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Selvavinayagam TS, Viswanathan V, Ramalingam A, Kangusamy B, Joseph B, Subramaniam S, Sheela JS, Wills S, Ramasamy S, Venkatasamy V, Rajasekar D, Chinnasamy G, Govindasamy E, Duraisamy A, Chokkalingam D, Durairajan D, Kriina M, Vasu H, Selvam JM, Sakthivel U, Kaur P, Palaniandi S. Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020. PLoS One 2024; 19:e0298340. [PMID: 38718057 PMCID: PMC11078398 DOI: 10.1371/journal.pone.0298340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions. METHODS A state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI). RESULTS Due to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension. CONCLUSION The burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.
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Affiliation(s)
- T. S. Selvavinayagam
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
| | - Vidhya Viswanathan
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Bency Joseph
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Soniya Wills
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Daniel Rajasekar
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | | | - D. Chokkalingam
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Dinesh Durairajan
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Mosoniro Kriina
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Harshavardhini Vasu
- Tamil Nadu Health Systems Reforms Project, Government of Tamil Nadu, Chennai, India
| | | | - Uma Sakthivel
- Tamil Nadu Health Systems Reforms Project, Government of Tamil Nadu, Chennai, India
| | - Prabhdeep Kaur
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
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Kumar S, Chhabra V, Mehra M, K S, Kumar B H, Shenoy S, Swamy RS, Murti K, Pai KSR, Kumar N. The fluorosis conundrum: bridging the gap between science and public health. Toxicol Mech Methods 2024; 34:214-235. [PMID: 37921264 DOI: 10.1080/15376516.2023.2268722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.
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Affiliation(s)
- Sachindra Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vishal Chhabra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Manmeet Mehra
- Department of Pharmacology, Guru Nanak Dev University, Amritsar, India
| | - Saranya K
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Harish Kumar B
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Smita Shenoy
- Department of Pharmacology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ravindra Shantakumar Swamy
- Division of Anatomy, Department of Basic Medical Sciences (DBMS), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - K Sreedhara Ranganath Pai
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
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Das U, Kar N. Prevalence and risk factor of diabetes among the elderly people in West Bengal: evidence-based LASI 1st wave. BMC Endocr Disord 2023; 23:170. [PMID: 37568234 PMCID: PMC10416355 DOI: 10.1186/s12902-023-01421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The complication of Diabetes is one of the important health issues among the older adult population in any region. The higher risks of diabetes prevalence among older adult people in the countries was due to social-cultural changes such as increasing urbanization, dietary changes, without physical activity, and unhealthy lifestyle behavior. The present study examines the prevalence and associated risk factors of diabetes among older adults in the state of West Bengal. METHODS The first wave of the Longitudinal Ageing Study in India 2017-18 was used to achieve the study objectives. Descriptive statistics with multinomial logistic regression models were used to carry out crude and adjusted odds ratios with 95% confidence intervals and examine the associated risk factors of diabetes prevalence among older adults. RESULTS The findings of the study indicate that the overall prevalence of diabetes among the study participants was found to be 12.4% which was significantly higher in urban areas (19%) compare to rural areas (6%). The socio-economic and bio-demographic factors like educational status, richest background family, marital status, obesity, and family history of diabetes were significantly associated with higher risks of diabetes prevalence among the older adult population in West Bengal. The risks of diabetes in the richest adult people were significantly higher than in the poorest adult people (OR = 2.78; 95% CI: 1.974-3.917). The higher risks of diabetes mellitus among the richest wealthy people are because of lifestyle behavior, smoking, and tobacco consumption respectively. CONCLUSION The study needs to policy and awareness program to reduce economic inequality and prevention of diabetes care and treatment-seeking behavior, especially for the older adult population in West Bengal.
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Affiliation(s)
- Ujjwal Das
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
- Dept. of Geography, Fakir Mohan University, Balasore, Odisha India
| | - Nishamani Kar
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
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Zheng W, Chu J, Ren J, Dong J, Bambrick H, Wang N, Mengersen K, Guo X, Hu W. Age- and Gender-Specific Differences in the Seasonal Distribution of Diabetes Mortality in Shandong, China: A Spatial Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17024. [PMID: 36554905 PMCID: PMC9779441 DOI: 10.3390/ijerph192417024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Diabetes mortality in Shandong is higher than the national average in China. This study first explored diabetes mortality variation spatially at the county/district level among adults aged over 30 years in terms of age and gender, specifically by season. Daily diabetes mortality data were collected from 31 mortality surveillance points across Shandong Province in 2014. A geographic information system, spatial kriging interpolation and a spatial clustering method were used to examine the spatial patterns of diabetes mortality at the county/district level by season. Sensitivity analysis was conducted using diabetes mortality data from 10 mortality surveillance points from 2011 to 2020. As a result, the total diabetes mortality in eastern counties/districts was the highest (relative risk (RR) of cluster: 1.58, p = 0.00) across the whole province. For subgroups, women had higher mortality (16.84/100,000) than men (12.15/100,000), people aged over 75 years were the most vulnerable (93.91/100,000) and the highest-risk season was winter. However, the mortality differences between winter and summer were smaller in eastern and coastal regions than in other regions for all gender- and age-specific groups. The findings provide further evidence for early warning and precision preventative strategies for diabetes mortality in different regions of Shandong Province. Future research is required to identify the risk factors for diabetes and understand the differences in the social and environmental contexts.
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Affiliation(s)
- Wenxiu Zheng
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Jie Chu
- The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Jie Ren
- The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Jing Dong
- The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Hilary Bambrick
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Ning Wang
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing 100050, China
| | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Xiaolei Guo
- The Department for Chronic and Non-Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Wenbiao Hu
- Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia
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Chakraborty S, Devi Rajeswari V. Biomedical aspects of beta-glucan on glucose metabolism and its role on primary gene PIK3R1. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Li Y, Jiang Y, Lin J, Wang D, Wang C, Wang F. Prevalence and associated factors of diabetes mellitus among individuals aged 18 years and above in Xiaoshan District, China, 2018: a community-based cross-sectional study. BMJ Open 2022; 12:e049754. [PMID: 35296469 PMCID: PMC8928303 DOI: 10.1136/bmjopen-2021-049754] [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: 11/04/2022] Open
Abstract
OBJECTIVE With the rapid development of the Chinese economy, Xiaoshan District, Zhejiang Province has experienced urbanisation, population ageing and significant lifestyle changes, so diabetes mellitus (DM) has attracted more attention. This study aimed to evaluate the prevalence of DM and its risk factors among individuals aged 18 years and above in the district. STUDY DESIGN AND METHODS A community-based cross-sectional study was carried out in Xiaoshan, China from 1 March to 31 August 2018. A multistage sampling method was used. Sociodemographic and behavioural characteristics were collected using a combination of centralised surveys and household surveys. Anthropometric parameters were measured with standardised techniques and calibrated equipment. Venous blood samples were obtained after at least 8 hours of fasting to determine the level of fasting blood glucose (FBG) and blood lipids. A standard 2-hour 75 g oral glucose tolerance test was also given if 6.1 mmol/L≤FBG<7.0 mmol/L. Univariate and multivariate logistic regression analyses were used to assess the associated factors of DM. RESULTS The overall prevalence of DM was 12.47%, and the proportion of previously undiagnosed DM (UDM) was 48.66%. The prevalence of pre-diabetes was 10.92%. Age, family history of DM (FHDM), obesity, abdominal obesity, systolic blood pressure (SBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were significantly associated with DM. CONCLUSIONS This study found a high prevalence of DM and pre-diabetes, especially a high prevalence of UDM among adults. The associated risk factors identified for DM were age, FHDM, obesity, abdominal obesity, SBP, TG and HDL-C.
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Affiliation(s)
- Yurong Li
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyuan Jiang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junying Lin
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Dongfei Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Chunli Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fenjuan Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Trends in the diabetes incidence and mortality in India from 1990 to 2019: a joinpoint and age-period-cohort analysis. J Diabetes Metab Disord 2021; 20:1725-1740. [PMID: 34900822 DOI: 10.1007/s40200-021-00834-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
Introduction Globally, a metabolic disorder like Diabetes is considered as one of the largest global health issues, as it accounts for the majority of the disease burden and happens to be one of the leading causes of mortality as well as reduced life expectancy across the world. As in 2019, India is home to the second-largest number (77 million) of Diabetic adults and the number of people affected has been increasing rapidly over the years. Termed as "the diabetes capital of the world," with every fifth diabetic in the world being an Indian, there is an urgent need to address many critically significant challenges posed by Diabetes in India, like, increasing prevalence among young people in urban areas, less awareness among people, high cost of disease management, limited healthcare facilities, suboptimal diabetes control etc. In Indian context, not enough attempts have been made to observe and understand the long-term pattern of diabetes incidence and mortality. This study aims to provide deep insights into the recent trends of diabetes incidence and mortality in India from 1990 to 2019. Materials and methods This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of diabetes (from 1990 to 2019) from the Global Health Data Exchange. The average annual percentage changes in incidence and mortality were analysed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results During the study period, age-standardized incidence and mortality rates of diabetes in India experienced an upsurge in numbers, the incidence rate increased from 199.14 to 317.02, and consequently, mortality increased from 22.30 to 27.35 per 100,000 population. The joinpoint regression analysis showed that the age-standardized incidence significantly rose by 1.63 % (95 % CI: 1.57 %, 1.69 %) in Indian males and 1.56 % in Indian females (95 % CI: 1.49 %, 1.63 %) from 1990 to 2019. On the other hand, the age-standardized mortality rates rose by 0.77 % (95 % CI: 0.24 %, 1.31 %) in Indian males and 0.57 % (95 % CI: -0.54 %, 1.70 %) in Indian females. For age-specific rates, incidence increased in most age groups, with exception of age groups 5-9, 70-74, 75-79 and 80-84 in male, and age groups 5-9, 75-79 and 80-84 in female. Mortality in male saw a decreasing trend till age group 20-24, whereas in female, the rate decreased till age group 35-39. The age effect on incidence showed no obvious changes with advancing age, but the mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period; cohort effect on diabetes incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts, while incidence showed no material changes from 1975 to 1979 to 2000-2004 birth cohort. Conclusions Mortality of diabetes decreased in younger age groups but increased in older age groups; however, Incidence increased in most age groups for both male and female. The net age or period effect showed an unfavourable trend while the net cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of diabetes. Timely population-level interventions aiming for health education, lifestyle modification with special emphasis on the promotion of physical activity and healthy diet should be conducted, especially for male and earlier birth cohorts at high risk of diabetes.
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Tripathy B, Sahoo N, Sahoo SK. Trends in diabetes care with special emphasis to medicinal plants: Advancement and treatment. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2021; 33:102014. [PMID: 35342487 PMCID: PMC8941016 DOI: 10.1016/j.bcab.2021.102014] [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: 03/27/2021] [Revised: 04/15/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022]
Abstract
Diabetic mellitus (DM) is a common metabolic disorder prevailing throughout the world. It may affect a child to an older person depending upon the physiology and the factors influencing the internal metabolic system of the body. Several treatments are available in the market ranges from synthetic drugs, insulin therapy, herbal drugs, and transdermal patches. Interestingly, the development of technologies and digital health have proving very helpful in improving the lifestyle of diabetic patients. All treatment approaches have their own advantages and disadvantages in the form of effectiveness and side effects. Medicinal plants have a long history of traditional application in the treatment of diabetes and even the use of plants are growing day-by-day due to the significant results against diseases and fewer side effects as compared to other treatment therapies. The intention behind writing this review is to gather all information and discussed them exhaustively in an article. The novel Coronavirus 2019 (COVID-19) pandemic has affected my lives including diabetic patients. The antidiabetic treatment strategies during this period has also discussed. In this article, we highlighted the molecular mechanism and herbal phytoconstituents that are responsible for lowering blood glucose level. The factors responsible for the progression of metabolic disorders can be controlled with the use of phytoconstituents present in herbal plants to maintain β-cells performance and restore blood glucose level. It can be concluded that medicinal plants are effective and affordable with lesser side effects for treating DM.
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Affiliation(s)
| | - Nityananda Sahoo
- Centurion University of Technology & Management, Odisha, 752050, India
| | - Sudhir Kumar Sahoo
- Royal College of Pharmacy and Health Sciences, Berhampur, Odisha, 759024, India
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Medhi GK, Dutta G, Borah P, Lyngdoh M, Sarma A. Prevalence of Diabetes and Its Relationship With Body Mass Index Among Elderly People in a Rural Area of Northeastern State of India. Cureus 2021; 13:e12747. [PMID: 33614345 PMCID: PMC7886600 DOI: 10.7759/cureus.12747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Diabetes and its complications are a major public health concern in elderly populations. However, there is little population-based data on diabetes and its risk factors among the elderly population living in rural areas of India. The objective of this population-based study was to assess the prevalence of diabetes in the elderly population and its relationship with body mass index (BMI). Methodology A population-based, cross-sectional study was conducted among elderly individuals (≥60 years) during the period 2013-2016 in rural areas of Dibrugarh district of Assam. Multi-stage sampling design was adopted to select the study participants. Data on socio-demographic profile and diagnosis/treatment history of diabetes were collected using pre-designed and pre-tested questionnaire. Fasting blood sugar was tested. Weight and height were measured to calculate BMI. Multivariate logistic regression analysis was performed to assess the relationship between diabetes and BMI. Results Data were collected from 430 (male: 210, female: 220) individuals. The overall prevalence of diabetes was 7.9% (male: 7.1%, female: 8.6%). Higher level of education was associated with increased prevalence of diabetes. Prevalence of diabetes increased as the BMI of participants increased. Prevalence of diabetes among obese individuals (BMI ≥25 kg/m2) was 30.4% compared to only 5% among normal weight individuals. Obesity was associated with eight-fold higher risk of diabetes compared with the individuals of normal weight in multivariate analysis. Conclusions The study reveals nearly 8% population-based prevalence of diabetes in rural elderly people in the study district. Our study provides epidemiological evidence that obesity is a major driver of diabetes among rural elderly people.
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Affiliation(s)
- Gajendra K Medhi
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Gitashree Dutta
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Prasanta Borah
- Epidemiology and Nutrition, ICMR-Regional Medical Research Centre, Northeast (NE) Region, Dibrugarh, IND
| | - Markordor Lyngdoh
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Amitav Sarma
- Anatomy, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
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Samaddar A, Cuevas RP, Custodio MC, Ynion J, Ray (Chakravarti) A, Mohanty SK, Demont M. Capturing diversity and cultural drivers of food choice in eastern India. Int J Gastron Food Sci 2020; 22:100249. [PMID: 33343768 PMCID: PMC7737094 DOI: 10.1016/j.ijgfs.2020.100249] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The EAT-Lancet Commission urgently called for "planetary health diets". The success of encouraging dietary shifts, however, crucially hinges on people, and more specifically on consumers' culture, context, socioeconomic status, food environment, attitudes, perceptions, beliefs, and behavior towards food choice. In India, enhanced food availability and accessibility do not readily lead to improved nutritional status. Thus, developing planetary health diets in India requires an understanding of systemic drivers of food choice. Food is an essential part of Indian culture and deeply rooted to the country's history, traditions, lifestyles, and customs. Yet, the diversity and cultural drivers of food choice are still insufficiently understood. To address this knowledge gap, we use expert elicitation to contextualize the "gastronomic systems research" framework to a target population of low-to middle-income households to capture the diversity and cultural drivers of food choice and its nutritional implications in rice-based diets in two states in eastern India. The experts catalogued 131 unique dishes associated with five differentiated daily dining occasions. The majority of dishes belong to the starch food group. Morning snacks exhibit the lowest nutritional diversity while dinners feature the highest diversity in both states. In West Bengal, dish options tend to be carbohydrate-rich and energy-dense, and a significant number of dishes are fried and oily. The gastronomic system mapped by the experts provides a useful baseline for nutritionists, policymakers, and food system actors as a first step in the design of nutrition intervention strategies to develop planetary health diets in eastern India.
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Affiliation(s)
- Arindam Samaddar
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | - Rosa Paula Cuevas
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | | | - Jhoanne Ynion
- International Rice Research Institute, Los Baños, Laguna, Philippines
| | | | - Suva Kanta Mohanty
- Kalinga Institute of Industrial Technology, KIIT School of Management, Bhubaneswar, India
- Institute of Rural Management Anand (IRMA), Anand, Gujrat, India
| | - Matty Demont
- International Rice Research Institute, Los Baños, Laguna, Philippines
- Corresponding author. International Rice Research Institute (IRRI), DAPO Box 7777, Metro Manila, 1301, Philippines.
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Mehreen TS, Kamalesh R, Pandiyan D, Kumar DS, Anjana RM, Mohan V, Ranjani H. Incidence and Predictors of Dysglycemia and Regression to Normoglycemia in Indian Adolescents and Young Adults: 10-Year Follow-Up of the ORANGE Study. Diabetes Technol Ther 2020; 22:875-882. [PMID: 32349530 DOI: 10.1089/dia.2020.0109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The prevalence of diabetes in youth is increasing worldwide in parallel with the obesity epidemic. This study aimed to determine the incidence rates of dysglycemia (diabetes or prediabetes) and evaluate the predictors of its progression or regression to normal glucose tolerance (NGT) in a cohort of children and adolescents studied in Chennai, South India. Methods: A longitudinal follow-up of the Obesity Reduction and Awareness of Noncommunicable Diseases through Group Education (ORANGE) cohort was performed after a median of 7.1 years (n = 845; 5928 person-years of follow-up). To determine their diabetes status at follow-up, participants underwent an oral glucose tolerance test (n = 811 with NGT and 34 with prediabetes at baseline), excluding those with diabetes at baseline. Incidence rates for dysglycemia were reported per 1000 person-years of follow-up. Cox proportional hazards model was used to estimate the predictors of progression and regression. Results: Out of 811 individuals with NGT at baseline, 115 developed dysglycemia giving an incidence rate of 20.2 per 1000 person-years (95% confidence interval: 16.8-24.2). Among those with prediabetes at baseline, 70.6% of the individuals converted to NGT and the remaining 29.4% either got converted to diabetes or remained as prediabetes. Higher age, body mass index, fasting plasma glucose, 2-hour plasma glucose (2-h PG), positive family history of diabetes, and systolic blood pressure (BP) were independent predictors of incident dysglycemia, whereas lower age, waist circumference, 2-h PG, systolic BP, and triglycerides predicted regression to normoglycemia. Conclusions: This study highlights the growing burden of dysglycemia in Asian Indian youth and emphasizes the need for targeted preventive actions.
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Affiliation(s)
- T S Mehreen
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R Kamalesh
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, India
| | - D Pandiyan
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - D Sathish Kumar
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
| | - R M Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - V Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, India
| | - H Ranjani
- Department of Translational Research, Madras Diabetes Research Foundation, Chennai, India
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Ganie MA, Sahar T, Rashid A, Baba MS, Ahmad N, Bhat H, Wani IA, Shah ZA. Prevalence of diabetes and prediabetes in tribal population of Kashmir: Lessons for the future. Diabetes Res Clin Pract 2020; 169:108457. [PMID: 32979420 DOI: 10.1016/j.diabres.2020.108457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
AIMS Considering a surge in the incidence of Diabetes mellitus (DM) across all ethnic groups and lack of any representative data from the tribal communities of Jammu and Kashmir, the present study aimed to assess the prevalence of DM and prediabetes in them. METHODS Subjects were recruited from five districts of Kashmir valley using multistage cluster sampling by probability proportional to size (PPS) technique. Data collection included recording of socio-demographic, medical facts, assessment of anthropometric parameters and biochemical evaluation HbA1c and random blood glucose measurements as per the American Diabetes Association (ADA) criteria were used for diagnosis of DM. RESULTS A total of 6808 subjects were recruited in this study including 2872 (42%) men and 3936 (58%) women with mean age of 39.60 ± 20.19 years and 35.17 ± 16.70 years, respectively. Around 8.60% subjects were obese, 38.9% were found to be hypertensive, 73% had dyslipidemia and 3.75% had metabolic syndrome. About 1.26% (0.5% males and 0.9% females) had DM and 11.64% had prediabetes based on HbA1c cut offs. Increasing age, body mass index and family history portend significant risk factors while smoking and sedentary lifestyle increased the risk marginally. CONCLUSIONS Although the prevalence of DM among tribals of Kashmir valley is lower than general population, the higher prediabetes to DM ratio may indicate a future trend of increasing DM prevalence in this disadvantageous subpopulation.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India.
| | - Tajali Sahar
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mohd Saleem Baba
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Nisar Ahmad
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Hilal Bhat
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Imtiyaz Ahmad Wani
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zafar Amin Shah
- Department of Immunology and Molecular Medicine, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
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Rai RK, Barik A, Mazumdar S, Chatterjee K, Kalkonde YV, Mathur P, Chowdhury A, Fawzi WW. Non-communicable diseases are the leading cause of mortality in rural Birbhum, West Bengal, India: a sex-stratified analysis of verbal autopsies from a prospective cohort, 2012-2017. BMJ Open 2020; 10:e036578. [PMID: 33099492 PMCID: PMC7590361 DOI: 10.1136/bmjopen-2019-036578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES There is a dearth of data on causes of death in rural India, which impedes identification of public health priorities to guide health interventions. This study aims to offer insights from verbal autopsies, to understand the pattern and distribution of causes of death in a rural area of Birbhum District, West Bengal, India. DESIGN Causes of death data were retrieved from a prospective vital event surveillance system. SETTING The Birbhum Population Project, a Health and Demographic Surveillance System, West Bengal, India. PARTICIPANTS Between January 2012 and December 2017, all deaths were recorded. MAIN OUTCOME MEASURES Trained Surveyors tracked all deaths prospectively and used a previously validated verbal autopsy (VA) tool to record causes of death. Experienced physicians reviewed completed VA forms, and assigned cause of death using the 10th version of International Classification of Diseases. In addition to cause-specific mortality fraction, cause-specific crude death rate (CDR) among males and females were estimated. RESULTS A total of 2320 deaths (1348 males and 972 females) were recorded. An estimated CDR was 708/100 000. Over half of all deaths (1176 deaths, 50.7%) were attributed to non-communicable diseases (NCDs), with nearly 30% of all deaths attributed to circulatory system disorders; whereas 24.2% and 3.9% deaths were due to cerebrovascular diseases and ischaemic heart disease, respectively. Equal percent (13%) of males died from external causes and from infectious and parasitic diseases, and 11% died from respiratory system-related diseases. Among females, 12% died from infectious and parasitic diseases. Among children aged 0-4 years, 50% of all male deaths and 45% of all female deaths were attributed to conditions in the perinatal period. CONCLUSIONS NCDs are the leading cause of death among adults in a select population of rural Birbhum, India. Health programmes for rural India should prioritise plans to mitigate deaths due to NCDs.
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Affiliation(s)
- Rajesh Kumar Rai
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Economics, University of Göttingen, Göttingen, Germany
- Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Anamitra Barik
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Chest Clinic, DTC District Hospital and Niramoy TB Sanatorium, Birbhum, West Bengal, India
| | - Saibal Mazumdar
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Kajal Chatterjee
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
| | - Yogeshwar V Kalkonde
- Rural NCDs and Tribal Health Programme, Society for Education Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | - Prashant Mathur
- Indian Council of Medical Research-National Centre for Disease Informatics and Research, Bengaluru, Karnataka, India
| | - Abhijit Chowdhury
- Society for Health and Demographic Surveillance, Suri, West Bengal, India
- Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
- Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States
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Talukder A, Hossain MZ. Prevalence of Diabetes Mellitus and Its Associated Factors in Bangladesh: Application of Two-level Logistic Regression Model. Sci Rep 2020; 10:10237. [PMID: 32581295 PMCID: PMC7314753 DOI: 10.1038/s41598-020-66084-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
This study intends to explore the prevalence of diabetes mellitus (DM) and its associated factors in Bangladesh. The necessary information was extracted from Bangladesh Demographic and Health Survey (BDHS) 2011. In bivariate analysis, Chi-square test was performed to assess the association between selected covariates and diabetes status. A two-level logistic regression model with a random intercept at each of the individual and regional level was considered to identify the risk factors of DM. A total of 7,535 individuals were included in this study. From the univariate analysis, the prevalence of DM was found to be 33.3% in 50-54 age group for instance. In bivariate setup, all the selected covariates except sex of the participants were found significant for DM (p < 0.05). According to the two-level logistic regression model, the chance of occurring DM increases as age of the participants' increases. It was observed that female participants were more likely to have DM. The occurrence of DM was 62% higher for higher educated participants, 42% higher for the individuals who came from rich family and 63% higher for the individuals having hypertension. The chance of developing diabetes among overweighed people was almost double. However, the individuals engaged in physical work had less chance to have DM. This study calls for greater attention of government and other concerned entities to come up with appropriate policy interventions to lower the risk of DM.
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Affiliation(s)
- Ashis Talukder
- Statistics Discipline, Khulna University, Khulna, 9208, Bangladesh.
| | - Md Zobayer Hossain
- Development Studies Discipline, Khulna University, Khulna, 9208, Bangladesh
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Hernandez AM, Jia P, Kim HY, Cuadros DF. Geographic Variation and Associated Covariates of Diabetes Prevalence in India. JAMA Netw Open 2020; 3:e203865. [PMID: 32356884 PMCID: PMC7195623 DOI: 10.1001/jamanetworkopen.2020.3865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Diabetes is a severe metabolic disorder affecting human health worldwide, with increasing prevalence in low- and middle-income countries. Gaps in knowledge regarding factors that lead to diabetes and its association with tuberculosis (TB) endemicity at the national scale still exist, mainly because of the lack of large-scale dual testing and appropriate evaluation methods. OBJECTIVES To identify locations in India where diabetes prevalence is concentrated, examine the association of diabetes with sociodemographic and behavioral covariates, and uncover where high regional TB endemicity overlaps with diabetes. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 803 164 men aged 15 to 54 years and women aged 15 to 49 years who participated in the Demographic Health Survey (2015-2016), carried out by the India Ministry of Health and Family Welfare using a 2-stage clustered sampling, which included a diabetes estimation component. The survey was conducted from January 2015 to December 2016, and data analysis was conducted from July 2018 to January 2019. EXPOSURES Self-reported diabetes status. MAIN OUTCOMES AND MEASURES Self-reported diabetes status was used to estimate the association of covariates, including educational level, sex, age, religion, marital status, alcohol use, tobacco use, obesity status, and household socioeconomic level, with diabetes prevalence. Additionally, regional tuberculosis endemicity level, estimated using the India TB report for 2014 from the Revised National TB Program, was included to evaluate the national extent of the spatial overlap of diabetes and TB. RESULTS Among 803 164 sampled individuals (691 982 [86.2%] women; mean [SD] age, 30.09 [9.97] years), substantial geographic variation in diabetes prevalence in India was found, with a concentrated burden at the southern coastline (cluster 1, Andhra Pradesh and Telangana: prevalence, 3.01% [1864 of 61 948 individuals]; cluster 2, Tamil Nadup and Kerala: prevalence, 4.32% [3429 of 79 435 individuals]; cluster 3, east Orissa: prevalence, 2.81% [330 of 11 758 individuals]; cluster 4, Goa: prevalence, 4.43% [83 of 1883 individuals]). Having obesity and overweight (odds ratio [OR], 2.44; 95% CI, 2.18-2.73; P < .001; OR, 1.66; 95% CI, 1.52-1.82; P < .001, respectively), smoking tobacco (OR, 3.04; 95% CI, 1.66-5.56; P < .001), and consuming alcohol (OR, 2.01; 95% CI, 1.37-2.95; P < .001) were associated with increased odds of diabetes. Regional TB endemicity and diabetes spatial distributions showed that there is a lack of consistent geographical overlap between these 2 diseases (eg, TB cluster 4: 60 213 TB cases; 186.79 diabetes cases in 20 183.88 individuals; 0.93% diabetes prevalence; TB cluster 8: 47 381 TB cases; 180.53 diabetes cases in 22 449.18 individuals; 0.80% diabetes prevalence; TB cluster 9: 37 620 TB cases, 601.45 diabetes cases in 12 879.36 individuals; 4.67% diabetes prevalence). CONCLUSIONS AND RELEVANCE In this study, identifying spatial clusters of diabetes on the basis of a nationally representative survey suggests that India may face different levels of disease severity, and each region might need to implement control strategies that are more appropriate for its unique epidemiologic context.
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Affiliation(s)
- Andrés M. Hernandez
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, Ohio
- Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, Ohio
| | - Peng Jia
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China
- State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Hae-Young Kim
- Africa Health Research Institute, Kwazulu-Natal, South Africa
- University of KwaZulu-Natal School of Nursing and Public Health, Kwazulu-Natal, South Africa
| | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, Ohio
- Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, Ohio
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Vijay A, Ranganathan P, Vellingiri B. A survey to validate the traditional Siddha perception of diabetes mellitus. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0980-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0710-6] [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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18
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Moorthy V, Sim MA, Liu W, Chew STH, Ti LK. Risk factors and impact of postoperative hyperglycemia in nondiabetic patients after cardiac surgery: A prospective study. Medicine (Baltimore) 2019; 98:e15911. [PMID: 31169705 PMCID: PMC6571260 DOI: 10.1097/md.0000000000015911] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cardiac surgery induces a significant inflammatory hypermetabolic stress response, resulting in postoperative hyperglycemia in both preoperatively diabetic and nondiabetic patients. Such postoperative hyperglycemia has been associated with adverse outcomes in surgery and postsurgical recovery. Yet, while diabetes is a known risk factor for postoperative hyperglycemia, predictors of postoperative hyperglycemia among nondiabetics in the local Southeast Asian population remain unknown.We aim to investigate the predictors and outcomes associated with hyperglycemia after cardiac surgery among nondiabetics in the local Southeast Asian population. We analyzed data from 1602 nondiabetic adult patients undergoing elective cardiac surgery, from 2008 to 2010 at the 2 main heart centers in Singapore.Nondiabetic patients who developed postoperative hyperglycemia tended to be women, older, more obese, and hypertensive. Higher body mass index (BMI), age, aortic cross-clamp time, and blood transfusion were identified as independent risk factors of postoperative hyperglycemia. Postoperative hyperglycemia was also significantly associated with postoperative cardiac arrhythmias (26.9% vs 15.0%, P < .001), acute kidney injury (30.0% vs 20.1%, P < .001), longer intensive care unit (ICU) stay (46.7 ± 104.1 vs 37.2 ± 76.6 hours, P = .044) and longer hospitalization (11.5 ± 12.2 vs 9.6 ± 8.0 days, P < .001).Our study identified aortic cross-clamp time and blood transfusion as independent risk factors of postoperative hyperglycemia after cardiac surgery in nondiabetics. Similar to other studies, higher BMI and age were independent risk factors for postoperative hyperglycemia. Postoperative hyperglycemia was also associated with adverse perioperative outcomes and should thereby be avoided by treating modifiable risk factors identified in this study including reducing blood transfusion and aortic cross-clamp time. Our findings contribute to early risk stratification of nondiabetic patients who are at increased risk of postoperative hyperglycemia.
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Affiliation(s)
- Vikaesh Moorthy
- Yong Loo Lin School of Medicine, National University of Singapore
| | - Ming Ann Sim
- Department of Anaesthesia, National University Hospital
| | - Weiling Liu
- Department of Anaesthesia, National University Hospital
| | | | - Lian Kah Ti
- Department of Anaesthesia, National University Hospital
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Chinniah R, Vijayan M, Sivanadham R, Ravi P, Panneerselvam D, Kannan A, Karuppiah B. Diversity and association of HLA/KIR receptors with type 2 diabetes in South India. Int J Immunogenet 2019; 46:166-178. [PMID: 30809938 DOI: 10.1111/iji.12417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 12/08/2018] [Accepted: 01/03/2019] [Indexed: 12/21/2022]
Abstract
The present study was undertaken to delineate the association(s) of KIR-HLA combination in South Indian Type 2 diabetes mellitus (T2DM) patients. The T2DM patients (n = 343) and healthy controls (n = 309) were genotyped for KIR/HLA ligands by PCR-SSP method. The increased frequency of activatory KIR (aKIR) 2DS2 (OR = 1.91; p < 2.91 × 10-4 ) was observed in patients suggesting a susceptible association. The frequencies of iKIR 2DL2 (OR = 0.38; p < 1.55 × 10-5 ) and aKIRs 2DS1 (OR = 0.60; p < 0.001) and 3DS1 (OR = 0.52; p < 5.83 × 10-5 ) were decreased in patients suggesting protective associations. The C1/C2 combinatorial analysis has revealed an increased frequency of C1+ /C2- in T2DM patients (OR = 1.62; p < 0.014). The KIR "AB" genotype (OR = 2.41; p < 3.87 × 10-5 ) was observed to be higher in patients. However, the "BB" genotype (OR = 0.32; p < 4.71 × 10-7 ) was increased in controls. The KIR motifs, "Tel-B/B" (OR = 1.84; p < 0.007), were observed higher among patients. However, the frequency of "Tel-A/B" motif genotype was decreased in patients (OR = 0.56; p < 3.13 × 10-4 ). The iKIR/HLA combinations such as 2DL2/3 +C1 and 3DL2+A3/A11 were increased in patients (OR = 3.90; p < 7.5 × 10-5 ) suggesting susceptible associations. On the contrary, the aKIR+HLA combinations such as 2DS2+C1, 2DS1+C2 and 3DS1+Bw4 were less frequent in patients (OR = 0.32; p < 4.2 × 10-4 ) suggesting protective associations. Thus, the present study clearly establishes the positive and negative associations of different KIR-HLA receptor combinations with T2DM in South India.
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Affiliation(s)
- Rathika Chinniah
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu, India
| | - Murali Vijayan
- Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Ramgopal Sivanadham
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu, India
| | - Padmamalini Ravi
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu, India
| | | | - Arun Kannan
- Endocrinology and Diabetology, Madurai Institute of Diabetes and Endocrine Practice and Research, Madurai, Tamil Nadu, India
| | - Balakrishnan Karuppiah
- Department of Immunology, School of Biological Sciences, Madurai Kamaraj University, Madurai, Tamil Nadu, India
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Barik A, Das K, Chowdhury A, Rai RK. Metabolic syndrome among rural Indian adults. Clin Nutr ESPEN 2018; 23:129-135. [DOI: 10.1016/j.clnesp.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/24/2017] [Accepted: 11/14/2017] [Indexed: 11/30/2022]
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Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, Prasad R, Saran R. Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metab Syndr 2017; 9:8. [PMID: 28127405 PMCID: PMC5259959 DOI: 10.1186/s13098-017-0207-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey. METHODS A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters. RESULTS Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3-9.4%) whereas prevalence of prediabetes was 6.3% (5.4-7.3%). Age group (45-69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status. CONCLUSIONS The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.
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Affiliation(s)
- Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India
| | - J. S. Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gursimer Jeet
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sohan Chawla
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Pal
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajendra Prasad
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajiv Saran
- Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI USA
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