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Montes YD, Vergara TA, Molina RT, Guerrero GM, Arrieta LAA, Aschner P, Acosta-Reyes J, Florez-Garcia V, Lechuga EN, Barengo NC. The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities. Prim Care Diabetes 2024; 18:458-465. [PMID: 38862312 DOI: 10.1016/j.pcd.2024.06.001] [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: 09/30/2023] [Revised: 05/25/2024] [Accepted: 06/02/2024] [Indexed: 06/13/2024]
Abstract
AIMS To assess the association between sociodemographic and clinical factors with body mass index (BMI) in a population at risk of type 2 diabetes (T2D) in Bogotá and Barranquilla, Colombia. METHODS This cross-sectional study used data from the PREDICOL Study. Participants with a FINDRISC ≥ 12 who underwent an Oral Glucose Tolerance Test (OGTT) were included in the study (n=1166). The final analytical sample size was 1101 participants. Those with missing data were excluded from the analysis (n=65). The main outcome was body mass index (BMI), which was categorized as normal, overweight, and obese. We utilized unadjusted and adjusted ordinal logistic regression analysis to calculate odds ratios (OR) and 95 % confidence intervals (CI). RESULTS The prevalence of overweight and obesity was 41 % (n=449) and 47 % (n=517), respectively. Participants with a 2-hour glucose ≥139 mg/dl had 1.71 times higher odds of being overweight or obese (regarding normal weight) than participants with normal 2-hour glucose values. In addition, being a woman, waist circumference altered, and blood pressure >120/80 mmHg were statistically significantly associated with a higher BMI. CONCLUSION Strategies to control glycemia, blood pressure, and central adiposity are needed in people at risk of T2D. Future studies should be considered with a territorial and gender focus, considering behavioral, and sociocultural patterns.
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Affiliation(s)
- Yenifer Diaz Montes
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; Faculty of Nursing Sciences, Universidad Cooperativa de Colombia, Santa Marta, Colombia.
| | - Tania Acosta Vergara
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Rafael Tuesca Molina
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; ScienceFlows Research Group, Universidad de Valencia, Valencia, Spain
| | - Gillian Martinez Guerrero
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Luis A Anillo Arrieta
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; College of Basic Sciences, Department of Mathematics and Statistics, Universidad del Norte, Barranquilla, Colombia
| | - Pablo Aschner
- Colombian Association for Diabetes, Bogotá, Colombia; Universidad Javeriana, Bogotá, Colombia; San Ignacio University Hospital, Bogotá, Colombia
| | - Jorge Acosta-Reyes
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Victor Florez-Garcia
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia; Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Edgar Navarro Lechuga
- Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia
| | - Noël C Barengo
- Department of Medical Education, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Escuela Superior de Medicina, Universidad Nacional de Mar del Plata, Mar del Plata, Argentina
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Abate TW, Genanew A, Gedamu H, Tegenaw A, Ayalew E, Berhie AY, Ergetie T, Shibesh BF. Unmasking the silent epidemic: a comprehensive systematic review and meta-analysis of undiagnosed diabetes in Ethiopian adults. Front Endocrinol (Lausanne) 2024; 15:1372046. [PMID: 39086906 PMCID: PMC11288971 DOI: 10.3389/fendo.2024.1372046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Background Undiagnosed diabetes mellitus poses a significant global public health concern, exerting a substantial impact on the well-being of individuals, their families, and societies at large. Those individuals with undiagnosed diabetes miss opportunities to maintain quality of life and prevent diabetes-related complications. Even if there are ample primary studies on undiagnosed diabetes in Ethiopia, the results reveal conflicting results. Therefore, a comprehensive national picture of undiagnosed diabetes is essential for designing effective strategies at the national level. Methods This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for prevalence studies (PROSPERO ID: CRD42021266676). PubMed, Web of Science and the World Health Organization's Hinari portal were searched using a strategy developed in collaboration with Liberians. The inclusion criteria comprised studies reporting undiagnosed diabetes in Ethiopia. Two independent reviewers conducted a quality assessment using a 10-item appraisal tool. Meta-analysis and meta-regression were performed using a random-effects model. Result Twenty-five studies with 22,193 participants met the inclusion criteria. The pooled prevalence of undiagnosed diabetes among the Ethiopian adult population was 5.68% (95% CI: 4.53 - 6.83, I2 = 75.4). Factors significantly associated with undiagnosed diabetes include age, waist circumference, overweight, family history of diabetes, and a history of hypertension. Conclusion Our systematic review found a noteworthy prevalence of undiagnosed diabetes in Ethiopia. The majority of factors linked with undiagnosed diabetes in this review were modifiable. This underscores the importance of targeted factors and public health interventions to improve early detection and reduce the burden of undiagnosed diabetes and its complications in Ethiopia. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42021266676.
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Affiliation(s)
- Teshager Woldegiyorgis Abate
- Faculty of Nursing University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
- Department of Adult Health Nursing, Scholl of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Genanew
- Department of Pharmacy, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Haileyesus Gedamu
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebu Tegenaw
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Emiru Ayalew
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Alemeshet Yirga Berhie
- Department of Adult Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Ergetie
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Belayneh Fentahun Shibesh
- Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain
- Department of Public Health, Medical School of the University of Nicosia, Nicosia, Cyprus
- Nature, Climate and Health, United Nations University CRIS, Bruges, Belgium
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Sharma SK, Thakur K, Kant R, Mudgal SK. Impact of Nurse-Led Titration Versus Physician Prescription of Hypoglycaemic Agents on HbA1c Level in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus 2021; 13:e20436. [PMID: 35047273 PMCID: PMC8759459 DOI: 10.7759/cureus.20436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/18/2022] Open
Abstract
A nurse-led diabetic clinic to manage type 2 diabetes, which emphasizes medication adherence, titration of hypoglycemic agents, behavior modification, and motivation for lifestyle changes, is widely recommended and practiced in western countries. This review aims to examine the impact of a nurse-led diabetic clinic versus a standard physician-led diabetic clinic on glycaemic control of type 2 diabetes patients. Studies were obtained using a comprehensive search in the electronic databases of PubMed, Embase, SCOPUS, Cochrane Library, and gray literature through March 2021. We calculated the pooled effect estimate with 95% confidence intervals (CIs) comparing subjects with and without nurse-led titration of hypoglycemic agents using standardized mean difference (SMD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes. Four trials comprising 470 participants (241 intervention group and 229 control group) met the inclusion criteria. Glycated hemoglobin (HbA1c levels and BMI were lower in participants with a nurse-led diabetic clinic (SMD = -0.54, 95% CI -0.89 to -0.20, I2 = 67%, p = 0.002) and (SMD = -0.26 (95% CI -0.45 to -0.07, I2 = 0%, p = .008), respectively, than in those attending a standard physician-led diabetic clinic. Similarly, the pooled result shown that patients attending the nurse-led diabetic clinic had a 31% higher satisfaction level (RR 0.69; 95% CI, 0.51 to 0.92, I2 = 0%, p= 0.01). On the other hand, there was no significant association of the nurse-led diabetic clinics on patients' blood pressure and intensification of hypoglycemic agents. The certainty of the evidence assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was moderate for outcomes like HbA1c level, intensification of hypoglycemic agents, and patients' satisfaction and low for other secondary outcomes. Our meta-analysis allows for the conclusion that nurse-led titration of hypoglycemic agents is associated with better glycemic control and enhances patients' satisfaction. Therefore, it is recommended to establish and strengthen nurses-led diabetic clinics for better HbA1c control where physician-led diabetic services are limited. Further research is needed to enhance the quality of the evidence.
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Affiliation(s)
- Suresh K Sharma
- Medical and Surgical Department, All India Institute of Medical Sciences, Jodhpur, IND
| | - Kalpana Thakur
- Psychiatry and Mental Health Department, All India Institute of Medical Sciences, Rishikesh, IND
| | - Ravi Kant
- Diabetes and Metabolism Division, All India Institute of Medical Sciences, Rishikesh, IND
| | - Shiv K Mudgal
- Medical and Surgical Department, All India Institute of Medical Sciences, Deoghar, IND
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