EPIDEMIOLOGY OF PREDIABETES AND IT’S DIAGNOSIS AND TREATMENT: A REVIEW

Authors

  • S ASHRAF Department of Zoology, University of Sialkot, Sialkot Pakistan
  • A TAHIR Department of Zoology, University of Sialkot, Sialkot Pakistan
  • A SHABBIR Department of Zoology, University of Sialkot, Sialkot Pakistan
  • M AWAIS Department of Zoology, University of Sialkot, Sialkot Pakistan
  • A ALI Department of Pharmacy, University of Agriculture Faisalabad, Pakistan
  • R SHAHZADI Department of Zoology, University of Sialkot, Sialkot Pakistan
  • S ULLAH Faculty of Veterinary Science, University of Agriculture Faisalabad, Pakistan
  • R IMTIAZ Department of Zoology, University of Sialkot, Sialkot Pakistan
  • S HAMEED Department of Zoology, University of Sialkot, Sialkot Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.615

Keywords:

Lifestyle modification, Prediabetes, Diabetes, Metformin, Impaired glucose tolerance

Abstract

A state of hyperglycemia known as prediabetes is characterized by glycemic indices that are above normal but still below the diabetes threshold. Pre-diabetes remains significantly connected with a yearly conversion rate of 5% to 10% to diabetes, even with differences in the diagnostic criteria among international professional organizations. Observational research suggests a potential link between prediabetes and diabetic sequelae, including small fiber neuropathy, early retinopathy, early nephropathy, and an increased risk of macrovascular disease. Numerous studies showing the value of lifestyle changes in avoiding diabetes have shown a relative risk reduction of 40%–70% in those with prediabetes. Although there is growing evidence that pharmaceutical therapy alternatives other than metformin are beneficial in preventing diabetes in individuals with prediabetes, their use is limited due to adverse effects. The health outcomes of childhood prediabetes have not been the subject of any rigorous evaluations. Pharmacotherapy for prediabetes may have uncertain consequences on a child's growth and pubertal development. High-risk individuals are advised to undergo secondary intervention with metformin pharmacotherapy; nevertheless, the eventual goal of therapy, the long-term cost-effectiveness of such interventions, and the advantages of early intervention are not well understood. In kids with prediabetes, pharmacotherapy needs to be used carefully. Prediabetes is the term for blood glucose levels that are higher than usual but not entirely above the diabetic threshold. In this at-risk status, diabetes is considered to be highly likely to develop. Even though prediabetes is usually an asymptomatic condition, it is always present before the beginning of diabetes. As hyperglycemia is a continuum, prediabetes cannot be ruled out as a completely benign illness. In this review, we discussed the difficulties in diagnosing prediabetes, the potential adverse health consequences that come with it, the available treatments for prediabetes, and the reasons behind using them.

Downloads

Download data is not yet available.

References

Algvere, P., Efendić, S., Luft, R., and Wajngot, A. (1985). Retinal microangiopathy and pigment epithelial lesions in subjects with normal, borderline, and decreased oral glucose tolerance. British journal of ophthalmology 69, 416-419.

Aschner, P. (2017). New IDF clinical practice recommendations for managing type 2 diabetes in primary care. Diabetes research and clinical practice 132, 169-170.

Association, A. D. (2014a). Diagnosis and classification of diabetes mellitus. Diabetes care 37, S81-S90.

Association, A. D. (2014b). Standards of medical care in diabetes—2014. Diabetes care 37, S14-S80.

Association, A. D. (2019). 3. Prevention or delay of type 2 diabetes: standards of medical care in diabetes—2019. Diabetes Care 42, S29-S33.

Atlas, D. (2006). International Diabetes Federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 2015. Eur. Respir. J 27, 188-207.

Bansal, N. (2015). Prediabetes diagnosis and treatment: A review. World journal of diabetes 6, 296.

Barbagallo, C., Danaei, G., Finucane, M., Lu, Y., Singh, G., Cowan, M., Paciorek, C., Lin, J., Farzadfar, F., and Khang, Y. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2· 7 million participants. The Lancet 378, 31-40.

Barr, E. L., Zimmet, P. Z., Welborn, T. A., Jolley, D., Magliano, D. J., Dunstan, D. W., Cameron, A. J., Dwyer, T., Taylor, H. R., and Tonkin, A. M. (2007). Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 116, 151-157.

Be, M. (2008). Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358, 1991-2002.

Bischoff, H. (1995). The mechanism of alpha-glucosidase inhibition in the management of diabetes. Clinical and investigative medicine. Medecine clinique et experimentale 18, 303-311.

Bloomgarden, Z. T. (2008). American College Of Endocrinology pre-diabetes consensus conference: Part one. Diabetes Care 31, 2062.

Brunner, E. J., Shipley, M. J., Witte, D. R., Fuller, J. H., and Marmot, M. G. (2006). Relation between blood glucose and coronary mortality over 33 years in the Whitehall Study. Diabetes care 29, 26-31.

Chen, E. A., Roof, M. A., Lygrisse, K. A., Kurapatti, M., Hepinstall, M. S., and Schwarzkopf, R. (2021). ICD-10 coding mismatch in computer and robotic assisted primary total hip arthroplasty. The Journal of Arthroplasty 36, 3934-3937.

Chiasson, J.-L., Josse, R. G., Gomis, R., Hanefeld, M., Karasik, A., and Laakso, M. (2002). Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. The Lancet 359, 2072-2077.

Cohen, R. M., Snieder, H., Lindsell, C. J., Beyan, H., Hawa, M. I., Blinko, S., Edwards, R., Spector, T. D., and Leslie, R. D. G. (2006). Evidence for independent heritability of the glycation gap (glycosylation gap) fraction of HbA1c in nondiabetic twins. Diabetes care 29, 1739-1743.

Collaboration, E. R. F. (2011). Diabetes mellitus, fasting glucose, and risk of cause-specific death. New England Journal of Medicine 364, 829-841.

DeFronzo, R. A., Tripathy, D., Schwenke, D. C., Banerji, M., Bray, G. A., Buchanan, T. A., Clement, S. C., Henry, R. R., Hodis, H. N., and Kitabchi, A. E. (2011). Pioglitazone for diabetes prevention in impaired glucose tolerance. New England Journal of Medicine 364, 1104-1115.

Echouffo‐Tcheugui, J., Narayan, K., Weisman, D., Golden, S. H., and Jaar, B. (2016). Association between prediabetes and risk of chronic kidney disease: a systematic review and meta‐analysis. Diabetic Medicine 33, 1615-1624.

EDEG, Forouhi, N., Balkau, B., Borch-Johnsen, K., Dekker, J., Glumer, C., Qiao, Q., Spijkerman, A., Stolk, R., and Tabac, A. (2006). The threshold for diagnosing impaired fasting glucose: a position statement by the European Diabetes Epidemiology Group. Diabetologia 49, 822-827.

Eriksson, K.-F., and Lindgärde, F. (1998). No excess 12-year mortality in men with impaired glucose tolerance who participated in the Malmö Preventive Trial with diet and exercise. Diabetologia 41, 1010-1016.

Forouhi, N., Luan, J., Hennings, S., and Wareham, N. (2007). Incidence of type 2 diabetes in England and its association with baseline impaired fasting glucose: the Ely study 1990–2000. Diabetic Medicine 24, 200-207.

Fox, C. S., Larson, M. G., Leip, E. P., Meigs, J. B., Wilson, P. W., and Levy, D. (2005). Glycemic status and development of kidney disease: the Framingham Heart Study. Diabetes care 28, 2436-2440.

Gabir, M. M., Hanson, R. L., Dabelea, D., Imperatore, G., Roumain, J., Bennett, P. H., and Knowler, W. C. (2000). Plasma glucose and prediction of microvascular disease and mortality: evaluation of 1997 American Diabetes Association and 1999 World Health Organization criteria for diagnosis of diabetes. Diabetes care 23, 1113-1118.

Genuth, S., and Kahn, R. (2008). A step backward-or is it forward? Diabetes Care 31, 1093.

Gerritsen, J., Dekker, J., TenVoorde, B., Bertelsmann, F., Kostense, P., Stehouwer, C., Heine, R., Nijpels, G., Heethaar, R., and Bouter, L. (2000). Glucose tolerance and other determinants of cardiovascular autonomic function: the Hoorn Study. Diabetologia 43, 561-570.

Gerstein, H. C., Santaguida, P., Raina, P., Morrison, K. M., Balion, C., Hunt, D., Yazdi, H., and Booker, L. (2007). Annual incidence and relative risk of diabetes in people with various categories of dysglycemia: a systematic overview and meta-analysis of prospective studies. Diabetes research and clinical practice 78, 305-312.

Gong, Q., Gregg, E., Wang, J., An, Y., Zhang, P., Yang, W., Li, H., Li, H., Jiang, Y., and Shuai, Y. (2011). Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study. Diabetologia 54, 300-307.

Gosmanov, A. R., and Wan, J. (2014). Low positive predictive value of hemoglobin A1c for diagnosis of prediabetes in clinical practice. The American journal of the medical sciences 348, 191-194.

Group, D. P. P. R. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England journal of medicine 346, 393-403.

Group, D. P. P. R. (2007). The prevalence of retinopathy in impaired glucose tolerance and recent‐onset diabetes in the Diabetes Prevention Program. Diabetic Medicine 24, 137-144.

Grover, S. A., Lowensteyn, I., Kaouache, M., Marchand, S., Coupal, L., DeCarolis, E., Zoccoli, J., and Defoy, I. (2006). The prevalence of erectile dysfunction in the primary care setting: importance of risk factors for diabetes and vascular disease. Archives of internal medicine 166, 213-219.

Guo, F., Moellering, D. R., and Garvey, W. T. (2014). Use of HbA1c for diagnoses of diabetes and prediabetes: comparison with diagnoses based on fasting and 2-hr glucose values and effects of gender, race, and age. Metabolic syndrome and related disorders 12, 258-268.

Hamman, R. F., Wing, R. R., Edelstein, S. L., Lachin, J. M., Bray, G. A., Delahanty, L., Hoskin, M., Kriska, A. M., Mayer-Davis, E. J., and Pi-Sunyer, X. (2006). Effect of weight loss with lifestyle intervention on risk of diabetes. Diabetes care 29, 2102-2107.

Heianza, Y., Hara, S., Arase, Y., Saito, K., Fujiwara, K., Tsuji, H., Kodama, S., Hsieh, S. D., Mori, Y., and Shimano, H. (2011). HbA1c 5· 7–6· 4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS 3): a longitudinal cohort study. The Lancet 378, 147-155.

Heymsfield, S. B., Segal, K. R., Hauptman, J., Lucas, C. P., Boldrin, M. N., Rissanen, A., Wilding, J. P., and Sjöström, L. (2000). Effects of weight loss with orlistat on glucose tolerance and progression to type 2 diabetes in obese adults. Archives of Internal Medicine 160, 1321-1326.

Hoehner, C. M., Greenlund, K. J., Rith-Najarian, S., Casper, M. L., and McClellan, W. M. (2002). Association of the insulin resistance syndrome and microalbuminuria among nondiabetic native Americans. The Inter-Tribal Heart Project. Journal of the American Society of Nephrology 13, 1626-1634.

Hoffman-Snyder, C., Smith, B. E., Ross, M. A., Hernandez, J., and Bosch, E. P. (2006). Value of the oral glucose tolerance test in the evaluation of chronic idiopathic axonal polyneuropathy. Archives of neurology 63, 1075-1079.

Hopper, I., Billah, B., Skiba, M., and Krum, H. (2011). Prevention of diabetes and reduction in major cardiovascular events in studies of subjects with prediabetes: meta-analysis of randomised controlled clinical trials. European Journal of Cardiovascular Prevention & Rehabilitation 18, 813-823.

Hostalek, U. (2019). Global epidemiology of prediabetes-present and future perspectives. Clinical diabetes and endocrinology 5, 5.

Huang, Y., Cai, X., Mai, W., Li, M., and Hu, Y. (2016). Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. Bmj 355.

Investigators, D. T. (2008). Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose: results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial. Diabetes care 31, 1007-1014.

Jackson, M. C., Dai, S., Skeete, R. A., Owens-Gary, M., Cannon, M. J., Smith, B. D., Jabrah, R., Masalovich, S. E., and Soler, R. E. (2020). An examination of gender differences in the National diabetes prevention program’s lifestyle change program. The Diabetes Educator 46, 580-586.

Kawamori, R., Tajima, N., Iwamoto, Y., Kashiwagi, A., Shimamoto, K., and Kaku, K. (2009). Voglibose for prevention of type 2 diabetes mellitus: a randomised, double-blind trial in Japanese individuals with impaired glucose tolerance. The lancet 373, 1607-1614.

Lee, C. C., Perkins, B. A., Kayaniyil, S., Harris, S. B., Retnakaran, R., Gerstein, H. C., Zinman, B., and Hanley, A. J. (2015). Peripheral neuropathy and nerve dysfunction in individuals at high risk for type 2 diabetes: the PROMISE cohort. Diabetes care 38, 793-800.

Li, G., Zhang, P., Wang, J., Gregg, E. W., Yang, W., Gong, Q., Li, H., Li, H., Jiang, Y., and An, Y. (2008). The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. The Lancet 371, 1783-1789.

Lily, M., and Godwin, M. (2009). Treating prediabetes with metformin: systematic review and meta-analysis. Canadian Family Physician 55, 363-369.

McDonagh, M. S., Selph, S., Ozpinar, A., and Foley, C. (2014). Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger. JAMA pediatrics 168, 178-184.

Metcalf, P. A., Baker, J. R., Scragg, R. K., Dryson, E., Scott, A. J., and Wild, C. J. (1993). Microalbuminuria in a middle-aged workforce: effect of hyperglycemia and ethnicity. Diabetes Care 16, 1485-1493.

Mohan, V. (2006). Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. The Lancet 368, 1096-1105.

Natangelo, R., Luè, D., Bianchi, G., Ronchi, E., and Conti, D. (1990). The hypoglycemic reactions in diabetic patients in the emergency room. Which patients are going to be hospitalized? Minerva Medica 81, 561-565.

Nguyen, T. T., Wang, J. J., Islam, F. A., Mitchell, P., Tapp, R. J., Zimmet, P. Z., Simpson, R., Shaw, J., and Wong, T. Y. (2008). Retinal arteriolar narrowing predicts incidence of diabetes: the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. Diabetes 57, 536-539.

Nguyen, T. T., Wang, J. J., and Wong, T. Y. (2007). Retinal vascular changes in pre-diabetes and prehypertension: new findings and their research and clinical implications. Diabetes care 30, 2708-2715.

Organization, W. H. (2006). Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation.

Plantinga, L. C., Crews, D. C., Coresh, J., Miller III, E. R., Saran, R., Yee, J., Hedgeman, E., Pavkov, M., Eberhardt, M. S., and Williams, D. E. (2010). Prevalence of chronic kidney disease in US adults with undiagnosed diabetes or prediabetes. Clinical journal of the American Society of Nephrology: CJASN 5, 673.

Ramachandran, A., Snehalatha, C., Mary, S., Mukesh, B., Bhaskar, A., Vijay, V., and Programme, I. D. P. (2006). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 49, 289-297.

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A. A., and Ogurtsova, K. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice 157, 107843.

Saito, T., Watanabe, M., Nishida, J., Izumi, T., Omura, M., Takagi, T., Fukunaga, R., Bandai, Y., Tajima, N., and Nakamura, Y. (2011). Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels: a randomized controlled trial. Archives of internal medicine 171, 1352-1360.

Sarwar, N., Gao, P., Seshasai, S., Gobin, R., Kaptoge, S., Di Angelantonio, E., Ingelsson, E., Lawlor Da, S. E., Stampfer, M., and Stehouwer CDa, L. S. (2010). Thompson a, Sattar N, White IR, Ray KK, Danesh J. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375, 2215-22.

Schroeder, E. B., Chambless, L. E., Liao, D., Prineas, R. J., Evans, G. W., Rosamond, W. D., and Heiss, G. (2005). Diabetes, glucose, insulin, and heart rate variability: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes care 28, 668-674.

Singh, J. P., Larson, M. G., O’Donnell, C. J., Wilson, P. F., Tsuji, H., Lloyd-Jones, D. M., and Levy, D. (2000). Association of hyperglycemia with reduced heart rate variability (The Framingham Heart Study). The American journal of cardiology 86, 309-312.

Singleton, J. R., Smith, A. G., and Bromberg, M. B. (2001). Increased prevalence of impaired glucose tolerance in patients with painful sensory neuropathy. Diabetes care 24, 1448-1453.

Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgren, S., Larsson, B., Narbro, K., and Sjöström, C. D. (2004). Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. New England Journal of Medicine 351, 2683-2693.

Sjöström, L., Peltonen, M., Jacobson, P., Sjöström, C. D., Karason, K., Wedel, H., Ahlin, S., Anveden, Å., Bengtsson, C., and Bergmark, G. (2012). Bariatric surgery and long-term cardiovascular events. Jama 307, 56-65.

Smith, A. G., Ramachandran, P., Tripp, S., and Singleton, J. R. (2001). Epidermal nerve innervation in impaired glucose tolerance and diabetes-associated neuropathy. Neurology 57, 1701-1704.

Smith, U. (2001). Pioglitazone: mechanism of action. International journal of clinical practice. Supplement, 13-18.

Stern, M. P., Williams, K., and Haffner, S. M. (2002). Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Annals of internal medicine 136, 575-581.

Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., and Kivimäki, M. (2012). Prediabetes: a high-risk state for diabetes development. The Lancet 379, 2279-2290.

Tapp, R. J., Tikellis, G., Wong, T. Y., Harper, C. A., Zimmet, P. Z., Shaw, J. E., Obesity, A. D., and Group, L. S. (2008). Longitudinal association of glucose metabolism with retinopathy: results from the Australian Diabetes Obesity and Lifestyle (AusDiab) study. Diabetes care 31, 1349-1354.

Tasyurek, H. M., Altunbas, H. A., Balci, M. K., and Sanlioglu, S. (2014). Incretins: their physiology and application in the treatment of diabetes mellitus. Diabetes/metabolism research and reviews 30, 354-371.

Tesfaye, S., Boulton, A. J., Dyck, P. J., Freeman, R., Horowitz, M., Kempler, P., Lauria, G., Malik, R. A., Spallone, V., and Vinik, A. (2010). Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes care 33, 2285-2293.

Thomas, G., Sehgal, A. R., Kashyap, S. R., Srinivas, T. R., Kirwan, J. P., and Navaneethan, S. D. (2011). Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clinical journal of the American Society of Nephrology: CJASN 6, 2364.

Torgerson, J. S., Hauptman, J., Boldrin, M. N., and Sjöström, L. (2004). XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study. A randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Clinical Diabetology 5, 95-104.

Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., and Rastas, M. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344, 1343-1350.

Van't Riet, E., Alssema, M., Rijkelijkhuizen, J. M., Kostense, P. J., Nijpels, G., and Dekker, J. M. (2010). Relationship between A1C and glucose levels in the general Dutch population: the new Hoorn study. Diabetes care 33, 61-66.

Wong, T. Y., Klein, R., Sharrett, A. R., Schmidt, M. I., Pankow, J. S., Couper, D. J., Klein, B. E., Hubbard, L. D., Duncan, B. B., and Investigators, A. (2002). Retinal arteriolar narrowing and risk of diabetes mellitus in middle-aged persons. Jama 287, 2528-2533.

Wu, J.-S., Yang, Y.-C., Lin, T.-S., Huang, Y.-H., Chen, J.-J., Lu, F.-H., Wu, C.-H., and Chang, C.-J. (2007). Epidemiological evidence of altered cardiac autonomic function in subjects with impaired glucose tolerance but not isolated impaired fasting glucose. The Journal of Clinical Endocrinology & Metabolism 92, 3885-3889.

Xu, M., Li, X., Wang, J., Wang, X., Huang, Y., Cheng, Q., Huang, H., Li, R., Xiang, J., and Tan, J. (2009). Retinol-binding protein 4 is associated with impaired glucose regulation and microalbuminuria in a Chinese population. Diabetologia 52, 1511-1519.

Yeboah, J., Bertoni, A. G., Herrington, D. M., Post, W. S., and Burke, G. L. (2011). Impaired fasting glucose and the risk of incident diabetes mellitus and cardiovascular events in an adult population: MESA (Multi-Ethnic Study of Atherosclerosis). Journal of the American College of Cardiology 58, 140-146.

Zinman, B., Harris, S. B., Neuman, J., Gerstein, H. C., Retnakaran, R. R., Raboud, J., Qi, Y., and Hanley, A. J. (2010). Low-dose combination therapy with rosiglitazone and metformin to prevent type 2 diabetes mellitus (CANOE trial): a double-blind randomised controlled study. The Lancet 376, 103-111.

Downloads

Published

2023-12-24

How to Cite

ASHRAF , S., TAHIR , A., SHABBIR , A., AWAIS , M., ALI , A., SHAHZADI , R., ULLAH , S., IMTIAZ , R., & HAMEED , S. (2023). EPIDEMIOLOGY OF PREDIABETES AND IT’S DIAGNOSIS AND TREATMENT: A REVIEW. Biological and Clinical Sciences Research Journal, 2023(1), 616. https://doi.org/10.54112/bcsrj.v2023i1.615

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 > >>