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Jang SA, Min Kim K, Jin Kang H, Heo SJ, Sik Kim C, Won Park S. Higher mortality and longer length of stay in hospitalized patients with newly diagnosed diabetes. Diabetes Res Clin Pract 2024; 210:111601. [PMID: 38432469 DOI: 10.1016/j.diabres.2024.111601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
AIMS We investigated the association between diabetes status at admission and in-hospital outcomes in all hospitalized patients, regardless of the reason for admission. METHODS All individuals aged 20 years or older who were admitted to Yongin Severance Hospital between March 2020 and February 2022 were included in study. Subjects were categorized into three groups: non-DM, known DM, and newly diagnosed DM, based on medical history, anti-diabetic medications use, and laboratory test. Hospitalization-related outcomes, including in-hospital mortality and length of hospital stay, were compared between groups. RESULTS 33,166 participants were enrolled. At hospitalization, 6,572 (19.8 %) subjects were classified as known DM, and another 2,634 (7.9 %) subjects were classified as newly diagnosed DM. In-hospital mortality was highest in newly diagnosed DM (HR 1.89, 95% CI 1.58-2.26, p < 0.001) followed by known DM (HR 1.41, 95% CI 1.18-1.69, p < 0.001) compared to non-DM. Length of hospital stay was significantly longer in newly diagnosed DM (median [IQR] 9.0 [5.0-18.0],days) than known DM (median [IQR] 5.0 [3.0-10.0],days)(p < 0.001) and non-DM (median [IQR] 4.0 [2.0-7.0],days). After adjusting for multiple covariates, newly diagnosed diabetes was independently associated with increased in-hospital mortality (p < 0.001). CONCLUSIONS Diabetes status at admission was closely linked to hospitalization-related outcomes. Notably, individuals with newly diagnosed diabetes demonstrated a higher risk of in-hospital mortality and a prolonged length of hospital stay.
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Affiliation(s)
- Seol A Jang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Kyoung Min Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Hye Jin Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Seok-Jae Heo
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Sik Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Seok Won Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
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Velázquez-Jurado H, Flores-Torres A, Pérez-Peralta L, Salinas-Rivera E, Valle-Nava MD, Arcila-Martinez D, Hernández-Jiménez S. Cognitive behavioral treatment to improve psychological adjustment in people recently diagnosed with type 2 diabetes: Psychological treatment in type 2 diabetes. Health Psychol Behav Med 2023; 11:2179058. [PMID: 36846199 PMCID: PMC9946322 DOI: 10.1080/21642850.2023.2179058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic disease that affects a person's general well-being. Current evidence sets an association between psychological well-being and controlled metabolic parameters. People newly diagnosed with T2DM show higher prevalence of depression and anxiety symptoms. Cognitive behavioral therapy (CBT) has effectively improved psychological adjustment, but most studies do not specifically address recently diagnosed people nor usually include long-term follow-up measures. Objective We sought to assess changes in psychological variables in people with newly diagnosed diabetes who received a cognitive-behavioral intervention, within a comprehensive care program. Method 1208 adults with T2DM (≤5 years) who attended a national health institute in Mexico received a cognitive-behavioral intervention aimed at improving quality of life and reducing emotional distress that often interferes with diabetes control, as well as evaluating cognitive and emotional resources and social support. Measures of quality of life, diabetes-related distress, anxiety and depression questionnaires were compared at pre-test, post-test and follow up using Friedman's ANOVAs. Multiple logistic regression models evaluated glycosylated hemoglobin (HbA1c) and triglycerides control at post-test and follow up. Results Questionnaire measures and metabolic variables significantly decreased symptomatology at post-test and these changes maintained at follow-up. Significant associations were found between quality-of-life scores and HbA1c and triglycerides levels in post-test and follow-up. Diabetes-related distress scores increased the odds of having adequate HbA1c control at post-test. Conclusion This study contributes to the evidence on the importance of considering psychological factors as part of comprehensive diabetes care to improve quality of life and emotional burden and facilitate the achievement of metabolic goals.
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Affiliation(s)
- Héctor Velázquez-Jurado
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico, Héctor Velázquez-Jurado Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico; National Autonomous University of Mexico, Mexico City, Mexico; Av. Vasco de Quiroga #15, Col. Belisario Dominguez, Sección XVI, Alc. Tlalpan, C.P. 14080, Ciudad de Mexico
| | - Athena Flores-Torres
- Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Liliana Pérez-Peralta
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Edgar Salinas-Rivera
- Department of Educational Psychology, National Pedagogic University (UPN), Mexico City, Mexico
| | - Marianne Daniela Valle-Nava
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico,Postgraduate Studies Division, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Denise Arcila-Martinez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Sergio Hernández-Jiménez
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - for the CAIPaDi Study Group
- Centre for the Comprehensive Care of the Patient with Diabetes, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
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Haldar S, Roy S, Sen S, Dasgupta A, Ghosh S. Association of the Val66Met polymorphism of the BDNF gene and the deletional mutation of CYP2D6 gene with the prevalence and severity of depressive disorder in an Eastern Indian population. Indian J Psychiatry 2022; 64:269-276. [PMID: 35859549 PMCID: PMC9290417 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_541_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/06/2022] [Accepted: 03/01/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The Val66Met single nucleotide polymorphism (SNP) of the brain-derived growth factor (BDNF) and deletional mutation of the cytochrome P4502D6 (CYP2D6) have been reported to be linked to the etiology and severity of depressive disorders (DD) in a variable manner among different ethnicities and populations. AIMS The present study was aimed to find the relationship of mutational variations of these two neurotrophins with the severity of DD and their serum cortisol levels as a marker of the stress factor. METHODS In 104 drug-naïve newly diagnosed cases of DD and 106 control subjects, the severity of depression was assessed using the HAM-D score. Val66Met SNP of the BDNF was analyzed in them using restriction digestion of its polymerase chain reaction (PCR) product. CYP2D6 deletional variants were detected by the absence of their PCR products. Serum cortisol levels were measured by the enzyme-linked immunosorbent assay (ELISA) technique. RESULTS The Chi-square test (Χ2 = 1.42, P = 0.49) did not show any higher prevalence of Val66Met SNP of the BDNF gene in the case group. A correlation coefficient (R) of -0.14 for HAM-D score with a P value of 0.29 signified no direct link of the severity of DD with this SNP. However, a Χ2 of 12.68 with P < 0.001 indicated a significantly higher prevalence of the CYP2D6 deletional mutants in DD cases, whereas an R-value of 0.39 for HAM-D score with P < 0.001 suggested a significantly higher severity of DD having with them. Serum cortisol level showed a significant positive correlation with the deletional variants of CYP2D6 (R = 0.198, P = 0.04) and the HAM-D score (R = 0.22, P = 0.025). CONCLUSION We conclude that CYP2D6 deletion significantly contributes to the severity and stress factor in the DD patients in our study population. Early identification of these mutations may provide important molecular and cellular predisposition for the disease and may lay the ground for possible more effective measures of intervention.
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Affiliation(s)
- Somnath Haldar
- Department of Biochemistry, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Suparna Roy
- Department of Biochemistry, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Santanu Sen
- Department of Biochemistry, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Anindya Dasgupta
- Department of Biochemistry, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Srijit Ghosh
- Department of Psychiatry, Calcutta National Medical College, Kolkata, West Bengal, India
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Attenuated brain derived neurotrophic factor and depression in type 2 diabetes mellitus patients: A case-control study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Chen MH, Lin YS, Tsai SJ. Associations between brain-derived neurotrophic factor val66met polymorphism, melancholic feature, and treatment refractoriness in patients with treatment-resistant depression. TAIWANESE JOURNAL OF PSYCHIATRY 2022. [DOI: 10.4103/tpsy.tpsy_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cahill S, Chandola T, Hager R. Genetic Variants Associated With Resilience in Human and Animal Studies. Front Psychiatry 2022; 13:840120. [PMID: 35669264 PMCID: PMC9163442 DOI: 10.3389/fpsyt.2022.840120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
Resilience is broadly defined as the ability to maintain or regain functioning in the face of adversity and is influenced by both environmental and genetic factors. The identification of specific genetic factors and their biological pathways underpinning resilient functioning can help in the identification of common key factors, but heterogeneities in the operationalisation of resilience have hampered advances. We conducted a systematic review of genetic variants associated with resilience to enable the identification of general resilience mechanisms. We adopted broad inclusion criteria for the definition of resilience to capture both human and animal model studies, which use a wide range of resilience definitions and measure very different outcomes. Analyzing 158 studies, we found 71 candidate genes associated with resilience. OPRM1 (Opioid receptor mu 1), NPY (neuropeptide Y), CACNA1C (calcium voltage-gated channel subunit alpha1 C), DCC (deleted in colorectal carcinoma), and FKBP5 (FKBP prolyl isomerase 5) had both animal and human variants associated with resilience, supporting the idea of shared biological pathways. Further, for OPRM1, OXTR (oxytocin receptor), CRHR1 (corticotropin-releasing hormone receptor 1), COMT (catechol-O-methyltransferase), BDNF (brain-derived neurotrophic factor), APOE (apolipoprotein E), and SLC6A4 (solute carrier family 6 member 4), the same allele was associated with resilience across divergent resilience definitions, which suggests these genes may therefore provide a starting point for further research examining commonality in resilience pathways.
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Affiliation(s)
- Stephanie Cahill
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom.,Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom
| | - Tarani Chandola
- Faculty of Humanities, Cathie Marsh Institute for Social Research, The University of Manchester, Manchester, United Kingdom.,Methods Hub, Department of Sociology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Reinmar Hager
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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