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Putallaz P, Seematter-Bagnoud L, Draganski B, Rouaud O, Krief H, Büla CJ. Diabetes mellitus in older persons with neurocognitive disorder: overtreatment prevalence and associated structural brain MRI findings. BMC Geriatr 2024; 24:427. [PMID: 38745127 PMCID: PMC11095019 DOI: 10.1186/s12877-024-05025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Tight diabetes control is often applied in older persons with neurocognitive disorder resulting in increased hypoglycemic episodes but little is known about the pattern of brain injury in these overtreated patients. This study aims to: (a) quantify the prevalence of diabetes overtreatment in cognitively impaired older adults in a clinical population followed in an academic memory clinic (b) identify risk factors contributing to overtreatment; and (c) explore the association between diabetes overtreatment and specific brain region volume changes. METHODS Retrospective study of older patients with type 2 diabetes and cognitive impairment who were diagnosed in a memory clinic from 2013 to 2020. Patients were classified into vulnerable and dependent according to their health profile. Overtreatment was defined when glycated hemoglobin was under 7% for vulnerable and 7.6% for dependent patients. Characteristics associated to overtreatment were examined in multivariable analysis. Grey matter volume in defined brain regions was measured from MRI using voxel-based morphometry and compared in patients over- vs. adequately treated. RESULTS Among 161 patients included (median age 76.8 years, range 60.8-93.3 years, 32.9% women), 29.8% were considered as adequately treated, 54.0% as overtreated, and 16.2% as undertreated. In multivariable analyses, no association was observed between diabetes overtreatment and age or the severity of cognitive impairment. Among patients with neuroimaging data (N = 71), associations between overtreatment and grey matter loss were observed in several brain regions. Specifically, significant reductions in grey matter were found in the caudate (adj β coeff: -0.217, 95%CI: [-0.416 to -0.018], p = .033), the precentral gyri (adj βcoeff:-0.277, 95%CI: [-0.482 to -0.073], p = .009), the superior frontal gyri (adj βcoeff: -0.244, 95%CI: [-0.458 to -0.030], p = .026), the calcarine cortex (adj βcoeff:-0.193, 95%CI: [-0.386 to -0.001], p = .049), the superior occipital gyri (adj βcoeff: -0.291, 95%CI: [-0.521 to -0.061], p = .014) and the inferior occipital gyri (adj βcoeff: -0.236, 95%CI: [-0.456 to - 0.015], p = .036). CONCLUSION A significant proportion of older patients with diabetes and neurocognitive disorder were subjected to excessively intensive treatment. The association identified with volume loss in several specific brain regions highlights the need to further investigate the potential cerebral damages associated with overtreatment and related hypoglycemia in larger sample.
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Affiliation(s)
- Pauline Putallaz
- Service of geriatric medicine and geriatric rehabilitation, University of Lausanne Medical Center (CHUV), Route de Mont Paisible 16, Lausanne, 1011, Switzerland.
- Service of geriatric medicine, Hospital of Valais, Avenue de la Fusion 27, Martigny, 1920, Switzerland.
| | - Laurence Seematter-Bagnoud
- Service of geriatric medicine and geriatric rehabilitation, University of Lausanne Medical Center (CHUV), Route de Mont Paisible 16, Lausanne, 1011, Switzerland
- Department of Epidemiology and Public Health (Unisanté), Lausanne, 1011, Switzerland
| | - Bogdan Draganski
- Laboratory of Research in Neuroimaging (LREN) - Department of Clinical Neuroscience - CHUV, University of Lausanne, Lausanne, 1011, Switzerland
| | - Olivier Rouaud
- Leenaards Memory Center, University of Lausanne Medical Center (CHUV), Route de Mont Paisible 16, Lausanne, 1011, Switzerland
| | - Hélène Krief
- Service of geriatric medicine and geriatric rehabilitation, University of Lausanne Medical Center (CHUV), Route de Mont Paisible 16, Lausanne, 1011, Switzerland
| | - Christophe J Büla
- Service of geriatric medicine and geriatric rehabilitation, University of Lausanne Medical Center (CHUV), Route de Mont Paisible 16, Lausanne, 1011, Switzerland
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Sahatqija F, Hunsberger M, Cook S, Kholmatova K, Shapkina M, Malyutina S, Kudryavtsev AV. Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults. Int J Hypertens 2024; 2024:8542671. [PMID: 38567246 PMCID: PMC10985646 DOI: 10.1155/2024/8542671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes mellitus (DM). This study aimed to assess awareness of these three conditions among Russian adults (N = 3803) and the associated socio-demographic, lifestyle, and health characteristics. We used cross-sectional data from a randomly drawn population-based sample of Russians aged 35-69 years, who participated in the Know Your Heart (KYH) study conducted in Arkhangelsk and Novosibirsk between 2015-2018. Participants' self-reported awareness of hypertension, hypercholesterolemia, and DM was assessed against the measures at the KYH health check (blood pressure, cholesterol, HbA1c and/or use of medication for each condition). Prevalence estimates for the awareness were age- and sex-standardized to the Standard European Population. Socio-demographic, lifestyle, and health-related correlates of the awareness were investigated using logistic regression modelling. Among participants with hypertension (N = 2206), hypercholesterolemia (N = 3171), and DM (N = 329) recorded at a health check, 79%, 45%, and 61% self-reported these conditions, respectively. Higher awareness of hypercholesterolemia and hypertension was associated with older age, female sex, nonsmoking status, obesity, and history of CVD diagnoses. Low household income and history of CVD diagnoses were associated with being aware of DM. The awareness rates of hypertension were relatively high, whereas awareness rates of hypercholesterolemia and DM were relatively low. CVD prevention and early intervention could be improved in Russia through increasing the awareness of the risk factors.
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Affiliation(s)
- Filip Sahatqija
- Shalgrenska Academy, University of Gothenburg, Gothenburg 41390, Sweden
| | - Monica Hunsberger
- Shalgrenska Academy, University of Gothenburg, Gothenburg 41390, Sweden
| | - Sarah Cook
- School of Public Health, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
| | - Kamila Kholmatova
- International Research Competence Centre, Northern State Medical University, Arkhangelsk 163069, Russia
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø N-9037, Norway
| | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630089, Russia
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630089, Russia
- Department of Therapy, Haematology and Transfusiology, Novosibirsk State Medical University, Novosibirsk 630090, Russia
| | - Alexander V. Kudryavtsev
- International Research Competence Centre, Northern State Medical University, Arkhangelsk 163069, Russia
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø N-9037, Norway
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Maung KK, Marques-Vidal P. Impact of the COVID-19 pandemic on CVD prevention between different socioeconomic groups in Switzerland. Open Heart 2023; 10:e002368. [PMID: 37730269 PMCID: PMC10510922 DOI: 10.1136/openhrt-2023-002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted the continuing management of cardiovascular disease (CVD) risk factors in the population. Socioeconomic status (SES) is a major determinant of health. Whether the COVID-19 pandemic increased, the SES gap in CVD risk factors is unknown. AIMS To compare the management of CVD risk factors and the SES gap before and during the pandemic. METHODS Cross-sectional study conducted between 2018 and 2021 in Lausanne, Switzerland. Prevalence, awareness, treatment and control rates of hypertension, dyslipidaemia and diabetes were compared between the periods before (N=2416, 45.2% men, 65.3±9.8 years) and during (N=776, 44.5% men, 63.9±9.1 years) the COVID-19 pandemic. SES was defined by education and categorised as low (compulsory or apprenticeship), middle (high school) and high (university). RESULTS After multivariable analysis, the prevalence of hypertension increased, and awareness decreased during the pandemic: OR and (95% CI) 1.26 (1.04 to 1.53) and 0.70 (0.53 to 0.94), respectively. For dyslipidaemia, prevalence decreased during the pandemic 0.82 (95% CI 0.69 to 0.98); awareness did not change. For diabetes, prevalence did not change but awareness increased 5.76 (95% CI 1.23 to 27.04). No differences were found before and during the pandemic regarding treatment and control for all CVD risk factors. Relative to high SES, a decrease in hypertension awareness among middle SES categories was observed during the pandemic (OR and 95% CI 1.11 (0.73 to 1.69) before and 0.45 (95% CI 0.23 to 0.85) during, p for interaction<0.05), while no other changes were found. CONCLUSION Prevalence and management of CVD risk factors changed little during the pandemic. The SES gap did not increase except for hypertension awareness.
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Affiliation(s)
- Ko Ko Maung
- Department of Medicine, Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Gutzwiller JP, Müller-Bolla K, Ferrari C, Stanga Z, Nydegger UE, Risch L, Risch M. Mortality risk factors in community-dwelling, subjectively healthy, Swiss older adults: update after 8-years follow-up. BMC Geriatr 2023; 23:303. [PMID: 37198577 DOI: 10.1186/s12877-023-03959-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 04/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Worldwide population is ageing, but little is known regarding risk factors associated with increased mortality in subjectively healthy, community-dwelling older adults. We present the updated results of the longest follow-up carried out on Swiss pensioners and we provide results on potential risk factors associated with mortality before the onset of the COVID-19 pandemic. MATERIALS AND METHODS Within the SENIORLAB study, we collected demographic data, anthropometric measures, medical history, and laboratory parameters of 1467 subjectively healthy, community-dwelling, Swiss adults aged ≥ 60 years over a median follow-up of 8.79 years. The variables considered in the multivariable Cox-proportional hazard model for mortality during follow-up were selected based on prior knowledge. Two separate models for males and females were calculated; moreover, we fitted the old model obtained in 2018 to the complete follow-up data to highlight differences and similarities. RESULTS The population sample included 680 males and 787 females. Age of participants ranged between 60 and 99 years. We experienced 208 deaths throughout the entire follow-up period; no patients were lost at follow-up. The Cox-proportional hazard regression model included female gender, age, albumin levels, smoking status, hypertension, osteoporosis and history of cancer within predictors of mortality over the follow-up period. Consistent findings were obtained also after gender stratification. After fitting the old model, female gender, hypertension, and osteoporosis still showed statistically significant independent associations with all-cause mortality. CONCLUSIONS Understanding the predictors of a healthy survival can improve the overall quality of life of the ageing population and simultaneously reduce their global economic burden. TRIAL REGISTRATION The present study was registered in the International Standard Randomized Controlled Trial Number registry: https://www.isrctn.com/ISRCTN53778569 (registration date: 27/05/2015).
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Affiliation(s)
- Jean-Pierre Gutzwiller
- Magendarm Thalwil AG, Zürcherstrasse 61, Thalwil, 8800, Switzerland
- University of Basel, Klingelbergstrasse 61, Basel, 4056, Switzerland
| | - Krisztina Müller-Bolla
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, Bern, Switzerland
| | | | - Zeno Stanga
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Urs E Nydegger
- Divisions of Clinical Chemistry and Haematology, Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, Bern, 3097, Switzerland
| | - Lorenz Risch
- Divisions of Clinical Chemistry and Haematology, Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, Bern, 3097, Switzerland
- Labormedizinisches Zentrum Dr. Risch, Landstrasse 157, Schaan, 9494, Liechtenstein
| | - Martin Risch
- Central Laboratory, Kantonsspital Graubünden, Loëstrasse 170, Chur, 7000, Switzerland
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Alkandari A, Vaucher J, Marques-Vidal P. Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland: the CoLaus|PsyCoLaus Study. BMJ Open Diabetes Res Care 2023; 11:11/3/e003377. [PMID: 37188394 DOI: 10.1136/bmjdrc-2023-003377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/30/2023] [Indexed: 05/17/2023] Open
Abstract
AIM To assess the 15-year trends in the level of glycemic, blood pressure, and cholesterol control in adults with diabetes in a Swiss population-based cohort. RESEARCH DESIGN AND METHODS CoLaus|PsyCoLaus is a prospective cohort study of 6733 adults aged 35-75 years in Lausanne, Switzerland. Baseline recruitment was conducted in 2003-6 and was followed by three subsequent follow-ups in 2009-12, 2014-17 and 2018-21. In adults with diabetes, glycemic control was defined as fasting plasma glucose <7 mmol/L, blood pressure control as systolic and diastolic pressures of <140/90 mm Hg, and lipid control as non-high-density lipoprotein (non-HDL) cholesterol control <3.4 mmol/L. RESULTS Rates of glycemic control improved from 23.2% (95% CI 19.5 to 27.3) in 2003-6 to 32.8% (95% CI 28.1 to 37.8) in 2018-21. Blood pressure control also improved, from 51.5% at baseline (95% CI 46.8 to 56.2) to 63.3% (95% CI 58.2 to 68.1) 15 years later. The largest improvement was in cholesterol control, from 29.1% (95% CI 25.1 to 33.6) in 2003-6 to 56.3% (95% CI 51.1 to 61.4) in 2018-21. Overall, simultaneous control of all three improved from 5.5% (95% CI 3.7 to 8.1) at baseline to 17.2% (95% CI 13.7 to 21.5) 15 years later. Improvements in risk factor control tallied with an increase in the use of glucose-lowering agents, blood pressure-lowering medication, and statins. Men were less likely to achieve blood pressure control but presented with a better control of non-HDL cholesterol. Caucasians were less likely to achieve simultaneous control than non-Caucasians. CONCLUSION Cardiovascular risk factor control in adults with diabetes in Switzerland has increased in the last 15 years, but there remains a margin for improvement.
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Affiliation(s)
- Abdullah Alkandari
- Population Health Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
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Duan M, Xi Y, Tian Q, Na B, Han K, Zhang X, Wang W, Zheng D, Wang Y. Prevalence, awareness, treatment and control of type 2 diabetes and its determinants among Mongolians in China: a cross-sectional analysis of IMAGINS 2015-2020. BMJ Open 2022; 12:e063893. [PMID: 36319058 PMCID: PMC9628690 DOI: 10.1136/bmjopen-2022-063893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study aims to estimate the prevalence, awareness, treatment and control rates of type 2 diabetes (T2D) and pre-diabetes as well as to identify its associated factors among Mongolians living in the Inner Mongolia Autonomous Region, China. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS This sample included 11 361 Mongolian participants from the Inner Mongolian Healthy Aging Intervention Study, a population-based screening project consisting of 141 255 adults aged above 35 years in Inner Mongolia from 2015 to 31 December 2020. OUTCOME MEASURES The prevalence and 95% CIs of T2D and pre-diabetes were calculated. Factors associated with the prevalence, awareness, treatment and control of T2D were explored by a binomial logistic regression. RESULTS A total of 17.2% (95% CI 16.5% to 17.9%) of the sample had T2D, of whom 34.0% (95% CI 31.9% to 36.1%) were aware of their diagnosis, 24.7% (95% CI 22.8% to 26.6%) were taking prescribed antidiabetic medications, 6.7% (95% CI 5.6% to 7.8%) had achieved control and 27.5% (95 % CI 26.7% to 28.3%) had pre-diabetes. The prevalence of T2D increased with increasing age, male, lower education level, smoking, obesity and a history of hypertension or dyslipidaemia (all p<0.05). CONCLUSIONS T2D is highly prevalent, with suboptimal awareness, treatment and control rates, and an escalating health challenge among the Mongolian population. Broad-based strategies, including diabetes prevention education, better screening and affordable treatment, should be implemented to raise awareness, treatment and control rates of T2D in Inner Mongolia.
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Affiliation(s)
- Mingrui Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yunfeng Xi
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Qiuyue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Buqi Na
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Ke Han
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Xingguang Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Wenrui Wang
- The Inner Mongolia Autonomous Region Comprehensive Center or Disease Control and Prevention, Hohhot, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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Bandiera C, Lam L, Locatelli I, Dotta-Celio J, Duarte D, Wuerzner G, Pruijm M, Zanchi A, Schneider MP. Understanding reasons and factors for participation and non-participation to a medication adherence program for patients with diabetic kidney disease in Switzerland: a mixed methods study. Diabetol Metab Syndr 2022; 14:140. [PMID: 36167584 PMCID: PMC9516833 DOI: 10.1186/s13098-022-00898-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An interprofessional medication adherence intervention led by pharmacists, combining motivational interviews and feedback with electronic monitor (EM) drug assessment, was offered to all consecutive patients with diabetic kidney disease (DKD) (estimated glomerular filtration rate < 60 mL/min/1.73 m2) visiting their nephrologist or endocrinologist. Approximately 73% (202/275) of eligible patients declined to participate, and the factors and reasons for refusal were investigated. METHODS Sociodemographic and clinical data of included patients and those who refused were collected retrospectively for those who had previously signed the general consent form. Multivariate logistic regression analysis was performed to identify independent variables associated with non-participation. Patients who refused or accepted the adherence study were invited to participate in semi-structured interviews. Verbatim transcription, thematic analysis, and inductive coding were performed. RESULTS Patients who refused to participate were older (n = 123, mean age 67.7 years, SD:10.4) than those who accepted (n = 57, mean age 64.0 years, SD:10.0, p = 0.027) and the proportion of women was higher among them than among patients who accepted it (30.9% vs 12.3%, p = 0.007). The time from diabetes diagnosis was longer in patients who refused than in those who accepted (median 14.2 years IQR 6.9-22.7 vs. 8.6 years, IQR 4.5-15.9, p = 0.003). Factors associated with an increased risk of non-participation were female sex (OR 3.8, 95% CI 1.4-10.0, p = 0.007) and the time from diabetes diagnosis (OR 1.05, 95% CI 1.01-1.09, p = 0.019). The included patients who were interviewed (n = 14) found the interprofessional intervention useful to improve their medication management, support medication literacy, and motivation. Patients who refused to participate and who were interviewed (n = 16) explained no perceived need, did not agree to use EM, and perceived the study as a burden and shared that the study would have been beneficial if introduced earlier in their therapeutic journey. Other barriers emerged as difficult relationships with healthcare providers, lack of awareness of the pharmacist's role, and negative perception of clinical research. CONCLUSIONS Investigating the factors and reasons for participation and non-participation in a study helps tailor intervention designs to the needs of polypharmacy patients. Patients who refused the adherence intervention may not be aware of the benefits of medication management and medication literacy. There is an urgent need to advocate for interprofessional outpatient collaborations to support medication adherence in patients with DKD. Trial registration Clinicaltrials.gov NCT04190251_PANDIA IRIS.
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Affiliation(s)
- Carole Bandiera
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Liliane Lam
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Isabella Locatelli
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jennifer Dotta-Celio
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Dina Duarte
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gregoire Wuerzner
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Menno Pruijm
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anne Zanchi
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie P. Schneider
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
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Di Gangi S, Lüthi B, Diaz Hernandez L, Zeller A, Zechmann S, Fischer R. Quality outcome of diabetes care during COVID-19 pandemic: a primary care cohort study. Acta Diabetol 2022; 59:1189-1200. [PMID: 35780277 PMCID: PMC9329414 DOI: 10.1007/s00592-022-01920-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/08/2022] [Indexed: 11/14/2022]
Abstract
AIM Management of diabetes care can be affected by COVID-19 pandemic control measures. This study aimed to determine the impact of the pandemic, during 17.03.2020-16.03.2021, on quality outcomes of diabetes care in general practice in Switzerland. METHODS In this retrospective cohort study, diabetes mellitus patients (≥ 18 years) with at least one consultation at a general practitioner, during 17.03.2018-16.03.2019 (cohort 1) and 17.03.2019-16.03.2020 (cohort 2) were included and followed-up for two years. Quality indicators and outcomes of diabetes care, at patient and practitioner level, were compared before and during the pandemic. Logistic regression was performed to identify patient's risk factors for dropout from follow-up. RESULTS Data from 191 practices, 23,903 patients, cohort 1 and 25,092 patients, cohort 2, were analyzed. The fraction of patients lost to follow-up, attributable to the pandemic, was 28% (95% confidence interval: 25%, 30%). During the pandemic, compared to the previous year, regular measurement of weight, HbA1c, blood pressure and serum creatinine were less frequent and less patients per practitioner reached HbA1c and blood pressure target outcomes. Factors associated with continuity of care during the pandemic were: patient age 41-80 years, longer diabetes duration, diagnosis of hypertension or dyslipidemia, influenza vaccination during the last year. Risk factors for dropout were age > 80 and receiving only insulin as anti-diabetic medication. CONCLUSION A considerable quality reduction in diabetes mellitus care could be observed during the pandemic. Though the most vulnerable patients were not the most affected by the pandemic, key factors that might reduce dropout from follow-up were identified.
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Affiliation(s)
- Stefania Di Gangi
- Institute of Primary Care, University and University Hospital Zurich, Pestalozzistrasse 24, CH-8091 Zurich, Switzerland
| | - Benjamin Lüthi
- Centre for Primary Health Care, University of Basel, Basel, Switzerland
| | | | - Andreas Zeller
- Centre for Primary Health Care, University of Basel, Basel, Switzerland
| | - Stefan Zechmann
- Institute of Primary Care, University and University Hospital Zurich, Pestalozzistrasse 24, CH-8091 Zurich, Switzerland
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Roland Fischer
- Centre for Primary Health Care, University of Basel, Basel, Switzerland
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Recent Progress in the Diagnosis and Management of Type 2 Diabetes Mellitus in the Era of COVID-19 and Single Cell Multi-Omics Technologies. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081205. [PMID: 36013384 PMCID: PMC9409806 DOI: 10.3390/life12081205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is one of the world’s leading causes of death and life-threatening conditions. Therefore, we review the complex vicious circle of causes responsible for T2DM and risk factors such as the western diet, obesity, genetic predisposition, environmental factors, and SARS-CoV-2 infection. The prevalence and economic burden of T2DM on societal and healthcare systems are dissected. Recent progress on the diagnosis and clinical management of T2DM, including both non-pharmacological and latest pharmacological treatment regimens, are summarized. The treatment of T2DM is becoming more complex as new medications are approved. This review is focused on the non-insulin treatments of T2DM to reach optimal therapy beyond glycemic management. We review experimental and clinical findings of SARS-CoV-2 risks that are attributable to T2DM patients. Finally, we shed light on the recent single-cell-based technologies and multi-omics approaches that have reached breakthroughs in the understanding of the pathomechanism of T2DM.
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10
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Johari MG, Jokari K, Mirahmadizadeh A, Seif M, Rezaianzadeh A. The prevalence and predictors of pre-diabetes and diabetes among adults 40-70 years in Kharameh cohort study: A population-based study in Fars province, south of Iran. J Diabetes Metab Disord 2022; 21:85-95. [PMID: 35673470 DOI: 10.1007/s40200-021-00938-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
Purpose In this study, the prevalence of diabetes and pre-diabetes (pre-DM) has been estimated; also, some factors related to diabetes and pre-diabetes in the city of Kharameh, southern Iran, were investigated. Methods This cross-sectional study was conducted on a total of 10,474 subjects aged 40-70 years who participated in phase one of PERSIAN Kharameh cohort carried out between 2015 and 2016. Eligible individuals were included in the study by census method. Results Prevalence of diabetes is 20.17% (95% CI: 19.95-20.39) and that of pre-diabetes is 15.74% (95% CI 15.54-15.93). Multivariate logistic regression results showed that the prevalence of diabetes had a direct relationship with increasing age (p < 0.001), being single (p = 0.005), family history of diabetes (p < 0.001), abdominal obesity (p < 0.001), hypertension (p: < 0.001), and high triglycerides (p: < 0.001); also, it had an inverse relationship with residence in rural areas (p < 0.001), education (p < 0.001), and employment (p < 0.001).Also, the prevalence of pre-diabetes showed a direct relationship with increasing age (60-70 years p = 0.010), being single (p = 0.004), living in rural areas (P < 0.001), having a family history of diabetes ( both P = 0.023), abdominal obesity (P < 0.001), hypertension (P < 0.001), high cholesterol (P < 0.001) and high triglycerides (P < 0.001), and an inverse relationship with female gender (P < 0.001), education (high school P = 0.022), employment (P = 0.010), and smoking habit (P = 0.019). These results were all statistically significant. Conclusion The present study shows the high prevalence of diabetes and pre- diabetes in the city of Kharameh. Diabetes prevention policies should be developed and implemented for the public.
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Affiliation(s)
| | - Kimia Jokari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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11
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Stucki M, Nemitz J, Trottmann M, Wieser S. Decomposition of outpatient health care spending by disease - a novel approach using insurance claims data. BMC Health Serv Res 2021; 21:1264. [PMID: 34809613 PMCID: PMC8609863 DOI: 10.1186/s12913-021-07262-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background Decomposing health care spending by disease, type of care, age, and sex can lead to a better understanding of the drivers of health care spending. But the lack of diagnostic coding in outpatient care often precludes a decomposition by disease. Yet, health insurance claims data hold a variety of diagnostic clues that may be used to identify diseases. Methods In this study, we decompose total outpatient care spending in Switzerland by age, sex, service type, and 42 exhaustive and mutually exclusive diseases according to the Global Burden of Disease classification. Using data of a large health insurance provider, we identify diseases based on diagnostic clues. These clues include type of medication, inpatient treatment, physician specialization, and disease specific outpatient treatments and examinations. We determine disease-specific spending by direct (clues-based) and indirect (regression-based) spending assignment. Results Our results suggest a high precision of disease identification for many diseases. Overall, 81% of outpatient spending can be assigned to diseases, mostly based on indirect assignment using regression. Outpatient spending is highest for musculoskeletal disorders (19.2%), followed by mental and substance use disorders (12.0%), sense organ diseases (8.7%) and cardiovascular diseases (8.6%). Neoplasms account for 7.3% of outpatient spending. Conclusions Our study shows the potential of health insurance claims data in identifying diseases when no diagnostic coding is available. These disease-specific spending estimates may inform Swiss health policies in cost containment and priority setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07262-x.
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Affiliation(s)
- Michael Stucki
- ZHAW Zurich University of Applied Sciences, Winterthur Institute of Health Economics, Gertrudstrasse 15, 8401, Winterthur, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Janina Nemitz
- ZHAW Zurich University of Applied Sciences, Winterthur Institute of Health Economics, Gertrudstrasse 15, 8401, Winterthur, Switzerland.,Helsana Insurance Group, Zürich, Switzerland
| | | | - Simon Wieser
- ZHAW Zurich University of Applied Sciences, Winterthur Institute of Health Economics, Gertrudstrasse 15, 8401, Winterthur, Switzerland
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12
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Rohner M, Heiz R, Feldhaus S, Bornstein SR. Hepatic-Metabolite-Based Intermittent Fasting Enables a Sustained Reduction in Insulin Resistance in Type 2 Diabetes and Metabolic Syndrome. Horm Metab Res 2021; 53:529-540. [PMID: 34192792 PMCID: PMC8360708 DOI: 10.1055/a-1510-8896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/12/2021] [Indexed: 11/03/2022]
Abstract
Insulin resistance is the hallmark of Type 2 Diabetes and is still an unmet medical need. Insulin resistance lies at the crossroads of non-alcoholic fatty liver disease, obesity, weight loss and exercise resistance, heart disease, stroke, depression, and brain health. Insulin resistance is purely nutrition related, with a typical molecular disease food intake pattern. The insulin resistant state is accessible by TyG as the appropriate surrogate marker, which is found to lead the personalized molecular hepatic nutrition system for highly efficient insulin resistance remission. Treating insulin resistance with a molecular nutrition-centered approach shifts the treatment paradigm of Type 2 Diabetes from management to cure. This allows remission within five months, with a high efficiency rate of 85%. With molecular intermittent fasting a very efficient treatment for prediabetes and metabolic syndrome is possible, improving the non-alcoholic fatty liver disease (NAFL) state and enabling the body to lose weight in a sustainable manner.
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Affiliation(s)
| | - Robert Heiz
- Zentrum für Komplementärmedizin AG, Uster,
Switzerland
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13
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Lee J, Kim KH, Ahn JC, Kim JA, Lee G, Son JS, Choi SJ, Oh YH, Park SM. Prevalence, awareness, treatment, and control of diabetes mellitus by depressive symptom severity: a cross-sectional analysis of NHANES 2011-2016. BMJ Open Diabetes Res Care 2021; 9:e002268. [PMID: 34099441 PMCID: PMC8186749 DOI: 10.1136/bmjdrc-2021-002268] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/11/2021] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Despite extensive studies on the relationship between diabetes mellitus (DM) and depression, the associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes remain unclear. We aimed to investigate changes in these outcomes of diabetes as depressive symptoms aggravate. RESEARCH DESIGN AND METHODS We conducted a cross-sectional analysis of 14 328 participants in the 2011-2016 National Health and Nutrition Examination Survey. Participants were classified into depressive symptom groups of none, mild, moderate, moderately severe, and severe depending on their Patient Health Questionnaire-9 scores. Multivariate logistic regression analyses were conducted in three models adjusted for expanding confounders to evaluate the associations between severity of depressive symptoms and prevalence, awareness, treatment, and control of DM. RESULTS As depressive symptom severity worsened, both prevalence and awareness of DM increased regardless of models (p value for trend <0.01 in all models for prevalence and awareness; adjusted OR (aOR) 2.14, 95% CI 1.29 to 3.56 for prevalence in the severe group, model 1; aOR 2.43, 95% CI 1.27 to 4.64 for awareness in the moderately severe group, model 1). Notwithstanding higher awareness of diabetes in the moderately severe and severe groups (84.5% and 86.2%, respectively, vs 71.3% in the none group), these groups were treated less (aOR 0.25, 95% CI 0.11 to 0.55 in the severe group, model 3) or inadequately controlled (aOR 0.51, 95% CI 0.27 to 0.98 in the moderately severe group, model 3). CONCLUSIONS The gap between patients' higher awareness and lower treatment rate or control of diabetes among individuals with severe depressive symptoms highlights the unmet needs for postdiagnostic multidisciplinary care for patients with comorbid depression and DM.
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Affiliation(s)
- Jaewon Lee
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Kyae Hyung Kim
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Joseph C Ahn
- Division of Gastroenterology and Hepatology, Mayo Clinic in Rochester, Rochester, Minnesota, USA
| | - Jihoon Andrew Kim
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Joung Sik Son
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea (the Republic of)
| | - Soo Jung Choi
- Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea (the Republic of)
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea (the Republic of)
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Hospital, Seoul, Korea (the Republic of)
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
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Bai A, Tao J, Tao L, Liu J. Prevalence and risk factors of diabetes among adults aged 45 years or older in China: A national cross-sectional study. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00265. [PMID: 34277988 PMCID: PMC8279593 DOI: 10.1002/edm2.265] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/14/2021] [Accepted: 04/30/2021] [Indexed: 12/25/2022]
Abstract
Background Although there is preponderance of literature on disease burden of diabetes in developed countries, limited investigations have been conducted in less developed regions including China. This study aimed to explore the current prevalence and risk factors for diabetes, pre‐diabetes, awareness, treatment and control of diabetes in China. Methods We included 12,458 adults from the China Health and Retirement Longitudinal Study. We estimated prevalence of diabetes and pre‐diabetes in the overall sample and by socio‐demographics. Bivariate associations of diabetes, pre‐diabetes, awareness, control and treatment of diabetes with health and function measures were evaluated by chi‐squared test and multivariate logistic regression analysis. Results We found that the prevalence of diabetes and pre‐diabetes was 13.21% and 25.16%. The prevalence of diabetes increased with advanced age (12.37%, 15.98% and 16.52% among persons who were 45 to 55, 55 to 65 and ≥65 years old, respectively), educational background (14.52%, 15.52% and 15.58% among persons who were illiterate, had primary education and had secondary or above education) and weight (8.18%, 17.05% and 22.54% among persons with a body mass index of 18.5 to 24.9, 25.0 to 29.9 and ≥30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (19.04% vs. 12.85%). We also observed that aged between 55 and 65 years, obesity, history of hypertension and coronary heart disease, and inactivity were significant risk factors of awareness of diabetes. Conclusion Our results indicated that diabetes is high prevalent in adults aged 45 years or above in China. The potentially modifiable risk factors should be further studied to develop interventions and strategies aimed at prevention and treatment of diabetes among middle‐aged and older Chinese adults.
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Affiliation(s)
- Anying Bai
- School of Public Health Peking University Beijing China
| | - Jing Tao
- College of Rehabilitation Medicine Fujian University of Traditional Chinese Medicine Fujian China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology Peking University Third Hospital Beijing China
| | - Jue Liu
- School of Public Health Peking University Beijing China
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Tokgozoglu L, Kayikcioglu M, Ekinci B. The landscape of preventive cardiology in Turkey: Challenges and successes. Am J Prev Cardiol 2021; 6:100184. [PMID: 34327504 PMCID: PMC8315400 DOI: 10.1016/j.ajpc.2021.100184] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/24/2021] [Accepted: 04/04/2021] [Indexed: 12/20/2022] Open
Abstract
Turkey, like many countries, is facing a growing burden of non-communicable disease (NCD)s and is among the countries with high cardiovascular mortality in Europe. Moreover, Turkey currently has the highest rate of premature cardiovascular disease (CVD) in Europe. During the last decades, Turkey made fundamental reforms in the health system to improve the treatment of risk factors to prevent CVD. The most outstanding success was in the area of tobacco control (13.4% decrease in smoking prevalence) and decreasing the salt consumption of the population (from 18 to 9.9 g/day) leading to a significant decrease in CVD mortality from 45% to 36.8% of all deaths. However, obesity and diabetes are increasing rapidly as a result of urbanization, low physical activity and unhealthy eating and the new generation is starting to take up smoking. The increase in cardiometabolic risk factors and aging of the population are expected to increase the number of CVD deaths. All CVD risk factors except smoking are significantly more prevalent in women. In addition, rare disease is a country specific problem with a significant contribution to the high rates of premature CVD in Turkey. Despite major improvements in management in acute coronary syndromes, sustained achievement in guideline recommended goals is suboptimal. In patients with a previous cardiovascular event smoking rate is 25.5%, 80.9% of these patients are overweight (BMI ≥25 kg/m2), 30% obese (BMI ≥30 kg/m2), and LDL‐cholesterol targets of 70 mg/dL are attained in only 18%. Herein, we scrutinize the achievements and challenges of Turkey in establishing a ‘National Heart Health Policy’ aiming to decrease the burden of CVD and its risk factors.
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Affiliation(s)
- Lale Tokgozoglu
- Department of Cardiology, Hacettepe University Medical Faculty, Ankara, Turkey
| | - Meral Kayikcioglu
- Department of Cardiology, Ege University Medical Faculty, Izmir, Turkey
| | - Banu Ekinci
- Department of Chronic Disease and Elderly Health, Ministry of Health, Ankara, Turkey
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16
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Stucki M. Factors related to the change in Swiss inpatient costs by disease: a 6-factor decomposition. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:195-221. [PMID: 33433763 PMCID: PMC7881977 DOI: 10.1007/s10198-020-01243-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
There is currently little systematic knowledge about the contribution of different factors to the increase in health care spending in high-income countries such as Switzerland. The aim of this paper is to decompose inpatient care costs in the Swiss canton of Zurich by 100 diseases and 42 age/sex groups and to assess the contribution of six factors to the change in aggregate costs between 2013 and 2017. These six factors are population size, age and sex structure, inpatient treated prevalence, utilization in terms of stays per patient, length of stay per case, and costs per treatment day. Using detailed inpatient cost data at the case level, we find that the most important contributor to the change in disease-specific costs was a rise in costs per treatment day. For most conditions, this effect was partly offset by a reduction in the average length of stay. Changes in population size accounted for one third of the total increase, but population structure had only a small positive association with costs. The most expensive cases accounted for the largest part of the increase in costs, but the magnitude of this effect differed across diseases. A better understanding of the factors related to cost changes at the disease level over time is essential for the design of targeted health policies aiming at an affordable health care system.
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Affiliation(s)
- Michael Stucki
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland.
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
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17
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Jung CH, Son JW, Kang S, Kim WJ, Kim HS, Kim HS, Seo M, Shin HJ, Lee SS, Jeong SJ, Cho Y, Han SJ, Jang HM, Rho M, Lee S, Koo M, Yoo B, Moon JW, Lee HY, Yun JS, Kim SY, Kim SR, Jeong IK, Mok JO, Yoon KH. Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status. Diabetes Metab J 2021; 45:1-10. [PMID: 33434426 PMCID: PMC7850879 DOI: 10.4093/dmj.2020.0254] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/04/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND This study aimed to investigate the recent prevalence, management, and comorbidities of diabetes among Korean adults aged ≥30 years by analyzing nationally representative data. METHODS This study used data from the Korea National Health and Nutrition Examination Survey from 2016 to 2018, and the percentage and total number of people ≥30 years of age with diabetes and impaired fasting glucose (IFG) were estimated. RESULTS In 2018, 13.8% of Korean adults aged ≥30 years had diabetes, and adults aged ≥65 years showed a prevalence rate of 28%. The prevalence of IFG was 26.9% in adults aged ≥30 years. From 2016 to 2018, 35% of the subjects with diabetes were not aware of their condition. Regarding comorbidities, 53.2% and 61.3% were obese and hypertensive, respectively, and 72% had hypercholesterolemia as defined by low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL in people with diabetes. Of the subjects with diabetes, 43.7% had both hypertension and hypercholesterolemia. With regard to glycemic control, only 28.3% reached the target level of <6.5%. Moreover, only 11.5% of subjects with diabetes met all three targets of glycosylated hemoglobin, blood pressure, and LDL-C. The percentage of energy intake from carbohydrates was higher in diabetes patients than in those without diabetes, while that from protein and fat was lower in subjects with diabetes. CONCLUSION The high prevalence and low control rate of diabetes and its comorbidities in Korean adults were confirmed. More stringent efforts are needed to improve the comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.
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Affiliation(s)
- Chan-Hee Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jang Won Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Shinae Kang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Won Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hun-Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Mihae Seo
- Department of Endocrinology and Metabolism, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Su Jin Jeong
- Department of Endocrinology and Metabolism, Sejong General Hospital, Bucheon, Korea
| | - Yongin Cho
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, Korea
| | - Seung Jin Han
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Hyang Mi Jang
- Department of Nursing, Gangnam Severance Hospital, Yonsei University, Seoul, Korea
| | - Mira Rho
- Department of Nutrition, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Shinbi Lee
- Department of Clinical Nutrition, Korea University Anam Hospital, Seoul, Korea
| | - Mihyun Koo
- Department of Social Work, Samsung Medical Center, Seoul, Korea
| | - Been Yoo
- Department of Social Work, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Jung-Wha Moon
- Department of Sports Medical Center, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hye Young Lee
- Sport Health Medicine Center, Asan Medical Center, Seoul, Korea
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sun Young Kim
- Department of Nursing, Samsung Medical Center, Seoul, Korea
| | - Sung Rae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - In-Kyung Jeong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji-Oh Mok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
- Corresponding author: Ji-Oh Mok https://orcid.org/0000-0003-4882-1206 Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea E-mail:
| | - Kun Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea
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A cross-sectional study on diabetes epidemiology among people aged 40 years and above in Shenyang, China. Sci Rep 2020; 10:17742. [PMID: 33082483 PMCID: PMC7576584 DOI: 10.1038/s41598-020-74889-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022] Open
Abstract
This study aimed at understanding the diabetic prevalence, awareness, treatment and control rates and their influencing factors among people aged ≥ 40 years in Shenyang, China. A face-to-face cross-sectional epidemiological survey was conducted on the respondents using the national unified questionnaire. A total of 3922 respondents were enrolled, including 609 cases of diabetes. The diabetic prevalence rate was 15.5%, and was higher in rural areas than that in urban areas (17.7% vs. 14.2%, p = 0.004), while no difference was observed between men and women (14.8% vs. 16.1%, p = 0.242). Advanced age, hypertension and dyslipidemia were the diabetes influencing factors. Among the 609 respondents with diabetes, the diabetic awareness and treatment rates, and the control rate of fasting plasma glucose were 82.3%, 36.6% and 17.1%, respectively. In different age groups, the diabetic awareness rate was higher in men than that in women, and the treatment rate was higher in women than that in men. The diabetic patients, who consumed fruit for ≥ 5 days a week, accounted for 16.3%, and their diabetic treatment (28.1%) and control rates (44.1%) were lower. Shenyang people aged ≥ 40 years have higher diabetic prevalence and awareness rates, and lower diabetic treatment and control rates. Finally, it is necessary to enhance awareness and education about diabetes, to improve its treatment and control rates.
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de Mestral C, Stringhini S, Guessous I, Jornayvaz FR. Thirteen-year trends in the prevalence of diabetes in an urban region of Switzerland: a population-based study. Diabet Med 2020; 37:1374-1378. [PMID: 31814147 DOI: 10.1111/dme.14206] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 01/24/2023]
Abstract
AIM To assess trends in prevalence of total and diagnosed diabetes, and in the probability of detecting undiagnosed diabetes in the Swiss population. METHODS The Bus Santé study is an annual cross-sectional study of adults residing in Geneva state, Switzerland. We included 8532 participants (51% women) from the years 2005 to 2017, when fasting plasma glucose data became available. Total diabetes was defined as the sum of diagnosed and undiagnosed diabetes, while diagnosed diabetes was defined as having a previous diagnosis, and undiagnosed diabetes as having fasting plasma glucose level of ≥7 mmol/l and no previous diagnosis. We calculated the probability of finding undiagnosed diabetes among participants without a diagnosis. We examined for linear and quadratic trends, grouping survey years into five survey periods. RESULTS In total, 711 diabetes cases were identified over 13 years. The age- and gender-standardized prevalence of total diabetes decreased between the periods 2005-2009 and 2012-2013 from 9.6% (95% CI 8.3, 10.9) to 7.1% (95% CI 5.8, 8.4), but increased to 8.6% (95% CI 7.3%, 9.9%) by 2016-2017 (P-quadratic <0.01). For diagnosed diabetes, the prevalence decreased between 2005-2009 and 2014-2015 from 8.3% (95% CI 7.0%, 9.5%) to 6.1% (95% CI 5.0%, 7.2%), but increased slightly again to 7.0% (95% CI 5.8%, 8.2%) by 2016-2017 (P-quadratic = 0.01). Men generally had a higher prevalence of total and diagnosed diabetes than women, except in 2016-2017, when the prevalence of total diabetes was 9.5% (95% CI 7.6, 11.5) among men and 7.7% (95% CI 6.0, 9.5) among women (P >0.05). The probability of finding undetected diabetes among participants without a diabetes diagnosis decreased slightly between 2005-2009 and 2012-2013 from 1.5% (95% CI 0.9, 2.0) to 1.0% (95% CI 0.5, 1.5), but increased afterwards to 1.7% (95% CI 1.0, 2.3) by 2016-2017 (P-quadratic = 0.06); in 2016-2017, it was 2.6% (95% CI 1.5, 3.7) among men and 0.7% (95% CI 0.1, 1.3) among women (P <0.01). CONCLUSION The prevalence of diabetes has remained relatively constant over time. However, the probability of finding undetected cases of diabetes in the population without diabetes may be increasing among men.
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Affiliation(s)
- C de Mestral
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - S Stringhini
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland
- Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - I Guessous
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - F R Jornayvaz
- Unit of Diabetology, Service of Endocrinology, Diabetology, Hypertension and Nutrition Services, Department of Medical Specialties, University Hospitals of Geneva, Geneva, Switzerland
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Helou N, Talhouedec D, Zumstein-Shaha M, Zanchi A. A Multidisciplinary Approach for Improving Quality of Life and Self-Management in Diabetic Kidney Disease: A Crossover Study. J Clin Med 2020; 9:E2160. [PMID: 32650548 PMCID: PMC7408890 DOI: 10.3390/jcm9072160] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023] Open
Abstract
Individuals with diabetic kidney disease are at high risk of complications and challenged to self-manage. Previous research suggested that multidisciplinary approaches would improve health outcomes. This study investigated the effect of a multidisciplinary self-management approach of diabetic kidney disease on quality of life, and self-management, glycemic control, and renal function. A uniform balanced crossover design was used because it attains a high level of statistical power with a lower sample size. A total of 32 participants (aged 67.8 ± 10.8) were randomized into four study arms. In differing sequences, each participant was treated twice with three months of usual care alternated with three months of multidisciplinary management. The intervention improved the present dimension of quality of life demonstrating higher mean rank as compared to usual care (52.49 vs. 41.01; p = 0.026, 95% CI) and three self-care activities, general diet habits, diabetes diet habits, and blood sugar testing (respectively: 55.43 vs. 38.31; p = 0.002, 56.84 vs. 37.02; p = 0.000, 53.84 vs. 39.77; p = 0.008; 95% CI). Antihypertensive medication engagement was high across the study period (Mean = 95.38%, Min = 69%, Max = 100%). Glycemic control and renal function indicators were similar for the intervention and the usual care. Studies are needed to determine how the new recommended therapies for diabetic kidney disease such as SGLT2 inhibitors and GLP-1 receptor agonists impact on self-management and quality of life.
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Affiliation(s)
- Nancy Helou
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland
| | | | - Maya Zumstein-Shaha
- Department of Health, Bern University of Applied Sciences, 3010 Bern, Switzerland;
| | - Anne Zanchi
- Service of Nephrology and Hypertension, Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
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de Mestral C, Stringhini S, Guessous I, Jornayvaz FR. Thirteen-year trends in the prevalence of diabetes according to socioeconomic condition and cardiovascular risk factors in a Swiss population. BMJ Open Diabetes Res Care 2020; 8:8/1/e001273. [PMID: 32661192 PMCID: PMC7359178 DOI: 10.1136/bmjdrc-2020-001273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION To estimate the prevalence of and trends in diabetes according to sociodemographic indicators and cardiovascular risk factors in a Swiss population. RESEARCH DESIGN AND METHODS Annual cross-sectional study of adults residing in the state of Geneva. We included 9886 participants (51% women; mean age (SD) of 48.9 (13.4) years). Diagnosed diabetes was self-reported; undiagnosed diabetes was defined as having fasting plasma glucose level of ≥7 mmol/L and no previous diagnosis; total diabetes as the sum of diagnosed and undiagnosed diabetes. To assess trends, we grouped survey years into three time periods: 2005-2010, 2011-2014, and 2015-2017. To assess inequalities, we constructed the relative index of inequality (RII) and the slope index of inequality (SII) for education, income, and health insurance subsidy (state program based on socioeconomic disadvantage). RESULTS In total, 683 diabetes cases were identified. In 2015-2017, total diabetes prevalence was 11.8% (8.6%-14.9%) among lowest income participants, and 4.7% (3.4%-5.9%) among highest income participants (p<0.01). Similar findings were observed for education. Among participants with full health insurance subsidy, diabetes prevalence was 19.4% (12.1%-26.8%), and 6.1% (5.3%-7.0%) among those without (p<0.01). High diabetes prevalence was observed among participants who were men, older, overweight or obese, hypertensive, and hypercholesterolemic. Among participants with diabetes, 74.0% (63.5%-84.4%) in the lowest income group were diagnosed, compared with 90.2% (81.9%-98.4%) in the highest income group (p=0.04). Over the 13-year period, widening relative and absolute inequalities in total diabetes prevalence were observed for education and income. The education-RII (95% CI) increased from 1.51 (95% CI 1.01 to 2.32) in 2005-2010 to 2.54 (95% CI 1.58 to 4.07) in 2015-2017 (p=0.01), and the education-SII (95% CI) from 0.04 (95% CI 0.01 to 0.08) to 0.08 (95% CI 0.04 to 0.10; p<0.01). The income-RII increased from 2.35 (95% CI 1.44 to 3.84) to 3.91 (95% CI 2.24 to 6.85; p<0.01), and the income-SII from 0.08 (95% CI 0.04 to 0.12) to 0.011 (95% CI 0.07 to 0.14; p=0.01). Inequalities by health insurance subsidy were large (RII 3.56 (95% CI 1.90 to 6.66) and SII 0.10 (95% CI 0.05 to 0.15)) but stable across the study period. CONCLUSION Among adults living in Geneva, Switzerland, substantial differences were observed in diabetes prevalence across socioeconomic and cardiovascular risk groups over a 13-year period, and relative and absolute socioeconomic inequalities appeared to have increased.
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Affiliation(s)
- Carlos de Mestral
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Silvia Stringhini
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Idris Guessous
- Population Epidemiology Unit, Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - François R Jornayvaz
- Unit of Diabetology, Service of Endocrinology, Diabetology, Hypertension and Nutrition Services, Department of Medical Specialties, Geneva University Hospitals, Geneva, Switzerland
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Abstract
Diabetic retinopathy (DR) is one of the main causes of visual loss in individuals aged 20–64 years old. The aim of this study was to investigate, in a multicenter retrospective cross-sectional study, sex-gender difference in DR in a large sample of type 2 diabetic patients (T2DM). 20,611 T2DM regularly attending the units for the last three years were classified as having: (a) No DR (NDR), (b) nonproliferative DR (NPDR), or (c) preproliferative/proliferative DR (PPDR). DR of all grades was present in 4294 T2DM (20.8%), with a significant higher prevalence in men as compared to women (22.0% vs. 19.3% p < 0.0001). Among DR patients, both NPDR and PPDR were significantly more prevalent in men vs. women (p = 0.001 and p = 0.0016, respectively). Women had similar age and BMI, but longer diabetes duration, worse glycemic metabolic control, and more prevalence of hypertension and chronic renal failure (CRF) of any grade vs. men. No significant differences between sexes were evident in term of drug therapy for diabetes and associate pathologies. Conclusions: In this large sample of T2DM, men show higher prevalence of DR vs. women, in spite of less represented risk factors, suggesting that male sex per se might be a risk factor for DR development.
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Kraege V, Fabecic J, Marques-Vidal P, Waeber G, Méan M. Validation of Seven Type 2 Diabetes Mellitus Risk Scores in a Population-Based Cohort: The CoLaus Study. J Clin Endocrinol Metab 2020; 105:5645526. [PMID: 31781764 DOI: 10.1210/clinem/dgz220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/22/2019] [Indexed: 01/22/2023]
Abstract
AIM To assess the validity of seven type 2 diabetes mellitus (T2DM) risk scores in predicting the 10-year incidence of T2DM in a Swiss population-based study. METHODS The prospective study included 5131 participants (55% women, age range 35 to 75 years) living in Lausanne, Switzerland. The baseline survey was conducted between 2003 and 2006, and the average follow-up was 10.9 years. Five clinically-based scores (the Balkau, Kahn clinical, Griffin, Swiss Diabetes Association [SDAS], and Finnish Diabetes Risk Score [FINDRISC]) and two clinically and biologically based scores (the Kahn CB and Wilson) were tested. RESULTS 405 (7.9%) participants developed T2DM. The overall prevalence of participants at high risk ranged from 13.7% for the Griffin score to 43.3% for the Balkau score. The prevalence of participants at high risk among those who developed T2DM ranged from 34.6% for the Griffin score to 82.0% for the Kahn CB score. The Kahn CB score had the highest area under the ROC (value and 95% confidence interval: 0.866 [0.849-0.883]), followed by the FINDRISC (0.818 [0.798-0.838]), while the Griffin score had the lowest (0.740 [0.718-0.762]). Sensitivities and specificities were above 70%, except for the Griffin and the Kahn C scores (for sensitivity) and the Balkau score (for specificity). The numbers needed to screen ranged from 15.5 for the Kahn CB score to 36.7 for the Griffin score. CONCLUSION The Kahn CB and the FINDRISC scores performed the best out of all the scores. The FINDRISC score could be used in an epidemiological setting, while the need for blood sampling for the Kahn CB score restricts its use to a more clinical setting.
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Affiliation(s)
- Vanessa Kraege
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Janko Fabecic
- Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Marie Méan
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Zhang X, Liu J, Shao S, Yang Y, Qi D, Wang C, Lin Q, Liu Y, Tu J, Wang J, Ning X, Cui J. Sex Differences in the Prevalence of and Risk Factors for Abnormal Glucose Regulation in Adults Aged 50 Years or Older With Normal Fasting Plasma Glucose Levels. Front Endocrinol (Lausanne) 2020; 11:531796. [PMID: 33679598 PMCID: PMC7933576 DOI: 10.3389/fendo.2020.531796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
AIMS Abnormal glucose regulation, which can present as diabetes and prediabetes, has become one of the most common chronic conditions. However, sex differences in the prevalence of and factors associated with abnormal glucose regulation remain unclear. Thus, we aimed to explore sex differences in the prevalence of and factors associated with abnormal glucose regulation in low-income adults in China aged ≥50 years with normal fasting plasma glucose levels. MATERIALS AND METHODS A total of 2,175 individuals aged ≥50 years with normal fasting plasma glucose levels were recruited into this study. After an overnight fast of at least 10 h, individuals underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose levels were measured to determine the state of glucose regulation. RESULTS Women were more likely than men to have isolated-impaired glucose tolerance (i-IGT) overall (24.7% vs 20.8%; P= 0.034), among individuals aged <65 years (21.7% vs 15.9%; P= 0.012). Among men, independent risk factors for i-IGT were an age of ≥65 years, hypertension, and high serum uric acid (SUA) and triglyceride levels; independent risk factors for diabetes mellitus (DM) were an age of ≥75 years and alcohol consumption. Among women, independent risk factors for i-IGT were central obesity and high levels of high-sensitivity C-reactive protein and SUA; independent risk factors for DM were low education and an elevated white blood cell count. CONCLUSIONS Our findings suggest that conventional cardiovascular disease risk factors (i.e., age, hypertension, and dyslipidemia) associated with high risk of developing DM in men, but poor life style (i.e., obesity) and low education attainment in women. It is necessary for delay or stopping the development of DM among low-income adults in China to implement the personalized scheme of prevention DM between men and women, especially highlight control the risk factors in young and middle aged women.
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Affiliation(s)
- Xinxin Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Shuang Shao
- Department of Endocrinology and Metabolism, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuan Yang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Dongwang Qi
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Conglin Wang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Yue Liu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
- *Correspondence: Jingqiu Cui, ; Xianjia Ning, ; Jinghua Wang,
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
- *Correspondence: Jingqiu Cui, ; Xianjia Ning, ; Jinghua Wang,
| | - Jingqiu Cui
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Jingqiu Cui, ; Xianjia Ning, ; Jinghua Wang,
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Zhang H, Qi D, Gu H, Wang T, Wu Y, Li J, Ni J, Liu J, Tu J, Ning X, Wang J. Trends in the prevalence, awareness, treatment and control of diabetes in rural areas of northern China from 1992 to 2011. J Diabetes Investig 2020; 11:241-249. [PMID: 31172682 PMCID: PMC6944834 DOI: 10.1111/jdi.13095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/27/2019] [Accepted: 06/04/2019] [Indexed: 01/06/2023] Open
Abstract
AIMS/INTRODUCTION The worldwide prevalence of diabetes mellitus has been increasing over the past decades, particularly in developing countries. Because of the lack of information regarding changes in diabetes mellitus prevalence, awareness, treatment and control in rural China, we assessed these trends - overall and in the context of related health conditions - to explore the impact of these primary health issues on these rates in a poorly educated, rural population. MATERIALS AND METHODS Diabetes mellitus prevalence, awareness, treatment and control rates were compared between two surveys carried out in 1992 and 2011. The residents of three villages, aged 35-64 years, were recruited for this study. RESULTS In 1992, 1,091 individuals were interviewed and, in 2011, 2,338 individuals were interviewed. Between the two surveys, the overall diabetes mellitus prevalence in the study population was lower in 1992 than that in 2011 (P < 0.001); among men, the prevalence was 5.2-fold higher in 2011 than in 1992 (10.5 vs 1.7%) and nearly 4.3-fold higher (11.2 vs 2.1%) among women. Men aged 35-44 years, with >6 years of education, stage I hypertension and being overweight, had a higher prevalence of diabetes mellitus in 2011 than in 1992. Similarly, for the same time periods, there was also a higher diabetes mellitus prevalence among women aged 55-64 years, with 1-6 years of education, stage III hypertension and who were overweight. However, there were no significant changes in diabetes mellitus awareness, treatment or control in this population. CONCLUSIONS These results suggest that particular efforts must be made to enhance diabetes mellitus prevention, control and public awareness in rural communities in China.
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Affiliation(s)
- Hongyan Zhang
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Dongwang Qi
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Hongfei Gu
- Department of NeurologyTianjin Haibin People's HospitalTianjinChina
| | - Tao Wang
- Department of NeurologyTianjin Haibin People's HospitalTianjinChina
| | - Yanan Wu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jingyan Li
- Department of Endocrinology and MetabolismTianjin Medical University General HospitalTianjinChina
| | - Jingxian Ni
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jie Liu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jun Tu
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Xianjia Ning
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
| | - Jinghua Wang
- Department of NeurologyTianjin Medical University General HospitalTianjinChina
- Laboratory of EpidemiologyTianjin Neurological InstituteTianjinChina
- Key Laboratory of Post‐Neuroinjury Neuro‐Repair and Regeneration in Central Nervous SystemTianjin Neurological InstituteMinistry of Education and Tianjin CityTianjinChina
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An Overview of Disease Burden, Mechanism, Traditional and Non-traditional Management of Type 2 Diabetes. JOURNAL OF INTERDISCIPLINARY MEDICINE 2019. [DOI: 10.2478/jim-2019-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abstract
Diabetes is a major global health problem leading to high morbidity, mortality, and economic burden. Diabetes is connected to complex social, environmental, and behavioral factors and requires multisectoral evidence-based strategies to reduce its incidence and prevalence. Here we attempt to connect existing diabetes data with the underlying mechanism of the disease, while touching disease processes and traditional management approaches for diabetes and its complications. The major objective of this manuscript is to examine the effect of nontraditional treatment modalities, e.g. non-pharmaceutical interventions, supplements, alternative and integrative therapies etc., on diabetes. We performed an extensive literature search and review using electronic databases (PubMed and Google Scholar) to examine recent and historical diabetes statistics, the underlying mechanism of the disease, traditional treatments, remission possibility, and finally, the role of alternative therapies and supplements in its management. We found that there is no sufficient evidence to make most of the alternative therapies the first line of management and prevention approach for diabetes. Long-term and large-scale studies are needed to evaluate the safety and efficacy of alternative medicine. We feel that this review could urge other health researchers to plan comprehensive studies to examine the role of alternative or newly-identified therapies in diabetes. Also, this information can be useful for diverse health professionals and policymakers in developing and implementing evidence-based strategies.
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The prevalence and associated factors of type 2 diabetes in rural areas of Ningbo, China. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Jiang L, Wang K, Lo K, Zhong Y, Yang A, Fang X, Akezhuoli H, Song Z, Chen L, An P, Xu M, Min J, Wang F. Sex-Specific Association of Circulating Ferritin Level and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Studies. J Clin Endocrinol Metab 2019; 104:4539-4551. [PMID: 31074789 DOI: 10.1210/jc.2019-00495] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/06/2019] [Indexed: 12/15/2022]
Abstract
CONTEXT Although the role of iron in the development of type 2 diabetes (T2D) has long been a concern, prospective studies directly linking body iron stores to T2D risk in a sex-dependent context have been inconsistent. OBJECTIVE A systematic meta-analysis was conducted to explore the sex-specific association of circulating ferritin with T2D risk. DATA SOURCES We searched PubMed, Web of Science, and EMBASE databases to identify available prospective studies through 1 August 2018. RESULTS Fifteen prospective studies comprising 77,352 participants and 18,404 patients with T2D, aged 20 to 80 years, and with ∼3 to 17 years of follow-up were identified. For each 100-μg/L increment in ferritin levels of overall participants, T2D risk increased by 22% (RR, 1.22; 95% CI, 1.14 to 1.31). Of note, major heterogeneities by sex were identified, with increased ferritin level having an apparently greater effect on T2D risk in women (RR, 1.53; 95% CI, 1.29 to 1.82) than in men (RR, 1.21; 95% CI, 1.15 to 1.27) after exclusion of a study with high heterogeneity (41,512 men and 6974 women for sex-specific analyses; P = 0.020 for sex difference). Further nonlinear analysis between circulating ferritin and T2D risk also showed sex-dimorphic association in that the T2D risk of women was twice as strong in magnitude as that of men at the same ferritin level. CONCLUSIONS Greater circulating ferritin levels were independently associated with increased T2D risk, which appeared stronger among women than men. Our findings provide prospective evidence for further testing of the utility of ferritin levels in predicting T2D risk in a sex-specific manner.
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Affiliation(s)
- Li Jiang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
- The First Affiliated Hospital, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Kai Wang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Kenneth Lo
- Departments of Cardiology and Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island
| | - Yueyang Zhong
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Kong Kong SAR, China
| | - Xuexian Fang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Hailati Akezhuoli
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Zijun Song
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Liyun Chen
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng An
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
| | - Mingqing Xu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China
| | - Junxia Min
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Fudi Wang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
- The First Affiliated Hospital, School of Public Health, Zhengzhou University, Zhengzhou, China
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Srugo SA, de Groh M, Jiang Y, Morrison HI, Villeneuve PJ. Evaluating the utility of self-reported questionnaire data to screen for dysglycemia in young adults: Findings from the US National Health and Nutrition Examination Survey. Prev Med 2019; 120:50-59. [PMID: 30639079 DOI: 10.1016/j.ypmed.2019.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/29/2018] [Accepted: 01/08/2019] [Indexed: 12/25/2022]
Abstract
Dysglycemia, including prediabetes and type 2 diabetes, is dangerous and widespread. Yet, the condition is transiently reversible and sequelae preventable, prompting the use of prediction algorithms to quickly assess dysglycemia status through self-reported data. However, as current algorithms have largely been developed in older populations, their application to younger adults is uncertain considering associations between risk factors and dysglycemia vary by age. We sought to identify sex-specific predictors of current dysglycemia among young adults and evaluate their ability to screen for prediabetes and undiagnosed diabetes. We analyzed 2005-2014 data from the National Health and Nutrition Examination Survey for 3251 participants aged 20-39, who completed an oral glucose tolerance test (OGTT), had not been diagnosed with diabetes, and, for females, were not pregnant. Sex-specific stepwise logistic models were fit with predictors identified from univariate analyses. Risk scores were developed using adjusted odds ratios and model performance was assessed using area under the curve (AUC) measures. The OGTT identified 906 (27.9%) and 78 (2.4%) participants with prediabetes or undiagnosed diabetes, respectively. Predictors of dysglycemia status for males were BMI, age, race, and first-degree family history of diabetes, and, in addition to those, education, delivered baby weight, waist circumference, and vigorous physical activity for females. Our male- and female-specific models demonstrated improved validity to assess dysglycemia presence among young adults relative to the widely-used American Diabetes Association test (AUC = 0.69 vs. 0.61; 0.92 vs. 0.71, respectively). Thus, age-specific scoring algorithms employing questionnaire data show promise and are effective in identifying dysglycemia among young adults.
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Affiliation(s)
- Sebastian A Srugo
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | | | - Ying Jiang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.
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Li J, Ni J, Wu Y, Zhang H, Liu J, Tu J, Cui J, Ning X, Wang J. Sex Differences in the Prevalence, Awareness, Treatment, and Control of Diabetes Mellitus Among Adults Aged 45 Years and Older in Rural Areas of Northern China: A Cross-Sectional, Population-Based Study. Front Endocrinol (Lausanne) 2019; 10:147. [PMID: 30923514 PMCID: PMC6426742 DOI: 10.3389/fendo.2019.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/19/2019] [Indexed: 01/03/2023] Open
Abstract
Aims: Diabetes mellitus (DM) has reached epidemic proportions among adults worldwide, with China having the world's largest population of individuals with the disease. Although the consequences of low rates of awareness, treatment, and control of DM are understood, sex-related differences in these rates remain unknown. We assessed sex-related differences in the prevalence, awareness, treatment, and control of DM in a low-income, rural population in China. Materials and Methods: Individuals ≥45 years old without cardiovascular disease were recruited into this study. The prevalence, awareness, treatment, and control of DM in both men and women were assessed after accounting for age, educational level, body mass index, and blood pressure. Results: A total of 3,725 participants (women, 58.8%) were included. A male preponderance in the prevalence of DM was found among individuals aged 45-54 years, whereas there was a female preponderance among patients aged 65-74 years and among those who were illiterate. Among individuals with >6 years of formal education, overweight individuals, and normotensive individuals, there was greater DM awareness among women than among men. There was also a higher DM treatment rate among overweight women than among overweight men. However, better disease control was observed among men than among women for individuals aged 55-64-years, those with 1-6 years of education, and those with stage II hypertension. Conclusions: These results suggest that DM awareness should be improved among men and that regular DM screening should be implemented for men, especially young men. In addition, disease education and management should be strengthened for elderly women, especially those with low levels of education. Further studies are necessary to explore this situation among a representative population sample in China in order to establish a valid protocol against DM.
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Affiliation(s)
- Jingyan Li
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Hongyan Zhang
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jingqiu Cui
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Jingqiu Cui
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
- Xianjia Ning
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
- Jinghua Wang
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Zhang FL, Xing YQ, Guo ZN, Wu YH, Liu HY, Yang Y. Prevalence and risk factors for diabetes and impaired fasting glucose in Northeast China: Results from the 2016 China National Stroke Screening Survey. Diabetes Res Clin Pract 2018; 144:302-313. [PMID: 30217593 DOI: 10.1016/j.diabres.2018.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 08/16/2018] [Accepted: 09/05/2018] [Indexed: 11/20/2022]
Abstract
AIMS To explore the current prevalence and risk factors for diabetes and impaired fasting glucose in Northeast China. METHODS This study adopted the multistage stratified random cluster sampling method to obtain a representative sample of adults aged 40 years or older in Dehui City, Jilin Province, Northeast China. Diabetes and impaired fasting glucose were defined according to the 1999 World Health Organization criteria. RESULTS A total of 4052 participants were included, with prevalence of diabetes in Northeast China of 11.2% (95% confidence interval [CI], 10.1-12.4%); that of diagnosed, 5.9% (95% CI, 5.1-6.8%); and that of impaired fasting glucose, 6.9% (95% CI, 6.0-8.0%). Among them, 52.9% were aware of their condition, 47.7% were receiving antidiabetic medication, and 75.9% had their diabetes controlled. Rural residents were more likely to have diabetes but were less inclined to be aware of and report antidiabetic treatment and to have their diabetes controlled than urban residents. CONCLUSION Diabetes and impaired fasting glucose were highly prevalent among adults in Northeast China. However, awareness and treatment rates remained relatively low compared with those of developed countries. Health policymakers should put more basic medical and healthcare into rural areas in the future.
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Affiliation(s)
- Fu-Liang Zhang
- Stroke Center, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China.
| | - Ying-Qi Xing
- Center for Neurovascular Ultrasound, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China.
| | - Zhen-Ni Guo
- Clinical Trail and Research Center for Stroke, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China
| | - Yan-Hua Wu
- Division of Clinical Research, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China
| | - Hao-Yuan Liu
- Stroke Center, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China
| | - Yi Yang
- Stroke Center, Neuroscience Center, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China; Clinical Trail and Research Center for Stroke, Department of Neurology, the First Hospital of Jilin University, Chang Chun, Jilin 130021, China.
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Schimke KE, Renström F, Meier S, Stettler C, Brändle M. Compliance with guidelines for disease management in diabetes: results from the SwissDiab Registry. BMJ Open Diabetes Res Care 2018. [PMID: 29527307 PMCID: PMC5841515 DOI: 10.1136/bmjdrc-2017-000454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Tight glycemic control and aggressive treatment of additional cardiovascular risk factors can substantially reduce risk of diabetes-related complications. In 2013, the Swiss Society of Endocrinology and Diabetology (SSED) established national criteria on good disease management in diabetes, but little is known about compliance in clinical care. Here we assessed to what extent patients from two tertiary care centers in the German-speaking part of Switzerland enrolled in the Swiss Diabetes (SwissDiab) Registry adhere to the SSED criteria. RESEARCH DESIGN AND METHODS SwissDiab is a prospective observational cohort study of patients regularly treated at Swiss tertiary diabetes centers. Data were collected through standardized annual health examinations. Baseline participant descriptive statistics, stratified by diabetes mellitus type 1 (DM1) and type 2 (DM2), were compared with SSED targets for glycemic control, blood pressure, blood lipids, weight maintenance, and ophthalmic examination. RESULTS By the end of 2016, 604 participants with DM1 (40%) and DM2 (60%) had data available for analyses, 36% and 29% women, respectively. At baseline, all the SSED targets were met with two exceptions: a glycated hemoglobin A1c value <7% was measured in 32% of participants with DM1 (SSED target: ≥40%) and 47% and 56% of overweight or obese participants with DM1 and DM2, respectively, received nutritional counseling in the previous year (SSED target: ≥80%). CONCLUSIONS The SSED targets for good disease management in diabetes were achieved in the majority of participants at the time of enrollment, but results also highlight areas where disease management can be improved, particularly the role of nutrition counseling.
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Affiliation(s)
- Katrin E Schimke
- Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Frida Renström
- Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sandro Meier
- Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christoph Stettler
- Division of Endocrinology, Diabetes and Clinical Nutrition, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Michael Brändle
- Division of Endocrinology and Diabetes, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Ioanna Z, Christian S, Christian G, Daniel B. Plasma levels of hypoxia-regulated factors in patients with age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2017; 256:325-332. [PMID: 29177891 PMCID: PMC5790859 DOI: 10.1007/s00417-017-3846-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/18/2017] [Accepted: 11/04/2017] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Various hypoxia-related proteins are differentially expressed in the retina and secreted to the vitreous and/or aqueous humor of patients affected by dry or neovascular age-related macular degeneration (nAMD). To determine whether these conditions alter concentrations of cytokines also in the systemic circulation, we measured plasma levels of six hypoxia-related proteins. METHODS Plasma was prepared from EDTA blood that was collected from patients affected by dry AMD (n = 5), nAMD (n = 11), proliferative diabetic retinopathy (PDR; n = 9), and patients with an epiretinal membrane (ERM; n = 11). ERM samples served as negative controls, PDR samples as positive controls. Protein concentrations of vascular endothelial growth factor (VEGF), erythropoietin (EPO), angiopoietin-like 4 (ANGPTL4), placental growth factor (PlGF), tumor necrosis factor alpha (TNF-α), and pigment epithelium-derived factor (PEDF) were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS The concentration of PlGF was significantly increased in plasma of patients affected by nAMD. Although no statistically significant differences were found for EPO, ANGPTL4, PlGF, TNF-α, and PEDF, the mean concentration of VEGF was lowest in the nAMD group. Plasma concentrations of the six factors did not correlate with gender or age of patients. CONCLUSIONS nAMD may increase plasma concentrations of PlGF, making it a candidate as a biomarker for the neovascular form of AMD. Other factors, however, were not differentially regulated, suggesting that their systemic concentrations are not generally increased in hypoxia-related retinal diseases.
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Affiliation(s)
- Zygoula Ioanna
- Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Schori Christian
- Lab for Retinal Cell Biology, Department of Ophthalmology, Zurich Centre for Integrative Human Physiology (ZIHP), and Neuroscience Centre (ZNZ), University of Zurich, Zurich, Switzerland
| | - Grimm Christian
- Lab for Retinal Cell Biology, Department of Ophthalmology, Zurich Centre for Integrative Human Physiology (ZIHP), and Neuroscience Centre (ZNZ), University of Zurich, Zurich, Switzerland
| | - Barthelmes Daniel
- Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
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Ntontolo PN, Lukanu PN, Ogunbanjo GA, Fina JPL, Kintaudi LNM. Knowledge of type 2 diabetic patients about their condition in Kimpese Hospital diabetic clinic, Democratic Republic of the Congo. Afr J Prim Health Care Fam Med 2017; 9:e1-e7. [PMID: 29041795 PMCID: PMC5645560 DOI: 10.4102/phcfm.v9i1.1385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 03/25/2017] [Accepted: 04/09/2017] [Indexed: 11/14/2022] Open
Abstract
Background Diabetes mellitus is a worldwide increasing health problem of which type 2 diabetes is the most prevalent. Previously considered as a problem of industrialised countries, diabetes is currently a huge concern in developing countries and the Democratic Republic of the Congo (DRC) is one of the sub-Saharan countries with a high prevalence rate of diabetes. Deficit of knowledge has already been shown to be one of the barriers preventing diabetic patients from controlling their disease. Objectives This study aimed to assess the knowledge of type 2 diabetic patients seen at the Institut Médical Evangélique (IME) Kimpese Hospital diabetic clinic, DRC, and the factors associated with their knowledge. Methods A cross-sectional study involving 184 respondents was conducted at the diabetic clinic of the IME Kimpese Hospital, DRC. We administered a pre-tested questionnaire. Out of a total of 10, scores of < 5, 5 to < 7, and ≥ 7 were classified as ‘poor knowledge’, ‘moderate knowledge’ and ‘good knowledge’, respectively, according to expert consensus. All statistical tests were performed using p < 0.05 as the level of statistical significance. Results The mean age of respondents was 57.5 years (s.d. ± 1.4, ranging from 40 to 83 years), with 56% being male. The mean diabetes knowledge score was poor: 3.2 out of a total of 10 (s.d. ± 1.7), with the range between 0.2 and 7.7. The majority of respondents (72.3%) had poor general knowledge about diabetes mellitus. Respondents also scored poorly in areas of the causes (35.6%), risk factors (39.3%), clinical features (34.9%), complications (20.5%) and management (42.4%) of diabetes mellitus. Using the student t-test analysis, it was found that age (p = 0.001), gender (p = 0.002), educational level (p = 0.007) and duration of disease (p = 0.032) were significantly associated with poor knowledge of diabetes mellitus. Conclusions Knowledge of diabetes mellitus among type 2 diabetic patients seen at our setting was poor. Areas of deficiency and factors associated with knowledge of diabetes were identified. Our findings suggest the need for a health education intervention programme for our diabetic patients.
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Affiliation(s)
| | - Philippe N Lukanu
- Department of Family Medicine and Primary Health care, Protestant University of Congo, Democratic Republic of the Congo.
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Konstantinidis L, Carron T, de Ancos E, Chinet L, Hagon-Traub I, Zuercher E, Peytremann-Bridevaux I. Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort. BMC Endocr Disord 2017; 17:56. [PMID: 28882117 PMCID: PMC5590154 DOI: 10.1186/s12902-017-0206-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 08/29/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. METHODS A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. RESULTS While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. CONCLUSIONS Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. TRIAL REGISTRATION ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered).
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Affiliation(s)
- Lazaros Konstantinidis
- Jules Gonin University Eye Hospital, University of Lausanne, Avenue de France 15 - Case Postale 5143 - 1000 Lausanne 2, Lausanne, Switzerland
| | - Tania Carron
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Léonie Chinet
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Isabelle Hagon-Traub
- Public Health Service, Department of Health and Social Action, Canton of Vaud, Lausanne, Switzerland
| | - Emilie Zuercher
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Peytremann-Bridevaux
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Prevalence, Awareness and Associated Risk Factors of Diabetes among Adults in Xi'an, China. Sci Rep 2017; 7:10472. [PMID: 28874777 PMCID: PMC5585342 DOI: 10.1038/s41598-017-10797-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 08/15/2017] [Indexed: 12/15/2022] Open
Abstract
The study aimed to investigate the prevalence, awareness, treatment and glycaemic control of diabetes and its associated risk factors among adults in Xi’an, China. We collected data among participants aged 18 years or older through a self-developed questionnaire and an additional health examination. A total of 8150 participants were included, with an overall prevalence of diabetes of 8.0%. Among 655 participants with diabetes, 52.5% were aware they had diabetes, 48.1% took antidiabetic treatment, and 19.1% had their fasting blood glucose level at less than 7.0 mmol/l. Older age, lower educational level, higher body mass index, larger waist circumference, having an unhealthy diet and having more comorbidities were positively associated with the risk of diabetes. Participants who were older, who had higher education and who had more comorbidities were more aware that they had diabetes. Being older age, having higher education and having more comorbidities were also factors for better treatment. Participants who were older were more likely to have their glucose level controlled. The prevalence of diabetes among adults in Xi’an is high, with suboptimal awareness, treatment, and glycaemic control rates. Comprehensive integrated strategies based on risk factors should be implemented to improve the prevention and glycaemic control of diabetes.
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Obadan NO, Walker RJ, Egede LE. Independent correlates of chronic kidney disease awareness among adults with type 2 diabetes. J Diabetes Complications 2017; 31:988-991. [PMID: 28363729 PMCID: PMC5438883 DOI: 10.1016/j.jdiacomp.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 03/02/2017] [Accepted: 03/14/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Chronic Kidney Disease (CKD) is usually silent until advanced stages. Awareness of CKD is important to mitigate poorer outcomes. This study aims to understand the relationship(s) between CKD self-awareness and diagnosed CKD. METHODS The study included 345 adults with type 2 diabetes from two primary care settings. Participants completed surveys assessing demographic information, self-care behaviors and co-morbidities. Biological data were taken from medical records. CKD was diagnosed as eGFR=<59ml/min. CKD awareness was defined by a positive response to "has a doctor, nurse or other health professional ever told you that you have a kidney disease?" and/or "have you ever had kidney failure that required dialysis or a kidney transplant?" Logistic regression models were used to examine the association between CKD awareness and clinical/socio-demographic variables. RESULTS 31% of study patients had CKD based on eGFR (of which only 63% were aware). Stepwise regression showed that non-Hispanic blacks (OR=3.49, p=0.04), those with college education (OR=8.02, p=0.01), history of myocardial infarction (OR=10.12, p=0.002) or hypertension (OR=23.25, p=0.02), and those with Medicare, VA insurance, or other insurance (OR=8.08, 8.72, 101.47, respectively, p<0.01) were significantly more likely to be aware of CKD. Those with a history of stroke or depression (OR=0.21, 0.28, respectively, p=0.03, p=0.04) were significantly less likely to be aware of CKD. CONCLUSION CKD awareness was found to be lower than diagnosed CKD rates. Factors associated with awareness include race, educational status and cardiovascular disease. Targeted strategies to increase CKD awareness may lead to improved health outcomes.
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Affiliation(s)
- Ndidiamaka O Obadan
- Department of Medicine, Division of Nephrology, Medical University of South Carolina, Charleston, SC
| | - Rebekah J Walker
- Department of Medicine, Division of General Internal Medicine, Froedtert and The Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, USA 53226; Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA 53226
| | - Leonard E Egede
- Department of Medicine, Division of General Internal Medicine, Froedtert and The Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, USA 53226; Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA 53226.
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Al-Thani M, Al-Thani AA, Al-Chetachi W, Khalifa SE, Vinodson B, Al-Malki B, Haj Bakri A, Akram H. Situation of Diabetes and Related Factors Among Qatari Adults: Findings From a Community-Based Survey. JMIR Diabetes 2017; 2:e7. [PMID: 30291095 PMCID: PMC6238852 DOI: 10.2196/diabetes.7535] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 01/21/2023] Open
Abstract
Background Diabetes mellitus (DM) is a prominent public health problem in Qatar with one of the highest prevalence in the Gulf Cooperation Council region. Obesity continues to be a challenging public health problem in Qatar along with other social determinants contributing to the high DM prevalence. Objective This paper examines the data from Qatar National STEPS survey (2012) to determine diabetes prevalence among Qatari adults and identify the effect of both generalized and central obesity on it. The article also describes the contribution of selected social and demographic factors on diabetes prevalence in Qatar. Methods Secondary data analysis of 1471 Qatari adults (18-64 years) from STEP 3 component of the 2012 STEPS Survey was executed. Multivariate binary logistic regression analysis was carried out to assess the role of social and biomedical factors in the prevalence of DM. Results Among participants, 18.97% (279/1471) of the study population had DM. Both generalized (OR 1.8, P=.005) and central obesity (OR 1.9, P<.001) were significantly associated with DM when adjusted for various respondent characteristics. Older age (P<.001), marital status of ever married (P<.001), and lower educational status (P=.01) were associated with DM. Hypertension (OR 1.5, P=.003 total cholesterol level ≥190 mg/dL (OR 2.2, P<.001) and triglyceride level ≥150 mg/dL (OR 3.6, P<.001) were significantly associated with DM among the study participants. Although family history of DM was significantly associated with development of DM (OR 1.7, P=.01), parental consanguinity was not associated with DM (OR 0.96, P=.80). Conclusions The DM prevalence in Qatar seems to be highly associated with obesity; however, various additional population characteristics and comorbidity factors should also require attention and should be incorporated while developing intervention strategies.
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Feng BY, Huang C, Cao J, Dong Z, Liu FC, Ji LN, Yang JK, Li G, Li JX, Yang XL, Xie J, Fang K, Huang JF, Gu DF. Diabetes awareness, treatment, control rates and associated risk factors among Beijing residents in 2011: A cross-sectional survey. Chronic Dis Transl Med 2016; 2:147-158. [PMID: 29063036 PMCID: PMC5643831 DOI: 10.1016/j.cdtm.2016.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Indexed: 01/19/2023] Open
Abstract
Objective To examine the awareness, treatment and control rates of diabetes and identify their associated risk factors among Beijing residents. Methods A cross-sectional survey was conducted in 2011, using a stratified multistage cluster random sampling method to select a representative sample of 20,242 residents in Beijing aged 18–79 years. Diabetes was defined as fasting blood glucose (FBG) ≥7.0 mmol/L and/or history of diabetes and/or using insulin or hypoglycemic agents. All estimates of awareness, treatment and control rates were weighted by the 2010 Beijing Population Census data and the sampling scheme. Multivariate Logistic regression was used to identify factors associated with awareness, treatment and control rates. Results A total of 2061 (10.3%) participants were diagnosed as diabetes. The overall awareness, treatment and control rate among patients were 60.9%, 51.3% and 22.4%, respectively, while overall control rate among treated patients was 33.8%. These rates differed across subgroups. Women were more likely to be aware of diabetes status, receive treatment and have better glucose controlled than men (69.5% vs. 54.7% for awareness, 61.0% vs. 44.3% for treatment, and 27.6% vs. 18.6% for control, respectively). In addition, only 22.2% of treated patients had both FBG and hemoglobin A1c (HbA1c) controlled well. Multivariate Logistic regression suggested that old age, women, higher education and family history of diabetes were associated with higher awareness, treatment and control rates (All P < 0.05). Treated individuals living in rural (OR = 0.67(95%CI: 0.47–0.96)) or with dyslipidemia (OR = 0.63 (95%CI: 0.44–0.91)) had a lower diabetic control rate. Conclusions Awareness, treatment and control rates of diabetes in Beijing were still low. A comprehensive intervention strategy on diabetes management and control is warranted.
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Affiliation(s)
- Bao-Yu Feng
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Chen Huang
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Zhong Dong
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing 100013, China
| | - Fang-Chao Liu
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Li-Nong Ji
- Department of Endocrinology, Peking University People's Hospital, Beijing 100044, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Gang Li
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing 100013, China
| | - Jian-Xin Li
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Xue-Li Yang
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Jin Xie
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing 100013, China
| | - Kai Fang
- Institute of Chronic Diseases Control and Prevention, Beijing Center for Diseases Control and Prevention, Beijing 100013, China
| | - Jian-Feng Huang
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Dong-Feng Gu
- Department of Epidemiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
- Corresponding author. Fax: +86 10 88363812.Department of EpidemiologyFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical SciencesPeking Union Medical College167 Beilishi RoadBeijing100037China
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Jackson Y, Lozano Becerra JC, Carpentier M. Quality of diabetes care and health insurance coverage: a retrospective study in an outpatient academic public hospital in Switzerland. BMC Health Serv Res 2016; 16:540. [PMID: 27716186 PMCID: PMC5048692 DOI: 10.1186/s12913-016-1801-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socioeconomic disadvantage is associated with an increased risk of adverse diabetes outcomes. In Switzerland, a country with theoretical universal healthcare coverage, people without health insurance face barriers in accessing to and in receiving standard quality care. The Geneva University Hospitals (HUG) have implemented policies aiming at reducing these gaps. We compared quality of diabetes care and ambulatory healthcare services utilization among insured and uninsured diabetic patients. METHODS This retrospective study linked health and administrative data of type 2 diabetic outpatients with at least one HbA1c test performed in 2012-2013 at HUG. Quality of care evaluation relied on processes (annual serum HbA1c, cholesterol and microalbuminuria tesing) and outcomes (HbA1c) assessment. Healthcare utilization was assessed by the number of ambulatory clinical and laboratory visits. Results were stratified by disease course (newly diagnosed versus prevalent diabetes). RESULTS Of the 198 patients included, 80 (40.4 %) were uninsured. Both groups underwent annual testing of HbA1c, cholesterol, kidney function and microalbuminuria at comparably high rates and numbers of ambulatory visits did not significantly differ. After adjustments for age and sex, there were no significant differences in serum HbA1c between groups both in those with prevalent or with newly diagnosed diabetes. Initial medical intervention entailed comparable glycaemic improvement after 6 months in incident diabetes among insured and uninsured patients. CONCLUSIONS This study did not find any difference in quality of diabetes care between insured and uninsured patients in a public hospital enforcing health-equity policies for access to and for delivery of standard diabetes care. It highlights the frontline role of public hospitals in contributing to care delivery equity even in countries with theoretical universal healthcare coverage.
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Affiliation(s)
- Yves Jackson
- Division of primary care medicine, Department of community medicine, primary care and emergency medicine, Geneva University Hospitals, Geneva, Switzerland. .,Global health institute, University of Geneva, Geneva, Switzerland.
| | - Juan Carlos Lozano Becerra
- Division of primary care medicine, Department of community medicine, primary care and emergency medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marc Carpentier
- Division of clinical epidemiology, Geneva University Hospitals, Geneva, Switzerland
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Aregbesola A, Voutilainen S, Virtanen JK, Mursu J, Tuomainen TP. Gender difference in type 2 diabetes and the role of body iron stores. Ann Clin Biochem 2016; 54:113-120. [PMID: 27166309 DOI: 10.1177/0004563216646397] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Studies of gender difference in type 2 diabetes have been inconclusive. We investigated gender difference in type 2 diabetes and the contribution of body iron, as assessed by serum ferritin to this difference. Methods We performed cross-sectional ( n = 1707) and prospective ( n = 1506) analyses in males and females aged 53-73 years in 1998-2001. Type 2 diabetes diagnosis was determined by questionnaire, blood glucose measurements and record linkage to type 2 diabetes registers. Gender difference in type 2 diabetes and serum ferritin contribution to the difference was examined in multivariable logistic and Cox regression models. Gender difference in fasting plasma glucose and insulin and homeostasis model assessment of insulin resistance was examined in linear regression analysis. Results In the cross-sectional analysis, a total of 201 type 2 diabetes cases were observed (males = 111 [55.2%] vs. female = 90 [44.8%], P = 0.032), and in adjusted models, males had higher odds of type 2 diabetes (OR = 1.61, 95% CI 1.10 to 2.34); higher fasting plasma glucose (β = 0.28, 95% CI 0.15 to 0.41), fasting plasma insulin (β = 0.73, 95% CI 0.26 to 1.19) and homeostasis model assessment of insulin resistance (β = 0.11, 95% CI 0.04 to 0.17). In the prospective analysis, males had increased risk of type 2 diabetes (HR = 1.46, 95% CI 1.03 to 2.07). With serum ferritin introduction (100 µg/L, log-transformed) into the models, the type 2 diabetes prevalence (OR = 1.35, 95% CI 0.91 to 1.99) and incidence (HR = 1.38, 95% CI 0.96 to 1.97) were appreciably attenuated. Conclusions These data suggest a gender difference in type 2 diabetes, with a higher prevalence and increased type 2 diabetes risk in males. Body iron explains about two-fifths and one-fifth of the gender difference in type 2 diabetes prevalence and incidence, respectively.
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Affiliation(s)
- Alex Aregbesola
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland
| | - Sari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland
| | - Jaakko Mursu
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland
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Dizdar OS, Gul OO, Baspınar O, Cander S, Sisman P, Eker B, Ersoy C. Assessment of Factors Related to the Understanding of Education and Knowledge of Self-Care among Patients with Diabetes Mellitus: A Cross-Sectional Prospective Study. Adv Ther 2016; 33:1565-78. [PMID: 27397589 DOI: 10.1007/s12325-016-0378-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The prevalence of diabetes mellitus is rapidly increasing particularly in developing countries. The aim of this study was to assess the knowledge and self-care practices of diabetes patients and to assess the contribution of the education to this knowledge level and glycemic control. METHODS We formed patient groups consisting of 15-30 diabetic patients. First, patients were surveyed using a diabetes self-care knowledge questionnaire (DSCKQ-30). Sunsequently, a standard PowerPoint presentation about diabetes self-management was made to the patients who were then surveyed again using DSCKQ-30. All patients were invited to hospital to measure their control glycated hemoglobin (HbA1c) level 3 months later. RESULTS Of the total 364 participants, 62.9% were females. Significant increases in the percentage of correct responses were determined in all components between, before and after education. There was a significant decline of 1.1 in HbA1c levels after 3 months of education. Married or active working patients had a better understanding of the education about diabetes and had a greater knowledge of self-care management regardless of their level of education or income. CONCLUSION Education about diabetes can significantly improve knowledge of self-care management and can help in achieving glycemic control. Continuing education about self-care management and complications is crucial and this should be accompanied by a regular assessment of pateients' diabetic knowledge.
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Liu X, Li Y, Li L, Zhang L, Ren Y, Zhou H, Cui L, Mao Z, Hu D, Wang C. Prevalence, awareness, treatment, control of type 2 diabetes mellitus and risk factors in Chinese rural population: the RuralDiab study. Sci Rep 2016; 6:31426. [PMID: 27510966 PMCID: PMC4980764 DOI: 10.1038/srep31426] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/18/2016] [Indexed: 01/19/2023] Open
Abstract
The study aimed to investigate prevalence, awareness, treatment and control of type 2 diabetes mellitus (T2DM), and to explore potential risk factors in rural areas of China. A total of 16413 individuals aged 18–74 years in rural districts were recruited from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study for the epidemiological research. Meanwhile, a meta-analysis including 7 published studies was conducted to validate the result of the cross-sectional study. The rates of crude and age-standardized prevalence, awareness, treatment and control of T2DM were 12.19%, 67.00%, 62.35%, 22.20% and 6.98%, 60.11%, 54.85%, 18.77%, respectively. The prevalence, awareness, treatment and control of T2DM displayed increased trends with age (Ptrend < 0.01) and were strongly associated with education, drinking, more vegetable and fruit intake, physical activity, family history of diabetes, body mass index (BMI). The results of this meta-analysis showed that the pooled prevalence, awareness, treatment and control of T2DM in China countryside were 7.3% (5.3–9.4%), 57.3% (36.9–77.6%), 48.4% (32.4–64.5%) and 21.0% (9.9–32.1%), respectively. The prevalence of T2DM was high with inadequate awareness, treatment and control of T2DM in China rural areas. Healthy lifestyles should be advocated to reduce prevalence and improve awareness, treatment, and control of T2DM in Chinese rural residents.
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Affiliation(s)
- Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Linlin Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Luning Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yongcheng Ren
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Hao Zhou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lingling Cui
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Dongsheng Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.,Department of Prevention Medicine, Shenzhen University School of Medicine, Shenzhen, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
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Su R, Cai L, Cui W, He J, You D, Golden A. Multilevel Analysis of Socioeconomic Determinants on Diabetes Prevalence, Awareness, Treatment and Self-Management in Ethnic Minorities of Yunnan Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080751. [PMID: 27463725 PMCID: PMC4997437 DOI: 10.3390/ijerph13080751] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/14/2016] [Accepted: 07/19/2016] [Indexed: 01/19/2023]
Abstract
Objectives: The objective of this manuscript is to investigate socioeconomic differences in prevalence, awareness, treatment and self-management of diabetes among ethnic minority groups in Yunnan Province, China. Methods: We conducted a cross-sectional survey in a sample of 5532 Na Xi, Li Su, Dai and Jing Po ethnic minorities. Multilevel modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes prevalence, as well as the other outcomes. Results: Higher individual educational level was associated with a higher rate of awareness, treatment, adherence to medicines and monitoring of blood glucose (OR = 1.87, 4.89, 4.83, 6.45; 95% CI: 1.26–2.77, 1.87–12.7, 1.95–11.9, 2.23–18.6, respectively). Diabetic respondents with better household assets tended to receive more treatment (OR = 2.81, 95% CI: 1.11–7.12) and to monitor their blood glucose (OR = 3.29, 95% CI: 1.48–7.30). Diabetic patients with better access to medical services were more likely to treat (OR = 7.09, 95% CI: 2.46–20.4) and adhere to medication (OR = 4.14, 95% CI: 1.46–11.7). Income at the contextual level was significantly correlated with diabetes prevalence, treatment and blood glucose monitoring (OR = 1.84, 3.04, 4.34; 95% CI: 1.20–2.83, 1.20–7.73, 1.45–13.0, respectively). Conclusions: Future diabetes prevention and intervention programs should take both individual and township-level socioeconomic factors into account in the study regions.
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Affiliation(s)
- Rong Su
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
- Department of Gerontology, The Affiliated Ganmei Hospital of Kunming Medical University, 504 Qing Nian Road, Kunming 650011, China.
| | - Le Cai
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
| | - Wenlong Cui
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
| | - Jianhui He
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
| | - Dingyun You
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
| | - Allison Golden
- School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
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45
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Cho EH. Letter: Characterization of Patients with Type 2 Diabetes according to Body Mass Index: Korea National Health and Nutrition Examination Survey from 2007 to 2011 (Endocrinol Metab 2015;30:514-21, Dong-Hwa Lee et al.). Endocrinol Metab (Seoul) 2016; 31:345-6. [PMID: 27349702 PMCID: PMC4923421 DOI: 10.3803/enm.2016.31.2.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Eun Hee Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
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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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Yazdanpanah L, Shahbazian HB, Moravej Aleali A, Jahanshahi A, Ghanbari S, Latifi SM. Prevalence, awareness and risk factors of diabetes in Ahvaz (South West of Iran). Diabetes Metab Syndr 2016; 10:S114-S118. [PMID: 27312373 DOI: 10.1016/j.dsx.2016.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 03/05/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study was designed to assess the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. MATERIALS AND METHODS The study population was chosen by cluster sampling. A checklist included: age, sex, weight, height, blood pressure, waist circumference, educational level, smoking status and previous history of diabetes was completed for each patient. Fasting Plasma Glucose (FPG) ≥126mg/dl and/or oral hypoglycemic treatment and/or insulin consumption was defined as diabetes, FPG=100-125mg/dl as Impaired Fasting Glucose (IFG) and FPG <100mg/dl as normal. RESULTS Study population was 944 persons. Mean age of population was 42.2±14 years. Diabetes was detected in 15.1% of population. Only 40.4% of cases were aware of their disease. Diabetes was detected in 14.7% of female and 15.7% of male participants. Diabetes was related to age, waist circumference, family history of diabetes, hypertension, waist to hip ratio, educational level, marital status, serum triglyceride, cholesterol and body mass index (BMI) in both genders. But by using logistic regression analysis, age, family history of diabetes, hypertension, hypertriglyceridemia, and marital status had significant effect on diabetes. CONCLUSION This study showed that using FPG criteria or current medication 15.1% of this population had diabetes and about 60% of patients were unaware of their disease. Age, hypertension, family history of diabetes, hypertriglyceridemia and marital status are the risk factors of diabetes in Ahvaz population. IFG have high prevalence and diabetes screening should be intensified in this population.
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Affiliation(s)
- L Yazdanpanah
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - H B Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - A Moravej Aleali
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - A Jahanshahi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - S Ghanbari
- Department of Biostatistics, The Medical School Shiraz University of Medical Sciences, Shiraz, Iran
| | - S M Latifi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Liu M, Wang J, He Y, Jiang B, Wu L, Wang Y, Di Z, Zeng J. Awareness, treatment and control of type 2 diabetes among Chinese elderly and its changing trend for past decade. BMC Public Health 2016; 16:278. [PMID: 26987372 PMCID: PMC4797198 DOI: 10.1186/s12889-016-2874-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/16/2016] [Indexed: 12/25/2022] Open
Abstract
Background This study aims to evaluate the awareness, treatment, control rate of type 2 diabetes and its risk factors among Chinese community elderly, and also examine the changing trend for the past decade. Methods We conducted two population-based cross-sectional studies in a representative urban area of Beijing in 2001 and 2010 respectively, using with the same method. A total of 2,277 participants (943 male, 1,334 female) in 2001 and 2,102 participants (848 male, 1,254 female) in 2010 were recruited. All the participants diagnosed with diabetes were included in this study. Results The prevalence of diabetes was 21.4 % and 24.8 % in 2001 and 2010 respectively. Among participants with diabetes, 74.2 % were aware of the condition, 51.0 % were treated, 20.1 % well controlled the condition in 2001, and the corresponding rates were 78.5 %, 69.3 %,15.9 % in 2010 respectively. Higher education level and a positive family history were related to better management of diabetes, while obesity and alcohol drinking showed a reverse direction. Conclusions The prevalence and awareness of diabetes stayed high for the past decade. The treatment increased 18.3 % while the control rate decreased among community elderly for the past 10 years. It’s urgent to carry out effective measures to raise awareness, treatment, and control rate of diabetes in order to avoid growing disease burden in China.
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Affiliation(s)
- Miao Liu
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jianhua Wang
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yao He
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China. .,State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Bin Jiang
- Department of Chinese Traditional Medicine and Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Lei Wu
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yiyan Wang
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhang Di
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jing Zeng
- Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
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Bayındır Çevik A, Metin Karaaslan M, Koçan S, Pekmezci H, Baydur Şahin S, Kırbaş A, Ayaz T. Prevalence and screening for risk factors of type 2 diabetes in Rize, Nourtheast Turkey: findings from a population-based study. Prim Care Diabetes 2016; 10:10-18. [PMID: 26117174 DOI: 10.1016/j.pcd.2015.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 04/03/2015] [Accepted: 06/01/2015] [Indexed: 01/22/2023]
Abstract
AIMS We aimed to determine the prevalence of diagnosed and undiagnosed diabetes, risk factors affecting the healthy population, and factors that increase diabetes risk in the adult northeast Turkish population. METHODS Using population proportional cluster sampling, 930 adults were selected. After excluding people with diabetes, risk screening was conducted in the healthy population (n: 825) using the Information Form and FINDRISK questionnaire. Fasting venous blood and biochemical parameters were measured. RESULTS Prevalence of diabetes was 13.6% (new % 2.3), translating to approximately 44 thousand adults. Among the healthy population, 37.5% had high risk. Prevalence of not exercising (78.2%), obesity (36.1%), and hypertension (24.5%) were high. Predictors of risk of diabetes were aging (OR 1.09), low education (OR 0.51), familial diabetes history (OR 15.27), not exercising (OR 0.41), obesity (OR 5.17), high waist circumference (OR 1.05), heart disease (OR 4.81), and hypertension (OR 2.60). CONCLUSIONS This study can stimulate early screening for cardiovascular diseases and hypertension and initiating aggressive treatments in people with high diabetes risk. In primary health services, number of doctors and nurses trained in diabetes should be increased and dieticians should be involved. People with high risk should receive lifestyle regulations training.
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Affiliation(s)
- A Bayındır Çevik
- Recep Tayyip Erdoğan University (RTEU) School of Health Department of Medical Nursing Turkey.
| | | | - S Koçan
- RTEÜ Health Care Services Vocational School Turkey
| | - H Pekmezci
- RTEÜ Health Care Services Vocational School Turkey
| | - S Baydur Şahin
- RTEU School of Medicine Department of Endocrinology and Metabolic Diseases Turkey
| | - A Kırbaş
- RTEÜ School of Medicine Department of Biochemistry Turkey
| | - T Ayaz
- RTEÜ School of Medicine Department of Internal Medicine Turkey
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50
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Marques-Vidal P, Vollenweider P, Grange M, Guessous I, Waeber G. Dietary intake of subjects with diabetes is inadequate in Switzerland: the CoLaus study. Eur J Nutr 2016; 56:981-989. [PMID: 26744301 DOI: 10.1007/s00394-015-1146-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 12/22/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE To characterize the dietary intake of subjects aged 40-80 years according to self-reported diabetes and presence of an anti-diabetic diet. METHODS Cross-sectional study conducted between 2009 and 2012 on 4289 participants (2274 women) living in Lausanne. RESULTS Of the 299 (7 %) participants with self-reported diabetes, only 151 (51 %) reported an anti-diabetic diet. Compared to participants not reporting diabetes, participants with self-reported diabetes (with or without a diet) had a higher consumption of artificial sweeteners (0.3 ± 0.7 vs. 0.4 ± 0.8 and 0.8 ± 1.0 times/day) and a lower consumption of honey/jam (mean ± standard deviation: 0.5 ± 0.5 vs. 0.4 ± 0.4 and 0.4 ± 0.4 times/day) or sugar (0.6 ± 0.9 vs. 0.4 ± 0.7 and 0.2 ± 0.5 times/day) for participants not reporting diabetes, participants with self-reported diabetes not on a diet and on a diet, respectively. Compared to participants not on a diet, participants on a diet had a higher consumption of vegetables (1.8 ± 1.3 vs. 1.4 ± 1.0 portions/day), while no differences were found regarding all other food groups and nutrients. Participants with self-reported diabetes on a diet had a higher consumption of meat (5.6 ± 3.6 vs. 4.8 ± 2.9 portions/week) and a lower consumption of simple carbohydrates (21.0 ± 7.9 vs. 23.5 ± 8.4 % total energy intake) than participants not reporting diabetes. CONCLUSION People with diabetes eat less simple carbohydrates, but do not comply with current advice on fish, nuts, fruits and vegetables. Improvement of the dietary intake in persons with diabetes in Switzerland is needed.
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Affiliation(s)
- Pedro Marques-Vidal
- Department of Internal Medicine, BH10-642, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
| | - Peter Vollenweider
- Department of Internal Medicine, BH10-642, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Matthieu Grange
- Department of Internal Medicine, BH10-642, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Idris Guessous
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Biopôle 2, 1010, Lausanne, Switzerland.,Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Gérard Waeber
- Department of Internal Medicine, BH10-642, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland
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