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Introduction: The relationship between arthropathy and dipeptidyl peptidase-4 (DPP-4) inhibitors has rarely been investigated in Asian patients with type 2 diabetes mellitus (DM) treated with DPP-4 inhibitors. Materials and Methods: The Longitudinal Health Insurance Database 2000, which contains the claims data of one million beneficiaries of the National Health Insurance program, was used as the data source. A total of 19,729 patients who had received a diagnosis of type 2 DM, had received oral antidiabetic agents for at least 3 months, or were hospitalized with a diagnosis of DM without joint pain between January 1, 2009, and December 31, 2010, were recruited and followed for 1 year. Patients who received sitagliptin for at least 1 month were defined as sitagliptin users. Results: With sitagliptin use, arthralgia occurred early after the initiation of treatment when the cumulative defined daily dose (DDD) of sitagliptin was <84. The risk of joint pain did not increase significantly when sitagliptin was used for 1 year. By contrast, joint pain significantly decreased with sitagliptin use (p < 0.001). Conclusions: The cumulative DDD of nonsteroidal anti-inflammatory drugs did not increase with sitagliptin use; however, it significantly decreased within 1 year after the beginning of sitagliptin use. This may be attributable to the anti-inflammatory effect exerted by sitagliptin. Thus, Dipeptidyl Peptidase-4 Inhibitor use may reduce joint pain in patients with type 2 Diabetes Mellitus.

The Covid-19 outbreak renders managing diabetes mellitus problematic. Infection with Covid-19 predisposes infected individuals to hyperglycemia, leading to hyper glycosylation of ACE2 and increased viral proliferation. Worsening of hyperglycaemia induces inflammation, endothelial dysfunction, and thrombosis via the generation of oxidative stress driving the dysregulation of glucose metabolism and hypercoagulability. Severe infection in the individuals predisposed to vasculopathy and impaired immunity may accentuate thrombotic and ischemic complications associated with multiorgan failure and increased mortality rates. Covid-19 poses a major risk to the diabetes patients. This risk in diabetes patients could through cytokine storm. Some inflammatory cytokines especially interleukin 6 should be monitored.

Diabetes mellitus, indicated by increased levels of blood sugar stemming from inadequate insulin synthesis or poor usage, presents a persistent metabolic challenge. Nutrition stands as a critical pillar in managing diabetes, emphasizing a balanced diet with controlled carbohydrate intake and whole-food emphasis. Yet, implementing nutritional strategies tailored to individual needs remains challenging due to diverse dietary information and evolving science. Though consensus on optimal nutritional therapy lacks uniformity, fundamental dietary principles persist across diabetes types. Studies have shown the effectiveness of nutritional interventions in managing other health conditions, underscoring the need to enhance care for individuals with diabetes. This manuscript delves into the comprehensive landscape of nutritional guidelines for diabetes management, addressing macronutrients\' roles, micronutrient significance, herbal supplements, dietary fiber, glycemic index/load comprehension, and the pivotal role of nutritional counseling. It highlights the importance of tailored dietary plans, focusing on carbohydrates, proteins, and fats, while also elucidating the crucial role of micronutrients such as magnesium, zinc, chromium, and vitamins in diabetes care. Additionally, it examines the potential benefits and caution around herbal supplements in diabetes management. This manuscript provides a holistic exploration of nutritional strategies, emphasizing the need for personalized approaches and comprehensive support systems to optimize diabetes care and overall well-being.