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Chandra DN, Bardosono S. The effect of fiber-rich milk and equi-carbohydrate snack on glycemic and insulin response and satiety feeling. MEDICAL JOURNAL OF INDONESIA 2016. [DOI: 10.13181/mji.v25i2.1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Additional dietary fibers which can decrease the glycemic response by slowing down digestion whilst maintaining the available carbohydrate content is one approach of healthy diet. This study aimed to compare post-prandial glycemic and insulin response, hunger and satiety feeling after consuming fiber-rich milk compare with equi-carbohydrate food as morning snack in healthy adults.Methods: Cross-over study was conducted on 12 healthy subjects who fulfilled the criteria. Each test food was given after consuming standard breakfast. Venous blood samples for insulin and glucose level were taken before consuming test food, at 30, 60, 120, and 180 minutes after, and plotted against time to generate a curve. Hunger and satiety assessments were taken by visual analog scale (VAS) after each blood sampling.Results: In average, age was 30.8+4.3 years old, body mass index was 20.6±1.6 kg/m2. Seven of twelve subjects were females. There were significantly differences in postprandial glycemic response (p<0.001), insulin response (p=0.045) and hunger feeling (p=0.021) between the two foods. However, postprandial satiety feelings were not different significantly (p=0.357). The glycemic response area under the curve of fiber-rich milk was significantly lower than the equi-carbohydrate snack (p=0.010). Conclusion: Differences in glycemic and insulin response, and hunger feeling between two test foods, suggesting that fiber-rich milk can be used as an alternative snack for healthy adults. Further study is needed for the use of fiber-rich milk as an alternative snack for pre-diabetic patients.
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152
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Chlebowy DO, Kubiak N, Myers J, Jorayeva A. The Relationships of Demographic Characteristics with Diabetes Biomarkers and Physical Activity Adherence in African American Adults. J Racial Ethn Health Disparities 2016; 3:240-4. [PMID: 27271064 DOI: 10.1007/s40615-015-0133-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/30/2015] [Accepted: 05/19/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this study was to examine the relationships of demographic characteristics with diabetes biomarkers and physical activity adherence in African American adults with type 2 diabetes mellitus. METHODS Data for this secondary analysis were collected in a controlled trial conducted at an ambulatory internal medicine clinic located in a mid-sized metropolitan area in the southeastern USA. Demographic information was obtained at baseline for all participants receiving a motivational interviewing intervention. Diabetes biomarkers and physical activity adherence were measured at baseline and 3-month follow-up. RESULTS Being female, older, and having a higher education significantly predicted a decrease in serum glucose over time. Being female and older significantly predicted a slower decrease in body mass index over time. Being younger and more educated significantly predicted probability of improved physical activity adherence. CONCLUSION Although older African American women had a significant decrease in serum glucose over time, they experienced a slower decrease in their body mass indices and were less likely to adhere to physical activity recommendations. Specific attention should be paid to the demographic characteristics of African Americans with type 2 diabetes mellitus in order to promote optimal clinical outcomes in this vulnerable population. This approach to treatment planning opens a window into the micro-level processes by which social determinants lead to a better response to treatment.
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Affiliation(s)
| | - Nancy Kubiak
- School of Medicine, University of Louisville, Louisville, KY, USA
| | - John Myers
- School of Medicine, University of Louisville, Louisville, KY, USA
| | - Anna Jorayeva
- School of Nursing, University of Louisville, Louisville, KY, USA
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153
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Jindal RM, Mehta K, Soni R, Doyle A, Patel TG. Diabetes, hypertension, sanitation, and health education by high school students in Guyana, South America. Indian J Nephrol 2016; 26:192-8. [PMID: 27194834 PMCID: PMC4862265 DOI: 10.4103/0971-4065.161522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We initiated a program for early detection of diabetes and hypertension, the main causes of kidney failure in Guyana, South America. We trained local high school students with the goal that these students would stay in the villages for long-term, become health advocates and shift the reliance away from physicians. This project involved 7 high school students who were taught to monitor the health of one village of 1000–1500 population each. The program will be implemented for 3 years in which the entire population of seven villages (approximately 10,000 people) will be covered. This represents 1.3% population in Guyana. We present data from the pilot study from the sample of 619 people. The prevalence of diabetes mellitus was 13.9%. Among diabetics, 33.7% were using insulin and 86% oral hypoglycemic agents. Prevalence of hypertension was 29.4%, 63.2% were overweight and 17% were obese. About 9.9% patients were unaware about the existence of hypertension. We have shown in our study that high school students can be used to collect health data and monitor diabetes and hypertension. There was also a significant incidence of undetected diabetes and hypertension.
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Affiliation(s)
- R M Jindal
- Department of Surgery, Division of Global Health, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Medicine and Surgery, The George Washington University, Washington, DC, USA
| | - K Mehta
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - R Soni
- Department of Medicine, Central Michigan University College of Medicine, Saginaw, MI, USA
| | - A Doyle
- Department of Medicine, Drexel University School of Medicine, Philadelphia, PA, USA
| | - T G Patel
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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154
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Tracey ML, McHugh SM, Fitzgerald AP, Buckley CM, Canavan RJ, Kearney PM. Risk Factors for Macro- and Microvascular Complications among Older Adults with Diagnosed Type 2 Diabetes: Findings from The Irish Longitudinal Study on Ageing. J Diabetes Res 2016; 2016:5975903. [PMID: 27294152 PMCID: PMC4884580 DOI: 10.1155/2016/5975903] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/26/2016] [Indexed: 12/17/2022] Open
Abstract
Objective. To explore risk factors for macro- and microvascular complications in a nationally representative sample of adults aged 50 years and over with type 2 diabetes in Ireland. Methods. Data from the first wave of The Irish Longitudinal Study on Ageing (TILDA) (2009-2011) was used in cross-sectional analysis. The presence of doctor diagnosis of diabetes, risk factors, and macro- and microvascular complications were determined by self-report. Gender-specific differences in risk factor prevalence were assessed with the chi-squared test. Binomial regression analysis was conducted to explore independent associations between established risk factors and diabetes-related complications. Results. Among 8175 respondents, 655 were classified as having type 2 diabetes. Older age, being male, a history of smoking, a lower level of physical activity, and a diagnosis of high cholesterol were independent predictors of macrovascular complications. Diabetes diagnosis of 10 or more years, a history of smoking, and a diagnosis of hypertension were associated with an increased risk of microvascular complications. Older age, third-level education, and a high level of physical activity were protective factors (p < 0.05). Conclusions. Early intervention to target modifiable risk factors is urgently needed to reduce diabetes-related morbidity in the older population in Ireland.
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Affiliation(s)
- Marsha L. Tracey
- Department of Epidemiology and Public Health, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
| | - Sheena M. McHugh
- Department of Epidemiology and Public Health, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
| | - Anthony P. Fitzgerald
- Department of Epidemiology and Public Health, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
- Department of Statistics, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
| | - Claire M. Buckley
- Department of Epidemiology and Public Health, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
- Department of Public Health, Health Service Executive (HSE) South, St. Finbarr's Hospital, Douglas Road, Cork, Ireland
| | - Ronan J. Canavan
- Department of Endocrinology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Patricia M. Kearney
- Department of Epidemiology and Public Health, University College Cork, Western Road, Western Gateway Building, Cork, Ireland
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155
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Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya. Libyan J Med 2016; 11:31086. [PMID: 27005896 PMCID: PMC4803895 DOI: 10.3402/ljm.v11.31086] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 02/23/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. METHODS A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level. RESULTS Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94). CONCLUSION The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
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Affiliation(s)
- Sana Taher Ashur
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Shamsul Azhar Shah
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Soad Bosseri
- National Centre for Diabetes and Endocrinology, Tripoli, Libya
| | - Tong Seng Fah
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Khadijah Shamsuddin
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia;
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156
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Hirst JA, Farmer AJ, Feakins BG, Aronson JK, Stevens RJ. Quantifying the effects of diuretics and β-adrenoceptor blockers on glycaemic control in diabetes mellitus - a systematic review and meta-analysis. Br J Clin Pharmacol 2016; 79:733-43. [PMID: 25377481 DOI: 10.1111/bcp.12543] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/31/2014] [Indexed: 11/29/2022] Open
Abstract
AIMS Although there are reports that β-adrenoceptor antagonists (beta-blockers) and diuretics can affect glycaemic control in people with diabetes mellitus, there is no clear information on how blood glucose concentrations may change and by how much. We report results from a systematic review to quantify the effects of these antihypertensive drugs on glycaemic control in adults with established diabetes. METHODS We systematically reviewed the literature to identify randomized controlled trials in which glycaemic control was studied in adults with diabetes taking either beta-blockers or diuretics. We combined data on HbA1c and fasting blood glucose using fixed effects meta-analysis. RESULTS From 3864 papers retrieved, we found 10 studies of beta-blockers and 12 studies of diuretics to include in the meta-analysis. One study included both comparisons, totalling 21 included reports. Beta-blockers increased fasting blood glucose concentrations by 0.64 mmol l(-1) (95% CI 0.24, 1.03) and diuretics by 0.77 mmol l(-1) (95% CI 0.14, 1.39) compared with placebo. Effect sizes were largest in trials of non-selective beta-blockers (1.33, 95% CI 0.72, 1.95) and thiazide diuretics (1.69, 95% CI 0.60, 2.69). Beta-blockers increased HbA1c concentrations by 0.75% (95% CI 0.30, 1.20) and diuretics by 0.24% (95% CI -0.17, 0.65) compared with placebo. There was no significant difference in the number of hypoglycaemic events between beta-blockers and placebo in three trials. CONCLUSIONS Randomized trials suggest that thiazide diuretics and non-selective beta-blockers increase fasting blood glucose and HbA1c concentrations in patients with diabetes by moderate amounts. These data will inform prescribing and monitoring of beta-blockers and diuretics in patients with diabetes.
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Affiliation(s)
- Jennifer A Hirst
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, United Kingdom; National Institute for Health Research School for Primary Care Research, Oxford, United Kingdom
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Cheng L, Leung DYP, Sit JWH, Li XM, Wu YN, Yang MY, Gao CX, Hui R. Factors associated with diet barriers in patients with poorly controlled type 2 diabetes. Patient Prefer Adherence 2016; 10:37-44. [PMID: 26834464 PMCID: PMC4716765 DOI: 10.2147/ppa.s94275] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The study was conducted to investigate the diet barriers perceived by patients with poorly controlled type 2 diabetes and examine the associations between diet barriers and sociodemographic characteristics, medical condition, and patient-centered variables. METHODS Secondary subgroup analyses were conducted based on the responses of 246 adults with poorly controlled type 2 diabetes from a multicenter, cross-sectional study. Diet barriers were captured by the Diet Barriers subscale of the Personal Diabetes Questionnaire. Participants also completed validated measures of diet knowledge, empowerment level, and appraisal of diabetes. Multiple regression techniques were used for model building, with a hierarchical block design to determine the separate contribution of sociodemographic characteristics, medical condition, and patient-centered variables to diet barriers. RESULTS Diet barriers were moderately evident (2.23±0.86) among Chinese patients with poorly controlled type 2 diabetes. The feeling of deprivation as a result of complying with a diet was the most recognized diet barrier (3.24±1.98), followed by "eating away from home" (2.79±1.82). Significantly higher levels of diet barriers were observed among those with lower levels of diet knowledge (β=-0.282, P<0.001) and empowerment (β=-0.190, P=0.015), and more negative appraisal (β=0.225, P=0.003). CONCLUSION Culturally tailored, patient-centered intervention programs that acknowledge individuals' preferences and allow for flexibility in diet management should be launched. Interventions programs that could enhance diet knowledge, promote positive appraisal, and improve empowerment level might effectively address diet barriers perceived by patients with poorly controlled type 2 diabetes.
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Affiliation(s)
- Li Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Shatin, New Territories, Hong Kong
- Correspondence: Li Cheng, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Shatin, New Territories, 999077, Hong Kong, Tel +852 3943 9908, Fax +852 26035935, Email
| | - Doris Yin-ping Leung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Shatin, New Territories, Hong Kong
| | - Janet Wing-hung Sit
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Shatin, New Territories, Hong Kong
| | - Xiao-mei Li
- The Department of Nursing, Faculty of Medicine, The Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yu-ning Wu
- The Department of Endocrinology, The Ninth Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Miao-yan Yang
- The Department of Endocrinology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Cui-xia Gao
- The Department of Endocrinology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Rong Hui
- The Department of Endocrinology, Shaanxi Provincial People’s Hospital, Xi’an, People’s Republic of China
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158
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Cahn A, Miccoli R, Dardano A, Del Prato S. New forms of insulin and insulin therapies for the treatment of type 2 diabetes. Lancet Diabetes Endocrinol 2015; 3:638-52. [PMID: 26051044 DOI: 10.1016/s2213-8587(15)00097-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 03/18/2015] [Accepted: 03/30/2015] [Indexed: 12/17/2022]
Abstract
Insulin is a common treatment option for many patients with type 2 diabetes, and is generally used late in the natural history of the disease. Its injectable delivery mode, propensity for weight gain and hypoglycaemia, and the paucity of trials assessing the risk-to-safety ratio of early insulin use are major shortcomings associated with its use in patients with type 2 diabetes. Development of new insulins-such as insulin analogues, including long-acting and short-acting insulins-now provide alternative treatment options to human insulin. These novel insulin formulations and innovative insulin delivery methods, such as oral or inhaled insulin, have been developed with the aim to reduce insulin-associated hypoglycaemia, lower intraindividual pharmacokinetic and pharmacodynamic variability, and improve imitation of physiological insulin release. Availability of newer glucose-lowering drugs (such as glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose co-transporter-2 inhibitors) also offers the opportunity for combination treatment; the results of the first trials in this area of research suggest that such treatment might lead to use of reduced insulin doses, less weight gain, and fewer hypoglycaemic episodes than insulin treatment alone. These and future developments will hopefully offer better opportunities for individualisation of insulin treatment for patients with type 2 diabetes.
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Affiliation(s)
- Avivit Cahn
- Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Roberto Miccoli
- Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy
| | - Angela Dardano
- Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy
| | - Stefano Del Prato
- Department of Clinical and Experimental Medicine, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy.
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160
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Lopez JMS, Bailey RA, Rupnow MFT. Demographic Disparities Among Medicare Beneficiaries with Type 2 Diabetes Mellitus in 2011: Diabetes Prevalence, Comorbidities, and Hypoglycemia Events. Popul Health Manag 2015; 18:283-9. [PMID: 25647516 DOI: 10.1089/pop.2014.0115] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This study describes demographic characteristics, comorbidities, and hypoglycemia events in patients with type 2 diabetes mellitus (T2DM) identified using 2011 Medicare 5% Standard Analytical Files. Among 1,913,477 Medicare beneficiaries, 367,602 (19.2%) had T2DM. T2DM prevalence increased with age and was higher in blacks (26.4%) and Hispanics (25.5%) than in whites (18.0%); and in Medicare/Medicaid dual-eligible versus non-dual-eligible patients (28.0% vs 17.2%, respectively). Compared with whites, diagnosed hypertension and diabetic retinopathy were more common in blacks and Hispanics, and lipid metabolism disorders and atrial fibrillation were less common. Hypoglycemia requiring health care services was more common in blacks (4.7%) and Hispanics (3.6%) compared with whites (2.9%). T2DM, related comorbidities, and hypoglycemia are burdensome to the Medicare population. Differences in these endpoints were observed based on race/ethnicity, age, and dual-eligible status, highlighting the importance of demographic factors when determining T2DM management strategies.
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161
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Diabetic Complications among Adult Diabetic Patients of a Tertiary Hospital in Northeast Ethiopia. ADVANCES IN PUBLIC HEALTH 2015. [DOI: 10.1155/2015/290920] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background.The diabetic complications are becoming common community problems. The outcomes of diabetic complications are increased hospitalization, increased direct patient costs, and mortality. In Dessie, the prevalence of the diabetic complications is not well studied so far. Thus, the aim of this study is to assess prevalence of diabetic complications and associated factors among adult diabetic patients of Dessie Referral Hospital, Northeast Ethiopia.Methods.Cross-sectional study was conducted in the diabetic clinic of Dessie Referral Hospital from April to May 31, 2013. All diabetic patients who visited the clinic during the study period were included. Data was collected using interview guided self-administered questionnaire. Presence of complications and the type of medications the patient was on were identified through review of patient records. Data were cleaned, coded, and entered into SPSS for Windows version 17.0. Descriptive statistics and chi-square tests were carried out to meet the stated objective.The Results.Overall 129 (59.7%) of the patients were found to have been affected by one or more of the diabetic complications. Complications were identified mainly among type II diabetic patients. The age of patients (Pvalue-0.048), type of diabetes (Pvalue-0.00), and medication (Pvalue-0.00) were strongly associated with the occurrence of diabetic complication but self-reported adherence, attitude, and knowledge level of patients and the family history were not associated with the presence of complication.Conclusion.The prevalence of complications among diabetic patients in Dessie Referral Hospital was high. Targeted counseling and health information provision to the patients by the clinical staff will be helpful in reducing avoidable morbidity and mortality in the patients.
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162
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Longo PL, Artese HPC, Rabelo MS, Kawamoto D, Foz AM, Romito GA, Dib SA, Mayer MPA. Serum levels of inflammatory markers in type 2 diabetes patients with chronic periodontitis. J Appl Oral Sci 2014; 22:103-8. [PMID: 24676580 PMCID: PMC3956401 DOI: 10.1590/1678-775720130540] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 12/12/2013] [Indexed: 01/20/2023] Open
Abstract
Diabetes has been associated with periodontitis, but the mechanisms through which
periodontal diseases affect the metabolic control remain unclear.
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Affiliation(s)
- Priscila Larcher Longo
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Hilana Paula Carillo Artese
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Marianade Sousa Rabelo
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Dione Kawamoto
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Adriana Moura Foz
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Giuseppe Alexandre Romito
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Sergio Atala Dib
- Department of Endocrinology, School of Medicine, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcia Pinto Alves Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
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Cheng Y, Zhang H, Chen R, Yang F, Li W, Chen L, Lin S, Liang G, Cai D, Chen H. Cardiometabolic risk profiles associated with chronic complications in overweight and obese type 2 diabetes patients in South China. PLoS One 2014; 9:e101289. [PMID: 24992024 PMCID: PMC4081665 DOI: 10.1371/journal.pone.0101289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/05/2014] [Indexed: 01/19/2023] Open
Abstract
Background Type 2 diabetes is often accompanied by altered cardiometabolic risk profiles, including abdominal obesity, hypertension, and dyslipidaemia. The association of altered cardiometabolic risk profiles with chronic complications of diabetes is not well investigated. Methods We recruited 2954 type 2 diabetes patients with a body mass index ≥25 kg/m2 who visited the diabetes clinics of 62 hospitals in 21 cities in Guangdong province of China from August 2011 to March 2012. Demographic characteristics, personal and family medical histories, and data on chronic complications of diabetes were collected. Clinical examinations and laboratory assessment were conducted. Results Abdominal obesity was found in 91.6% of the study population, elevated blood pressure in 78.3%; elevated serum triacylglycerols in 57.8%, and reduced serum HDL-C in 55.9%. Among the cardiometabolic risk factors, elevated blood pressure was significantly associated with almost all the chronic complications of diabetes. After adjusting for age, gender, duration of diabetes, and HbA1c, elevated blood pressure was significantly associated with diabetic retinopathy (OR 1.63, 95% CI: 1.22–2.19), diabetic nephropathy (OR 3.16, 95% CI: 2.25–4.46), cardiovascular disease (OR 2.71, 95% CI: 1.70–4.32), and stroke (OR 1.90, 95% CI: 1.15–3.12). Abdominal adiposity was significantly associated with diabetic nephropathy (OR 1.39, 95% CI: 1.11–1.74). Elevated triacylglycerols was significantly associated with diabetic retinopathy (OR 1.29, 95% CI: 1.05–1.58) and diabetic nephropathy (OR 1.30, 95% CI: 1.05–1.58). Reduced HDL-C was significantly associated with stroke (OR 1.41, 95% CI: 1.05–1.88). Conclusions Altered cardiometabolic risk profiles, and elevated blood pressure in particular, were significantly associated with chronic complications in overweight and obese patients with type 2 diabetes. Future studies on the prevention of chronic complications of diabetes might make lowering blood pressure a primary target.
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Affiliation(s)
- Yanzhen Cheng
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Hua Zhang
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Rongping Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Fan Yang
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
- Department of Endocrinology, Affiliated Hospital of Gulin Medicine University, Guilin, China
| | - Wei Li
- Department of Endocrinology, Wu Jing Zong Dui Hospital of Guangdong Province, Guangzhou, China
| | - Lishu Chen
- Department of Endocrinology, The Second Affiliated Hospital of Shantou University Medicine College, Shantou, China
| | - Shaoda Lin
- Department of Endocrinology, The first Affiliated Hospital of Shantou University Medicine College, Shantou, China
| | - Ganxiong Liang
- Department of Endocrinology, People's Hospital of Zhongshan City, Zhongshan, China
| | - Dehong Cai
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Hong Chen
- Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
- * E-mail:
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