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Zhao Y, Liu L, Li GH, Li HF, Wu X, Golden AR, Cai L. Ethnic disparities in the prevalence of diabetes and its association with sleep disorder among older adults in rural southwest China. ETHNICITY & HEALTH 2024; 29:435-446. [PMID: 38682471 DOI: 10.1080/13557858.2024.2346252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. METHODS A cross-sectional survey of 5,642 was conducted among the rural southwest population aged ≥60 years, consisting of a structured interview and measurement of fasting blood glucose, height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. RESULTS The overall prevalence of diabetes and sleep disorder was 10.2% and 40.1%, respectively. Bai participants had the highest prevalence of diabetes (15.9%) and obesity (9.9%)(P < 0.01), while Ha Ni participants had the lowest prevalence of diabetes (5.1%) and obesity (3.4%)(P < 0.01). The highest prevalence of sleep disorder (48.4%) was recorded in Bai participants, while Dai participants had the lowest prevalence of sleep disorder (25.6%)(P < 0.01). In all four studied ethnicities, females had a higher prevalence of sleep disorder than males (P < 0.01), and the prevalence of sleep disorder increased with age (P < 0.01). The results of multivariate logistic regression analysis indicated older adults with sleep disorder had a risk of developing diabetes (P < 0.05). Moreover, the higher educational level, family history of diabetes, and obesity were the main risk factors for diabetes in participants (P < 0.01). CONCLUSION There are stark ethnic disparities in the prevalence of diabetes and sleep disorders in southwest China. Future diabetes prevention and control strategies should be tailored to address ethnicity, and improving sleep quality may reduce the prevalence of diabetes.
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Affiliation(s)
- Yi Zhao
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
- The First Affiliated Hospital, Kunming Medical University, Kunming, People's Republic of China
| | - Lan Liu
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
| | - Guo-Hui Li
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
| | - Hui-Fang Li
- The First Affiliated Hospital, Kunming Medical University, Kunming, People's Republic of China
| | - Xia Wu
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
- The Second Affiliated Hospital, Kunming Medical University, Kunming, People's Republic China
| | - Allison Rabkin Golden
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
| | - Le Cai
- Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, Kunming, People's Republic of China
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Erbakan AN, Arslan Bahadir M, Kaya FN, Güleç B, Vural Keskinler M, Faydaliel Ö, Mesçi B, Oğuz A. The effect of close and intensive therapeutic monitoring of patients with poorly controlled type 2 diabetes with different glycemic background. Medicine (Baltimore) 2023; 102:e36680. [PMID: 38115271 PMCID: PMC10727544 DOI: 10.1097/md.0000000000036680] [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: 10/12/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023] Open
Abstract
Patients with type 2 diabetes who have HbA1c values ≥ 10% have different previous glycemic trends, including new diagnosis of diabetes. We aimed to assess the efficacy of 3 months of intensive and facilitated antihyperglycemic treatment in patients with different glycemic backgrounds. In this observational study, patients with type 2 diabetes and poor glycemic control (indicated by an HbA1c level of > = 10%) were divided into groups based on their previous HbA1c levels (group 1; newly diagnosed type 2 diabetics, group 2; patients with previously controlled but now deteriorated HbA1c levels, group 3; patients whose HbA1c was not previously in the target range but was now above 10%, and group 4; patients whose HbA1c was above 10% from the start). Patients received intensive diabetes management with close monitoring and facilitated hospital visits. For further analysis, patients who were known to have previously had good metabolic control (either did not have diabetes or had previously had an HbA1c value < =7) and patients who had prior poor metabolic control were analyzed separately. Of the 195 participants [female, n = 84 (43.1%)], the median age was 54 years (inter-quantile range [IQR] = 15, min = 29, max = 80) and the median baseline HbA1c was 11.8% (IQR = 2.6%, min = 10%, max = 18.3%). The median duration of diabetes was 10 years (IQR = 9, min = 1, max = 35) when newly diagnosed patients were excluded. The ≥ 20% reduction in HbA1c at month 3 was observed in groups 1 to 4 in 97%, 88.1%, 69.1%, and 55.4%, respectively. The percentage of patients who achieved an HbA1c level of 7% or less was 60.6%, 38.1%, 16.4%, and 6.2% in the groups, respectively. The rate of those who achieved an HbA1c of 7% or less was nearly 50% of patients with type 2 diabetes mellitus who had previously had good metabolic control, whereas successful control was achieved in only 1 in 10 patients with persistently high HbA1c levels. Patients' glycemic history played an important role in determining their HbA1c levels at 3 months, suggesting that previous glycemic management patterns may indicate future success in diabetes control.
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Affiliation(s)
- Ayşe Naciye Erbakan
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Müzeyyen Arslan Bahadir
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Fatoş Nimet Kaya
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Büşra Güleç
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Miraç Vural Keskinler
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Özge Faydaliel
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Banu Mesçi
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Aytekin Oğuz
- Department of Internal Medicine, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Henríquez-Beltrán M, Dreyse J, Jorquera J, Jorquera-Diaz J, Salas C, Fernandez-Bussy I, Labarca G. The U-Shaped Association between Sleep Duration, All-Cause Mortality and Cardiovascular Risk in a Hispanic/Latino Clinically Based Cohort. J Clin Med 2023; 12:4961. [PMID: 37568362 PMCID: PMC10419896 DOI: 10.3390/jcm12154961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Sleep is essential for life, and inappropriate sleep duration patterns may lead to chronic consequences regarding human health. Several studies have confirmed the presence of a U-shaped association between sleep duration and mortality. Moreover, many consequences related to cardiometabolic aspects have been suggested in patients with abnormal sleep durations. In this study, we analyzed the associations between sleep duration, total sleep time (TST), the risk of all-cause mortality, and 10-year cardiovascular risk in a cohort of patients at a sleep medicine center in Santiago, Chile. We conducted a prospective cohort study of patients (SantOSA). A short TST was defined as ≤6 h, a normal TST as 6 to 9 h, and a long TST as ≥9 h. Adjusted hazard ratios (aHRs) for all-cause mortality were calculated. A cross-sectional analysis between TST and 10-year cardiovascular risk (calculated using the Framingham 2008 formula) was determined using logistic regression models. A total of 1385 subjects were included in the results (78% male; median age: 53, interquartile range (IQR): 42-64 years; median BMI: 29.5, IQR: 16.7-33.1). A total of 333 subjects (24%) reported short TSTs, 938 (67.7%) reported normal TSTs, and 114 (8.3%) reported long TSTs. In the fully adjusted model, the association remained significant for short (aHR: 2.51 (1.48-4.25); p-value = 0.01) and long TSTs (aHR: 3.97 (1.53-10.29); p-value = 0.04). Finally, a U-shaped association was found between short and long TSTs, with an increase in cardiovascular risk at 10 years. Compared with normal TSTs, short (≤6 h) and long (≥9 h) TSTs were significantly associated with all-cause mortality and increased 10-year cardiovascular risk.
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Affiliation(s)
- Mario Henríquez-Beltrán
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Los Angeles 4440000, Chile;
| | - Jorge Dreyse
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | - Jorge Jorquera
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | | | - Constanza Salas
- Centro de Enfermedades Respiratorias, Clínica Las Condes, Facultad de Medicina Universidad Finis Terrae, Santiago 7591047, Chile; (J.D.); (J.J.); (C.S.)
| | | | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepción, Concepción 4070112, Chile
- Division of Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA
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Binjabr MA, Alalawi IS, Alzahrani RA, Albalawi OS, Hamzah RH, Ibrahim YS, Buali F, Husni M, BaHammam AS, Vitiello MV, Jahrami H. The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants. CURRENT SLEEP MEDICINE REPORTS 2023; 9:1-19. [PMID: 37359215 PMCID: PMC10238781 DOI: 10.1007/s40675-023-00258-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
Abstract Purpose of Review Several studies have found that medical students have a significant prevalence of sleep issues, such as poor sleep quality, excessive daytime sleepiness, and inadequate sleep duration. The purpose of this review is to carefully evaluate the current research on sleep problems among medical students and, as a result, estimate the prevalence of these disturbances. The EMBASE, PsychINFO, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science and retrieved article reference lists were rigorously searched and rated for quality. Random effects meta-analysis was performed to compute estimates. Recent Findings The current meta-analysis revealed an alarming estimated pooled prevalence of poor sleep quality (K = 95, N = 54894) of 55.64% [95%CI 51.45%; 59.74%]. A total of 33.32% [95%CI 26.52%; 40.91%] of the students (K = 28, N = 10122) experienced excessive sleepiness during the day. The average sleep duration for medical students (K = 35, N = 18052) is only 6.5 h per night [95%CI 6.24; 6.64], which suggests that at least 30% of them get less sleep than the recommended 7-9 h per night. Summary Sleep issues are common among medical students, making them a genuine problem. Future research should focus on prevention and intervention initiatives aimed at these groups. Supplementary Information The online version contains supplementary material available at 10.1007/s40675-023-00258-5.
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Affiliation(s)
- Mohammed A. Binjabr
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Idrees S. Alalawi
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Rayan A. Alzahrani
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Othub S. Albalawi
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Rakan H. Hamzah
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Yazed S. Ibrahim
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fatima Buali
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mariwan Husni
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed S. BaHammam
- Department of Medicine, University Sleep Disorders Center and Pulmonary Service, King Saud University, KSA, Riyadh, Saudi Arabia
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Michael V. Vitiello
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, USA
| | - Haitham Jahrami
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Government Hospitals, Manama, Bahrain
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