BACKGROUND: Diabetes is problematic in all populations but is a challenge for Black Americans.

OBJECTIVE: This study explored demographic factors associated with the diagnosis of diabetes and peripheral artery disease (PAD), precursors to lower limb amputation.

METHODS: The All of Us Research Workbench database was used. Persons ≥18 years, with a diagnosis of diabetes, PAD or both during observation years 2018-2021 were included. Bivariate analyses examined associations between patient race/ethnicity, age, gender, and patient diagnoses. P-values < 0.05 were statistically significant. Statistical analysis was completed using R (R Core Team, 2023).

RESULTS: 40,465 participants met inclusion criteria: diabetes only (N=33,847), PAD only (N=4,249) or both (N=2,369). Race/ethnicity included 26% Black, 44% White, 22% Hispanic, and 8% other races. The majority were female (55%); age group 46-65 (51%). Significant associations were found between cohort, gender, race/ethnicity, and age. A higher proportion of persons assigned to diabetes only were female, Hispanic, and between the ages of 46-65 (p-values<0.05); PAD only were male, White, and age 66+ (p-values<0.05); diabetes and PAD were male, Black, and age 66+ (p-values<0.05). Compared to White persons, Black persons were 1.98 times more likely to have diabetes and 1.14 times more likely to be diagnosed with diabetes and PAD, with a higher proportion in the age group 46-65.

CONCLUSIONS: Gender, race/ethnicity, and age are significant factors in the diagnosis of diabetes and PAD. Black persons are more likely to be diagnosed with both conditions, are at risk of lower-limb amputation, and should receive care commensurate with that risk.

Background: The COVID-19 pandemic and associated restrictions resulted in higher incidence of Type 2 diabetes (DM2) and prediabetes in children and teenagers, which creates risk for chronic disease. From March 2020 until August 2021, most US schools were virtual, and organized activities including sports were cancelled, which affected children’s lives and health statuses.

Objective: We investigated the risk for diabetes in children and teenagers, evaluating contributions of race, gender, age, BMI, socioeconomic status, and COVID infection.

Methods: Using the database of a large integrated health plan, the incidence of new onset diabetes and prediabetes in subjects aged 0-19 was determined during study years 2020 to 2023. Chi Square analyses of the risk of DM2 and prediabetes due to race, gender, age, socioeconomic status, BMI, and COVID infection were performed. Unique contributions of these variables in multivariate analyses are planned.

Results: DM2 subjects were more likely to be adolescent (81 vs. 33%), Black (54 vs. 37%), publicly insured (50 vs. 39%), and obese (86 vs. 19%) compared to nondiabetics. Prediabetics were also more likely to be adolescent (64 vs. 33%), Black (60 vs. 37%), obese (79 vs. 19%), and socioeconomically disadvantaged (43 vs. 35%). Prediabetics were significantly more likely than nondiabetics to have had a COVID infection (26 vs. 20%).

Conclusions: Adolescent, Black, obese, and disadvantaged youths may have been more vulnerable to the pandemic circumstances, which included cancellation of school and activities. Given the disproportionate health impact with chronic disease consequences, health surveillance and preventive programs should target these groups.

Background: Visual impairment is significant concern in 74.5% diabetic individuals developing a serious condition like Diabetic Retinopathy causing severe loss of vision and in 10% cases leading to blindness. This study explores the predictors of Visual impairments (VI) in peoples living with Type 2 Diabetes Mellitus in Pakistan. Method: Overall,4674 patients reported Mehboob Charity Vision Eye and General Hospital, Pakistan across May 2023 to March 2024, the study included 505 eligible patients. Data on socio-demographic, behavioral, and clinical-related variables were collected through structured interviews and clinical examinations. Considering P-value<0.50, Multivariable binary logistic regression analysis was performed to identify VI predictors. Results: The study found that Visual impairment was prevalent in 74.5% (n=376) of respondents, with mild and moderate VI being the most common. Older age was a significant predictor, with the odds of having mild and moderate VI increasing with age. A higher number of respondents were in the age bracket of 51-70 years old (n=307, 60%) and only 4 (0.8%) respondent were under 30 years of age. 286(56.6%) patients had poor glycemic. Hypertension was reported in 370(73.3%) participants.377 (74.7%) of the participants were uneducated. other factors such as diabetes duration, were also identified as predictors. Female were found at more risk than male. Conclusion: The study emphasizes the importance of early detection and management of visual impairment in T2DM patients and recommends further research with larger sample sizes and longitudinal designs. The underrepresentation of younger people highlights the need for focused initiatives to reduce health inequities associated with diabetes.

Over a million US adults are diagnosed with type 2 diabetes (T2D) annually. Initial disease management decreases individuals’ future complication risk. Predicting individuals at the highest risk of not achieving treatment goals can enable the targeting of intensive initial care. We used EHR data to stratify newly diagnosed individuals by their risk for suboptimal glycemic control and compared individuals’ characteristics by predicted risk level.

We identified adults (21-74 years) diagnosed with T2D between 2010-2016 and split them into training (80%) and validation (20%) sets. We developed a LASSO predictive model of suboptimal early glycemic control (average HbA1c≥8% during first 5 years). The model had good discrimination (c-statistic: 0.85) and calibration. We stratified individuals by predicted risk (low [LR]<10%, moderate [MR] 10-25%, and high [HR]>25%) and used chi-square tests and ANOVA to compare groups.

Among 49,213 individuals, 15% were HR, 20% MR, and 65% LR. HR individuals were more likely to <45 years old (45% HR vs. 35% MR vs 6% LR, p<0.01), Latinx (45% HR vs 30% MR vs 27% LR, p<0.01), have an HbA1c ≥ 10% ( 80% HR vs. 18% MR vs. 1% LR, p<0.01) but less likely to have received a flu shot ( 33% HR vs 42% MR vs 66% LR, p<0.01) or used the online patient portal (48% HR vs 56% MR vs 70% LR, p<0.01).

These between risk-group differences suggest that initial care for HR individuals should consider the needs of younger individuals who present with marked hyperglycemia and have less prior healthcare engagement.