Dexamethasone can reduce mortality in hospitalised COVID-19 patients needing oxygen and ventilation by 18% and 36%, respectively. Here, we estimate the potential number of lives saved and life years gained if this treatment were to be rolled out in the UK and globally, as well as the cost-effectiveness of implementing this intervention. Assuming SARS-CoV-2 exposure levels of 5% to 15%, we estimate that, for the UK, approximately 12,000 (4,250 - 27,000) lives could be saved between July and December 2020. Assuming that dexamethasone has a similar effect size in settings where access to oxygen therapies is limited, this would translate into approximately 650,000 (240,000 - 1,400,000) lives saved globally over the same time period. If dexamethasone acts differently in these settings, the impact could be less than half of this value. To estimate the full potential of dexamethasone in the global fight against COVID-19, it is essential to perform clinical research in settings with limited access to oxygen and/or ventilators, for example in low- and middle-income countries.

BACKGROUND: Diabetic neuropathy is one of the most complicated complications of diabetes patients with Type 2 diabetes. AIM: The purpose of this study was to determine the diagnosis of diabetic neuropathy based on Clinical Neurological Examination (CNE) and the factors that influence the occurrence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care (PHC) in Medan City. METHODS: The research design was descriptive-analytic with the cross-sectional approach. The study population was all Type 2 DM patients who came to Amplas PHC with a total sample of 53 people using the consecutive sampling. The research data source is primary data, namely the assessment of diabetic neuropathy using the Clinical Neurological Examination (CNE) criteria. Data were processed using SPSS and analysis using the chi-square test. RESULTS: The results showed the majority of Type 2 DM patients had mild neuropathy as many as 24 people (45.3%). The Chi-square test results showed there was a relationship between age and duration of diabetes with the incidence of diabetic neuropathy in Type 2 DM patients at Amplas Primary Health Care. CONCLUSION: Education and early detection with proper management can prevent more severe complications so that the quality of life of patients can be maintained better.

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Background: Macrovascular complications occur very frequently in patients with type 2 diabetes mellitus (T2DM) with a high mortality rate, due to the development of cardiovascular disease (CVD), such as stroke, atherosclerosis acceleration, and atrial fibrillation. T2DM is a significant risk factor for CVD and has become the leading cause of death. The purpose of this study was to detect the early risk of macrovascular complications by using the ankle brachial index (ABI) as a marker. Methods: This study was an analytic study with a cross-sectional approach. The study population was patients with T2DM from several primary health care centers in Medan. In total, 89 subjects who met the inclusion and exclusion criteria were recruited with consecutive sampling. ABI was determined as the ratio of systolic blood pressure in the brachial artery to the posterior tibial artery after the subjects had been relaxed and felt comfortable in a supine position. Examination of vitamin D and lipid profile was derived from examination of venous blood.  Data were processed using SPSS and analyzed with one-way ANOVA. Results: The study found that there was a relationship between LDL-C, triglyceride, and vitamin D (25OH-D) based on the ABI (p > 0.05). Conclusions: ABI can be used for an early detection of macrovascular complications. Apart from being easy to perform, ABI was non-invasive. Some other risk factors that can also be used to assess complications and have relationships with ABI were LDL-C, triglyceride, and vitamin D (25OH-D). Complications in T2DM patients can be prevented with reasonable blood sugar control and lifestyle changes. Education and motivation need to be given to patients so that they become more independent in controlling their disease and improving their quality of life.

A Correction to this paper has been published: https://doi.org/10.1038/s41467-021-22038-x.