Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,im...Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.展开更多
Introduction Human papillomavirus(HPV)vaccination is a cornerstone of cervical cancer prevention,particularly in low-and middle-income countries(LMICs),where the burden of disease remains high~1.The World Health Organ...Introduction Human papillomavirus(HPV)vaccination is a cornerstone of cervical cancer prevention,particularly in low-and middle-income countries(LMICs),where the burden of disease remains high~1.The World Health Organization(WHO)HPV Vaccine Introduction Clearing House reported that 147 countries(of 194 reporting)had fully introduced the HPV vaccine into their national schedules as of 20242.After COVID-19 pandemic disruptions,global coverage is again increasing.展开更多
The field of biometric identification has seen significant advancements over the years,with research focusing on enhancing the accuracy and security of these systems.One of the key developments is the integration of d...The field of biometric identification has seen significant advancements over the years,with research focusing on enhancing the accuracy and security of these systems.One of the key developments is the integration of deep learning techniques in biometric systems.However,despite these advancements,certain challenges persist.One of the most significant challenges is scalability over growing complexity.Traditional methods either require maintaining and securing a growing database,introducing serious security challenges,or relying on retraining the entiremodelwhen new data is introduced-a process that can be computationally expensive and complex.This challenge underscores the need for more efficient methods to scale securely.To this end,we introduce a novel approach that addresses these challenges by integrating multimodal biometrics,cancelable biometrics,and incremental learning techniques.This work is among the first attempts to seamlessly incorporate deep cancelable biometrics with dynamic architectural updates,applied incrementally to the deep learning model as new users are enrolled,achieving high performance with minimal catastrophic forgetting.By leveraging a One-Dimensional Convolutional Neural Network(1D-CNN)architecture combined with a hybrid incremental learning approach,our system achieves high recognition accuracy,averaging 98.98% over incrementing datasets,while ensuring user privacy through cancelable templates generated via a pre-trained CNN model and random projection.The approach demonstrates remarkable adaptability,utilizing the least intrusive biometric traits like facial features and fingerprints,ensuring not only robust performance but also long-term serviceability.展开更多
BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is exp...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is expected when both diseases co-exist.Therefore,thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.AIM To identify the CVD and cardiovascular event(CVE)risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.METHODS A systematic review was performed by compiling data by searching PubMed,EMBASE and Cochrane Library databases.Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute(JBI)tool and RevMan 5.4 software respectively.The effect indicators for CVE and CVD risk were expressed as odds ratios(OR)and 95%CI with P-values<0.05 as significant.RESULTS Fourteen(5 cohort and 9 cross-sectional)studies with 370013 participants were included in this review.The metaanalysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group[OR 1.28(95%CI,1.04-1.56)P=0.02]with follow up duration ranging between 5-6 years.The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher[OR 1.47(95%CI,1.21-1.78)P=0.0001]in T2DM with MAFLD when compared to T2DM without MAFLD.Significant heterogeneity exists due to variations in study design,methodologies,and MAFLD diagnostic criteria,which may have influenced the study's findings.CONCLUSION The presence of MAFLD in T2DM increased the risk of CVE.The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD.Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.展开更多
Pancreatic neuroendocrine tumors(pNETs)are rare,presenting significant challenges in timely diagnosis and subsequent treatment.The clinical and pathobiological behavior of these tumors varies significantly,making foll...Pancreatic neuroendocrine tumors(pNETs)are rare,presenting significant challenges in timely diagnosis and subsequent treatment.The clinical and pathobiological behavior of these tumors varies significantly,making follow-up and therapeutic approaches challenging for clinicians.Although the majority of these neoplasms are hormonally inactive,some can be associated with endocrine dysfunction.Very rarely,a nonfunctional tumor can later become hormonally active,further complicating prognostication and management.Depending on the character of the disease,clinical picture and prognosis,different treatment modalities are instituted with varying effectivities.We recently came across a unique case of nonfunctioning malignant pNET at an advanced stage,metastatic disease upon diagnosis,managed medically with somatostatin analog therapy(Octreotide)and targeted therapy(Everolimus)with stable disease for 40 months that subsequently turned out to become functional(insulinoma).With the aid of this unique case,we update the current clinical,diagnostic and therapeutic approach to pNETs in this evidence-based review.展开更多
BACKGROUND Type 2 diabetes(T2D),as well as obesity,are risk factors for chronic kidney disease(CKD)and end-stage renal disease.The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefi...BACKGROUND Type 2 diabetes(T2D),as well as obesity,are risk factors for chronic kidney disease(CKD)and end-stage renal disease.The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefits in preventing CKD often guide clinicians in choosing them appropriately.Only limited data based on randomized controlled trials(RCTs)is currently available on the renal effects and safety profile of tirzepatide.AIM To explore the renal benefits and safety of tirzepatide vs controls.METHODS RCTs involving patients receiving tirzepatide for any indication in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases.The co-primary outcomes were percent change from baseline(CFB)in urine albumin-to-creatinine ratio(UACR)and absolute CFB in estimated glomerular filtration rate(eGFR;in mL/min/1.73 m^(2));the secondary outcome was tirzepatide’s renal safety profile.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MD)or risk ratios with 95%confidence intervals.RESULTS Fifteen RCTs(n=14471)with mostly low risk of bias(RoB)were included.Over 26-72 weeks,tirzepatide 10 mg[MD-26.95%(-40.13,-13.76),P<0.0001]and 15 mg[MD-18.03%(-28.58,-7.47),P=0.0008]were superior to placebo in percent reductions of UACR.Tirzepatide,at all doses,outperformed insulin in percent reductions of UACR.Compared to the placebo,the percent UACR reduction was greater in subjects with T2D than those with obesity but without T2D(MD-33.25%vs-7.93%;P=0.001).The CFB in eGFR with all doses of tirzepatide was comparable[5 mg:MD 0.36(-1.41,2.14);10 mg:MD 1.17(-0.22,2.56);15 mg:MD 1.42(-0.04,2.88)];P>0.05 for all vs insulin.Tirzepatide(pooled and separate doses)did not increase the risks of adverse renal events,urinary tract infection,nephrolithiasis,acute kidney injury,and renal cancer compared to the placebo,insulin,and glucagon-like peptide-1 receptor agonists.CONCLUSION Short-term data from RCTs with low RoB suggests that tirzepatide positively impacts UACR without detrimental effects on eGFR in subjects with T2D and obesity without T2D,with a reassuring renal safety profile.Larger RCTs are warranted to prove the longer-term renal benefits of tirzepatide,which might also prevent eGFR decline and worsening of CKD.展开更多
Buddhism and local cultural traditions have long protected wildlife species and their habitats in Tibetan-dominated areas of western Sichuan. In Daocheng County, the White Eared-pheasant (Crossoptilon crossoptilon) ha...Buddhism and local cultural traditions have long protected wildlife species and their habitats in Tibetan-dominated areas of western Sichuan. In Daocheng County, the White Eared-pheasant (Crossoptilon crossoptilon) has been afforded special protection by local people because it is conspicuous and white, a color with special symbolism for Buddhists. This and other cultural reasons have led to pheasants and forests benefiting in some areas. Pheasants were found during surveys between January 2003 and June 2004 in forests with varying degrees of local (non-formal) protection. However, there were significant signs that these traditional attitudes were changing in the face of three particular pressures brought to bear by better roads, improving access to and from the rest of China. The first was the development of a significant local demand for the Chinese caterpillar fungus (Cordyceps sinesis), which is much sought after throughout East Asia and mushrooms. Second, and more recent, is a dramatic increase in tourism from major Chinese cities, bringing non-Tibetan values into Daocheng County and changing the local attitudes to all animals. And then, there is a rise in income of the local population, resulting in a higher timber demand for building big houses, which impact all wildlife in the forest, but local attitudes to sacred forests have been retained so far in spite of this increased timber demand. Lessons should be learnt from the impact that unregulated tourism at Chonggu monastery, the most visited area in the county, has on the surrounding forests so that other sacred and non-sacred forests can best be protected for the long term. The alternative is that several Tibetan Plateau Galliformes, currently considered non-threatened because of their extensive distribution in a remote area, cannot be guaranteed such a healthy future.展开更多
A fuzzy model was presented to predict the weldment shape profile of submerged arc welds （SAW） including the shape of heat affected zone （HAZ）. The SAW bead-on-plates were welded by following a full factorial desi...A fuzzy model was presented to predict the weldment shape profile of submerged arc welds （SAW） including the shape of heat affected zone （HAZ）. The SAW bead-on-plates were welded by following a full factorial design matrix. The design matrix consisted of three levels of input welding process parameters. The welds were cross-sectioned and etched, and the zones were measured. A mapping technique was used to measure the various segments of the weld zones. These mapped zones were used to build a fuzzy logic model. The membership functions of the fuzzy model were chosen for the accurate prediction of the weld zone. The fuzzy model was further tested for a set of test case data. The weld zone predicted by the fuzzy logic model was compared with the experimentally obtained shape profiles and close agreement between the two was noted. The mapping technique developed for the weld zones and the fuzzy logiemodel earl be used for on-line control of the SAW process. From the SAW fuzzy logic model an estimation of the fusion and HAZ can also be developed.展开更多
BACKGROUND Diabesity(diabetes as a consequence of obesity)has emerged as a huge healthcare challenge across the globe due to the obesity pandemic.Judicious use of antidiabetic medications including semaglutide is impo...BACKGROUND Diabesity(diabetes as a consequence of obesity)has emerged as a huge healthcare challenge across the globe due to the obesity pandemic.Judicious use of antidiabetic medications including semaglutide is important for optimal management of diabesity as proven by multiple randomized controlled trials.However,more real-world data is needed to further improve the clinical practice.AIM To study the real-world benefits and side effects of using semaglutide to manage patients with diabesity.METHODS We evaluated the efficacy and safety of semaglutide use in managing patients with diabesity in a large academic hospital in the United States.Several parameters were analyzed including demographic information,the data on improvement of glycated hemoglobin(HbA1c),body weight reduction and insulin dose adjustments at 6 and 12 months,as well as at the latest follow up period.The data was obtained from the electronic patient records between January 2019 to May 2023.RESULTS 106 patients(56 males)with type 2 diabetes mellitus(T2DM),mean age 60.8±11.2 years,mean durations of T2DM 12.4±7.2 years and mean semaglutide treatment for 2.6±1.1 years were included.Semaglutide treatment was associated with significant improvement in diabesity outcomes such as mean weight reductions from baseline 110.4±24.6 kg to 99.9±24.9 kg at 12 months and 96.8±22.9 kg at latest follow up and HbA1c improvement from baseline of 82±21 mmol/mol to 67±20 at 12 months and 71±23 mmol/mol at the latest follow up.An insulin dose reduction from mean baseline of 95±74 units to 76.5±56.2 units was also observed at the latest follow up.Side effects were mild and mainly gastrointestinal like bloating and nausea improving with prolonged use of semaglutide.CONCLUSION Semaglutide treatment is associated with significant improvement in diabesity outcomes such as reduction in body weight,HbA1c and insulin doses without major adverse effects.Reviews of largescale real-world data are expected to inform better clinical practice decision making to improve the care of patients with diabesity.展开更多
文摘Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1DM)is an interesting area for research.These include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or cytokines.Teplizumab is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target antigen.Preclinical and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of T1DM.The benefits have been apparent as early as six months to as long as seven years after therapy.It has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of age.In their recent metaanalysis published in the World Journal of Diabetes,Ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety profile.However,all the included randomized control trials have been conducted in high-income countries.High cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.
文摘Introduction Human papillomavirus(HPV)vaccination is a cornerstone of cervical cancer prevention,particularly in low-and middle-income countries(LMICs),where the burden of disease remains high~1.The World Health Organization(WHO)HPV Vaccine Introduction Clearing House reported that 147 countries(of 194 reporting)had fully introduced the HPV vaccine into their national schedules as of 20242.After COVID-19 pandemic disruptions,global coverage is again increasing.
基金the Deputyship for Research&Innovation,Ministry of Education in Saudi Arabia for funding this research work through project number RI-44-0833.
文摘The field of biometric identification has seen significant advancements over the years,with research focusing on enhancing the accuracy and security of these systems.One of the key developments is the integration of deep learning techniques in biometric systems.However,despite these advancements,certain challenges persist.One of the most significant challenges is scalability over growing complexity.Traditional methods either require maintaining and securing a growing database,introducing serious security challenges,or relying on retraining the entiremodelwhen new data is introduced-a process that can be computationally expensive and complex.This challenge underscores the need for more efficient methods to scale securely.To this end,we introduce a novel approach that addresses these challenges by integrating multimodal biometrics,cancelable biometrics,and incremental learning techniques.This work is among the first attempts to seamlessly incorporate deep cancelable biometrics with dynamic architectural updates,applied incrementally to the deep learning model as new users are enrolled,achieving high performance with minimal catastrophic forgetting.By leveraging a One-Dimensional Convolutional Neural Network(1D-CNN)architecture combined with a hybrid incremental learning approach,our system achieves high recognition accuracy,averaging 98.98% over incrementing datasets,while ensuring user privacy through cancelable templates generated via a pre-trained CNN model and random projection.The approach demonstrates remarkable adaptability,utilizing the least intrusive biometric traits like facial features and fingerprints,ensuring not only robust performance but also long-term serviceability.
文摘BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)and type 2 diabetes mellitus(T2DM)are independent risk factors for the development of cardiovascular disease(CVD)and an exaggerated CVD risk is expected when both diseases co-exist.Therefore,thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.AIM To identify the CVD and cardiovascular event(CVE)risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.METHODS A systematic review was performed by compiling data by searching PubMed,EMBASE and Cochrane Library databases.Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute(JBI)tool and RevMan 5.4 software respectively.The effect indicators for CVE and CVD risk were expressed as odds ratios(OR)and 95%CI with P-values<0.05 as significant.RESULTS Fourteen(5 cohort and 9 cross-sectional)studies with 370013 participants were included in this review.The metaanalysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group[OR 1.28(95%CI,1.04-1.56)P=0.02]with follow up duration ranging between 5-6 years.The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher[OR 1.47(95%CI,1.21-1.78)P=0.0001]in T2DM with MAFLD when compared to T2DM without MAFLD.Significant heterogeneity exists due to variations in study design,methodologies,and MAFLD diagnostic criteria,which may have influenced the study's findings.CONCLUSION The presence of MAFLD in T2DM increased the risk of CVE.The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD.Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.
文摘Pancreatic neuroendocrine tumors(pNETs)are rare,presenting significant challenges in timely diagnosis and subsequent treatment.The clinical and pathobiological behavior of these tumors varies significantly,making follow-up and therapeutic approaches challenging for clinicians.Although the majority of these neoplasms are hormonally inactive,some can be associated with endocrine dysfunction.Very rarely,a nonfunctional tumor can later become hormonally active,further complicating prognostication and management.Depending on the character of the disease,clinical picture and prognosis,different treatment modalities are instituted with varying effectivities.We recently came across a unique case of nonfunctioning malignant pNET at an advanced stage,metastatic disease upon diagnosis,managed medically with somatostatin analog therapy(Octreotide)and targeted therapy(Everolimus)with stable disease for 40 months that subsequently turned out to become functional(insulinoma).With the aid of this unique case,we update the current clinical,diagnostic and therapeutic approach to pNETs in this evidence-based review.
文摘BACKGROUND Type 2 diabetes(T2D),as well as obesity,are risk factors for chronic kidney disease(CKD)and end-stage renal disease.The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefits in preventing CKD often guide clinicians in choosing them appropriately.Only limited data based on randomized controlled trials(RCTs)is currently available on the renal effects and safety profile of tirzepatide.AIM To explore the renal benefits and safety of tirzepatide vs controls.METHODS RCTs involving patients receiving tirzepatide for any indication in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases.The co-primary outcomes were percent change from baseline(CFB)in urine albumin-to-creatinine ratio(UACR)and absolute CFB in estimated glomerular filtration rate(eGFR;in mL/min/1.73 m^(2));the secondary outcome was tirzepatide’s renal safety profile.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MD)or risk ratios with 95%confidence intervals.RESULTS Fifteen RCTs(n=14471)with mostly low risk of bias(RoB)were included.Over 26-72 weeks,tirzepatide 10 mg[MD-26.95%(-40.13,-13.76),P<0.0001]and 15 mg[MD-18.03%(-28.58,-7.47),P=0.0008]were superior to placebo in percent reductions of UACR.Tirzepatide,at all doses,outperformed insulin in percent reductions of UACR.Compared to the placebo,the percent UACR reduction was greater in subjects with T2D than those with obesity but without T2D(MD-33.25%vs-7.93%;P=0.001).The CFB in eGFR with all doses of tirzepatide was comparable[5 mg:MD 0.36(-1.41,2.14);10 mg:MD 1.17(-0.22,2.56);15 mg:MD 1.42(-0.04,2.88)];P>0.05 for all vs insulin.Tirzepatide(pooled and separate doses)did not increase the risks of adverse renal events,urinary tract infection,nephrolithiasis,acute kidney injury,and renal cancer compared to the placebo,insulin,and glucagon-like peptide-1 receptor agonists.CONCLUSION Short-term data from RCTs with low RoB suggests that tirzepatide positively impacts UACR without detrimental effects on eGFR in subjects with T2D and obesity without T2D,with a reassuring renal safety profile.Larger RCTs are warranted to prove the longer-term renal benefits of tirzepatide,which might also prevent eGFR decline and worsening of CKD.
基金supported by the National Science Foundation of China (Grant No. 30800101)the Chicago Zoological Society, the World Pheasant Association and the Critical Ecosystem Partnership FundPeter Garson (Chair,WPA-IUCN Pheasant Specialist Group) provided constructive advice on the work and helped facilitate financial support
文摘Buddhism and local cultural traditions have long protected wildlife species and their habitats in Tibetan-dominated areas of western Sichuan. In Daocheng County, the White Eared-pheasant (Crossoptilon crossoptilon) has been afforded special protection by local people because it is conspicuous and white, a color with special symbolism for Buddhists. This and other cultural reasons have led to pheasants and forests benefiting in some areas. Pheasants were found during surveys between January 2003 and June 2004 in forests with varying degrees of local (non-formal) protection. However, there were significant signs that these traditional attitudes were changing in the face of three particular pressures brought to bear by better roads, improving access to and from the rest of China. The first was the development of a significant local demand for the Chinese caterpillar fungus (Cordyceps sinesis), which is much sought after throughout East Asia and mushrooms. Second, and more recent, is a dramatic increase in tourism from major Chinese cities, bringing non-Tibetan values into Daocheng County and changing the local attitudes to all animals. And then, there is a rise in income of the local population, resulting in a higher timber demand for building big houses, which impact all wildlife in the forest, but local attitudes to sacred forests have been retained so far in spite of this increased timber demand. Lessons should be learnt from the impact that unregulated tourism at Chonggu monastery, the most visited area in the county, has on the surrounding forests so that other sacred and non-sacred forests can best be protected for the long term. The alternative is that several Tibetan Plateau Galliformes, currently considered non-threatened because of their extensive distribution in a remote area, cannot be guaranteed such a healthy future.
基金Supported by the IIT Roorkee Project under Grant No. FIG-A Scheme-A
文摘A fuzzy model was presented to predict the weldment shape profile of submerged arc welds （SAW） including the shape of heat affected zone （HAZ）. The SAW bead-on-plates were welded by following a full factorial design matrix. The design matrix consisted of three levels of input welding process parameters. The welds were cross-sectioned and etched, and the zones were measured. A mapping technique was used to measure the various segments of the weld zones. These mapped zones were used to build a fuzzy logic model. The membership functions of the fuzzy model were chosen for the accurate prediction of the weld zone. The fuzzy model was further tested for a set of test case data. The weld zone predicted by the fuzzy logic model was compared with the experimentally obtained shape profiles and close agreement between the two was noted. The mapping technique developed for the weld zones and the fuzzy logiemodel earl be used for on-line control of the SAW process. From the SAW fuzzy logic model an estimation of the fusion and HAZ can also be developed.
文摘BACKGROUND Diabesity(diabetes as a consequence of obesity)has emerged as a huge healthcare challenge across the globe due to the obesity pandemic.Judicious use of antidiabetic medications including semaglutide is important for optimal management of diabesity as proven by multiple randomized controlled trials.However,more real-world data is needed to further improve the clinical practice.AIM To study the real-world benefits and side effects of using semaglutide to manage patients with diabesity.METHODS We evaluated the efficacy and safety of semaglutide use in managing patients with diabesity in a large academic hospital in the United States.Several parameters were analyzed including demographic information,the data on improvement of glycated hemoglobin(HbA1c),body weight reduction and insulin dose adjustments at 6 and 12 months,as well as at the latest follow up period.The data was obtained from the electronic patient records between January 2019 to May 2023.RESULTS 106 patients(56 males)with type 2 diabetes mellitus(T2DM),mean age 60.8±11.2 years,mean durations of T2DM 12.4±7.2 years and mean semaglutide treatment for 2.6±1.1 years were included.Semaglutide treatment was associated with significant improvement in diabesity outcomes such as mean weight reductions from baseline 110.4±24.6 kg to 99.9±24.9 kg at 12 months and 96.8±22.9 kg at latest follow up and HbA1c improvement from baseline of 82±21 mmol/mol to 67±20 at 12 months and 71±23 mmol/mol at the latest follow up.An insulin dose reduction from mean baseline of 95±74 units to 76.5±56.2 units was also observed at the latest follow up.Side effects were mild and mainly gastrointestinal like bloating and nausea improving with prolonged use of semaglutide.CONCLUSION Semaglutide treatment is associated with significant improvement in diabesity outcomes such as reduction in body weight,HbA1c and insulin doses without major adverse effects.Reviews of largescale real-world data are expected to inform better clinical practice decision making to improve the care of patients with diabesity.
