Prevalence of diabetes in Poland: a combined analysis of national databases

Why Should Diabetic Women Be Active?-The Role of Personality, Self-Esteem, Body-Esteem, and Imagery

Diabetes is one of the fastest spreading diseases in the 21st century. The aim of the study is twofold: (1) to find differences in personality traits, self-esteem, body-esteem, and imagery between healthy women and women with diabetes; (2) to verify whether there are differences in the analyzed factors among women with diabetes who engage in sports compared to those who do not. We used 3 questionnaires: Imagination in Sport-short form, Self-Esteem Scale (SES), and BFIS Personality, which were tested online. We found that women with diabetes were characterized by significantly higher neuroticism, lower extraversion, and higher conscientiousness (marginally significant). We also found that women with diabetes who practice sport rated their bodies more highly in terms of sexual attractiveness and made better use of imagined affirmations than women without diabetes who were not active. Our study provides new insights into diabetics in terms of women navigating the disease.

Public Expectations and Needs Related to Type 2 Diabetes Prevention: A Population-Based Cross-Sectional Study in Poland

Objective: This study aimed to understand the public's expectations regarding type 2 diabetes prevention and to identify factors associated with willingness to participate in preventive activities among adults in Poland. Methods: A cross-sectional survey was carried out using a computer-assisted web interview (CAWI) on a representative sample of 1,046 adults in Poland. A non-probability quota sampling method was used. A study tool was a self-prepared questionnaire. Results: Most respondents (77.3%) declared willingness to participate in preventive activities. Consultation with a diabetologist (75.1%) or family doctor consultation (74.9%) were the most often selected. Lifestyle interventions in the form of dietary and culinary workshops (58.1%) were the least chosen. Having higher education (OR = 3.83, 1.64-8.94, p = 0.002), chronic diseases (OR = 1.36, 1.01-1.85, p = 0.04), and a history of diabetes in the family (OR = 1.67, 1.21-2.30, p = 0.002) were significantly associated with a higher interest in type 2 diabetes prevention. Conclusion: The adults in Poland are keen on participating in diabetes prevention programs, mostly those based on medical counselling rather than lifestyle-oriented interventions. Educational level was the most important factor associated with willingness to participate in type 2 diabetes prevention.

The cancer-risk variant frequency among Polish population reported by the first national whole-genome sequencing study

Introduction

Population-based cancer screening has raised many controversies in recent years, not only regarding the costs but also regarding the ethical nature and issues related to variant interpretation. Nowadays, genetic cancer screening standards are different in every country and usually encompass only individuals with a personal or family history of relevant cancer.

Methods

Here we performed a broad genetic screening for cancer-related rare germline variants on population data from the Thousand Polish Genomes database based on 1076 Polish unrelated individuals that underwent whole genome sequencing (WGS).

Results

We identified 19 551 rare variants in 806 genes related to oncological diseases, among them 89% have been located in non-coding regions. The combined BRCA1/BRCA2 pathogenic/likely pathogenic according to ClinVar allele frequency in the unselected population of 1076 Poles was 0.42%, corresponding to nine carriers.

Discussion

Altogether, on the population level, we found especially problematic the assessment of the pathogenicity of variants and the relation of ACMG guidelines to the population frequency. Some of the variants may be overinterpreted as disease-causing due to their rarity or lack of annotation in the databases. On the other hand, some relevant variants may have been overseen given that there is little pooled population whole genome data on oncology. Before population WGS screening will become a standard, further studies are needed to assess the frequency of the variants suspected to be pathogenic on the population level and with reporting of likely benign variants.

Public knowledge and awareness of diabetes mellitus, its risk factors, complications, and prevention methods among adults in Poland-A 2022 nationwide cross-sectional survey

Introduction

Regular monitoring of public awareness of diabetes is necessary to provide effective educational and preventive strategies. This study aimed to assess (1) public knowledge and awareness of diabetes among adults in Poland, as well as (2) to identify sociodemographic factors associated with public awareness of diabetes.

Methods

This cross-sectional survey was carried out between 24 and 27 June 2022, on a non-probability random quota sample of 1,051 adults in Poland. The questionnaire included ten questions related to the awareness of risk factors, symptoms, and complications of diabetes.

Results

Among the respondents, 10.5% had diabetes and 43.8% declared that they have a history of diabetes in their family. Only 17.3% of respondents declared a good level of knowledge of diabetes. Out of 10 symptoms of diabetes analyzed in this study, high blood sugar (80.7%) and chronic fatigue (74.6%) were the most recognized. Out of 8 diabetes risk factors analyzed in this study, overweight/obesity (80.4%) and unhealthy diet (74.1%) were the most recognized diabetes risk factors, while only 22.7% of respondents indicated tobacco use. The diabetic foot was the most recognized diabetes complication (79.8%), but approximately half of the respondents indicated vision problems (56.9%), kidney damage (52.1%), or cardiovascular diseases (50.2%) as diabetes complications. Female gender, having higher education and having a family member with diabetes were the most im-portent factors associated (p < 0.05) with a higher level of awareness of diabetes.

Conclusions

This study demonstrated insufficient public awareness of diabetes among adults in Poland. Gender and educational level were the most important factors significantly associated with the awareness of the selected aspects of diabetes, while self-reported financial situation and place of residence had none or marginal influence. The presented data manifest the importance of adopting a comprehensive education strategy regarding diabetes in Poland.

Local Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers

Background: Diabetes mellitus is one of the most common metabolic diseases. The most serious complication of diabetes is diabetic foot ulcer, which affects several million people around the world each year. In recent years, increasingly modern methods of physical medicine including hyperbaric oxygen therapy have been used often in the complex therapy of this complication. Methods: This study included 45 patients, 24 male (53.3%) and 21 female (46.6%), whose age was between 49 and 83 years (mean age: 66.7 ± 8.8 years) with diabetes lasting for 1.5-18 years, who underwent local hyperbaric oxygen therapy at the pressure of 2.5 ATA (30 exposures for 30 min each) due to diabetic foot ulcers. The progress in wound healing before and after the end of therapy was evaluated by computerized planimetry, and the pain intensity was assessed with the use of a VAS. Results: The analysis of results showed a statistically significant reduction in the wound surface area after the treatment, from 8.54 ± 3.34 cm to 4.23 ± 3.23 cm² (p = 0.000001). In 5 patients (11.1%), the wounds were healed completely. In 25 patients (55.5%), the topical state of the wound surface was significantly decreased by 50% on average. There was also a significant reduction in the perceived pain on the VAS in all examined patients from 4.64 ± 1.68 points before treatment to 1.51 ± 0.92 points after treatment (p = 0.000001). Conclusions: The application of local HBO therapy in the treatment of diabetic foot ulcers accelerates the ulcer healing process, as judged in objective planimetric assessment, and reduces the intensity of perceived pain ailments.

The Prevalence of Diabetes among Hypertensive Polish in Relation to Sex-Difference in Body Mass Index, Waist Circumference, Body Fat Percentage and Age

Background: Little is known about sex differences in the risk of type 2 diabetes (DM2) development related to body fat depot. The main aim of this study was to assess sex-specific differences in the prevalence of diabetes in the relation to body mass, body mass index (BMI), waist circumference (WC), and calculated body fat percentage (BF), adjusted by physical activity, in younger and older hypertensive adults. Subjects/Methods: The survey enrolled 12,289 adult hypertensive outpatients with body weight, height, and WC reported by their physicians across Poland. Prevalence of diabetes was plotted against body mass, BMI, WC, and calculated BF and adjusted by the self-reported level of physical activity. Results: In our cohort, younger women (<60 years) with BMI < 25.0 kg/m2 had lower adjusted prevalence of diabetes than corresponding men (3.4% vs. 6.5%), while among older (≥60 years) with BMI < 25.0 kg/m2, the prevalence of diabetes was greater in women than in men (19.4% vs. 11.2%). A 25% probability of diabetes was observed for younger women with lower BMI than younger men (32.1 kg/m2 and 35.3 kg/m2, respectively) and WC (100.7 cm and 116.1 cm, respectively) but greater BF (45.5% and 38.9%, respectively). The corresponding differences in BMI and WC in older ones were much smaller (27.6 kg/m2 and 27.2 kg/m2, respectively; 83.7 cm and 85.6 cm, respectively), but not for BF (40.7% and 30.1%, respectively). A doubling of diabetes probability (from 25% to 50%), adjusted by physical activity, was attributable to the lower increase in BMI and WC and BF in women than in men (6.3 vs. 9.8 kg/m2, 25.0 vs. 36.1 cm, and 6.5 vs. 10.8%, for younger, and 8.1 vs. 11.3 kg/m2, 26.2 vs. 73.2 cm and 8.8 vs. 13.3%, for older). Conclusions: This study shows a lower probability of diabetes in younger women than younger men with normal weight BMI ranges, adjusted to physical activity. This probability is greater for hypertensive women, regardless of age, due to the increase in BMI/WC and BF values adjusted for physical activity.

Twenty-Year Mortality Trends in Patients with Kidney Disease in Poland with the Use of the Years of Life Lost Measure, 2000-2019

Due to the significant socioeconomic burden of kidney diseases, we decided to analyse years of life lost (YLLs) from this cause in Poland between the years 2000 and 2019. The standard expected years of life lost (SEYLL) measure was used to calculate the number of YLLs, the value of which was related to the size of the study population and calculated per 100,000 persons (SEYLLp). A time trend analysis was performed using the Joinpoint regression method. In 2000, the number of YLLs for the entire population was 72,795 (SEYLLp = 190.3 years). After a period of minor changes between 2000 and 2011 (increasing at 0.9% per year), the YLL index rapidly declined between 2011 and 2015 (at −15.4% yearly) and then increased in the last years of the study period (at 12.5% yearly). These changes resulted in a decrease in the number of YLLs to 57,278 in 2019 (SEYLLp = 149.2). The deteriorating health status of Poles after 2015 most likely was caused by the aging of the population, as well as the increasing incidence of risk factors, in particular diabetes and arterial hypertension.

HCV Genotype Has No Influence on the Incidence of Diabetes-EpiTer Multicentre Study

HCV infection is one of the main reasons for liver cirrhosis and hepatocellular carcinoma. In recent years, one finds more and more extrahepatic manifestations of HCV infection, including its possible influence on the development of diabetes. In the presented work, one finds the frequency analysis of the incidence of diabetes among 2898 HCV infected patients treated in Poland, and the assessment of their relevance to the HCV genotype and the progression of fibrosis. The results indicate that the hepatitis C infection seems to be a risk factor for diabetes in persons with more advanced liver fibrosis, for older people, and for the male gender. Thus, one found no differences regarding the frequency of its incidence depending on HCV genotype, including genotype 3.

The association among health behaviors, shift work and chronic morbidity: A cross-sectional study on nurses working in full-time positions

Background: Nurses are known to work in conditions of stress and physical overload. Health behaviors are modifiable factors that may reduce the adverse effects of work on general health. The present study examined health-related behaviors and their association with current night shift work and chronic morbidity among female nurses.

Design and Method: Four hundred seventy-two female nurses (M ± SD = 44.28±7.14 years) self-reported their health habits, physical activity, body mass index (BMI), and chronic disorders that required current treatment. Instruments used in the study consisted of an author-developed questionnaire and the Health Behavior Inventory (HBI). Reported diagnoses were classified as cardio-vascular, gastro-intestinal, malignant neoplastic, endocrine, or other.

Results: The most common reported disorders were cardiovascular disorders (5.7% of nurses) followed by other (7.6%), endocrine (7.4%), gastro-intestinal (6.4%), and malignancy (0.2%). On average, health-related behaviors on the HBI were average (83.49 ± 14.33). Overweight and/or obesity (i.e., BMI ≥25 kg/m²) were reported by 41.5% of nurses, 24.2% were current smokers, and 36% reported no recreational physical activity. The remaining 64% of nurses who performed physical activity did not report activity levels that met World Health Organization recommendations. Physical activity and HBI scores (total and subscales; i.e., positive attitude, preventive behaviors, proper dietary habits, health-related practices) were not associated with current night shift work or morbidity.

Conclusion: Health-promoting programs are needed to support weight control and promote health-related behaviors among nurses. Future research should identify potential barriers to healthy lifestyle recommendations in the workplace.

The influence of frailty syndrome on quality of life in elderly patients with type 2 diabetes

Introduction

There have been no comprehensive studies that assess the impact of frailty syndrome on quality of life (QoL) of patients with diagnosed type 2 diabetes. The purpose of the study was to assess the impact of frailty syndrome on QoL and depression symptoms of patients with type 2 diabetes.

Methods

The study included 148 consecutive patients (aged ≥ 60y). The patients were divided into two groups according to the prevalence of the frailty syndrome: robust and frailty. For all of the patients that were included in the study, we used the Polish version of validated instruments: ADDQoL, TFI and BDI.

Results

In the study group, 43.2% had been diagnosed with frailty syndrome. An analysis of QoL assessment depending on the prevalence of the frailty syndrome showed that patients who were robust (without recognized frailty syndrome) assessed QoL significantly better than patients with coexisting frailty syndrome. Robust patients did not have any severe depressive symptoms, whereas in the group of patients with the frailty syndrome 43.8% of the patients had a depression. 70.2% of the patients without any depressive symptoms were robust patients, meanwhile only 14% of the patients had frailty syndrome recognized.

Conclusions

Frailty syndrome occurred in 43 percent of the patients with type 2 diabetes. This has a negative impact on QoL of patients. Depression is more common in patients with the frailty syndrome and diabetes.

Analysis of medical expenses of inpatients with diabetes: China's Eastern, Central, and Western regions (2013-2015)

OBJECTIVE

With the continuing rise in the global incidence of diabetes, the prevention of diabetes and control of associated medical expenses has become a public health issue worldwide. This study aims to identify the medical expenses of patients with diabetes in different regions of China and examine the differences in inpatient medical expenses and the impacts of them on these patients.

STUDY DESIGN

This study is a longitudinal analysis of medical expenses for inpatients with diabetes for different years; horizontal analysis of medical expenses among different regions; and literature review.

METHODS

Data were derived from China's Medical Insurance Department database. We selected inpatients with diabetes in the eastern, central, and western regions of China for the period 2013-2015 and randomly selected data through systematic sampling.

RESULTS

Among the 4150 patients with diabetes considered in this study, the patients' medical expenses were found to differ significantly across regions, years, ages, medical insurance types, medical institution levels, total medical expenses, medical insurance fund payments, and out-of-pocket (OOP) expenses. In addition, there were significant differences in total medical expenses for male and female patients. Furthermore, medical insurance type, patients' age, medical institution level, and year significantly influenced total medical expenses.

CONCLUSIONS

Inpatients with diabetes in different regions exhibited significant differences in total medical expenses, medical insurance fund payments, and OOP expenses. China should invest more in chronic disease treatment in its central and western regions, narrow the regional differences in medical expenses, and endeavor to ensure equity in the availability and cost of medical services. Moreover, patients with diabetes must be encouraged to access primary care to reduce their medical expenses.

Diabetic autonomic neuropathy of the gastrointestinal tract

Diabetes is a metabolic disease leading to the development of numerous health complications. In developed countries, it is the main cause of blindness, end-stage renal disease, and non-traumatic amputation of the lower limbs. Neuropathy is the most common chronic complication of diabetes. A long-term course of a metabolically unbalanced disease causing damage to the autonomic nervous system of the digestive tract results in the development of many complications, such as intensification of gastro-oesophageal reflux disease, gastroparesis, chronic diarrhoea or faecal incontinence.

Polish Adaptation of the Self-Care of Diabetes Inventory (SCODI)

PURPOSE

As the guidelines indicate, education and self-care in diabetic patients are essential elements in the treatment process. The efficient evaluation of the level of self-care will enable the patient's needs to be identified and education and care to be optimised. The Self-Care of Diabetes Inventory (SCODI) is a valid and reliable tool which can measure self-care behaviours among patients with diabetes. The purpose of this study was to assess the reliability of the Polish version of the SCODI.

METHODS

The World Health Organization (WHO) translation protocol was used for the translation and cultural adaptation of the English version of the SCODI into Polish. The study included 276 Polish patients with type 2 diabetes (mean age 61.28±12.02 years). There were 145 men and 131 women in the study. The internal consistency of the SCODI was evaluated using Cronbach's Alpha.

RESULTS

The original four actor tool structure was confirmed. The mean overall levels of self-care in the four SCODI scales in the study group were self-care maintenance (67.66 pts; SD=18.55), self-care monitoring (61.81 pts; SD=24.94), self-care management (54.65 pts; SD=22.98) and self-care confidence (62.86 pts; SD=20.87). The item-total correlations were positive, so there is no need to change the scales of any of the questions. The overall consistencies for individual scales were assessed using Cronbach's Alpha: self-care maintenance (0.759), self-care monitoring (0.741), self-care management (0.695) and self-care confidence (0.932). Exploratory factor analysis and item factor loadings of the individual items ranged from 0.137 to 0.886 and, with two exceptions (questions number 23 and 32), were statistically significant (p<0.05).

CONCLUSION

The SCODI questionnaire has acceptable internal consistency and reliability in assessing self-care among diabetic patients in the Polish population. This reliable research tool can be managed in planned studies of Polish patients with diabetes.