Prevalence of impaired fasting glucose, type 2 diabetes and associated risk factors in undiagnosed Chinese rural population: the Henan Rural Cohort Study

The magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town, northcentral Ethiopia: A community-based cross-sectional study

Background

Diabetes mellitus (DM) is a worldwide public health problem. The burden of diabetes has been continuously increasing from day to day, especially in developing countries like Ethiopia. Globally, half of all cases of diabetes mellitus are undiagnosed. Diabetes mellitus can be easily handled if it is detected early. There is limited evidence on the magnitude of undiagnosed diabetics and prediabetes at the community level in Ethiopia, particularly in the study area.

Objective

To assess the magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town.

Methods

A community-based cross-sectional study was conducted in Debre Tabor town from October to December 2021. A total of 407 participants were selected using a multistage sampling technique. A pretested structural questionnaire was used to collect demographic, behavioral, and clinical data. Anthropometric measurements were taken with standardized and calibrated equipment. A fasting venous blood sample was collected for blood glucose level determination. Logistic regression was used to identify risk factors. A P-value ≤0.05 was considered statistically significant.

Result

The magnitude of undiagnosed diabetes mellitus and prediabetes was found to be 4.5% (95% CI: 2.9-7.4) and 14.5% (95% CI: 11.1-18.1), respectively. Older age (AOR: 6.50, 95% CI: 1.82-23.21), abnormal body mass index (AOR: 6.84, 95% CI: 1.91-24.54), systolic hypertension (AOR: 8.74, 95% CI: 2.53-30.19), and family history of diabetes mellitus (FHDM) (AOR: 12.45, 95% CI: 3.63-42.65) were significantly associated with undiagnosed diabetes mellitus. Using saturated oil (AOR: 1.97, 95% CI: 1.09-3.55), having a high waist circumference (AOR: 2.16, 95% CI: 1.20-3.87), and being hypertensive (AOR: 2.26, 95% CI: 1.04-4.96) were all significantly associated with Prediabetes.

Conclusion

Adults in Debre Tabor town have a high prevalence of undiagnosed diabetes and prediabetes. A variety of modifiable risk factors were also identified. As a result, focusing the prevention strategy on such modifiable risk factors may help to minimize the prevalence of undiagnosed diabetes mellitus and prediabetes as well as future disease complications.

Combined Effects of ESRα DNA Methylation and Progesterone on Glucose Metabolic Disorders: The Henan Rural Cohort Study

To explore the independent and combined effects of ESRα methylation and progesterone on impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), a case-control study including 901 subjects was conducted. Generalized linear models were performed to assess the independent and combined effects of ESRα methylation and progesterone on IFG or T2DM. Methylation level of cytosine-phosphoguanine (CpG) 1 in the estrogen receptor α (ESRα) gene was positively related to IFG in both men (odds ratio (OR) (95% confidence interval (CI)): 1.77 (1.05, 3.00)) and postmenopausal women (OR (95% CI): 1.82 (1.09, 3.04)), whereas the association between CpG 1 and T2DM was not significant. Positive associations of progesterone with IFG and T2DM were observed in both men (OR (95% CI): 2.03 (1.18, 3.49) and 3.00 (1.63, 5.52)) and postmenopausal women (OR (95% CI): 2.13 (1.27, 3.56) and 3.30 (1.85, 5.90)). Participants with high CpG 1 methylation plus high progesterone had an increased risk of IFG and T2DM, both in men and postmenopausal women. ESRα methylation and progesterone were positively associated with IFG, and the positive association between progesterone and T2DM was also found. Importantly, we firstly found the combined effects of ESRα methylation and progesterone on IFG and T2DM.

The Association between Unhealthy Food Consumption and Impaired Glucose Metabolism among Adults with Overweight or Obesity: A Cross-Sectional Analysis of the Indonesian Population

BACKGROUND

It has been shown that dietary patterns are associated with glucose control. However, the association between the types of food consumed and blood glucose in overweight or obese individuals is still unclear. The present study aimed to determine the association between unhealthy food consumption and impaired glucose metabolism in adults with overweight or obesity.

METHODS

The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2018/RISKESDAS 2018). The body mass index (BMI) was calculated as weight (kg)/height squared (m²) and was determined based on the World Health Organization (WHO) criteria for the Asian population. A validated questionnaire and food card were used to assess the diet. Fasting plasma glucose and 2-hpost-prandial glucose were employed to determine blood glucose markers.

RESULTS

In total, 8752 adults with overweight or obesity were included in this analysis. We found that consumption of sweet, grilled, and processed foods was associated with impaired fasting plasma glucose (IFG) before and after adjustment (p < 0.05). Consumption of high-fat foods was also associated with impaired glucose tolerance (IGT) for all models tested (p < 0.05). Furthermore, all models showed a link between processed food consumption and combined glucose intolerance (CGI) (p ≤ 0.001).

CONCLUSIONS

Differential food group consumption was associated with IFG, IGT, and CGI in Indonesian adults who were overweight or obese.

Undiagnosed diabetes mellitus and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Diabetes has become a major public health problem, with 4.6 million deaths annually. The number of people living with undiagnosed diabetes is on the rise and has a diverse prevalence. Thus, this systematic review and meta-analysis was aimed to synthesize the pooled estimate prevalence of undiagnosed diabetes mellitus, impaired fasting glucose and its associated factors in Ethiopia. The databases Medline, Hinari, Google Scholar, and Google search were used to find potential studies published from January 2013 until January 2021. Extracted data were entered into the excel spreadsheet. The random effects model with Der Simonian-Laird weights was used to assess the pooled estimate of prevalence of undiagnosed diabetes, impaired fasting glucose, and its associated factors. The Cochrane Q-test and I² statistics were used to screen for statistical heterogeneity. A funnel plot and Egger's statistical test were also used to search for any publication bias (small study effect). After extensive searching of articles on different databases, a total of nine studies were included for this systematic review and meta-analysis. In random effects model, the pooled prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was 5.75%, 95% CI (3.90-7.59%), and 8.94%, 95% CI (2.60-15.28%), respectively. Regarding the associated factors, participants family history of diabetes was significantly associated with diabetes status. The pooled odds of developing diabetes mellitus among participants with a family history of diabetes mellitus were about 3.56 times higher than those without a family history of diabetes mellitus (OR = 3.56, 95% CI (2.23, 5.68)). In this review, the higher prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was observed among adults in Ethiopia. Family history of diabetes was found to have an association with increased risk of diabetes mellitus. Our finding highlights the need of screening at the community level, with special focus on adults with family history of diabetes mellitus.

Undiagnosed Diabetes and Prediabetes in Patients with Chronic Coronary Syndromes-An Alarming Public Health Issue

Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male (n = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.

Epidemiology of Isolated Impaired Glucose Tolerance Among Adults Aged Above 50 Years in Rural China

INTRODUCTION

Isolated impaired glucose tolerance (i-IGT) is a subtype of prediabetes in which an individual demonstrates elevated 2-h post-glucose load glucose levels but normal fasting plasma glucose levels. However, few studies have explored the prevalence and risk factors of i-IGT among adults in rural China. Thus, we aimed to explore the prevalence and risk factors of i-IGT among adults ≥50 years old in a low-income, rural population in China.

MATERIALS AND METHODS

Individuals aged ≥50 years with normal fasting plasma glucose levels were included in the final analysis. Fasting and 2-h venous blood samples were collected to assess the selected parameter measurements.

RESULTS

A total of 2175 individuals were included in this study. The i-IGT prevalence was 22.9% and significantly higher among females than among males (P<0.05). Older age [odds ratio (OR), 1.606; 95% confidence interval (CI), 1.101-2.342; P=0.014), hypertension (OR, 1.554; 95% CI, 1.152-2.019; P=0.004), and central obesity (OR, 1.395; 95% CI, 1.099-1.771; P=0.006) were associated with i-IGT. Moreover, white blood cell (OR, 1.089; 95% CI, 1.009-1.175; P=0.029), high-sensitivity C-reactive protein (OR, 1.049; 95% CI, 1.020-1.078; P=0.001), serum uric acid (OR, 1.0003; 95% CI, 1.001-1.004; P=0.001), triglyceride (OR, 1.540; 95% CI, 1.105-2.147; P=0.011), and alanine aminotransferase (OR, 1.012; 95% CI, 1.004-1.021; P=0.004) levels were also linked to i-IGT in the analyzed population.

CONCLUSION

Health promotion education and a standardized approach to managing body weight, BP, and lipid and uric acid levels would benefit this low-income population in rural China for reducing the risk of cardiovascular disease.

Chitosan modifies glycemic levels in people with metabolic syndrome and related disorders: meta-analysis with trial sequential analysis

BACKGROUND

Chitosan supplementation has been shown to modulate glycemic levels; however, studies have reported conflicting results. The present meta-analysis with trial sequential analysis was conducted to verify the overall influence of chitosan on glycemic levels in patients with metabolic syndrome.

METHODS

The PubMed, Cochrane library, and EMBASE databases were systematically searched for randomized controlled studies of chitosan intake and glycemic levels.

RESULTS

A total of ten clinical trials including 1473 subjects were included in this meta-analysis. Pooled effect sizes were determined by random-effects meta-analysis. Subgroup analysis was performed to analyze the sources of heterogeneity and their influence on the overall results. The results revealed a significant reduction in fasting glucose levels (SMD: - 0.39 mmol/L, 95% CI: - 0.62 to - 0.16) and hemoglobin A1c (HbA1c) levels (SMD: -1.10; 95% CI: - 2.15 to - 0.06) following chitosan supplementation but no effect on insulin levels (SMD: - 0.20 pmol/L, 95% CI: - 0.64 to 0.24). Subgroup analyses further demonstrated significant reductions in fasting glucose levels in subjects administered 1.6-3 g of chitosan per day and in studies longer than 13 weeks. Trial sequential analysis of the pooled results of the hypoglycemic effect demonstrated that the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary for glucose and HbA1c.

CONCLUSIONS

The glucose level of patients who are diabetic and obese/overweight can be improved by supplementation with chitosan for at least 13 weeks at 1.6-3 g per day. Additional clinical research data are needed to confirm the role of chitosan, particularly in regulating glycosylated hemoglobin and insulin.

Abnormal Glucose Metabolism and Associated Risk Factors Among Adults in Mekelle City, Ethiopia

BACKGROUND

In the past decade, the prevalence of diabetes has grown more rapidly in low- and middle-income countries than in high-income countries. In 2019, Ethiopia is the fourth highest contributor to cases with diabetes in Africa with 1.7 million total cases. The present study was aimed to determine the prevalence of abnormal glucose metabolism and associated factors in Mekelle city, Northern Ethiopia.

METHODS AND MATERIALS

Community-based cross-sectional study was conducted among 321 randomly selected participants aged 20 years and above. Sociodemographic, lifestyle, clinical, and anthropometric data were collected in accordance with the STEPwise approach as recommended by the World Health Organization (WHO) for non-communicable disease (NCDs) surveillance. Blood glucose and lipid profiles were determined using a fasting venous blood sample. Bivariate and multivariable logistic regression analysis was used to identify factors associated with abnormal glucose metabolism. The level of statistical significance was set at p ≤0.05.

RESULTS

More than half (54.8%) of the participants were women with an overall mean (±SD) age of 39.0 (±14.2) years. The overall prevalence of pre-diabetes and diabetes was 12.5% and 9.3%, respectively, with a mean (±SD) fasting blood glucose of 97.42 (±38.03) mg/dL. More than two-thirds (70.0%) of adults with diabetes were not aware of being diabetes. Advanced age, hypercholesterolemia, medium and high rank of heart rate, and raised waist to height ratio were significantly associated with a higher risk of pre-diabetes, whereas having house servant, systolic hypertension, and hypercholesterolemia were significantly associated with diabetes.

CONCLUSION

We found a high prevalence of prediabetes and diabetes with more than two-thirds (70.0%) of newly diagnosed adults with diabetes, which showed a lack of awareness in the community. Awareness creation together with access to basic diagnostics in the primary health-care settings should therefore be a top priority to prevent its progression and complication.

Prevalence of Diabetes, Prediabetes, and Associated Factors in an Adult Chinese Population: Baseline of a Prediabetes Cohort Study

PURPOSE

To report baseline information of a prediabetes mellitus (PDM) cohort with the aim of exploring related factors for the progression of PDM and its complications.

METHODS

This study is an exploratory and cross-sectional analysis of the baseline data from a cohort study. Residents aged 18 to 70 years from Houtang Village, Nanyue Town, Yueqing City, Zhejiang Province, China, were invited to participate between October 1, 2018 and July 1, 2019. Blood samples were collected for analysis, and questionnaire interviews were conducted to assess behavioral characteristics. The study participants were divided into DM, PDM, and normal groups for comparisons based on their blood work, and multiple multinomial logistic regression analyses were used to assess the risk factors for DM and PDM.

RESULTS

Data from 406 participants were used in the baseline analysis, with a mean age of 51.2 ± 11.0 years and 160 (33.0%) males. The number of participants in the DM, PDM, and normal group was 58 (14.3%), 166 (40.9%), and 182 (44.8%), respectively. The prevalence of DM was 14.3%, and the prevalence of PDM was 40.9%. The regression analysis showed that older age (relative risk ratio (RRR) = 1.06; 95% CI, 1.01-1.11, P = 0.018), higher systolic blood pressure (RRR = 1.04; 95% CI, 1.004-1.08, P = 0.030), higher BMI (RRR = 1.20; 95% CI, 1.06-3.06, P = 0.004), higher TG (RRR = 1.80; 95% CI, 1.06-3.06, P = 0.029), and higher WBC count (RRR = 1.32; 95% CI, 1.07-1.64, P = 0.010) were significantly associated with a higher risk of DM. Meanwhile, higher systolic blood pressure (RRR = 1.03; 95% CI, 1.004-1.06, P = 0.025) was the only factor significantly associated with a higher risk of PDM.

CONCLUSION

The prevalence of DM and PDM is relatively high in this wealthy East China village population. Many modifiable risk factors exist for DM and PDM, which will be closely monitored during our longitudinal observation.

Associations between dietary patterns and 10-year cardiovascular disease risk score levels among Chinese coal miners--a cross-sectional study

Background

Diet-related cardiovascular diseases have produced a large health burden in China. Coal miners are a high-risk population for cardiovascular disease, but there is little evidence concerning associations between coal miners’ dietary patterns and their 10-year cardiovascular disease risk score levels.

Methods

The study included 2632 participants and focused on dietary patterns associated with higher 10-year cardiovascular disease risk score levels. A valid semi-quantitative food frequency questionnaire was used to collect data regarding dietary intake, and dietary patterns were identified using factor analysis combined with cluster analysis. Logistic regression was used to assess associations between dietary patterns and 10-year cardiovascular disease risk score levels.

Results

For ground workers, compared with the ‘Healthy’ pattern, the ‘High-salt’ and ‘Refined grains’ patterns were significantly associated with higher 10-year atherosclerotic cardiovascular disease risk score level (OR: 1.50, 95% CI: 1.02–2.21; OR: 1.92, 95% CI: 1.26–2.93) and 10-year ischemic cardiovascular disease risk score level (OR: 2.18, 95% CI: 1.25–3.80; OR: 2.64, 95% CI: 1.48–4.72) adjusted for gender, and behavioural and socioeconomic factors. The ‘High-fat and salt’ pattern was significantly associated with higher 10-year ischemic cardiovascular disease risk score level (OR: 1.97, 95% CI: 1.13–3.42). For underground workers, the ‘High-salt’ pattern was significantly associated with higher 10-year atherosclerotic cardiovascular disease risk score level (OR: 1.65, 95% CI: 1.16–2.36) and 10-year ischemic cardiovascular disease risk score level (OR: 1.76, 95% CI: 1.09–2.84).

Conclusions

This study provides evidence for dietary patterns associated with higher 10-year cardiovascular disease risk score levels in Chinese miners, and facilitates relevant departments in designing effective dietary guidelines to ameliorate dietary structures.