Deutsche Diabetes Stiftung

Background: Considering the growing importance of tele-dentistry and its potential to enhance the delivery of dental services, this study aimed to assess the knowledge, attitude, and practice (KAP) of private dental offices towards this technology. Methods: This analytical cross-sectional study included 50 general dentists practicing in Semnan city, selected based on entry criteria through the enumeration method. Participants completed a demographic questionnaire (including gender and years since graduation) and a 15-item researcher-made questionnaire designed to assess their KAP towards tele-dentistry. Results: Among the participants, 54% (27 participants) were female, and 46% (23 participants) were male, with an average age of 30.2 ± 6.48 years. The mean number of years since graduation was 7.74 ± 5.13 years. The mean and standard deviation of KAP scores were 5.96 ± 1.07 (knowledge), 34.32 ± 3.41 (attitude), and 1.44 ± 0.50 (practice), respectively. Men scored significantly higher in knowledge compared to women (7.26 ± 0.91 vs. 6.70 ± 1.14; P = 0.037). There was a significant inverse correlation between knowledge scores and years since graduation (r = -0.292; P = 0.032). Additionally, 52% (26 participants) reported having used tele-dentistry, while 96% (48 participants) expressed an intention to use it in the future. Conclusions: The findings suggest that knowledge regarding tele-dentistry was notably higher among men and those with fewer years since graduation. Health policies should prioritize training programs to enhance general dentists' knowledge and practice of tele-dentistry, supporting its effective implementation in dental care.

The DDG clinical practice guidelines are updated regularly during the second half of the calendar year. Please ensure that you read and cite the respective current version. Part 1 of the clinical practice guideline Change 1: An additional section on the prevalence and incidence of type 2 diabetes in Germany has been added. Reason: These current figures highlight the medical, psychosocial and health policy significance of this complex disease. Change 2: On the basis of current data, the various risk factors and their structured assessment (including the increasing importance of fatty liver) for the development of cardiovascular and renal complications are again highlighted. Reason: For an individual therapy decision, the in-depth risk assessment is very helpful Supporting reference: [6-7] Change 3: The short diagnostics section has been brought forward Reason: More logical order of sections Change 4: The section on plasma glucose self-measurement was supplemented to include the possibilities and possible necessity of using CGM in people with type 2 diabetes Reason: The treatment of people with type 2 diabetes is becoming more individual and therefore more complex. Temporary information about TiR and TuR can at minimum be helpful in the treatment decision. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Glucose overload drives diabetic cardiomyopathy by affecting the tricarboxylic acid pathway. However, it is still unknown how cells could overcome massive chronic glucose influx on cellular and structural level. Expression profiles of hyperglycemic, glucose transporter-4 (GLUT4) overexpressing H9C2 (KE2) cardiomyoblasts loaded with 30 mM glucose (KE230L) and wild type (WT) cardiomyoblasts loaded with 30 mM glucose (WT30L) were compared using proteomics, real-time polymerase quantitative chain reaction analysis, or Western blotting, and immunocytochemistry. The findings suggest that hyperglycemic insulin-sensitive cells at the onset of diabetic cardiomyopathy present complex changes in levels of structural cell-related proteins like tissue inhibitor of metalloproteases-1 (1.3 fold), intercellular adhesion molecule 1 (1.8 fold), type-IV-collagen (3.2 fold), chaperones (Glucose-Regulated Protein 78: 1.8 fold), autophagy (Autophagosome Proteins LC3A, LC3B: 1.3 fold), and in unfolded protein response (UPR; activating transcription factor 6α expression: 2.3 fold and processing: 2.4 fold). Increased f-actin levels were detectable with glucose overload by immnocytochemistry. Effects on energy balance (1.6 fold), sirtuin expression profile (Sirtuin 1: 0.7 fold, sirtuin 3: 1.9 fold, and sirtuin 6: 4.2 fold), and antioxidant enzymes (Catalase: 0.8 fold and Superoxide dismutase 2: 1.5 fold) were detected. In conclusion, these findings implicate induction of chronic cell distress by sustained glucose accumulation with a non-compensatory repair reaction not preventing final cell death. This might explain the chronic long lasting pathogenesis observed in developing heart failure in diabetes mellitus.

The DDG clinical practice guidelines are updated regularly during the second half of the calendar year.Please note that due to the overlap of the deadlines for the printing version of this clinical practice guideline and the publication of the 5th edition of the S3 guideline on the treatment of type 1 diabetes in September 2023, the present clinical practice guideline still refers to the version from 2018.