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Hu J, Wang X, Cheng L, Dang K, Ming Z, Tao X, Xu X, Sarker SK, Li Y. Sleep patterns and risks of incident cardiovascular disease and mortality among people with type 2 diabetes: a prospective study of the UK Biobank. Diabetol Metab Syndr 2024; 16:15. [PMID: 38212811 PMCID: PMC10782582 DOI: 10.1186/s13098-024-01261-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND To explore the relationship between sleep patterns and cardiovascular disease (CVD) incidence and mortality risk in a population with type 2 diabetes through a UK Biobank sample. METHODS A total of 6860 patients with type 2 diabetes were included in this study. Five sleep factors (including Chronotype, sleep duration, insomnia, daytime sleepiness, and snoring) were collected as a questionnaire. The calculation generates a sleep score of 0-5, and then three sleep patterns were defined based on the sleep scores: poor sleep pattern (0-2), Intermediate sleep pattern (3-4), and healthy sleep pattern (5). HRs and 95% confidence intervals were calculated by multivariate COX proportional risk model adjustment. Restricted cubic splines were used to validate linear associations between sleep scores CVD events. RESULTS Our results found a reduced risk of CVD events in individuals with healthy sleep patterns compared to participants with poor sleep patterns. CVD Mortality (HR, 0.690; 95% CI 0.519-0.916), ASCVD (Atherosclerosis CVD) (HR, 0.784; 95% CI 0.671-0.915), CAD (Coronary Artery Disease) (HR, 0.737; 95% CI 0.618-0.879), PAD (Peripheral Arterial Disease) (HR, 0.612; 95% CI 0.418-0.896), Heart Failure (HR, 0.653; 95% CI 0.488-0.875). Restricted cubic spline responded to a negative linear correlation between sleep scores and CVD Mortality, ASCVD, CAD, PAD, and Heart Failure. CONCLUSIONS Healthy sleep patterns are significantly associated with a reduced risk of CVD Mortality, ASCVD, CAD, PAD, and Heart Failure in the diabetes population.
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Affiliation(s)
- Jinxia Hu
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Xuanyang Wang
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Licheng Cheng
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Keke Dang
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Zhu Ming
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Xinmiao Tao
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Xiaoqing Xu
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Shuvan Kumar Sarker
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China
| | - Ying Li
- Department of Nutrition and Food Hygiene, Key Laboratory of Precision Nutrition and Health, School of Public Health, Ministry of Education, Harbin Medical University, 157 Baojian Road, Heilongjiang, 150081, People's Republic of China.
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Tsai YH, Chuang LL, Lee YJ, Chiu CJ. Behavioral and Psychological Factors in Buffering Diabetes-related Disability Development. Ann Behav Med 2023; 57:1046-1057. [PMID: 37549141 DOI: 10.1093/abm/kaad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Diabetes is associated with disability development. Healthy behaviors and psychosocial support can help patients manage their disease. PURPOSE To examine the role of various behavioral and psychological factors in buffering the effect of diabetes on disability development over time in Taiwanese adults. METHODS Data on 5,131 adults aged ≥50 years were obtained from the Taiwan Longitudinal Study on Aging. A cohort sequential multilevel design was employed to analyze the association between behavioral and psychosocial factors and the risk of disability over a 11-year period. RESULTS In patients with diabetes, having social support and exercising more than six times a week were associated with 4% and 49% reductions in the risk of disability, respectively (βdiabetes*socialsupport = -0.285, p = .006; βdiabetes*exercise3 = -2.612, p = .007). Exercising more than six times a week had an additional significant protective effect against disability development per year (βdiabetes*exercises3*age = -0.241, p = .038). Depression did not significantly interact with diabetes. However, a trajectory analysis revealed that individuals who had both diabetes and depression had the highest disability score from middle age among all participants. CONCLUSIONS Engaging in frequent exercise is the most influential factor for reducing the risk of disability in patients with diabetes. Social support provides an additional benefit for disability prevention in individuals with diabetes.
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Affiliation(s)
- Yi-Hsuan Tsai
- Division of Pulmonary & Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Li-Lun Chuang
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan
| | - Yau-Jiunn Lee
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Taki H, Tuomilehto J, Zimmet P, Tamosiunas A, Kowlessur S, Magliano DJ, Shaw JE, Söderberg S, Nilsson U. Left ventricular hypertrophy: an ECG-based study of prevalence and risk factors in a multiethnic population. Open Heart 2023; 10:e002495. [PMID: 37935562 PMCID: PMC10632900 DOI: 10.1136/openhrt-2023-002495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Left ventricular hypertrophy (LVH) is frequently seen in association with arterial hypertension and indicates poor prognosis. This study aimed to determine the prevalence of LVH and associated factors in a multiethnic population from Mauritius. METHODS Population-based health surveys were performed in 2009 and 2015 and included in total 8961 individuals aged 35-75 years with recorded 12-lead ECG. LVH was defined according to three criteria: Sokolow-Lyon, Cornell voltage and Cornell product. Data were collected about health and lifestyle behaviour. Anthropometry and blood pressure were measured. Fasting levels of blood lipids and glucose were determined, oral glucose tolerance test was performed in people without glucose-lowering medications. RESULTS The age-standardised prevalence of LVH was 9% (n=875) according to any of the three ECG criteria. Individuals with LVH were older, more likely to have hypertension, diabetes, known cardiovascular disease (CVD) and elevated levels of cholesterol and creatinine. Further, they were more likely to be of African descent (Creole) and have lower educational level. In a multivariable model, Creole (OR (95% CI)) (1.56 (1.33 to 1.83)), low educational level (1.49 (1.28 to 1.75)), hypertension (3.01 (2.55 to 3.56)), known CVD (1.42 (1.11 to 1.83)) and elevated creatinine (1.08 (1.03 to 1.14)) remained associated with LVH. Individuals with non-treated or uncontrolled hypertension had a higher risk for LVH (3.09 (95% CI 2.57 to 3.71) and 4.07 (95% CI 3.29 to 5.05), respectively), than individuals with well controlled hypertension or normotension. CONCLUSION LVH occurs more frequently in individuals with hypertension, as well as in individuals with African ancestry and/or low education level.
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Affiliation(s)
- Hina Taki
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Jaakko Tuomilehto
- Public Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Paul Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Dianna J Magliano
- Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jonathan E Shaw
- Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ulf Nilsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Liu M, Ahmed WL, Zhuo L, Yuan H, Wang S, Zhou F. Association of Sleep Patterns with Type 2 Diabetes Mellitus: A Cross-Sectional Study Based on Latent Class Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:393. [PMID: 36612714 PMCID: PMC9819015 DOI: 10.3390/ijerph20010393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Sleep duration, sleep quality and circadian rhythm disruption indicated by sleep chronotype are associated with type 2 diabetes. Sleep involves multiple dimensions that are closely interrelated. However, the sleep patterns of the population, and whether these sleep patterns are significantly associated with type 2 diabetes, are unknown when considering more sleep dimensions. Our objective was to explore the latent classes of sleep patterns in the population and identify sleep patterns associated with type 2 diabetes. Latent class analysis was used to explore the best latent classes of sleep patterns based on eleven sleep dimensions of the study population. Logistic regression was used to identify sleep patterns associated with type 2 diabetes. A total of 1200 participants were included in the study. There were three classes of sleep patterns in the study population: "circadian disruption with daytime dysfunction" (class 1), "poor sleep status with daytime sleepiness" (class 2), and "favorable sleep status" (class 3). After controlling for all confounding factors, people in class 2 have significantly higher prevalence of type 2 diabetes than those in class 3 (OR: 2.24, 95% CI 1.26-4.00). Sleep problems have aggregated characteristics. People with sleep patterns involving more or worse sleep problems have higher significantly prevalence of T2DM.
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Affiliation(s)
- Mengdie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou 221004, China
| | | | - Lang Zhuo
- School of Public Health, Xuzhou Medical University, Xuzhou 221004, China
| | - Hui Yuan
- School of Nursing, Xuzhou Medical University, Xuzhou 221004, China
| | - Shuo Wang
- School of Nursing, Xuzhou Medical University, Xuzhou 221004, China
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Xuzhou 221004, China
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Kim T, Park SY, Oh IH. Health-related factors leading to disabilities in Korea: Survival analysis. Front Public Health 2022; 10:1048044. [PMID: 36620295 PMCID: PMC9813747 DOI: 10.3389/fpubh.2022.1048044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study is to analyze (a) population and socioeconomic factors affecting disability, excluding the occurrence of disability due to accidents and congenital diseases, and (b) health-related behavioral factors and factors that can prevent and reduce the cause of disability due to disease in Korea. This study was a longitudinal research. Data were obtained from The 2018 Korean Health Panel (KHP) is a survey jointly conducted by the Korea Institute of Health and Social Affairs and the National Health Insurance Service. A total of 7, 372 (Mage = 52.14, SD = 21.39; Male = 47.52%) were analyzed in this study. People with Higher education attainments and more income levels were associated with lower hazard of developing new disabilities (all p < 0.05). In this study, the health factors that could be related to the occurrence of new disabilities were smoking, alcohol consumption, physical activity, and stress (all p < 0.0001). However, physical activity was negatively associated with the risk of developing a disability at all follow-ups (p < 0.05). Higher scores on the number of chronic diseases (valid scores = 0, 1, 2, 3, or more) represented a greater level of newly developing disability present at all follow-ups (all p < 0.0001). This longitudinal study confirmed the relationship between health-related factors and specific chronic diseases. Its findings can be used as a crucial foundation for establishing healthcare policies and services that can lower and prevent disability by preventing and reducing specific negative health behaviors and unhealthy behavioral factors, and alleviating chronic diseases in Korea.
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Affiliation(s)
- TaeEung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - So-Youn Park
- Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea,*Correspondence: In-Hwan Oh ✉
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Chen L, Wang L, Qian Y, Chen H. Changes and Trend Disparities in Life Expectancy and Health-Adjusted Life Expectancy Attributed to Disability and Mortality From 1990 to 2019 in China. Front Public Health 2022; 10:925114. [PMID: 35923968 PMCID: PMC9339800 DOI: 10.3389/fpubh.2022.925114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aims to investigate sex, age, and cause-specific contributions to changes and trend disparities in life expectancy (LE) and health-adjusted life expectancy (HALE) attributed to disability and mortality from 1990 to 2019 in China, which provides insight into policy-making, health systems planning, and resource allocation. Methods Contributions of disability and mortality to changes and trend disparities in LE and HALE were estimated with standard abridged life table, Sullivan's method, and decomposition method, using retrospective demographic analysis based on mortality and years lived with disability (YLD) rates extracted from Global Burden of Disease Study 2019 (GBD 2019). Results From 1990 to 2019, LE and HALE increased by 10.49 and 8.71 years for both sexes, mainly due to noncommunicable diseases (NCDs) (5.83 years, 55.58% for LE and 6.28 years, 72.10% for HALE). However, HIV/AIDS and sexually transmitted infections had negative effects on changes in LE (−0.03 years, −0.29%) and HALE (−0.05 years, −0.57%). Lung cancer and ischemic heart disease caused the biggest reduction in LE (−0.14 years, −1.33%) and HALE (−0.42 years, −4.82%). Also, cardiovascular diseases (−0.08 years, −0.92%), neurological disorders (−0.08 years, −0.92%), diabetes and kidney diseases (−0.06 years, −0.69%), and transport injuries (−0.06 years, −0.69%) had main negative disability effects in HALE. Moreover, life expectancy lived with disability (LED) increased by 1.78 years, mainly attributed to respiratory infections and tuberculosis (1.04 years, 58.43%) and maternal and neonatal disorders (0.78 years, 43.82%). Conclusion The LE and HALE in China have grown rapidly over the past few decades, mainly attributed to NCDs. It is necessary to further reduce the negative mortality effect of HIV/AIDS, lung cancer, colon and rectum cancer, pancreatic cancer, and ischemic heart disease and the negative disability effect of stroke, diabetes mellitus, and road injuries. In addition, the signs of disparities in mortality and disability of different sexes and ages call for targeted and precise interventions for key groups such as males and the elderly. According to the decomposition results, we may better determine the key objects of health policies that take into account substantial cause-specific variations to facilitate the realization of “healthy China 2030” plan.
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Wang Y, Wang Y. Accelerated Ovarian Aging Among Type 2 Diabetes Patients and Its Association With Adverse Lipid Profile. Front Endocrinol (Lausanne) 2022; 13:780979. [PMID: 35432199 PMCID: PMC9005646 DOI: 10.3389/fendo.2022.780979] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The impact of diabetes on reproductive function is still not clearly defined. This study aimed to evaluate accelerated ovarian aging in women with type 2 diabetes mellitus (T2DM) and its association with adverse lipid profile. METHODS Female patients with T2DM (n=964) and non-T2DM controls (n=263) aging from 18-80 years were included. Levels of circulating sex hormones were measured at the follicular phase in menstruating women. We analyzed the age-specific trends in the levels of sex hormones between T2DM and controls. The correlations of sex hormones with the lipid profile, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides (TG) were also evaluated. RESULTS In the temporal trends analysis, LH and FSH both started to increase obviously approximately from the age of 45 years among patients with T2DM, and displayed peaks of LH and FSH among patients with T2DM aged between 61 and 65, both of which were obviously earlier than that in non-T2DM controls and proved the accelerated ovarian aging among patients with T2DM. E2 of patients with T2DM was continuous lower than that of non-T2DM controls from approximately 45 years old, and LH and FSH of patients with T2DM were higher than those of non-T2DM controls between the age of 55 to 65 years. Multiple linear regression analyses revealed that LH was positively correlated with LDL-C (Coefficient=0.156, P=0.001) and TC (Coefficient=0.134, P=0.025), and was negatively correlated with HDL-C (Coefficient =-0.065, P=0.001) in patients with T2DM aged between 51 and 60, which was independent of age, T2DM duration, body mass index (BMI), glycosylated hemoglobin (HbA1c), FSH, E2 and other potential confounders. Higher E2 level was significantly and independently correlated with lower LDL-C (Coefficient= -0.064, P=0.033) in patients with T2DM aged between 51 and 60. CONCLUSIONS This study suggests that patients with T2DM have accelerated ovarian aging, and it is correlated with the occurrence of disturbed lipid profile in patients with T2DM. With an ever increasing number of female patients with T2DM diagnosed at younger ages, the accelerated ovarian aging and its adverse impacts in T2DM need to be carefully managed.
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Affiliation(s)
- Yahao Wang
- Affiliated Hospital of Qingdao University, Qingdao, China
- Huashan Hospital, Fudan University, Shanghai, China
| | - Yangang Wang
- Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yangang Wang,
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Tsai YH, Chuang LL, Lee YJ, Chiu CJ. How Does Diabetes Accelerate Normal Aging? An Examination of ADL, IADL, and Mobility Disability in Middle-aged and Older Adults With and Without Diabetes. Diabetes Res Clin Pract 2021; 182:109114. [PMID: 34756960 DOI: 10.1016/j.diabres.2021.109114] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/24/2021] [Accepted: 10/15/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To build an age norm to quantify and compare the different progression rates of disability in people with and without diabetes. METHODS Data were extracted from 5,131 adults aged 50 and older from the Taiwan Longitudinal Study in Aging (TLSA) conducted in 1996. Using multilevel mixed models, the disabilities were measured in 1999, 2003, and 2007. RESULTS Diabetes accelerated the occurrence and progression of disabilities during aging. Participants with diabetes developed to mobility, IADL, and ADL at the age of 55, near the age of 60, and near the age of 70, respectively. Diabetes accelerated the onset of disabilities of mobility by 3 years, IADL by 7 years, and ADL by 11 years. In the fully adjusted model, diabetes remains a robust predictor for levels of disability (MobilityβDM = 1.668, p < 0.001, IADLβDM = 1.031, p < 0.001) (IADβDM = 0.690, p < 0.001), and rate of change for developing mobility disability (MobilityβDM*age = 0.088, p < 0.001). CONCLUSIONS This study showed that diabetes accelerated the occurrence and progression of disabilities starting in middle age. A three to eleven years of acceleration on disability development on mobility, IADL, and ADL was observed.
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Affiliation(s)
- Yi-Hsuan Tsai
- Division of Plumonary & Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
| | - Li-Lun Chuang
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan.
| | - Yau-Jiunn Lee
- Department of Endocrinology & Metabolism, Lee's Endocrinology Clinic, Pingtung, Taiwan.
| | - Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Paurobally N, Kruger E, Tennant M. Oral Health Behaviour and Predictors of Oral Health Behaviour Among Patients With Diabetes in the Republic of Mauritius. Int Dent J 2021; 72:106-115. [PMID: 33875276 PMCID: PMC9275285 DOI: 10.1016/j.identj.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate the oral care habits and assess the determinants of oral care behaviour among people with diabetes in the Republic of Mauritius. METHODS The present study draws on data collected from 589 dentate persons with diabetes by means of a close-ended questionnaire. Multivariate logistic regression analyses were used to estimate the association of different demographic and clinical factors with recommended dental hygiene practices. RESULTS The majority of the participants brushed at least twice daily (84.2%), never flossed (88.6%), attended dental clinics on need only (87.1%), and did not monitor their blood glucose levels regularly (69.9%). Neither awareness about the increased risk of periodontal disease and xerostomia nor receiving advice from diabetes care providers was found to be associated with good oral hygiene or increased service utilisation. The experience of oral diseases did not encourage recommended oral health practice, with participants without experience with periodontal disease being 3 times more likely to floss (odds ratio [OR], 2.9; P = .045). Regular dental visits were strongly associated with self-reported type 1 diabetes (OR, 7.8; P = .025). Participants from urban areas were more than twice as likely to visit their dental care provider at least once annually (OR, 2.3; P = .006). Regular dental attendance (OR, 3.7; P = .011) and flossing (OR, 4.5; P = .012) were strongly associated with one another. CONCLUSION There is widespread noncompliance with regular flossing and dental service utilisation. Our findings highlight the need for an emphasis on preventive care through the provision of integrated medical and dental interventions to high-risk individuals suffering from both diabetes and chronic periodontitis.
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Affiliation(s)
- Nesha Paurobally
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Australia
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Ali SM, Chen P, Sheikh S, Ahmad A, Ahmad M, Paithankar M, Desai B, Patel P, Khan M, Chaturvedi A, Patel R, Panchal DT, Shah K, Chavda V, Saboo BD, Patel A, Ahmad I. Thymoquinone with Metformin Decreases Fasting, Post Prandial Glucose, and HbA1c in Type 2 Diabetic Patients. Drug Res (Stuttg) 2021; 71:302-306. [PMID: 33684953 DOI: 10.1055/a-1388-5415] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Antihyperglycemic activity of Thymoquinone (TQ) was evaluated in diabetic mouse model and patients. METHODS TQ (50 mg/kg) was orally administered daily for 21 days in combination with metformin in diabetic mice and a reduction on blood glucose level was monitored. In human, a 90-day randomized study was carried out in 60 Type 2 Diabetes mellitus patients to evaluate safety and efficacy of TQ administration with metformin in a 3-arm study. Patients in arm 1 (T1) received 1 tablet of metformin SR 1000 mg and 1 tablet of TQ 50 mg once daily. The second arm (T2) patients received 1 tablet of metformin SR 1000 mg and 2 tablets of TQ 50 mg once daily. Patients in arm 3 (R) received 1 tablet of metformin SR 1000 mg only. RESULTS The diabetic mice treated with combination of TQ and metformin showed significant decrease in blood sugar compared to those treated with only metformin. In patients who completed the study, the glycated hemoglobin (HbA1c) values in T1, T2 and R decreased after 3 months from 7.2, 7.2 and 7.3 to 6.7, 6.8, and 7.1, respectively. A greater reduction in Fasting Blood Glucose and Post Prandial Blood Glucose was also observed in T1 and T2 arms compared to R. CONCLUSION At dose levels of 50 and 100 mg of TQ combined with a daily dose of 1000 mg Metformin demonstrated a reduction in the levels of HbA1c and blood glucose compared to the standard treatment of diabetic patients with metformin alone.
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Affiliation(s)
| | - Paul Chen
- Jina Pharmaceuticals Inc., Libertyville, IL, USA
| | | | - Ateeq Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL, USA
| | - Moghis Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL, USA
| | | | - Brijesh Desai
- Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
| | - Piyush Patel
- Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
| | - Mujtaba Khan
- Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
| | | | - Ronak Patel
- Lambda Therapeutics Research Limited, Ahmedabad, Gujarat, India
| | | | - Kuntal Shah
- Bodyline Hospitals, Ahmedabad, Gujarat, India
| | | | - Banshi D Saboo
- Bakeri Medical Research Center, Ahmedabad, Gujarat, India
| | - Alpesh Patel
- Shree Nidhi Heart & Medial Hospital, Mehsana, Gujarat, India
| | - Imran Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL, USA
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Paurobally N, Kruger E, Tennant M. Awareness About the Oral and Systemic Complications of Diabetes Among a Cohort of Diabetic Patients of the Republic of Mauritius. Int Dent J 2021; 71:438-448. [PMID: 33640154 PMCID: PMC9275114 DOI: 10.1016/j.identj.2020.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Persistent hyperglycaemia in patients with uncontrolled or poorly controlled diabetes may cause serious oral and systemic complications. Persons with diabetes are mostly unaware of their increased risk of oral complications. Objective This study investigated awareness about the association of diabetes with other diseases and knowledge about the systemic and oral complications of diabetes among patients with diabetes in the Republic of Mauritius. Methods Data were collected from 720 patients with diabetes using an anonymous closed-end questionnaire. Descriptive statistics and multivariate logistic regression analyses were used to report the results and to identify factors associated with awareness about the link between diabetes and other diseases and knowledge about oral and systemic complications. Results The majority of the study participants were aware of the association between diabetes and other diseases. However, knowledge about oral complications of diabetes was limited (caries [29%], periodontal disease [37%], and xerostomia [52%]). Education and the number of years since diagnosis of diabetes were the most significant predictors of awareness about complications. The experience of xerostomia and periodontal disease were associated with knowledge about their respective increased risk. Receiving advice from diabetes care providers increased awareness about caries and periodontal disease. Age and type of diabetes were associated with knowledge about systemic complications. Conclusion Awareness about the oral complications of diabetes was limited and was mainly linked with the experience of disease. This indicates a need for increased health promotion with customised educational programs to inform patients with diabetes of their increased risk of developing complications.
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Affiliation(s)
- Nesha Paurobally
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Western Australia.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Western Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, University of Western Australia, Crawley, Western Australia
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12
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Ochieng JM, Crist JD. "I put diabetes on the shelf": African-American Women's Perceptions of Risk for Diabetes Complications. Clin Nurs Res 2021; 30:1012-1022. [PMID: 33615849 DOI: 10.1177/1054773821996551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to describe the perceptions of African American (AA) women with Type 2 diabetes mellitus (T2DM) about developing diabetes mellitus (DM) complications and explore how their perceived risk influenced DM self-management. Ten (N = 10) AA women participated in the qualitative description study through semi-structured interviews. Thematic analysis informed by the Health Belief Model and Risk Perception Conceptual Model revealed the perceived probability of DM complications by AA women with T2DM and how they made judgments regarding the seriousness, extent, or severity of complications. Those with high levels of DM knowledge perceived themselves at high risk of developing DM complications and those with low DM knowledge perceived themselves at low risk of DM complications. Risk perceptions and health literacy also influenced DM self-management behaviors.
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13
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Yun H, Xie F, Chen L, Yang S, Ferri L, Alemao E, Curtis JR. Evaluation of the Effect of Diabetes on Rheumatoid Arthritis-related Outcomes in an Electronic Health Record-based Rheumatology Registry. J Rheumatol 2020; 48:992-1001. [PMID: 33262304 DOI: 10.3899/jrheum.200486] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients with rheumatoid arthritis (RA) who also have diabetes mellitus (DM) might have worse clinical outcomes and adverse events compared to patients with RA who do not have DM. We evaluated the effects of DM on Health Assessment Questionnaire (HAQ) changes and outpatient infection rates in patients with RA. METHODS Using the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) electronic health record-based registry, we identified patients with RA who had ≥ 1 rheumatologist visit with a HAQ measured in 2016 (index visit), ≥ 1 previous visit, and a subsequent outcome visit with the same HAQ measured at 12 months (± 3 months). We identified DM by diagnosis codes, medications, or laboratory values. Outpatient infection was defined by diagnosis codes or antiinfective medications. We calculated mean HAQ change and incidence rate (IR) of outpatient infections among patients with and without DM. Generalized linear models and Cox regression were used to calculate the adjusted mean HAQ change and HRs. RESULTS We identified 3853 RA patients with DM and 18,487 without DM. The mean HAQ change between index and outcome visit among patients with DM was 0.03 and without DM was 0.002 (P < 0.01). We identified 761 outpatient infections for patients with DM with an IR of 22.6 (95% CI 21.0-24.2) per 100 person-years and 3239 among patients without DM with an IR of 19.8 (95% CI 19.1-20.5). The adjusted HR of outpatient infections among patients with DM was 0.99 (95% CI 0.91-1.07), compared to patients without DM. CONCLUSION Patients with RA with concomitant DM had greater worsening, or less improvement, in their functional status, suggesting additional interventions may be needed for RA patients with DM to optimize treatment and management of other comorbidities.
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Affiliation(s)
- Huifeng Yun
- H. Yun, PhD, F. Xie, PhD, L. Chen, PhD, S. Yang, MS, J.R. Curtis, MD, MPH, University of Alabama at Birmingham, Birmingham, Alabama
| | - Fenglong Xie
- H. Yun, PhD, F. Xie, PhD, L. Chen, PhD, S. Yang, MS, J.R. Curtis, MD, MPH, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lang Chen
- H. Yun, PhD, F. Xie, PhD, L. Chen, PhD, S. Yang, MS, J.R. Curtis, MD, MPH, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shuo Yang
- H. Yun, PhD, F. Xie, PhD, L. Chen, PhD, S. Yang, MS, J.R. Curtis, MD, MPH, University of Alabama at Birmingham, Birmingham, Alabama
| | - Leticia Ferri
- L. Ferri, MD, PhD, E. Alemao, PhD, Bristol Myers Squibb, New York, New York, USA
| | - Evo Alemao
- L. Ferri, MD, PhD, E. Alemao, PhD, Bristol Myers Squibb, New York, New York, USA
| | - Jeffrey R Curtis
- H. Yun, PhD, F. Xie, PhD, L. Chen, PhD, S. Yang, MS, J.R. Curtis, MD, MPH, University of Alabama at Birmingham, Birmingham, Alabama;
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Bello-Chavolla OY, Aguilar-Salinas CA, Avila-Funes JA. The type 2 diabetes-specific dementia risk score (DSDRS) is associated with frailty, cognitive and functional status amongst Mexican community-dwelling older adults. BMC Geriatr 2020; 20:363. [PMID: 32962659 PMCID: PMC7510254 DOI: 10.1186/s12877-020-01776-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/16/2020] [Indexed: 11/21/2022] Open
Abstract
Background The type 2 diabetes (T2D) specific dementia-risk score (DSDRS) was developed to evaluate dementia risk in older adults with T2D. T2D-related factors have been shown increase the risk of age-related conditions, which might also increase dementia risk. Here, we investigate the associations of DSDRS with frailty, disability, quality of life (QoL) and cognition in community-dwelling older adults with T2D. Methods We included 257 community-dwelling older adults with T2D to evaluate the association between DSDRS and Mini-mental state examination (MMSE), Isaac’s set-test (IST), clock drawing test (CDT), quality of life (SF-36), risk of malnutrition (Mini-Nutritional Assessment or MNA), as well as frailty, Katz’ and Lawton-Brody scores. We also assessed the phenotype and correlates of high-estimated dementia risk by assessing individuals with DSDRS >75th age-specific percentiles. Results Mean age of participants was 78.0 ± 6.2 years. DSDRS showed a significant correlation with MMSE test, IST, CDT, SF-36, MNA, Lawton-Brody and Katz scores, and an increasing number of frailty components. DSDRS was higher among frail, pre-frail, and subjects with limited ADL and IADL (p < 0.001). Participants with DSDRS >75th age-specific percentiles had lower education, MMSE, IST, SF-36, MNA, Katz, Lawton-Brody, and higher frailty scores. High-estimated 10-year dementia risk was associated with ADL and IADL disability, frailty and risk of malnutrition. When assessing individual components of DSDRS, T2D-related microvascular complications were associated to all outcome measures. Conclusion The DSDRS is associated with frailty, disability, malnutrition and lower cognitive performance. These findings support that T2D-related factors have significant burden on functional status, QoL, disability and dementia risk.
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Affiliation(s)
- Omar Yaxmehen Bello-Chavolla
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico. .,Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15. CP 14080, Tlalpan, Mexico City, Mexico. .,Department of Physiology, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico.
| | - Carlos Alberto Aguilar-Salinas
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15. CP 14080, Tlalpan, Mexico City, Mexico.,Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Instituto Tecnologico y de Estudios Superiores de Monterrey Tec Salud, Nuevo León, Mexico
| | - José Alberto Avila-Funes
- Geriatrics Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.,Centre de recherche INSERM, U1219, F-33076, Bordeaux, France
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Fabrizi D, Rebora P, Luciani M, Di Mauro S, Valsecchi MG, Ausili D. How do self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in adults with type 2 diabetes? A multicentre observational study. Endocrine 2020; 69:542-552. [PMID: 32504379 DOI: 10.1007/s12020-020-02354-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/15/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate how self-care maintenance, self-care monitoring, and self-care management affect glycated haemoglobin in type 2 diabetes mellitus patients and to set cut-off points of the Self-Care of Diabetes Inventory scales using glycated haemoglobin as outcome of interest. METHODS A secondary analysis of a previous multicentre observational cross-sectional study was conducted. Overall, 540 adults with type 2 diabetes mellitus confirmed diagnosis were involved. Socio-demographic and clinical data were collected. Self-care maintenance, self-care monitoring, and self-care management were measured by the Self-Care of Diabetes Inventory. Linear regression models were performed to assess the relationship between self-care maintenance, self-care monitoring, and self-care management and glycated haemoglobin. Receiver operating characteristics curves were carried out to identify the best cut-off score for each self-care scale considering glycated haemoglobin >7% as outcome of interest. RESULTS Self-care monitoring and self-care management were associated to glycated haemoglobin in both patients without (self-care monitoring p = 0.0008; self-care management p = 0.0178) and with insulin therapy (self-care monitoring p = 0.0007; self-care management p = 0.0224). Self-care maintenance was associated to glycated haemoglobin in patients without insulin therapy (p = 0.0118). Cut-off scores providing the best performance were 70 points for self-care maintenance and self-care monitoring, and 60 points for self-care management. CONCLUSIONS Self-care maintenance, self-care monitoring, and self-care management differently affect glycated haemoglobin in patients with type 2 diabetes mellitus. Clinicians could implement tailored interventions to improve glycaemic control considering the lacking area of self-care.
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Affiliation(s)
- Diletta Fabrizi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Paola Rebora
- Bicocca Bioinformatics Biostatistics And Bioimaging Centre-B4, Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maria Grazia Valsecchi
- Bicocca Bioinformatics Biostatistics And Bioimaging Centre-B4, Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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Wojszel ZB, Magnuszewski L. Type 2 Diabetes Correlates with Comorbidity and Nutritional Status but Not with Functional Health in Geriatric Ward Patients: A Cross-Sectional Study in Poland. Diabetes Metab Syndr Obes 2020; 13:4599-4607. [PMID: 33273835 PMCID: PMC7705262 DOI: 10.2147/dmso.s279388] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/05/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The study aimed to assess the comorbidity profile, functional, and nutritional health in geriatric ward patients depending on their type 2 diabetes (DM) status. PATIENTS AND METHODS We performed a cross-sectional study of 416 patients - median age 82 years (IQR 77-86), 77.4% female, 96.9% community-dwelling - consecutively admitted to the geriatric ward at the turn of 2014 and 2015. Comprehensive geriatric assessment results were analyzed (including self-care and instrumental activities of daily living, cognitive abilities, emotional health, risk of falls, frailty status, dynapenia, nutritional health, morbidity, biochemical parameters, and pharmacotherapy). RESULTS DM was observed in 126 (30.3%) patients hospitalized in the study period; 4% of DM cases were newly diagnosed. In comparison to patients without DM, older adults with type 2 DM were significantly more frequently burdened with multimorbidity (61.1% versus 39.7%, P<0.001), polypharmacy (88.9% versus 74.7%, P=0.001), obesity (59.8% versus 34.5%, P<0.001), abdominal obesity (94.4% versus 75.5%, P<001), chronic kidney disease (61.1% versus 48.6%, P=0.02) and cardiovascular diseases: ischemic heart disease (66.7% versus 47.9%, P<0.001), congestive heart failure (50.0% versus 34.1%, P=0.002), atrial fibrillation (30.2% versus 20.7%, P=0.04) and peripheral arterial disease (24.6% versus 11.4%, p<0.001). There were no significant differences in all functional parameters evaluated. CONCLUSION Type 2 DM patients were significantly more often burdened with multimorbidity, polypharmacy, obesity, and had an unfavorable profile of cardiovascular diseases than patients without DM, but - contrary to our expectations - they did not differ in any functional characteristic assessed. However, this may be due to the geriatric ward patients' specificity of health problems in the advanced, more complex disablement process phases.
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Affiliation(s)
- Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland
- Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, Bialystok, Poland
- Correspondence: Zyta Beata WojszelDepartment of Geriatrics, Medical University of Bialystok, Fabryczna str. 27, Bialystok15-471, PolandTel +48 85 8694 982Fax +48 85 8694974 Email
| | - Lukasz Magnuszewski
- Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, Bialystok, Poland
- Doctoral Studies, Department of Geriatrics, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
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Zhou M, Shen L, Jiao Q, Ye L, Zhou Y, Zhu W, Wang W, Wang S. ROLE OF MAGNETIC RESONANCE IMAGING IN THE ASSESSMENT OF ACTIVE THYROID-ASSOCIATED OPHTHALMOPATHY PATIENTS WITH LONG DISEASE DURATION. Endocr Pract 2019; 25:1268-1278. [PMID: 31412229 DOI: 10.4158/ep-2019-0133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: In thyroid-associated ophthalmopathy (TAO), long disease duration is negatively correlated with the response to immunosuppression treatment. The current treatment decision-making process does not involve magnetic resonance imaging (MRI); thus, we investigated the predictive value of MRI parameters for the immunosuppressive response in active moderate to severe TAO patients with different disease durations. Methods: We retrospectively analyzed the baseline MRI parameters of active TAO patients treated with guideline-recommended weekly glucocorticoid therapy in our center. Data were stratified by the quartile of disease duration. The signal intensity ratio (SIR) of T2-weighted images was used to describe the activity of extraocular muscles (EOMs). Results: Compared to the lowest quartile of disease duration, SIR values of EOMs were significantly lower in quartile 3 (Q3) and quartile 4 (Q4). Meanwhile, the clinical activity score (CAS) curve did not change in parallel and was not correlated with the SIR curve. In the highest quartile of disease duration, nonresponders had significantly lower SIR values of the most inflamed muscle (P = .03) and the medial rectus (P = .004) than did the responders, while no such significance was observed in patients within the lower 3 quartiles. A multivariable predictive model (including CAS, TAO duration, and SIR value) was established in each quartile. The fit of the model was better than CAS with regard to prognostic prediction and showed a high positive predictive value (Model 1: 86.67%; Model 2: 92.86%) and negative predictive value (Model 1: 88.89%; Model 2: 90%) in the top quartile. Conclusion: The anterior manifestation assessed by CAS is not always consistent with retro-orbital activity in long-term TAO patients. CAS is sufficient to reflect disease activity in short-term TAO patients. The supplementation of CAS with orbital MRI would be valuable in selecting appropriate active patients with a long disease duration. Abbreviations: AUC = area under the curve; CAS = clinical activity score; EOM = extraocular muscle; FT3 = free triiodothyronine; FT4 = free thyroxine; GC = glucocorticoid; ivGC = intravenous glucocorticoids; MRI = magnetic resonance imaging; NPV = negative predictive value; PPV = positive predictive value; SIR = signal intensity ratio; TAO = thyroid-associated ophthalmopathy; TRAb = thyroid-stimulating hormone receptor antibody; TSH = thyroid-stimulating hormone.
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18
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Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol 2019; 56:631-650. [PMID: 30903433 DOI: 10.1007/s00592-019-01295-9] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/02/2019] [Indexed: 02/06/2023]
Abstract
AIMS Depression is a common co-morbidity in patients with type 2 diabetes mellitus (T2DM). Untreated depression in these patients adversely affects self-care activities and other diabetes complications. The aim of this study is to estimate the prevalence of depression among patients with T2DM by conducting a meta-analysis of observational studies. METHODS MEDLINE, Web of Science, Science Direct, and Google Scholar databases were searched for all observational studies that assessed depression in T2DM. Relevant articles were searched using the combination of Medical Subject Heading (MeSH) terms of "depression", "depressive disorder", and "diabetes mellitus" published between January 2007 and July 2018. Random effects model was used to estimate the weighted prevalence rates and 95% CI using "metaprop program in STATA 11". RESULTS In total, the 248 included studies (with 273 reported prevalence) identified 83,020,812 participants; of them, 23,245,827 (28%; 95% CI 27, 29) suffered from different severity levels of depressive disorders. The prevalence of depression was separately reported in 137,372 males and 134,332 females. Of them, 31,396 males (23%, 95% CI: 20, 26) and 45,673 females (34%, 95% CI: 31, 38) were depressed. Compared with global estimate, depression prevalence was lower in Europe (24%) and Africa (27%), but higher in Australia (29%) and Asia (32%). The prevalence in America was equal to the estimated prevalence in the world (28%). Depression was more common in subjects younger than 65 compared with elderlies (31% vs. 21%). CONCLUSION Our findings demonstrated that almost one in four adults with T2DM experienced depression. Given the high prevalence of depressive disorders in diabetic patients, screening these patients for co-morbid depression and its relevant risk factors is highly recommended.
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Affiliation(s)
- Mohammad Khaledi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Xin Y, Davies A, McCombie L, Briggs A, Messow CM, Grieve E, Leslie WS, Taylor R, Lean MEJ. Within-trial cost and 1-year cost-effectiveness of the DiRECT/Counterweight-Plus weight-management programme to achieve remission of type 2 diabetes. Lancet Diabetes Endocrinol 2019; 7:169-172. [PMID: 30581081 PMCID: PMC6383752 DOI: 10.1016/s2213-8587(18)30346-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/14/2018] [Accepted: 11/27/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Yiqiao Xin
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Andrew Davies
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Louise McCombie
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G31 2ER, UK
| | - Andrew Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C-Martina Messow
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Eleanor Grieve
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Wilma S Leslie
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G31 2ER, UK
| | - Roy Taylor
- Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Campus for Ageing & Vitality, Newcastle University, Newcastle-upon-Tyne, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G31 2ER, UK.
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Pepper I, Vinik A, Lattanzio F, McPheat W, Dobrian A. Countering the Modern Metabolic Disease Rampage With Ancestral Endocannabinoid System Alignment. Front Endocrinol (Lausanne) 2019; 10:311. [PMID: 31156558 PMCID: PMC6533883 DOI: 10.3389/fendo.2019.00311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/30/2019] [Indexed: 12/18/2022] Open
Abstract
When primitive vertebrates evolved from ancestral members of the animal kingdom and acquired complex locomotive and neurological toolsets, a constant supply of energy became necessary for their continued survival. To help fulfill this need, the endocannabinoid (eCB) system transformed drastically with the addition of the cannabinoid-1 receptor (CB1R) to its gene repertoire. This established an eCB/CB1R signaling mechanism responsible for governing the whole organism's energy balance, with its activation triggering a shift toward energy intake and storage in the brain and the peripheral organs (i.e., liver and adipose). Although this function was of primal importance for humans during their pre-historic existence as hunter-gatherers, it became expendable following the successive lifestyle shifts of the Agricultural and Industrial Revolutions. Modernization of the world has further increased food availability and decreased energy expenditure, thus shifting the eCB/CB1R system into a state of hyperactive deregulated signaling that contributes to the 21st century metabolic disease pandemic. Studies from the literature supporting this perspective come from a variety of disciplines, including biochemistry, human medicine, evolutionary/comparative biology, anthropology, and developmental biology. Consideration of both biological and cultural evolution justifies the design of improved pharmacological treatments for obesity and Type 2 diabetes (T2D) that focus on peripheral CB1R antagonism. Blockade of peripheral CB1Rs, which universally promote energy conservation across the vertebrate lineage, represents an evolutionary medicine strategy for clinical management of present-day metabolic disorders.
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Affiliation(s)
- Ian Pepper
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, United States
- *Correspondence: Ian Pepper
| | - Aaron Vinik
- Strelitz Diabetes Center, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Frank Lattanzio
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, United States
| | - William McPheat
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Anca Dobrian
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, United States
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Atif M, Saleem Q, Babar ZUD, Scahill S. Association between the Vicious Cycle of Diabetes-Associated Complications and Glycemic Control among the Elderly: A Systematic Review. ACTA ACUST UNITED AC 2018; 54:medicina54050073. [PMID: 30344304 PMCID: PMC6262334 DOI: 10.3390/medicina54050073] [Citation(s) in RCA: 12] [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: 08/31/2018] [Revised: 09/27/2018] [Accepted: 10/11/2018] [Indexed: 01/01/2023]
Abstract
Background and objectives: Improved quality of life (QoL) and life expectancy of elderly diabetic patients revolves around optimal glycemic control. Inadequate glycemic control may lead to the development of diabetes-associated complications (DAC), which not only complicate the disease, but also affect morbidity and mortality. Based on the available literature, the aim was to elucidate the vicious cycle underpinning the relationship between diabetes complications and glycemic control. Materials and Methods: A comprehensive literature search was performed to find eligible studies published between 1 January 2000 and 22 September 2018 pertaining to diabetes complications and glycemic control. Results: Initially, 261 studies were retrieved. Out of these, 67 were duplicates and therefore were excluded. From the 194 remaining articles, 85 were removed based on irrelevant titles and/or abstracts. Subsequently, the texts of 109 articles were read in full and 71 studies were removed at this stage for failing to provide relevant information. Finally, 38 articles were selected for this review. Depression, impaired cognition, poor physical functioning, frailty, malnutrition, chronic pain, and poor self-care behavior were identified as the major diabetes-associated complications that were associated with poor glycemic control in elderly diabetic patients. Conclusions: This paper proposes that diabetes-associated complications are interrelated, and that impaired glycemic control aggravates diabetes complications; as a result, patient’s self-care abilities are compromised. A schema is generated to reflect a synthesis of the literature found through the systematic review process. This not only affects patients’ therapeutic goals, but may also hamper their health-related quality of life (HRQoL) and financial status.
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Affiliation(s)
- Muhammad Atif
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan.
| | - Quratulain Saleem
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan.
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield HD6 2LZ, UK.
| | - Shane Scahill
- School of Management, Massey University, Auckland 0632, New Zealand.
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