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Dugani SB, Lahr BD, Xie H, Mielke MM, Bailey KR, Vella A. County Rurality and Incidence and Prevalence of Diagnosed Diabetes in the United States. Mayo Clin Proc 2024; 99:1078-1090. [PMID: 38506780 PMCID: PMC11222038 DOI: 10.1016/j.mayocp.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To examine differences in the incidence and prevalence of diagnosed diabetes by county rurality. PATIENTS AND METHODS This observational, cross-sectional study used US Centers for Disease Control and Prevention data from 2004 through 2019 for county estimates of incidence and prevalence of diagnosed diabetes. County rurality was based on 6 levels (large central metro counties [most urban] to noncore counties [most rural]). Weighted least squares regression was used to relate rurality with diabetes incidence rates (IRs; per 1000 adults) and prevalence (percentage) in adults aged 20 years or older after adjusting for county-level sociodemographic factors (eg, food environment, health care professionals, inactivity, obesity). RESULTS Overall, in 3148 counties and county equivalents, the crude IR and prevalence of diabetes were highest in noncore counties. In age and sex ratio-adjusted models, the IR of diabetes increased monotonically with increasing rurality (P<.001), whereas prevalence had a weak, nonmonotonic but statistically significant increase (P=.002). Further adjustment for sociodemographic factors including food environment, health care professionals, inactivity, and obesity attenuated differences in incidence across rurality levels, and reversed the pattern for prevalence (prevalence ratios [vs large central metro] ranged from 0.98 [95% CI, 0.97 to 0.99] for large fringe metro to 0.94 [95% CI, 0.93 to 0.96] for noncore). In region-stratified analyses adjusted for sociodemographic factors including inactivity and obesity, increasing rurality was inversely associated with incidence in the Midwest and West only and inversely associated with prevalence in all regions. CONCLUSION The crude incidence and prevalence of diagnosed diabetes increased with increasing county rurality. After accounting for sociodemographic factors including food environment, health care professionals, inactivity, and obesity, county rurality showed no association with incidence and an inverse association with prevalence. Therefore, interventions targeting modifiable sociodemographic factors may reduce diabetes disparities by region and rurality.
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Affiliation(s)
- Sagar B Dugani
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN; Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
| | - Brian D Lahr
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Hui Xie
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Michelle M Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Kent R Bailey
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Adrian Vella
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
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Kovács N, Shahin B, Andrade CAS, Mahrouseh N, Varga O. Lifestyle and metabolic risk factors, and diabetes mellitus prevalence in European countries from three waves of the European Health Interview Survey. Sci Rep 2024; 14:11623. [PMID: 38773149 PMCID: PMC11109107 DOI: 10.1038/s41598-024-62122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 05/14/2024] [Indexed: 05/23/2024] Open
Abstract
Population shift towards healthier lifestyles can help reduce the burden of type 2 diabetes mellitus (DM), therefore understanding and monitoring the lifestyle-related risk factors are crucial for setting up effective preventive strategies and disease management. The present study aimed to explore the changes in prevalence of DM and major risk factors including smoking, physical activity, fruit and vegetable consumption, as well as body mass index (BMI) over three waves of European Health Interview Survey, and to investigate the association between risk factors and presence of DM across 11 European Union member states. Poisson regression models were used to evaluate the association between risk factors and DM, adjusted for demographic and socioeconomic variables. The estimated age-standardized prevalence of DM increased from 7.01% in 2009 to 7.96% in 2019, with substantial increase in subgroups with higher BMI and unhealthy lifestyle including physically inactive people, or current smokers. Obesity and overweight and physical inactivity were significantly associated with DM in all survey waves. Our findings underline that obesity prevention and weight loss promotion along with physical activity promotion are the subject of lifestyle interventions to reduce the burden of DM in EU member states.
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Affiliation(s)
- Nóra Kovács
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Balqees Shahin
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
- Syreon Research Institute, Budapest, Hungary.
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Gu L, Ma Y, Zheng Q, Gu W, Ke T, Li L, Zhao D, Dai Y, Dong Q, Ji B, Xu F, Shi J, Peng Y, Zhang Y, Shen T, Du R, Yang J, Kang M, Peng Y, Wang Y, Wang W. The effects of economic status on metabolic control in type 2 diabetes mellitus at 10 metabolic management centers in China. J Diabetes 2024; 16:e13466. [PMID: 37670495 PMCID: PMC10809306 DOI: 10.1111/1753-0407.13466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/15/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE This study investigated the association of economic status with metabolic index control in type 2 diabetes mellitus (T2DM) patients. METHODS In total, 37 454 T2DM patients from 10 National Metabolic Management Centers in China were recruited and categorized into two groups: a high-gross domestic product (GDP) group (n = 23 993) and a low-GDP group (n = 13 461). Sociodemographic characteristics, medical histories, and lifestyle factors were recorded. Logistic regression and interaction analysis were performed to evaluate the association of economic status and healthy lifestyle with metabolic control. RESULTS Compared to the low-GDP group, there were fewer patients with glycated hemoglobin (HbA1c) levels ≥7% in the high-GDP group. Fewer patients with a high GDP had an abnormal metabolic state (HbA1c ≥ 7%, blood pressure [BP] ≥130/80 mm Hg, total cholesterol [TCH] ≥4.5 mmol/L or body mass index [BMI] ≥24 kg/m2 ). The risks of developing HbA1c ≥ 7% (odds ratios [OR] = 0.545 [95% CI: 0.515-0.577], p < .001), BP ≥ 130/80 mm Hg (OR = 0.808 [95% CI: 0.770-0.849], p < .001), BMI ≥ 24 kg/m2 (OR = 0.840 [95% CI: 0.799-0.884], p < .001), and an abnormal metabolic state (OR = 0.533 [95% CI: 0.444-0.636], p < .001) were significantly lower in the high-GDP group even after adjustment for confounding factors. Younger participants; those with a family history of diabetes, normal weight, and a physical activity level up to standard; and those who did not drink alcohol in the high-GDP group were predisposed to better glycemic levels. CONCLUSIONS T2DM patients in economically developed regions had better metabolic control, especially glycemic control. A healthy lifestyle had an additive effect on achieving glycemic goals, even among high-GDP patients.
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Affiliation(s)
- Liping Gu
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yuhang Ma
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Qidong Zheng
- Department of Internal medicineThe Second People's Hospital of YuhuanYuhuanChina
| | - Weiqiong Gu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Tingyu Ke
- Department of EndocrinologyThe Second Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Li Li
- Department of EndocrinologyThe First Affiliated Hospital of Ningbo UniversityNingboChina
| | - Dong Zhao
- Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe HospitalCapital Medical UniversityBeijingChina
| | - Yuancheng Dai
- Department of Internal medicine of traditional Chinese medicineSheyang Diabetes HospitalYanchengChina
| | - Qijuan Dong
- Department of Endocrinology and MetabolismPeople's Hospital of Zhengzhou Affiliated Henan University of Chinese MedicineZhengzhouChina
| | - Bangqun Ji
- Department of EndocrinologyXingyi People's HospitalXingyiChina
| | - Fengmei Xu
- Department of Endocrinology and Metabolism, Hebi Coal (group). LTDGeneral hospitalHebiChina
| | - Juan Shi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Ying Peng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yifei Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Tingting Shen
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Rui Du
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jiaying Yang
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Mei Kang
- Clinical Research Center, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yufan Wang
- Department of Endocrinology and Metabolism, Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Madela SLM, Harriman NW, Sewpaul R, Mbewu AD, Williams DR, Sifunda S, Manyaapelo T, Nyembezi A, Reddy SP. Area-level deprivation and individual-level socioeconomic correlates of the diabetes care cascade among black south africans in uMgungundlovu, KwaZulu-Natal, South Africa. PLoS One 2023; 18:e0293250. [PMID: 38079422 PMCID: PMC10712896 DOI: 10.1371/journal.pone.0293250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/09/2023] [Indexed: 12/18/2023] Open
Abstract
South Africa is experiencing a rapidly growing diabetes epidemic that threatens its healthcare system. Research on the determinants of diabetes in South Africa receives considerable attention due to the lifestyle changes accompanying South Africa's rapid urbanization since the fall of Apartheid. However, few studies have investigated how segments of the Black South African population, who continue to endure Apartheid's institutional discriminatory legacy, experience this transition. This paper explores the association between individual and area-level socioeconomic status and diabetes prevalence, awareness, treatment, and control within a sample of Black South Africans aged 45 years or older in three municipalities in KwaZulu-Natal. Cross-sectional data were collected on 3,685 participants from February 2017 to February 2018. Individual-level socioeconomic status was assessed with employment status and educational attainment. Area-level deprivation was measured using the most recent South African Multidimensional Poverty Index scores. Covariates included age, sex, BMI, and hypertension diagnosis. The prevalence of diabetes was 23% (n = 830). Of those, 769 were aware of their diagnosis, 629 were receiving treatment, and 404 had their diabetes controlled. Compared to those with no formal education, Black South Africans with some high school education had increased diabetes prevalence, and those who had completed high school had lower prevalence of treatment receipt. Employment status was negatively associated with diabetes prevalence. Black South Africans living in more deprived wards had lower diabetes prevalence, and those residing in wards that became more deprived from 2001 to 2011 had a higher prevalence diabetes, as well as diabetic control. Results from this study can assist policymakers and practitioners in identifying modifiable risk factors for diabetes among Black South Africans to intervene on. Potential community-based interventions include those focused on patient empowerment and linkages to care. Such interventions should act in concert with policy changes, such as expanding the existing sugar-sweetened beverage tax.
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Affiliation(s)
| | - Nigel Walsh Harriman
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ronel Sewpaul
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | - Anthony David Mbewu
- Department of Internal Medicine, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - David R Williams
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of African and American Studies, Harvard University, Cambridge, Massachusetts, United States of America
| | - Sibusiso Sifunda
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town, South Africa
| | | | - Anam Nyembezi
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Antwi J. Precision Nutrition to Improve Risk Factors of Obesity and Type 2 Diabetes. Curr Nutr Rep 2023; 12:679-694. [PMID: 37610590 PMCID: PMC10766837 DOI: 10.1007/s13668-023-00491-y] [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] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE OF REVIEW Existing dietary and lifestyle interventions and recommendations, to improve the risk factors of obesity and type 2 diabetes with the target to mitigate this double global epidemic, have produced inconsistent results due to interpersonal variabilities in response to these conventional approaches, and inaccuracies in dietary assessment methods. Precision nutrition, an emerging strategy, tailors an individual's key characteristics such as diet, phenotype, genotype, metabolic biomarkers, and gut microbiome for personalized dietary recommendations to optimize dietary response and health. Precision nutrition is suggested to be an alternative and potentially more effective strategy to improve dietary intake and prevention of obesity and chronic diseases. The purpose of this narrative review is to synthesize the current research and examine the state of the science regarding the effect of precision nutrition in improving the risk factors of obesity and type 2 diabetes. RECENT FINDINGS The results of the research review indicate to a large extent significant evidence supporting the effectiveness of precision nutrition in improving the risk factors of obesity and type 2 diabetes. Deeper insights and further rigorous research into the diet-phenotype-genotype and interactions of other components of precision nutrition may enable this innovative approach to be adapted in health care and public health to the special needs of individuals. Precision nutrition provides the strategy to make individualized dietary recommendations by integrating genetic, phenotypic, nutritional, lifestyle, medical, social, and other pertinent characteristics about individuals, as a means to address the challenges of generalized dietary recommendations. The evidence presented in this review shows that precision nutrition markedly improves risk factors of obesity and type 2 diabetes, particularly behavior change.
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Affiliation(s)
- Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, USA.
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Yeheyis T, Hoyiso D, Ekubazgi KW, Chura GK, Alemayehu Y. The Pattern of Initial Presentation of Diabetes, Treatment Outcome and Its Predictors Among Diabetic Pediatrics Attended Service at Selected Public Hospitals of Southern Ethiopia: A Multi-Center Study. Risk Manag Healthc Policy 2023; 16:2485-2495. [PMID: 38024493 PMCID: PMC10676097 DOI: 10.2147/rmhp.s437361] [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: 09/20/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Diabetes mellitus is the most common metabolic disorder in the pediatric population. Globally the incidence of diabetes increased from 11.3 million (95% UI 10.6-12.1) in 1990 to 22.9 million (21.1-25.4) in 2017, with a 102.9% increase and there was a 3% increase in diabetes mortality rates by age between 2000 and 2019. Objective This study aims to assess the pattern of initial presentation of pediatric diabetes mellitus, treatment outcome, and its predictors among pediatrics who attended service at selected public hospitals in southern Ethiopia from 2015 to 2019. Methods A cross-sectional study was conducted among 422 randomly selected pediatrics from October 1st, 2021 to December 30, 2021, and participants were selected randomly from 8 randomly selected public hospitals in southern Ethiopia after proportional to client flow allocation of samples. Data was extracted from clients' charts using a data extraction checklist. Statistical Package for Social Sciences (SPSS) version 24, and logistic regression analysis were applied to determine the presence of an association between dependent and independent variables, and significance was declared at p-value <0.05. Results In this study, most (74.6%) of the pediatrics initially presented with Diabetic ketoacidosis (DKA). This study found that Two-thirds (67.1%) of the respondents in the study had a good treatment outcome. In this study residence, presenting signs and symptoms; poly symptoms and weight loss, history of hospitalization, and comorbidity were predictors of treatment outcome of pediatric diabetes mellitus. Conclusion Diabetes mellitus with Diabetic ketoacidosis is the predominant pattern of initial presentation in the study. The magnitude of poor treatment outcomes of diabetes mellitus among pediatrics in this study is high and unacceptable Residence, signs, and symptoms at initial presentation, history of hospitalization, and comorbidity were found to be significant independent predictors of treatment outcome of pediatric diabetes mellitus.
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Affiliation(s)
- Tomas Yeheyis
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Dawit Hoyiso
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Kinfe Woldu Ekubazgi
- School of medicine, College of Medicine and health sciences, Hawassa University, Hawassa, Ethiopia
| | - Gemechu Kediro Chura
- Department of Nursing, College of medicine and health sciences, Meda Welabu University, Shashemene, Ethiopia
| | - Yonas Alemayehu
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Guan Q, Zhu C, Zhang G, Wang J, Xiang H, Chen Y, Cui H. Association of land urbanization and type 2 diabetes mellitus prevalence and mediation of greenness and physical activity in Chinese adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122579. [PMID: 37741540 DOI: 10.1016/j.envpol.2023.122579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023]
Abstract
The prevalence of type 2 diabetes (T2D) is higher in urban than in rural areas. Limited information is available on the association between T2D and Land urbanization (LU) while LU influences not only greenness and Particulate Matter 2.5 (PM2.5) but also inhabitant behavior. We aimed to explore the association between the LU level and T2D prevalence, as well as whether greenness, PM2.5, or conscious physical activity mediated any of the observed associations. This study encompassed 27,633 adult participants from Shandong Province who completed the sixth National Health Service Survey in 2018. Ambient LU exposure was estimated by spatial characteristics, including the existing impervious surface area (ISA), road density (RD), and annual night light (NL). Exposures were estimated using satellite images and OpenStreetMap, with 1000 m used as the main analysis buffer. Two-level logistic regression models were used to investigate the association between the LU metrics and T2D. Additionally, we explored potential mechanisms of the association through mediation analysis. The prevalence of T2D among participants was 5.14%, with average exposures to ISA_1000m of 1.441 km2, RD_1000m of 3.856 km/km2, and NL_1000m of 9.821 nW/cm2/sr. Higher levels of LU exposure were associated with higher T2D ORs [for each interquartile of ISA_1000m, RD_1000m, and NL_1000m, the adjusted OR (95% CI) for the T2D prevalence were 1.29 (1.19-1.4), 1.25 (1.15-1.36), and 1.25 (1.15-1.36), respectively]. This relationship persisted in several sensitivity analyses including use of different buffer sizes. We observed stronger associations among participants younger than 65 years or in men. Greenness mediated a 20.78%-65.36% of the estimated associations, conscious physical activity mediated a 10.35%-15.85%, while PM2.5 mediated insignificantly. These results suggest a deleterious association between higher levels of LU and T2D among adult residents in a developing country. Greenness and conscious physical activity mediate the association.
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Affiliation(s)
- Qing Guan
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Chunyang Zhu
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Guo Zhang
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan 430072, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Yujia Chen
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
| | - Hao Cui
- State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan 430079, China.
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Campero MN, Scavuzzo CM, Andreo V, Mileo MS, Franzois MB, Oberto MG, Gonzalez Rodriguez C, Defagó MD. A geospatial analysis of cardiometabolic diseases and their risk factors considering environmental features in a midsized city in Argentina. GEOSPATIAL HEALTH 2023; 18. [PMID: 37873994 DOI: 10.4081/gh.2023.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/19/2023] [Indexed: 10/25/2023]
Abstract
New approaches to the study of cardiometabolic disease (CMD) distribution include analysis of built environment (BE), with spatial tools as suitable instruments. We aimed to characterize the spatial dissemination of CMD and the associated risk factors considering the BE for people attending the Non-Invasive Cardiology Service of Hospital Nacional de Clinicas in Córdoba City, Argentina during the period 2015-2020. We carried out an observational, descriptive, cross-sectional study performing non-probabilistic convenience sampling. The final sample included 345 people of both sexes older than 35 years. The CMD data were collected from medical records and validated techniques and BE information was extracted from Landsat-8 satellite products. A geographic information system (GIS) was constructed to assess the distribution of CMD and its risk factors in the area. Out of the people sampled, 41% showed the full metabolic syndrome and 22.6% only type-2 diabetes mellitus (DM2), a cluster of which was evidenced in north-western Córdoba. The risk of DM2 showed an association with high values of the normalized difference vegetation index (NDVI) (OR= 0.81; 95% CI: - 0.30 to 1.66; p=0.05) and low normalized difference built index (NDBI) values that reduced the probability of occurrence of DM2 (OR= -1.39; 95% CI: -2.62 to -0.17; p=0.03). Considering that the results were found to be linked to the environmental indexes, the study of BE should include investigation of physical space as a fundamental part of the context in which people develop medically within society. The novel collection of satellite-generated information on BE proved efficient.
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Affiliation(s)
- Micaela Natalia Campero
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba; Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - Carlos Matías Scavuzzo
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba; Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba.
| | - Veronica Andreo
- Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - María Sol Mileo
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - Micaela Belén Franzois
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - María Georgina Oberto
- Centre for Research in Human Nutrition School of Nutrition, Faculty of Medical Sciences, National University of Cordoba" by "Centro de Investigaciones en Nutrición Humana, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Ciudad de Córdoba, Córdoba.
| | - Carla Gonzalez Rodriguez
- Mario Gulich Institute for Advance Spatial Studies, National University of Cordoba, National Commision for Space Activities by Instituto de Altos Estudios Espaciales Mario Gulich, Comisión Nacional de Actividades Espaciales, Universidad Nacional de Córdob, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research by Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires.
| | - María Daniela Defagó
- Centro de Investigaciones en Nutrición Humana (CenINH), Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba. Ciudad de Córdoba, Córdoba.
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Li X, Liu R, Chen Y, Han Y, Wang Q, Xu Y, Zhou J, Jiang S. Patterns and Trends in Mortality Associated With and Due to Diabetes Mellitus in a Transitioning Region With 3.17 Million People: Observational Study. JMIR Public Health Surveill 2023; 9:e43687. [PMID: 37665630 PMCID: PMC10507522 DOI: 10.2196/43687] [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: 10/20/2022] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) imposes a significant disease burden in economically transitioning regions. Most transitioning regions share similar experience in urbanization processes. Shanghai's Pudong district serves as a representative area of such regions. OBJECTIVE We aimed to assess the burden of and trends in DM mortality in Shanghai's Pudong district and analyze the impact of aging and multimorbidity. METHODS A longitudinal, population-based study was conducted to analyze DM mortality in Pudong from 2005 to 2020. We used joinpoint regression to analyze epidemiological features and long-term trends in crude mortality rate (CMR), age-standardized mortality rate worldwide (ASMRW), and years of life lost (YLL). Furthermore, the decomposition method was used to evaluate the contribution of demographic and nondemographic factors associated with mortality. RESULTS There were 49,414 deaths among individuals with DM, including 15,512 deaths due to DM. The CMR and ASMRW were 109.55/105 and 38.01/105 person-years, respectively. Among the mortality associated with and due to DM, the total annual ASMRW increased by 3.65% (95% CI 3.25%-4.06%) and 1.38% (95% CI 0.74%-2.02%), respectively. Additionally, the total annual YLL rate increased by 4.98% (95% CI 3.92%-6.05%) and 2.68% (95% CI 1.34%-4.04%). The rates of YLL increase in persons aged 30 to 44 years (3.98%, 95% CI 0.32%-7.78%) and 45 to 59 years (4.31%, 95% CI 2.95%-5.69%) were followed by the increase in persons aged 80 years and older (10.53%, 95% CI 9.45%-11.62%) for deaths associated with DM. The annual CMR attributable to demographic factors increased by 41.9% (95% CI 17.73%-71.04%) and 36.72% (95% CI 16.69%-60.2%) for deaths associated with and due to DM, respectively. Hypertension, cerebrovascular disease, and ischemic heart disease were the top 3 comorbidities. CONCLUSIONS Aging and multimorbidity played essential roles in changing the burden of DM in an urbanizing and transitioning region. There is an increasing disease burden among young and middle-aged people, emphasizing the need for greater attention to these groups. Health management is an emerging method that holds important implications for alleviating the future burden of DM.
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Affiliation(s)
- Xiaopan Li
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ru Liu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yichen Chen
- Office of Scientific Research and Information Management, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China
- School of Public Health, Fudan University, Shanghai, China
| | - Yan Han
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qizhe Wang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yaxin Xu
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jing Zhou
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Sunfang Jiang
- Department of Health Management Center, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China
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10
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Berhe KK, Mselle LT, Gebru HB. The magnitude of chronic diabetes complications and its associated factors among diabetic patients attending the general hospitals in Tigray region, Northern Ethiopia. PLoS One 2023; 18:e0290240. [PMID: 37624794 PMCID: PMC10456170 DOI: 10.1371/journal.pone.0290240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Diabetes is a severe challenge to global public health since it is a leading cause of morbidity, mortality, and rising healthcare costs. 3.0 million Ethiopians, or 4.7% of the population, had diabetes in 2021. Studies on the chronic complications of diabetes in Ethiopia have not been conducted in lower-level healthcare facilities, so the findings from tertiary hospitals do not accurately reflect the issues with chronic diabetes in general hospitals. In addition, there is a lack of information and little research on the complications of chronic diabetes in Ethiopia. The objective of this study was to assess the degree of chronic diabetes complications and associated factors among diabetic patients presenting to general hospitals in the Tigray area in northern Ethiopia. METHODS As part of a multi-centre cross-sectional study, 1,158 type 2 diabetes (T2D) patients from 10 general hospitals in the Tigray region were randomly chosen. An interviewer-administered questionnaire, a record review, and an SPSS version 20 analysis were used to collect the data. All continuous data were presented as mean standard deviation (SD), while categorical data were identified by frequencies. Using a multivariable logistic regression model, the factors associated with chronic diabetes complications among T2D diabetic patients were found, and linked factors were declared at p 0.05. RESULTS Fifty-four of people with diabetes have chronic problems. Hypertension (27%) eye illness, renal disease (19.1%), and hypertension (27%) eye disease were the most common long-term effects of diabetes. Patients with chronic diabetes complications were more likely to be older than 60, taking insulin and an OHGA (Oral Hyperglycemic Agent) (AOR = 3.00; 95% CI 1.73, 5.26), having diabetes for more than five years, taking more than four tablets per day (AOR = 1.63; 95% CI 1.23,2.15), and having high systolic and diastolic blood pressure. Patients with government employment (AOR = 0.48; 95% CI 0.26, 0.90), antiplatelet drug use (AOR = 0.29; 95% CI 0.16, 0.52), and medication for treating dyslipidemia (AOR = 0.54; 95% CI 0.35, 0.84), all had a decreased chance of developing a chronic diabetes problem. CONCLUSION At least one chronic diabetic complication was present in more than half of the patients in this study. Chronic diabetes problems were related to patients' characteristics like age, occupation, diabetes treatment plan, anti-platelet, anti-dyslipidemia medicine, duration of diabetes, high Systolic BP, high Diastolic BP, and pill burden. To avoid complications from occurring, diabetes care professionals and stakeholders must collaborate to establish appropriate methods, especially for individuals who are more likely to experience diabetic complications.
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Affiliation(s)
- Kalayou K. Berhe
- School of Nursing, College of Health Sciences, Mekelle University, Mekelle City, Tigray Region, Northern Ethiopia
| | - Lilian T. Mselle
- Department of Clinical Nursing, School of Nursing, Muhimbli University of Health and Allied Sciences, (MUHAS), Dar es Salaam, Tanzania
| | - Haftu B. Gebru
- School of Nursing, College of Health Sciences, Mekelle University, Mekelle City, Tigray Region, Northern Ethiopia
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11
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Boadu WIO, Anto EO, Frimpong J, Ntiful F, Korsah EE, Ansah E, Tamakloe VCKT, Agyapomaa A, Opoku S, Senu E, Nyantakyi M, Etwi‐Mensah A, Acheampong E, Boadu KO, Donkoh ET, Obirikorang C. Prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus patients in rural and urban areas: A multicenter cross-sectional study. Health Sci Rep 2023; 6:e1475. [PMID: 37636287 PMCID: PMC10447875 DOI: 10.1002/hsr2.1475] [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: 04/30/2023] [Revised: 07/09/2023] [Accepted: 07/23/2023] [Indexed: 08/29/2023] Open
Abstract
Background and Aims Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas. Methods This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p < 0.05 were considered statistically significant. Results The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty-seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70-8.37), p = 0.001] significantly increased one's risk of having dyslipidemia by 3.8-fold compared to eating supper earlier (before 5 p.m.). Conclusion Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it's independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas.
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Affiliation(s)
- Wina I. O. Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Enoch O. Anto
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Centre for Precision Health, ECU Strategic Research CentreEdith Cowan UniversityPerthAustralia
| | - Joseph Frimpong
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Felix Ntiful
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel E. Korsah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ezekiel Ansah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Valentine C. K. T. Tamakloe
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Afia Agyapomaa
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Stephen Opoku
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Michael Nyantakyi
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Albright Etwi‐Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel Acheampong
- School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Kwame O. Boadu
- Department of Obstetrics and Gynaecology, Kumasi South HospitalAtonsu‐AgogoKumasiGhana
| | - Emmanuel Timmy Donkoh
- Department of Medical Laboratory ScienceUniversity of Energy and Natural ResourcesSunyaniGhana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
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12
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Kovanur Sampath K, Ann-Rong Y, Haggie M, Tapara T, Brownie S. Exploring the option of student-run free health clinics to support people living with type 2 diabetes mellitus: a scoping review. Front Public Health 2023; 11:1128617. [PMID: 37533530 PMCID: PMC10392832 DOI: 10.3389/fpubh.2023.1128617] [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: 12/20/2022] [Accepted: 06/27/2023] [Indexed: 08/04/2023] Open
Abstract
Diabetes is a major cause of morbidity and premature mortality worldwide and now identified as a 'public health emergency' and a 'modern and preventable pandemic'. Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. Student run free clinics (SRFCs) may play an important role in the prevention and management of T2DM. The primary objective of this scoping review was to investigate the opportunity for curriculum enhancement through the role and effectiveness of SRFCs in managing T2DM. Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to October 2022. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. The research team collectively created a data charting table/form to standardize data collection. A narrative synthesis was used to summarize the evidence. Six studies (total of 319 participants) that met our eligibility criteria were included in this scoping review. SRFCs can provide high-quality diabetic care, especially for uninsured and economically weaker population. Preliminary evidence further indicate that shared medical appointments and telehealth may facilitate diabetic care especially during times where access to care may be difficult (e.g., COVID lockdown). However, no study included in the review explored or discussed family centred/culturally sensitive interventions. Hence, such interventions should be made part of the curriculum in the future with students in SRFCs exposed to such an approach.
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Affiliation(s)
- Kesava Kovanur Sampath
- Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
- University of Canberra, Canberra, ACT, Australia
| | - Yan Ann-Rong
- University of Canberra, Canberra, ACT, Australia
| | - Marrin Haggie
- Waikato Institute of Technology – Te Pukenga, Hamilton, New Zealand
| | - Timi Tapara
- Tu Tonu Rehabilitation Ltd., Hamilton, New Zealand
| | - Sharon Brownie
- University of Canberra, Canberra, ACT, Australia
- Swinburne University, Melbourne, VIC, Australia
- Griffith University, Gold Coast, QLD, Australia
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13
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Dahal PK, Rawal L, Ademi Z, Mahumud RA, Paudel G, Vandelanotte C. Estimating the Health Care Expenditure to Manage and Care for Type 2 Diabetes in Nepal: A Patient Perspective. MDM Policy Pract 2023; 8:23814683231216938. [PMID: 38107033 PMCID: PMC10725113 DOI: 10.1177/23814683231216938] [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: 07/16/2023] [Accepted: 10/05/2023] [Indexed: 12/19/2023] Open
Abstract
Background. This study aimed to estimate the health care expenditure for managing type 2 diabetes (T2D) in the community setting of Nepal. Methods. This is a baseline cross-sectional study of a heath behavior intervention that was conducted between September 2021 and February 2022 among patients with T2D (N = 481) in the Kavrepalanchok and Nuwakot districts of Nepal. Bottom-up and micro-costing approaches were used to estimate the health care costs and were stratified according to residential status and the presence of comorbid conditions. A generalized linear model with a log-link and gamma distribution was applied for modeling the continuous right-skewed costs, and 95% confidence intervals were obtained from 10,000 bootstrapping resampling techniques. Results. Over 6 months the mean health care resource cost to manage T2D was US $22.87 per patient: 61% included the direct medical cost (US $14.01), 15% included the direct nonmedical cost (US $3.43), and 24% was associated with productivity losses (US $5.44). The mean health care resource cost per patient living in an urban community (US $24.65) was about US $4.95 higher than patients living in the rural community (US $19.69). The health care costs per patient with comorbid conditions was US $22.93 and was US $22.81 for those without comorbidities. Patients living in rural areas had 16% lower health care expenses compared with their urban counterparts. Conclusion. T2D imposes a substantial financial burden on both the health care system and individuals. There is a need to establish high-value care treatment strategies for the management of T2D to reduce the high health care expenses. Highlights More than 60% of health care expenses comprise the direct medical cost, 15% direct nonmedical cost, and 24% patient productivity losses. The costs of diagnosis, hospitalization, and recommended foods were the main drivers of health care costs for managing type 2 diabetes.Health care expenses among patients living in urban communities and patients with comorbid conditions was higher compared with those in rural communities and those with without comorbidities.The results of this study are expected to help integrate diabetes care within the existing primary health care systems, thereby reducing health care expenses and improving the quality of diabetes care in Nepal.
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Affiliation(s)
- Padam Kanta Dahal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, NSW, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Queensland, Australia
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, NSW, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Queensland, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rashidul Alam Mahumud
- NHRMC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, NSW, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Queensland, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Queensland, Australia
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14
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Majety P, Lozada Orquera FA, Edem D, Hamdy O. Pharmacological approaches to the prevention of type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1118848. [PMID: 36967777 PMCID: PMC10033948 DOI: 10.3389/fendo.2023.1118848] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
About 1 in 10 adults worldwide are estimated to have diabetes mellitus. They are at risk of developing life-threatening complications resulting in reduced quality of life, increased mortality and higher healthcare costs. The ability to prevent or delay type 2 diabetes mellitus (T2DM) by modifying some of its risk factors has been hypothesized for decades. The long and often gradual time-course of increasing dysglycemia prior to diabetes diagnosis suggests that interventions during that period could be effective in preventing T2DM. In addition to lifestyle modifications, certain drugs prevent or slow development of hyperglycemia. Recently, drugs used for obesity management were shown to prevent T2DM. In this review, we discuss various pharmacotherapeutic options for preventing T2DM.
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Affiliation(s)
- Priyanka Majety
- Division of Endocrinology, Diabetes and Metabolism, Virginia Commonwealth University Health System, Richmond, VA, United States
| | | | - Dinesh Edem
- Division of Endocrinology, Diabetes and Metabolism, University of Arkansas Medical Center, Little Rock, AR, United States
| | - Osama Hamdy
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, United States
- *Correspondence: Osama Hamdy,
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15
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Anza-Ramirez C, Lazo M, Zafra-Tanaka JH, Avila-Palencia I, Bilal U, Hernández-Vásquez A, Knoll C, Lopez-Olmedo N, Mazariegos M, Moore K, Rodriguez DA, Sarmiento OL, Stern D, Tumas N, Miranda JJ. The urban built environment and adult BMI, obesity, and diabetes in Latin American cities. Nat Commun 2022; 13:7977. [PMID: 36581636 PMCID: PMC9800402 DOI: 10.1038/s41467-022-35648-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
Latin America is the world's most urbanized region and its heterogeneous urban development may impact chronic diseases. Here, we evaluated the association of built environment characteristics at the sub-city -intersection density, greenness, and population density- and city-level -fragmentation and isolation- with body mass index (BMI), obesity, and type 2 diabetes (T2D). Data from 93,280 (BMI and obesity) and 122,211 individuals (T2D) was analysed across 10 countries. Living in areas with higher intersection density was positively associated with BMI and obesity, whereas living in more fragmented and greener areas were negatively associated. T2D was positively associated with intersection density, but negatively associated with greenness and population density. The rapid urban expansion experienced by Latin America provides unique insights and vastly expand opportunities for population-wide urban interventions aimed at reducing obesity and T2D burden.
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Affiliation(s)
- Cecilia Anza-Ramirez
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mariana Lazo
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Jessica Hanae Zafra-Tanaka
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ione Avila-Palencia
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.4777.30000 0004 0374 7521Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland UK
| | - Usama Bilal
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.166341.70000 0001 2181 3113Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Akram Hernández-Vásquez
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolyn Knoll
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Nancy Lopez-Olmedo
- grid.415771.10000 0004 1773 4764Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Mónica Mazariegos
- grid.418867.40000 0001 2181 0430INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Kari Moore
- grid.166341.70000 0001 2181 3113Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Daniel A. Rodriguez
- grid.47840.3f0000 0001 2181 7878Department of City and Regional Planning, University of California, Berkeley, CA USA
| | - Olga L. Sarmiento
- grid.7247.60000000419370714School of Medicine, Universidad de los Andes, Bogota, Colombia
| | - Dalia Stern
- grid.415771.10000 0004 1773 4764CONACyT- Center for Population and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Natalia Tumas
- grid.5612.00000 0001 2172 2676Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain ,grid.5612.00000 0001 2172 2676Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain ,grid.10692.3c0000 0001 0115 2557Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina
| | - J. Jaime Miranda
- grid.11100.310000 0001 0673 9488CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru ,grid.11100.310000 0001 0673 9488School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Karigidi KO, Akintimehin ES, Akinyemi O, Fapetu AP, Adetuyi FO. Nutritional, antioxidant, antidiabetic, and oxidative stability properties of turmeric (
Curcuma longa
) supplemented muffins. J FOOD PROCESS PRES 2022. [DOI: 10.1111/jfpp.17009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kayode Olayele Karigidi
- Department of Chemical Sciences (Biochemistry Unit) Olusegun Agagu University of Science and Technology Okitipupa Nigeria
| | - Emmanuel Sina Akintimehin
- Department of Chemical Sciences (Biochemistry Unit) Olusegun Agagu University of Science and Technology Okitipupa Nigeria
| | - Oluwatoyin Akinyemi
- Department of Chemical Sciences (Biochemistry Unit) Olusegun Agagu University of Science and Technology Okitipupa Nigeria
| | - Aanuoluwapo Patricia Fapetu
- Department of Chemical Sciences (Biochemistry Unit) Olusegun Agagu University of Science and Technology Okitipupa Nigeria
| | - Foluso Olutope Adetuyi
- Department of Chemical Sciences (Biochemistry Unit) Olusegun Agagu University of Science and Technology Okitipupa Nigeria
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Soeiro VMDS, Vasconcelos VV, Caldas ADJM. [Tuberculosis and diabetes comorbidity in Brazil, 2012-2018: exploratory spatial data analysis and statistical modelingLa comorbilidad tuberculosis-diabetes en Brasil, 2012-2018: análisis exploratorio de la distribución espacial y modelización estadística]. Rev Panam Salud Publica 2022; 46:e51. [PMID: 35620175 PMCID: PMC9128662 DOI: 10.26633/rpsp.2022.51] [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: 09/16/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Descrever a distribuição espacial da comorbidade tuberculose-diabetes e identificar os determinantes sociais da dupla carga no período de 2012 a 2018 no Brasil. Métodos. Este estudo ecológico utilizou os municípios como unidade de análise. Incluíram-se todos os casos de tuberculose notificados de 2012 a 2018 ao Sistema de Informação de Agravos de Notificação. Como determinantes, foram analisadas variáveis socioeconômicas de emprego, renda e desenvolvimento e o indicador de cobertura da atenção básica. O índice de Moran global foi calculado para verificar a existência de autocorrelação espacial da comorbidade. O índice de Moran local foi utilizado para delimitar clusters de tuberculose-diabetes: alto/alto (municípios com alta proporção de tuberculose-diabetes cujos vizinhos também apresentaram altas proporções) e baixo/baixo (municípios com proporção abaixo da média, cercados por municípios com baixas proporções). Resultados. Observou-se elevação na proporção de tuberculose-diabetes na maioria das regiões brasileiras. Constatou-se autocorrelação espacial da comorbidade tuberculose-diabetes e identificou-se um cluster alto-alto de tuberculose-diabetes reunindo 88 municípios, pertencentes principalmente às regiões Nordeste, Sudeste e Sul, com média de prevalência da comorbidade de 28,04%. As variáveis “percentual da população que vive em domicílios com densidade superior a duas pessoas por dormitório”, “percentual de desemprego de pessoas maiores de 18 anos” e “renda per capita” relacionaram-se à ocorrência da comorbidade. Conclusão. Os resultados mostraram uma distribuição não aleatória da comorbidade tuberculose-diabetes, com áreas de alto risco e variáveis explicativas de sua ocorrência. Esses achado reforçam a necessidade de operacionalizar a colaboração entre programas de tuberculose e diabetes, com vistas ao controle tanto de cada agravo isoladamente quanto da sindemia.
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Affiliation(s)
- Vanessa Moreira da Silva Soeiro
- Universidade Federal do Maranhão Programa de Pós-Graduação em Saúde Coletiva São Luís (MA) Brasil Universidade Federal do Maranhão, Programa de Pós-Graduação em Saúde Coletiva, São Luís (MA), Brasil
| | - Vitor Vieira Vasconcelos
- Universidade Federal do ABC Programa de Pós-Graduação em Ciência e Tecnologia Ambiental São Bernardo do Campo (SP) Brasil Universidade Federal do ABC, Programa de Pós-Graduação em Ciência e Tecnologia Ambiental, São Bernardo do Campo (SP), Brasil
| | - Arlene de Jesus Mendes Caldas
- Universidade Federal do Maranhão Programa de Pós-Graduação em Enfermagem São Luís (MA) Brasil Universidade Federal do Maranhão, Programa de Pós-Graduação em Enfermagem, São Luís (MA), Brasil
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18
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Houguig K, Ouzennou N, Rayadi M, Rkha S. Observance of hygiene and dietary rules and the associated factors among diabetic subjects in Essaouira Province, Morocco: a cross-sectional study. Pan Afr Med J 2022; 41:22. [PMID: 35291359 PMCID: PMC8895567 DOI: 10.11604/pamj.2022.41.22.30196] [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: 06/05/2021] [Accepted: 11/07/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction hygiene and dietary recommendations are a fundamental pillar of diabetes management. The objective of this study is to measure the rate of observance of hygiene and dietary rules and the factors associated with these among a group of Moroccan diabetic subjects. Methods a cross-sectional questionnaire survey was conducted on 522 subjects with types 1 and 2 diabetes followed at different health centres in the province of Essaouira (Morocco). Results non-observance of hygiene and dietary rules rate was assessed at 41,4%, (66.5% for diet, 32.4% for lifestyle and 30.8% for physical activity). Rural area (p<0.001), poor glycaemic control (p<0.001), ignorance of hygiene and dietary rules (p<0.001) and long duration of diabetes (p<0.01) are associated with non-observance of diet. Good family support (p<0.01) is associated with good observance of lifestyle recommendations, short duration of diabetes progression (p<0.01) is associated with good observance of physical activity recommendations. Conclusion non-observance of hygiene and dietary rules is always a problem in the management of chronic diseases. Ignorance of hygiene and dietary measures, lassitude and difficulty in adapting to a new lifestyle are the main obstacles that diabetics must overcome in order to better manage their disease.
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Affiliation(s)
- Khaoula Houguig
- Department of Biology, Pharmacology, Neurobiology, Anthropobiology and Environment Laboratory, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Nadia Ouzennou
- Department of Biology, Pharmacology, Neurobiology, Anthropobiology and Environment Laboratory, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Higher Institute of Nursing and Technical Health, Marrakech, Morocco
| | - Mahassine Rayadi
- Endocrinology Service, Sidi Mohamed Ben Abdellah Hospital, Essaouira, Morocco
| | - Samia Rkha
- Department of Biology, Pharmacology, Neurobiology, Anthropobiology and Environment Laboratory, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
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19
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Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, Pavkov ME, Ramachandaran A, Wild SH, James S, Herman WH, Zhang P, Bommer C, Kuo S, Boyko EJ, Magliano DJ. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022; 183:109119. [PMID: 34879977 PMCID: PMC11057359 DOI: 10.1016/j.diabres.2021.109119] [Citation(s) in RCA: 2866] [Impact Index Per Article: 1433.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/12/2022]
Abstract
AIMS To provide global, regional, and country-level estimates of diabetes prevalence and health expenditures for 2021 and projections for 2045. METHODS A total of 219 data sources meeting pre-established quality criteria reporting research conducted between 2005 and 2020 and representing 215 countries and territories were identified. For countries without data meeting quality criteria, estimates were extrapolated from countries with similar economies, ethnicity, geography and language. Logistic regression was used to generate smoothed age-specific diabetes prevalence estimates. Diabetes-related health expenditures were estimated using an attributable fraction method. The 2021 diabetes prevalence estimates were applied to population estimates for 2045 to project future prevalence. RESULTS The global diabetes prevalence in 20-79 year olds in 2021 was estimated to be 10.5% (536.6 million people), rising to 12.2% (783.2 million) in 2045. Diabetes prevalence was similar in men and women and was highest in those aged 75-79 years. Prevalence (in 2021) was estimated to be higher in urban (12.1%) than rural (8.3%) areas, and in high-income (11.1%) compared to low-income countries (5.5%). The greatest relative increase in the prevalence of diabetes between 2021 and 2045 is expected to occur in middle-income countries (21.1%) compared to high- (12.2%) and low-income (11.9%) countries. Global diabetes-related health expenditures were estimated at 966 billion USD in 2021, and are projected to reach 1,054 billion USD by 2045. CONCLUSIONS Just over half a billion people are living with diabetes worldwide which means that over 10.5% of the world's adult population now have this condition.
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Affiliation(s)
- Hong Sun
- International Diabetes Federation, Brussels, Belgium
| | - Pouya Saeedi
- International Diabetes Federation, Brussels, Belgium
| | | | | | - Katherine Ogurtsova
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Bruce B Duncan
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Stein
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Abdul Basit
- Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences and Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences and Biotechnology Center, The University of Yaounde I, Yaounde, Cameroon
| | - Meda E Pavkov
- Division of Diabetes Translation, Centers for Diseases Control and Prevention, Atlanta, GA, United States
| | - Ambady Ramachandaran
- India Diabetes Research Foundation & Dr.A.Ramachandran's Diabetes Hospital, Chennai, India
| | - Sarah H Wild
- Usher Institute, University of Edinburgh, Teviot Place, EH8 9AG, Scotland
| | - Steven James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie Queensland, Australia
| | - William H Herman
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Diseases Control and Prevention, Atlanta, GA, United States
| | - Christian Bommer
- Centre for Modern Indian Studies, University of Goettingen, Goettingen, Germany; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Shihchen Kuo
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, United States
| | - Dianna J Magliano
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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20
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Pandey AR, Aryal KK, Shrestha N, Sharma D, Maskey J, Dhimal M. Burden of Diabetes Mellitus in Nepal: An Analysis of Global Burden of Disease Study 2019. J Diabetes Res 2022; 2022:4701796. [PMID: 36582811 PMCID: PMC9794432 DOI: 10.1155/2022/4701796] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
Globally, the number of people living with diabetes mellitus (DM) increased by 62% between 1990 and 2019, affecting 463 million people in 2019, and is projected to increase further by 51% by 2045. The increasing burden of DM that requires chronic care could have a considerable cost implication in the health system, particularly in resource constraint settings like Nepal. In this context, this study attempts to present the burden of DM in terms of prevalence, mortality, and disability adjusted life years (DALYs). The study is based on the Global Burden of Disease Study 2019, a multinational collaborative research, led by the Institute for Health Metrics and Evaluations. In the study, the overall prevalence of DM was estimated using DisMod MR-2.1, a Bayesian metaregression model. DALYs were estimated summing years of life lost due to premature death and years lived with disability. There were a total of 1,412,180 prevalent cases of DM, 3,474 deaths and 189,727 DALYs, due to DM in 2019. All-age prevalence rate and the age-standardized prevalence rate of DM stood at 4,642.83 (95% uncertainty interval (UI): 4,178.58-5,137.74) and 5,735.58 (95% UI: 5,168.74-6327.73) cases per 100,000 population, respectively, in 2019. In 2019, 1.8% (95% UI: 1.54, 2.07) of total deaths were from DM, which is a more than three-fold increase from the proportion of deaths attributed in 1990 (0.43%, 95% UI: 0.36, 0.5) with most of these deaths being from DM type 2. In 2019, a total of 189,727 disability adjusted life years (DALYs) were attributable to DM of which 105,950 DALYs were among males, and the remaining 83,777 DALYs were among females. Overall, between 1990 and 2019, the DALYs, attributable to Type 1 and 2 DM combined and for Type 2 DM only, have increased gradually across both sexes. However, the DALYs per 100,000 attributable to DM have slightly reduced across both sexes in that time. There is a high burden of DM in Nepal in 2019 with a steep increase in the proportion of deaths attributable to DM in Nepal which could pose a serious challenge to the health system. Primary prevention of DM requires collaborative efforts from multiple sectors. Meanwhile, the current federal structure could be an opportunity for integrated, locally tailored public health and clinical interventions for the prevention of the disease and its consequences.
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Affiliation(s)
| | | | | | | | - Jasmine Maskey
- Oxford University Clinical Research Unit, Lalitpur, Nepal
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21
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Iheagwam FN, Batiha GES, Ogunlana OO, Chinedu SN. Terminalia catappa Extract Palliates Redox Imbalance and Inflammation in Diabetic Rats by Upregulating Nrf-2 Gene. Int J Inflam 2021; 2021:9778486. [PMID: 34956587 PMCID: PMC8702315 DOI: 10.1155/2021/9778486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/09/2021] [Accepted: 11/25/2021] [Indexed: 12/30/2022] Open
Abstract
This study aims at evaluating the ameliorative role of Terminalia catappa aqueous leaf extract (TCA) on hyperglycaemia-induced oxidative stress and inflammation in a high-fat, low dose streptozotocin-induced type 2 diabetic rat model. Experimental rats were treated orally with 400 and 800 mg/kg bw TCA daily for four weeks. Antioxidant enzyme activities, plasma glucose concentration, protein concentration, oxidative stress, and inflammation biomarkers were assayed using standard methods. Hepatic relative expressions of tumour necrosis factor-alpha (TNF-α), interleukin-six (IL-6), and nuclear factor-erythroid 2 related factor 2 (Nrf-2) were also assessed. Molecular docking and prediction of major TCA phytoconstituents' biological activity related to T2DM-induced oxidative stress were evaluated in silico. Induction of diabetes significantly (p < 0.05) reduced superoxide dismutase, glutathione-S-transferase, and peroxidase activities. Glutathione and protein stores were significantly (p < 0.05) depleted, while glucose, MDA, interleukin-six (IL-6), and tumour necrosis factor-α (TNF-α) concentrations were significantly (p < 0.05) increased. A significant (p < 0.05) upregulation of hepatic TNF-α and IL-6 expression and downregulation (p < 0.05) of Nrf-2 expression were observed during diabetes onset. TCA treatment significantly (p < 0.05) modulated systemic diabetic-induced oxidative stress and inflammation, mRNA expression dysregulation, and dysregulated macromolecule metabolism. However, only 800 mg/kg TCA treatment significantly (p < 0.05) downregulated hepatic TNF-α expression. 9-Oxabicyclo[3.3.1]nonane-2,6-diol and 1,2,3-Benzenetriol bound comparably to glibenclamide in Nrf-2, IL-6, and TNF-α binding pockets. They were predicted to be GST A and M substrate, JAK2 expression, ribulose-phosphate 3-epimerase, NADPH peroxidase, and glucose oxidase inhibitors. These results suggest that TCA ameliorates hyperglycaemia-induced oxidative stress and inflammation by activating Nrf-2 gene.
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Affiliation(s)
- Franklyn Nonso Iheagwam
- Department of Biochemistry, Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
- Covenant University Public Health and Wellbeing Research Cluster (CUPHWERC), Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, AlBeheira, Egypt
| | - Olubanke Olujoke Ogunlana
- Department of Biochemistry, Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
- Covenant University Public Health and Wellbeing Research Cluster (CUPHWERC), Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
| | - Shalom Nwodo Chinedu
- Department of Biochemistry, Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
- Covenant University Public Health and Wellbeing Research Cluster (CUPHWERC), Covenant University, P.M.B. 1023 Ota, Ogun State, Nigeria
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Pradeepa R, Subashini R, Venkatesan U, Ningombam S, Purty A, John M, Reang T, Luaia R, Tripathy SK, Modi S, Mokta JK, Desai A, Dash K, Deepa M, Nirmal E, Unnikrishnan R, Anjana RM, Kaur T, Dhaliwal RS, Mohan V. Effect of internal migration on diabetes and metabolic abnormalities in India - The ICMR-INDIAB study. J Diabetes Complications 2021; 35:108051. [PMID: 34607777 DOI: 10.1016/j.jdiacomp.2021.108051] [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: 08/09/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
AIMS To assess the effect of migration (rural-to-urban and vice versa) on prevalence of diabetes and metabolic disorders in Asian Indians participating in the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. MATERIALS AND METHODS The ICMR-INDIAB study is a national study on diabetes and associated cardiometabolic disorders in individuals aged ≥20 years from 28 states and 2 union territories of India. Individuals who moved to a different place from their place of birth and had resided in the new location for at least one year were considered as migrants. Anthropometric measurements, blood pressure estimation and a capillary oral glucose tolerance test were performed. RESULTS Of the 113,043 participants, 66.4% were non-migrant rural dwellers, 19.4% non-migrant urban dwellers, 8.4% rural-urban migrants, 3.8% multiple migrants and 2.0% urban-rural migrants. Weighted prevalence of diabetes was highest in rural-urban migrants followed by urban dwellers, urban-rural migrants and rural dwellers [14.7%, 13.2%, 12.7% and 7.7% respectively (p < 0.001)]. Rural-urban migrants had highest prevalence of abdominal obesity (50.5%) compared to the other three groups. The risk for diabetes was 1.9 times higher in rural-urban migrants than among rural dwellers. Five risk factors [hypertension, abdominal and generalized obesity, physical inactivity and low fruit and vegetable intake] together explained 69.8% (partial population attributable risk) of diabetes among rural-urban migrants and 66.4% among non-migrant urban dwellers. CONCLUSIONS Rural-to-urban migration is associated with increased risk of developing diabetes and other cardiometabolic abnormalities. Adoption of healthier lifestyle patterns among migrants could help prevent/delay onset of these abnormalities in this population.
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Affiliation(s)
- Rajendra Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India.
| | - Radhakrishnan Subashini
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ulagamathesan Venkatesan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | | | - Anil Purty
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Mary John
- Christian Medical College & Hospital, Ludhiana, India
| | | | | | | | - Sagar Modi
- Himalayan Institute of Medical Sciences, Dehradun, India
| | | | | | | | - Mohan Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Elangovan Nirmal
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
| | - Tanvir Kaur
- Non-Communicable Disease Division, Indian Council of Medical Research, New Delhi, India
| | | | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, ICMR Centre for Advanced Research on Diabetes, Chennai, India
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Venkateswaran MR, Vadivel TE, Jayabal S, Murugesan S, Rajasekaran S, Periyasamy S. A review on network pharmacology based phytotherapy in treating diabetes- An environmental perspective. ENVIRONMENTAL RESEARCH 2021; 202:111656. [PMID: 34265348 DOI: 10.1016/j.envres.2021.111656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/19/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
Diabetes has become common lifestyle disorder associated with obesity and cardiovascular diseases. Environmental factors like physical inactivity, polluted surroundings and unhealthy dieting also plays a vital role in diabetes pathogenesis. As the current anti-diabetic drugs possess unprecedented side effects, traditional herbal medicine can be used an alternative therapy. The paramount challenge with the herbal formulation usage is the lack of standardized procedure, entangled with little knowledge on drug safety and mechanism of drug action. Heavy metal contamination is a major environmental hazard where plants tend to accumulate toxic metals like nickel, chromium and lead through industrial and agricultural activities. It becomes inappropriate to use these plants for phytotherapy as it may affect the human health on long term consumption. This review discuss about the environmental risk factors related to diabetes and better implication of medicinal plants in anti-diabetic therapy using network pharmacology. It is an in silico analytical tool that helps to unravel the multi-targeted action of herbal formulations rich in secondary metabolites. Also, a special focus is attempted to pool the databases regarding the medicinal plants for diabetes and associated diseases, their bioactive compounds, possible diabetic targets, drug-target interaction and toxicology reports that may open an aisle in safer, effective and toxicity-free drug discovery.
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Affiliation(s)
- Meenakshi R Venkateswaran
- Department of Biotechnology, Anna University, BIT-Campus, Tiruchirappalli, 620024, Tamil Nadu, India
| | - Tamil Elakkiya Vadivel
- Department of Biotechnology, Anna University, BIT-Campus, Tiruchirappalli, 620024, Tamil Nadu, India
| | - Sasidharan Jayabal
- Department of Biotechnology, Anna University, BIT-Campus, Tiruchirappalli, 620024, Tamil Nadu, India
| | - Selvakumar Murugesan
- Department of Biotechnology, Anna University, BIT-Campus, Tiruchirappalli, 620024, Tamil Nadu, India
| | - Subbiah Rajasekaran
- Department of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Sureshkumar Periyasamy
- Department of Biotechnology, Anna University, BIT-Campus, Tiruchirappalli, 620024, Tamil Nadu, India.
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Diabetes prevalence is associated with obesity, hypertension, dyslipidemia, and sociodemographic factors in adults living in Casablanca-Settat and Rabat-Sale-Kenitra regions, Morocco. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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25
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Qian CX, Zhao Y, Anindya K, Tenneti N, Desloge A, Atun R, Qin VM, Mulcahy P, Lee JT. Non-communicable disease risk factors and management among internal migrant in China: systematic review and meta-analysis. BMJ Glob Health 2021; 6:bmjgh-2020-003324. [PMID: 34593512 PMCID: PMC8487202 DOI: 10.1136/bmjgh-2020-003324] [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: 08/06/2020] [Accepted: 06/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background In 2019, there are more than 290 million people who have ever migrated from rural to urban areas in China. These rural-to-urban internal migrants account for more than one-fifth of China’s population and is the largest internal migrant group globally. We present the first systematic review that examines whether internal migrants are more likely to exhibit non-communicable diseases (NCDs) risk factors and have worse NCD management outcomes than non-migrant counterparts in China. Methods A systematic review was conducted via medical, public health, and economic databases including Scopus, MEDLINE, JSTOR, WHO Library Database and World Bank e-Library from 2000 to 2020. Study quality was assessed using the National Institute of Health Quality Assessment tool. We conducted a narrative review and synthesised differences for all studies included, stratified by different types of outcomes. We also conducted random-effects meta-analysis where we had a minimum of two studies with 95% CIs reported. The study protocol has been registered with PROSPERO: CRD42019139407. Results For most NCD risk factors and care cascade management, comparisons between internal migrants and other populations were either statistically insignificant or inconclusive. While most studies found migrants have a higher prevalence of tobacco use than urban residents, these differences were not statistically significant in the meta-analysis. Although three out four studies suggested that migrants may have worse access to NCD treatment and both studies suggested migrants have lower blood pressure control rates than non-migrants, these findings were not statistically significant. Conclusion Findings from this systematic review demonstrate that there is currently insufficient evidence on migrant and non-migrant differences in NCD risk factors and management in China. Further research is expected to investigate access to healthcare among internal and its effect on both their NCD outcomes and long-term healthcare costs in China.
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Affiliation(s)
- Cynthia Xinyi Qian
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA .,The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yang Zhao
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Kanya Anindya
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naveen Tenneti
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Allissa Desloge
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rifat Atun
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Vicky Mengqi Qin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Patrick Mulcahy
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Tayu Lee
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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26
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Karigidi KO, Olaiya CO. Effects of Curculigo pilosa supplementation on antioxidant and antidiabetic activities of yam flour. Journal of Food Science and Technology 2021; 58:4110-4117. [PMID: 34538895 DOI: 10.1007/s13197-020-04872-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 11/30/2022]
Abstract
The practice of using nutritional knowledge to enhance the general health of the populace forms the basis of food fortification. In this study, an antioxidant-rich Curculigo pilosa is substituted (1, 3, 5 and 10%) into yam tuber flour with the aim of improving the antidiabetic and antioxidant properties of the yam tuber flour. Antioxidant property was evaluated by polyphenol contents, ascorbic acid content, reducing effects, scavenging activity and inhibition of linoleic acid peroxidation. Antidiabetic activity was assessed by inhibition of α- amylase and α- glucosidase enzymes. The antioxidant property was significantly (p < 0.05) enhanced; also, the ability of the sample to inhibit the activity of α- amylase and α- glucosidase enzymes were significantly (p < 0.05) enhanced by supplementation with Curculigo pilosa. The profiling of the samples by High Performance Liquid Chromatography revealed some proven antioxidant and antidiabetic agents which were enhanced in supplemented yam flour. It can be concluded from the results obtained in this study that Curculigo pilosa powder could be a promising functional ingredient for yam flour in the management of diabetes and other oxidant-related diseases.
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Affiliation(s)
- Kayode O Karigidi
- Nutritional and Industrial Biochemistry Research Laboratories, Department of Biochemistry, University of Ibadan, Ibadan, Nigeria.,Department of Chemical Sciences, Ondo State University of Science and Technology, Okitipupa, Akure, Nigeria
| | - Charles O Olaiya
- Nutritional and Industrial Biochemistry Research Laboratories, Department of Biochemistry, University of Ibadan, Ibadan, Nigeria
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Alsulami S, Bodhini D, Sudha V, Shanthi Rani CS, Pradeepa R, Anjana RM, Radha V, Lovegrove JA, Gayathri R, Mohan V, Vimaleswaran KS. Lower Dietary Intake of Plant Protein Is Associated with Genetic Risk of Diabetes-Related Traits in Urban Asian Indian Adults. Nutrients 2021; 13:3064. [PMID: 34578944 PMCID: PMC8466015 DOI: 10.3390/nu13093064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 01/19/2023] Open
Abstract
The increasing prevalence of type 2 diabetes among South Asians is caused by a complex interplay between environmental and genetic factors. We aimed to examine the impact of dietary and genetic factors on metabolic traits in 1062 Asian Indians. Dietary assessment was performed using a validated semi-quantitative food frequency questionnaire. Seven single nucleotide polymorphisms (SNPs) from the Transcription factor 7-like 2 and fat mass and obesity-associated genes were used to construct two metabolic genetic risk scores (GRS): 7-SNP and 3-SNP GRSs. Both 7-SNP GRS and 3-SNP GRS were associated with a higher risk of T2D (p = 0.0000134 and 0.008, respectively). The 3-SNP GRS was associated with higher waist circumference (p = 0.010), fasting plasma glucose (FPG) (p = 0.002) and glycated haemoglobin (HbA1c) (p = 0.000066). There were significant interactions between 3-SNP GRS and protein intake (% of total energy intake) on FPG (Pinteraction = 0.011) and HbA1c (Pinteraction = 0.007), where among individuals with lower plant protein intake (<39 g/day) and those with >1 risk allele had higher FPG (p = 0.001) and HbA1c (p = 0.00006) than individuals with ≤1 risk allele. Our findings suggest that lower plant protein intake may be a contributor to the increased ethnic susceptibility to diabetes described in Asian Indians. Randomised clinical trials with increased plant protein in the diets of this population are needed to see whether the reduction of diabetes risk occurs in individuals with prediabetes.
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Affiliation(s)
- Sooad Alsulami
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (S.A.); (J.A.L.)
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Dhanasekaran Bodhini
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai 603103, India; (D.B.); (V.R.)
| | - Vasudevan Sudha
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (V.S.); (R.G.)
| | | | - Rajendra Pradeepa
- Department of Diabetology, Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai 600086, India; (R.P.); (R.M.A.); (V.M.)
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai 600086, India; (R.P.); (R.M.A.); (V.M.)
| | - Venkatesan Radha
- Department of Molecular Genetics, Madras Diabetes Research Foundation, Chennai 603103, India; (D.B.); (V.R.)
| | - Julie A. Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (S.A.); (J.A.L.)
| | - Rajagopal Gayathri
- Department of Foods, Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai 600086, India; (V.S.); (R.G.)
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation & Dr. Mohan’s Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai 600086, India; (R.P.); (R.M.A.); (V.M.)
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK; (S.A.); (J.A.L.)
- The Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading RG6 6AP, UK
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Leyns CC, Couvreur N, Willems S, Van Hecke A. Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: a people-centred perspective. Int J Equity Health 2021; 20:104. [PMID: 33879174 PMCID: PMC8056633 DOI: 10.1186/s12939-021-01442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met. METHODS From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health. RESULTS The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs. CONCLUSIONS This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people's worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.
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Affiliation(s)
- Christine Cécile Leyns
- Fundación Vida Plena, Juan Capriles 346, Cochabamba, Bolivia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Niek Couvreur
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- University Center for Nursing and Midwifery, Ghent University Hospital, Ghent, Belgium
| | - Sara Willems
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- University Center for Nursing and Midwifery, Ghent University Hospital, Ghent, Belgium
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Braverman-Bronstein A, Hessel P, González-Uribe C, Kroker MF, Diez-Canseco F, Langellier B, Lucumi DI, Rodríguez Osiac L, Trotta A, Diez Roux AV. Association of education level with diabetes prevalence in Latin American cities and its modification by city social environment. J Epidemiol Community Health 2021; 75:874-880. [PMID: 33542029 PMCID: PMC7611487 DOI: 10.1136/jech-2020-216116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/14/2021] [Accepted: 01/23/2021] [Indexed: 11/30/2022]
Abstract
Background Diabetes prevalence continues to increase in urban areas of low-income and middle-income countries (LMIC). Evidence from high-income countries suggests an inverse association between educational attainment and diabetes, but research in LMIC is limited. We investigated educational differences in diabetes prevalence across 232 Latin American (LA) cities, and the extent to which these inequities vary across countries/cities and are modified by city socioeconomic factors. Methods Using harmonised health survey and census data for 110 498 city dwellers from eight LA countries, we estimated the association between education and diabetes. We considered effect modification by city Social Environment Index (SEI) as a proxy for city-level development using multilevel models, considering heterogeneity by sex and country. Results In women, there was an inverse dose–response relationship between education and diabetes (OR: 0.80 per level increase in education, 95% CI 0.75 to 0.85), consistent across countries and not modified by SEI. In men, Argentina, Brazil, Colombia, Chile and Mexico showed an inverse association (pooled OR: 0.92; 95% CI 0.86 to 0.99). Peru, Panama and El Salvador showed a positive relationship (pooled OR 1.24; 95% CI 1.04 to 1.49). For men, these associations were further modified by city-SEI: in countries with an inverse association, it became stronger as city-SEI increased. In countries where the association was positive, it became weaker as city-SEI increased. Conclusion Social inequities in diabetes inequalities increase as cities develop. To achieve non-communicable disease-related sustainable development goals in LMIC, there is an urgent need to develop policies aimed at reducing these educational inequities.
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Affiliation(s)
| | - Philipp Hessel
- School of Government, Universidad de los Andes, Bogota, Colombia
| | | | - Maria F Kroker
- INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Francisco Diez-Canseco
- CRONICAS, Center of Excellence in Chronic Diseases, University Peruana Cayetano Heredia, Lima, Peru
| | - Brent Langellier
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Diego I Lucumi
- School of Government, Universidad de los Andes, Bogota, Colombia
| | | | - Andrés Trotta
- Institute of Collective Health, National University of Lanus, Buenos Aires, Argentina
| | - Ana V Diez Roux
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
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30
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De la Fuente F, Saldías MA, Cubillos C, Mery G, Carvajal D, Bowen M, Bertoglia MP. Green Space Exposure Association with Type 2 Diabetes Mellitus, Physical Activity, and Obesity: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010097. [PMID: 33375559 PMCID: PMC7796153 DOI: 10.3390/ijerph18010097] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/12/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a public health challenge that must be addressed considering the large number of risk factors involved in its appearance. Some environmental risk factors are currently described as predictors of diabetes, with access to green spaces being an element to consider in urban settings. This review aims to study the association between exposure to green spaces and outcomes such as diabetes, obesity, and physical activity in the general population. A systematic review was carried out using the PubMed, Embase, and LILACS databases and other sources. The search strategy was carried out from October 2019 to October 2020. Cross-sectional and cohort studies were included. The article selection was made by a pair of reviewers, and data extraction was carried out using a data extraction sheet. The quality assessment of the included studies was carried out using a validated tool. Finally, 19 scientific articles were included in this review. Evidence supports that people and communities exposed to green spaces, especially in their neighborhood, reduce the risk of T2DM and reduce the risk of being obese and increase the likelihood of physical activity. The onset of T2DM can be moderated by using green spaces, improving physical activity levels, and reducing the risk of being overweight and obese.
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Affiliation(s)
- Felipe De la Fuente
- Nursing Department, University of Chile, Santiago 8320000, Chile; (F.D.l.F.); (M.A.S.); (C.C.); (G.M.); (D.C.)
| | - María Angélica Saldías
- Nursing Department, University of Chile, Santiago 8320000, Chile; (F.D.l.F.); (M.A.S.); (C.C.); (G.M.); (D.C.)
| | - Camila Cubillos
- Nursing Department, University of Chile, Santiago 8320000, Chile; (F.D.l.F.); (M.A.S.); (C.C.); (G.M.); (D.C.)
| | - Gabriela Mery
- Nursing Department, University of Chile, Santiago 8320000, Chile; (F.D.l.F.); (M.A.S.); (C.C.); (G.M.); (D.C.)
| | - Daniela Carvajal
- Nursing Department, University of Chile, Santiago 8320000, Chile; (F.D.l.F.); (M.A.S.); (C.C.); (G.M.); (D.C.)
| | - Martín Bowen
- Medical School, University of Chile, Santiago 8320000, Chile;
| | - María Paz Bertoglia
- School of Public Health, University of Chile, Santiago 8320000, Chile
- Correspondence:
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31
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Mobegi FM, Leong LE, Thompson F, Taylor SM, Harriss LR, Choo JM, Taylor SL, Wesselingh SL, McDermott R, Ivey KL, Rogers GB. Intestinal microbiology shapes population health impacts of diet and lifestyle risk exposures in Torres Strait Islander communities. eLife 2020; 9:58407. [PMID: 33074097 PMCID: PMC7572126 DOI: 10.7554/elife.58407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/29/2020] [Indexed: 02/02/2023] Open
Abstract
Poor diet and lifestyle exposures are implicated in substantial global increases in non-communicable disease burden in low-income, remote, and Indigenous communities. This observational study investigated the contribution of the fecal microbiome to influence host physiology in two Indigenous communities in the Torres Strait Islands: Mer, a remote island where a traditional diet predominates, and Waiben a more accessible island with greater access to takeaway food and alcohol. Counterintuitively, disease markers were more pronounced in Mer residents. However, island-specific differences in disease risk were explained, in part, by microbiome traits. The absence of Alistipes onderdonkii, for example, significantly (p=0.014) moderated island-specific patterns of systolic blood pressure in multivariate-adjusted models. We also report mediatory relationships between traits of the fecal metagenome, disease markers, and risk exposures. Understanding how intestinal microbiome traits influence response to disease risk exposures is critical for the development of strategies that mitigate the growing burden of cardiometabolic disease in these communities.
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Affiliation(s)
- Fredrick M Mobegi
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,SAHMRI Microbiome Research Laboratory, School of Medicine, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Lex Ex Leong
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Fintan Thompson
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Australia
| | - Sean M Taylor
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Australia
| | - Linton R Harriss
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Australia
| | - Jocelyn M Choo
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,SAHMRI Microbiome Research Laboratory, School of Medicine, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Steven L Taylor
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,SAHMRI Microbiome Research Laboratory, School of Medicine, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Steve L Wesselingh
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn McDermott
- Centre for Chronic Disease Prevention, Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Australia.,School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Kerry L Ivey
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, United States.,Department of Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Geraint B Rogers
- Microbiome and Host Health Programme, South Australian Health and Medical Research Institute, Adelaide, Australia.,SAHMRI Microbiome Research Laboratory, School of Medicine, College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Dany F, Dewi RM, Tjandrarini DH, Pradono J, Delima D, Sariadji K, Handayani S, Kusumawardani N. Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a cross-sectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals. BMC Public Health 2020; 20:1509. [PMID: 33023540 PMCID: PMC7539503 DOI: 10.1186/s12889-020-09592-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/22/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to identify urban-rural differences in potential determinants for prediabetes in Indonesia. METHODS This analysis used secondary data collected from nationwide Health Survey in 2018. Respondents were aged ≥15 years who met inclusion criteria of analysis with no history of diabetes mellitus. Prediabetes criteria followed American Diabetes Association 2019. Multiple logistic regression was also employed to assess the transition probability of potential determinants for prediabetes in urban and rural Indonesia. RESULTS Up to 44.8% of rural respondents were prediabetics versus their urban counterparts at 34.9%, yet non-response bias was observed in the two. Young adults aged 30 years were already at risk of prediabetes. Urban-rural distinction for marital status and triglyceride level was observed while other determinants tended to overlap across residence. Several modifiable factors might contribute differently in both population with careful interpretation. CONCLUSIONS The minimum age limit for early prediabetes screening may start from 30 years old in Indonesia. Urban-rural distinction for marital status and triglyceride level was observed, yet non-response bias between the two groups could not be excluded. A proper model for early prediabetes screening need to be developed from a cohort study with adequate sample size.
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Affiliation(s)
- Frans Dany
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia.
| | - Rita Marleta Dewi
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Dwi Hapsari Tjandrarini
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Julianty Pradono
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Delima Delima
- Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Kambang Sariadji
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Sarwo Handayani
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Nunik Kusumawardani
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
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33
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Dany F, Dewi RM, Tjandrarini DH, Pradono J, Delima D, Sariadji K, Handayani S, Kusumawardani N. Urban-rural distinction of potential determinants for prediabetes in Indonesian population aged ≥15 years: a cross-sectional analysis of Indonesian Basic Health Research 2018 among normoglycemic and prediabetic individuals. BMC Public Health 2020. [PMID: 33023540 DOI: 10.1186/s12889-020-09592-7/peer-review] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Based on Basic Health Research (RISKESDAS) conducted by Ministry of Health, Indonesia, prediabetes prevalence tends to increase from 2007 until 2018. The numbers are relatively higher in rural than those in urban area despite of small discrepancies between the two (~ 2-4%). The purpose of this study was to identify urban-rural differences in potential determinants for prediabetes in Indonesia. METHODS This analysis used secondary data collected from nationwide Health Survey in 2018. Respondents were aged ≥15 years who met inclusion criteria of analysis with no history of diabetes mellitus. Prediabetes criteria followed American Diabetes Association 2019. Multiple logistic regression was also employed to assess the transition probability of potential determinants for prediabetes in urban and rural Indonesia. RESULTS Up to 44.8% of rural respondents were prediabetics versus their urban counterparts at 34.9%, yet non-response bias was observed in the two. Young adults aged 30 years were already at risk of prediabetes. Urban-rural distinction for marital status and triglyceride level was observed while other determinants tended to overlap across residence. Several modifiable factors might contribute differently in both population with careful interpretation. CONCLUSIONS The minimum age limit for early prediabetes screening may start from 30 years old in Indonesia. Urban-rural distinction for marital status and triglyceride level was observed, yet non-response bias between the two groups could not be excluded. A proper model for early prediabetes screening need to be developed from a cohort study with adequate sample size.
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Affiliation(s)
- Frans Dany
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia.
| | - Rita Marleta Dewi
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Dwi Hapsari Tjandrarini
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Julianty Pradono
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Delima Delima
- Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Kambang Sariadji
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Sarwo Handayani
- Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
| | - Nunik Kusumawardani
- Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta Pusat, Jakarta, Indonesia
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Venn BJ. Macronutrients and Human Health for the 21st Century. Nutrients 2020; 12:E2363. [PMID: 32784664 PMCID: PMC7468865 DOI: 10.3390/nu12082363] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
Fat, protein and carbohydrate are essential macronutrients. Various organisations have made recommendations as to the energy contribution that each of these components makes to our overall diet. The extent of food refining and the ability of food systems to support future populations may also impact on how macronutrients contribute to our diet. In this Special Issue, we are calling for manuscripts from all disciplines to provide a broad-ranging discussion on macronutrients and health from personal, public and planetary perspectives.
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Affiliation(s)
- Bernard J Venn
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
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35
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Janjani H, Nabizadeh R, Shamsipour M, Yunesian M. Association between exposure to ambient fine particulate matter and prevalence of type 2 diabetes in Iran: an ecological study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:26182-26190. [PMID: 32361975 DOI: 10.1007/s11356-020-08659-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological evidence for the link between long-term exposure to air particulate matter (PM2.5) and occurrence of type 2 diabetes (T2D) is limited such that little is known about the effect of PM2.5 exposure and adult T2D prevalence. Thus, the aim of this ecological study is to evaluate the contribution of ambient PM2.5 exposure to the adult T2D prevalence in the large population of Iran. The study was conducted based on Iran's large-scale cross-sectional surveilling non-communicable diseases (NCDs) risk factors (Timpka et al. 2015b). A total of 31,050 participants were enrolled in three sequential processes of study using cluster random sampling. PM2.5 data in the urban area of 31 provinces of Iran were acquired from Tehran Air Quality Control Company (AQCC) and the Department of Environment (DoE) of Iran during 2012-2016. Moreover, major and minor diabetes risk factors were considered; the Pearson correlation and a stepwise regression model were performed to estimate associations between risk factors and diabetes and prediabetes prevalence. The results showed T2D prevalence was more frequent among women (10.61%) than men (9.35%). A weak positive correlation was observed between PM2.5 level and diabetes prevalence with a correlation coefficient of 0.275, although there was no significant association between PM2.5 value and prediabetes prevalence. Moreover, none of the variables included in the regression model could predict the prevalence of diabetes and prediabetes. According to our study results, it can be suggested that investigating the association between PM2.5 exposure and T2D prevalence at individual level may provide a better understanding of PM2.5 exposure and the risk of T2D prevalence.
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Affiliation(s)
- Hosna Janjani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
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Opazo-Ríos L, Plaza A, Sánchez Matus Y, Bernal S, Lopez-Sanz L, Jimenez-Castilla L, Carpio D, Droguett A, Mezzano S, Egido J, Gomez-Guerrero C. Targeting NF-κB by the Cell-Permeable NEMO-Binding Domain Peptide Improves Albuminuria and Renal Lesions in an Experimental Model of Type 2 Diabetic Nephropathy. Int J Mol Sci 2020; 21:ijms21124225. [PMID: 32545818 PMCID: PMC7352510 DOI: 10.3390/ijms21124225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Diabetic nephropathy (DN) is a multifactorial disease characterized by hyperglycemia and close interaction of hemodynamic, metabolic and inflammatory factors. Nuclear factor-κB (NF-κB) is a principal matchmaker linking hyperglycemia and inflammation. The present work investigates the cell-permeable peptide containing the inhibitor of kappa B kinase γ (IKKγ)/NF-κB essential modulator (NEMO)-binding domain (NBD) as therapeutic option to modulate inflammation in a preclinical model of type 2 diabetes (T2D) with DN. Black and tan, brachyuric obese/obese mice were randomized into 4 interventions groups: Active NBD peptide (10 and 6 µg/g body weight); Inactive mutant peptide (10 µg/g); and vehicle control. In vivo/ex vivo fluorescence imaging revealed efficient delivery of NBD peptide, systemic biodistribution and selective renal metabolization. In vivo administration of active NBD peptide improved albuminuria (>40% reduction on average) and kidney damage, decreased podocyte loss and basement membrane thickness, and modulated the expression of proinflammatory and oxidative stress markers. In vitro, NBD blocked IKK-mediated NF-κB induction and target gene expression in mesangial cells exposed to diabetic-like milieu. These results constitute the first nephroprotective effect of NBD peptide in a T2D mouse model that recapitulates the kidney lesions observed in DN patients. Targeting IKK-dependent NF-κB activation could be a therapeutic strategy to combat kidney inflammation in DN.
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Affiliation(s)
- Lucas Opazo-Ríos
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
| | - Anita Plaza
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
| | - Yenniffer Sánchez Matus
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
| | - Susana Bernal
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
| | - Laura Lopez-Sanz
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
| | - Luna Jimenez-Castilla
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
| | - Daniel Carpio
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
| | - Alejandra Droguett
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
| | - Sergio Mezzano
- Division of Nephrology, School of Medicine, Universidad Austral de Chile, 5090000 Valdivia, Chile; (L.O.-R.); (A.P.) (Y.S.M.); (D.C.); (A.D.); (S.M.)
| | - Jesús Egido
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
| | - Carmen Gomez-Guerrero
- Renal, Vascular and Diabetes Research Laboratory, IIS-Fundación Jiménez Díaz Universidad Autónoma de Madrid, Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), 28040 Madrid, Spain; (S.B.); (L.L.-S.); (L.J.-C.); (J.E.)
- Correspondence: or
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Dennis M, Cook PA, James P, Wheater CP, Lindley SJ. Relationships between health outcomes in older populations and urban green infrastructure size, quality and proximity. BMC Public Health 2020; 20:626. [PMID: 32375720 PMCID: PMC7201616 DOI: 10.1186/s12889-020-08762-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/22/2020] [Indexed: 01/03/2023] Open
Abstract
Background There is a growing body of literature supporting positive associations between natural environments and better health. The type, quality and quantity of green and blue space (‘green-space’) in proximity to the home might be particularly important for less mobile populations, such as for some older people. However, considerations of measurement and definition of green-space, beyond single aggregated metrics, are rare. This constitutes a major source of uncertainty in current understanding of public health benefits derived from natural environments. We aimed to improve our understanding of how such benefits are conferred to different demographic groups through a comprehensive evaluation of the physical and spatial characteristics of urban green infrastructure. Methods We employed a green infrastructure (GI) approach combining a high-resolution spatial dataset of land-cover and function with area-level demographic and socio-economic data. This allowed for a comprehensive characterization of a densely populated, polycentric city-region. We produced multiple GI attributes including, for example, urban vegetation health. We used a series of step-wise multi-level regression analyses to test associations between population chronic morbidity and the functional, physical and spatial components of GI across an urban socio-demographic gradient. Results GI attributes demonstrated associations with health in all socio-demographic contexts even where associations between health and overall green cover were non-significant. Associations varied by urban socio-demographic group. For areas characterised by having higher proportions of older people (‘older neighbourhoods’), associations with better health were exhibited by land-cover diversity, informal greenery and patch size in high income areas and by proximity to public parks and recreation land in low income areas. Quality of GI was a significant predictor of good health in areas of low income and low GI cover. Proximity of publicly accessible GI was also significant. Conclusions The influence of urban GI on population health is mediated by green-space form, quantity, accessibility, and vegetation health. People in urban neighbourhoods that are characterised by lower income and older age populations are disproportionately healthy if their neighbourhoods contain accessible, good quality public green-space. This has implications for strategies to decrease health inequalities and inform international initiatives, such as the World Health Organisation’s Age-Friendly Cities programme.
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Affiliation(s)
- Matthew Dennis
- Department of Geography, School of Environment Education and Development, University of Manchester, Arthur Lewis Building, Manchester, M13 9PL, UK.
| | - Penny A Cook
- School of Health and Society, University of Salford, The Crescent, Allerton Building, Salford, M5 4WT, UK
| | - Philip James
- School of Science, Engineering and Environment, University of Salford, The Crescent, Peel Building, Salford, M5 4WT, UK
| | - C Philip Wheater
- School of Science and the Environment, Manchester Metropolitan University, Chester Street, John Dalton Building, Manchester, M1 5GD, UK
| | - Sarah J Lindley
- Department of Geography, School of Environment Education and Development, University of Manchester, Arthur Lewis Building, Manchester, M13 9PL, UK
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Tuan Kiet Pham H, Tuyet Mai Kieu T, Duc Duong T, Dieu Van Nguyen K, Tran NQ, Hung Tran T, Yi Siu Ng J. Direct medical costs of diabetes and its complications in Vietnam: A national health insurance database study. Diabetes Res Clin Pract 2020; 162:108051. [PMID: 32027924 DOI: 10.1016/j.diabres.2020.108051] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/21/2020] [Accepted: 01/31/2020] [Indexed: 01/22/2023]
Abstract
AIM To estimate the direct medical cost of type 2 diabetes mellitus (T2DM) and its complications in Vietnam. METHODS Using the public payer perspective, the direct medical cost was estimated using routine data in the national claims database in Vietnam in 2017. People were identified as being diagnosed with T2DM if they were aged ≥ 30 years and who either (1) had at least one ICD-10 code E11 or (2) had been prescribed with oral antihyperglycemic medication on two separate visit records. The Diabetes Severity Complications Index was used to assess the presence of diabetes-related complications. All costs were standardized to 2017 United States dollars (USD). RESULTS Of the 1,395,204 people identified with T2DM, 55% had diabetes-related complications. The most common complication was cardiovascular diseases (34%). The total direct medical cost was USD 435 million, of which 24% was spent on hospitalization, 20% on outpatient care, 7% on emergency care, 36% on non-diabetes-related medication, and 13% on antihyperglycemic medication. About 70% of the total direct medical costs were attributed to diabetes-related complications. CONCLUSION The high proportion of hospitalization and complications costs in Vietnam suggests that the possibility exists to make economic savings through better preventative care.
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Affiliation(s)
| | - Thi Tuyet Mai Kieu
- Department of Pharmaceutical Management and Pharmacoeconomics, Hanoi University of Pharmacy, Viet Nam
| | - Tuan Duc Duong
- North Center for Medical Review and Tertiary Care Payment, Vietnam Social Security, Viet Nam
| | | | - Nam Quang Tran
- Department of Endocrinology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Tien Hung Tran
- North Center for Medical Review and Tertiary Care Payment, Vietnam Social Security, Viet Nam
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Age and gender influence healthy eating and physical activity behaviours in South African adolescents and their caregivers: Transforming Adolescent Lives through Nutrition Initiative (TALENT). Public Health Nutr 2019; 24:5187-5206. [DOI: 10.1017/s1368980019002829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract
Objective:
To: (i) understand facilitators and barriers to healthy eating practices and physical activity in younger and older urban adolescent South African boys and girls; and (ii) understand how the views of caregivers interact with, and influence, adolescent behaviours.
Design:
Semi-structured focus group discussions (FGD) were conducted in July 2018. Data were analysed using thematic analysis.
Setting:
Soweto, Johannesburg, South Africa.
Participants:
Seventy-five participants were stratified into eight FGD as follows: two for young boys and girls (10–12 years); two for older boys and girls (15–17 years); two for caregivers of young adolescents (boys and girls); and two for caregivers of older adolescents (boys and girls).
Results:
Unlike their caregivers, adolescents were not motivated to eat healthily and failed to appreciate the need to develop consistent patterns of both healthy eating and physical activity for their long-term health. Although adolescents gained independence with age, they commonly attributed unhealthy food choices to a lack of autonomy and, thereby, to the influence of their caregivers. Adolescents and caregivers perceived their engagement in physical activity according to distinct siloes of recreational and routine activity, respectively. Both similarities and differences in the drivers of healthy eating and physical activity exist in adolescents and caregivers, and should be targeted in future interventions.
Conclusions:
Our study identified a complex paradigm of eating practices and physical activity in South African adolescents and their caregivers. We also highlighted the need for a new narrative in addressing the multifaceted and interrelated determinants of adolescent health within urban poor settings.
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Dietary patterns and practices in rural eastern Uganda: Implications for prevention and management of type 2 diabetes. Appetite 2019; 143:104409. [PMID: 31445996 DOI: 10.1016/j.appet.2019.104409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 07/30/2019] [Accepted: 08/17/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND The burden of type 2 diabetes in Sub-Saharan Africa is projected to double by 2040, partly attributable to rapidly changing diets. In this paper, we analysed how community members in rural Uganda understood the concept of a healthy or unhealthy diet, food preparation and serving practices to inform the process of facilitating knowledge and skill necessary for self-management and care for type 2 diabetes. This was a qualitative study involving 20 focus group discussions and eight in-depth interviews among those at risk, patients with type 2 diabetes and the general community members without diabetes mellitus. Data was coded and entered into Atlas ti version 7.5.12 and interpreted using thematic analysis. We identified three main themes, which revealed, the perceptions on food and diet concerning health; the social dimensions of food and influence on diet practices; and food as a gendered activity. Participants noted that eating and cooking practices resulted in unhealthy diets. Their practices were affected by beliefs, poverty and food insecurity. Women determined which foods to prepare, but men prepared only some of the foods such as delicacies like a rice dish "pilau." New commercial and processed foods were increasingly available and consumed even in rural areas. Participants linked signs and symptoms of illness to diet as they narrated changes from past to current food preparation behaviours. Their view of overweight and obesity was also gendered and linked to social status. Participants' perception of disease influenced by diet was similar among those with and without type 2 diabetes, and those at risk. People described what is a healthy diet was as recommended by the health workers, but stated that their practices differed greatly from their knowledge. There was high awareness about healthy and balanced diets, but food is entrenched within social and gendered paradigms, which are slowly changing. Social and gender dimensions of food will need to be addressed through interventions in communities to promote change on a society level.
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Dennis M, Scaletta KL, James P. Evaluating urban environmental and ecological landscape characteristics as a function of land-sharing-sparing, urbanity and scale. PLoS One 2019; 14:e0215796. [PMID: 31344035 PMCID: PMC6657829 DOI: 10.1371/journal.pone.0215796] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/10/2019] [Indexed: 01/21/2023] Open
Abstract
Within urban landscape planning, debate continues around the relative merits of land-sharing (sprawl) and land-sparing (compaction) scenarios. Using three of the ten districts in Greater Manchester (UK) as a case-study, we present a landscape approach to mapping green infrastructure and variation in social-ecological-environmental conditions as a function of land sharing and sparing. We do so for the landscape as a whole and in a more focussed approach for areas of high and low urbanity. Results imply potential trade-offs between land-sharing-sparing scenarios relevant to characteristics critical to urban resilience such as landscape connectivity and diversity, air quality, surface temperature, and access to green space. These trade-offs are complex due to the parallel influence of patch attributes such as land-cover and size and imply that both ecological restoration and spatial planning have a role to play in reconciling tensions between land-sharing and sparing strategies.
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Affiliation(s)
- Matthew Dennis
- Department of Geography, School of Environment Education and Development, University of Manchester, Manchester, United Kingdom
- * E-mail:
| | - Katherine L. Scaletta
- School of Science, Engineering and Environment, University of Salford, The Crescent, Salford, United Kingdom
| | - Philip James
- School of Science, Engineering and Environment, University of Salford, The Crescent, Salford, United Kingdom
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Exploring Differences in the Rate of Type 2 Diabetes Among American Cities: How Urbanization Continues to Challenge the Traditional Epidemiological View. URBAN SCIENCE 2019. [DOI: 10.3390/urbansci3020053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
As the world’s largest urban regions continue to expand, a concomitant rise in non-communicable diseases, particularly type 2 diabetes, poses an increasingly ominous challenge to experts in the field of public health. Given that the majority of the world’s population (54%) resides in urban areas, a figure likely to reach two-thirds by 2050, this issue presents serious implications for medical practitioners as well as policymakers seeking to manage long-term healthcare costs while sustaining historic increases in life expectancy. To explore how these trends are continuing to affect the United States, a multiple regression analysis was conducted using data provided by the Centers for Disease Control and Prevention (CDC) through their initiative, 500 Cities: Local Data for Better Health. The regression models revealed that larger cities reported significantly higher rates of type 2 diabetes even after controlling for variables that have been perennially linked to disease onset (e.g., levels of obesity, sedentary behavior). Implications are discussed, most notably the argument for moving beyond the ‘food desert’ paradigm when identifying and explaining which characteristics of larger cities place their residents at increased risk. This approach could help reveal opportunities for intervention that may not have garnered sufficient attention in the extant literature.
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Assaad Khalil SH, Abdelaziz SI, Al Shammary A, Al Zahrani A, Amir A, Elkafrawy N, Hassoun AA, Hostalek U, Jahed A, Jarrah N, Mrabeti S, Paruk I, Zilov AV. Prediabetes management in the Middle East, Africa and Russia: Current status and call for action. Diab Vasc Dis Res 2019; 16:213-226. [PMID: 30606039 DOI: 10.1177/1479164118819665] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Most data on the burden of diabetes and prediabetes are from countries where local infrastructure can support reliable estimates of the burden of non-communicable diseases. Countries in the Middle East and Africa, together with Russia, have a total population of almost 2 billion, but have been relatively overlooked by authors in this field. We reviewed the prevalence and drivers of prediabetes and diabetes across this large region. A large, and variable, burden of dysglycaemia exists, especially in Middle Eastern and North African countries, associated with high levels of obesity and sedentariness, with a generally lower prevalence in most other parts of Africa. The design and size of studies are highly variable, and more research to quantify the scale of the problem is needed. Local barriers to care relating to issues concerned with gender, consanguinity, lack of understanding of diabetes, lack of understanding of obesity as a health issue, and limited resource at a national level for tracking and intervention for diabetes and other non-communicable diseases. Lifestyle interventions with proven local cost-effectiveness, enhanced access to pharmacologic intervention, and societal interventions to promote better diet and more activity will be an important element in strategies to combat these adverse trends.
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Affiliation(s)
- Samir Helmy Assaad Khalil
- 1 Unit of Diabetology, Lipidology & Metabolism, Department of Internal Medicine, Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sulaf Ibrahim Abdelaziz
- 2 Department of Internal Medicine and Endocrinology, Soba University Hospital, University of Khartoum, Khartoum, Sudan
| | - Affaf Al Shammary
- 3 International Health Department, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
| | - Ali Al Zahrani
- 4 Medicine and Molecular Endocrinology Section, Department of Molecular Oncology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - Ashraf Amir
- 5 Department of Family Medicine, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Nabil Elkafrawy
- 6 Egyptian National Committee of Diabetes, Department of Internal Medicine and Diabetology, Menoufia University, Al Menoufia, Egypt
| | | | | | - Adel Jahed
- 9 Diabetes Education Advisory Committee, Gabric Diabetes Education Association, Tehran, Iran
- 10 Tehran General Hospital, Tehran, Iran
| | - Nadim Jarrah
- 11 Internal Medicine Department, The Specialty Hospital, Amman, Jordan
| | | | - Imran Paruk
- 13 University of KwaZulu-Natal, Durban, South Africa
| | - Alexey V Zilov
- 14 Department of Endocrinology, Sechenov's First Moscow Medical University, Moscow, Russia
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Abstract
PURPOSE OF REVIEW Mood disorders are highly prevalent and represent a leading cause of global disability. Urbanization holds great public health implications spanning various environmental, lifestyle behavioural, economic and social domains. Underlying risk factors for mood disorders are heterogeneous but the psychiatric literature has extended beyond individual-level risk, to account for population-level environment and social-related precursors to mental ill health. This review summarizes recent studies published since 2017 examining the impact of urbanization and associated environmental, social and lifestyle risks for mood disorders, specifically depression. RECENT FINDINGS All identified studies examined depression or subclinical mood-related symptomatology. Recent evidence suggests individuals residing in urban areas experience increased risk of depression. Mechanistic pathways include increased exposure to noise, light and air pollution, poor quality housing, reduced diet quality, physical inactivity, economic strain and diminished social networks. The role of the gut microbiome in the development of mood disorders represents a novel research domain expected to hold potential for the psychiatric and environmental field. Further research is needed to extrapolate the relationship between increased sedentary lifestyles and technology use and depression in urban societies. SUMMARY Recent evidence highlights the complexity and reciprocity of underlying driving factors in the relationship between urbanization and mood disorders. Future epidemiological research should continue to untangle such complexity. There was a dearth of evidence relating to urbanization and mood disorders other than depression. Future research should identify the unique experiences of vulnerable subgroups who experience disproportionate increased risk of adverse health experiences associated with urbanization.
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Hou B, Nazroo J, Banks J, Marshall A. Are cities good for health? A study of the impacts of planned urbanization in China. Int J Epidemiol 2019; 48:1083-1090. [DOI: 10.1093/ije/dyz031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Urbanization in developing countries is usually accompanied by migration to cities, making it a challenge to unpack the independent relationships between migration, urbanization and health, particularly in the presence of health-selective migration. Since 1978, unprecedented planned urbanization has taken place in China and further increases to the urban population are expected. This paper explored the impacts of urbanization in China through a comparative study of in situ urbanized population.
Methods
Using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset for people aged 45 years or older, we compared self-assessed general health, depressive symptoms and waist circumference among three groups: (i) in situ urbanized-rural residents; (ii) rural residents; and (iii) urban residents. Using a model informed by the literature on the social determinants of health in later life, we investigated the patterning and drivers of differences in health outcomes between these three groups, in order to explore the impact of urbanization independent of the impact of migration.
Results
There are consistent advantages in health and less depression among urbanized-rural residents compared with the rural group; and this group has even better health outcomes than the urban group after adjusting for early life differences. However, this relationship is reversed for waist circumference. Socioeconomic circumstances and factors related to a planned urbanization partly explain these effects.
Conclusions
Urbanization in China has, on average, had an independent and positive effect on health and well-being. Planned urbanization could benefit people’s health in developing countries. It is likely that improved infrastructure is a key driver.
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Affiliation(s)
- Bo Hou
- National School of Development, Peking University, Beijing, China
| | - James Nazroo
- Sociology Department
- Manchester Institute for Collaborative Research on Ageing
- Cathie Marsh Institute for Social Research
| | - James Banks
- Economics Department, School of Social Sciences, University of Manchester, Manchester, UK
- Institute for Fiscal Studies, London, UK
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
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Bönhof GJ, Herder C, Strom A, Papanas N, Roden M, Ziegler D. Emerging Biomarkers, Tools, and Treatments for Diabetic Polyneuropathy. Endocr Rev 2019; 40:153-192. [PMID: 30256929 DOI: 10.1210/er.2018-00107] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/23/2018] [Indexed: 12/12/2022]
Abstract
Diabetic neuropathy, with its major clinical sequels, notably neuropathic pain, foot ulcers, and autonomic dysfunction, is associated with substantial morbidity, increased risk of mortality, and reduced quality of life. Despite its major clinical impact, diabetic neuropathy remains underdiagnosed and undertreated. Moreover, the evidence supporting a benefit for causal treatment is weak at least in patients with type 2 diabetes, and current pharmacotherapy is largely limited to symptomatic treatment options. Thus, a better understanding of the underlying pathophysiology is mandatory for translation into new diagnostic and treatment approaches. Improved knowledge about pathogenic pathways implicated in the development of diabetic neuropathy could lead to novel diagnostic techniques that have the potential of improving the early detection of neuropathy in diabetes and prediabetes to eventually embark on new treatment strategies. In this review, we first provide an overview on the current clinical aspects and illustrate the pathogenetic concepts of (pre)diabetic neuropathy. We then describe the biomarkers emerging from these concepts and novel diagnostic tools and appraise their utility in the early detection and prediction of predominantly distal sensorimotor polyneuropathy. Finally, we discuss the evidence for and limitations of the current and novel therapy options with particular emphasis on lifestyle modification and pathogenesis-derived treatment approaches. Altogether, recent years have brought forth a multitude of emerging biomarkers reflecting different pathogenic pathways such as oxidative stress and inflammation and diagnostic tools for an early detection and prediction of (pre)diabetic neuropathy. Ultimately, these insights should culminate in improving our therapeutic armamentarium against this common and debilitating or even life-threatening condition.
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Affiliation(s)
- Gidon J Bönhof
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, Munich-Neuherberg, Neuherberg, Partner Düsseldorf, Düsseldorf, Germany.,Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Alexander Strom
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, Munich-Neuherberg, Neuherberg, Partner Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Papanas
- Second Department of Internal Medicine, Diabetes Center, Diabetic Foot Clinic, Democritus University of Thrace, Alexandroupolis, Greece
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, Munich-Neuherberg, Neuherberg, Partner Düsseldorf, Düsseldorf, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, Munich-Neuherberg, Neuherberg, Partner Düsseldorf, Düsseldorf, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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