1
|
Oluwadiya KS, Raimi TH, Dada SA, Dele-Ojo BF, Adeoti AO, Solomon OO, Amu E, Awoleke JO, Atiba SA, Babatola AO, Dada MU, Ariyo OE, Omotayo AJ, Adelekan AO, Ezeani ES, Ogundipe L, Akinwunmi AF, Aina FO, Agboola SM. Uncovering the Burden of Diabetes in Ekiti State, Nigeria: Insights From a Statewide, Household-Based, Cross-Sectional Study. Cureus 2023; 15:e50686. [PMID: 38229802 PMCID: PMC10791138 DOI: 10.7759/cureus.50686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is an important global public health challenge, and the burden of the disease is huge, particularly in low- and middle-income countries (LMICs), where the majority of people with this condition reside. Undiagnosed DM is more prevalent in LMICs. The aim of this study is to determine the prevalence and associated factors for DM in Ekiti State. MATERIALS AND METHODS A cross-sectional, household-based survey using a four-stage multistage sampling design and the World Health Organization (WHO)-STEPS survey manual was conducted from July to September 2020 as a part of the Ekiti State coronavirus disease 2019 (COVID-19) survey. Of the 5,145 sampled households, 4,726 individuals gave consent to participate in the survey. Out of these, 3043 had fasting plasma glucose results available and were included in the analysis. RESULTS There were 2257 (74.2%) women and 786 (25.8%) men. The prevalence of DM was 6.5% (6.5% in males and 6.6% in females, P = 0.946). Diabetes was found to be more prevalent among those with a secondary school education or higher (10.9%); employed in the formal sector (13.4%); separated, divorced, or widowed (8.5%); with raised blood pressure (9.3%); and who were aged 30-59 years (all P < 0.05). Multivariable logistic regression showed that age, education, occupation, and hypertension were all positively and significantly associated with an increased risk of DM. CONCLUSION The prevalence of DM in Ekiti State is high, and its predictors include advancing age, hypertension, education, and occupation. This calls for scaling up public health interventions for controlling DM, targeting the identified risk factors among the people of Ekiti.
Collapse
Affiliation(s)
| | - Taiwo H Raimi
- Department of Medicine, Ekiti State University, Ado Ekiti, NGA
| | - Samuel A Dada
- Department of Medicine, Ekiti State University, Ado Ekiti, NGA
| | | | | | - Oluremi O Solomon
- Department of Community Medicine, Ekiti State University, Ado Ekiti, NGA
| | - Eyitope Amu
- Department of Community Medicine, Ekiti State University, Ado Ekiti, NGA
| | - Jacob O Awoleke
- Department of Obstetrics and Gynaecology, Ekiti State University, Ado Ekiti, NGA
| | - Samuel A Atiba
- Department of Chemical Pathology, Ekiti State University, Ado Ekiti, NGA
| | | | - Mobolaji U Dada
- Department of Psychiatry and Behavioral Sciences, Ekiti State University, Ado Ekiti, NGA
| | | | - Adetunji J Omotayo
- Department of Anatomic Pathology, Ekiti State University, Ado Ekiti, NGA
| | - Ademola O Adelekan
- Department of Chemical Pathology, Federal Teaching Hospital, Ido Ekiti, NGA
| | - Esu S Ezeani
- Department of Epidemiology and Biostatistics, Ministry of Health and Human Services, Ekiti State, Ado Ekiti, NGA
| | - Laofe Ogundipe
- Department of Community Medicine and Psychiatry, Afe Babalola University, Ado Ekiti, NGA
| | | | - Felix O Aina
- Department of Family Medicine, Ekiti State University, Ado Ekiti, NGA
| | - Segun M Agboola
- Department of Family Medicine, Afe Babalola University, Ado Ekiti, NGA
| |
Collapse
|
2
|
Csonka Á, Gárgyán I, Varga E. Multidisciplinary treatment of a complicated crural degloving injury in a diabetic patient. Injury 2021; 52 Suppl 1:S74-S77. [PMID: 32067776 DOI: 10.1016/j.injury.2020.02.050] [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: 01/21/2020] [Accepted: 02/09/2020] [Indexed: 02/02/2023]
Abstract
Diabetes is a common disease that potentially interferes with healing processes after lower limb trauma. In our presented case a trimalleolar ankle fracture with undiscovered serious soft-tissue injuries resulted in chronic soft-tissue complications in a diabetic patient, requiring three and a half months of hospitalization in a higher level center and the application of state-of-the-art wound treatment, including vacuum-assisted closure therapy, Integra bioengineered skin substitute, split-thickness skin-grafting, and methods enhancing wound healing, such as polarized light therapy and transdermal CO2 delivery. The presented case emphasizes the importance of soft-tissue care and multidisciplinary approach in diabetic trauma patients with poor compliance.
Collapse
Affiliation(s)
- Ákos Csonka
- Department of Traumatology, University of Szeged, Hungary.
| | - István Gárgyán
- Department of Traumatology, University of Szeged, Hungary
| | - Endre Varga
- Department of Traumatology, University of Szeged, Hungary
| |
Collapse
|
3
|
Tóth G, Szabó D, Sándor GL, Szepessy Z, Barsi Á, Nagy ZZ, Limburg H, Németh J. Rural–urban disparities in the prevalence of diabetes and diabetic eye complications in Hungary. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Summary
Background
To examine the rural–urban differences in the prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) in the population aged 50 years and older in Hungary.
Methods
105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness (RAAB) with the diabetic retinopathy module was performed. Participants were classified as diabetic if they had a previous diagnosis of DM or a random blood glucose level ≥200 mg/dl. Each individual with DM who agreed underwent dilated fundus examination and DR grading.
Results
The prevalence of DM was higher in rural (21.8%) than in urban (18.6%) areas (p = 0.016). The prevalence of DR did not differ significantly between rural and urban areas in DM cases. Blindness (0.9% vs. 0.1%; p = 0.048) and blindness due to DM (0.3% vs. 0.0%; p = 0.021) in diabetic participants was significantly more common in rural than in urban areas. Diabetic eye screening coverage was significantly lower in rural than in urban areas (p ≤ 0,007).
Conclusion
Based on our results and the high rate of blindness and blindness due to DR in rural areas, primary eye care should be improved and a telemedical eye screening program should be undertaken, especially concentrating on rural areas.
Collapse
|
4
|
Tóth G, Szabó D, Sándor GL, Nagy ZZ, Karadeniz S, Limburg H, Németh J. Diabetes and blindness in people with diabetes in Hungary. Eur J Ophthalmol 2018; 29:141-147. [PMID: 30458640 DOI: 10.1177/1120672118811738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION: The purpose of the study was to estimate the number of people with diabetes mellitus, the prevalence of diabetes mellitus and the prevalence of blindness and severe visual impairment among people with diabetes mellitus in Hungary based on our recent national representative survey. METHODS: Altogether 105 clusters of 35 people aged 50 years or older were randomly selected. Standardized rapid assessment of avoidable blindness with the diabetic retinopathy module was used. Each individual received a visual acuity assessment, and every person with diabetes mellitus underwent dilated fundus examination. RESULTS: The estimated number of people with diabetes mellitus was 807,885 in the adult (⩾18 years) population in Hungary with 9.9% prevalence. Diabetic retinopathy exhibited an increasing tendency with age. The prevalence rates of blindness and severe visual impairment in people with diabetes mellitus aged ⩾50 years were 1.0% and 0.9%, respectively. Diabetic retinopathy was responsible for 28% of blindness and 50% of severe visual impairment among participants aged ⩾50 years with diabetes mellitus. CONCLUSION: The estimated number of people with diabetes mellitus and prevalence of diabetes mellitus were lower than those recently reported. However, if we extend our estimation, prevalence of undiagnosed diabetes mellitus may be higher and thus prevalence of diabetes mellitus may reach a higher value (between 9.9% and 13.4%). Because of the high number of ophthalmologically uncontrolled diabetic eyes and high rate of blindness due to diabetic retinopathy, primary eye care should be improved, and a nationwide telemedical eye-screening programme should be undertaken.
Collapse
Affiliation(s)
- Gábor Tóth
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Dorottya Szabó
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Gábor L Sándor
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltán Z Nagy
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Sehnaz Karadeniz
- 2 Department of Ophthalmology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey
| | - Hans Limburg
- 3 Health Information Services, Grootebroek, The Netherlands
| | - János Németh
- 1 Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
5
|
Domján BA, Ferencz V, Tänczer T, Szili-Janicsek Z, Barkai L, Hidvégi T, Jermendy G, Kempler P, Winkler G, Gerő L, Tabák AG. Large increase in the prevalence of self-reported diabetes based on a nationally representative survey in Hungary. Prim Care Diabetes 2017; 11:107-111. [PMID: 27669637 DOI: 10.1016/j.pcd.2016.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 08/22/2016] [Accepted: 09/03/2016] [Indexed: 11/19/2022]
Abstract
AIMS To estimate and compare the prevalence of self-reported diabetes based on nationally representative surveys of the Hungarian adult population in 2002 (published data - Hungarostudy) and a survey in 2012. METHODS A cross-sectional computer-assisted telephone interview survey on a stratified representative sample of community-dwelling adults (n=1000) in 2012. To describe self-reported diabetes prevalence and its temporal changes generalized linear models were used and results were compared to figures from Hungarostudy. RESULTS Age standardized prevalence of self-reported type 2 diabetes was 11.7% (95%CI 10.0-13.8%) without gender or rural-urban differences in 2012. People with self-reported diabetes were older than controls (mean [SE]: 63.9 [0.9] vs. 45.9 [0.3] years, p<0.0001). The prevalence of diabetes sharply increased after 40 years of age and peaked at age 70 (27.7% [2.5], page*age<0.0001). The prevalence of self-reported diabetes increased by 89% (OR 1.89, 95%CI 1.53-2.32) from 6.2 to 11.7% between the two surveys with the most pronounced increase in the age group 55-64 years (from 11.6 to 24.4%). CONCLUSIONS We reported an alarming increase in the prevalence of self-reported type 2 diabetes in the last decade that mostly affects working age people. If this trend continues, a major public health crisis in Hungary can be envisaged.
Collapse
Affiliation(s)
- Beatrix A Domján
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - Viktória Ferencz
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - Tímea Tänczer
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - Zsófia Szili-Janicsek
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - László Barkai
- Institute of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Egyetem út, Miskolc H-3515, Hungary; Velkey László Center for Child Health, Borsod County University Hospital, Szentpéteri kapu 72-76, Miskolc H-3526, Hungary; Postgraduate Institute of Pediatrics, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen H-4032, Hungary.
| | - Tibor Hidvégi
- Department of Internal Medicine, Aladár Petz County Hospital, Vasvári Pál utca 2-4, Győr H-9023, Hungary.
| | - György Jermendy
- Department of Medicine, Bajcsy-Zsilinszky Hospital, Maglódi út 89-91, Budapest H-1106, Hungary.
| | - Péter Kempler
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - Gábor Winkler
- Institute of Theoretical Health Sciences, Faculty of Health Care, University of Miskolc, Egyetem út, Miskolc H-3515, Hungary; Department of Medicine and Diabetology, Saint John's Hospital, Diós árok 1, Budapest H-1125, Hungary.
| | - László Gerő
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary.
| | - Adam G Tabák
- 1st Department of Medicine, Semmelweis University Faculty of Medicine, Korányi S. u. 2/a, Budapest H-1083, Hungary; Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| |
Collapse
|
6
|
Tóth G, Szabó D, Sándor GL, Szalai I, Lukács R, Pék A, Tóth GZ, Papp A, Nagy ZZ, Limburg H, Németh J. Diabetes and diabetic retinopathy in people aged 50 years and older in Hungary. Br J Ophthalmol 2016; 101:965-969. [PMID: 27793820 DOI: 10.1136/bjophthalmol-2016-309016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/23/2016] [Accepted: 10/13/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND/AIMS The purpose of this study was to estimate the prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) in the population aged 50 years and older in Hungary, and to assess the coverage of diabetic eye care services. METHODS In total, 105 clusters of 35 people aged 50 years or older were randomly selected. The standardised rapid assessment of avoidable blindness (RAAB) with the diabetic retinopathy module (DRM) was used. Participants were classified as having DM if they were known to have DM or if their random blood glucose level was ≥200 mg/dL. Dilated fundus examination and Scottish DR grading were performed. RESULTS In total, 3523 (95.9%) out of 3675 eligible subjects were examined. And 705 (20.0%) out of 3523 had known (661) or newly diagnosed DM (44). Twenty per cent of participants with known DM had a blood glucose level ≥200 mg/dL, and 27.4% had never had an ophthalmological examination for DR. Prevalence of DR and/or maculopathy was 20.7% and prevalence of sight-threatening DR (STDR) was 4.3% in one or both eyes among participants with DM. CONCLUSIONS Prevalence of DM was in line with findings of other RAAB+DRM surveys and slightly lower than the unpublished earlier age-matched Hungarian estimate. Prevalence of DR was slightly lower than expected. The prevalence of STDR was low in people aged 50 years and older in Hungary compared with the results of other RAAB with DRM surveys. DR screening coverage was low. To prevent severe complications of DM and possible concomitant visual loss, the coverage of ophthalmic examinations in patients with DM should be increased.
Collapse
Affiliation(s)
- Gábor Tóth
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Dorottya Szabó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Gábor L Sándor
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Irén Szalai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Regina Lukács
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Department of Ophthalmology, Flór Ferenc Hospital, Kistarcsa, Hungary
| | - Anita Pék
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary.,Department of Ophthalmology, Petz Aladár Hospital, Győr, Hungary
| | - Georgina Z Tóth
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - András Papp
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Zoltán Z Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Hans Limburg
- Health Information Services, Grootebroek, The Netherlands
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
7
|
The Association Between Body Mass Index (BMI) and Back or Leg Pain in Patients With Spinal Conditions: Results from the Genodisc Study. Spine (Phila Pa 1976) 2016; 41:E1237-E1243. [PMID: 27760064 DOI: 10.1097/brs.0000000000001606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A prospective observational study. OBJECTIVE The aim of this study was to identify the relationship between obesity, quantified by body mass index (BMI), and both back and leg pain in spinal patients. SUMMARY OF BACKGROUND DATA Obesity and back pain are massive public health problems. Given the poor correlation between pain and a pathological change in the spine, further investigation is required into other, nonpathological predictors such as obesity. METHODS The Genodisc Study was one of the largest cross-sectional studies of patients presenting to tertiary spinal units and recruited from six centers in four European countries. In total, 2636 patients were recruited over a 5-year period between 2008 and 2013. Both back and leg pain were scored by patients in the range of 0 to 10. Linear regression was used to model the relationship between BMI and pain. Potential confounders included in the model were age, Zung Depression score, episodes of sport, gender, disability benefit, family history, previous surgery, smoking status, work type, clinical diagnosis, and relevant comorbidities. Back and leg pain outcomes were modeled separately. RESULTS The study included 1160 men and 1349 women with a mean age of 50.9 years and mean BMI of 27.2 kg/m. In our fully adjusted model, a 5-point increase in BMI was associated with greater leg [0.19 units (95% confidence interval 0.08-0.31)] but not back [0.10 units (95% CI -0.02 to 0.22)] pain scores. Although this relationship was statically significant, given the small magnitude of the relationship, the clinical significance is limited. Similarly, female gender, heavy workload, rheumatoid arthritis, previous spine surgery, and depression were associated with higher back and leg pain. CONCLUSION In this large observational study of spine patients presenting to tertiary European centers, obesity, as measured by increased BMI, was associated with greater leg pain. LEVEL OF EVIDENCE 2.
Collapse
|
8
|
Yazdanpanah L, Shahbazian HB, Moravej Aleali A, Jahanshahi A, Ghanbari S, Latifi SM. Prevalence, awareness and risk factors of diabetes in Ahvaz (South West of Iran). Diabetes Metab Syndr 2016; 10:S114-S118. [PMID: 27312373 DOI: 10.1016/j.dsx.2016.03.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 03/05/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study was designed to assess the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. MATERIALS AND METHODS The study population was chosen by cluster sampling. A checklist included: age, sex, weight, height, blood pressure, waist circumference, educational level, smoking status and previous history of diabetes was completed for each patient. Fasting Plasma Glucose (FPG) ≥126mg/dl and/or oral hypoglycemic treatment and/or insulin consumption was defined as diabetes, FPG=100-125mg/dl as Impaired Fasting Glucose (IFG) and FPG <100mg/dl as normal. RESULTS Study population was 944 persons. Mean age of population was 42.2±14 years. Diabetes was detected in 15.1% of population. Only 40.4% of cases were aware of their disease. Diabetes was detected in 14.7% of female and 15.7% of male participants. Diabetes was related to age, waist circumference, family history of diabetes, hypertension, waist to hip ratio, educational level, marital status, serum triglyceride, cholesterol and body mass index (BMI) in both genders. But by using logistic regression analysis, age, family history of diabetes, hypertension, hypertriglyceridemia, and marital status had significant effect on diabetes. CONCLUSION This study showed that using FPG criteria or current medication 15.1% of this population had diabetes and about 60% of patients were unaware of their disease. Age, hypertension, family history of diabetes, hypertriglyceridemia and marital status are the risk factors of diabetes in Ahvaz population. IFG have high prevalence and diabetes screening should be intensified in this population.
Collapse
Affiliation(s)
- L Yazdanpanah
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - H B Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - A Moravej Aleali
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - A Jahanshahi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - S Ghanbari
- Department of Biostatistics, The Medical School Shiraz University of Medical Sciences, Shiraz, Iran
| | - S M Latifi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
9
|
Tamayo T, Rosenbauer J, Wild SH, Spijkerman AMW, Baan C, Forouhi NG, Herder C, Rathmann W. Diabetes in Europe: an update. Diabetes Res Clin Pract 2014; 103:206-17. [PMID: 24300019 DOI: 10.1016/j.diabres.2013.11.007] [Citation(s) in RCA: 156] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Diabetes is among the leading causes of death in the IDF Europe Region (EUR), continues to increase in prevalence with diabetic macro- and microvascular complications resulting in increased disability and enormous healthcare costs. In 2013, the number of people with diabetes is estimated to be 56 million in EUR with an overall estimated prevalence of 8.5%. However, estimates of diabetes prevalence in 2013 vary widely in the 56 diverse countries in EUR from 2.4% in Moldova to 14.9% in Turkey. Trends in diabetes prevalence also vary between countries with stable prevalence since 2002 for many countries but a doubling of diabetes prevalence in Turkey. For 2035, a further increase of nearly 10 million people with diabetes is projected for the EUR. Prevalence of type 1 has also increased over the past 20 years in EUR and there was estimated to be 129,350 cases in children aged 0-14 years in 2013. Registries provide valid information on incidence of type 1 diabetes with more complete data available for children than for adults. There are large differences in distribution of risk factors for diabetes at the population level in EUR. Modifiable risk factors such as obesity, physical inactivity, smoking behaviour (including secondhand smoking), environmental pollutants, psychosocial factors and socioeconomic deprivation could be tackled to reduce the incidence of type 2 diabetes in Europe. In addition, diabetes management is a major challenge to health services in the European countries. Improved networking practices of health professionals and other stakeholders in combination with empowerment of people with diabetes and continuous quality monitoring need to be further developed in Europe.
Collapse
Affiliation(s)
- T Tamayo
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - J Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - S H Wild
- Centre for Population Health Sciences, University of Edinburgh, UK
| | - A M W Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - C Baan
- Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N G Forouhi
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - C Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - W Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
| |
Collapse
|
10
|
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014; 103:137-49. [PMID: 24630390 DOI: 10.1016/j.diabres.2013.11.002] [Citation(s) in RCA: 2839] [Impact Index Per Article: 283.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Diabetes is a serious and increasing global health burden and estimates of prevalence are essential for appropriate allocation of resources and monitoring of trends. METHODS We conducted a literature search of studies reporting the age-specific prevalence for diabetes and used the Analytic Hierarchy Process to systematically select studies to generate estimates for 219 countries and territories. Estimates for countries without available source data were modelled from pooled estimates of countries that were similar in regard to geography, ethnicity, and economic development. Logistic regression was applied to generate smoothed age-specific prevalence estimates for adults 20-79 years which were then applied to population estimates for 2013 and 2035. RESULTS A total of 744 data sources were considered and 174 included, representing 130 countries. In 2013, 382 million people had diabetes; this number is expected to rise to 592 million by 2035. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. CONCLUSION The new estimates of diabetes in adults confirm the large burden of diabetes, especially in developing countries. Estimates will be updated annually including the most recent, high-quality data available.
Collapse
Affiliation(s)
- L Guariguata
- International Diabetes Federation, Brussels, Belgium.
| | - D R Whiting
- Directorate of Public Health, Medway Council, Chatham, United Kingdom
| | - I Hambleton
- University of the West Indies, Cave Hill, Barbados
| | - J Beagley
- International Diabetes Federation, Brussels, Belgium
| | - U Linnenkamp
- International Diabetes Federation, Brussels, Belgium
| | - J E Shaw
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| |
Collapse
|
11
|
Sal I, Susánszky É, Papp I. Quality of life in diabetes mellitus assessed on the basis of Hungarostudy Health Panel survey. Orv Hetil 2013; 154:531-7. [DOI: 10.1556/oh.2013.29579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction: Examining the quality of life has a great importance in the treatment of chronic patients. Aim: The aim of the authors was to assess the national status on the basis of the database of the Hungarostudy Health Panel using statistical evaluation. Methods: Three validated questionnaries in the test-battery served as instruments: the shortened version of the WHO Well-being Questionnaire, the Shortened Beck’s Depression Scale Rating and the Illness Intrusiveness Rating Scale. Results: It was found that in accordance with international data, the quality of life index of Hungarian diabetic patients was significantly worse than that of the non-diabetic population. Conclusions: International data also show that the decline in quality of life is correlated with a decline of cooperation and life expectancy of diabetic patients. This explains why methods of behavioral medicine focusing on improving life quality are of great importance, that have not yet been considered currently in psychoeducation. Referring to international examples the authors make a proposal on an extensive survey among Hungarian diabetic patients with the help of validated disease-specific questionnaires and using Transtheoretical Model in order to make education more efficient. Orv. Hetil., 2013, 154, 531–537.
Collapse
Affiliation(s)
- István Sal
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4., XX. emelet 1089
| | - Éva Susánszky
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4., XX. emelet 1089
| | - Ildikó Papp
- Semmelweis Egyetem, Általános Orvostudományi Kar Magatartástudományi Intézet Budapest Nagyvárad tér 4., XX. emelet 1089
| |
Collapse
|
12
|
Winkler G, Hidvégi T, Vándorfi G, Balogh S, Jermendy G. Prevalence of undiagnosed abnormal glucose tolerance in adult patients cared for by general practitioners in Hungary. Results of a risk-stratified screening based on FINDRISC questionnaire. Med Sci Monit 2013; 19:67-72. [PMID: 23344680 PMCID: PMC3629009 DOI: 10.12659/msm.883747] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 08/02/2012] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes mellitus is rapidly increasing, worldwide and also in Hungary. Timely diagnosis and early treatment could be aided by targeted screening. Recognizing this, the Hungarian Diabetes Association initiated a risk-stratified screening with the involvement of primary care physicians. MATERIAL/METHODS In the first phase of screening, the FINDRISC questionnaire was completed, followed by an oral glucose tolerance test (OGTT) for those with a score of ≥12. Between September 1, 2010 and March 31, 2011, 70,432 non-diabetic adults, who visited their general practitioners for any reason, were involved in the screening. Of these, 68,476 questionnaires proved to be suitable for processing. RESULTS From the questionnaires, 28,077 (41.0%) had a score of ≥12. A valid OGTT was performed in 22,846 cases; of this group 3,217 subjects (14.1%) had elevated fasting glucose levels, 5,663 (24.8%) had impaired glucose tolerance, and 1,750 (7.6%) had manifest, previously undiagnosed, diabetes mellitus. Overall, from the valid OGTT group, 46.5% subjects had some degree of glucose intolerance. CONCLUSIONS Based on the FINDRISC questionnaire, the risk-stratified screening for diabetes mellitus proved to be simple and cost-effective method for the early detection of carbohydrate metabolism disorders. Using this method, the prevalence rate of previously undiagnosed abnormal glucose tolerance was high in adult patients cared for by general practitioners in Hungary.
Collapse
Affiliation(s)
- Gábor Winkler
- Department of Medicine and Diabetology, Saint John’s Hospital, Budapest, Hungary
- Department of Health Sciences, Faculty of Health Care, University of Miskolc, Miskolc, Hungary
| | - Tibor Hidvégi
- Department of Medicine, Petz County Teaching Hospital, Győr, Hungary
| | - Győző Vándorfi
- Centre for Medicine, Diabetology and Metabolism, Veszprém County Csolnoky Hospital, Veszprém, Hungary
| | - Sándor Balogh
- National Institute for Primary Health Care, Budapest, Hungary
| | - György Jermendy
- Department of Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| |
Collapse
|
13
|
Epidemiology of the metabolic syndrome in Hungary. Public Health 2012; 126:143-9. [DOI: 10.1016/j.puhe.2011.11.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 08/03/2011] [Accepted: 11/08/2011] [Indexed: 01/25/2023]
|
14
|
Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94:311-21. [PMID: 22079683 DOI: 10.1016/j.diabres.2011.10.029] [Citation(s) in RCA: 2592] [Impact Index Per Article: 199.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 10/20/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Diabetes is an increasingly important condition globally and robust estimates of its prevalence are required for allocating resources. METHODS Data sources from 1980 to April 2011 were sought and characterised. The Analytic Hierarchy Process (AHP) was used to select the most appropriate study or studies for each country, and estimates for countries without data were modelled. A logistic regression model was used to generate smoothed age-specific estimates which were applied to UN population estimates for 2011. RESULTS A total of 565 data sources were reviewed, of which 170 sources from 110 countries were selected. In 2011 there are 366 million people with diabetes, and this is expected to rise to 552 million by 2030. Most people with diabetes live in low- and middle-income countries, and these countries will also see the greatest increase over the next 19 years. DISCUSSION This paper builds on previous IDF estimates and shows that the global diabetes epidemic continues to grow. Recent studies show that previous estimates have been very conservative. The new IDF estimates use a simple and transparent approach and are consistent with recent estimates from the Global Burden of Disease study. IDF estimates will be updated annually.
Collapse
|
15
|
Socio-demographic characteristics, health behaviour, co-morbidity and accidents in snorers: a population survey. Sleep Breath 2010; 15:809-18. [DOI: 10.1007/s11325-010-0442-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 10/27/2010] [Indexed: 11/26/2022]
|
16
|
Winkler G, Hidvégi T, Vándorfi G, Jermendy G. [Risk-stratified screening for diabetes in adults: results of the first investigation in Hungary]. Orv Hetil 2010; 151:691-6. [PMID: 20388612 DOI: 10.1556/oh.2010.28819] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Prevalence rate of diabetes mellitus, especially of type 2 diabetes, has been increasing worldwide; this is the case in Hungary as well. The early diagnosis of diabetes should be considered as one of the most important factors improving the late prognosis of the disease. Due to cost-effectiveness, screening should primarily be implemented in subjects at high risk to glucose intolerance. A risk-stratified nationwide screening procedure was performed by the Hungarian Diabetes Association in collaboration with general practitioners (GPs) in adult subjects without known diabetes. The screening procedure, which was sponsored by the 77 Elektronika Ltd (Budapest), was performed in a two steps manner. At first step, the Hungarian version of the internationally validated FINDRISC questionnaire (maximal score 26) was filled out by subjects while waiting for GP. At second step, blood glucose value in venous sample was locally measured by standard laboratory methods in subjects with a score value of > or = 12. The further diagnostic steps were carried out by WHO guidelines. As a total, 8921 subjects (59.7% women, 40.3% men) were screened between 01, April 2008 and 31, March 2009. Out of 4286 subjects with a score of > or = 12 (age 53.4 +/- 11.4 years; BMI: 29.9 +/- 4.8 kg/m2; waist circumference: 101.7 +/- 12.7 cm) 3733 (87.1%) had normal fasting blood glucose values, while 283 subjects (6.6%) had IFG, 122 (2.85%) had IGT and 19 participants (0.44%) had isolated IGT. Unknown diabetes was found in 129 subjects (3.01%). If the score value requiring laboratory confirmation was set at higher level (> or = 15 or > or = 20), the proportion of subjects with any degree of glucose intolerance increased. Among anthropometric parameters, BMI had the strongest association with the risk of glucose intolerance: 1 kg/m 2 increase in BMI value increased the risk of abnormal score category (> or = 12) by 24.7% (95% confidence interval: 23.3-26.2%). The risk-stratified screening procedure proved to be simple and effective for detecting early impairment of the carbohydrate metabolism, therefore, its wider implementation should be considered advisable.
Collapse
Affiliation(s)
- Gábor Winkler
- Fovárosi Szent János Kórház és Eszak-budai Egyesített Intézményei, II. Belgyógyászat-Diabetológia, Budapest.
| | | | | | | |
Collapse
|
17
|
Wang H, Qiu Q, Tan LL, Liu T, Deng XQ, Chen YM, Chen W, Yu XQ, Hu BJ, Chen WQ. Prevalence and determinants of diabetes and impaired fasting glucose among urban community-dwelling adults in Guangzhou, China. DIABETES & METABOLISM 2009; 35:378-84. [DOI: 10.1016/j.diabet.2009.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 03/03/2009] [Accepted: 03/09/2009] [Indexed: 01/15/2023]
|
18
|
Comorbid depression is associated with increased healthcare utilization and lost productivity in persons with diabetes: a large nationally representative Hungarian population survey. Psychosom Med 2009; 71:501-7. [PMID: 19528291 DOI: 10.1097/psy.0b013e3181a5a7ad] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To estimate the prevalence of depression among people with diabetes and to examine the association of comorbid depression with lost productivity and health resource utilization in persons with and without diabetes. METHODS Cross-sectional survey, enrolling 12,643 individuals aged >18 years. Clustered, stratified sampling procedure was utilized. This sample represented 0.16% of the Hungarian adult population according to age, gender, and geographic regions. The severity of depressive symptoms was measured by the abbreviated Beck Depression Inventory. RESULTS The prevalence of diabetes in the sample was 6.2% (95% Confidence Interval (CI) = 5.7-6.6), and 13.4% (95% CI = 12.8-13.9) were classified as depressed. Adults with diabetes were two times more likely to have depression (adjusted odds ratio (OR) = 1.83, 95% CI = 1.53-2.19, p < .001) versus individuals without diabetes. Compared with nondepressed people with diabetes, those with diabetes and comorbid depression were older, less educated, more likely to be female and physically inactive, less likely to be employed, and married and had more comorbidities. In multivariate regression analyses, people with diabetes and depression had significantly greater odds of prolonged bed days due to illness (>or=20 days) (OR = 2.6, 95% CI = 1.69-3.88, p < .001), prolonged length of hospital stay (>or=18 days) (OR = 2.1, 95% CI = 1.27-3.45, p = .004), and multiple hospital admissions (>or=2) (OR = 1.8, 95% CI = 1.13-2.82, p = .01) compared with nondepressed diabetic patients. CONCLUSIONS These findings further document the association between depression and health resource utilization and lost productivity in people with diabetes. Screening and treating depression are important for everyday clinical care and public health initiatives to improve health outcomes for people with diabetes.
Collapse
|