No abstract

Obstructive sleep apnea (OSA) is a recognized independent risk factor for metabolic disorders, type 2 diabetes mellites (DM2) in particular. Therefore, the study aimed to assess the influence of nocturnal oxygen saturation parameters on the onset of DM2 among OSA patients. The study consisted of 549 participants, who underwent polysomnography examination. Based on apnea hypopnea index (AHI), 465 patients were diagnosed with OSA. One hundred and seven individuals had comorbid DM2. Cox regression models were used to assess the effect of oxygen saturation parameters on the onset of DM2. Classification and regression trees (CART) analysis was used to assess the onset of the DM2 in the study group in context of oxygen saturation variables. One-way Cox regression showed higher risk of earlier DM2 for increased values of BMI, AHI, decreased basal O2 and O2 nadir value, while lowered mean O2 desaturation has not shown statistical significance. In the CART analysis, the following cut-off points 92.2%, 81.7%, 87.1% were determined for basal O2, O2 nadir and mean O2 desaturation, respectively, with the first two parameters being statistically significant. Therefore, basal O2 is independent from AHI, BMI and age is a risk factor of DM2 among OSA patients.

Background In the current era of widespread access to the internet, we can monitor public interest in a topic via information-targeted web browsing. We sought to provide direct proof of the global population’s altered use of Wikipedia medical knowledge resulting from the new COVID-19 pandemic and related global restrictions. Objective We aimed to identify temporal search trends and quantify changes in access to Wikipedia Medicine Project articles that were related to the COVID-19 pandemic. Methods We performed a retrospective analysis of medical articles across nine language versions of Wikipedia and country-specific statistics for registered COVID-19 deaths. The observed patterns were compared to a forecast model of Wikipedia use, which was trained on data from 2015 to 2019. The model comprehensively analyzed specific articles and similarities between access count data from before (ie, several years prior) and during the COVID-19 pandemic. Wikipedia articles that were linked to those directly associated with the pandemic were evaluated in terms of degrees of separation and analyzed to identify similarities in access counts. We assessed the correlation between article access counts and the number of diagnosed COVID-19 cases and deaths to identify factors that drove interest in these articles and shifts in public interest during the subsequent phases of the pandemic. Results We observed a significant (P<.001) increase in the number of entries on Wikipedia medical articles during the pandemic period. The increased interest in COVID-19–related articles temporally correlated with the number of global COVID-19 deaths and consistently correlated with the number of region-specific COVID-19 deaths. Articles with low degrees of separation were significantly similar (P<.001) in terms of access patterns that were indicative of information-seeking patterns. Conclusions The analysis of Wikipedia medical article popularity could be a viable method for epidemiologic surveillance, as it provides important information about the reasons behind public attention and factors that sustain public interest in the long term. Moreover, Wikipedia users can potentially be directed to credible and valuable information sources that are linked with the most prominent articles.

Therapy for type 1 diabetes (T1DM) focuses on maintaining optimal blood glucose levels, achieved with intensive insulin treatment, proper nutrition, and physical activity. The aim of this study was to investigate postprandial glycemic changes under low (30%) and standard (50%) carbohydrate diets in adolescents with T1DM. A single-center cross-over nutritional study was conducted, during which 26 adolescent patients provided 220 continuous glucose-monitored (CGM) meals data from the two consecutive 3-day nutritional plans. Overall, the 50% carbohydrate diet was associated with higher postprandial glucose variability in the small meals (afternoon snacks, second breakfast) and greater postprandial peaks for other meals (breakfast, dinner, supper). Nevertheless, after the adjustment of a patient’s individual clinical variables (age, Tanner classification, glucose disposal rate), we observed that mean postprandial glucose was higher for afternoon snacks and lower for suppers in the 30% carbohydrate diet. Although a 30% carbohydrate diet seems to offer better postprandial glycemia, it requires additional attention from the physician and patient when it comes to modifying daily carbohydrate intake. Increased fat/protein content and size of the main meal lead to a prolonged postprandial glycemic response, which may affect the insulin treatment and result in suboptimal glycemic control.