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Fazekas-Pongor V, Domján BA, Major D, Péterfi A, Horváth VJ, Mészáros S, Vokó Z, Vásárhelyi B, Szabó AJ, Burián K, Merkely B, Tabák AG. Prevalence and determinants of diagnosed and undiagnosed diabetes in Hungary based on the nationally representative cross-sectional H-UNCOVER study. Diabetes Res Clin Pract 2024; 216:111834. [PMID: 39168185 DOI: 10.1016/j.diabres.2024.111834] [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: 05/15/2024] [Revised: 08/02/2024] [Accepted: 08/19/2024] [Indexed: 08/23/2024]
Abstract
AIMS To estimate prevalence of diagnosed (dDM) and undiagnosed diabetes (uDM) in Hungary and investigate determinants of uDM. METHODS Data was obtained from the nationally representative H-UNCOVER study. As laboratory measurements were available for 11/19 Hungarian counties, n = 5,974/17,787 people were eligible. After exclusions, 5,673 (representing 4,976,097 people) were included. dDM was defined by self-reporting, while uDM as negative self-reporting and elevated fasting glucose (≥7 mmol/l) and/or HbA1c (≥48 mmol/mol). Logistic regression for complex samples was used to calculate comparisons between dDM and uDM adjusted for age and BMI. RESULTS Diabetes prevalence was 12.0 %/11.9 % (women/men, 95 %CI:10.7-13.4 %/10.7-13.2 %), while 2.2 %/2.8 % (1.7-2.8 %/2.2-3.6 %) of women/men were uDM. While the proportion of uDM vs. dDM was similar for women ≥ 40, men in their forties had the highest odds for uDM. Neither unemployment (women/men OR:0.58 [0.14-2.45]/0.50 [0.13-1.92]), nor education level (tertiary vs. primary; women/men OR: 1.16 [0.53-2.56]/ 0.53 [0.24-1.18]) were associated with uDM. The risk of uDM was lower in both sexes with chronic morbidities. CONCLUSIONS We report higher prevalence of diabetes and undiagnosed diabetes than previous Hungarian estimates. The finding that socioeconomic factors are not associated to uDM suggests that universal health care could provide equitable access to diabetes diagnosis.
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Affiliation(s)
- Vince Fazekas-Pongor
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary.
| | - Beatrix A Domján
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Dávid Major
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Anna Péterfi
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Viktor J Horváth
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Szilvia Mészáros
- Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Zoltán Vokó
- Center for Health Technology Assessment, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary; Syreon Research Institute, Mexikói út 65/A, Budapest H-1126, Hungary
| | - Barna Vásárhelyi
- Department of Laboratory Medicine, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Attila J Szabó
- Pediatric Center, Semmelweis University, Bókay János u. 53-54, Budapest H-1083, Hungary
| | - Katalin Burián
- Department of Clinical Microbiology, University of Szeged, Semmelweis u. 6, Szeged H-6725, Hungary
| | - Béla Merkely
- Heart and Vascular Centre, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary
| | - Adam G Tabák
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary; Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Üllői út 26, Budapest H-1085, Hungary; UCL Brain Sciences, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
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Wesche J, Bakken T, Vetrhus M, Hufthammer KO, Nyroenning LA, Fagertun H, Saethre I, Wold BH, Lyng C, Pettersen EM, Kjellsen IS, Gubberud ET, Kiil S, Loose H, Helgeland MT, Altreuther ME, Mattsson E, Jonung T, Hjellestad ID. High proportion of undiagnosed diabetes in patients surgically treated for infrarenal abdominal aortic aneurysm: findings from the multicentre Norwegian Aortic Aneurysm and Diabetes (ABANDIA) Study. Cardiovasc Diabetol 2024; 23:333. [PMID: 39252002 PMCID: PMC11386390 DOI: 10.1186/s12933-024-02421-w] [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: 06/22/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND The aim was to investigate the total prevalence of known and undiagnosed diabetes mellitus (DM), and the association of DM with perioperative complications following elective, infrarenal, open surgical (OSR) or endovascular (EVAR), Abdominal Aortic Aneurysm (AAA) repair. METHODS In this Norwegian prospective multicentre study, 877 patients underwent preoperative screening for DM by HbA1c measurements from November 2017 to December 2020. Diabetes was defined as screening detected HbA1c ≥ 48 mmol/mol (6.5%) or previously diagnosed diabetes. The association of DM with in-hospital complications, length of stay, and 30-day mortality rate were evaluated using adjusted and unadjusted logistic regression models. RESULTS The total prevalence of DM was 15% (95% CI 13%,17%), of which 25% of the DM cases (95% CI 18%,33%) were undiagnosed upon admission for AAA surgery. The OSR to EVAR ratio was 52% versus 48%, with similar distribution among DM patients, and no differences in the prevalence of known and undiagnosed DM in the EVAR versus the OSR group. Total 30-day mortality rate was 0.6% (5/877). Sixty-six organ-related complications occurred in 58 (7%) of the patients. DM was not statistically significantly associated with a higher risk of in-hospital organ-related complications (OR 1.23, 95% CI 0.57,2.39, p = 0.57), procedure-related complications (OR 1.48, 95% CI 0.79,2.63, p = 0.20), 30-day mortality (p = 0.09) or length of stay (HR 1.06, 95% CI 0.88,1.28, p = 0.54). According to post-hoc-analyses, organ-related complications were more frequent in patients with newly diagnosed DM (n = 32) than in non-DM patients (OR 4.92; 95% CI 1.53,14.3, p = 0.005). CONCLUSION Twenty-five percent of all DM cases were undiagnosed at the time of AAA surgery. Based on post-hoc analyses, undiagnosed DM seems to be associated with an increased risk of organ related complications following AAA surgery. This study suggests universal DM screening in AAA patients to reduce the number of DM patients being undiagnosed and to improve proactive diabetes care in this population. The results from post-hoc analyses should be confirmed in future studies.
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Affiliation(s)
- J Wesche
- University of Oslo, Oslo, Norway
- Department of Vascular Surgery, Akershus University Hospital, Lørenskog, Norway
| | - T Bakken
- Department of Vascular Surgery, Vestfold Hospital Trust Tønsberg, Tønsberg, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Laboratory Medicine and Pathology, Hormone Laboratory, Haukeland University Hospital, Postbox 1400, 5021, Bergen, Norway
| | - M Vetrhus
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Vascular Surgery, Stavanger University Hospital, Stavanger, Norway
| | - K O Hufthammer
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - L Aa Nyroenning
- Department of Circulation and Medical Imaging, NTNU- Norwegian University of Science and Technology, Trondheim, Norway
- Department of Vascular Surgery, St Olavs University Hospital, Trondheim, Norway
| | - H Fagertun
- Department of Circulation and Medical Imaging, NTNU- Norwegian University of Science and Technology, Trondheim, Norway
- Department of Vascular Surgery, St Olavs University Hospital, Trondheim, Norway
| | - I Saethre
- Department of Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
| | - B H Wold
- Department of Vascular Surgery, Nordland Hospital Trust Bodø, Bodø, Norway
| | - C Lyng
- Department of Vascular Surgery, Innlandet Hospital Trust Hamar, Hamar, Norway
| | - E M Pettersen
- Department of Circulation and Medical Imaging, NTNU- Norwegian University of Science and Technology, Trondheim, Norway
- Department of Surgery, Sørlandet Sykehus Kristiansand, Kristiansand, Norway
- The Norwegian Registry for Vascular Surgery (NORKAR), Department of Medical Quality Registries, St Olavs University Hospital, Trondheim, Norway
| | - I S Kjellsen
- Department of Vascular Surgery, Stavanger University Hospital, Stavanger, Norway
| | - E T Gubberud
- Department of Vascular Surgery, Clinic of Surgery, Haukeland University Hospital, Bergen, Norway
| | - S Kiil
- Department of Vascular Surgery, Vestre Viken Hospital Trust Drammen, Drammen, Norway
| | - H Loose
- Department of Vascular Surgery, Oslo University Hospital Ullevaal and Aker, Oslo, Norway
| | - M T Helgeland
- Department of Vascular Surgery, Akershus University Hospital, Lørenskog, Norway
| | - M E Altreuther
- Department of Circulation and Medical Imaging, NTNU- Norwegian University of Science and Technology, Trondheim, Norway
- Department of Vascular Surgery, St Olavs University Hospital, Trondheim, Norway
- The Norwegian Registry for Vascular Surgery (NORKAR), Department of Medical Quality Registries, St Olavs University Hospital, Trondheim, Norway
| | - E Mattsson
- Department of Circulation and Medical Imaging, NTNU- Norwegian University of Science and Technology, Trondheim, Norway
| | - T Jonung
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - I D Hjellestad
- Department of Laboratory Medicine and Pathology, Hormone Laboratory, Haukeland University Hospital, Postbox 1400, 5021, Bergen, Norway.
- Clinic of Medicine, Section for Endocrinology, Haukeland University Hospital, Bergen, Norway.
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Gharacheh L, Amini-Rarani M, Torabipour A, Karimi S. A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus. Int J Prev Med 2024; 15:5. [PMID: 38487697 PMCID: PMC10935579 DOI: 10.4103/ijpvm.ijpvm_374_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/17/2023] [Indexed: 03/17/2024] Open
Abstract
Background As socioeconomic inequalities are key factors in access and utilization of type 2 diabetes (T2D) services, the purpose of this scoping review was to identify solutions for decreasing socioeconomic inequalities in T2D. Methods A scoping review of scientific articles from 2000 and later was conducted using PubMed, Web of Science (WOS), Scopus, Embase, and ProQuest databases. Using the Arksey and O'Malley framework for scoping review, articles were extracted, meticulously read, and thematically analyzed. Results A total of 7204 articles were identified from the reviewed databases. After removing duplicate and nonrelevant articles, 117 articles were finally included and analyzed. A number of solutions and passways were extracted from the final articles. Solutions for decreasing socioeconomic inequalities in T2D were categorized into 12 main solutions and 63 passways. Conclusions Applying identified solutions in diabetes policies and interventions would be recommended for decreasing socioeconomic inequalities in T2D. Also, the passways could be addressed as entry points to help better implementation of diabetic policies.
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Affiliation(s)
- Laleh Gharacheh
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Amini-Rarani
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Torabipour
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Karimi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Larsen EN, Sloth MMB, Nielsen J, Andersen SP, Osler M, Jørgensen TSH. The interplay between the impact of household's and children's education on the risk of type 2 diabetes and death among older adults: a Danish register-based cohort study. Public Health 2023; 224:178-184. [PMID: 37804713 DOI: 10.1016/j.puhe.2023.08.033] [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] [Received: 02/15/2023] [Revised: 08/16/2023] [Accepted: 08/27/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVES This study aims to assess the association of household's and children's education on the risk of type 2 diabetes (T2D) and subsequent death. STUDY DESIGN Danish register-based cohort study. METHODS In total, 1,021,557 adults were included at their 65th birthday between 2000 and 2018. A multistate survival model was performed to estimate the association of household's and children's education on the transition between the three states: 1) 65th birthday; 2) diagnosis of T2D; and 3) all-cause death. RESULTS The incidence rates per 1000 person-years were 9.1 for T2D, 18.4 for death without T2D, and 45.0 for death with T2D. Compared to long household's education and children's education, long household's education combined with either short-medium children's education or no children were associated with a 1.49- (95% confidence interval [CI]: 1.44; 1.54] and 1.69-times (95% CI: 1.61;1.78) higher hazard of T2D, respectively. Short-medium household's education combined with either long children's education or no children were associated with 0.64- (95% CI: 0.62; 0.66) and 0.77-times (95% CI: 0.74; 0.79) lower hazard of T2D, respectively. Compared to long household's education and children's education, any other combination of household's and children's education was associated with higher hazards of death both without and with T2D. CONCLUSION Older adults living in households with long education with no children or children with short-medium education had higher hazards of T2D. Households with short-medium education and no children or children with long education were associated with lower hazards of T2D. Both household's and children's education were associated with higher hazard of death without and with T2D.
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Affiliation(s)
- E N Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M M B Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - J Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - S P Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - M Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Copenhagen 1353, Denmark
| | - T S H Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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Johnsen B, Martinaityte I, Wilsgaard T, Schirmer H. Incidence of dementia over a period of 20 years in a Norwegian population. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12479. [PMID: 37780861 PMCID: PMC10540268 DOI: 10.1002/dad2.12479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION In Norway, the prevalence of dementia is higher than in demographically comparable, high income countries, but reliable incidence studies are lacking. This study calculated the incidence of age-specific dementia from 2000 to 2019. METHODS Participants from The Tromsø Study (n = 44,214) were included. Participants with a dementia diagnosis (n = 2049 cases) were identified. Poisson regression was used to calculate age-specific yearly and 5-year incidence rates from 2000 to 2019. RESULTS The incidence of dementia has decreased from 2000 to 2019. The trend was highly significant for ages of 60-99 years, and was similar for both sexes. DISCUSSION The incidence of dementia in North Norway has decreased over the past two decades similar to that in Western countries, indicating that the total prevalence is increasing due to an aging population. This decrease of incidence could introduce a reduction in future estimation of dementia prevalence.
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Affiliation(s)
- Bente Johnsen
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Geriatric MedicineUniversity Hospital of North NorwayTromsøNorway
| | - Ieva Martinaityte
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Geriatric MedicineUniversity Hospital of North NorwayTromsøNorway
| | - Tom Wilsgaard
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Henrik Schirmer
- Department of CardiologyAkershus University HospitalLørenskogNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
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Sørensen M, Poulsen AH, Hvidtfeldt UA, Christensen JH, Brandt J, Frohn LM, Ketzel M, Andersen C, Valencia VH, Lassen CF, Raaschou-Nielsen O. Effects of Sociodemographic Characteristics, Comorbidity, and Coexposures on the Association between Air Pollution and Type 2 Diabetes: A Nationwide Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:27008. [PMID: 36802347 PMCID: PMC9942819 DOI: 10.1289/ehp11347] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to air pollution has been associated with a higher risk of type 2 diabetes (T2D), but studies investigating whether deprived groups are more susceptible to the harmful effects of air pollution are inconsistent. OBJECTIVES We aimed to investigate whether the association between air pollution and T2D differed according to sociodemographic characteristics, comorbidity, and coexposures. METHODS We estimated residential exposure to PM2.5, ultrafine particles (UFP), elemental carbon, and NO2 for all persons living in Denmark in the period 2005-2017. In total, 1.8 million persons 50-80 y of age were included for main analyses of whom 113,985 developed T2D during follow-up. We conducted additional analyses on 1.3 million persons age 35-50 y. Using Cox proportional hazards model (relative risk) and Aalens additive hazard model (absolute risk), we calculated associations between 5-y time-weighted running means of air pollution and T2D in strata of sociodemographic variables, comorbidity, population density, road traffic noise, and green space proximity. RESULTS Air pollution was associated with T2D, especially among people age 50-80 y, with hazard ratios of 1.17 [95% confidence interval (CI): 1.13, 1.21] per 5 μg/m3 PM2.5 and 1.16 (95% CI: 1.13, 1.19) per 10,000 UFP/cm3. In the age 50-80 y population, we found higher associations between air pollution and T2D among men in comparison with women, people with lower education vs. individuals with high education, people with medium income vs. those with low or high income, people cohabiting vs. those living alone, and people with comorbidities vs. those without comorbidities. We observed no marked changes according to occupation, population density, road noise, or surrounding greenness. In the age 35-50 y population, similar tendencies were observed, except in relation to sex and occupation, where we observed associations with air pollution only among women and blue-collar workers. DISCUSSION We found stronger associations between air pollution and T2D among people with existing comorbidities and weaker associations among people with high socioeconomic status in comparison with those with lower socioeconomic status. https://doi.org/10.1289/EHP11347.
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Affiliation(s)
- Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Aslak Harbo Poulsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ulla Arthur Hvidtfeldt
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate – Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Lise Marie Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate – Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, UK
| | | | - Victor H. Valencia
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Christina Funch Lassen
- Centre of Social Medicine, University Hospital Bispebjerg-Frederiksberg, Frederiksberg, Denmark
| | - Ole Raaschou-Nielsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Pengpid S, Peltzer K. Prevalence and factors associated with undiagnosed type 2 diabetes among adults in Iraq: analysis of cross-sectional data from the 2015 STEPS survey. BMJ Open 2022; 12:e064293. [PMID: 36418142 PMCID: PMC9684960 DOI: 10.1136/bmjopen-2022-064293] [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] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The purpose of the study was to assess the prevalence and correlates of undiagnosed type 2 diabetes (UT2D) among adults (aged 18 years and older) in Iraq. DESIGN Cross-sectional, population-based study. SETTING Nationally representative sample of general community-dwelling adult population in Iraq from the 2015 Iraq STEPS survey. PARTICIPANTS The sample included 3853 adults (mean age 41.8 years, SD=15.8), with complete fasting blood glucose values, from the 2015 Iraq STEPS survey. OUTCOME MEASURES Data collection included: (1) social and behavioural information, (2) physical parameters and blood pressure measurements and (3) biochemical measurements. UT2D was classified as not being diagnosed with T2D and fasting plasma glucose level ≥126 mg/dL. Multivariable multinomial and logistic regression was used to identify factors associated with UT2D. RESULTS The prevalence of UT2D was 8.1% and the prevalence of diagnosed T2D (DT2D) was 8.9%. Participants aged 50 years and older (adjusted relative risk ratio (ARRR): 2.11, 95% CI 1.30 to 3.43) and those with high cholesterol (ARRR: 1.54, 95% CI 1.05 to 2.24) had a higher risk of UT2D. Older age (≥50 years) (ARRR: 17.90, 95% CI 8.42 to 38.06), receipt of healthcare advice (ARRR: 2.15, 95% CI 1.56 to 2.96), history of cholesterol testing (ARRR: 2.17, 95% CI 1.58 to 2.99), stroke or heart attack (ARRR: 1.81, 95% CI 1.13 to 2.92), and high cholesterol (ARRR: 1.55, 95% CI 1.17 to 2.06) were positively associated with DT2D, and high physical activity (ARRR: 0.57, 95% CI 0.38 to 0.84) was negatively associated with DT2D. Higher than primary education (adjusted OR (AOR): 2.02, 95% CI 1.21 to 3.37) was positively associated with UT2D versus DT2D, while older age (≥50 years) (AOR: 0.12, 95% CI 0.06 to 0.25), healthcare advice (AOR: 0.45, 95% CI 0.29 to 0.70), and history of cholesterol screening (AOR: 0.37, 95% CI 0.24 to 0.58) were inversely associated with UT2D versus DT2D. CONCLUSION Almost one in ten adults in Iraq had UT2D, and various associated factors were identified that could be useful in planning interventions.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Aministration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Prevalence and correlates of undiagnosed, diagnosed, and total type 2 diabetes among adults in Morocco, 2017. Sci Rep 2022; 12:16092. [PMID: 36168026 PMCID: PMC9515107 DOI: 10.1038/s41598-022-20368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/12/2022] [Indexed: 11/24/2022] Open
Abstract
The study aimed to estimate the prevalence and associated factors of undiagnosed type 2 diabetes (T2D) among adults in Morocco. Cross-sectional data were analyzed from 4779 people (≥ 18 years, mean age 41.7 years) who participated in the Morocco STEPS nationally representative survey in 2017 and had completed fasting blood glucose measurement. The results indicate that the prevalence of undiagnosed T2D was 5.9% (44.7% of total T2D), diagnosed T2D 7.3% and total T2D 13.2%. In the adjusted multinomial logistic regression analysis, older age (≥ 50 years), receipt of health care advice, and obesity were positively associated with undiagnosed T2D. Older age (≥ 50 years), urban residence, receipt of health care advice, ever cholesterol screening, moderate sedentary behaviour, obesity, hypertension, and elevated total cholesterol were positively associated with diagnosed T2D. In adjusted logistic regression analysis, older age (≥ 50 years), receipt of health care advice and cholesterol screening were negatively associated with undiagnosed T2D versus diagnosed T2D. A significant proportion of adults in Morocco had undiagnosed T2D and several associated factors were identified that can help guide interventions.
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