Diabetes mellitus (DM) is a serious and common chronic disease with high morbidity and mortality rates. Recently, stem cell-based therapy has shown considerable promise as a future therapeutic modality for DM. This review aims to summarize the types of stem cells that have the most successful evidence in treating type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), and also to assess the safety and efficacy of different types of stem cells in the treatment of DM. PubMed, MEDLINE, and PubMed Central databases were searched up to October 15, 2020, using medical subject heading (MeSH) terms. After application of inclusion criteria and exclusion criteria, 10 studies were included in our final review: six T1DM studies including 120 patients, and four T2DM studies including 65 patients. Our data showed that autologous and allogeneic stem cell therapy is a relatively safe and effective method for selected individuals with DM. The best therapeutic outcome was achieved by transplantation of bone marrow hemopoietic stem cells (BM-HSCs) for T1DM and bone marrow mononuclear cells (BM-MNCs) along with mesenchymal stromal cells (MSCs) for T2DM. However, patients with DKA are not a good candidate for stem cell transplantation. Further rigorous experiments are needed in order to be able to establish stem cell-based therapies as the future standard of care for treating DM.

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e13504 Background: Lung cancer is the leading cause of cancer-related mortality worldwide. USPSTF recommends annual lung cancer screening with low dose computed tomography (LDCT) for adults aged 50-80 years with 20-pack year smoking history and are currently smoking or have quit within the past 15 years. Unfortunately, adherence rates with screenings remain suboptimal. This study aimed to assess the compliance rates with LDCT recommendations in a community hospital and propose an implementation plan to enhance patient adherence. Methods: A retrospective study was conducted by analyzing the medical charts of 1090 patients who underwent LDCT screenings at Mercy Catholic Medical Center between January 2018 and June 2021. Medical records were reviewed to determine whether patients had appropriate follow-ups done based on the LUNG-RADs category with focus on those with higher LUNG-RADs designations. A survey was administered to current internal medicine residents to evaluate their understanding of screening guidelines. Based on the survey results and literature review, a plan to enhance adherence with screenings is proposed. Results: Total 1090 patients underwent LDCT screenings, comprising of 522 males and 568 females. 166 patients were assigned LUNG-RADs category 3, 4A, 4B, or 4X. Amongst these 166 patients, compliance rate with recommended follow-up imaging and/or biopsies was only 51.2% (95% confidence interval [CI], 44.0-59.0). 15% of patients had biopsies that were positive for malignancies. 70% of the residents participated in the survey. Only 57% demonstrated knowledge of the recommended age group for screening; only 47% knew the pack-year criteria for screening. Questions gauging the understanding of when to stop screening, implications of imaging findings, and estimated mortality reduction from LDCT screenings underscored the knowledge gap amongst physicians as a factor needing improvement. Conclusions: This study comprised of a patient population primarily from poor socioeconomic and educational background. Therefore, many of the patients in this study may not have fully comprehended the LDCT implications solely from receiving a letter with radiology impressions, leading to the high non-compliance rate observed. To enhance follow-ups, residents should be educated on LDCT screening indications and benefits so they can promote patient health better. After receiving LDCT results, providers should inform patients about the findings either via phone calls or in-person office visits and emphasize the importance of specific follow-ups. We propose the appointment of a designated coordinator to call patients who failed to follow-up to re-emphasize the importance and identify barriers to adherence (i.e., transportation, cost). Studies found an increase in adherence to screening from 22% to 66% after hiring a coordinator. Adherence rates can, thus, be improved by a collaborative team approach.

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