulin resistance. With whole-exome sequencing (WES), this patient was classified into monogenic diabetes and diagnosed as AS with one novel gene mutation identified. This study highlights the clinical application of WES in the diagnosis of monogenic diabetes.