Diabetes increases preventative sickness and costs healthcare and productivity. Type 2 diabetes and macrovascular disease consequences cause most diabetes-related costs. Type 2 diabetes greatly costs healthcare institutions, reducing economic productivity and efficiency. This cost of illness (COI) analysis examines the direct and indirect costs of treating and managing type 1 and type 2 diabetes mellitus. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Cochrane, PubMed, Embase, CINAHL, Scopus, Medline Plus, and CENTRAL were searched for relevant articles on type 1 and type 2 diabetes illness costs. The inquiry returned 873 2011–2023 academic articles. The study included 42 papers after an abstract evaluation of 547 papers. Most articles originated in Asia and Europe, primarily on type 2 diabetes. The annual cost per patient ranged from USD87 to USD9,581. Prevalence-based cost estimates ranged from less than USD470 to more than USD3475, whereas annual pharmaceutical prices ranged from USD40 to more than USD450, with insulin exhibiting the greatest disparity. Care for complications was generally costly, although costs varied significantly by country and problem type. This study revealed substantial heterogeneity in diabetes treatment costs; some could be reduced by improving data collection, analysis, and reporting procedures. Diabetes is an expensive disease to treat in low- and middle-income countries, and attaining Universal Health Coverage should be a priority for the global health community.

Background: Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected information and data from diabetes patients throughout Pakistan out-patient clinics. Direct and indirect costs were evaluated, and data were analyzed with descriptive and inferential statistics. Results: An overall of 1839 diabetes patients participated in the study. The results have shown that direct and indirect costs are positively associated with the participants’ socio-demographic characteristics, except for household income and educational status. The annual total cost of diabetes care was USD 740.1, amongst which the share of the direct cost was USD 646.7, and the indirect cost was USD 93.65. Most direct costs comprised medicine (USD 274.5) and hospitalization (USD 319.7). In contrast, the productivity loss of the patients had the highest contribution to the indirect cost (USD 81.36). Conclusion: This study showed that direct costs significantly contributed to diabetes’s overall cost in Pakistan and overall diabetes management estimated to be 1.67% (USD 24.42 billion) of the country’s total gross domestic product. The expense of medications and hospitalization mostly drove the direct cost. Additionally, patients’ loss of productivity contributed significantly to the indirect cost. It is high time for healthcare policymakers to address this huge healthcare burden. It is time to develop a thorough diabetes management plan to be implemented nationwide.

Background: Kidney failure is a global health problem with a worldwide mean prevalence rate of 13.4%. Kidney failure remains symptomless during most of the early stages until symptoms appear in the advanced stages. Kidney failure is associated with a decrease in health-related quality of life (HRQOL), deterioration in physical and mental health, and an increased risk of cardiovascular morbidity and mortality. This study aimed to evaluate the factors associated with decreased HRQOL and other factors affecting the overall health of patients. Another objective was to measure how medication adherence and depression could affect the overall HRQOL in patients with kidney failure. Methodology: The study used a prospective follow-up mix methodology approach with six-month follow-ups of patients. The participants included in the study population were those with chronic kidney disease grade 4 and kidney failure. Pre-validated and translated questionnaires (Kidney Disease Quality of Life-Short Form, Hamilton Depression Rating Scale Urdu Version, and Morisky Lewis Greens Adherence Scale) and assessment tools were used to collect data. Results: This study recruited 314 patients after an initial assessment based on inclusion criteria. The mean age of the study population was 54.64 ± 15.33 years. There was a 47.6% male and a 52.4% female population. Hypertension and diabetes mellitus remained the most predominant comorbid condition, affecting 64.2% and 74.6% of the population, respectively. The study suggested a significant (p < 0.05) deterioration in the mental health composite score with worsening laboratory variables, particularly hematological and iron studies. Demographic variables significantly impact medication adherence. HRQOL was found to be deteriorating with a significant impact on mental health compared to physical health. Conclusions: Patients on maintenance dialysis for kidney failure have a significant burden of physical and mental symptoms, depression, and low HRQOL. Given the substantial and well-known declines in physical and psychological well-being among kidney failure patients receiving hemodialysis, the findings of this research imply that these areas related to health should receive special attention in the growing and expanding population of kidney failure patients.

Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated efficacy in improving glycemic control and promoting weight loss in clinical trials. However, real-world data from diverse populations, particularly from South Asia, are limited. The study aims to evaluate the long-term efficacy and safety of liraglutide in a real-world setting among Pakistani patients with type 2 diabetes mellitus (T2DM). A retrospective cohort study of 624 patients initiated on liraglutide was conducted. Data were collected at baseline and 6, 12, 18, and 24 months. Primary outcomes were HbA1c and weight changes. Secondary outcomes included fasting plasma glucose, lipid profile, and blood pressure. Statistical analyses were performed using appropriate methods. In study population the mean HbA1c reduction of −1.45 ± 0.67% was observed at 24 months, with 30.6% achieving HbA1c ≤ 7.5%. A rapid and sustained weight loss of −7.51 kg was achieved, with 27.2% experiencing ≥5% weight loss. Additionally, liraglutide led to a significant reduction in LDL cholesterol, with 46.7% of patients achieving a ≥ 10% reduction at 24 months. Liraglutide was well-tolerated, with a low discontinuation rate of 4.6%. Liraglutide demonstrated sustained efficacy and safety in a diverse Pakistani population with T2DM, regardless of baseline characteristics. These findings support the use of liraglutide as an effective treatment option for T2DM in real-world clinical practice.

Introduction: Diabetes is a growing global health issue that can have serious consequences. As the value of behavioral intervention programs for preventing and managing this disease in adults becomes more evident, this study aimed to assess the effectiveness of these programs in mitigating and managing diabetes among adult populations. Methods: A comprehensive search strategy was employed utilising a range of electronic databases like Google Scholar, PubMed, Science Direct, Medline, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature. Only research articles written in English and published between 2012 and 2024 were included. Included were articles focusing on behavioral interventions targeting glycemic control (HbA1c) in adults (≥ 18 years) with or at risk for type 2 diabetes. The review adhered to PRISMA guidelines, with 39 studies meeting inclusion criteria after screening 1,156 initial records. Results: Thirty-nine studies met inclusion criteria. Of these, 28 reported significant glycemic improvements, with mean HbA1c reductions of − 0.3% to − 0.7% (Cohen’s d ≈ 0.28). Dietary and culturally tailored programs achieved the largest reductions, while CBT and technology-assisted approaches showed modest but clinically relevant effects. Prevention trials reduced diabetes incidence by 20–30% compared with controls. Conclusion: Behavioral interventions effectively improve glycemic control and prevent diabetes in at-risk populations. Key components of success include individualized support, multidisciplinary care, and technology integration. These findings underscore the potential of behavioral strategies to complement clinical diabetes management globally.

Background: Maternal mental health influences the key psychological process of maternal–fetal attachment (MFA) during pregnancy. Women with a history of miscarriage are at increased risk of prenatal anxiety and depression, which may affect their emotional bond with the fetus. Evidence on how anxiety and depression influence MFA in high‐risk pregnancies is inconsistent, particularly in low‐income settings such as Pakistan, where prenatal mental health research is limited. Aims: This study aimed to examine the association between prenatal anxiety and prenatal depression with maternal–fetal attachment and its dimensions among pregnant women with a history of miscarriage and to explore differences based on selected demographic and psychosocial factors. Methods: A cross‐sectional study was conducted at Bahawalpur Victoria Hospital, Pakistan, from October 2024 to December 2024. A total of 523 third‐trimester pregnant women with prior miscarriages were recruited using purposive sampling. Prenatal depression, anxiety, and maternal–fetal attachment were assessed using the EPDS, SAS, and MAAS, respectively. Independent sample t ‐tests, Pearson's correlations, and multiple linear regression analyses were performed using SPSS 27.0. Results: Prenatal anxiety was significantly and positively associated with maternal–fetal attachment and its subdimensions, whereas prenatal depression showed no such association. Regression analysis confirmed anxiety as a significant predictor of attachment quality and total MFA scores, whereas depression was non‐significant. Planned pregnancy, marital satisfaction, employment, sleep disturbances, and younger maternal age were associated with stronger maternal–fetal attachment and higher anxiety. Conclusion: Prenatal anxiety, but not depression, is positively associated with maternal–fetal attachment among women with a history of miscarriage. These findings emphasize the importance of the early identification and management of prenatal anxiety and highlight the need for culturally appropriate mental health interventions to support maternal well‐being and mother–fetus bonding in high‐risk pregnancies.