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Meer R, Romero Prats ML, Vervloet MG, van der Schouw YT, de Jong PA, Beulens JWJ. The effect of six-month oral vitamin K supplementation on calcification propensity time in individuals with type 2 diabetes mellitus: A post hoc analysis of a randomized, double-blind, placebo-controlled trial. Atherosclerosis 2024; 394:117307. [PMID: 37852868 DOI: 10.1016/j.atherosclerosis.2023.117307] [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: 04/26/2023] [Revised: 06/26/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND AIMS Experimental studies suggested that vitamin K supplementation may retard arterial calcification. Recently, serum calcification propensity time (T50) has been suggested as a functional biomarker for arterial wall calcification propensity. In this post-hoc analysis of a clinical trial, we evaluated the effect of six-month oral vitamin K supplementation on T50 and assessed the correlation between T50 and imaging arterial calcification parameters in people with type 2 diabetes (T2DM). METHODS This double-blind, randomized, placebo-controlled trial included 68 participants (age = 69 ± 8 years, 76% male) with T2DM. Participants were assigned to menaquinone-7 (360 μg/day; n = 35) or placebo (n = 33). T50 was measured via nephelometry in serum collected at baseline, three and six months. Arterial calcification was measured at baseline and six months via 18F-Na PET-CT and conventional CT using Target-to-Background ratio (TBR) and Agatston score. Longitudinal analysis of covariance adjusted for baseline T50 was used to study the treatment effect. Spearman's correlation was used to assess the correlation between T50 and imaging calcification parameters. RESULTS Median baseline T50 was similar in the vitamin K (350 [321-394] minutes) and placebo groups (363 [320-398]). There was no significant difference in T50 between treatment arms over time (ẞ = 1.00, 95%C.I. = 0.94-1.07, p = 0.982). The correlation coefficient of T50 with TBR and Agatston score at baseline were -0.185 (p = 0.156) and -0.121 (p = 0.358), respectively. CONCLUSIONS No effect of vitamin K supplementation on T50 was observed in T2DM. Moreover, T50 did not correlate with TBR and Agatston score. Further research on vitamin K in arterial calcification and on the validity of T50 as arterial calcification marker is warranted.
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Affiliation(s)
- R Meer
- Department of Epidemiology & Data Science, Amsterdam UMC - Location Vrije Universiteit, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands.
| | - M L Romero Prats
- Department of Epidemiology & Data Science, Amsterdam UMC - Location Vrije Universiteit, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands
| | - M G Vervloet
- Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands; Department of Nephrology, Amsterdam UMC - Location VUmc, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Y T van der Schouw
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - P A de Jong
- Department of Radiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands
| | - J W J Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - Location Vrije Universiteit, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
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Chubakova KA, Kamenskikh EM, Bakhareva YO, Saprina TV. Biobanking potential for biomedical research in endocrinology. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Biobanking is an actively developing scientific area that provides tools for conducting biomedical research, increasing the reliability and reproducibility of their results. In endocrinology, more and more attention is paid to the study of molecular and genetic markers of diseases for the selection of new points of influence in treatment, the development of targeted therapy and a strategy for personalized prevention. This approach is designed to solve the problems of endocrine disorders, their complications, causing significant damage to the individual and he population health, and reduce the financial burden of chronic endocrine disorders. To increase the reliability and reproducibility of research results, requirements for working with biological material should be strictly complied. The use of biobanking will increase the validity of data obtained in clinical trials in endocrinology. There are successful examples of Russian and foreign studies using the capabilities of biobanks aimed at studying diabetes, polycystic ovary syndrome, adenomas and other endocrine disorders. The article discusses the prospects for partnership with biobanks in the framework of endocrinology research. The purpose of this review is to analyze the literature to systematize knowledge for application of biobanking in biomedical research in the field of endocrinology.
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de Vries M, El-Morabit F, van Erpecum KJ, Westerink J, Bac ST, Kaasjager HAHK, de Valk HW. Non-alcoholic fatty liver disease: identical etiologic factors in patients with type 1 and type 2 diabetes. Eur J Intern Med 2022; 100:77-82. [PMID: 35387749 DOI: 10.1016/j.ejim.2022.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/18/2022] [Accepted: 03/18/2022] [Indexed: 01/08/2023]
Abstract
AIMS To compare NAFLD prevalence, distribution and its etiologic determinants in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS In this cross-sectional study, NAFLD was evaluated by transient elastography in adult outpatients with T1D and T2D. NAFLD was defined as hepatic steatosis with or without fibrosis. Associations between insulin resistance related factors and NAFLD and advanced fibrosis (≥ F3) were explored in T1D and T2D separately, using multivariate logistic regression models. Interaction analysis was performed to compare the associations in patients with T1D and T2D. RESULTS One hundred and fifty patients with T1D (mean age 47 years, male 55%, mean diabetes duration 25 years, median BMI 25 kg/m2) and 100 patients with T2D (median age 67 years, male 56%, median diabetes duration 17 years, mean BMI 30 kg/m2) were included. NAFLD prevalence was 20% in patients with T1D and 76% in patients with T2D. Advanced fibrosis prevalence was 2.0% in patients with T1D and 22% in patients with T2D. In both patients with T1D and T2D, waist circumference, BMI and metabolic syndrome were positively associated, and estimated insulin sensitivity was negatively associated with the presence of NAFLD, adjusted for age, sex and diabetes duration. There was no effect modification by diabetes type for any of these associations. CONCLUSIONS Despite differences in population characteristics and pathophysiology between T1D and T2D, insulin resistance related factors are similarly associated with NAFLD in both groups.
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Affiliation(s)
- Marieke de Vries
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Fatima El-Morabit
- Department of Gastroenterology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Karel J van Erpecum
- Department of Gastroenterology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Westerink
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Simon T Bac
- Department of Gastroenterology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - H A H Karin Kaasjager
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Harold W de Valk
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
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Pagano E, Konings SRA, Di Cuonzo D, Rosato R, Bruno G, van der Heijden AA, Beulens J, Slieker R, Leal J, Feenstra TL. Prediction of mortality and major cardiovascular complications in type 2 diabetes: External validation of UK Prospective Diabetes Study outcomes model version 2 in two European observational cohorts. Diabetes Obes Metab 2021; 23:1084-1091. [PMID: 33377255 DOI: 10.1111/dom.14311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/03/2020] [Accepted: 12/20/2020] [Indexed: 11/29/2022]
Abstract
AIM To externally validate the UK Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2) by comparing the predicted and observed outcomes in two European population-based cohorts of people with type 2 diabetes. MATERIALS AND METHODS We used data from the Casale Monferrato Survey (CMS; n = 1931) and a subgroup of the Hoorn Diabetes Care System (DCS) cohort (n = 5188). The following outcomes were analysed: all-cause mortality, myocardial infarction (MI), ischaemic heart disease (IHD), stroke, and congestive heart failure (CHF). Model performance was assessed by comparing predictions with observed cumulative incidences in each cohort during follow-up. RESULTS All-cause mortality was overestimated by the UKPDS-OM2 in both the cohorts, with a bias of 0.05 in the CMS and 0.12 in the DCS at 10 years of follow-up. For MI, predictions were consistently higher than observed incidence over the entire follow-up in both cohorts (10 years bias 0.07 for CMS and 0.10 for DCS). The model performed well for stroke and IHD outcomes in both cohorts. CHF incidence was predicted well for the DCS (5 years bias -0.001), but underestimated for the CMS cohort. CONCLUSIONS The UKPDS-OM2 consistently overpredicted the risk of mortality and MI in both cohorts during follow-up. Period effects may partially explain the differences. Results indicate that transferability is not satisfactory for all outcomes, and new or adjusted risk equations may be needed before applying the model to the Italian or Dutch settings.
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Affiliation(s)
- Eva Pagano
- Unit of Clinical Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Turin, Italy
| | - Stefan R A Konings
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Daniela Di Cuonzo
- Unit of Clinical Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Turin, Italy
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy
| | - Graziella Bruno
- Laboratory of Diabetic Nephropathy, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Amber A van der Heijden
- Department of General Practice, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Joline Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Roderick Slieker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jose Leal
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Talitha L Feenstra
- University of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, The Netherlands
- RIVM, Bilthoven, The Netherlands
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van Oort S, Rutters F, Warlé‐van Herwaarden MF, Schram MT, Stehouwer CD, Tack CJ, Abbink EJ, Wolffenbuttel BH, van der Klauw MM, DeVries JH, Siegelaar SE, Sijbrands EJ, Özcan B, de Valk HW, Silvius B, Schroijen MA, Jazet IM, van Ballegooijen AJ, Beulens JWJ, Elders PJ, Kramers C. Characteristics associated with polypharmacy in people with type 2 diabetes: the Dutch Diabetes Pearl cohort. Diabet Med 2021; 38:e14406. [PMID: 32961611 PMCID: PMC8048843 DOI: 10.1111/dme.14406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/15/2020] [Accepted: 09/11/2020] [Indexed: 12/30/2022]
Abstract
AIM To describe the prevalence and characteristics of polypharmacy in a Dutch cohort of individuals with type 2 diabetes. METHODS We included people with type 2 diabetes from the Diabetes Pearl cohort, of whom 3886 were treated in primary care and 2873 in academic care (secondary/tertiary). With multivariable multinomial logistic regression analyses stratified for line of care, we assessed which sociodemographic, lifestyle and cardiometabolic characteristics were associated with moderate (5-9 medications) and severe polypharmacy (≥10 medications) compared with no polypharmacy (0-4 medications). RESULTS Mean age was 63 ± 10 years, and 40% were women. The median number of daily medications was 5 (IQR 3-7) in primary care and 7 (IQR 5-10) in academic care. The prevalence of moderate and severe polypharmacy was 44% and 10% in primary care, and 53% and 29% in academic care respectively. Glucose-lowering and lipid-modifying medications were most prevalent. People with severe polypharmacy used a relatively large amount of other (i.e. non-cardiovascular and non-glucose-lowering) medication. Moderate and severe polypharmacy across all lines of care were associated with higher age, low educational level, more smoking, longer diabetes duration, higher BMI and more cardiovascular disease. CONCLUSIONS Severe and moderate polypharmacy are prevalent in over half of people with type 2 diabetes in primary care, and even more in academic care. People with polypharmacy are characterized by poorer cardiometabolic status. These results highlight the significance of polypharmacy in type 2 diabetes.
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Affiliation(s)
- S. van Oort
- Department of Epidemiology and BiostatisticsAmsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research Institute and Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
- Department of Pharmacology and ToxicologyRadboud University Medical CenterNijmegenthe Netherlands
| | - F. Rutters
- Department of Epidemiology and BiostatisticsAmsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research Institute and Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | | | - M. T. Schram
- Department of Internal MedicineCardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+Maastrichtthe Netherlands
| | - C. D. Stehouwer
- Department of Internal MedicineCardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center+Maastrichtthe Netherlands
| | - C. J. Tack
- Department of Internal MedicineRadboud University Medical CenterNijmegenthe Netherlands
| | - E. J. Abbink
- Department of Internal MedicineRadboud University Medical CenterNijmegenthe Netherlands
| | - B. H. Wolffenbuttel
- Department of EndocrinologyUniversity of Groningen, University Medical Centre GroningenGroningenthe Netherlands
| | - M. M. van der Klauw
- Department of EndocrinologyUniversity of Groningen, University Medical Centre GroningenGroningenthe Netherlands
| | - J. H. DeVries
- Department of Internal MedicineAmsterdam University Medical Center, University of AmsterdamAmsterdamthe Netherlands
| | - S. E. Siegelaar
- Department of Internal MedicineAmsterdam University Medical Center, University of AmsterdamAmsterdamthe Netherlands
| | - E. J. Sijbrands
- Department of Internal MedicineErasmus University Medical CenterRotterdamthe Netherlands
| | - B. Özcan
- Department of Internal MedicineErasmus University Medical CenterRotterdamthe Netherlands
| | - H. W. de Valk
- Department of Internal MedicineUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - B. Silvius
- Department of Internal MedicineUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - M. A. Schroijen
- Department of Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenthe Netherlands
| | - I. M. Jazet
- Department of Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenthe Netherlands
| | - A. J. van Ballegooijen
- Department of Epidemiology and BiostatisticsAmsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research Institute and Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
- Department of NephrologyAmsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research InstituteAmsterdamthe Netherlands
| | - J. W. J. Beulens
- Department of Epidemiology and BiostatisticsAmsterdam University Medical Center, location VUmc, Amsterdam Cardiovascular Sciences Research Institute and Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - P. J. Elders
- Department of General Practice and Elderly Care MedicineAmsterdam University Medical Center, location VUmc, Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - C. Kramers
- Department of Pharmacology and ToxicologyRadboud University Medical CenterNijmegenthe Netherlands
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Vluggen S, Candel M, Hoving C, Schaper NC, de Vries H. A Web-Based Computer-Tailored Program to Improve Treatment Adherence in Patients With Type 2 Diabetes: Randomized Controlled Trial. J Med Internet Res 2021; 23:e18524. [PMID: 33620321 PMCID: PMC7943340 DOI: 10.2196/18524] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/17/2020] [Accepted: 12/21/2020] [Indexed: 01/01/2023] Open
Abstract
Background Adherence to core type 2 diabetes mellitus (T2DM) treatment behaviors is suboptimal, and nonadherence is generally not limited to one treatment behavior. The internet holds promise for programs that aim to improve adherence. We developed a computer-tailored eHealth program for patients with T2DM to improve their treatment adherence, that is, adherence to both a healthy lifestyle and medical behaviors. Objective The objective of this study is to examine the effectiveness of the eHealth program in a randomized controlled trial. Methods Patients with T2DM were recruited by their health professionals and randomized into either the intervention group, that is, access to the eHealth program for 6 months, or a waiting-list control group. In total, 478 participants completed the baseline questionnaire, of which 234 gained access to the eHealth program. Of the 478 participants, 323 were male and 155 were female, the mean age was 60 years, and the participants had unfavorable BMI and HbA1c levels on average. Outcome data were collected through web-based assessments on physical activity (PA) levels, caloric intake from unhealthy snacks, and adherence to oral hypoglycemic agents (OHAs) and insulin therapy. Changes to separate behaviors were standardized and summed into a composite change score representing changes in the overall treatment adherence. Further standardization of this composite change score yielded the primary outcome, which can be interpreted as Cohen d (effect size). Standardized change scores observed in separate behaviors acted as secondary outcomes. Mixed linear regression analyses were conducted to examine the effectiveness of the intervention on overall and separate treatment behavior adherence, accommodating relevant covariates and patient nesting. Results After the 6-month follow-up assessment, 47.4% (111/234) of participants in the intervention group and 72.5% (177/244) of participants in the control group were retained. The overall treatment adherence improved significantly in the intervention group compared with the control group, reflected by a small effect size (d=0.27; 95% CI 0.032 to 0.509; P=.03). When considering changes in separate treatment behaviors, a significant decrease was observed only in caloric intake from unhealthy snacks in comparison with the control group (d=0.36; 95% CI 0.136 to 0.584; P=.002). For adherence to PA (d=−0.14; 95% CI −0.388 to 0.109; P=.27), OHAs (d=0.27; 95% CI −0.027 to 0.457; P=.08), and insulin therapy (d=0.35; 95% CI −0.066 to 0.773; P=.10), no significant changes were observed. These results from the unadjusted analyses were comparable with the results of the adjusted analyses, the per-protocol analyses, and the sensitivity analyses. Conclusions Our multibehavior program significantly improved the overall treatment adherence compared with the control group. To further enhance the impact of the intervention in the personal, societal, and economic areas, a wide-scale implementation of our eHealth intervention is suggested. Trial Registration Netherlands Trial Register NL664; https://www.trialregister.nl/trial/6664
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Affiliation(s)
- Stan Vluggen
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Math Candel
- Department of Methodology and Statistics, Maastricht University, Maastricht, Netherlands
| | - Ciska Hoving
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Nicolaas C Schaper
- Department of Endocrinology and Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
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de Jong M, Oskam MJ, Sep SJS, Ozcan B, Rutters F, Sijbrands EJG, Elders PJM, Siegelaar SE, DeVries JH, Tack CJ, Schroijen M, de Valk HW, Abbink EJ, Stehouwer CDA, Jazet I, Wolffenbuttel BHR, Peters SAE, Schram MT. Sex differences in cardiometabolic risk factors, pharmacological treatment and risk factor control in type 2 diabetes: findings from the Dutch Diabetes Pearl cohort. BMJ Open Diabetes Res Care 2020; 8:8/1/e001365. [PMID: 33023896 PMCID: PMC7539590 DOI: 10.1136/bmjdrc-2020-001365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/21/2020] [Accepted: 07/25/2020] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Sex differences in cardiometabolic risk factors and their management in type 2 diabetes (T2D) have not been fully identified. Therefore, we aimed to examine differences in cardiometabolic risk factor levels, pharmacological treatment and achievement of risk factor control between women and men with T2D. RESEARCH DESIGN AND METHODS Cross-sectional data from the Dutch Diabetes Pearl cohort were used (n=6637, 40% women). Linear and Poisson regression analyses were used to examine sex differences in cardiometabolic risk factor levels, treatment, and control. RESULTS Compared with men, women had a significantly higher body mass index (BMI) (mean difference 1.79 kg/m2 (95% CI 1.49 to 2.08)), while no differences were found in hemoglobin A1c (HbA1c) and systolic blood pressure (SBP). Women had lower diastolic blood pressure (-1.94 mm Hg (95% CI -2.44 to -1.43)), higher total cholesterol (TC) (0.44 mmol/L (95% CI 0.38 to 0.51)), low-density lipoprotein cholesterol (LDL-c) (0.26 mmol/L (95% CI 0.22 to 0.31)), and high-density lipoprotein cholesterol (HDL-c) sex-standardized (0.02 mmol/L (95% CI 0.00 to 0.04)), and lower TC:HDL ratio (-0.29 (95% CI -0.36 to -0.23)) and triglycerides (geometric mean ratio 0.91 (95% CI 0.85 to 0.98)). Women had a 16% higher probability of being treated with antihypertensive medication in the presence of high cardiovascular disease (CVD) risk and elevated SBP than men (relative risk 0.84 (95% CI 0.73 to 0.98)), whereas no sex differences were found for glucose-lowering medication and lipid-modifying medication. Among those treated, women were less likely to achieve treatment targets of HbA1c (0.92 (95% CI 0.87 to 0.98)) and LDL-c (0.89 (95% CI 0.85 to 0.92)) than men, while no differences for SBP were found. CONCLUSIONS In this Dutch T2D population, women had a slightly different cardiometabolic risk profile compared with men and a substantially higher BMI. Women had a higher probability of being treated with antihypertensive medication in the presence of high CVD risk and elevated SBP than men, and were less likely than men to achieve treatment targets for HbA1c and LDL levels.
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Affiliation(s)
- Marit de Jong
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marieke J Oskam
- Department of Internal Medicine, School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Behiye Ozcan
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam UMC - VUMC location, Amsterdam, The Netherlands
| | - Eric J G Sijbrands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Petra J M Elders
- Department of General Practice and Elderly Care, Amsterdam Public Health Research Institute, Amsterdam UMC - VUMC location, Amsterdam, The Netherlands
| | - Sarah E Siegelaar
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - J Hans DeVries
- Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Cees J Tack
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marielle Schroijen
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Harold W de Valk
- Department of Internal Medicine, Universty Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Evertine J Abbink
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ingrid Jazet
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne A E Peters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Miranda T Schram
- Department of Internal Medicine, School for Cardiovascular Diseases CARIM, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Gangadharan C, Wills S, Vangala RK, Sigamani A. Biobanking for Translational Diabetes Research in India. Biores Open Access 2020; 9:183-189. [PMID: 32908805 PMCID: PMC7473039 DOI: 10.1089/biores.2019.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2020] [Indexed: 11/22/2022] Open
Abstract
India is declared as the diabetic capital of the world. Clinically well-annotated blood samples will advance diabetes research for better diagnostic and treatment methods. Building a disease-specific biobank with high-quality peripheral blood mononuclear cells (PBMCs) and clinical follow-up data system will serve as a good platform for clinical research in diabetes. Processing and storage of high-quality biospecimen for translational research in diabetes demand the implementation of good clinical laboratory practices. “Certification or accreditation programs” that improve biorepository processes and frameworks are lacking in Indian context. To sustain and translate the research into clinical practice, good governance of the biobank and financial resources is required. For ethical issues related to health needs of the people and participants in the research, issues related to research process, translational research, and commercialization, data sharing should be addressed. For India to be an innovation and sustainable country Indian government is supporting translational research facilities, including biobanks. India has developed biobanks for various diseases; however, diabetes-specific research biorepository is lacking. Given the dangers of diabetic burden, India should set up a diabetes disease-specific repository learning from the global organizations and customize to the needs of Indian context. It is important to have private agencies get involved to develop biobanks and future research as there are commercial goals to translate research into practice. New technologies of specimen storing and preservation, data management, and data sharing should be adopted for developing cost-effective long-standing disease-specific population biobank in India.
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Affiliation(s)
- Charitha Gangadharan
- Department of Clinical Research, Narayana Hrudayalaya Foundations, Bommasandra, Bangalore, India
| | - Soniya Wills
- Department of Clinical Research, Narayana Hrudayalaya Foundations, Bommasandra, Bangalore, India
| | - Rajani Kanth Vangala
- Institute for Applied Research and innovation (InARI), Chikkalasandra, Bangalore, India
| | - Alben Sigamani
- Department of Clinical Research, Narayana Hrudayalaya Foundations, Bommasandra, Bangalore, India
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van Meijel LA, de Vegt F, Abbink EJ, Rutters F, Schram MT, van der Klauw MM, Wolffenbuttel BHR, Siegelaar S, DeVries JH, Sijbrands EJG, Özcan B, de Valk HW, Silvius B, Schaper N, Stehouwer CDA, Elders PJM, Tack CJ, de Galan BE. High prevalence of impaired awareness of hypoglycemia and severe hypoglycemia among people with insulin-treated type 2 diabetes: The Dutch Diabetes Pearl Cohort. BMJ Open Diabetes Res Care 2020; 8:8/1/e000935. [PMID: 32107264 PMCID: PMC7206921 DOI: 10.1136/bmjdrc-2019-000935] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/03/2019] [Accepted: 12/15/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE People with type 2 diabetes on insulin are at risk for hypoglycemia. Recurrent hypoglycemia can cause impaired awareness of hypoglycemia (IAH), and increase the risk for severe hypoglycemia. The aim of this study was to assess the prevalence and determinants of self-reported IAH and severe hypoglycemia in a Dutch nationwide cohort of people with insulin-treated type 2 diabetes. RESEARCH DESIGN AND METHODS Observational study of The Dutch Diabetes Pearl, a cohort of people with type 2 diabetes treated in primary, secondary and tertiary diabetes care centers. The presence of IAH and the occurrence of severe hypoglycemia in the past year, defined as an event requiring external help to recover, were assessed using the validated Dutch version of the Clarke questionnaire. In addition, clinical variables were collected including age, diabetes duration, hemoglobin A1c, ethnicity and education. RESULTS 2350 people with type 2 diabetes on insulin were included: 59.1% men, mean age 61.1±10.4 years, mean diabetes duration 14.8±9.2 years and 79.5% on basal-bolus therapy. A total of 229 patients (9.7%) were classified as having IAH and 742 patients (31.6%) reported severe hypoglycemia. Increased odds for IAH were found with complex insulin regimens and lower odds with having a partner and body mass index ≥30 kg/m2. Severe hypoglycemia was associated with complex insulin regimens, non-Caucasian ethnicity and use of psychoactive drugs, and inversely with metformin use. CONCLUSIONS In this nationwide cohort, almost one out of ten people with type 2 diabetes on insulin had IAH and >30% had a history of severe hypoglycemia in the past year.
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Affiliation(s)
- Lian A van Meijel
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Femmie de Vegt
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Evertine J Abbink
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Femke Rutters
- Department of Epidemiology & Biostatistics, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - Miranda T Schram
- Department of Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah Siegelaar
- Department of Internal Medicine, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
| | - J Hans DeVries
- Department of Internal Medicine, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
| | | | - Behiye Özcan
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Harold W de Valk
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bianca Silvius
- Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicolaas Schaper
- Department of Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Petra J M Elders
- Department of General Practice and Elderly Care, Amsterdam Public Health Research Institute, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
| | - Cornelis J Tack
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
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10
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Zwakenberg SR, de Jong PA, Bartstra JW, van Asperen R, Westerink J, de Valk H, Slart RHJA, Luurtsema G, Wolterink JM, de Borst GJ, van Herwaarden JA, van de Ree MA, Schurgers LJ, van der Schouw YT, Beulens JWJ. The effect of menaquinone-7 supplementation on vascular calcification in patients with diabetes: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2019; 110:883-890. [PMID: 31387121 PMCID: PMC6766434 DOI: 10.1093/ajcn/nqz147] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/24/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Vitamin K occurs in the diet as phylloquinone and menaquinones. Observational studies have shown that both phylloquinone and menaquinone intake might reduce cardiovascular disease (CVD) risk. However, the effect of vitamin K on vascular calcification is unknown. OBJECTIVES The aim of this study was to assess if menaquinone supplementation, compared to placebo, decreases vascular calcification in people with type 2 diabetes and known CVD. METHODS In this double-blind, randomized, placebo-controlled trial, we randomly assigned men and women with type 2 diabetes and CVD to 360 µg/d menaquinone-7 (MK-7) or placebo for 6 mo. Femoral arterial calcification at baseline and 6 mo was measured with 18sodium fluoride positron emission tomography (18F-NaF PET) scans as target-to-background ratios (TBRs), a promising technique to detect active calcification. Calcification mass on conventional computed tomography (CT) scan was measured as secondary outcome. Dephosphorylated-uncarboxylated matrix Gla protein (dp-ucMGP) concentrations were measured to assess compliance. Linear regression analyses were performed with either TBR or CT calcification at follow-up as the dependent variable, and treatment and baseline TBR or CT calcification as independent variables. RESULTS We randomly assigned 35 patients to the MK-7 group (33 completed follow-up) and 33 to the placebo group (27 completed follow-up). After the 6-mo intervention, TBR tended to increase in the MK-7 group compared with placebo (0.25; 95% CI: -0.02, 0.51; P = 0.06), although this was not significant. Log-transformed CT calcification mass did not increase in the intervention group compared with placebo (0.50; 95% CI: -0.23, 1.36; P = 0.18). MK-7 supplementation significantly reduced dp-ucMGP compared with placebo (-205.6 pmol/L; 95% CI: -255.8, -155.3 pmol/L). No adverse events were reported. CONCLUSION MK-7 supplementation tended to increase active calcification measured with 18F-NaF PET activity compared with placebo, but no effect was found on conventional CT. Additional research investigating the interpretation of 18F-NaF PET activity is necessary. This trial was registered at clinicaltrials.gov as NCT02839044.
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Affiliation(s)
- S R Zwakenberg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - P A de Jong
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - J W Bartstra
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - R van Asperen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands,Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - J Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - H de Valk
- Department of Endocrinology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - R H J A Slart
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - G Luurtsema
- Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - J M Wolterink
- Image Sciences Institute, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - G J de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - J A van Herwaarden
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - M A van de Ree
- Department of Internal Medicine, Diakonessenhuis, Utrecht, Netherlands
| | - L J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Y T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - J W J Beulens
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands,Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, Netherlands,Address correspondence to JWJB (e-mail: )
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11
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Jalalzadeh H, Indrakusuma R, Blankensteijn JD, Wisselink W, Yeung KK, Lindeman JHN, Hamming JF, Koelemay MJW, Legemate DA, Balm R. Design and protocol of a comprehensive multicentre biobank for abdominal aortic aneurysms. BMJ Open 2019; 9:e028858. [PMID: 31375618 PMCID: PMC6688677 DOI: 10.1136/bmjopen-2018-028858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/21/2019] [Accepted: 06/28/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The pathophysiology and natural course of abdominal aortic aneurysms (AAAs) are insufficiently understood. In order to improve our understanding, it is imperative to carry out longitudinal research that combines biomarkers with clinical and imaging data measured over multiple time points. Therefore, a multicentre biobank, databank and imagebank has been established in the Netherlands: the 'Pearl Abdominal Aortic Aneurysm' (AAA bank). METHODS AND ANALYSIS The AAA bank is a prospective multicentre observational biobank, databank and imagebank of patients with an AAA. It is embedded within the framework of the Parelsnoer Institute, which facilitates uniform biobanking in all university medical centres (UMCs) in the Netherlands. The AAA bank has been initiated by the two UMCs of Amsterdam UMC and by Leiden University Medical Center. Participants will be followed during AAA follow-up. Clinical data are collected every patient contact. Three types of biomaterials are collected at baseline and during follow-up: blood (including DNA and RNA), urine and AAA tissue if open surgical repair is performed. Imaging data that are obtained as part of clinical care are stored in the imagebank. All data and biomaterials are processed and stored in a standardised manner. AAA growth will be based on multiple measurements and will be analysed with a repeated measures analysis. Potential associations between AAA growth and risk factors that are also measured on multiple time points can be assessed with multivariable mixed-effects models, while potential associations between AAA rupture and risk factors can be tested with a conditional dynamic prediction model with landmarking or with joint models in which linear mixed-effects models are combined with Cox regression. ETHICS AND DISSEMINATION The AAA bank is approved by the Medical Ethics Board of the Amsterdam UMC (University of Amsterdam). TRIAL REGISTRATION NUMBER NCT03320408.
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Affiliation(s)
- Hamid Jalalzadeh
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Reza Indrakusuma
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan D. Blankensteijn
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willem Wisselink
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kak K Yeung
- Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan H N Lindeman
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap F Hamming
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark J W Koelemay
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Dink A Legemate
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ron Balm
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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12
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Khabour OF, Abu-Siniyeh A. Challenges that face the establishment of diabetes biobank in Jordan: a qualitative analysis of an online discussion forum. J Multidiscip Healthc 2019; 12:229-234. [PMID: 31114216 PMCID: PMC6489903 DOI: 10.2147/jmdh.s194161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction: Diabetes is common in Jordan with a prevalence of about 13% of the population. Establishment of a diabetes biobank in Jordan could have an enormous impact on the management and prevention of the disease. Methods: In the current study, ethical challenges that might face the establishment of a biobank were examined by 28 researchers from the Middle East and North Africa region using an online discussion forum. Results: All participants agreed on the importance of the establishment of a diabetes biobank in Jordan. The possible challenges that were discussed included confidentiality and privacy, informed consent, specimen ownership and participants’ rights, data sharing, returning of research results and incidental findings, lack of legislations, and importance of social awareness and public engagements with biobanks. Conclusion: In conclusion, participants support the establishment of a diabetes biobank in Jordan; however, some ethical issues should be considered to ensure the success of the biobank.
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Affiliation(s)
- Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmed Abu-Siniyeh
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.,Department of Medical Laboratory Sciences, Faculty of Science, Al-Balqa' Applied University, As Salt, Jordan.,Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taif University, Taif, Kingdom of Saudi Arabia
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13
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Vluggen S, Hoving C, Schaper NC, de Vries H. A web-based program to improve treatment adherence in patients with type 2 diabetes: Development and study protocol. Contemp Clin Trials 2018; 74:38-45. [PMID: 30290275 DOI: 10.1016/j.cct.2018.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many patients with type 2 diabetes mellitus (T2DM) sub-optimally adhere to core treatment recommendations, such as healthy diets, sufficient physical activity and pharmacological support. This paper describes the development of the web-based computer-tailored program My Diabetes Profile (MDP), incorporating identified success factors of web-based interventions, and the protocol for testing the effectiveness of this program in a randomized multicentre trial. METHODS Formative research - including the input of a program committee, qualitative and quantitative studies with patients and health professionals and a literature search - yielded input for the development of the MDP program. MDP provides video and text tailored advice, based on determinants and salient beliefs derived from the I-Change Model, on decreasing unhealthy snack intake, increasing physical activity, and improving adherence to both oral blood glucose lowering drugs and self-administered insulin therapy. Patients with T2DM recruited by practice nurses and diabetes nurses across the Netherlands fill in online questionnaires at baseline and six-months follow-up. Participants are randomized on patient level to the intervention group (access to the MDP program) or control group (receiving care as usual). DISCUSSION The formative research using co-creation principles proved essential in the development of the MDP program and involved various disciplines in T2DM management including target group representatives. Co-creation revealed clearly that patients needed short and attractive messages. Consequently, a mix of video and short text messages were chosen for the ultimate program format. Pilot testing was useful to further shape the program to needs of patients and professionals. TRIAL REGISTRATION Dutch Trial Register NTR6840; Archived program website: http://www.webcitation.org/6xXz01S7X.
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Affiliation(s)
- S Vluggen
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - C Hoving
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - N C Schaper
- Department of Endocrinology and Internal Medicine, School CAPHRI, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
| | - H de Vries
- Department of Health Promotion, School CAPHRI, Maastricht University, Maastricht, the Netherlands.
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14
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Özcan B, Rutters F, Snoek FJ, Roosendaal M, Sijbrands EJ, Elders PJM, Holleman F, Pijl H, Tack CJ, Abbink EJ, de Valk HW, Wolffenbuttel BHR, Stehouwer CDA, Schaper NC, Dekker JM, Schram MT. High Diabetes Distress Among Ethnic Minorities Is Not Explained by Metabolic, Cardiovascular, or Lifestyle Factors: Findings From the Dutch Diabetes Pearl Cohort. Diabetes Care 2018; 41:1854-1861. [PMID: 29945936 DOI: 10.2337/dc17-2181] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/20/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes distress among patients from ethnic minorities is still poorly understood. We investigated the association between ethnicity and diabetes distress among ethnic minority groups of people with type 2 diabetes in the Netherlands, focusing on the possible effects of glycemic control, lifestyle factors, cardiovascular risk factors, and diabetes complications. RESEARCH DESIGN AND METHODS Cross-sectional data from the Dutch Diabetes Pearl cohort included people with type 2 diabetes from primary, secondary, and tertiary diabetes care programs. We used the 20-item Problem Areas in Diabetes Survey (PAID) scale to assess diabetes distress; a score ≥40 is considered to represent high distress. Ethnicity was estimated on the basis of country of birth. Sociodemographic and lifestyle data were self-reported; cardiovascular and metabolic data were retrieved from medical charts. Logistic regression analysis determined the association between ethnicity and diabetes distress, with Caucasians as the reference group. RESULTS Diabetes distress scores and ethnicity were available for 4,191 people with type 2 diabetes: 3,684 were Caucasian, 83 were Asian, 51 were Moroccan, 92 were African, 134 were Latin American, 46 were Turkish, and 101 were Hindustani-Surinamese. Overall, participants in minority groups had worse health outcomes than those of Caucasian descent, and diabetes distress was more prevalent (ranging from 9.6 to 31.7%, compared with 5.8% among Caucasians), even after adjusting for age, sex, education level, alcohol use, smoking, BMI, lipid profile, HbA1c, medication use, and the presence of diabetes complications. CONCLUSIONS Among people with type 2 diabetes in the Netherlands, ethnicity is independently associated with high diabetes distress. Further research is warranted to explain the higher prevalence of diabetes distress in minority groups and to develop effective interventions.
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Affiliation(s)
- Behiye Özcan
- Erasmus Medical Center, Rotterdam, the Netherlands
| | - Femke Rutters
- VU University Medical Center, Amsterdam, the Netherlands
| | - Frank J Snoek
- VU University Medical Center, Amsterdam, the Netherlands.,Academic Medical Center, Amsterdam, the Netherlands
| | - Mandy Roosendaal
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | | | | | | | - Hanno Pijl
- Leiden University Medical Center, Leiden, the Netherlands
| | - Cees J Tack
- Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | | | - Coen D A Stehouwer
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | - Nicholas C Schaper
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
| | | | - Miranda T Schram
- Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
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Manders P, Peters TM, Siezen AE, van Rooij IA, Snijder R, Swinkels DW, Zielhuis GA. A Stepwise Procedure to Define a Data Collection Framework for a Clinical Biobank. Biopreserv Biobank 2018; 16:138-147. [DOI: 10.1089/bio.2017.0084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peggy Manders
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tessa M.A. Peters
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ariaan E. Siezen
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Iris A.L.M. van Rooij
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Dorine W. Swinkels
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gerhard A. Zielhuis
- Radboud Biobank, Radboud University Medical Center, Nijmegen, the Netherlands
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
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16
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Vluggen S, Hoving C, Schaper NC, de Vries H. Exploring beliefs on diabetes treatment adherence among Dutch type 2 diabetes patients and healthcare providers. PATIENT EDUCATION AND COUNSELING 2018; 101:92-98. [PMID: 28729129 DOI: 10.1016/j.pec.2017.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 06/21/2017] [Accepted: 07/08/2017] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Despite well-known beneficial effects, adherence to core elements of diabetes treatment is suboptimal. This study, conducted in the Netherlands, aimed to explore if and how treatment adherence success factors are applied in diabetes consultations, and to explore salient personal beliefs about type 2 diabetes treatment including both healthy lifestyle adaptations and pharmacotherapy. METHODS A qualitative study using semi-structured interviews among nine Dutch healthcare providers predominantly involved in diabetes management and 19 Dutch type 2 diabetes patients. Data was systematically analysed through deductive coding analysis using Nvivo. RESULTS Most patients visited their consultations unprepared. Patients did not or vaguely experience goal-setting in consultations, whereas healthcare providers indicated to set treatment goals. Shared-decision making was applied, however patients were rather passive collaborators as mostly healthcare providers were in charge of making treatment decisions. Despite suboptimal treatment adherence, many advantages and few disadvantages of treatment strategies were reported. Adherence self-efficacy was lower in situations outside daily routine. CONCLUSION Treatment adherence success factors are not optimally applied, and in particular treatment adherence self-efficacy could be improved. PRACTICE IMPLICATIONS The application of treatment adherence success factors in consultations could be improved, and personal beliefs should be addressed to improve treatment adherence and optimize counselling.
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Affiliation(s)
- S Vluggen
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
| | - C Hoving
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
| | - N C Schaper
- Department of Endocrinology and Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
| | - H de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands.
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17
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Empana JP, Blom MT, Bӧttiger BW, Dagres N, Dekker JM, Gislason G, Jouven X, Meitinger T, Ristagno G, Schwartz PJ, Jonsson M, Tfelt-Hansen J, Truhlar A, Tan HL. Determinants of occurrence and survival after sudden cardiac arrest-A European perspective: The ESCAPE-NET project. Resuscitation 2017; 124:7-13. [PMID: 29246744 DOI: 10.1016/j.resuscitation.2017.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/23/2017] [Accepted: 12/10/2017] [Indexed: 11/16/2022]
Abstract
AIMS The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies for survival after SCA on a European scale. METHODS This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. RESULTS The 11 clinical studies with SCA cases comprise 85,790 SCA cases; the 5 observational prospective population cohorts include 53,060 subjects. A total of 15,000 SCA samples will be genotyped for common and rare variants at the Helmholtz Zentrum München (Germany) using the Illumina Global Screening Array which contains > 770,000 SNPs, and after imputation, a database of an estimated > 9 million variants will be available for genome wide association studies. Standardization of risk factors definition and outcomes is ongoing. An Executive Committee has been created along with a Collaboration Policy document. CONCLUSION ESCAPE-NET will complement ongoing efforts on SCA outside Europe and within Europe including the EuReCa project.
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Affiliation(s)
- Jean-Philippe Empana
- Université Paris Descartes, INSERM UMRS-970, Paris Cardiovascular Research Centre, Paris, France
| | - Marieke T Blom
- Department of Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Bernd W Bӧttiger
- European Resuscitation Council, Brussels, Belgium; Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Nikolaos Dagres
- European Heart Rhythm Association, representing the European Society of Cardiology, Sophia Antipolis, France
| | | | - Gunnar Gislason
- Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark and Danish Heart Foundation
| | - Xavier Jouven
- Université Paris Descartes, INSERM UMRS-970, Paris Cardiovascular Research Centre, Paris, France
| | | | - Giuseppe Ristagno
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy; Italian Resuscitation Council, Bologna, Italy
| | - Peter J Schwartz
- IRCCS Istituto Auxologico Italiano, Reference Network for Rare and Low Prevalence Complexe Diseases of the Heart (ERN GUARD-HEART), Italy
| | - Martin Jonsson
- Center for Resuscitation Science, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark and Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark and Reference Network for Rare and Low Prevalence Complexe Diseases of the Heart (ERN GUARD-HEART)
| | - Anatolij Truhlar
- Emergency Medical Services of the Hradec Kralove Region, Czech Republic
| | - Hanno L Tan
- Department of Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands.
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18
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Rutte A, Rauh SP, Schram MT, Nijpels G, DeVries JH, Holleman F, Pijl H, Dekkers OM, Özcan B, Sijbrands EJG, Tack CJ, Abbink EJ, de Valk HW, Silvius B, Wolffenbuttel BHR, Stehouwer CDA, Schaper NC, Dekker JM, Beulens JW, Elders PJM, Rutters F. Individual and partner's level of occupation and the association with HbA 1c levels in people with Type 2 diabetes mellitus: the Dutch Diabetes Pearl cohort. Diabet Med 2017; 34:1623-1628. [PMID: 28703888 DOI: 10.1111/dme.13422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2017] [Indexed: 11/28/2022]
Abstract
AIMS Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner's socio-economic status and HbA1c levels. We therefore examined the cross-sectional association between individual and partner's level of occupation on HbA1c levels in people with Type 2 diabetes in the Netherlands. METHODS We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. RESULTS In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA1c levels [e.g. ISCO level 3: -2 mmol/mol (95% CI -4;-1) or -0.2% (95% CI -0.4;-0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA1c levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. CONCLUSIONS Partner's occupational status provided additional information on the association between socio-economic status and HbA1c levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.
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Affiliation(s)
- A Rutte
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - S P Rauh
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - M T Schram
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - G Nijpels
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J H DeVries
- Department of Internal Medicine, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - F Holleman
- Department of Internal Medicine, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - H Pijl
- Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands
| | - O M Dekkers
- Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands
| | - B Özcan
- Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - E J G Sijbrands
- Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C J Tack
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - E J Abbink
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - H W de Valk
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - B Silvius
- Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - B H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - C D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - N C Schaper
- Department of Endocrinology, Maastricht University Medical Centre, Maastricht, The Netherlands
- School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - J M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - J W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P J M Elders
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - F Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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van der Heijden AAWA, Rauh SP, Dekker JM, Beulens JW, Elders P, ‘t Hart LM, Rutters F, van Leeuwen N, Nijpels G. The Hoorn Diabetes Care System (DCS) cohort. A prospective cohort of persons with type 2 diabetes treated in primary care in the Netherlands. BMJ Open 2017; 7:e015599. [PMID: 28588112 PMCID: PMC5729999 DOI: 10.1136/bmjopen-2016-015599] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort. PARTICIPANTS The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands. Enrolment in the cohort started in 1998 and this prospective dynamic cohort currently holds 12 673 persons with T2D. FINDINGS TO DATE Clinical measures are collected annually, with a high internal validity due to the centrally organised standardised examinations. Microvascular complications are assessed by measuring kidney function, and screening feet and eyes. Information on cardiovascular disease is obtained by 1) self-report, 2) electrocardiography and 3) electronic patient records. In subgroups of the cohort, biobanking and additional measurements were performed to obtain information on, for example, lifestyle, depression and genomics. Finally, the DCS cohort is linked to national cancer and all-cause mortality registers. A selection of published findings from the DCS includes identification of subgroups with distinct development of haemoglobin A1c, blood pressure and retinopathy, and their predictors; validation of a prediction model for personalised retinopathy screening; the assessment of the role of genetics in development and treatment of T2D, providing options for personalised medicine. FUTURE PLANS We will continue with the inclusion of persons with newly diagnosed T2D, follow-up of persons in the cohort and linkage to morbidity and mortality registries. Currently, we are involved in (inter)national projects on, among others, biomarkers and prediction models for T2D and complications and we are interested in collaborations with external researchers. TRIAL REGISTRATION ISRCTN26257579.
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Affiliation(s)
- Amber AWA van der Heijden
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Simone P Rauh
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline M Dekker
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Petra Elders
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - Leen M ‘t Hart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, The Netherlands
- Department of Molecular Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Femke Rutters
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Nienke van Leeuwen
- Department of Molecular Cell Biology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Giel Nijpels
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
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20
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Kurstjens S, de Baaij JHF, Bouras H, Bindels RJM, Tack CJJ, Hoenderop JGJ. Determinants of hypomagnesemia in patients with type 2 diabetes mellitus. Eur J Endocrinol 2017; 176:11-19. [PMID: 27707767 DOI: 10.1530/eje-16-0517] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/13/2016] [Accepted: 10/04/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hypomagnesemia (plasma magnesium (Mg2+) concentration <0.7 mmol/L) has been described in patients with type 2 diabetes. Polypharmacy is inevitable when treating a complex disease such as type 2 diabetes and could explain disturbances in the plasma Mg2+ concentration. In this study, we aimed to establish the extent of hypomagnesemia in a cohort of type 2 diabetes patients and to identify the determinants of plasma Mg2+ levels. METHODS Patient data and samples of 395 type 2 diabetes patients were investigated. Plasma Mg2+ concentrations were measured using a spectrophotometric assay. Using Pearson correlation analyses, variables were correlated to plasma Mg2+ levels. After excluding confounding variables, all parameters correlating (P < 0.1) with plasma Mg2+ were included in a stepwise backward regression model. RESULTS The mean plasma Mg2+ concentration in this cohort was 0.74 ± 0.10 mmol/L. In total, 121 patients (30.6%) suffered from hypomagnesemia. Both plasma triglyceride (r = -0.273, P < 0.001) and actual glucose levels (r = -0.231, P < 0.001) negatively correlated with the plasma Mg2+ concentration. Patients using metformin (n = 251, 62%), proton pump inhibitors (n = 179, 45%) or β-adrenergic receptor agonists (n = 31, 8%) displayed reduced plasma Mg2+ levels. Insulin use (n = 299, 76%) positively correlated with plasma Mg2+ levels. The model predicted (R2) 20% of all variance in the plasma Mg2+ concentration. CONCLUSIONS Hypomagnesemia is highly prevalent in type 2 diabetes patients. Plasma triglycerides and glucose levels are major determinants of the plasma Mg2+ concentration, whereas only a minor part (<10%) of hypomagnesemia can be explained by drug intake, excluding polypharmacy as a major cause for hypomagnesemia in type 2 diabetes.
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Affiliation(s)
| | | | | | | | - Cees J J Tack
- Internal MedicineRadboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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21
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van Dooren FEP, Denollet J, Verhey FRJ, Stehouwer CDA, Sep SJS, Henry RMA, Kremers SPJ, Dagnelie PC, Schaper NC, van der Kallen CJH, Koster A, Pouwer F, Schram MT. Psychological and personality factors in type 2 diabetes mellitus, presenting the rationale and exploratory results from The Maastricht Study, a population-based cohort study. BMC Psychiatry 2016; 16:17. [PMID: 26817600 PMCID: PMC4728860 DOI: 10.1186/s12888-016-0722-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 01/19/2016] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Strong longitudinal evidence exists that psychological distress is associated with a high morbidity and mortality risk in type 2 diabetes. Little is known about the biological and behavioral mechanisms that may explain this association. Moreover, the role of personality traits in these associations is still unclear. In this paper, we first describe the design of the psychological part of The Maastricht Study that aims to elucidate these mechanisms. Next, we present exploratory results on the prevalence of depression, anxiety and personality traits in type 2 diabetes. Finally, we briefly discuss the importance of these findings for clinical research and practice. METHODS We measured psychological distress and depression using the MINI diagnostic interview, the PHQ-9 and GAD-7 questionnaires in the first 864 participants of The Maastricht Study, a large, population-based cohort study. Personality traits were measured by the DS14 and Big Five personality questionnaires. Type 2 diabetes was assessed by an oral glucose tolerance test. Logistic regression analyses were used to estimate the associations of depression, anxiety and personality with type 2 diabetes, adjusted for age, sex and education level. RESULTS Individuals with type 2 diabetes had higher levels of depressive and anxiety symptoms, odds ratios (95 % CI) were 3.15 (1.49; 6.67), 1.73 (0.83-3.60), 1.50 (0.72-3.12), for PHQ-9 ≥ 10, current depressive disorder and GAD-7 ≥ 10, respectively. Type D personality, social inhibition and negative affectivity were more prevalent in type 2 diabetes, odds ratios were 1.95 (1.23-3.10), 1.35 (0.93-1.94) and 1.70 (1.14-2.51), respectively. Individuals with type 2 diabetes were less extraverted, less conscientious, less agreeable and less emotionally stable, and similar in openness to individuals without type 2 diabetes, although effect sizes were small. CONCLUSIONS Individuals with type 2 diabetes experience more psychological distress and have different personality traits compared to individuals without type 2 diabetes. Future longitudinal analyses within The Maastricht Study will increase our understanding of biological and behavioral mechanisms that link psychological distress to morbidity and mortality in type 2 diabetes.
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Affiliation(s)
- Fleur E. P. van Dooren
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,Department of Medical and Clinical Psychology, CoRPS – Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands ,MHeNS – Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Johan Denollet
- Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
| | - Frans R. J. Verhey
- MHeNS – Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Coen D. A. Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Simone J. S. Sep
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Ronald M. A. Henry
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Stef P. J. Kremers
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Pieter C. Dagnelie
- CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands ,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands ,Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Nicolaas C. Schaper
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands ,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Carla J. H. van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Frans Pouwer
- Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
| | - Miranda T. Schram
- Department of Internal Medicine, Maastricht University Medical Centre, Randwycksingel 35, 6229 EG Maastricht, The Netherlands ,CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
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Milley KM, Nimmo JS, Bacci B, Ryan SD, Richardson SJ, Danks JA. DogMATIC--A Remote Biospecimen Collection Kit for Biobanking. Biopreserv Biobank 2015; 13:247-54. [PMID: 26186583 DOI: 10.1089/bio.2014.0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Canine tumors are valuable comparative oncology models. This research was designed to create a sustainable biobank of canine mammary tumors for breast cancer research. The aim was to provide a well-characterized sample cohort for specimen sharing, data mining, and long-term research aims. Canine mammary tumors are most frequently managed at a local veterinary clinic or hospital. We adopted a biobank framework based on a large number of participating veterinary hospitals and clinics acting as collection centers that were serviced by a centralized storage facility. Recruitment was targeted at rural veterinary clinics. A tailored, stable collection kit (DogMATIC) was designed that was used by veterinarians in remote or rural locations to collect both fresh and fixed tissue for submission to the biobank. To validate this methodology the kit design, collection rate, and sample quality were analyzed. The Australian Veterinary Cancer Biobank was established as a network of 47 veterinary clinics and three veterinary pathology laboratories spanning over 200,000 km(2). In the first 12 months, 30 canine mammary tumor cases were submitted via the DogMATIC kit. Pure intact RNA was isolated in over 80% of samples with an average yield of 14.49 μg. A large network biobank, utilizing off-site collection with the DogMATIC kit, was successfully coordinated. The creation of the Australian Veterinary Cancer Biobank has established a long-term, sustainable, comparative oncology research resource in Australia. There are broader implications for biobanking with this very different form of collection and banking.
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Affiliation(s)
- Kristi M Milley
- 1 School of Medical Sciences, RMIT University , Bundoora, Australia .,2 Australian Veterinary Cancer Biobank , Bundoora, Australia
| | - Judith S Nimmo
- 3 Australian Specialized Animal Pathology Laboratories , Mulgrave, Australia
| | - Barbara Bacci
- 2 Australian Veterinary Cancer Biobank , Bundoora, Australia .,4 Faculty of Veterinary Science, The University of Melbourne , Werribee, Australia
| | - Stewart D Ryan
- 2 Australian Veterinary Cancer Biobank , Bundoora, Australia .,4 Faculty of Veterinary Science, The University of Melbourne , Werribee, Australia
| | | | - Janine A Danks
- 1 School of Medical Sciences, RMIT University , Bundoora, Australia .,2 Australian Veterinary Cancer Biobank , Bundoora, Australia .,5 Department of Medicine, The University of Melbourne , Austin Health, Heidelberg, Australia
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Vaithilingam RD, Safii SH, Baharuddin NA, Karen-Ng LP, Saub R, Ariffin F, Ramli H, Sharifuddin A, Hidayat MFH, Raman R, Chan YK, Rani NA, Rahim RA, Shahruddin N, Cheong SC, Bartold PM, Zain RB. Establishing and managing a periodontal biobank for research: the sharing of experience. Oral Dis 2014; 21:e62-9. [PMID: 24930489 DOI: 10.1111/odi.12267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/12/2014] [Accepted: 06/08/2014] [Indexed: 12/30/2022]
Abstract
Periodontal bio-repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad-based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.
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Affiliation(s)
- R D Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Mustafina SV, Simonova GI, Rymar OD. Comparative characteristics of diabetes risk scores. DIABETES MELLITUS 2014. [DOI: 10.14341/dm2014317-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The worldwide prevalence of diabetes among adults (aged 20?79 years) was 8.35% in 2013, and this is expected to increase by 55% (592 million adults) by 2035. To avoid the increase in the prevalence of diabetes, primary prevention and early diagnosis of prediabetes are required. It is important to identify individuals at a high risk of hyperglycaemia using inexpensive and available methods. At present, risk score is an alternative to identify the risk of developing diabetes. There are approximately 10 types of risk scores in the world, and further research for the development and adaptation of risk scores for various populations are being conducted. The use of risk score methods for prediction allows the setting of the level of total risk, identification of high-risk patients and prescription of necessary preventive measures. Actual validation of existing diabetes risk score for the Russian population is being conducted. Assessment of the risk of diabetes is simple, fast, inexpensive, non-invasive and reliable.
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Abstract
The number of biobanks around the world has increased dramatically, owing in part, to the need for researchers to have access to large numbers of samples for genomic research. Policies for enrolling participants, returning research results and obtaining samples and data can have a far reaching impact on the type of research that can be performed with each biobank. Research using biobank samples includes studies of the impact of environmental and other risk exposures on health, understanding genetic risks for common disease, identification of biomarkers in disease progression and prognosis, and implementation of personalized medicine projects. This research has been instrumental in the progress of genetic and genomic research and translational medicine. This article will highlight some of the controversies and recent research associated with biobanking over the past year.
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