1
|
Kodani N, Kato A, Lee MK, Ma RCW, Sabidi A, Scibilia R, Zhou Z, Jenkins A. Diabetes advocacy in the Asia-Pacific region. J Diabetes Investig 2025. [PMID: 40421836 DOI: 10.1111/jdi.70084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2025] [Revised: 04/27/2025] [Accepted: 05/09/2025] [Indexed: 05/28/2025] Open
Abstract
Living with diabetes is challenging. From diagnosis, one has to deal with lifelong management of glycemia and other factors. Misunderstandings about diabetes persist. People with diabetes (PWD) are sometimes misperceived as having brought diabetes upon themself, being incapable of self-management, maintaining a healthy lifestyle, or appropriate dietary habits, among other negative attributes. As a result, PWD can face difficulties at school, at home, in the workplace, and in the community. PWD also face financial burden with medical costs, health insurance, and loans. There has been growing awareness of diabetes-related stigma, highlighting the prevalence and consequences of biased, one-sided, and inaccurate information. Stigma can negatively affect the self-esteem, self-confidence, and self-care of PWD, and adversely affect their clinical outcomes. Therefore, advocacy to reduce the burden is essential. The situation varies within and between countries. There are still countries with limited access to insulin, more powerful glucose-lowering, cardio- and reno-protective drugs for type 2 diabetes, glucose monitoring strips, let alone technologies including continuous glucose monitoring (CGM) and insulin pumps. As members of the Asia-Pacific region, we strive to improve the quality of life for PWD within our countries and to enhance the global advocacy movement to achieve sustainable health equity worldwide. Herein, we share information from some Asia-Pacific countries: Australia, China, Korea, Indonesia, and Japan, including some aspects of the advocacy movement in each country. Through mutual understanding and collaboration, we aim to strengthen advocacy efforts across the Asia-Pacific region and contribute to global initiatives that enhance health outcomes for PWD.
Collapse
Affiliation(s)
- Noriko Kodani
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan
| | - Asuka Kato
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Moon-Kyu Lee
- Eulji University School of Medicine, Uijeongbu, Korea
| | - Ronald Ching Wan Ma
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shan Tin, Hong Kong
| | - Anita Sabidi
- Indonesian Children with Diabetes Association (Ikatan Keluarga Diabetes Anak dan Remaja), Jacarta, Indonesia
- Indonesian Diabetes Association (Persatuan Diabetes Indonesia), Jacarta, Indonesia
- Diabetes Initiative Indonesia, Jacarta, Indonesia
| | - Renza Scibilia
- Community Engagement and Communications, Global Responsibility, New York, NY, USA
- #dedoc°, Berlin, Germany
| | - Zhiguang Zhou
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Alicia Jenkins
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shan Tin, Hong Kong
- Baker Heart and Diabetes Institute, Melbourne, Vic., Australia
- International Diabetes Federation, Western Pacific Region, Merbourne, Australia
| |
Collapse
|
2
|
Yi QH, Wang HL, Hou Y, Xu L, Tian WL, Zhang YX, Xu YS, Shi JB. A Comparison of the Decline in Glomerular Filtration Rate between Elderly Patients with Diabetes and those without Diabetes in Southwest China. Endocr Metab Immune Disord Drug Targets 2024; 24:1371-1376. [PMID: 38243974 DOI: 10.2174/0118715303261963231228125548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To investigate the effect of high blood glucose on the decline in the estimated glomerular filtration rate (eGFR) in the elderly. METHODS We compared the decline in eGFR of diabetic and non-diabetic groups in the noninterventional state and analyzed the effect of hyperglycemia on the decline in eGFR among the elderly in a retrospective analysis of 1,223 cases of elderly people aged 65 years or older with a 4-year follow-up period. RESULTS The prevalence of diabetes in the elderly increased significantly from 12.67% in 2017 to 16.68% in 2021. The rate of decline in eGFR in patients with diabetes was higher than in the population without diabetes, at 9.29% and 5.32%, respectively (both p <0.05). CONCLUSION The results of this study revealed that the prevalence of diabetes in the elderly increased significantly, and there is a more rapid decrease in the eGFR levels in those with diabetes than those without diabetes.
Collapse
Affiliation(s)
- Qing-Hua Yi
- Department of Nephrology, Kunming Guandu District People's Hospital, Kunming 650200, China
| | - Hong-Liang Wang
- Department of Nephrology, Kunming Guandu District People's Hospital, Kunming 650200, China
| | - Yun Hou
- Department of Internal Medicine, Community Health Service Center of Wujing Street, Guandu District, Kunming 650200, China
| | - Lang Xu
- Department of Internal Medicine, Community Health Service Center of Wujing Street, Guandu District, Kunming 650200, China
| | - Wei-Li Tian
- Department of Internal Medicine, Community Health Service Center of Wujing Street, Guandu District, Kunming 650200, China
| | - Yi-Xuan Zhang
- Department of Nephrology, Kunming Guandu District People's Hospital, Kunming 650200, China
| | - Yu-Shan Xu
- Department of Internal Secretion, First Affiliated Hospital of Kunming Medical University, Kunming 650200, China
| | - Jia-Bin Shi
- Department of Logistics, Kunming Guandu District People's Hospital, Kunming 650200, China
| |
Collapse
|
3
|
Miles LM, Hawkes RE, French DP. Description of the nationally implemented National Health Service digital diabetes prevention programme and rationale for its development: mixed methods study. BMC Health Serv Res 2023; 23:373. [PMID: 37072758 PMCID: PMC10114366 DOI: 10.1186/s12913-023-09210-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/22/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The National Health Service (NHS) Digital Diabetes Prevention Programme (DDPP) is a behaviour change programme for adults in England who are at high risk of developing type 2 diabetes. Four independent providers deliver the NHS-DDPP following a competitive tendering process. Although providers work to a single service specification, there is potential for some variation in the service across providers. This study (1) assesses fidelity of the structural features of the design of the NHS-DDPP compared to the service specification, (2) describes the structural features of delivery of the NHS-DDPP as implemented (3) reports developers' views on how the structural components of the NHS-DDPP were developed and why changes were made following implementation. METHODS Using mixed methods, we conducted a document review of providers' NHS-DDPP design and delivery documentation, and extracted information using the Template for Intervention Description and Replication checklist, which was adapted to capture features of digital delivery. Documentation was supplemented by content analysis of interviews with 12 health coaches involved in delivering the NHS-DDPP. Semi-structured interviews were also conducted with 6 programme developers employed by the digital providers. RESULTS Provider plans for the NHS-DDPP show relatively high fidelity to the NHS service specification. Despite this, there was wide variation in structural features of delivery of the NHS-DDPP across providers, particularly for delivery of 'support' (e.g. use, dose and scheduling of health coaching and/or group support). Interviews with developers of the programmes showed that much of this variation is likely to be attributable to the origin of each provider's programme, which was usually a pre-existing programme that was adapted to conform to the NHS-DDPP service specification. The NHS-DDPP is continually improved and developed based on user experience feedback and research conducted by the providers. CONCLUSION Indirect evidence suggests that variation in delivery of support could affect effectiveness of the NHS-DDPP. A priority for future research is ascertaining whether the variation in delivery of the NHS-DDPP across providers is related to any differences in health outcomes. It is recommended that future rounds of commissioning the NHS-DDPP pre-specify the type of support participants should receive, including expected dose and scheduling.
Collapse
Affiliation(s)
- Lisa M Miles
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Rhiannon E Hawkes
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - David P French
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom.
| |
Collapse
|
4
|
Adler AJ, Drown L, Boudreaux C, Coates MM, Marx A, Akala O, Waqanivalu T, Xu H, Bukhman G. Understanding integrated service delivery: a scoping review of models for noncommunicable disease and mental health interventions in low-and-middle income countries. BMC Health Serv Res 2023; 23:99. [PMID: 36717832 PMCID: PMC9885613 DOI: 10.1186/s12913-023-09072-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) and mental health conditions represent a growing proportion of disease burden in low- and middle-income countries (LMICs). While past efforts have identified interventions to be delivered across health system levels to address this burden, the challenge remains of how to deliver heterogenous interventions in resource-constrained settings. One possible solution is the Integration of interventions within existing care delivery models. This study reviews and summarizes published literature on models of integrated NCD and mental health care in LMICs. METHODS We searched Pubmed, African Index Medicus and reference lists to conduct a scoping review of studies describing an integrated model of NCD or neuropsychiatric conditions (NPs) implemented in a LMIC. Conditions of interest were grouped into common and severe NCDs and NPs. We identified domains of interest and types of service integration, conducting a narrative synthesis of study types. Studies were screened and characteristics were extracted for all relevant studies. Results are reported using PRISMA-ScR. RESULTS Our search yielded 5004 studies, we included 219 models of integration from 188 studies. Most studies were conducted in middle-income countries, with the majority in sub-Saharan Africa. Health services were offered across all health system levels, with most models implemented at health centers. Common NCDs (including type 2 diabetes and hypertension) were most frequently addressed by these models, followed by common NPs (including depression and anxiety). Conditions and/or services were often integrated into existing primary healthcare, HIV, maternal and child health programs. Services provided for conditions of interest varied and frequency of these services differed across health system levels. Many models demonstrated decentralization of services to lower health system levels, and task shifting to lower cadre providers. CONCLUSIONS While integrated service design is a promising method to achieve ambitious global goals, little is known about what works, when, and why. This review characterizing care integration programs is an initial step toward developing a structured study of care integration.
Collapse
Affiliation(s)
- Alma J Adler
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA.
| | - Laura Drown
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Chantelle Boudreaux
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Matthew M Coates
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| | - Andrew Marx
- Program in Global Noncommunicable Disease and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave, Boston, MA, USA
| | - Oyetayo Akala
- Noncommunicable Diseases Department, World Health Organization, 20, Avenue Appia-1211, Geneva, Switzerland
| | - Temo Waqanivalu
- Noncommunicable Diseases Department, World Health Organization, 20, Avenue Appia-1211, Geneva, Switzerland
| | - Hongyi Xu
- Noncommunicable Diseases Department, World Health Organization, 20, Avenue Appia-1211, Geneva, Switzerland
| | - Gene Bukhman
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, USA
| |
Collapse
|
5
|
Li H, Xie S, Zhang X, Xia Y, Zhang Y, Wang L. Mid-pregnancy consumption of fruit, vegetable and fruit juice and the risk of gestational diabetes mellitus: A correlation study. Clin Nutr ESPEN 2021; 46:505-509. [PMID: 34857242 DOI: 10.1016/j.clnesp.2021.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the potential association between mid-pregnancy consumption of fruit, vegetable and fruit juice and the risk of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS An observational study with 2987 pregnant women was conducted in China from June 2013 to June 2014. Fruit, vegetable and fruit juice consumption during weeks 13-28 of pregnancy was assessed by using 24 h dietary recall method and food frequency questionnaire. Cox proportional hazard model was used to assess the association between fruit, vegetable and fruit juice consumption (in quartiles) and GDM risks, and One-Way ANOVA was used to compare the incidences of GDM at various levels of fruit, vegetable and fruit juice consumption, adjusted for gestational age, family history of diabetes, physical activity, fiber and meat intake. RESULTS Among all the 2987 pregnant women, 405 (13.6%) were diagnosed as GDM for the first time. There was no association between total fruit and vegetable consumption and GDM. Quantity of grape, melon, potatoes and fruit juice consumption were positively associated with the incidence of GDM. In contrast, quantity of apple, orange and vegetables other than potatoes were negatively associated with the incidence of GDM. CONCLUSIONS Our findings indicate that appropriate quantity of fruit and vegetable intakes throughout pregnancy may have a beneficial effect on preventing the development of GDM, whereas excess consumption of fruits, potatoes and fruit juices is associated with an increased risk of GDM.
Collapse
Affiliation(s)
- Hui Li
- Department of Clinical Nutrition, General Hospital of Chinese People's Armed Police Forces, Beijing, PR China
| | - Shengzhi Xie
- Department of Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, PR China
| | - Xuyi Zhang
- Department of Clinical Nutrition, General Hospital of Chinese People's Armed Police Forces, Beijing, PR China
| | - Yixin Xia
- Department of Obstetrics and Gynecology, General Hospital of Chinese People's Armed Police Forces, Beijing, PR China
| | - Yun Zhang
- Department of Clinical Nutrition, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.
| | - Lei Wang
- Department of Clinical Nutrition, General Hospital of Chinese People's Armed Police Forces, Beijing, PR China; Department of Clinical Nutrition, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, PR China.
| |
Collapse
|
6
|
Yao D, GangYi Y, QiNan W. Autophagic dysfunction of β cell dysfunction in type 2 diabetes, a double-edged sword. Genes Dis 2021; 8:438-447. [PMID: 34179308 PMCID: PMC8209341 DOI: 10.1016/j.gendis.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/07/2020] [Accepted: 03/12/2020] [Indexed: 12/19/2022] Open
Abstract
Diabetes is an age-related disease, most of which is type 2 diabetes, and islet β cell dysfunction and insulin resistance are the main mechanisms of type 2 diabetes. Recent studies have revealed that autophagy plays an important role in maintaining the structure and function of islet beta cells and inhibiting insulin resistance and apoptosis induced by oxidative stress. In this review, we discussed the positive and negative effects of autophagy and its dysfunction on type 2 diabetes mellitus, which is the so-called double-edged sword, analysed its possible mechanism, and identified possible research hot spots.
Collapse
Affiliation(s)
- Ding Yao
- Endocrinology and Nephrology Department, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing, 400030, PR China
| | - Yang GangYi
- Endocrinology Department, The Second Affiliated Hospital of the Chongqing Medical University, Chongqing, 400010, PR China
| | - Wu QiNan
- Endocrinology and Nephrology Department, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing, 400030, PR China
| |
Collapse
|
7
|
Hao S, Pang L, Xie L, Wu X, Liu Z, Yu P, Li S. Case report: fast reversal of malignant obesity hypoventilation syndrome after noninvasive ventilation and pulmonary rehabilitation. SLEEP SCIENCE AND PRACTICE 2021. [DOI: 10.1186/s41606-021-00062-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Malignant obesity hypoventilation syndrome (MOHS) is described as a subtype condition of OHS, characterized by extreme obesity, obese-related hypoventilation, and multiorgan dysfunction. Because of low awareness and inadequate treatment, MOHS leads to high morbidity and mortality.
Case presentation
A 53-year-old man was diagnosed with MOHS evidenced by extreme obesity and multiorgan abnormalities. After taken noninvasive ventilation (NIV) treatment, he was rescued. And at the end of the six-month pulmonary rehabilitation (PR) program, improvement in terms of respiratory parameters, BMI, apnea-hypopnea index (AHI), and pulmonary hypertension were observed in the patient. Two years later, the patient was still in good condition.
Conclusions
This case highlights the awareness and proper use of NIV to rescue MOHS patients. Furthermore, the benefits of PR were explored in this case, which has not been considered within the therapeutic options for MOHS patients.
Collapse
|
8
|
IL-1 β Impaired Diabetic Wound Healing by Regulating MMP-2 and MMP-9 through the p38 Pathway. Mediators Inflamm 2021; 2021:6645766. [PMID: 34054346 PMCID: PMC8149221 DOI: 10.1155/2021/6645766] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetes mellitus is one of the most prominent metabolic disorders in the world, and insulin resistance in diabetic patients leads to several complications including increased inflammation and delayed wound healing. Fibroblast migration and reepithelialization play a significant role in wound healing. In this study, we explored the effects of IL-1β signaling on proliferation and migration of human fibroblasts from diabetic wound tissues. We observed elevated levels of IL-1β in samples from diabetic patients when compared to normal wound tissues. At high concentrations, IL-1β inhibited cell proliferation and migration in ex vivo fibroblast cultures. Moreover, expression of matrix metalloproteinases (MMPs) was upregulated, and tissue inhibitor of metalloproteinases (TIMPs) was downregulated in diabetic wound tissues and cells. These effects were regulated by levels of IL-1β. Furthermore, IL-1β induced p38 phosphorylation thereby activating the p38 MAPK pathway that in turn regulated the expression of MMPs and TIMPs. Together, our study identifies a novel mechanism behind delayed wound closure in diabetes mellitus that involves IL-1β-dependent regulation of cell proliferation and migration.
Collapse
|
9
|
Teo ZL, Tham YC, Yu M, Chee ML, Rim TH, Cheung N, Bikbov MM, Wang YX, Tang Y, Lu Y, Wong IY, Ting DSW, Tan GSW, Jonas JB, Sabanayagam C, Wong TY, Cheng CY. Global Prevalence of Diabetic Retinopathy and Projection of Burden through 2045: Systematic Review and Meta-analysis. Ophthalmology 2021; 128:1580-1591. [PMID: 33940045 DOI: 10.1016/j.ophtha.2021.04.027] [Citation(s) in RCA: 962] [Impact Index Per Article: 240.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 12/11/2022] Open
Abstract
TOPIC To provide updated estimates on the global prevalence and number of people with diabetic retinopathy (DR) through 2045. CLINICAL RELEVANCE The International Diabetes Federation (IDF) estimated the global population with diabetes mellitus (DM) to be 463 million in 2019 and 700 million in 2045. Diabetic retinopathy remains a common complication of DM and a leading cause of preventable blindness in the adult working population. METHODS We conducted a systematic review using PubMed, Medline, Web of Science, and Scopus for population-based studies published up to March 2020. Random effect meta-analysis with logit transformation was performed to estimate global and regional prevalence of DR, vision-threatening DR (VTDR), and clinically significant macular edema (CSME). Projections of DR, VTDR, and CSME burden were based on population data from the IDF Atlas 2019. RESULTS We included 59 population-based studies. Among individuals with diabetes, global prevalence was 22.27% (95% confidence interval [CI], 19.73%-25.03%) for DR, 6.17% (95% CI, 5.43%-6.98%) for VTDR, and 4.07% (95% CI, 3.42%-4.82%) for CSME. In 2020, the number of adults worldwide with DR, VTDR, and CSME was estimated to be 103.12 million, 28.54 million, and 18.83 million, respectively; by 2045, the numbers are projected to increase to 160.50 million, 44.82 million, and 28.61 million, respectively. Diabetic retinopathy prevalence was highest in Africa (35.90%) and North American and the Caribbean (33.30%) and was lowest in South and Central America (13.37%). In meta-regression models adjusting for habitation type, response rate, study year, and DR diagnostic method, Hispanics (odds ratio [OR], 2.92; 95% CI, 1.22-6.98) and Middle Easterners (OR, 2.44; 95% CI, 1.51-3.94) with diabetes were more likely to have DR compared with Asians. DISCUSSION The global DR burden is expected to remain high through 2045, disproportionately affecting countries in the Middle East and North Africa and the Western Pacific. These updated estimates may guide DR screening, treatment, and public health care strategies.
Collapse
Affiliation(s)
- Zhen Ling Teo
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Yih-Chung Tham
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Marco Yu
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Miao Li Chee
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Tyler Hyungtaek Rim
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Ning Cheung
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | | | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yating Tang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Ian Y Wong
- Department of Ophthalmology, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China; Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong SAR, China
| | - Daniel Shu Wei Ting
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Gavin Siew Wei Tan
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Charumathi Sabanayagam
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Tien Yin Wong
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Ching-Yu Cheng
- Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
| |
Collapse
|
10
|
Mao Y, Lin W, Wen J, Chen G. Impact and efficacy of mobile health intervention in the management of diabetes and hypertension: a systematic review and meta-analysis. BMJ Open Diabetes Res Care 2020; 8:e001225. [PMID: 32988849 PMCID: PMC7523197 DOI: 10.1136/bmjdrc-2020-001225] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/22/2020] [Accepted: 07/02/2020] [Indexed: 01/02/2023] Open
Abstract
With the continuous development of science and technology, mobile health (mHealth) intervention has been proposed as a treatment strategy for managing chronic diseases. In some developed countries, mHealth intervention has been proven to remarkably improve both the quality of care for patients with chronic illnesses and the clinical outcomes of these patients. However, the effectiveness of mHealth in developing countries remains unclear. Based on this fact, we conducted this systematic review and meta-analysis to evaluate the impact of mHealth on countries with different levels of economic development. To this end, we searched Pubmed, ResearchGate, Embase and Cochrane databases for articles published from January 2008 to June 2019. All of the studies included were randomized controlled trials. A meta-analysis was performed using the Stata software. A total of 51 articles (including 13 054 participants) were eligible for our systematic review and meta-analysis. We discovered that mHealth intervention did not only play a major role in improving clinical outcomes compared with conventional care, but also had a positive impact on countries with different levels of economic development. More importantly, our study also found that clinical outcomes could be ameliorated even further by combining mHealth with human intelligence rather than using mHealth intervention exclusively. According to our analytical results, mHealth intervention could be used as a treatment strategy to optimize the management of diabetes and hypertension in countries with different levels of economic development.
Collapse
Affiliation(s)
- Yaqian Mao
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China
| | - Wei Lin
- Endocrinology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Junping Wen
- Endocrinology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Gang Chen
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China
- Endocrinology, Fujian Provincial Hospital, Fuzhou, Fujian, China
- Fujian Provincial Key Laboratory of Medical Analysis, Fujian Academy of Medical, Fuzhou, Fujian, China
| |
Collapse
|
11
|
Lv J, Fan B, Wei M, Zhou G, Dayimu A, Wu Z, Su C, Zhang T. Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey. BMJ Open Diabetes Res Care 2020; 8:8/1/e000972. [PMID: 32327441 PMCID: PMC7202728 DOI: 10.1136/bmjdrc-2019-000972] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/11/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION This longitudinal study aims to characterize distinct body mass index (BMI) trajectories during early to mid-life adulthood and to explore the association between BMI change from young adulthood to midlife and incident diabetes. RESEARCH DESIGN AND METHODS This study included 7289 adults who had repeatedly measured BMI 3-9 times during 1989-2011 and information on incident diabetes. Latent class growth mixed model (LCGMM) was used to identify different BMI trajectories. Cox proportional hazard models were used to investigate the association between the trajectory group membership and incident hyperglycemia, adjusting for covariates. The hyperglycemia group included individuals with prediabetes or diabetes. The model-estimated BMI levels and slopes were calculated at each age point in 1-year intervals according to the model parameters and their first derivatives, respectively. Logistic regression analyses were used to examine the association of model-estimated levels and slopes of BMI at each age point with incident hyperglycemia. The area under the curve (AUC) was computed from longitudinal growth curve models during the follow-up for each individual. Prior to the logistic regression analyses, quartiles of total, baseline, and incremental AUC values were calculated. RESULTS Three distinct trajectories were characterized by LCGMM, comprising of low-increasing group (n=5136), medium-increasing group (n=1914), and high-increasing group (n=239). Compared with the low-increasing group, adjusted HRs and 95% CIs were 1.21 (0.99 to 1.48) and 1.56 (1.06 to 2.30) for the medium-increasing and the high-increasing group, respectively. The adjusted standardized ORs of model-estimated BMI levels increased among 20-50 years, ranging from 0.98 (0.87 to 1.10) to 1.19 (1.08 to 1.32). The standardized ORs of level-adjusted linear slopes increased gradually from 1.30 (1.16 to 1.45) to 1.42 (1.21 to 1.67) during 20-29 years, then decreased from 1.41 (1.20 to 1.66) to 1.20 (1.08 to 1.33) during 30-43 years, and finally increased to 1.20 (1.04 to 1.38) until 50 years. The fourth quartile of incremental AUC (OR=1.31, 95% CI 1.03 to 1.66) was significant compared with the first quartile, after adjustment for covariates. CONCLUSIONS These findings indicate that the BMI trajectories during early adulthood were significantly associated with later-life diabetes. Young adulthood is a crucial period for the development of diabetes, which has implications for early prevention.
Collapse
Affiliation(s)
- Jiali Lv
- Biostatistics, Shandong University, Jinan, China
| | - Bingbing Fan
- Biostatistics, Shandong University, Jinan, China
| | - Mengke Wei
- Biostatistics, Shandong University, Jinan, China
| | | | - Alim Dayimu
- Biostatistics, Shandong University, Jinan, China
| | - Zhenyu Wu
- Biostatistics, Fudan University, Shanghai, China
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Zhang
- Biostatistics, Shandong University, Jinan, China
| |
Collapse
|
12
|
Wu JN, Gu WR, Xiao XR, Zhang Y, Li XT, Yin CM. Gestational weight gain targets during the second and third trimesters of pregnancy for women with gestational diabetes mellitus in China. Eur J Clin Nutr 2019; 73:1155-1163. [PMID: 30375492 PMCID: PMC6760624 DOI: 10.1038/s41430-018-0358-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/29/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES Gestational weight gain (GWG) recommendations for pregnant women with gestational diabetes mellitus (GDM) in China are lacking. The present study aims to examine whether specific GWG targets for women with GDM can improve pregnancy outcomes in comparison with GWG according to the Institute of Medicine (IOM) targets. SUBJECTS/METHODS Pregnant women diagnosed with GDM were selected from a retrospective cohort study of 8299 singleton pregnant women aged 18-45 years in 2012 (n = 1820). GWG ranges were calculated using a receiver operating characteristic (ROC) curve analysis (ROC targets) and the interquartile range (IR) method (the range from the 25th to 75th percentiles of the GWG among GDM women without adverse pregnancy outcomes, IR targets). RESULTS The incidences of small for gestational age (SGA) births and pregnancy hypertension among women with GDM who gained weight within the ROC targets were lower than the incidences in women who gained weight within the IOM targets (SGA, 7.5% vs. 8.6%; pregnancy hypertension, 12.6% vs. 14.1%; both P < 0.05). GWG was associated with a risk of adverse pregnancy outcomes in the total sample (estimated values ranged from -2.95 to 2.08, all P < 0.05). No statistically significant associations between GWG and adverse pregnancy outcomes were observed in subgroups of pregnant women with appropriate GWGs according to the ROC, IR, and IOM targets. The ROC targets exhibited higher negative predictive values for adverse pregnancy outcomes than the IR and IOM targets. CONCLUSION The ROC targets improved pregnancy outcomes and thus represent potential special GWG guidelines for women with GDM in China.
Collapse
Affiliation(s)
- Jiang-Nan Wu
- Department of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Wei-Rong Gu
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Xi-Rong Xiao
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Yi Zhang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, 200025, China
| | - Xiao-Tian Li
- Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China.
| | - Chuan-Min Yin
- Department of Nutrition, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China.
| |
Collapse
|
13
|
Eriksson J. Developmental pathways and programming of diabetes: epidemiological aspects. J Endocrinol 2019; 242:JOE-18-0680.R2. [PMID: 30959482 DOI: 10.1530/joe-18-0680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/04/2019] [Indexed: 12/20/2022]
Abstract
Type 2 diabetes (T2D) is a major, rapidly increasing global public health challenge. The major risk factors for T2D include overweight and obesity, lifestyle related factors and genetic factors. Early life exposures shape the developmental trajectories and alter susceptibility to T2D. Based on epidemiological studies it has been suggested that fetal undernutrition plays a role in the etiology of T2D. A low birth weight has been considered a proxy for fetal undernutrition. A meta-analysis reported that a 1 kg increase in birth weight is associated with a roughly 20% lower risk of T2D. Although fetal life is of major importance for future health, the period spanning the first 1 000 days of life, is characterized by great plasticity and largely influencing later health. Different growth trajectories during this time period have also been associated with an increased risk of T2D. Studies assessing the association between age at BMI rebound in childhood and later risk for T2D have reported a 5-fold difference in T2D according to age at BMI rebound. Developmental and epidemiological cohort studies focusing on T2D have major public health implications supporting a paradigm shift; a shift from focusing upon risk factor modification in adult life to adopting a life course perspective when studying T2D. This paradigm shift will not only help us in getting a better understanding of the pathophysiology underlying T2D, but it will also open new possibilities and opportunities in the prevention of T2D and related disorders.
Collapse
Affiliation(s)
- Johan Eriksson
- J Eriksson, Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| |
Collapse
|
14
|
Ou X, Zhu C, Sun S. Effects of obesity and diabetes on the epigenetic modification of mammalian gametes. J Cell Physiol 2018; 234:7847-7855. [DOI: 10.1002/jcp.27847] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 11/15/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Xiang‐Hong Ou
- Fertility Preservation Lab, Reproductive Medicine Center, Guangdong Second Provincial General Hospital Guangzhou China
| | - Cheng‐Cheng Zhu
- College of Animal Science and Technology, Nanjing Agricultural University Nanjing China
- Nanjing Police Dog Institute of the Ministry of Public Security Nanjing China
| | - Shao‐Chen Sun
- College of Animal Science and Technology, Nanjing Agricultural University Nanjing China
| |
Collapse
|
15
|
Abstract
Type 2 diabetes is a major and accelerating public health challenge. Between 1980 and 2014, a period of just 35 years, the number of adults with diabetes globally is estimated to have increased from 108 to 422 million, due not only to sharply rising obesity rates, but also to increasing population size, longer life expectancy, and rising prevalence of diabetes worldwide. Overall, worldwide age-standardized adult diabetes prevalence doubled from 4.3% to 9.0% in men and from 5.0% to 7.9% in women. The largest increases in diabetes type 2 have been demonstrated in low- and middle-income countries, whilst rises in high-income countries have been less marked, or even flat. Diabetes type 2 rates in low- and middle-income countries now in many instances surpass those in high-income countries, in response to changes in lifestyle. One factor of particular concern are the large relative increases in type 2 diabetes amongst young individuals observed in many countries, their higher overall risk factor burden, long exposure to hyperglycaemia and greater risk of complications over the life course. Type 2 diabetes is increasingly found to be a heterogeneous condition, where risk of cardiovascular disease that traditionally has been estimated at 2-4 times that of the nondiabetic population varies substantially with diabetes phenotype and accordingly diabetes does not confer the same increase in relative or absolute risk in all people. New research shows that excess risk varies substantially with type of outcome, age, glycaemic control, the presence of renal complications and other factors. Heart failure, previously less recognized that other cardiovascular conditions, is increasingly coming into focus, because of strong links with poor glycaemic control and obesity. The knowledge about risk of cardiovascular disease in diabetes is almost entirely derived from high-income countries, whereas there is comparatively very little data from low- and middle income countries, where the majority of persons with type 2 diabetes live, and where management in many cases is far from optimal. The reductions in cardiovascular disease incidence and mortality now observed in high-income countries are encouraging, because this reinforces the fact that improvement is possible and that a near-normal, or even normal life-expectancy can be achieved in subtypes of type 2 diabetes.
Collapse
Affiliation(s)
- A Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
16
|
Hu X, Xiong Q, Xu Y, Zhang X, Xiao Y, Ma X, Bao Y. Contribution of maternal diabetes to visceral fat accumulation in offspring. Obes Res Clin Pract 2018; 12:426-431. [DOI: 10.1016/j.orcp.2018.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 06/27/2018] [Accepted: 07/09/2018] [Indexed: 12/19/2022]
|
17
|
Estimated daily quercetin intake and association with the prevalence of type 2 diabetes mellitus in Chinese adults. Eur J Nutr 2018; 58:819-830. [PMID: 29754250 DOI: 10.1007/s00394-018-1713-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/08/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Quercetin is one of potential antidiabetic substances because of its powerful antioxidant and anti-inflammatory actions. The purpose of this study is to estimate daily quercetin intake and assess the relationship between dietary quercetin intake and the prevalence of type 2 diabetes mellitus (T2DM) in a Chinese population. METHODS Dietary intake was investigated by a validated 100-item food frequency questionnaire. Daily intakes of quercetin and nutrients were calculated accordingly. T2DM was diagnosed based on the criteria of the American Diabetes Association. Adjusted logistic regression models were used to analyze the relationship between the quartiles of quercetin intake and the prevalence of T2DM. RESULTS The prevalences of T2DM were 8.35% in men and 4.68% in women. The main food sources of quercetin were apple, orange, and green tea. Daily intake of quercetin was 20.9 ± 2.32 mg/day (mean ± SD). After adjusting for potentially confounding factors, the odds ratios (95% CI) for T2DM across the ascending quartiles of quercetin intake were: 1.00 (reference), 0.75 (0.60-0.95), 0.76 (0.59-0.99), and 0.63 (0.51-0.94). CONCLUSIONS The results of the present study showed that quercetin intake was inversely related to the prevalence of T2DM in the Chinese population, suggesting a protective effect of quercetin in the development of T2DM.
Collapse
|
18
|
Loeken MR. Passive smoking as an independent risk factor for gestational diabetes that synergizes with prepregnancy obesity in urban Chinese women. Diabetes Metab Res Rev 2017; 33:10.1002/dmrr.2910. [PMID: 28580761 PMCID: PMC5639702 DOI: 10.1002/dmrr.2910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 01/15/2023]
Abstract
There are high-priority public health and legislative efforts around the world to reduce smoking and to reduce the spaces where smoking is allowable. These efforts are aimed at minimizing not only the adverse health effects of active smoking but also the adverse health effects of passive cigarette smoke exposure. While many cultures and societies make protection of a pregnant woman and her about-to-be-born-newborn a priority, the importance of protecting them from passive smoking that is prevalent in many modern societies has not been reported. The article by Leng et al, "Passive smoking increased risk of gestational diabetes mellitus independently and synergistically with prepregnancy obesity in Tianjin, China," newly published in Diabetes Metabolism Research and Reviews, provides evidence that passive smoke inhalation during pregnancy makes gestational diabetes more likely, bringing with it negative health consequences for the mother and her baby. This study will hopefully add support to public health officials' efforts to curb cigarette use, especially in public domains.
Collapse
Affiliation(s)
- Mary R Loeken
- Section on Islet and Regenerative Cell Biology, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|