1
|
Laurberg T, Graversen SB, Sandbæk A, Wild SH, Vos RC, Støvring H. Trends in cause-specific mortality among people with type 2 and type 1 diabetes from 2002 to 2019: a Danish population-based study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100909. [PMID: 38707867 PMCID: PMC11066523 DOI: 10.1016/j.lanepe.2024.100909] [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: 02/15/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 05/07/2024]
Abstract
Background Despite advances in primary and secondary prevention of cardiovascular disease, excess mortality persists within the diabetes population. This study explores the components of this excess mortality and their interaction with sex. Methods Using Danish registries (2002-2019), we identified residents aged 18-99 years, their diabetes status, and recorded causes of death. Applying Lexis-based methods, we computed age-standardized mortality rates (asMRs), mortality relative risks (asMRRs), and log-linear trends for cause-specific mortality. Findings From 2002 to 2019, 958,278 individuals died in Denmark (T2D: 148,620; T1D: 7830) during 84.4 M person-years. During the study period, overall asMRs declined, driven by reducing cardiovascular mortality, notably in men with T2D. Conversely, cancer mortality remained high, making cancer the leading cause of death in individuals with T2D. Individuals with T2D faced an elevated mortality risk from nearly all cancer types, ranging from 9% to 257% compared to their non-diabetic counterparts. Notably, obesity-related cancers exhibited the highest relative risks: liver cancer (Men: asMRR 3.58 (3.28; 3.91); Women: asMRR 2.49 (2.14; 2.89)), pancreatic cancer (Men: asMRR 3.50 (3.25; 3.77); Women: asMRR 3.57 (3.31; 3.85)), and kidney cancer (Men: asMRR 2.10 (1.84; 2.40); Women: asMRR 2.31 (1.92; 2.79)). In men with type 2 diabetes, excess mortality remained stable, except for dementia. In women, diabetes-related excess mortality increased by 6-17% per decade across all causes of death, except cardiovascular disease. Interpretation In the last decade, cancer has emerged as the leading cause of death among individuals with T2D in Denmark, emphasizing the need for diabetes management strategies incorporating cancer prevention. A sex-specific approach is crucial to address persistently higher relative mortality in women with diabetes. Funding Supported by Steno Diabetes Center Aarhus, which is partially funded by an unrestricted donation from the Novo Nordisk Foundation, and by The Danish Diabetes Academy.
Collapse
Affiliation(s)
- Tinne Laurberg
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd. 11, 8200, Aarhus, Denmark
| | - Susanne B. Graversen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd. 11, 8200, Aarhus, Denmark
| | - Annelli Sandbæk
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd. 11, 8200, Aarhus, Denmark
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark
| | - Sarah H. Wild
- Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Rimke C. Vos
- Public Health & Primary Care/Health Campus, The Hague Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Henrik Støvring
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Palle Juul-Jensens Blvd. 11, 8200, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, The Skou Building, Høegh-Guldbergs Gade 10, 8000, Aarhus, Denmark
| |
Collapse
|
2
|
Scherübl H. [Type-2-diabetes and gastrointestinal cancer screening]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2023; 61:683-689. [PMID: 35697066 DOI: 10.1055/a-1821-9108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
More than 8000000 Germans suffer from diabetes. People with type-2-diabetes (T2D) are at increased risk of gastrointestinal adenocarcinomas. They often develop cancer at younger age and their tumor-specific 5-year-survival is generally shorter. Cancer has become the leading cause of death of T2D-patients. Both chronic hyperglycemia and insulin resistance can stimulate gastrointestinal (GI) tumor growth. T2D can cause colorectal, pancreatic, hepatocellular, biliary and gastric cancer as well as esophageal adenocarcinoma. Both low-risk lifestyle and gastrointestinal cancer screening are effective and reduce GI cancer risk and GI cancer mortality of T2D-patients.
Collapse
Affiliation(s)
- Hans Scherübl
- Klinik für Innere Medizin; Gastroenterol., GI Onkol. u. Infektiol., Vivantes Klinikum Am Urban, Berlin, Germany
| |
Collapse
|
3
|
Nazari F, Khoshnood Z, Shahrbabaki PM. The Relationship Between Authenticity and Death Anxiety in Cancer Patients. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:966-979. [PMID: 33615894 DOI: 10.1177/0030222821997603] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
One of the many problems cancer patients experience is death anxiety. This descriptive-analytical cross-sectional study aimed to investigate the relationship between authenticity and death anxiety in cancer patients. The participants were 172 cancer patients who referred to medical centers in southeast Iran. The data were collected using authenticity inventory, and death and dying anxiety scale. There was a negative correlation between authenticity and death anxiety, i.e. patients who indicated higher authenticity scores showed lower levels of death anxiety. It seems that developing a comprehensive care program for increasing awareness of authenticity in patients, may be effective in reducing patient death anxiety.
Collapse
Affiliation(s)
- Faezeh Nazari
- Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Khoshnood
- Nursing Research Center, Department of Public Health Nursing, Razi Faculty Nursing and Midwifery, Kerman University of Medical Science, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Nursing Research Center, Department of Critical Care Nursing, Razi Faculty Nursing and Midwifery, Kerman University of Medical Science, Kerman, Iran
| |
Collapse
|
4
|
Li Z, Gao Z, Wang C, Zou D, Zhou H, Yi Y, Wang J, Wang L. Recent progress on bioimaging strategies based on Janus nanoparticles. NANOSCALE 2022; 14:12560-12568. [PMID: 36000475 DOI: 10.1039/d2nr03186h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Janus nanoparticles refer to a kind of asymmetric-structured nanoparticles composed of two or more distinct sides with differences in chemical nature and/or polarity on each side and thus can integrate two or more properties in one single particle. Due to their unique structure and surface properties, Janus nanoparticles have shown broad application potentials in optics, nuclear magnetic resonance, multi-mode imaging, and other fields. Unlike traditional contrast agents used in biological imaging, Janus nanoparticles are asymmetrically and directionally oriented to ensure stable partitioning of individual nanoparticles while integrating more functions. Much advancement have been carried out in the past few years, with some studies partially covering bioimaging applications. However, to our best knowledge, there are still no review papers specifically dedicated to the bioimaging applications with Janus nanoparticles. Bearing this in mind and taking the current challenges in this field into consideration, herein, we discuss representative approaches orchestrated for bioimaging applications, with the focus on the improvement of imaging quality brought by Janus nanoparticles and the development of multifunctional nanoplatforms in biological imaging fields, such as theranostics and therapies. Finally, based on the research experience of our group in this field, prospects for future research trends are put forward to provide new ideas for designing new Janus nanoparticles for clinical bioimaging.
Collapse
Affiliation(s)
- Zheyi Li
- School of Electronic and Information Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Zhiqiang Gao
- School of Aeronautics, Harbin Institute of Technology, Harbin 150001, China.
| | - Cong Wang
- School of Electronic and Information Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Danqing Zou
- School of Electronic and Information Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Huan Zhou
- School of Electronic and Information Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Yang Yi
- School of Electronic and Information Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Jun Wang
- School of Instrumentation Science and Engineering, Harbin Institute of Technology, Harbin 150001, China.
| | - Lei Wang
- School of Aeronautics, Harbin Institute of Technology, Harbin 150001, China.
| |
Collapse
|
5
|
Scherübl H. Krebsrisiko bei Prädiabetes und Typ-2-Diabetes mellitus. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1837-2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungKrebs ist nun die führende Todesursache bei Typ-2-Diabetes mellitus (T2D). Prädiabetes und T2D erhöhen das Risiko für bestimmte Tumoren. Zu den Prädiabetes- bzw. T2D-assoziierten Malignomen zählen gastrointestinale, gynäkologische, urologische und endokrine Karzinome aber auch Leukämien. Prädiabetes und T2D bedingen eine 1,2- bis 2,7-fach erhöhte Krebssterblichkeit. Zugrundeliegende Mechanismen der Assoziation zwischen T2D und Krebs beinhalten die chronische Hyperglykämie, einen chronischen systemischen Entzündungszustand, oxidativen Stress, Dyslipidämie, die Insulinresistenz sowie chronisch erhöhte Spiegel von insulin-like growth factor 1 (IGF-1) und von Insulin. Eine dauerhafte Gewichtsreduktion kann das Krebsrisiko adipöser T2D-Patienten signifikant senken. Ein gesunder Lebensstil und die regelmäßige Teilnahme an Vorsorgeuntersuchungen sind wichtig und können die Krebsmortalität von Diabetespatienten erheblich verringern.
Collapse
Affiliation(s)
- Hans Scherübl
- Klinik für Innere Medizin, Gastroenterologie, GI Onkologie, Diabetologie und Infektiologie, Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany
| |
Collapse
|
6
|
Scherübl H. Excess Body Weight and Gastrointestinal Cancer Risk. Visc Med 2021; 37:261-266. [PMID: 34540941 DOI: 10.1159/000515444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Background Excess body weight (EBW), defined as a body mass index (BMI) ≥25 kg/m2, has become the second most important as well as a potentially modifiable risk factor for cancer in many industrialized countries. The more excess weight people have, the higher the risk of certain cancers. Over the past several decades, EBW has been increasing globally not only among adults, but also among children and adolescents. Summary EBW is causally associated with colorectal, esophageal (adenocarcinoma), gastric (cardia), pancreatic, biliary and hepatocellular cancer. EBW when combined with tobacco smoking, risky alcohol use, or diabetes can act synergistically to cause gastrointestinal cancer. In recent years, more and more young adults (20-40 years old) were diagnosed with EBW-associated neoplasms. People with EBW should be encouraged to join cancer screening programs. Key Messages Keeping a healthy weight is a major public health concern and reduces the risk of cancer.
Collapse
Affiliation(s)
- Hans Scherübl
- Klinik für Innere Medizin II, Gastroenterologie, GI Onkologie, Diabetologie und Infektiologie, Vivantes Klinikum Am Urban, Berlin, Germany
| |
Collapse
|
7
|
Zhao C, Li X, Ma J, Zhu Z, Li H, Lou F, Zhai Y, Chen H, Xiao S, Peng Q, Hua H, Zhang Q, Lou F. Effects of liraglutide combined with metformin and Diamicron on glucose–lipid metabolism and islet β-cell function in elderly patients with type 2 diabetes mellitus. ALL LIFE 2021. [DOI: 10.1080/26895293.2021.1917457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Chunzhi Zhao
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Xing Li
- Department of Endocrinology, The Second Affiliated Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Jianhua Ma
- Department of Endocrinology, The Affiliated Nanjing Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Zhengtai Zhu
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Hua Li
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Fangli Lou
- Nursing School of Guizhou University of Traditional Chinese Medicine, Guiyang, People’s Republic of China
| | - Yuefang Zhai
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Hui Chen
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Shujun Xiao
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Qinhui Peng
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Huilian Hua
- Department of Pharmacy, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Qing Zhang
- Department of Geriatrics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| | - Fangyong Lou
- Department of Orthopaedics, Taizhou Peoples Hospital, Taizhou, People’s Republic of China
| |
Collapse
|
8
|
Risk-based diabetes screening in a Hungarian general practice: comparison of laboratory methods and diagnostic criteria. Prim Health Care Res Dev 2021; 22:e17. [PMID: 33883050 PMCID: PMC8101079 DOI: 10.1017/s1463423621000037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM Aim of cross-sectional study was to survey the risk of diabetes mellitus in a severely disadvantaged Hungarian community and then to use laboratory tests to screen for potential carbohydrate metabolism disorders among those in the moderate- and high-risk groups. BACKGROUND The prevalence of diabetes mellitus shows a worrisome trend worldwide. Low socio-economic status significantly affects the development of diabetes, healthy life years and life expectancy. METHOD Diabetes risk of the population was surveyed with the FINDRISC (Finnish Diabetes Risk Score) questionnaire, followed by oral glucose tolerance test (OGTT) and glycated haemoglobin test of moderate- and high-risk patients. FINDINGS In sample of 551 subjects, moderate or high risk for diabetes was confirmed in 147 patients (26.68%). There was significant correlation between increased risk and age (P < 0.001) and between increased risk and body mass index (P < 0.001). Significant difference was confirmed between incidences for disease based on the results of OGTT and glycated haemoglobin test when two different criteria systems were used. Age was the strongest predictor of pre-diabetes/diabetes (P = 0.016). The presence of metabolic syndrome increased the level of glycated haemoglobin by an average of 0.2% in normal glycemic status.
Collapse
|
9
|
Ghadimi M, Foroughi F, Hashemipour S, Nooshabadi MR, Ahmadi MH, Yari MG, Kavianpour M, Haghighian HK. Decreased insulin resistance in diabetic patients by influencing Sirtuin1 and Fetuin-A following supplementation with ellagic acid: a randomized controlled trial. Diabetol Metab Syndr 2021; 13:16. [PMID: 33546744 PMCID: PMC7866694 DOI: 10.1186/s13098-021-00633-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/22/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The beneficial effects of polyphenols have been reported. This study aimed to investigate the effect of oral Ellagic acid (EA) supplement on insulin resistance (IR) and Fetuin-A and serum sirtuin1 (SIRT1) in type 2 diabetics. METHODS In this double-blind, randomized clinical trial, 44 diabetic patients were selected. Patients were assigned to the intervention group (22 subjects) and placebo (22 subjects) and received a capsule containing 180 mg of EA per day or placebo for eight weeks, respectively. At the beginning and end of the study, anthropometric indices, fasting plasma glucose (FPG), plasma insulin level, IR, Fetuin-A, and SIRT1 were measured. Statistical analysis was performed using SPSS software. RESULTS At the beginning and end of the study, there was no significant difference between the two groups regarding anthropometric indices (P > 0.05). At the end of the survey, EA supplementation significantly reduced FPG, insulin, IR, and Fetuin-A and increased SIRT1 levels compared with the placebo group (P < 0.05). However, these changes were not significant in the placebo group (P > 0.05). CONCLUSION EA with antioxidant properties plays an essential role in reducing the macrovascular and microvascular complications of diabetes by reducing inflammation and insulin resistance. Trial registration The protocol of this clinical trial is registered with the Iranian Registry of Clinical Trials ( http://www.IRCT.IR , identifier: IRCT20141025019669N13).
Collapse
Affiliation(s)
- Mahnaz Ghadimi
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Farshad Foroughi
- Department of Immunology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Mohammad Hossein Ahmadi
- Department of Laboratory Sciences, School of Allied Medical Sciences, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Maria Kavianpour
- Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hossein Khadem Haghighian
- Department of Nutrition, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran.
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| |
Collapse
|
10
|
Zhu YY, Yang ZY, Li P, Huang XY, Zhang XH, Ji LN, Tang JL. Comparing the incidence of major cardiovascular events and severe microvascular complications in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. World J Meta-Anal 2020; 8:400-410. [DOI: 10.13105/wjma.v8.i5.400] [Citation(s) in RCA: 2] [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] [Received: 05/27/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) causes both macrovascular and microvascular complications. However, currently, selection of glycemic measures and their thresholds to diagnose T2DM, and efficacy outcomes in evaluation of anti-diabetic drugs is predominantly informed by the relation of T2DM to microvascular complications. We can be severely mistaken on T2DM by neglecting macrovascular complications which are generally more severe, if they also occur more commonly than microvascular complications.
AIM To compare the incidence of major cardiovascular events (MACEs) and severe microvascular complications (SMICs) in T2DM patients.
METHODS MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from inception to September 2017. Cohort studies or trials of T2DM patients aged 18 years or older that reported incidence of both MACEs and SMICs were included. MACEs were defined as nonfatal myocardial infarction and stroke, and cardiovascular death, while SMICs included serious retinopathy, nephropathy and diabetic disorder. The relative risk (RR) was estimated as the incidence of MACEs divided by that of SMICs in same patients and combined with meta-analysis in a random-effect model.
RESULTS Twelve studies with a total of 16 cohorts and 387376 patients were included, and the combined RR was 2.02 (95%CI: 1.46–2.79). The higher incidence of MACEs remained in various subgroup and sensitivity analyses.
CONCLUSION Patients with T2DM are much more likely to develop MACEs than SMICs. By taking more serious consequences and relatively higher incidence into consideration, macrovascular complications deserve more emphasis in developing the diagnostic criteria of T2DM and in evaluating the efficacy of anti-diabetic drugs.
Collapse
Affiliation(s)
- Ying-Ying Zhu
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zu-Yao Yang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ping Li
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xin-Ying Huang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue-Hong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Li-Nong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing 100044, China
| | - Jin-Ling Tang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|