Comparison of Optimal Cardiovascular Risk Factor Management in Patients with Type 2 Diabetes Who Attended Urban Medical Health Center with those Attended a Tertiary Care Center: Experiences from Tehran, Iran

The Relationship Between the Incidence of Coronary Heart Disease and Ethnic Minorities

The study aimed at the determination of risk factors, their relationship with the development of stenosing lesions of the coronary arteries in different ethnic groups in Kazakhstan.

Primary coronary angiographies of n=640 patients diagnosed with coronary heart disease (CHD) (2017-2019) have been analysed (Almaty, Kazakhstan). The patients were subdivided into: Kazakhs (n=338) and Russians (n=302).

In the Russian group, the chance of arterial hypertension incidence was higher (44% and 33%, p<0.05). In the Russian group, the percentage of obstructive CHD was higher than in the Kazakhs (66% and 57%, p<0.05). There was association between obstructive CHD and risk factors such as male sex, diabetes, smoking, and diastolic blood pressure (DBP) in the Kazakhs (p<0.05). In the Russian group, the relationship between development of CHD and age, level of total cholesterol and high-density lipoprotein (HDL) was higher (p<0.05). There is an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension.

There were significant ethnic differences in the risk factors and CHD, in the Russian group the probability of development of obstructive CHD was higher. There was an association between smoking, diabetes, sex, DBP and the development of CHD in Kazakhs. In the Russian group, CHD was associated with risk factors such as older age, dyslipidaemia and arterial hypertension. These finding indicate the need to develop differentiated programmes for the screening, preventive measures for different ethnic groups.

Prevalence and predictors of prediabetes and its coexistence with high blood pressure in first-degree relatives of patients with type 2 diabetes: A 9-year cohort study

Background:

Prediabetes is strongly associated with high blood pressure; however, a little is known about prediabetes and high blood pressure comorbidity in the high-risk individuals. This is the first study in the world to assess the long-term effects of risk factors associated with high blood pressure and prediabetes comorbidity in the first-degree relatives (FDRs) of type 2 diabetes mellitus (T2DM) patients.

Materials and Methods:

The longitudinal data obtained from 1388 nondiabetic FDRs of T2DM patients with at least two visits between 2003 and 2011. We used univariate and bivariate mixed-effects logistic regressions with a Bayesian approach to identify longitudinal predictors of high blood pressure and prediabetes separately and simultaneously.

Results:

The baseline prevalence of high blood pressure, prediabetes, and the coexistence of both was 27.4%, 19.1%, and 29.8%, respectively. The risks of high blood pressure and prediabetes were increased by one-unit raise in the age (odds ratio [OR] of high blood pressure: 1.419 (95% credible intervals [CI], 1.077–1.877), prediabetes: 1.055 (95% CI: 1.040–1.068)) and one-unit raise in remnant-cholesterol (OR of high blood pressure: 1.093 (95%CI, 1.067–1.121), and prediabetes: 1.086 (95% CI, 1.043–1.119)). Obese participants were more likely to have high blood pressure (OR: 2.443 [95% CI, 1.978–3.031]) and prediabetes (OR: 1.399 [95% CI, 1.129–1.730]) than other participants.

Conclusion:

We have introduced remnant-cholesterol, along with obesity and age, as a significant predictor of prediabetes, high blood pressure, and the coexistence of both in the FDRs of diabetic patients. Obesity index and remnant-cholesterol showed the stronger effects on high blood pressure and prediabetes comorbidity than on each condition separately.

Patients' perceptions of patient-provider communication and diabetes care: A systematic review of quantitative and qualitative studies

Objectives

To explore the association between patients’ perceptions of communication quality with their provider and a range of patients’ outcomes in T2DM. Also, to identify barriers and facilitators to effective communication from the patients’ perspective.

Methods

English and Persian papers published from 2000 to 2017 were searched in Web of Science, Pubmed, Scopus, Embase and SID, IranMedex, and MAGIRAN databases using appropriate search terms. Twenty-two studies complied the inclusion criteria. Each study was assessed for the focus of the study, study design (cross-sectional or qualitative study), population, outcome measures, patients’ outcomes, and methodological quality.

Results

The quality of most studies was moderate to high based on the JBI Critical Appraisal Checklists. Higher perceived quality of provider–patient communication in patients with T2DM was associated with improved self-management, adherence to diabetes care and greater well-being, perceived personal control, self-efficacy, and less diabetes distress. Factors that patients with T2DM perceived as important factors in facilitating or hampering effective communication were more related to the provision of emotional support.

Discussion

The limited evidence shows patient-perceived communication quality is a significant modifiable approach for improving a range of outcomes in patients with T2DM. Due to socio-cultural differences, further high-quality research is needed for deciding the best communication style in various societies.