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Alhomaid AM, Moin Ahmed M. Prevalence of Non-diabetic Hyperglycemia in Young Adults and Its Impact on Periodontal Health. Cureus 2024; 16:e53847. [PMID: 38465110 PMCID: PMC10924652 DOI: 10.7759/cureus.53847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background Non-diabetic hyperglycemia is a transitional phase of hyperglycemia that poses a hidden risk for the development of diabetes mellitus and related complications, including periodontal destruction. The current study sought to determine the prevalence of non-diabetic hyperglycemia in young adults and any possible links to periodontal health. Methods A total of 400 participants in this cross-sectional study were evaluated for non-diabetic hyperglycemia between the ages of 18 and 35 years. Group I consisted of non-diabetic hyperglycemic participants. Group II comprised an equal number of matched, healthy subjects. The groups' hyperglycemic and clinical periodontal characteristics were contrasted. Using a one-sample t-test and logistic regression analysis, the acquired data were subjected to statistical analysis. Results The prevalence of non-diabetic hyperglycemia was 19%, with men (13%) having a higher prevalence than women (6%). The mean fasting plasma glucose and hemoglobin A1c (HbA1c) levels were 114.47 ± 6.40 mg/dL and 6.10 ± 0.21%, respectively, for group I, and 85.72 ± 7.24 mg/dL and 4.38 ± 0.70% for group II. When compared to healthy controls, all periodontal parameters, including plaque index, gingival index, bleeding on probing, probing depth, and clinical attachment loss, were significantly higher in group I non-diabetic hyperglycemic patients. The regression analysis revealed statistically significant links between hyperglycemic and periodontal parameters. Conclusion The prevalence of non-diabetic hyperglycemia among young adults is a serious concern similar to that of older adults with the risk for periodontal diseases. Non-diabetic hyperglycemic considerations in young adults should be emphasized in dental and medical clinics to reduce the risk of developing diabetes mellitus and to avoid irreversible periodontal tissue damage.
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Affiliation(s)
| | - Muzammil Moin Ahmed
- Dental and Oral Health, College of Applied Health Sciences in Ar Rass, Qassim University, Ar Rass, SAU
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2
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Talapko J, Meštrović T, Škrlec I. Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review. World J Diabetes 2022; 13:809-821. [PMID: 36311997 PMCID: PMC9606786 DOI: 10.4239/wjd.v13.i10.809] [Citation(s) in RCA: 1] [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: 05/13/2022] [Revised: 08/06/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023] Open
Abstract
Both diabetes and fungal infections contribute significantly to the global disease burden, with increasing trends seen in most developed and developing countries during recent decades. This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients, particularly those that present with unsatisfactory glycemic control. In addition, a relatively new group of anti-hyperglycemic drugs, known as sodium glucose cotransporter 2 inhibitors, has been linked with an increased risk for colonization of the urogenital region with Candida spp., which can subsequently lead to an infectious process. In this review paper, we have highlighted notable virulence factors of Candida species (with an emphasis on Candida albicans) and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis, potentially complicated with recurrences and dire pregnancy outcomes. We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes, further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in (primarily uncircumcised) males. With a steadily increasing global burden of diabetes, urogenital mycotic infections will undoubtedly become more prevalent in the future; hence, there is a need for an evidence-based approach from both clinical and public health perspectives.
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Affiliation(s)
- Jasminka Talapko
- Laboratory for Microbiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek 31000, Croatia
| | - Tomislav Meštrović
- University North, University Centre Varaždin, Varaždin 42000, Croatia
- Institute for Health Metrics and Evaluation, Department for Health Metrics Sciences, University of Washington School of Medicine, Seattle, Washington 98195, United States
| | - Ivana Škrlec
- Department of Biophysics, Biology, and Chemistry, Faculty of Dental Medicine and Health, J. J. Strossmayer University of Osijek, Osijek 31000, Croatia
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3
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Ding H, Huang J, Deng Y, Tin SPP, Wong MCS, Yeoh EK. Characteristics of participants who take up screening tests for diabetes and lipid disorders: a systematic review. BMJ Open 2022; 12:e055764. [PMID: 35487721 PMCID: PMC9058764 DOI: 10.1136/bmjopen-2021-055764] [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] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To perform a systematic review on the characteristics of participants who attended screening programmes with blood glucose tests, lipid profiles or a combination of them, respectively. DESIGN Systematic review following the Meta-analysis Of Observational Studies in Epidemiology checklist. DATA SOURCES PubMed and Medline databases for English literature from 1 January 2000 to 1 April 2020. ELIGIBILITY CRITERIA Original observational studies that reported baseline characteristics of apparently healthy adult participants screening for diabetes and lipid disorders were included in this review. DATA EXTRACTION We examined their sociodemographic characteristics, including age, gender, body mass index (BMI) and lifestyle habits. The quality of the included articles was evaluated by the Appraisal of Cross-sectional Studies. RESULTS A total of 33 articles involving 38 studies in 22 countries were included and analysed in this systematic review. Overall, there was a higher participation rate among subjects who were female in all screening modalities (female vs male: 46.6%-63.9% vs 36.1%-53.4% for diabetes screening; 48.8%-58.4% vs 41.6%-51.2% for lipid screening; and 36.4%-76.8% vs 23.2%-63.6% for screening offering both). Compared with the BMI standard from the WHO, participants in lipid screening had lower BMI (male: 23.8 kg/m2 vs 24.2 kg/m2, p<0.01; female: 22.3 kg/m2 vs 23.6 kg/m2, p<0.01). Furthermore, it is less likely for individuals of lower socioeconomic status to participate in diabetes or lipid screening in developed areas. CONCLUSIONS We identified that individuals from lower socioeconomic groups were less likely to take up programmes for diabetes and/or lipid screening in developed areas. These populations are also likely to be at higher risk of non-communicable diseases. Future studies should investigate the barriers and facilitators of screening among non-participants, where targeted interventions to enhance their screening uptake are warranted.
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Affiliation(s)
- Hanyue Ding
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, People's Republic of China
| | - Junjie Huang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, People's Republic of China
| | - Yunyang Deng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, People's Republic of China
| | - Sze Pui Pamela Tin
- Healthcare & Social Development, Our Hong Kong Foundation, Hong Kong, People's Republic of China
| | - Martin Chi-Sang Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, People's Republic of China
- School of Public Health, Peking University, Beijing, People's Republic of China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, People's Republic of China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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Kelly JR, Gounden P, McLoughlin A, Legris Z, O'Carroll T, McCafferty R, Marques L, Haran M, Farrelly R, Loughrey K, Flynn G, Corvin A, Dolan C. Minding metabolism: targeted interventions to improve cardio-metabolic monitoring across early and chronic psychosis. Ir J Med Sci 2021; 191:337-346. [PMID: 33683562 PMCID: PMC7938026 DOI: 10.1007/s11845-021-02576-5] [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] [Received: 12/18/2020] [Accepted: 02/26/2021] [Indexed: 11/15/2022]
Abstract
Background Antipsychotics (APs) increase weight, metabolic syndrome, diabetes and cardiovascular disease. Guidelines recommend cardio-metabolic monitoring at initial assessment, at 3 months and then annually in people prescribed APs. Aim To determine the rates of cardio-metabolic monitoring in AP treated early and chronic psychosis and to assess the impact of targeted improvement strategies. Methods Medical records were reviewed in two cohorts of first-episode psychosis (FEP) patients before and after the implementation of a physical health parameter checklist and electronic laboratory order set. In a separate group of patients with chronic psychotic disorders, adherence to annual monitoring was assessed before and 3 months after an awareness-raising educational intervention. Results In FEP, fasting glucose (39% vs 67%, p=0.05), HbA1c (0% vs 24%, p=0.005) and prolactin (18% vs 67%, p=0.001) monitoring improved. There were no significant differences in weight (67% vs 67%, p=1.0), BMI (3% vs 10%, p=0.54), waist circumference (3% vs 0%, p=1.0), fasting lipids (61% vs 76% p=0.22) or ECG monitoring (67% vs 67%, p=1.0). Blood pressure (BP) (88% vs 57%, p=0.04) and heart rate (91% vs 65%, p=0.03) monitoring dis-improved. Diet (0%) and exercise (<15%) assessment was poor. In chronic psychotic disorders, BP monitoring improved (20% vs 41.4%, p=0.05), whereas weight (17.0% vs 34.1%, p=0.12), BMI (9.7% vs 12.1%, p=1.0), fasting glucose (17% vs 24.3%, p=0.58) and fasting lipids remained unchanged (17% vs 24.3%, p=0.58). Conclusions Targeted improvement strategies resulted in a significant improvement in a limited number of parameters in early and chronic psychotic disorders. Overall, monitoring remained suboptimal.
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Affiliation(s)
| | | | | | - Zahra Legris
- Department of Psychiatry, St. James's Hospital, Dublin, Ireland
| | | | | | | | - Maeve Haran
- Daughters of Charity Disability Services, Navan Road, Dublin, Ireland
| | | | - Karen Loughrey
- Department of Psychiatry, St. James's Hospital, Dublin, Ireland
| | - Gráinne Flynn
- Trinity Institute of Neurosciences, Trinity College Dublin, Dublin, Ireland
| | - Aiden Corvin
- Department of Psychiatry, St. James's Hospital, Dublin, Ireland.,Trinity Institute of Neurosciences, Trinity College Dublin, Dublin, Ireland
| | - Catherine Dolan
- Department of Psychiatry, Sligo/Leitrim Mental Health Services, Sligo, Ireland
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5
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O’Donovan M, Sezgin D, O’Caoimh R, Liew A. The Impact of and Interaction between Diabetes and Frailty on Psychosocial Wellbeing and Mortality in Ireland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249535. [PMID: 33352735 PMCID: PMC7766174 DOI: 10.3390/ijerph17249535] [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] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022]
Abstract
Frailty in middle-aged and older adults is associated with diabetes-related complications. The impact of and interaction between diabetes and frailty on psychosocial wellbeing and mortality in Ireland for adults aged ≥50 years were assessed using data from the Survey of Health, Ageing and Retirement in Europe. Measures included diabetes status (self-reported), frailty phenotype (≥3/5 criteria), low self-rated health (“fair” or “poor”), depression screening (EURO-D index score ≥4), and low quality of life (QoL) (CASP-12 index score < 35). Among the 970 participants, those with diabetes (n = 87) were more likely to be frail (23% vs. 8%; p < 0.001), have low self-rated health (46% vs. 19%; p < 0.001), depression (25% vs. 17%; p = 0.070), and low QoL (25% vs. 18%, p = 0.085). Adjusting for diabetes, age and sex, frailty independently predicted low self-rated health (OR: 9.79 (5.85–16.36)), depression (9.82 (5.93–16.25)), and low QoL (8.52 (5.19–13.97)). Adjusting for frailty, age and sex, diabetes independently predicted low self-rated health (2.70 (1.63–4.47)). The age-sex adjusted mortality hazard ratio was highest for frailty with diabetes (4.67 (1.08–20.15)), followed by frailty without diabetes (2.86 (1.17–6.99)) and being non-frail with diabetes (1.76 (0.59–5.22)). Frailty independently predicts lower self-reported wellbeing and is associated with reduced survival, underpinning its role as an integral part of holistic diabetes care.
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Affiliation(s)
- Mark O’Donovan
- HRB Clinical Research Facility Cork, Mercy University Hospital, T12 WE28 Cork, Ireland;
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Duygu Sezgin
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland;
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland;
| | - Aaron Liew
- College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, H91 TK33 Galway, Ireland;
- Department of Endocrinology, Portiuncula University Hospital, H53 T971 Galway, Ireland
- Correspondence:
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Benchoula K, Arya A, Parhar IS, Hwa WE. FoxO1 signaling as a therapeutic target for type 2 diabetes and obesity. Eur J Pharmacol 2020; 891:173758. [PMID: 33249079 DOI: 10.1016/j.ejphar.2020.173758] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/12/2020] [Accepted: 11/23/2020] [Indexed: 02/06/2023]
Abstract
Glucose production and the consumption of high levels of carbohydrate increase the chance of insulin resistance, especially in cases of obesity. Therefore, maintaining a balanced glucose homeostasis might form a strategy to prevent or cure diabetes and obesity. The activation and inhibition of glucose production is complicated due to the presence of many interfering pathways. These pathways can be viewed at the downstream level because they activate certain transcription factors, which include the Forkhead-O1 (FoxO1). This has been identified as a significant agent in the pancreas, liver, and adipose tissue, which is significant in the regulation of lipids and glucose. The objective of this review is to discuss the intersecting portrayal of FoxO1 and its parallel cross-talk which highlights obesity-induced insulin susceptibility in the discovery of a targeted remedy. The review also analyses current progress and provides a blueprint on therapeutics, small molecules, and extracts/phytochemicals which are explored at the pre-clinical level.
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Affiliation(s)
- Khaled Benchoula
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Aditya Arya
- Department of Pharmacology and Therapeutics, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia; Department of Pharmacology and Therapeutics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia; Malaysian Institute of Pharmaceuticals and Nutraceuticals (IPharm), Bukit Gambir, Gelugor, Pulau Pinang, Malaysia
| | - Ishwar S Parhar
- Monash University (Malaysia) BRIMS, Jeffrey Cheah School of Medicine & Health Sciences, Malaysia
| | - Wong Eng Hwa
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
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7
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Cha SA, Chon S, Yun JS, Rhee SY, Lim SY, Yoon KH, Ahn YB, Ko SH, Woo JT, Lee JH. Optimal fasting plasma glucose and haemoglobin A1c levels for screening of prediabetes and diabetes according to 2-hour plasma glucose in a high-risk population: The Korean Diabetes Prevention Study. Diabetes Metab Res Rev 2020; 36:e3324. [PMID: 32293089 DOI: 10.1002/dmrr.3324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The primary aim of this study was to assess the utility of fasting plasma glucose (FPG) and HbA1c to identify diabetes by the 2-hour plasma glucose (PG) criterion in the Korean population at high risk for diabetes. METHODS A total of 1646 participants with a body mass index of ≥23 kg/m2 without having a history of diabetes were recruited in this study. The cut-off values of FPG and HbA1c for detecting diabetes were identified using the Youden index using receiver operating characteristic (ROC) analysis. The gold standard for diabetes prediction was defined by the 2-hour PG level of ≥200 mg/dL. RESULTS The participants comprised 54.0% women, and the mean age of all participants was 55.0 ± 8.1 years. At baseline, FPG was 104.1 ± 14.2 mg/dL, the 2-hour PG value was 162.9 ± 55.3 mg/dL, and HbA1c was 5.9% ± 0.5%. Four hundred and forty-six subjects (27.1%) were diagnosed with diabetes and 976 subjects (59.3%) were determined to be at prediabetes. The area under the ROC curve (AUC) of FPG and HbA1c for diabetes were 0.776 and 0.802, while the AUC of FPG and HbA1c for prediabetes were 0.515 and 0.477. The optimal cut-off value for diagnosing diabetes of FPG and HbA1c were 104.5 mg/dL (sensitivity 75.8%, specificity 67.5%) and 5.9% (sensitivity 80.6%, specificity 63.8%), respectively. CONCLUSIONS FPG of 104.5 mg/dL and HbA1c value of 5.9% (41 mmol/mol) can be used as an optimal screening value for diabetes by 2-hour PG criterion in the Korean population at high risk for diabetes.
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Affiliation(s)
- Seon-Ah Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine , The Catholic University of Korea, Suwon-si, South Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of 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-si, South Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Sun-Young Lim
- Catholic Institute Of Smart Healthcare Center, Institute of Biomedical Industry, The Catholic University of Korea, Seoul, South Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine , The Catholic University of Korea, Suwon-si, South Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine , The Catholic University of Korea, Suwon-si, South Korea
| | - Jeong-Taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Jin-Hee Lee
- Catholic Institute Of Smart Healthcare Center, Institute of Biomedical Industry, The Catholic University of Korea, Seoul, South Korea
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8
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Mengzi S, Min W, Chong S, Pingping Z, Yaogai L, Liyuan P, Shuo L, Yan Y, Lina J. The cut-off value of impaired fasting glucose should be lower: Based on the associations of fasting blood glucose with blood lipids. Prim Care Diabetes 2020; 14:147-153. [PMID: 31405610 DOI: 10.1016/j.pcd.2019.07.004] [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: 12/26/2018] [Revised: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The previous study served impaired fasting glucose (IFG), a pre-diabetic state which was much greater than that of diabetic patients, have reached no consensus on its cut-off value. In this study, we aimed to explore the cut-off value of IFG via the associations of blood lipids with fasting plasma glucose (FPG). DESIGN A cross-sectional study in Jilin province, China, 2012. SAMPLE 13,093 participants aged 18-79 years in Jilin province were involved in the study. The Lamba-Mu-Sigma (LMS) method and generalized additive model (GAM) were used to explore the associations of different levels of FPG and blood lipids. RESULTS The distributions of FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) were significantly different by gender (p<0.01). In general, both LMS and GAM results showed that the TG and HDL-c curves had a steeper tendency when the FPG was greater than 6.0mmol/L. CONCLUSION FPG was positively associated with TG while negatively associated with HDL-c, and the associations were stronger in females. The cut-off value of IFG was suggested to be 6.0mmol/L.
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Affiliation(s)
- Sun Mengzi
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Wang Min
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Sun Chong
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Zheng Pingping
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Lv Yaogai
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Pu Liyuan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Li Shuo
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China
| | - Yao Yan
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
| | - Jin Lina
- Epidemiology and Biostatistics, School of Public Health, NO. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021 China.
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9
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Liang X, Xiao L, Luo Y, Xu J. Prevalence and risk factors of childhood hypertension from birth through childhood: a retrospective cohort study. J Hum Hypertens 2020; 34:151-164. [PMID: 31666662 DOI: 10.1038/s41371-019-0282-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/12/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023]
Abstract
The prevalence of childhood hypertension is recognized as an important parameter of cardiovascular risk in adults. This retrospective study aimed to ascertain the prevalence and risk factors for hypertension from birth through childhood as of 2014. Stratified cluster sampling was used to select 17,007 participants (5971 with biochemical indexes available) aged 6-12 years on two avenues per region in urban, suburban, and rural areas. The prevalence of hypertension was 12.55%; children with obesity combined with rural residence, low family income, birth weight (<3000 g) (BWP25) or >10 months of breastfeeding had a significantly elevated prevalence of hypertension (37.06%, 30.41%, 30.04%, and 30.84%, respectively). Obesity and heart rate were the significant anthropometric determinants; gestational hypertension, BWP25 and >10 months of breastfeeding were the significant perinatal determinants; rural residence was the significant socioeconomic determinant; fasting blood glucose, triglycerides, and low-density lipoprotein cholesterol were the significant serum biochemical determinants; and red blood cell counts and platelet counts were the significant haematological determinants of childhood hypertension. The adjusted R2 values were 14.45% and 24.88% in the full models excluding and including serum indexes, respectively. We observed a notable prevalence of hypertension in a large paediatric sample. Obesity, high heart rate, BWP25, >10 months of breastfeeding, low family income, rural residence, abnormal lipid metabolism, and abnormal blood counts were associated with an increased risk of hypertension.
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Affiliation(s)
- Xiaohua Liang
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China.
| | - Lun Xiao
- Disease Control and Prevention Center of Jiulongpo District, Chongqing, China
| | - Yetao Luo
- Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China
| | - Jiapei Xu
- Henan Provincial Hospital, Henan Province, China
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10
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Noell G, Faner R, Agustí A. From systems biology to P4 medicine: applications in respiratory medicine. Eur Respir Rev 2018; 27:27/147/170110. [PMID: 29436404 PMCID: PMC9489012 DOI: 10.1183/16000617.0110-2017] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 11/30/2017] [Indexed: 12/22/2022] Open
Abstract
Human health and disease are emergent properties of a complex, nonlinear, dynamic multilevel biological system: the human body. Systems biology is a comprehensive research strategy that has the potential to understand these emergent properties holistically. It stems from advancements in medical diagnostics, “omics” data and bioinformatic computing power. It paves the way forward towards “P4 medicine” (predictive, preventive, personalised and participatory), which seeks to better intervene preventively to preserve health or therapeutically to cure diseases. In this review, we: 1) discuss the principles of systems biology; 2) elaborate on how P4 medicine has the potential to shift healthcare from reactive medicine (treatment of illness) to predict and prevent illness, in a revolution that will be personalised in nature, probabilistic in essence and participatory driven; 3) review the current state of the art of network (systems) medicine in three prevalent respiratory diseases (chronic obstructive pulmonary disease, asthma and lung cancer); and 4) outline current challenges and future goals in the field. Systems biology and network medicine have the potential to transform medical research and practicehttp://ow.ly/r3jR30hf35x
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Affiliation(s)
- Guillaume Noell
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Rosa Faner
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Alvar Agustí
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain .,CIBER Enfermedades Respiratorias (CIBERES), Barcelona, Spain.,Respiratory Institute, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
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11
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Prakaschandra R, Naidoo DP. Fasting Plasma Glucose and the HbA1c Are Not Optimal Screening Modalities for the Diagnosis of New Diabetes in Previously Undiagnosed Asian Indian Community Participants. Ethn Dis 2018; 28:19-24. [PMID: 29467562 DOI: 10.18865/ed.28.1.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objectives There is no definitive consensus on the screening algorithm in high-risk communities for diabetes. The aims of our study were to determine the prevalence of undiagnosed diabetes in a high-risk community using the oral glucose tolerance test (OGTT), as well as determine the value of anthropometric measurements and other measures of glycemia in the detection of diabetes. Method All participants from the Phoenix Lifestyle project without known diabetes, and who had undergone an OGTT were selected for study. Anthropometric measurements were collected according to accepted guidelines. Diabetes was diagnosed if fasting plasma glucose (FPG) ≥7.0 mmol/l, if 2-hour plasma glucose level during OGTT was ≥ 11.0 mmol/l, or if HbA1c ≥ 6.5%. Results The prevalence of newly diagnosed diabetes was 14.3% (11.7 % age standardized) (women=15.4%; men=11.8%). The prevalence rates were underestimated using FPG criteria, but overestimated when using the HbA1c. The AUC (area under the receiver-operator characteristics curve) was highest for FPG (.879), HbA1c (.855), then anthropometry measures (BMI=.621; waist circumference=.627). For diabetes, at levels >6.3, the discriminant ability (DA) of HbA1c was highest (79%), while a cut-point of ≥5.5mmol/l for FPG yielded a DA= 81.5% (82% sensitivity; 81%; specificity of 81%). There was a low level of agreement between the FPG (Kappa = .506), HbA1c (Kappa = .537), and the OGTT. Age- and sex-adjusted independent determinants of diabetes using stepwise backward logistic regression were age, triglyceride levels and a positive family history for diabetes. Conclusion Neither the HbA1c nor the FPG approached adequate predictive accuracy in the diagnosis of diabetes. In view of the high prevalence of undiagnosed diabetes, this study underscores the need for ongoing national surveillance data.
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Affiliation(s)
- Rosaley Prakaschandra
- Department of Biomedical and Clinical Technology, Faculty of Health Sciences, Durban University of Technology; Durban, KwaZulu-Natal, South Africa
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12
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Gagliardino JJ, Elgart JF, Bourgeois M, Etchegoyen G, Fantuzzi G, Ré M, Ricart JP, García S, Giampieri C, González L, Suárez-Crivaro F, Kronsbein P, Angelini JM, Martínez C, Martínez J, Ricart A, Spinedi E. Diabetes primary prevention program: New insights from data analysis of recruitment period. Diabetes Metab Res Rev 2018; 34. [PMID: 28843031 DOI: 10.1002/dmrr.2943] [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: 04/23/2017] [Revised: 08/06/2017] [Accepted: 08/16/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Primary Prevention of Diabetes Program in Buenos Aires Province evaluates the effectiveness of adopting healthy lifestyle to prevent type 2 diabetes (T2D) in people at high risk of developing it. We aimed to present preliminary data analysis of FINDRISC and laboratory measurements taken during recruitment of people for the Primary Prevention of Diabetes Program in Buenos Aires Province in the cities of La Plata, Berisso, and Ensenada, Argentina. METHODS People were recruited through population approach (house-to-house survey by FINDRISC in randomized areas) and opportunistic approach (FINDRISC completed by participants during consultations for nonrelated prediabetes/diabetes symptoms in public and private primary care centres of cities involved). In people with FINDRISC score ≥ 13 points, we evaluated blood concentrations of HbA1c , creatinine, lipids, and an oral glucose tolerance test (OGTT). RESULTS Approximately 3415 individuals completed the FINDRISC populational survey and 344 the opportunistic survey; 43% of the 2 groups scored over 13 points; 2.8 and 75.4% of them, respectively, took the prescribed OGTT. Approximately 53.7% of the OGTT showed normal values and 5.2% unknown T2D. The remaining cases showed 69.5% impaired fasting glucose, 13.6% impaired glucose tolerance, and 16.9% both impairments. HbA1c values showed significant differences compared with normal glucose tolerance (4.96 ± 0.43%), prediabetes (5.28 ± 0.51%), and T2D (5.60 ± 0.51%). Participants with prediabetes and T2D showed a predominant increase in low-density lipoprotein-cholesterol values. In prediabetes, >50% showed insulin resistance. CONCLUSIONS People with prediabetes/T2D had dyslipidemia associated with insulin resistance, which promotes the development of T2D and cardiovascular disease. Thus, it merits its appropriate treatment.
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Affiliation(s)
- Juan J Gagliardino
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Jorge F Elgart
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Marcelo Bourgeois
- Chair of Epidemiology INUS Center, Faculty of Medical Sciences (UNLP), La Plata, Argentina
| | - Graciela Etchegoyen
- Chair of Epidemiology INUS Center, Faculty of Medical Sciences (UNLP), La Plata, Argentina
| | - Gabriel Fantuzzi
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Matías Ré
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Juan P Ricart
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Silvia García
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Cecilia Giampieri
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Lorena González
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
| | - Florencia Suárez-Crivaro
- Laboratory, Secretariat of Health and Social Medicine, Municipality of La Plata, La Plata, Argentina
| | - Peter Kronsbein
- Faculty of Nutrition, Food and Hospitality Sciences, Niederrhein University of Applied Sciences, Mönchengladbach, Germany
| | - Julieta M Angelini
- Faculty of Medical Sciences, National University of La Plata (UNLP), La Plata, Argentina
| | - Camilo Martínez
- Faculty of Medical Sciences, National University of La Plata (UNLP), La Plata, Argentina
| | - Jorge Martínez
- Faculty of Medical Sciences, National University of La Plata (UNLP), La Plata, Argentina
| | - Alberto Ricart
- Faculty of Humanities and Cs of Education (UNLP), IdIHCS Institute of Research in Humanities and Social Sciences (UNLP-CONICET La Plata), La Plata, Argentina
| | - Eduardo Spinedi
- Faculty of Medical Sciences (UNLP), CENEXA Center for Experimental and Applied Endocrinology (UNLP-CONICET La Plata), La Plata, Argentina
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Vinodhini R, Kebede L, Teka G, Asana B, Abel T. Prevalence of Prediabetes and its Risk Factors among the Employees of Ambo University, Oromia Region, Ethiopia. RESEARCH IN MOLECULAR MEDICINE 2017. [DOI: 10.29252/rmm.5.3.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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14
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Noctor E, Crowe C, Carmody LA, Saunders JA, Kirwan B, O'Dea A, Gillespie P, Glynn LG, McGuire BE, O'Neill C, O'Shea PM, Dunne FP. Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria. Eur J Endocrinol 2016; 175:287-97. [PMID: 27422889 DOI: 10.1530/eje-15-1260] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 07/15/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. DESIGN Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. METHODS Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan-Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. RESULTS Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (P<0.001). Women meeting IADPSG, but not the World Health Organization (WHO) 1999 criteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, P<0.001) and at longer-term follow-up (13.7% vs 32.6%, P<0.001). Predictive factors were glucose levels on the pregnancy oral glucose tolerance test, family history of diabetes, gestational week at testing, and BMI at follow-up. CONCLUSIONS The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal frequency and method needs further study.
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Affiliation(s)
- Eoin Noctor
- Galway Diabetes Research CentreNational University of Ireland, Galway, Ireland
| | - Catherine Crowe
- Galway Diabetes Research CentreNational University of Ireland, Galway, Ireland
| | - Louise A Carmody
- Galway Diabetes Research CentreNational University of Ireland, Galway, Ireland
| | - Jean A Saunders
- Statistical Consulting Unit/CSTAR @ ULUniversity of Limerick, Limerick, Ireland
| | - Breda Kirwan
- Galway Diabetes Research CentreNational University of Ireland, Galway, Ireland
| | | | | | | | - Brian E McGuire
- School of PsychologyNational University of Ireland, Galway, Ireland
| | | | - P M O'Shea
- Department of Clinical BiochemistryUniversity Hospital Galway, Galway, Ireland
| | - F P Dunne
- Galway Diabetes Research CentreNational University of Ireland, Galway, Ireland
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Huang YQ, Yang QF, Wang H, Xu YS, Peng W, Jiang YH. Long-term clinical effect of Tangyiping Granules (糖异平颗粒) on patients with impaired glucose tolerance. Chin J Integr Med 2016; 22:653-9. [DOI: 10.1007/s11655-016-2512-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Indexed: 12/30/2022]
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16
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Cobb J, Eckhart A, Motsinger-Reif A, Carr B, Groop L, Ferrannini E. α-Hydroxybutyric Acid Is a Selective Metabolite Biomarker of Impaired Glucose Tolerance. Diabetes Care 2016; 39:988-95. [PMID: 27208342 DOI: 10.2337/dc15-2752] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/23/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Plasma metabolites that distinguish isolated impaired glucose tolerance (iIGT) from isolated impaired fasting glucose (iIFG) may be useful biomarkers to predict IGT, a high-risk state for the development of type 2 diabetes. RESEARCH DESIGN AND METHODS Targeted metabolomics with 23 metabolites previously associated with dysglycemia was performed with fasting plasma samples from subjects without diabetes at time 0 of an oral glucose tolerance test (OGTT) in two observational cohorts: RISC (Relationship Between Insulin Sensitivity and Cardiovascular Disease) and DMVhi (Diabetes Mellitus and Vascular Health Initiative). Odds ratios (ORs) for a one-SD change in the metabolite level were calculated using multiple logistic regression models controlling for age, sex, and BMI to test for associations with iIGT or iIFG versus normal. Selective biomarkers of iIGT were further validated in the Botnia study. RESULTS α-Hydroxybutyric acid (α-HB) was most strongly associated with iIGT in RISC (OR 2.54 [95% CI 1.86-3.48], P value 5E-9) and DMVhi (2.75 [1.81-4.19], 4E-5) while having no significant association with iIFG. In Botnia, α-HB was selectively associated with iIGT (2.03 [1.65-2.49], 3E-11) and had no significant association with iIFG. Linoleoyl-glycerophosphocholine (L-GPC) and oleic acid were also found to be selective biomarkers of iIGT. In multivariate IGT prediction models, addition of α-HB, L-GPC, and oleic acid to age, sex, BMI, and fasting glucose significantly improved area under the curve in all three cohorts. CONCLUSIONS α-HB, L-GPC, and oleic acid were shown to be selective biomarkers of iIGT, independent of age, sex, BMI, and fasting glucose, in 4,053 subjects without diabetes from three European cohorts. These biomarkers can be used in predictive models to identify subjects with IGT without performing an OGTT.
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Affiliation(s)
| | | | - Alison Motsinger-Reif
- Department of Statistics, Bioinformatics Research Center, North Carolina State University, Raleigh, NC
| | | | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
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Tracey ML, Gilmartin M, O'Neill K, Fitzgerald AP, McHugh SM, Buckley CM, Canavan RJ, Kearney PM. Epidemiology of diabetes and complications among adults in the Republic of Ireland 1998-2015: a systematic review and meta-analysis. BMC Public Health 2016; 16:132. [PMID: 26861703 PMCID: PMC4748605 DOI: 10.1186/s12889-016-2818-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 02/03/2016] [Indexed: 12/14/2022] Open
Abstract
Background Accurate estimates of the burden of diabetes are essential for future planning and evaluation of services. In Ireland, there is no diabetes register and prevalence estimates vary. The aim of this review was to systematically identify and review studies reporting the prevalence of diabetes and complications among adults in Ireland between 1998 and 2015 and to examine trends in prevalence over time. Methods A systematic literature search was carried out using PubMed and Embase. Diabetes prevalence estimates were pooled by random-effects meta-analysis. Poisson regression was carried out using data from four nationally representative studies to calculate prevalence rates of doctor diagnosed diabetes between 1998 and 2015 and was also used to assess whether the rate of doctor diagnosed diabetes changed over time. Results Fifteen studies (eight diabetes prevalence and seven complication prevalence) were eligible for inclusion. In adults aged 18 years and over, the national prevalence of doctor diagnosed diabetes significantly increased from 2.2 % in 1998 to 5.2 % in 2015 (ptrend ≤ 0.001). The prevalence of diabetes complications ranged widely depending on study population and methodology used (6.5–25.2 % retinopathy; 3.2–32.0 % neuropathy; 2.5-5.2 % nephropathy). Conclusions Between 1998 and 2015, there was a significant increase in the prevalence of doctor diagnosed diabetes among adults in Ireland. Trends in microvascular and macrovascular complications prevalence could not be examined due to heterogeneity between studies and the limited availability of data. Reliable baseline data are needed to monitor improvements in care over time at a national level. A comprehensive national diabetes register is urgently needed in Ireland. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2818-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marsha L Tracey
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland.
| | - Michael Gilmartin
- Department of Medicine, Royal College of Surgeons, Dublin, Republic of Ireland
| | - Kate O'Neill
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland
| | - Anthony P Fitzgerald
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland
| | - Sheena M McHugh
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland
| | - Claire M Buckley
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland.,Department of Public Health, Heath Service Executive (HSE) South, Cork, Republic of Ireland
| | - Ronan J Canavan
- Department of Endocrinology, St. Vincent's University Hospital, Dublin, Republic of Ireland
| | - Patricia M Kearney
- Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Cork, Republic of Ireland
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18
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Leahy S, O' Halloran AM, O' Leary N, Healy M, McCormack M, Kenny RA, O' Connell J. Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA). Diabetes Res Clin Pract 2015; 110:241-9. [PMID: 26520567 DOI: 10.1016/j.diabres.2015.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/07/2015] [Accepted: 10/08/2015] [Indexed: 12/11/2022]
Abstract
AIMS The prevalence of type 2 diabetes and pre-diabetes has increased rapidly in recent decades and this trend will continue as the global population ages. This study investigates the prevalence of, and factors associated with, diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults in Ireland. METHODS Cross-sectional data from 5377 men and women aged 50 and over from Wave 1 of the Irish Longitudinal Study on Ageing (TILDA) was analysed. Diagnosed diabetes was defined using self-reported doctors' diagnosis and medications data. Glycated haemoglobin (HbA1c) analysis was used to identify undiagnosed and pre-diabetes. Age and sex-specific prevalence estimates were generated. Logistic regression was used to investigate the association between diabetes classification and the demographic, health and lifestyle characteristics of the population. RESULTS The prevalence of diagnosed and undiagnosed type 2 diabetes was 8.6% (95% confidence interval (CI): 7.6-9.5%) and 0.9% (95% CI: 0.6-1.1%) respectively. Diabetes was more prevalent in men than women and increased with age. The prevalence of pre-diabetes was 5.5% (95% CI: 4.8-6.3%) and increased with age. Diabetes and pre-diabetes were independently associated with male sex, central obesity and a history of hypertension, while undiagnosed diabetes was associated with geographic location and medical costs cover. CONCLUSION Despite high rates of obesity and other undiagnosed health conditions, the prevalence of undiagnosed and pre-diabetes is relatively low in community-dwelling older adults in Ireland. Addressing lifestyle factors in this population may help to further reduce the prevalence of pre-diabetes and improve outcomes for those with a previous diagnosis.
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Affiliation(s)
- S Leahy
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland.
| | - A M O' Halloran
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - N O' Leary
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - M Healy
- Department of Biochemistry, Central Pathology Laboratory, St. James' Hospital, Dublin 8, Ireland
| | - M McCormack
- Department of Biochemistry, Central Pathology Laboratory, St. James' Hospital, Dublin 8, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin 2, Ireland
| | - J O' Connell
- Blackrock Clinic, Blackrock, Co. Dublin, Ireland
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Aekplakorn W, Tantayotai V, Numsangkul S, Sripho W, Tatsato N, Burapasiriwat T, Pipatsart R, Sansom P, Luckanajantachote P, Chawarokorn P, Thanonghan A, Lakhamkaew W, Mungkung A, Boonkean R, Chantapoon C, Kungsri M, Luanseng K, Chaiyajit K. Detecting Prediabetes and Diabetes: Agreement between Fasting Plasma Glucose and Oral Glucose Tolerance Test in Thai Adults. J Diabetes Res 2015; 2015:396505. [PMID: 26347060 PMCID: PMC4543794 DOI: 10.1155/2015/396505] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/20/2015] [Accepted: 07/22/2015] [Indexed: 12/30/2022] Open
Abstract
AIM To evaluate an agreement in identifying dysglycemia between fasting plasma glucose (FPG) and the 2 hr postprandial glucose tolerance test (OGTT) in a population with high risk of diabetes. METHODS A total of 6,884 individuals aged 35-65 years recruited for a community-based diabetes prevention program were tested for prediabetes including impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), and diabetes. The agreement was assessed by Kappa statistics. Logistic regression was used to examine factors associated with missed prediabetes and diabetes by FPG. RESULTS A total of 2671 (38.8%) individuals with prediabetes were identified. The prevalence of prediabetes identified by FPG and OGTT was 32.2% and 22.3%, respectively. The proportions of diabetes classified by OGTT were two times higher than those identified by FPG (11.0% versus 5.4%, resp.). The Kappa statistics for agreement of both tests was 0.55. Overall, FPG missed 46.3% of all prediabetes and 54.7% of all diabetes cases. Prediabetes was more likely to be missed by FPG among female, people aged <45 yrs, and those without family history of diabetes. CONCLUSION The detection of prediabetes and diabetes using FPG only may miss half of the cases. Benefit of adding OGTT to FPG in some specific groups should be confirmed.
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Affiliation(s)
- Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- *Wichai Aekplakorn:
| | - Valla Tantayotai
- School of Nursing, Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand
| | | | - Wilarwan Sripho
- Nakhon Ratchasima City Municipality, Nakhon Ratchasima 30000, Thailand
| | - Nutchanat Tatsato
- Tha Sala Hospital, Tha Sala District, Nakhon Si Thammarat 80160, Thailand
| | | | - Rachada Pipatsart
- Buddhachinaraj Hospital, Muang District, Phitsanulok 65000, Thailand
| | - Premsuree Sansom
- Buddhachinaraj Hospital, Muang District, Phitsanulok 65000, Thailand
| | | | | | - Anek Thanonghan
- Thatphanom Crown Prince Hospital, Thatphanom District, Nakhon Phanom 48110, Thailand
| | - Watchira Lakhamkaew
- Thatphanom Crown Prince Hospital, Thatphanom District, Nakhon Phanom 48110, Thailand
| | | | - Rungnapa Boonkean
- Nonghualing Health Center, Pakplee District, Nakhon Nayok 26130, Thailand
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