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Alzaid A, Ladrón de Guevara P, Beillat M, Lehner Martin V, Atanasov P. Burden of disease and costs associated with type 2 diabetes in emerging and established markets: systematic review analyses. Expert Rev Pharmacoecon Outcomes Res 2020; 21:785-798. [PMID: 32686530 DOI: 10.1080/14737167.2020.1782748] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives: To estimate the clinical and economic burden of type 2 diabetes (T2D) in established (EST) and emerging markets (EMG).Methods: Three systematic literature reviews were conducted in MEDLINE and Embase to capture all relevant publications reporting 1) the epidemiology of T2D and complications in T2D and 2) the economic burden of T2D and associated complications.Results: In total, 294 studies were included in this analysis. Evidence indicates a high and increasing overall prevalence of T2D globally, ranging up to 23% in EMG markets and 14% in EST markets. Undiagnosed cases were higher in EMG versus EST markets (up to 67% vs 38%), potentially due to a lack of education and disease awareness in certain regions, that could lead to important clinical and economic consequences. Poor glycemic control was associated with the development of several complications (e.g. retinopathy, cardiovascular diseases and nephropathy) that increase the risk of morbidity and mortality. Direct costs were up to 9-fold higher in patients with vs without T2D-related complications.Conclusions: The burden of T2D, related complications and inherent costs are higher in emerging versus established market countries. This review explores potential strategies to reduce costs and enhance outcomes of T2D treatment in developing countries.
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Affiliation(s)
- Aus Alzaid
- Consultant Diabetologist, Riyadh, Saudi Arabia
| | - Patricia Ladrón de Guevara
- Health Economics & Market Access, Health Economics and Market Access, Amaris Consulting, Barcelona, Spain
| | - Maud Beillat
- Global Market Access, Health Economics & Outcomes Research, Servier Global Market Access & HEOR, France
| | | | - Petar Atanasov
- Health Economics & Market Access, Health Economics and Market Access, Amaris Consulting, Barcelona, Spain
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2
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Cseh D, Climie RE, Offredo L, Guibout C, Thomas F, Zanoli L, Danchin N, Sharman JE, Laurent S, Jouven X, Boutouyrie P, Empana JP. Type 2 Diabetes Mellitus Is Independently Associated With Decreased Neural Baroreflex Sensitivity: The Paris Prospective Study III. Arterioscler Thromb Vasc Biol 2020; 40:1420-1428. [PMID: 32188272 DOI: 10.1161/atvbaha.120.314102] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Impaired baroreflex function is an early indicator of cardiovascular autonomic imbalance. Patients with type 2 diabetes mellitus (T2D) have decreased baroreflex sensitivity (BRS), however, whether the neural BRS (nBRS) and mechanical component of the BRS is altered in those with high metabolic risk (HMR, impaired fasting glucose and metabolic syndrome) or with overt T2D, is unknown. We examined this in a community-based observational study, the Paris Prospective Study III (PPS3). Approach and Results: In 7626 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and RR [time elapsed between two successive R waves] intervals) and mechanical BRS were measured by high-precision carotid echotracking. The associations between overt T2D or HMR as compared with subjects with normal glucose metabolism and nBRS or mechanical BRS were quantified using multivariable linear regression analysis. There were 319 subjects with T2D (61±6 years, 77% male), 1450 subjects with HMR (60±6 years, 72% male), and 5857 subjects with normal glucose metabolism (59±6 years, 57% male). Compared with normal glucose metabolism, nBRS was significantly lower in HMR subjects (β=-0.07 [95% CI, -0.12 to -0.01]; P=0.029) and in subjects with T2D (β=-0.18 [95% CI, -0.29 to -0.07]; P=0.002) after adjustment for confounding and mediating factors. Subgroup analysis suggests significant and independent alteration in mechanical BRS only among HMR patients who had both impaired fasting glucose and metabolic syndrome. CONCLUSIONS In this community-based study of individuals aged 50 to 75, a graded decrease in nBRS was observed in HMR subjects and patients with overt T2D as compared with normal glucose metabolism subjects.
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Affiliation(s)
- Domonkos Cseh
- From the Department of Physiology, Semmelweis University, Budapest, Hungary (D.C.)
| | - Rachel E Climie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Baker Heart and Diabetes Institute, Melbourne, Australia (R.E.C.).,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Lucile Offredo
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Catherine Guibout
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Frédérique Thomas
- Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.)
| | - Luca Zanoli
- University of Catania, Catania, Italy (L.Z.)
| | - Nicolas Danchin
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Investigations Préventives et Cliniques (IPC), Paris, France (F.T., N.D.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (R.E.C., J.E.S.)
| | - Stéphane Laurent
- Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Xavier Jouven
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
| | - Pierre Boutouyrie
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.).,Department of Pharmacology, HEGP, APHP, Paris, France (N.D., S.L., P.B.)
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease team, Paris, France (R.E.C., L.O., C.G., N.D., X.J., P.B., J.-P.E.)
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3
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Cortet B, Chauvin P, Feron JM, Grange L, Coulomb A, Launois R, Alliot-Launois F, Sellami R, Touboul C, Vincent B, Joubert JM, Briot K. Fragility fractures in France: epidemiology, characteristics and quality of life (the EPIFRACT study). Arch Osteoporos 2020; 15:46. [PMID: 32170512 DOI: 10.1007/s11657-019-0674-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/21/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Between 1 and 2% of people aged 50 years and over living at home in France are likely to experience a fragility fracture each year. Three-quarters of these individuals are not diagnosed with osteoporosis and lose the opportunity for appropriate care. PURPOSE To estimate the incidence of fragility fractures in France and to describe the characteristics of individuals with such fractures and of their fractures. METHODS In April-May 2018, a postal survey was performed in France targeting a representative panel of 15,000 individuals aged ≥ 50 years, who were invited to complete a questionnaire. If they reported experiencing a fracture in the previous 3 years, they were asked to provide information on demographics, fracture type, risk factors for fractures and osteoporosis diagnosis. Only fragility fractures were considered, and these were classified as major (associated with increased mortality) or minor, based on the fracture site. RESULTS Around 13,914 panellists returned an exploitable questionnaire (92.8%). About 425 participants reported ≥ 1 fragility fracture (453 fractures), corresponding to a 12-month incidence rate of 1.4% [95%CI: 1.2, 1.6]. Incidence was higher in women (1.99% [1.87, 2.05]) than in men (0.69% [0.38, 0.86]) and increased with age. Around 157 fractures (34.6%) were classified as major. Participants reporting major fractures were older than those reporting minor fractures (mean age: 72.6 ± 11.3 vs 67.1 ± 10.6) and more likely to report previous corticosteroid use (odds ratio: 1.90 [95%CI: 1.13, 3.18]). No other patient characteristic was associated with fracture severity. About 117 participants with fractures (27.5%) had undergone bone densitometry, and 97 (22.8%) declared having received a diagnosis of osteoporosis. CONCLUSIONS Around 340,000 people aged ≥ 50 years living at home in France are estimated to experience osteoporotic fractures each year. However, > 75% of panellists reporting fractures were never diagnosed with osteoporosis and thus did not have the opportunity to receive appropriate care.
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Affiliation(s)
- Bernard Cortet
- Centre Hospitalier Régional Universitaire de Lille, Département Universitaire de Rhumatologie, Hôpital Roger Salengro, CHU Lille, Avenue du Professeur Emile Laine, 59037, Lille Cedex, France.
| | - Pierre Chauvin
- Department of Social Epidemiology, Institut Pierre Louis d'Epidémiologie et de Santé Publique (UMRS 1136), INSERM, Sorbonne Université, Paris, France
| | - Jean-Marc Feron
- Service de Chirurgie Orthopédique, HUEP Saint Antoine, Sorbonne Université, Paris, France
| | - Laurent Grange
- Service de Rhumatologie, CHU Grenoble Alpes, Hôpital Sud, Échirolles, France
- AFLAR - Association Française de Lutte Anti-Rhumatismale, Paris, France
| | | | | | | | | | | | | | | | - Karine Briot
- Service de Rhumatologie, Hôpital Cochin, Paris, France
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Ramzan S, Timmins P, Hasan SS, Babar ZUD. Trends in global prescribing of antidiabetic medicines in primary care: A systematic review of literature between 2000-2018. Prim Care Diabetes 2019; 13:409-421. [PMID: 31213359 DOI: 10.1016/j.pcd.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/18/2019] [Accepted: 05/23/2019] [Indexed: 12/28/2022]
Abstract
The aim of this review was to examine changes in the use of diabetes medicines prescribed to treat type 2 diabetes in the primary care setting. Five electronic databases were searched using strict inclusion/exclusion criteria. The quality of eligible studies was appraised using the Newcastle-Ottawa Scale. Findings show the trend has been away from using sulfonylurea and towards the use of metformin. The introduction of newer drugs has not shifted treatment outcomes and glycaemic control. It was not possible to determine how clinicians make choices about the medicines they prescribe for T2DM, or what influences those choices.
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Affiliation(s)
- Sara Ramzan
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom.
| | - Peter Timmins
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom.
| | - Syed Shahzad Hasan
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom.
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield, United Kingdom.
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5
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Graham EA, Thomson KH, Bambra CL. The association between diabetes and depressive symptoms varies by quality of diabetes care across Europe. Eur J Public Health 2019; 28:872-878. [PMID: 29617999 PMCID: PMC6148969 DOI: 10.1093/eurpub/cky050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Depressive symptoms are more common in adults with diabetes and may arise from the physical and psychosocial burden of disease. Better quality of diabetes care may be associated with a reduced disease burden and fewer depressive symptoms. Methods This cross-sectional study included 34 420 participants from 19 countries in the European Social Survey Round 7 (2014-2015). Countries were grouped into quartiles based on their quality of diabetes care as measured in the Euro Diabetes Index 2014. Individual-level depressive symptoms were measured using the 8-item Center for Epidemiologic Studies-Depression Scale. Negative binomial regression was used to compare the number of depressive symptoms between adults with and without diabetes in each quartile of diabetes care quality. Analyses included adjustment for covariates and survey weights. Results In countries with the highest quality of diabetes care, having diabetes was associated with only a 3% relative increase in depressive symptoms (95% CI 1.00-1.05). In countries in the second, third and fourth (lowest) quartiles of diabetes care quality, having diabetes was associated with a 13% (95% CI 1.08-1.17), 13% (1.08-1.19) and 22% (1.14-1.31) relative increase in depressive symptoms, respectively. Conclusion The association between diabetes and depressive symptoms appears stronger in European countries with lower quality of diabetes care. Potential pathways for this association include the financial aspects of diabetes care, access to services and differential exposure to the social determinants of heath. Further research is needed to unpack these mechanisms and improve the quality of life of people with diabetes across Europe.
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Affiliation(s)
- Eva A Graham
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Katie H Thomson
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Clare L Bambra
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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6
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Höner Zu Siederdissen C, Mederacke I. Editorial: diabetes in HIV-infected patients-do not blame the usual suspect! Aliment Pharmacol Ther 2018; 48:481-482. [PMID: 30588691 DOI: 10.1111/apt.14863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- C Höner Zu Siederdissen
- Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany
| | - I Mederacke
- Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany
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7
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Moulis G, Ibañez B, Palmaro A, Aizpuru F, Millan E, Lapeyre-Mestre M, Sailler L, Cambra K. Cross-national health care database utilization between Spain and France: results from the EPICHRONIC study assessing the prevalence of type 2 diabetes mellitus. Clin Epidemiol 2018; 10:863-874. [PMID: 30100760 PMCID: PMC6067780 DOI: 10.2147/clep.s151890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIM The EPICHRONIC (EPIdemiology of CHRONIC diseases) project investigated the possibility of developing common procedures for French and Spanish electronic health care databases to enable large-scale pharmacoepidemiological studies on chronic diseases. A feasibility study assessed the prevalence of type 2 diabetes mellitus (T2DM) in Navarre and the Basque Country (Spain) and the Midi-Pyrénées region (France). PATIENTS AND METHODS We described and compared database structures and the availability of hospital, outpatient, and drug-dispensing data from 5.9 million inhabitants. Due to differences in database structures and recorded data, we could not develop a common procedure to estimate T2DM prevalence, but identified an algorithm specific to each database. Patients were identified using primary care diagnosis codes previously validated in Spanish databases and a combination of primary care diagnosis codes, hospital diagnosis codes, and data on exposure to oral antidiabetic drugs from the French database. RESULTS Spanish and French databases (the latter termed Système National d'Information Inter-Régimes de l'Assurance Maladie [SNIIRAM]) included demographic, primary care diagnoses, hospital diagnoses, and outpatient drug-dispensing data. Diagnoses were encoded using the International Classification of Primary Care (version 2) and the International Classification of Diseases, version 9 and version 10 (ICD-9 and ICD-10) in the Spanish databases, whereas the SNIIRAM contained ICD-10 codes. All data were anonymized before transferring to researchers. T2DM prevalence in the population over 20 years was estimated to be 6.6-7.0% in the Spanish regions and 6.3% in the Midi-Pyrénées region with ~2% higher estimates for males in the three regions. CONCLUSION Tailored procedures can be designed to estimate the prevalence of T2DM in population-based studies from Spanish and French electronic health care records.
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Affiliation(s)
- Guillaume Moulis
- Department of Internal Medicine, Toulouse University Hospital, Toulouse, France,
- UMR1027 INSERM, University of Toulouse, Toulouse, France,
- Clinical Investigation Center 1436, Toulouse University Hospital, Toulouse, France,
| | - Berta Ibañez
- Navarrabiomed, Health Department, Public University of Navarra, Pamplona, Spain
- IdiSNA, Pamplona, Spain
- Health Service Research on Chronic Patients Network (REDISSEC), Pamplona, Spain
| | - Aurore Palmaro
- UMR1027 INSERM, University of Toulouse, Toulouse, France,
- Clinical Investigation Center 1436, Toulouse University Hospital, Toulouse, France,
| | - Felipe Aizpuru
- Health Service Research on Chronic Patients Network (REDISSEC), Pamplona, Spain
- Research Unit Araba (BioAraba), Osakidetza-Basque Health Department, Vitoria-Gasteiz, Spain
- Healthcare Services Sub-directorate, Osakidetza-Basque Health Service, Araba, Spain
| | - Eduardo Millan
- Health Service Research on Chronic Patients Network (REDISSEC), Pamplona, Spain
- Healthcare Services Sub-directorate, Osakidetza-Basque Health Service, Araba, Spain
| | - Maryse Lapeyre-Mestre
- UMR1027 INSERM, University of Toulouse, Toulouse, France,
- Clinical Investigation Center 1436, Toulouse University Hospital, Toulouse, France,
- Department of Medical and Clinical Pharmacology, Toulouse University Hospital, Toulouse, France
| | - Laurent Sailler
- Department of Internal Medicine, Toulouse University Hospital, Toulouse, France,
- UMR1027 INSERM, University of Toulouse, Toulouse, France,
- Clinical Investigation Center 1436, Toulouse University Hospital, Toulouse, France,
| | - Koldo Cambra
- IdiSNA, Pamplona, Spain
- Health Service Research on Chronic Patients Network (REDISSEC), Pamplona, Spain
- Institute of Public Health and Labour Health of Navarra, Pamplona, Spain
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8
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Gagner M. Toward a National Surgical Strategy for Type 2 Diabetes Resolution: Can We Do Better? JAMA Surg 2018; 153:533-534. [PMID: 29450454 DOI: 10.1001/jamasurg.2017.6154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Michel Gagner
- Department ofSurgery, Herbert Wertheim College of Medicine, Florida International University, Miami.,Hôpital du Sacre Coeur, Montreal, Quebec, Canada
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9
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and risk factors of type 2 diabetes in insomnia sufferers: a study on 1311 individuals referred for sleep examinations. Sleep Med 2018; 46:37-45. [PMID: 29773209 DOI: 10.1016/j.sleep.2018.02.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/26/2018] [Accepted: 02/28/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several studies have investigated the particular relationship between insomnia and type 2 diabetes. However, few studies have investigated the prevalence and risk factors for type 2 diabetes in insomnia sufferers. The aim of this study was to examine the prevalence and risk factors of type 2 diabetes in a large sample of insomnia sufferers. METHODS Data from 1311 insomnia sufferers recruited from the research database of the Erasme Hospital sleep laboratory were analyzed. Only individuals with a diagnosis of type 2 diabetes according to the diagnostic criteria of the American Diabetes Association at admission were included in the diabetes group. Logistic regression analyses were conducted to examine clinical and demographic risk factors of type 2 diabetes in insomnia sufferers. RESULTS The prevalence of type 2 diabetes in insomnia sufferers is 21.13%. Multivariate logistic regression analysis revealed that significant risk factors of type 2 diabetes in insomnia sufferers were as follows: being male, Z-drugs use, high blood pressure, hypertriglyceridemia, alcohol consumption of ≥4 units/day, BMI ≥25 & <30 kg/m2, BMI ≥30 kg/m2, age ≥50 years, C-reactive protein ≥4.5 mg/L, a sleep duration of <6.5 h, apnea-hypopnea index ≥15/hour, periodic limb movements index ≥26/hour, and severe complaints of early morning awakening. CONCLUSION Type 2 diabetes is a common pathology in insomnia sufferers. In this subpopulation, most of the risk factors for type 2 diabetes are reversible, which justifies better prevention and management of this pathology in order to avoid its negative consequences.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
| | - Jean-Pol Lanquart
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Gwénolé Loas
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium
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Hein M, Lanquart JP, Loas G, Hubain P, Linkowski P. Prevalence and Risk Factors of Type 2 Diabetes in Major Depression: A Study on 703 Individuals Referred for Sleep Examinations. PSYCHOSOMATICS 2018; 59:144-157. [DOI: 10.1016/j.psym.2017.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/16/2022]
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11
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Wang R, Zhang P, Lv X, Jiang L, Gao C, Song Y, Yu Y, Li B. Situation of Diabetes and Related Disease Surveillance in Rural Areas of Jilin Province, Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060538. [PMID: 27240391 PMCID: PMC4923995 DOI: 10.3390/ijerph13060538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/18/2016] [Accepted: 05/23/2016] [Indexed: 01/19/2023]
Abstract
Background: Several studies have investigated the prevalence and awareness of diabetes mellitus (DM) in China, but little is known about the situation of DM in the northeastern rural areas. Our present study investigated the prevalence, awareness and associated characteristics of DM in rural areas of Jilin Province, aiming to suggest more efforts for the prevention and control of DM. Methods: A multistage stratified random cluster sampling design was used in this cross-sectional study which took place in 2012. Data were collected by face-to-face interviews and physical examinations. Rao-Scott Chi-square test, t test and multivariate logistic regression analysis were used. Results: The estimated prevalence of DM in rural areas of Jilin province was 7.2%. DM was positively associated with age, Body mass index (BMI), hypotension, dyslipidemia and was high in participants with a family history of diabetes and those who exercise frequently, but low for high education level and married participants. 69.0% participants with DM were aware of their diabetes status, 88.2% of whom received treatment and 34.4% of whom had received treatment controlled their DM status. Conclusions: We observed a high prevalence and low awareness status of DM among the rural residents in Jilin Province, but the rate of effective control in those who have received treatment was considerable. The low rate of disease surveillance should draw health authority’s attention.
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Affiliation(s)
- Rui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Peng Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Xin Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Lingling Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Chunshi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Yuanyuan Song
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Yaqin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun 130021, Jilin, China.
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Petrovic M, Deschamps K, Verschueren SM, Bowling FL, Maganaris CN, Boulton AJM, Reeves ND. Is the metabolic cost of walking higher in people with diabetes? J Appl Physiol (1985) 2016; 120:55-62. [DOI: 10.1152/japplphysiol.00413.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/20/2015] [Indexed: 01/13/2023] Open
Abstract
People with diabetes walk slower and display biomechanical gait alterations compared with controls, but it remains unknown whether the metabolic cost of walking (CoW) is elevated. The aim of this study was to investigate the CoW and the lower limb concentric joint work as a major determinant of the CoW, in patients with diabetes and diabetic peripheral neuropathy (DPN). Thirty-one nondiabetic controls (Ctrl), 22 diabetic patients without peripheral neuropathy (DM), and 14 patients with moderate/severe DPN underwent gait analysis using a motion analysis system and force plates and treadmill walking using a gas analyzer to measure oxygen uptake. The CoW was significantly higher particularly in the DPN group compared with controls and also in the DM group (at selected speeds only) compared with controls, across a range of matched walking speeds. Despite the higher CoW in patients with diabetes, concentric lower limb joint work was significantly lower in DM and DPN groups compared with controls. The higher CoW is likely due to energetic inefficiencies associated with diabetes and DPN reflecting physiological and biomechanical characteristics. The lower concentric joint work in patients with diabetes might be a consequence of kinematic gait alterations and may represent a natural strategy aimed at minimizing the CoW.
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Affiliation(s)
- M. Petrovic
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - K. Deschamps
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium; and
| | - S. M. Verschueren
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium; and
| | - F. L. Bowling
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
| | - C. N. Maganaris
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - A. J. M. Boulton
- Faculty of Medical and Human Sciences, University of Manchester, Manchester, United Kingdom
| | - N. D. Reeves
- School of Healthcare Science, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
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Bucher S, Bauduceau B, Benattar-Zibi L, Bertin P, Berrut G, Corruble E, Danchin N, Delespierre T, Derumeaux G, Doucet J, Falissard B, Forette F, Hanon O, Ourabah R, Pasquier F, Piedvache C, Pinget M, Ringa V, Becquemont L. Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort - Baseline data. Prim Care Diabetes 2015; 9:267-274. [PMID: 25086913 DOI: 10.1016/j.pcd.2014.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/04/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
AIM S.AGES is a multicenter prospective cohort study of non-institutionalized patients aged 65 and over with atrial fibrillation, type 2 diabetes or chronic pain. Its objective is to describe the medical management in primary care. This article presents the baseline characteristics of subjects in the diabetes subcohort and compares the results to those from cohorts of older diabetic patients. METHODS From April 2009 to June 2011, 983 patients were included in the diabetes subcohort by 213 primary care providers. Demographic data, geriatric parameters and the history, characteristics and treatment of the diabetes were recorded at baseline. RESULTS The mean age was 76.7 ± 5.9 years. Most patients were living independently, with no cognitive impairment and in relatively good health. The duration of diabetes was 11.3 ± 8.7 years with average HbA1c of 6.9 ± 1.0%. 20% of patients had macrovascular disease, 33% renal failure, 14.6% ocular complication and 7.1% neuropathy. The first-line antidiabetic treatment was metformin (61.2%) and 18% of patients had used insulin. Treatment intensified with the worsening of diabetic symptoms. When compared to those from French and North American cohorts, the results showed increased complications and use of insulin with age, disease duration and severity. CONCLUSION Due to the method of recruitment, S.AGES patients were generally healthy with well-controlled diabetes. However, the results were consistent with those from other cohorts. Three-year follow-up is expected to study the management of diabetic patients aged 65 and over in primary care.
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Affiliation(s)
- Sophie Bucher
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France; INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France.
| | | | | | - Philippe Bertin
- Rheumatology Department, Limoges University Hospital, Limoges, France
| | - Gilles Berrut
- Clinical Gerontology, Nantes University Hospital, France
| | - Emmanuelle Corruble
- INSERM U 669, Paris-Sud Faculty of Medicine, University of Paris-Sud, Psychiatry Department, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Tiba Delespierre
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Geneviève Derumeaux
- Cardiovascular Functional Exploration, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Jean Doucet
- Internal Medicine, Geriatry and Therapeutics, Saint Julien University Hospital, Rouen University, Rouen, France
| | - Bruno Falissard
- INSERM U 669, Paris-Sud Faculty of Medicine, University of Paris-Sud, Biostatistics Department, Assistance Publique-Hôpitaux de Paris, Paul Brousse Hospital, Le Kremlin-Bicêtre, France
| | - Francoise Forette
- University of Paris Descartes, National Foundation of Gerontology, Paris, France
| | - Olivier Hanon
- University of Paris Descartes, EA 4468, AP-HP, Broca Hospital, Geriatrics Department, Paris, France
| | - Rissane Ourabah
- General Practice Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Florence Pasquier
- University of Lille Nord de France, UDSL, EA 1046, CHU, Lille, France
| | - Celine Piedvache
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Michel Pinget
- Endocrinology, Diabetes and Nutrition-Related Diseases (NUDE Unit), Strasbourg University Hospital and the European Centre for the Study of Diabetes (CeeD), University of Strasbourg, Strasbourg, France
| | - Virginie Ringa
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, University of Paris-Sud, Le Kremlin-Bicêtre, France
| | - Laurent Becquemont
- Pharmacology Department, Paris-Sud Faculty of Medicine, University of Paris-Sud, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France
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Eschwege E, Basdevant A, Crine A, Moisan C, Charles MA. Type 2 diabetes mellitus in France in 2012: Results from the ObEpi survey. DIABETES & METABOLISM 2015; 41:55-61. [DOI: 10.1016/j.diabet.2014.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/18/2014] [Indexed: 02/08/2023]
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Qi L, Feng L, Ding X, Mao D, Wang Y, Xiong H. Prevalence of diabetes and impaired fasting glucose among residents in the Three Gorges Reservoir Region, China. BMC Public Health 2014; 14:1152. [PMID: 25377171 PMCID: PMC4232641 DOI: 10.1186/1471-2458-14-1152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 09/15/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The Three Gorges Dam in China is the world's largest hydro-electric scheme in the contemporary world. After the construction of the Dam, great changes took place on the residents' lifestyles characterized by reduced physical activity due to the loss of arable land and a series of psychological problems caused by resettlement, which might be regarded as contributing factors to the development of diabetes in Three Gorges Reservoir Region (TGRR). However, there is no study that has been conducted targeting large population samples with the aim of determining the prevalence of diabetes in TGRR. This study purposed to estimate the prevalence of diabetes and impaired fasting glucose (IFG) in the adult population ≥18 years in TGRR and to evaluate the associated risk factors. METHODS A total of 3721 randomly selected adults, aged ≥18 years and having lived in TGRR for at least one year, participated in questionnaire-based interview from April to May 2013 and had their physical examinations and standard glucose taken. 75 g oral glucose tolerance test (OGTT) was conducted on the subjects with fasting glucose levels being ≥ 5.6 mmol/L. Diabetes and IFG were defined according to WHO 1999 criteria. RESULTS The age-standardized prevalence of diabetes and IFG were 7.6% (7.9% among men and 7.4% among women) and 9.0% (9.1% among men and 8.9% among women), respectively. Among the identified cases of diabetes in this study, 54.46% (171/314) were newly diagnosed. The prevalence of diabetes cases rose with age (4.0%, 4.5%, 8.1%, 11.2%, 12.4% and 12.9% among persons who were 18 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69 and ≥ 70 years of age, respectively). The results of multivariate logistic-regression analyses showed that the diabetes was significantly linked to age, family history of diabetes, central obesity, educational level and hypertension for both men and women. In addition, smoking was significantly associated with diabetes in men. CONCLUSIONS Diabetes has become a major public health problem in the TGRR with a large number of the cases undiagnosed. These results suggest that regular population-based diabetes screening should be conducted to identify early-stage diabetes and integrated strategies aimed at the prevention and treatment of diabetes initiated.
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Affiliation(s)
- Li Qi
- />Department of Military Epidemiology, College of Military Prevention, Third Military Medical University, Chongqing, China
- />Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Liangui Feng
- />Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
- />Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Xianbin Ding
- />Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Deqiang Mao
- />Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yulin Wang
- />Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Hongyan Xiong
- />Department of Military Epidemiology, College of Military Prevention, Third Military Medical University, Chongqing, China
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Traitement chirurgical conservateur du mal perforant plantaire en regard des têtes de métatarsiens chez le diabétique. Étude rétrospective cas-témoins. ANN CHIR PLAST ESTH 2014; 59:161-9. [DOI: 10.1016/j.anplas.2013.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 07/22/2013] [Indexed: 11/24/2022]
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Tamayo T, Rosenbauer J, Wild SH, Spijkerman AMW, Baan C, Forouhi NG, Herder C, Rathmann W. Diabetes in Europe: an update. Diabetes Res Clin Pract 2014; 103:206-17. [PMID: 24300019 DOI: 10.1016/j.diabres.2013.11.007] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Diabetes is among the leading causes of death in the IDF Europe Region (EUR), continues to increase in prevalence with diabetic macro- and microvascular complications resulting in increased disability and enormous healthcare costs. In 2013, the number of people with diabetes is estimated to be 56 million in EUR with an overall estimated prevalence of 8.5%. However, estimates of diabetes prevalence in 2013 vary widely in the 56 diverse countries in EUR from 2.4% in Moldova to 14.9% in Turkey. Trends in diabetes prevalence also vary between countries with stable prevalence since 2002 for many countries but a doubling of diabetes prevalence in Turkey. For 2035, a further increase of nearly 10 million people with diabetes is projected for the EUR. Prevalence of type 1 has also increased over the past 20 years in EUR and there was estimated to be 129,350 cases in children aged 0-14 years in 2013. Registries provide valid information on incidence of type 1 diabetes with more complete data available for children than for adults. There are large differences in distribution of risk factors for diabetes at the population level in EUR. Modifiable risk factors such as obesity, physical inactivity, smoking behaviour (including secondhand smoking), environmental pollutants, psychosocial factors and socioeconomic deprivation could be tackled to reduce the incidence of type 2 diabetes in Europe. In addition, diabetes management is a major challenge to health services in the European countries. Improved networking practices of health professionals and other stakeholders in combination with empowerment of people with diabetes and continuous quality monitoring need to be further developed in Europe.
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Affiliation(s)
- T Tamayo
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - S H Wild
- Centre for Population Health Sciences, University of Edinburgh, UK
| | - A M W Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C Baan
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N G Forouhi
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - C Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - W Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
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Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014; 103:137-49. [PMID: 24630390 DOI: 10.1016/j.diabres.2013.11.002] [Citation(s) in RCA: 2829] [Impact Index Per Article: 282.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Diabetes is a serious and increasing global health burden and estimates of prevalence are essential for appropriate allocation of resources and monitoring of trends. METHODS We conducted a literature search of studies reporting the age-specific prevalence for diabetes and used the Analytic Hierarchy Process to systematically select studies to generate estimates for 219 countries and territories. Estimates for countries without available source data were modelled from pooled estimates of countries that were similar in regard to geography, ethnicity, and economic development. Logistic regression was applied to generate smoothed age-specific prevalence estimates for adults 20-79 years which were then applied to population estimates for 2013 and 2035. RESULTS A total of 744 data sources were considered and 174 included, representing 130 countries. In 2013, 382 million people had diabetes; this number is expected to rise to 592 million by 2035. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. CONCLUSION The new estimates of diabetes in adults confirm the large burden of diabetes, especially in developing countries. Estimates will be updated annually including the most recent, high-quality data available.
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Affiliation(s)
- L Guariguata
- International Diabetes Federation, Brussels, Belgium.
| | - D R Whiting
- Directorate of Public Health, Medway Council, Chatham, United Kingdom
| | - I Hambleton
- University of the West Indies, Cave Hill, Barbados
| | - J Beagley
- International Diabetes Federation, Brussels, Belgium
| | - U Linnenkamp
- International Diabetes Federation, Brussels, Belgium
| | - J E Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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Pragmatic Diabetes Management in Nursing Homes: Individual Care Plan. J Am Med Dir Assoc 2013; 14:791-800. [DOI: 10.1016/j.jamda.2013.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/15/2013] [Accepted: 08/06/2013] [Indexed: 01/21/2023]
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20
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Flexor G, Zucman D, Berthé H, Meier F, Force G, Greder-Belan A, Billy C, Dupont C, Mortier E, Bizard A, Rouveix E, de Truchis P. Vieillissement et infection par le VIH : suivi de 149 patients âgés de plus de 60ans infectés par le VIH (COREVIH Île-de-France Ouest). Presse Med 2013; 42:e145-52. [DOI: 10.1016/j.lpm.2012.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/30/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022] Open
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Xu S, Ming J, Xing Y, Gao B, Yang C, Ji Q, Chen G. Regional differences in diabetes prevalence and awareness between coastal and interior provinces in China: a population-based cross-sectional study. BMC Public Health 2013; 13:299. [PMID: 23556471 PMCID: PMC3703289 DOI: 10.1186/1471-2458-13-299] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/14/2013] [Indexed: 12/14/2022] Open
Abstract
Background Most studies on diabetes prevalence and awareness in China are regional or about a single province, and differences between coastal and interior provinces have not been discussed even in the nation-based studies. The aim of this study was to determine regional differences in diabetes prevalence and awareness between coastal and interior provinces, and to identify the factors associated with diabetes prevalence and awareness. Methods Provinces Fujian and Shaanxi were chosen to represent the coastal and interior provinces, respectively. The data of two provinces were from the China National Diabetes and Metabolic Disorders Study 2007–08. A total of 5926 people (Fujian 2672 and Shaanxi 3254) aged above 20 years were included as participants in the study. Age-standardized prevalence and awareness were compared between provinces. Logistic regression analysis was performed not only to examine risk factors of diabetes prevalence and awareness, but also to examine the association between regional difference and diabetes prevalence and awareness. Results The age-standardized prevalence of diabetes in Fujian was higher than that in Shaanxi among total (11.5% vs. 8.0%), male (13.6% vs. 8.9%) and female (10.8% vs. 7.4%) populations. Diabetes awareness for total and male population in Fujian was higher than that in Shaanxi (42.3% vs. 34.9% and 46.8% vs. 35.2%, respectively). Age, sex, central obesity, family history of diabetes, and metabolic risk factors were all significantly associated with diabetes prevalence in both provinces. However, cigarette smoking was significantly associated with prevalence in Fujian and physical activity was significantly associated with the prevalence in Shaanxi. Family history of diabetes was the only independent risk factor of diabetes awareness in both provinces. After being adjusted for all listed risk factors, the regional difference of diabetes prevalence was still significant, but that of diabetes awareness lost significance. Conclusions Both diabetes prevalence and awareness were higher in coastal provinces and lower in interior provinces in China. Lifestyle risk factors were found to contribute differently to diabetes prevalence in the two provinces and other unknown risk factors may account for differences of diabetes prevalence between provinces. In addition, family history of diabetes was the only independent risk factor in both provinces.
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Affiliation(s)
| | | | | | | | | | - Qiuhe Ji
- Department of Endocrinology, First Affiliated Hospital of Fourth Military Medical University, 169 Changle Road West, Xi'an, China.
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Schulze-Döbold C, Erginay A, Robert N, Chabouis A, Massin P. Ophdiat(®): five-year experience of a telemedical screening programme for diabetic retinopathy in Paris and the surrounding area. DIABETES & METABOLISM 2012; 38:450-7. [PMID: 22765981 DOI: 10.1016/j.diabet.2012.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 05/22/2012] [Accepted: 05/22/2012] [Indexed: 10/28/2022]
Abstract
AIM This report describes our 5 years of experience with the ophthalmological diabetes telemedical network Ophdiat(®), designed to screen for diabetic retinopathy. METHODS Seventeen hospitals, 11 primary healthcare centres and two prisons in the Paris area were gradually equipped with a non-mydriatic funduscopic camera between June 2004 and December 2009. Photos were taken by trained orthoptists and nurses, and interpreted by an average of seven certified ophthalmologists. The software was updated twice in 2008. RESULTS In all, 38,596 patients were screened during 51,741 examinations between June 2004 and December 2009. Of these patients, 13,726 (26.55%) were referred to an ophthalmologist because of unreadable photographs (9.94%), advanced stages of retinopathy (14.71%) or concomitant eye diseases (1.90%). Patients screened in hospitals and prisons exhibited a greater prevalence of retinopathy and at more advanced stages. CONCLUSION Telemedicine is a screening method that is well adapted for diabetic patients. In view of the increasing number of such patients and the decreasing number of ophthalmologists, expansion of the Ophdiat(®) screening network is desirable.
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Affiliation(s)
- C Schulze-Döbold
- Assistance publique-Hôpitaux de Paris, Paris-Diderot University, Ophthalmology Department, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris cedex 10, France
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Azogui-Lévy S, Dray-Spira R. Sociodemographic factors associated with the dental health of persons with diabetes in France. SPECIAL CARE IN DENTISTRY 2012; 32:142-9. [DOI: 10.1111/j.1754-4505.2012.00257.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saint-Lary O, Boisnault P, Naiditch M, Szidon P, Duhot D, Bourgueil Y, Pelletier-Fleury N. Performance scores in general practice: a comparison between the clinical versus medication-based approach to identify target populations. PLoS One 2012; 7:e35721. [PMID: 22536430 PMCID: PMC3334971 DOI: 10.1371/journal.pone.0035721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 03/20/2012] [Indexed: 01/13/2023] Open
Abstract
Context From one country to another, the pay-for-performance mechanisms differ on one significant point: the identification of target populations, that is, populations which serve as a basis for calculating the indicators. The aim of this study was to compare clinical versus medication-based identification of populations of patients with diabetes and hypertension over the age of 50 (for men) or 60 (for women), and any consequences this may have on the calculation of P4P indicators. Methods A comparative, retrospective, observational study was carried out with clinical and prescription data from a panel of general practitioners (GPs), the Observatory of General Medicine (OMG) for the year 2007. Two indicators regarding the prescription for statins and aspirin in these populations were calculated. Results We analyzed data from 21.690 patients collected by 61 GPs via electronic medical files. Following the clinical-based approach, 2.278 patients were diabetic, 8,271 had hypertension and 1.539 had both against respectively 1.730, 8.511 and 1.304 following the medication-based approach (% agreement = 96%, kappa = 0.69). The main reasons for these differences were: forgetting to code the morbidities in the clinical approach, not taking into account the population of patients who were given life style and diet rules only or taking into account patients for whom morbidities other than hypertension could justify the use of antihypertensive drugs in the medication-based approach. The mean (confidence interval) per doctor was 33.7% (31.5–35.9) for statin indicator and 38.4% (35.4–41.4) for aspirin indicator when the target populations were identified on the basis of clinical criteria whereas they were 37.9% (36.3–39.4) and 43.8% (41.4–46.3) on the basis of treatment criteria. Conclusion The two approaches yield very “similar” scores but these scores cover different realities and offer food for thought on the possible usage of these indicators in the framework of P4P programmes.
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Kaiser A, Vollenweider P, Waeber G, Marques-Vidal P. Prevalence, awareness and treatment of type 2 diabetes mellitus in Switzerland: the CoLaus study. Diabet Med 2012; 29:190-7. [PMID: 21883431 DOI: 10.1111/j.1464-5491.2011.03422.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To assess the prevalence, awareness and treatment levels of Type 2 diabetes in a Swiss city. METHODS Population-based cross-sectional study of 6181 subjects (3246 women) aged 35-75 years living in Lausanne, Switzerland. Type 2 diabetes was defined as fasting plasma glucose ≥ 7 mmol/l and/or oral hypoglycaemic treatment and/or insulin. RESULTS Total prevalence of Type 2 diabetes was 6.3% (95% confidence interval: 5.7-7.0%), higher in men (9.1%) than in women (3.8%, P < 0.001) and increased with age. Two-thirds (65.3%; 60.4-70.0%) of participants with Type 2 diabetes were aware of their status and among those aware 86.0% (81.5-90.3%) were treated. Treatment was more frequent in men (91.3%) than in women (75.9%, P < 0.001). Two-thirds of those treated for Type 2 diabetes were on monotherapy. Biguanides were prescribed in 65.0% of Type 2 diabetes patients and represented 48% of all antidiabetic drugs. Multivariable analysis showed male gender, increasing age, waist or BMI to be positively associated with prevalence of Type 2 diabetes, while leisure-time physical activity and alcohol consumption were negatively associated. Among participants presenting with Type 2 diabetes, increasing age was positively associated with awareness of Type 2 diabetes. Among subjects diagnosed with Type 2 diabetes, male gender and increasing age were positively associated with treatment. CONCLUSION Prevalence of Type 2 diabetes in Switzerland is estimated to be between 5.7% and 7.0%. Two-thirds of patients with Type 2 diabetes are aware of their status, and over three quarters of those aware are treated.
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Affiliation(s)
- A Kaiser
- Department of Medicine Institute of Social and Preventive Medicine, Faculty of Biology and Medicine and Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Debussche X, Rollot O, Le Pommelet C, Fianu A, Le Moullec N, Régnier C, Boyer M, Cogne M, Bakiri F, Schwager J, Favier F. Quarterly individual outpatients lifestyle counseling after initial inpatients education on type 2 diabetes: The REDIA Prev-2 randomized controlled trial in Reunion Island. DIABETES & METABOLISM 2012; 38:46-53. [DOI: 10.1016/j.diabet.2011.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Revised: 07/23/2011] [Accepted: 07/24/2011] [Indexed: 11/25/2022]
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Detournay B, Simon D, Guillausseau PJ, Joly D, Verges B, Attali C, Clement O, Briand Y, Delaitre O. Chronic kidney disease in type 2 diabetes patients in France: prevalence, influence of glycaemic control and implications for the pharmacological management of diabetes. DIABETES & METABOLISM 2012; 38:102-12. [PMID: 22252014 DOI: 10.1016/j.diabet.2011.11.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 11/25/2011] [Accepted: 11/25/2011] [Indexed: 12/21/2022]
Abstract
AIM Type 2 diabetes mellitus (T2DM) is often associated with chronic kidney disease. For this reason, this article reviews the relationship between treatment of T2DM and renal disease. METHOD The review presents the recent French data on the management of diabetes in patients with renal impairment, and discusses the implications of renal disease for the treatment of such patients. Prescribing data are presented for various antidiabetic treatments, and the use of the more commonly prescribed medications is discussed with reference to T2DM patients with renal disease. RESULTS In France, it is estimated that 4-5% of the general population has T2DM and that almost 40% of patients with end-stage renal failure have diabetes. Diabetes and renal disease are both risk factors for cardiovascular morbidity and mortality. Glycaemic control is pivotal in T2DM patients for minimizing the risk of vascular complications and hypoglycaemic episodes, particularly in patients with renal disease who also have a higher risk of hypoglycaemia. Whereas poorly controlled glycaemia increases the risk of renal disease and its progression, the risk is diminished in patients treated intensively for diabetes and in those who achieve stable glycaemic control. Intensive multitargeted treatment can also help to decrease cardiovascular morbidity and mortality, especially if started early in patients who have not yet developed macrovascular complications. CONCLUSION In recent years, considerable improvement has been observed in France regarding the follow-up of diabetic patients. Less extensive, but nonetheless significant, improvement has also been observed in glycaemic control. However, even though treatment decisions generally take renal function into account, some at-risk treatments are often still being used in patients with renal insufficiency.
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Affiliation(s)
- B Detournay
- Cemka-Eval, 43 boulevard du Maréchal-Joffre, Bourg-la-Reine, France.
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Charbonnel B, Penfornis A, Varroud-Vial M, Kusnik-Joinville O, Detournay B. Insulin therapy for diabetes mellitus: treatment regimens and associated costs. DIABETES & METABOLISM 2011; 38:156-63. [PMID: 22172400 DOI: 10.1016/j.diabet.2011.10.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 10/26/2011] [Accepted: 10/27/2011] [Indexed: 02/05/2023]
Abstract
AIMS To describe insulin therapy in patients with diabetes, to determine treatment costs and to compare costs among treatment regimens. METHODS This observational study was performed by 734 French pharmacists. Adult patients filling an insulin prescription were invited to participate. Participants provided information on their diabetes history and management. Levels of intensification of insulin therapy were determined by the number of injections in type 1 diabetes mellitus (T1DM) patients, and by the different schemes used in type 2 (T2DM) patients, such as basal/intermediate-acting insulin only, and regimens using both basal and rapid-acting insulin. Costs were evaluated according to official medication costs, nurse visits and glucose monitoring kits. RESULTS A total of 361 patients with T1DM and 1902 with T2DM were enrolled in the survey. Patients with T1DM more frequently took 1-2 injections per day (46.3% of patients) and used single-dose basal insulin together with ≥1 dose of rapid insulin (43.8%). Patients with T2DM used multiple treatment regimens, with 58 different combinations documented. Most took basal/intermediate insulin only (42.5%) or combinations of basal/intermediate and rapid insulins (52.7%). Mean cost of insulin therapy was €27.4/week for T1DM and €45.4/week for T2DM. In T1DM, insulin was the biggest cost component and increased with the number of injections/day. In T2DM, nurse visits were the most important cost contributors irrespective of treatment regimen. Overall, the cost of insulin therapy increased with the complexity of the insulin schemes. CONCLUSION Considerable heterogeneity is found in insulin treatment regimens used in everyday diabetes care. Payers should consider the full costs associated with the use of insulin rather than the cost of insulin alone. Treatment algorithms to harmonize insulin therapy should help to improve care, while encouraging patients to self-inject insulin should help to reduce costs.
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Affiliation(s)
- B Charbonnel
- Service de diabétologie, CHU de Nantes, Nantes cedex 1, France
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Goulet V, Hebert M, Hedberg C, Laurent E, Vaillant V, De Valk H, Desenclos JC. Incidence of Listeriosis and Related Mortality Among Groups at Risk of Acquiring Listeriosis. Clin Infect Dis 2011; 54:652-60. [DOI: 10.1093/cid/cir902] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94:311-21. [PMID: 22079683 DOI: 10.1016/j.diabres.2011.10.029] [Citation(s) in RCA: 2592] [Impact Index Per Article: 199.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 10/20/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Diabetes is an increasingly important condition globally and robust estimates of its prevalence are required for allocating resources. METHODS Data sources from 1980 to April 2011 were sought and characterised. The Analytic Hierarchy Process (AHP) was used to select the most appropriate study or studies for each country, and estimates for countries without data were modelled. A logistic regression model was used to generate smoothed age-specific estimates which were applied to UN population estimates for 2011. RESULTS A total of 565 data sources were reviewed, of which 170 sources from 110 countries were selected. In 2011 there are 366 million people with diabetes, and this is expected to rise to 552 million by 2030. Most people with diabetes live in low- and middle-income countries, and these countries will also see the greatest increase over the next 19 years. DISCUSSION This paper builds on previous IDF estimates and shows that the global diabetes epidemic continues to grow. Recent studies show that previous estimates have been very conservative. The new IDF estimates use a simple and transparent approach and are consistent with recent estimates from the Global Burden of Disease study. IDF estimates will be updated annually.
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Mbaye MN, Niang K, Sarr A, Mbaye A, Diedhiou D, Ndao MD, Kane AD, Pessinaba S, Diack B, Kane M, Ka-Cissé MS, Diao M, Diop SN, Kane A. Aspects épidémiologiques du diabète au Sénégal : résultats d’une enquête sur les facteurs de risque cardiovasculaire dans la ville de Saint-Louis. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1957-2557(11)70343-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY, Chen CC, Lee DD, Chang YT, Wang WJ, Liu HN. Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study. J Am Acad Dermatol 2011; 65:949-56. [PMID: 21616562 DOI: 10.1016/j.jaad.2010.08.032] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Revised: 08/26/2010] [Accepted: 08/30/2010] [Indexed: 02/08/2023]
Abstract
BACKGROUND Alopecia areata (AA) is considered an autoimmune disease with undetermined pathogenesis. Age at onset predicts distinct outcomes. A nationwide study of the relationship of AA with associated diseases stratified by onset age has rarely been reported. OBJECTIVE We sought to clarify the role of atopic and autoimmune diseases in AA, thereby better understanding its pathogenesis. METHODS A total of 4334 patients with AA were identified from the National Health Insurance Database in Taiwan from 1996 to 2008. A national representative cohort of 784,158 persons served as control subjects. RESULTS Among patients with AA, there were significant associations with vitiligo, lupus erythematosus, psoriasis, atopic dermatitis, autoimmune thyroid disease, and allergic rhinitis. Different ages at onset resulted in disparate comorbidities. Increased risk of atopic dermatitis (odds ratio [OR] 3.82, 95% confidence interval 2.67-5.45) and lupus erythematosus (OR 9.76, 95% confidence interval 3.05-31.21) were found in childhood AA younger than 10 years. Additional diseases including psoriasis (OR 2.43) and rheumatoid arthritis (OR 2.57) appeared at onset age 11 to 20 years. Most atopic and autoimmune diseases were observed at onset ages of 21 to 60 years. With onset age older than 60 years, thyroid disease (OR 2.52) was highly related to AA. Moreover, patients with AA had higher risk for more coexisting diseases than control subjects. LIMITATIONS We could not differentiate hypothyroidism from hyperthyroidism. CONCLUSIONS AA is related to various atopic and autoimmune diseases. Different associated diseases in each onset age group of AA can allow clinician to efficiently investigate specific comorbidities.
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Affiliation(s)
- Szu-Ying Chu
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
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Prevalence of treated diabetes: Geographical variations at the small-area level and their association with area-level characteristics. A multilevel analysis in Southeastern France. DIABETES & METABOLISM 2010; 37:39-46. [PMID: 20980182 DOI: 10.1016/j.diabet.2010.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/13/2010] [Accepted: 07/17/2010] [Indexed: 01/27/2023]
Abstract
AIM This study estimated geographical variations in the prevalence of treated diabetes (TD) at the small-area level in Southeastern France to determine whether or not the characteristics of these areas (in particular, socioeconomic status or "SES") are associated with TD independent of person-level factors. METHODS The study used drug reimbursement data for 2008 from the General Health Insurance Scheme in Southeastern France for beneficiaries aged 18 years or over. TD patients were defined as those to whom oral antidiabetic drugs or insulin had been dispensed at least three times within the year. Area (canton) characteristics associated with the prevalence of TD were studied using multilevel Poisson regression. RESULTS In 2008, the crude prevalence of TD in adults in Southeastern France was 5.14%. In addition, TD prevalence was significantly higher in the more deprived and population-dense cantons independent of person-level factors (age, gender, low SES). CONCLUSION This study found a positive association between area deprivation and TD, and adds further evidence to the scanty data so far available on this topic. This finding should contribute to pinpointing priority action areas for programmes of diabetes prevention. However, more research is needed to further elucidate the mechanism(s) linking area deprivation and diabetes.
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Characteristics and management of diabetic patients hospitalized for myocardial infarction in France. DIABETES & METABOLISM 2010; 36:129-36. [DOI: 10.1016/j.diabet.2009.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 10/02/2009] [Accepted: 10/05/2009] [Indexed: 11/23/2022]
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Mahmud M, Mazza D. Preconception care of women with diabetes: a review of current guideline recommendations. BMC WOMENS HEALTH 2010; 10:5. [PMID: 20113524 PMCID: PMC2834595 DOI: 10.1186/1472-6874-10-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 01/31/2010] [Indexed: 11/17/2022]
Abstract
Background The prevalence of type 2 diabetes mellitus (T2DM) continues to rise worldwide. More women from developing countries who are in the reproductive age group have diabetes resulting in more pregnancies complicated by T2DM, and placing both mother and foetus at higher risk. Management of these risks is best achieved through comprehensive preconception care and glycaemic control, both prior to, and during pregnancy. The aim of this review was to compare the quality and content of current guidelines concerned with the preconception care of women with diabetes and to develop a summary of recommendations to assist in the management of diabetic women contemplating pregnancy. Methods Relevant clinical guidelines were identified through a search of several databases (MEDLINE, SCOPUS and The Cochrane Library) and relevant websites. Five guidelines were identified. Each guideline was assessed for quality using the AGREE instrument. Guideline recommendations were extracted, compared and contrasted. Results All guidelines were assessed as being of high quality and strongly recommended for use in practice. All were consistent in counselling about the risk of congenital malformation related to uncontrolled blood sugar preconceptionally, ensuring adequate contraception until glycaemic control is achieved, use of HBA1C to monitor metabolic control, when to commence insulin and switching from ACE inhibitors to other antihypertensives. Major differences were in the targets recommended for optimal metabolic control and opinion regarding the usage of metformin as an adjunct or alternative treatment before or during pregnancy. Conclusions International guidelines for the care of women with diabetes who are contemplating pregnancy are consistent in their recommendations; however some are more comprehensive than others. Having established current standards for the preconception care of diabetic women, there is now a need to focus on guideline implementation through an examination of the barriers and enablers to successful implementation, and the applicability of the recommendations in the local setting.
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Affiliation(s)
- Maimunah Mahmud
- Department of General Practice, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
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Current literature in diabetes. Diabetes Metab Res Rev 2009; 25:i-x. [PMID: 19790194 DOI: 10.1002/dmrr.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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