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Shahrestanaki E, Mohammadian Khonsari N, Seif E, Baygi F, Ejtahed HS, Sheidaei A, Djalalinia S, Magliano DJ, Qorbani M. The worldwide trend in diabetes awareness, treatment, and control from 1985 to 2022: a systematic review and meta-analysis of 233 population-representative studies. Front Public Health 2024; 12:1305304. [PMID: 38827607 PMCID: PMC11140097 DOI: 10.3389/fpubh.2024.1305304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 03/06/2024] [Indexed: 06/04/2024] Open
Abstract
Background With the rapid increase in the prevalence of DM, studies on the awareness, treatment, and control of this condition are essential. Therefore, this study aimed to review the literature and pool the awareness, treatment, and control of diabetes at the global, regional, and national levels. Methods In this systematic review and meta-analysis, several databases, including MEDLINE/PubMed, Institute of Scientific Information (ISI), Scopus, and Google Scholar, were searched using appropriate keywords up to June 2022. Observational studies investigating the awareness, treatment, and control of glucose levels among diabetic individuals were included. Awareness, treatment, and control were defined as the proportion of participants who were aware of their diabetes condition, treated pharmacologically, and achieved adequate glucose control, respectively. Two investigators independently conducted the study selection, data extraction, and quality assessment. Heterogeneity among studies was calculated using Chi-square, and a random-effect meta-analysis was used to pool the rates. Results A total of 233 studies published between 1985 and 2022 met the inclusion criteria. The included studies had a combined population of 12,537,968. The pooled awareness of DM was 60% (95%CI: 56-63) and ranged from 41% (25-57) in low-income countries to 68% (64-72) in high-income countries, with no significant trend observed over the assessed periods at the global level. The pooled treatment of DM globally was 45% (42-48) and varied from 37% (31-43) in lower-middle-income countries to 53% (47-59) in high-income countries, showing variation over the examined time period. Before 2000, the proportion of adequate DM control was 16% (12-20), which significantly improved and reached 22% (19-25) after 2010. The pooled awareness, treatment, and control of DM were higher in females, high-income countries, and urban areas compared to males, upper and lower-middle-income countries, and rural areas, respectively. The older adults population had higher awareness and treatment rates than the adult population, but their DM control did not differ significantly. Conclusion Despite the high level of awareness and treatment among the diabetic population, treatment success (control) is considerably low, particularly in low-income countries and rural areas. It is crucial to improve awareness, treatment, and control by strengthening the primary care system in all countries.
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Affiliation(s)
- Ehsan Shahrestanaki
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Seif
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research & Technology, Ministry of Health & Medical Education, Tehran, Iran
| | - Dianna J. Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Selvavinayagam TS, Viswanathan V, Ramalingam A, Kangusamy B, Joseph B, Subramaniam S, Sheela JS, Wills S, Ramasamy S, Venkatasamy V, Rajasekar D, Chinnasamy G, Govindasamy E, Duraisamy A, Chokkalingam D, Durairajan D, Kriina M, Vasu H, Selvam JM, Sakthivel U, Kaur P, Palaniandi S. Prevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020. PLoS One 2024; 19:e0298340. [PMID: 38718057 PMCID: PMC11078398 DOI: 10.1371/journal.pone.0298340] [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: 05/26/2023] [Accepted: 01/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs) account for nearly 75% of all deaths in Tamil Nadu. The government of Tamil Nadu has initiated several strategies to control NCDs under the Tamil Nadu Health Systems Reform Program (TNHSRP). We aimed to estimate the prevalence of NCD risk factors and determine the predictors of diabetes and hypertension, which will be helpful for planning and serve as a baseline for evaluating the impact of interventions. METHODS A state-wide representative cross-sectional study was conducted among 18-69-year-old adults in Tamil Nadu in 2020. The study used a multi-stage sampling method to select the calculated sample size of 5780. We adapted the study tools based on WHO's STEPS surveillance methodology. We collected information about sociodemographic factors, NCD risk factors and measured blood pressure and fasting capillary blood glucose. The predictors of diabetes and hypertension were calculated using generalised linear models with 95% confidence intervals (95% CI). RESULTS Due to the COVID-19 pandemic lockdown, we could cover 68% (n = 3800) of the intended sample size. Among the eligible individuals surveyed (n = 4128), we had a response rate of 92%. The mean age of the study participants was 42.8 years, and 51% were women. Current tobacco use was prevalent in 40% (95% CI: 33.7-40.0) of men and 7.9% (95% CI: 6.4-9.8) of women. Current consumption of alcohol was prevalent among 39.1% (95% CI: 36.4-42.0) of men. Nearly 28.5% (95% CI: 26.7-30.4) of the study participants were overweight, and 11.4% (95% CI: 10.1-12.7) were obese. The prevalence of hypertension was 33.9% (95% CI: 32.0-35.8), and that of diabetes was 17.6% (95% CI: 16.1-19.2). Older age, men, and obesity were independently associated with diabetes and hypertension. CONCLUSION The burden of NCD risk factors like tobacco use, and alcohol use were high among men in the state of Tamil Nadu. The prevalence of other risk factors like physical inactivity, raised blood pressure and raised blood glucose were also high in the state. The state should further emphasise measures that reduce the burden of NCD risk factors. Policy-based and health system-based interventions to control NCDs must be a high priority for the state.
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Affiliation(s)
- T. S. Selvavinayagam
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
| | - Vidhya Viswanathan
- Directorate of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Bency Joseph
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Soniya Wills
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | - Daniel Rajasekar
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | | | - D. Chokkalingam
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Dinesh Durairajan
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Mosoniro Kriina
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Harshavardhini Vasu
- Tamil Nadu Health Systems Reforms Project, Government of Tamil Nadu, Chennai, India
| | | | - Uma Sakthivel
- Tamil Nadu Health Systems Reforms Project, Government of Tamil Nadu, Chennai, India
| | - Prabhdeep Kaur
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
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Gudlavalleti AG, Babu GR, Agiwal V, Murthy GVS, Schaper NC, van Schayck OCP. Undesirable Levels of Practice Behaviours and Associated Knowledge amongst Community Health Workers in Rural South India Responsible for Type 2 Diabetes Screening and Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:562. [PMID: 38791775 PMCID: PMC11121515 DOI: 10.3390/ijerph21050562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/06/2024] [Accepted: 04/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Type 2 diabetes (T2DM) poses an enormous global health care challenge, especially among rural communities. Healthcare in these areas can be inadequate and inaccessible due to socio-demographic barriers. To overcome this situation, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. OBJECTIVE This cross-sectional study aimed to evaluate the proficiency of CHWs involved in diabetes screening and management in rural South India by identifying the existing practice behaviours and knowledge gaps. METHODS Employing a customised questionnaire, developed through inputs from experts and government officials, we assessed practice behaviours and the corresponding knowledge base of 275 CHWs. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. RESULTS The study showcased significant deficiencies in both practice behaviours (97%) and knowledge (95%) with current mean levels ranging from 48 to 50%, respectively, among the participants. The identified areas of insufficiency were broadly representative of the core competencies required for effective diabetes management, encompassing diabetes diagnosis and referral, HbA1c testing, diabetes diet, diabetes type and self-management, microvascular complications and their screening, peripheral neuropathy management, and diabetes risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management, and calculation of diabetes risk assessment. CONCLUSION This study highlights widespread deficiencies (97% CHWs) in diabetes management practices and knowledge (95% CHWs). To overcome these deficiencies, a thorough needs assessments is vital for effective CHW training. Training of CHWs should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.
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Affiliation(s)
- Anirudh G. Gudlavalleti
- Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India;
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
| | - Giridhara R. Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
| | - Varun Agiwal
- Indian Institute of Public Health Hyderabad, Rajendranagar, Hyderabad 500030, Telangana, India;
| | - G. V. S. Murthy
- Pragyaan Sustainable Health Outcomes Foundation, World Trade Centre, Nanakramguda, Hyderabad 500032, Telangana, India;
| | - Nicolaas C. Schaper
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (N.C.S.); (O.C.P.v.S.)
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Sequira L, Prabhu A R, S Mayya S, Prasad Nagaraju S, S Nayak B. Effectiveness of a Disease Management Program (DMP) in controlling the progression of Chronic Kidney Disease among hypertensives and diabetics. F1000Res 2024; 11:1111. [PMID: 38576797 PMCID: PMC10993008 DOI: 10.12688/f1000research.123787.3] [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] [Accepted: 04/04/2024] [Indexed: 04/06/2024] Open
Abstract
Background The occurrence rate of stage 5 chronic kidney disease (CKD) will be 151 per million population in India in the coming years. Comorbidities like diabetes mellitus and hypertension are the usual triggers of CKD. Hence this study aimed to control the progression of CKD and to note the effectiveness of a structured education program that would help in the prevention of complications related to diabetes and hypertension. Methods This quasi-experimental study was conducted among 88 participants who had hypertension, diabetes mellitus, or both for five or more years. The study objective was to find the effect of a Disease Management Program on delaying progression of CKD in patients with hypertension or diabetes mellitus.The baseline data were obtained from demographic proforma, and the clinical data collected were the blood pressure, serum creatinine, and random blood sugar (RBS) of the participants. The management of hypertension and diabetes mellitus was taught to them. In the fourth and the eighth month, blood pressure and blood sugar were reassessed. At one-year blood pressure, blood sugar, and serum creatinine were tested. Baseline and one-year follow-up blood pressure, blood sugar, and estimated Glomerular Filtration Rate were compared. Descriptive statistics and "Wilcoxon signed-rank test" were used to analyze the data. Results In one year, the mean systolic blood pressure reduced by six mm of Hg and mean blood sugar by 24 mg/dl. The prevalence of CKD stage three and above (< 60 ml/min/m2) was nine (10.22%). The median decline in eGFR was 5 ml/min/m2 (Z= 5.925, P< 0.001). Conclusion The Disease Management Program led to improvements in blood pressure and diabetes control and median progression of CKD was estimated at five ml/min/m2/year.
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Affiliation(s)
- Leena Sequira
- Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ravindra Prabhu A
- Nephrology, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shreemathi S Mayya
- Data Science, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shankar Prasad Nagaraju
- Nephrolgy, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Baby S Nayak
- Child Health Nursing, Manipal College of Nursing. Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
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Sujata S, B G, Thakur R. A Vulnerability Index for Mitigation and Prevention of Diabetes Growth in India: A Disaggregated Analysis. Value Health Reg Issues 2024; 40:89-99. [PMID: 38061309 DOI: 10.1016/j.vhri.2023.09.009] [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: 01/14/2023] [Revised: 08/29/2023] [Accepted: 09/22/2023] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to provide a vulnerability index (VI) for identifying vulnerable regions in different states of India, which may serve as a tool for state- and district-level planning for mitigation and prevention of diabetes growth in the country. METHODS Using data on 13 indicators under 4 domains, we generated domain-specific and overall VIs at state (36 states/union territories) and district levels (640 districts) using the percentile ranking method. The association of diabetes with individuals' socioeconomic status at different levels of regional vulnerability has also been observed through multivariable logistic regression models. RESULTS On a scale of 0 to 1, there are 13 states with an overall VI of >0.70, of which 5 states are from southern regions of India. A low VI has been achieved by socioeconomically backward states. We observed that prevalence rates and vulnerability levels for most of the top and bottom 11 states are in the same line. District-level analysis showed that the 20 most vulnerable and least vulnerable districts are mostly from coastal and socioeconomically backward states of the country, respectively. Furthermore, logistic regression revealed that rural adults and females are less likely to be diabetic in all vulnerability quartiles. The oldest, Muslims, wealthiest, widowed/deserted/separated, and those with schooling ≤12 years are significantly more likely to be diabetic than their counterparts. CONCLUSION The constructed VI is vital for identifying vulnerable areas and planners and policy-makers may use this comprehensive index and domain-specific VIs to prioritize resource allocation.
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Affiliation(s)
- Sujata Sujata
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India
| | - Gayathri B
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India
| | - Ramna Thakur
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India.
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Kesavan R, Sheela Sasikumar C, Narayanamurthy VB, Rajagopalan A, Kim J. Management of Diabetic Foot Ulcer with MA-ECM (Minimally Manipulated Autologous Extracellular Matrix) Using 3D Bioprinting Technology - An Innovative Approach. INT J LOW EXTR WOUND 2024; 23:161-168. [PMID: 34636693 DOI: 10.1177/15347346211045625] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Chronic foot ulcers are the leading cause of prolonged hospitalization and loss of social participation in people with diabetes. Conventional management of diabetic foot ulcers (DFU) is associated with slow healing, high cost, and recurrent visits to the hospital. Currently, the application of autologous lipotransfer is more popular, as the regenerative and reparative effects of fat are well established. Herein we report the efficacy of minimally manipulated extracellular matrix (MA-ECM) prepared from autologous homologous adipose tissue by using 3D bioprinting in DFU (test group) in comparison to the standard wound care (control group). A total of 40 subjects were screened and randomly divided into test and control groups. In the test group, the customized MA-ECM was printed as a scaffold from the patient autologous fat using a 3D bioprinter device and applied to the wound directly. The control group received standard wound care and weekly follow-up was done for all the patients. We evaluated the efficacy of this novel technology by assessing the reduction in wound size and attainment of epithelialization. The patients in the test group (n = 17) showed complete wound closure with re-epithelialization approximately within a period of 4 weeks. On the other hand, most of the patients in the control group (n = 16) who received standard wound dressings care showed a delay in wound healing in comparison to the test group. This technique can be employed as a personalized therapeutic method to accelerate diabetic wound healing and may provide a promising potential alternative approach to protect against lower foot amputation a most common complication in diabetes.
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Affiliation(s)
- Rajesh Kesavan
- Department of Podiatric Surgery, NRA Wound Care Pvt Ltd, Hycare Super speciality Hospital, Chennai, Tamilnadu, India
- SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, India
| | - Changam Sheela Sasikumar
- Department of Clinical Research, S.S. Healthcare, NRA Wound Care Pvt Ltd, Hycare Super Speciality, Hospital, Chennai, Tamilnadu, India
- Department of Biochemistry, Saveetha Dental College, Saveetha Institute of Medical & Technical Sciences, Saveetha University Chennai, Tamilnadu, India
| | - V B Narayanamurthy
- Department of Plastic Surgery, NRA Wound Care Pvt Ltd, Hycare Super Speciality Hospital, Chennai, Tamilnadu, India
| | - Arvind Rajagopalan
- Department of Orthopedic Surgery, NRA Wound Care Pvt Ltd, Hycare Super Speciality Hospital, Chennai, Tamilnadu, India
| | - Jeehee Kim
- R&D Center, ROKIT AMERICA, 3580 Wilshire Blvd., Los Angeles, CA, USA
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Madhukar M, Athavale PV, Gandham NR, Vyawahare CR, Athavale VS. Commonly associated aerobic microbial pathogens and their antibiotic susceptibility profile in diabetic foot ulcers in tertiary care centre in Western Maharashtra. Indian J Med Microbiol 2024; 48:100538. [PMID: 38354981 DOI: 10.1016/j.ijmmb.2024.100538] [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: 05/08/2023] [Revised: 06/20/2023] [Accepted: 02/09/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE Diabetes mellitus (DM-II) is a metabolic disorder either due to reduced insulin production or reduced insulin sensitivity. Diabetic foot ulcer (DFU) is one of the most devastating complications of DM-II. This study was performed to assess commonly isolated micro-organisms and their anti-microbial sensitivity pattern in diabetic foot ulcers in a tertiary care centre in Western Maharashtra. METHODS Adult patients with a known case of DM-II with foot lesions, suspected to be a Diabetic Foot Infections (DFIs) at the tertiary care hospital from Aug 2022 to Sept 2022 were included in the study. After obtaining informed written consent, pus sample was collected with sterile swab from lesion's base and submitted to Microbiology Laboratory for aerobic culture and sensitivity. RESULTS Out of 56 enrolled patients, 47 (83.9%) patients tested positive for bacteriological growth and there was 'no growth' in 9 (16.07%) patients at the end of 48 h of aerobic incubation. There was male preponderance and patients were in age group of 35-85 years. The most commonly isolated micro-organisms were P. aeruginosa (17.8%), followed by S. aureus (14.2%), K. pneumonia and P. mirabilis (12.5% each). The resistance markers observed was ESBL producer, AmpC producer, MBL producer, Methicillin resistance and Inducible Clindamycin Resistance (ICR). CONCLUSION Due to the injudicious use of antibiotics, antibiotic resistance has been increased in all types of soft tissue infections. The empirical formula for the treatment of DFIs should be decided for given geographical reasons according to antimicrobial susceptibility profile from particular geographical area or health care institute.
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Affiliation(s)
- Madineni Madhukar
- D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
| | - Prachi V Athavale
- D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
| | - Nageswari R Gandham
- D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
| | - Chanda R Vyawahare
- D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
| | - Virendra S Athavale
- D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
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Sahadevan P, Kamal VK, Sasidharan A, Bagepally BS, Kumari D, Pal A. Prevalence and risk factors associated with undiagnosed diabetes in India: Insights from NFHS-5 national survey. J Glob Health 2023; 13:04135. [PMID: 38063336 PMCID: PMC10704946 DOI: 10.7189/jogh.13.04135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Background Undiagnosed diabetes is a significant public health concern in India, considering the accumulative burden of diabetes and its long-term complications. We have estimated the prevalence and factors associated with undiagnosed diabetes in India. Methods We used data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21) to estimate undiagnosed diabetes prevalence aged under 50 (15-49) years. A log-binomial model with survey-adjusted Poisson regression was used to estimate the prevalence risk ratio (PR) between undiagnosed diabetes and various factors. Multinomial logistic regression analysis was performed to examine the factors associated with diagnosed diabetes (vs. healthy) and undiagnosed diabetes (vs. healthy). All the analyses were survey-weighted and stratified by gender and reported with 95% confidence intervals. Results The prevalence of diabetes for individuals aged 15-49 years was found to be 4.90% (4.80 to 5.00%) from the NFHS-5. Among them, the proportion of individuals with undiagnosed diabetes was 24.82% (24.07 to 25.59%), with higher among males (28.82% (26.45 to 31.30%)) than females (24.22% (23.44 to 25.01%)). The overall prevalence of undiagnosed diabetes was 1.22% (1.18 to 1.26%), with a higher prevalence among males (1.60% (1.46 to 1.76%)) than females (1.17% (1.13 to 1.21%)). Individuals who are middle-aged (45-49), have a higher body mass index (BMI), and are in a lower wealth index group, or live in the southern regions of India are at a higher risk of being undiagnosed for diabetes. Conclusion One in every four having diabetes is undiagnosed. The study highlights the need for public health interventions to improve diabetes screening and access to health care, particularly among middle-aged individuals, and those with higher BMI, as well as addressing lifestyle and dietary factors. The findings also reveal disparities in diabetes burden among population subgroups in India, underscoring the need for targeted efforts.
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Affiliation(s)
| | | | | | | | - Dolly Kumari
- Asian Development Research Institute, Patna, India
- Bihar Institute of Public Finance and Policy (BIPFP), Patna, India
| | - Anita Pal
- University of Hyderabad, Hyderabad, India
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Sharma D, Goel NK, Cheema YS, Garg K. Medication Adherence and its Predictors among Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Indian J Community Med 2023; 48:781-785. [PMID: 37970170 PMCID: PMC10637603 DOI: 10.4103/ijcm.ijcm_744_22] [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] [Received: 08/03/2022] [Accepted: 08/02/2023] [Indexed: 11/17/2023] Open
Abstract
Medication adherence is vital in managing noncommunicable diseases like diabetes. Illness perception and an individual's knowledge regarding the disease may influence medication adherence. The present study aimed to assess the prevalence and predictors of medication adherence among type 2 diabetic patients. A cross-sectional study was conducted among 400 diabetes mellitus patients attending an outdoor patient department (OPD) of a tertiary care hospital in North India. Brief Medication Questionnaire (BMQ) and Brief Illness Perception Questionnaire (B-IPQ) were used to study medication adherence and illness perception, respectively. Descriptive and analytic statistics were computed using Epi Info software for Windows (CDC, Atlanta, GA, USA). The prevalence of medication adherence was 79.5% (82/400). The odds of medication adherence increased with higher age (odds ratio [OR] = 1.8 [1.1-2.9]) and more duration of illness (OR = 1.8 [1.0-3.2]) Patients having good knowledge of diabetes were more likely to adhere to medications. [OR=1.8(1.1-3.1). Diabetes medicine-adherent patients had a higher perceived understanding of the disease, felt having lesser negative consequences, and were less concerned about the illness than their counterparts. A high proportion adhered to diabetes medication. The guiding factors to further improve medication adherence are age, duration of illness, illness perception, and knowledge regarding the disease.
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Affiliation(s)
- Deepak Sharma
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Naveen Krishan Goel
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Yuvraj Singh Cheema
- General Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Keshav Garg
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
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Joshi NK, Arora V, Purohit A, Lohra A, Joshi V, Shih T, Harsh J. Defeating diabetes in the desert: A community-based mHealth diabetes screening intervention in Jodhpur Rajasthan. J Family Med Prim Care 2023; 12:1571-1575. [PMID: 37767424 PMCID: PMC10521845 DOI: 10.4103/jfmpc.jfmpc_2273_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 09/29/2023] Open
Abstract
Background There is a paucity of demonstrated models for mHealth-based diabetes screening and coordinated care in India, especially in western Rajasthan, which is the part of Thar desert. Materials and Methods JSPH collaboratively developed and implemented an easy-to-use, noninvasive, mobile phone-based screening interview, to identify adults at high risk for diabetes. The high risk for diabetes was defined using multiple clinical and epidemiologic criteria, all based on the evidence for India and globally. Since participants above 35 years or older were only considered in the screening, the application was designed to categorize the participants as high and low risk. Results Out of 4000 screened participants, the percentage of males and females were 51% and 50%, respectively. Participants found to be at high risk and low risk were n = 3600 (90%) and 400 (10%). The mean age of high- and low-risk participants was 52.2 (+12.8) and 36.2 (+4.2), respectively. Of the 3600 high-risk individuals who have been given a follow-up interview, 90.50% of high-risk individuals obtained diabetes testing, and of these, 65.67% had a written report showing they test positive for diabetes or prediabetes, requiring ongoing clinical care. Conclusions JSPH mHealth application provided a novel noninvasive way to better identify those at high diabetes risk in the community and demonstrated how to optimize the use of mobile health methods in diabetes prevention and care services.
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Affiliation(s)
- Nitin K. Joshi
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Jodhpur School of Public Health, Jodhpur, Rajasthan, India
| | - Vikas Arora
- Jodhpur School of Public Health, Jodhpur, Rajasthan, India
| | - Anil Purohit
- Jodhpur School of Public Health, Jodhpur, Rajasthan, India
| | - Abhishek Lohra
- Jodhpur School of Public Health, Jodhpur, Rajasthan, India
| | - Vibha Joshi
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
- Jodhpur School of Public Health, Jodhpur, Rajasthan, India
| | - Ting Shih
- CEO, Click Medix, Maryland, United States
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Damtie S, Workineh L, Berhan A, Tiruneh T, Legese B, Getie B, Kiros T, Eyayu T. The magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town, northcentral Ethiopia: A community-based cross-sectional study. Heliyon 2023; 9:e17729. [PMID: 37519754 PMCID: PMC10372355 DOI: 10.1016/j.heliyon.2023.e17729] [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: 05/13/2022] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Background Diabetes mellitus (DM) is a worldwide public health problem. The burden of diabetes has been continuously increasing from day to day, especially in developing countries like Ethiopia. Globally, half of all cases of diabetes mellitus are undiagnosed. Diabetes mellitus can be easily handled if it is detected early. There is limited evidence on the magnitude of undiagnosed diabetics and prediabetes at the community level in Ethiopia, particularly in the study area. Objective To assess the magnitude of undiagnosed diabetes mellitus, prediabetes, and associated factors among adults living in Debre Tabor town. Methods A community-based cross-sectional study was conducted in Debre Tabor town from October to December 2021. A total of 407 participants were selected using a multistage sampling technique. A pretested structural questionnaire was used to collect demographic, behavioral, and clinical data. Anthropometric measurements were taken with standardized and calibrated equipment. A fasting venous blood sample was collected for blood glucose level determination. Logistic regression was used to identify risk factors. A P-value ≤0.05 was considered statistically significant. Result The magnitude of undiagnosed diabetes mellitus and prediabetes was found to be 4.5% (95% CI: 2.9-7.4) and 14.5% (95% CI: 11.1-18.1), respectively. Older age (AOR: 6.50, 95% CI: 1.82-23.21), abnormal body mass index (AOR: 6.84, 95% CI: 1.91-24.54), systolic hypertension (AOR: 8.74, 95% CI: 2.53-30.19), and family history of diabetes mellitus (FHDM) (AOR: 12.45, 95% CI: 3.63-42.65) were significantly associated with undiagnosed diabetes mellitus. Using saturated oil (AOR: 1.97, 95% CI: 1.09-3.55), having a high waist circumference (AOR: 2.16, 95% CI: 1.20-3.87), and being hypertensive (AOR: 2.26, 95% CI: 1.04-4.96) were all significantly associated with Prediabetes. Conclusion Adults in Debre Tabor town have a high prevalence of undiagnosed diabetes and prediabetes. A variety of modifiable risk factors were also identified. As a result, focusing the prevention strategy on such modifiable risk factors may help to minimize the prevalence of undiagnosed diabetes mellitus and prediabetes as well as future disease complications.
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Affiliation(s)
- Shewaneh Damtie
- Corresponding author. Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Ethiopia
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12
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M Ganji S, Ba PK, Varaprasad M D, Pichandi J. Effect of Behavior Change Communication on Self-Care Practices Among Adult Type-2 Diabetic Patients in a Semi-urban Community of South India: A Quasi-Experimental Study. Cureus 2023; 15:e38805. [PMID: 37303365 PMCID: PMC10250782 DOI: 10.7759/cureus.38805] [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] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Diabetes mellitus is often termed the modern epidemic, and India ranks second after China in the global disease burden. Practice and adherence to essential self-care behaviors, positively correlated with good glycemic control and reduced complications in people with diabetes, have been inadequately understood, especially in a semi-urban setting. METHODS This community-based interventional study was done among 269 known adult type 2 diabetic patients from a semi-urban community in South India for three months. By simple random sampling, known diabetics identified in the health survey by the tertiary care teaching institute were considered for the study. Self-care practices in diabetes were recorded in the pre-test using a validated semi-structured questionnaire. Two health education sessions, each for 30 minutes, were conducted with 15-20 subjects in a group. Health education materials on self-care in diabetes, such as charts, handouts, video clippings, and PowerPoint presentations in the local language, were used. The self-care practices were re-recorded in the post-test after two months. Inferential statistics were carried out with a t-test, analysis of variance (ANOVA), and Pearson correlation coefficient, and a p-value less than 0.05 was considered statistically significant. Results: A total of 253 diabetic subjects were included in the final analysis, with an attrition rate of 6%. The mean age of participants was 56.5 ± 11.9 years. The mean score of self-care practices among diabetic subjects at the baseline was 14.6 ± 13.2. Illiteracy and smoking habit were significantly associated with lower self-care scores in the pre-test. In the post-test, after health education, there was a significant improvement in the mean self-care practices score and a reduction in the mean fasting blood sugar level. Also, a significant mild negative correlation between the self-care scores and blood sugar levels was seen (Pearson correlation coefficient = -0.21, p < 0.001). CONCLUSION Self-care practices, which were not satisfactory in most diabetic participants, were found to be significantly impacted by the small group education. This stresses the need for effective health education sessions as envisaged under the national program.
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Affiliation(s)
| | - Praveen Kumar Ba
- Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, IND
| | - Devi Varaprasad M
- Department of Community Medicine, SRM (Sri Ramaswami Memorial) Medical College Hospital and Research Centre, Chennai, IND
| | - Janakiraman Pichandi
- Department of Community Medicine, PES Institute of Medical Sciences and Research, Kuppam, IND
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Yeh EJ, Grigolon RB, Rodrigues SR, A Bueno AP. Systematic literature review and meta-analysis of cardiovascular risk factor management in selected Asian countries. J Comp Eff Res 2023; 12:e220085. [PMID: 36861459 PMCID: PMC10402804 DOI: 10.57264/cer-2022-0085] [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: 05/06/2022] [Accepted: 01/20/2023] [Indexed: 03/03/2023] Open
Abstract
Aim: There is a need to understand the management status of hypertension, dyslipidemia/hypercholesterolemia, and diabetes mellitus in the Asia-Pacific region (APAC). Methods: We conducted a systematic literature review and meta-analysis to summarize the awareness, treatment, and/or control rates of these risk factors in adults across 11 APAC countries/regions. Results: We included 138 studies. Individuals with dyslipidemia had the lowest pooled rates compared with those with other risk factors. Levels of awareness with diabetes mellitus, hypertension, and hypercholesterolemia were comparable. Individuals with hypercholesterolemia had a statistically lower pooled treatment rate but a higher pooled control rate than those with hypertension. Conclusion: The management of hypertension, dyslipidemia, and diabetes mellitus was suboptimal in these 11 countries/regions.
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Okafor CN, Obikeze E, Young E, Onwujekwe O. Economic Burden of Diabetes and Hypertension: A Study of Direct and Indirect Cost of Treatment in Southeast Nigeria. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2023; 53:168-175. [DOI: : 10.1177/00207314221134035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2024]
Abstract
The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hypertension occurring both singly and in co-morbidity. The study was undertaken in the Enugu State University Teaching Hospital (a tertiary hospital) in Enugu State, Southeast Nigeria. Data were collected using a pre-tested questionnaire. Out of 817 patients interviewed, 37% had only diabetes mellitus, 35% had hypertension, and 28% had both diabetes mellitus and hypertension in co-morbidity. Direct costs of treating diabetes mellitus and hypertension in the month before the survey were $28.40 and $19.35, respectively, while the indirect costs of treatment in the month before the study were $7.36 and $5.51, respectively. Direct and indirect costs for diabetes mellitus and hypertension in co-morbidity were $37.00 and $4.62, respectively. A concentration index showed that diabetes mellitus and hypertension were more evident among the poor than the rich. The economic cost when compared with patients’ income revealed that >25% of their income is spent monthly on health care.
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Affiliation(s)
- Chinyere N. Okafor
- Department of Community Medicine, University of Nigeria Nsukka, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Eric Obikeze
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Nsukka, Enugu, Nigeria
| | - Ekenechukwu Young
- Department of Medicine, University of Nigeria Nsukka, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology/Therapeutics, University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria Nsukka, Enugu, Nigeria
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15
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Islam MM, Rahman MJ, Menhazul Abedin M, Ahammed B, Ali M, Ahmed NF, Maniruzzaman M. Identification of the risk factors of type 2 diabetes and its prediction using machine learning techniques. Health Syst (Basingstoke) 2022; 12:243-254. [PMID: 37234468 PMCID: PMC10208154 DOI: 10.1080/20476965.2022.2141141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
This study identified the risk factors for type 2 diabetes (T2D) and proposed a machine learning (ML) technique for predicting T2D. The risk factors for T2D were identified by multiple logistic regression (MLR) using p-value (p<0.05). Then, five ML-based techniques, including logistic regression, naïve Bayes, J48, multilayer perceptron, and random forest (RF) were employed to predict T2D. This study utilized two publicly available datasets, derived from the National Health and Nutrition Examination Survey, 2009-2010 and 2011-2012. About 4922 respondents with 387 T2D patients were included in 2009-2010 dataset, whereas 4936 respondents with 373 T2D patients were included in 2011-2012. This study identified six risk factors (age, education, marital status, SBP, smoking, and BMI) for 2009-2010 and nine risk factors (age, race, marital status, SBP, DBP, direct cholesterol, physical activity, smoking, and BMI) for 2011-2012. RF-based classifier obtained 95.9% accuracy, 95.7% sensitivity, 95.3% F-measure, and 0.946 area under the curve.
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Affiliation(s)
- Md. Merajul Islam
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
- Department of Statistics, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | | | | | - Benojir Ahammed
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - Mohammad Ali
- Statistics Discipline, Khulna University, Khulna, Bangladesh
| | - N.A.M Faisal Ahmed
- Institute of Education and Research, University of Rajshahi, Rajshahi, Bangladesh
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Okafor CN, Obikeze E, Young E, Onwujekwe O. Economic Burden of Diabetes and Hypertension: A Study of Direct and Indirect Cost of Treatment in Southeast Nigeria. INTERNATIONAL JOURNAL OF HEALTH SERVICES : PLANNING, ADMINISTRATION, EVALUATION 2022; 53:207314221134035. [PMID: 36285454 DOI: 10.1177/00207314221134035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hypertension occurring both singly and in co-morbidity. The study was undertaken in the Enugu State University Teaching Hospital (a tertiary hospital) in Enugu State, Southeast Nigeria. Data were collected using a pre-tested questionnaire. Out of 817 patients interviewed, 37% had only diabetes mellitus, 35% had hypertension, and 28% had both diabetes mellitus and hypertension in co-morbidity. Direct costs of treating diabetes mellitus and hypertension in the month before the survey were $28.40 and $19.35, respectively, while the indirect costs of treatment in the month before the study were $7.36 and $5.51, respectively. Direct and indirect costs for diabetes mellitus and hypertension in co-morbidity were $37.00 and $4.62, respectively. A concentration index showed that diabetes mellitus and hypertension were more evident among the poor than the rich. The economic cost when compared with patients' income revealed that >25% of their income is spent monthly on health care.
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Affiliation(s)
- Chinyere N Okafor
- Department of Community Medicine, 107769University of Nigeria Nsukka, Enugu, Nigeria
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
| | - Eric Obikeze
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, 107769University of Nigeria Nsukka, Enugu, Nigeria
| | - Ekenechukwu Young
- Department of Medicine, 107769University of Nigeria Nsukka, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology/Therapeutics, 107769University of Nigeria, Nsukka, Enugu, Nigeria
- Department of Health Administration and Management, 107769University of Nigeria Nsukka, Enugu, Nigeria
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Hinduja ARA, Tambe RR, Giri PA, Sunil S, Limaye H, Kalpana G. Mucormycosis and diabetes in the times of COVID-19: A Mumbai-based observational study. J Family Med Prim Care 2022; 11:6107-6114. [PMID: 36618183 PMCID: PMC9810900 DOI: 10.4103/jfmpc.jfmpc_291_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/23/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is a significant increase in the number of mucormycosis cases in the setting of the coronavirus disease 2019 (COVID-19) pandemic. This study was undertaken to understand the clinical profile of such patients and the risk factors associated with increased mortality of this already deadly infection. Materials and Methods A retrospective observational study was conducted by including microbiologically confirmed cases of mucormycosis with the background of COVID-19 infection (COVID-19-associated mucormycosis [CAM]). Data was segregated into those of survivors versus non-survivors and the two groups were analyzed for various risk factors. Early and late CAM were also compared. Results The case fatality rate was 21.73% (5/23 patients). Case fatality in early CAM was 33.3% versus 9.1% in late CAM. Rhino-orbital-cerebral mucormycosis (P = 0.01) and cranial nerve involvement (P = 0.0482) were associated with increased mortality. Diabetes and poor glycemic control were the common factors in all patients. Early CAM patients were more likely to have orbital or cerebral involvement (P = 0.0065). Patients having chronic liver disease had a higher risk of mortality (P = 0.0395). Sequential treatment or concurrent dual drug therapy with a combination of antifungal drugs was independently associated with better survival (P = 0.0395). The average duration of treatment with amphotericin-b required for cure by survivors was 29.05 ± 17.05 days. The average duration of treatment with isavuconazole/posaconazole for survivors was 50.32 ± 25.23 days. Conclusion Early CAM had a higher case fatality rate. Patients had better recovery rates with sequential or dual antifungal treatment. The raised incidence and mortality in the COVID-19 pandemic is probably related to the COVID-19-induced immunosuppression with associated diabetes and excessive use of steroids.
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Affiliation(s)
- Anupa R. A. Hinduja
- General Medicine, Nanavati Max Superspecialtiy Hospital, Maharashtra, India,Address for correspondence: Dr. Anupa R. A. Hinduja, 106 Palm View, Opp Akash Building, Santacruz West, Mumbai - 400 054, Maharashtra, India. E-mail:
| | - Rahul R. Tambe
- General Medicine, Nanavati Max Superspecialtiy Hospital, Maharashtra, India
| | | | - Suchithra Sunil
- General Medicine, Nanavati Max Superspecialtiy Hospital, Maharashtra, India
| | - Harshad Limaye
- General Medicine, Nanavati Max Superspecialtiy Hospital, Maharashtra, India
| | - G Kalpana
- Ear Nose and Throat, Nanavati Max Superspecialtiy Hospital, Maharashtra, India
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Validation of salivary glucose as a screening tool of diabetes mellitus. ROMANIAN JOURNAL OF INTERNAL MEDICINE 2022; 60:145-152. [DOI: 10.2478/rjim-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background: Improved prognosis and delay of clinical complications in diabetes mellitus can be ensured by early screening and regular monitoring after diagnosis. This requires venipuncture at regular intervals of time causing anxiety and discomfort to the patient. Hence, development of a painless, non-invasive procedure is desirable for which saliva is a potential tool. Also, this would provide easy and cost-effective means for large scale screening and epidemiological intervention.
Aim: To measure fasting plasma glucose (FPG) and compare and correlate with salivary glucose levels in normal and diabetic individuals. Also, the correlation between glycated hemoglobin (HbA1c) and salivary glucose is studied in the diabetics and controls.
Methods: Blood and salivary glucose was estimated by GOD-POD method and glycated hemoglobin by HPLC. Statistical analysis was done on SPSS 16. Mean, Standard deviation, independent t test, ANOVA (f test), Pearson’s correlation coefficient along with regression analysis was carried out and comparison was done between the control and diabetic groups and the different subgroups within the diabetic group.
Results: A significant difference between the salivary glucose levels in subjects indicating that a deranged glycemic status is reflected in saliva. Also, salivary glucose increases in proportion to an increase in the FPG and HbA1C of the diabetics. The regression coefficient was calculated and a formula was derived for prediction of FPG and HbA1c using salivary glucose.
Conclusion: Saliva can be used as a screening tool for diabetes. Standardization of the technique and setting up a reference range will also make it useful in diagnosing diabetes mellitus.
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Kasali FM, Kadima JN, Tusiimire J, Agaba AG. Hypoglycemic, Antihyperglycemic, and Toxic Effects of Physalis peruviana L. Aqueous and Methanolic Leaf Extracts in Wistar Rats. J Exp Pharmacol 2022; 14:185-193. [PMID: 35698475 PMCID: PMC9188478 DOI: 10.2147/jep.s356533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background Physalis peruviana L. (Solanaceae) is a plant widely used in traditional medicine systems to manage various diseases, including diabetes mellitus, which remains a global health problem in developing and developed countries. This study aimed to scientifically evaluate its antidiabetic bioactivity and short-term toxicity in rats. Methods We prepared various doses (100, 200, 400 mg/kg) of aqueous and methanolic leaf extracts for the antidiabetic study, and a dose of 2000 mg/Kg was prepared for the acute toxicity test. The first group that evaluated the hypoglycemic effect consisted of forty normoglycemic Wistar rats aged 7–8 months old with a weighted average of 265.8 ± 24.6 g. The second group consisted of intraperitoneal glucose-loaded male animals to evaluate the antihyperglycemic effect. The third group contained two groups of normoglycemic female rats (n = 3), aged 3 and 4 months old (weight average: 187.45 ± 14.82 g), treated for 14 days with aqueous and methanolic extracts (2 g/kg b.w) to assess mortality and toxic effects. Blood samples were taken at 30, 60, 90, and 120 min post-treatment in hypoglycemic and antihyperglycemic evaluations. Glibenclamide (5 mg/kg) was used as a reference drug. The control animals in each group did not receive the extracts. Results In hypoglycemic rats, 100 mg/kg of aqueous and methanolic extracts significantly lowered the fasting blood glucose level by 13.92% (p < 0.0001) and 21.95% (p < 0.01), respectively, compared to the control group. In glucose tolerance test group, methanolic extracts significantly reduced hyperglycemia by 54.55% (p < 0.0001), 46.50% (p < 0.0001), 39.78% (p < 0.0001) at 400, 200 and 100 mg/kg b.w, respectively, compared to control; aqueous extract 400 mg/kg reduced hyperglycemia by 39.44% (p < 0.05). At the 2000 mg/kg dose, leaf aqueous and methanolic extracts did not show any signs of intoxication and mortality. Conclusion Crude aqueous and methanolic leaf extracts of P. peruviana ambrosioides appeared safe at 2000 mg/kg and have bioactivity in controlling the blood glucose levels, supporting their use in treating diabetes.
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Affiliation(s)
- Félicien Mushagalusa Kasali
- Pharm-Bio Technology and Traditional Medicine Center, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, Official University of Bukavu, Bukavu, Democratic Republic of the Congo
- Correspondence: Félicien Mushagalusa Kasali, Pharm-Bio Technology and Traditional Medicine Center, Mbarara University of Science and Technology, Mbarara, Uganda, Tel +256 750919712, Email
| | | | - Jonans Tusiimire
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Amon Ganafa Agaba
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
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Thakur JS, Nangia R. Prevalence, Awareness, Treatment, and Control of Hypertension and Diabetes: Results From Two State-Wide STEPS Survey in Punjab and Haryana, India. Front Public Health 2022; 10:768471. [PMID: 35387189 PMCID: PMC8978601 DOI: 10.3389/fpubh.2022.768471] [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: 08/31/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background India which is home to more than one sixth of the world's population, accounts for more than two thirds of total deaths due to non-communicable diseases (NCD). Out of this, hypertension and diabetes are the most common NCDs. Awareness, treatment, and control of hypertension and diabetes remains a major challenge despite various national programs being run to curb the rising burden NCDs. In order to fill the knowledge gap, awareness, treatment, and control of diabetes and hypertension were studied by using data from the STEPS survey among the adult population in two major northern Indian states of Punjab and Haryana. Methods Two state-wide NCD risk factors surveys were conducted using WHO STEPS methodology among 5,127 individuals in Punjab and 5,078 individuals in Haryana aged 18-69 years in the year 2014-15 and 2016-18. Standardized questionnaire was used to determine the behavioral risk factors in step one followed by anthropometric measurements for physical risk factors in step two and in the third step serum and urine samples were collected for biochemical risk factors. Results The prevalence of hypertension in Punjab was 40.1% while that in Haryana was 26.2%. In Punjab, only 48.3% of the hypertensive were aware of their condition, 30.9% were on treatment while only 18.3% of the cases were controlled. While in Haryana 33.4% of the respondents were aware of their condition, 26.3% are on treatment while only 12% of the cases were controlled. Similarly, the prevalence of diabetes was 14.3 and 15.1% in Punjab and Haryana, respectively. In Punjab 34.2% of diabetics were aware of their condition, 28.2% were on treatment while only 14.2% of the cases were controlled. The awareness and control rates in Haryana were similar to that in Punjab. 29.5% of the respondents were aware of their condition, 22.4% were on treatment while only 13.8% of the cases of diabetes were controlled. Family history of diabetes and hypertension was found to be associated with higher odds of being aware, on treatment and controlled blood glucose and blood pressure levels in both Punjab and Haryana. Discussion Hypertension and diabetes are a major public health problem in Punjab and Haryana and awareness, treatment and control rates are low which require specific interventions with a focus on access to treatment, regular follow up for better control. There is an urgent need to effectively implement the existing national NCD programmes in these states in India.
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Affiliation(s)
- J S Thakur
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ria Nangia
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kasali FM, Kadima JN, Tusiimire J, Ajayi CO, Agaba AG. Effects of the Oral Administration of Aqueous and Methanolic Leaf Extracts of Chenopodium ambrosioides L. (Amaranthaceae) on Blood Glucose Levels in Wistar Rats. J Exp Pharmacol 2022; 14:139-148. [PMID: 35502164 PMCID: PMC9056057 DOI: 10.2147/jep.s356564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Diabetes mellitus is a metabolic disorder that poses a major global health threat. The current diabetes mellitus uses insulin and oral hypoglycemic agents, which have limitations, including adverse effects and secondary failures. Herbal medicine is being evaluated for its role in the pharmacotherapy of diabetes. This study was aimed to assess the anti-diabetic potential and short-term toxicity level of Chenopodium ambrosioides collected from Bukavu in Democratic Republic of Congo. Methods Leaves of C. ambrosioides were extracted by infusion and maceration with distilled water and 95% methanol, respectively. Hypoglycemic and antihyperglycemic potentials of the aqueous and methanolic were investigated in normoglycemic and intraperitoneal glucose-loaded rats at 100, 200, and 400 mg/kg body weight. An oral acute toxicity test was carried out on healthy female Wistar rats. Results Acute toxicity test showed the mean lethal dose (LD50) for both aqueous and methanol extracts of C. ambrosioides to be more than 2000 mg/kg. The group treated with glibenclamide (5 mg/kg b.w) and aqueous extract of the plant (200 mg/kg b.w) showed a significant reduction (p< 0.0001 and p< 0.05) of fasting blood glucose by 46.91% and 16.72%, respectively, compared to control and all other treatment groups. In acute conditions, a single oral administration of the aqueous and methanolic extracts lowered fasting blood glucose in rats. Any manifestation and signs of toxicity and mortality have been recorded for 14 days of observation. Conclusion Leaf aqueous and methanolic extracts of C. ambrosioides appeared safe at 2000 mg/kg. The plant demonstrated some anti-diabetic potential in rats, explaining its use as an anti-diabetic remedy locally.
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Affiliation(s)
- Félicien Mushagalusa Kasali
- Pharm-Bio Technology and Traditional Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, Official University of Bukavu, Bukavu, Democratic Republic of the Congo
- Correspondence: Félicien Mushagalusa Kasali, Pharm-Bio Technology, and Traditional Medicine, Mbarara University of Science and Technology, Mbarara, Uganda, Tel +256 750919712, Email
| | | | - Jonans Tusiimire
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Clement Olusoji Ajayi
- Pharm-Bio Technology and Traditional Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Amon Ganafa Agaba
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
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Li Y, Jiang Y, Lin J, Wang D, Wang C, Wang F. Prevalence and associated factors of diabetes mellitus among individuals aged 18 years and above in Xiaoshan District, China, 2018: a community-based cross-sectional study. BMJ Open 2022; 12:e049754. [PMID: 35296469 PMCID: PMC8928303 DOI: 10.1136/bmjopen-2021-049754] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE With the rapid development of the Chinese economy, Xiaoshan District, Zhejiang Province has experienced urbanisation, population ageing and significant lifestyle changes, so diabetes mellitus (DM) has attracted more attention. This study aimed to evaluate the prevalence of DM and its risk factors among individuals aged 18 years and above in the district. STUDY DESIGN AND METHODS A community-based cross-sectional study was carried out in Xiaoshan, China from 1 March to 31 August 2018. A multistage sampling method was used. Sociodemographic and behavioural characteristics were collected using a combination of centralised surveys and household surveys. Anthropometric parameters were measured with standardised techniques and calibrated equipment. Venous blood samples were obtained after at least 8 hours of fasting to determine the level of fasting blood glucose (FBG) and blood lipids. A standard 2-hour 75 g oral glucose tolerance test was also given if 6.1 mmol/L≤FBG<7.0 mmol/L. Univariate and multivariate logistic regression analyses were used to assess the associated factors of DM. RESULTS The overall prevalence of DM was 12.47%, and the proportion of previously undiagnosed DM (UDM) was 48.66%. The prevalence of pre-diabetes was 10.92%. Age, family history of DM (FHDM), obesity, abdominal obesity, systolic blood pressure (SBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were significantly associated with DM. CONCLUSIONS This study found a high prevalence of DM and pre-diabetes, especially a high prevalence of UDM among adults. The associated risk factors identified for DM were age, FHDM, obesity, abdominal obesity, SBP, TG and HDL-C.
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Affiliation(s)
- Yurong Li
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyuan Jiang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junying Lin
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Dongfei Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Chunli Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fenjuan Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
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Orazumbekova B, Issanov A, Atageldiyeva K, Berkinbayev S, Junusbekova G, Danyarova L, Shyman Z, Tashmanova A, Sarria-Santamera A. Prevalence of Impaired Fasting Glucose and Type 2 Diabetes in Kazakhstan: Findings From Large Study. Front Public Health 2022; 10:810153. [PMID: 35284393 PMCID: PMC8907545 DOI: 10.3389/fpubh.2022.810153] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/21/2022] [Indexed: 01/21/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a serious public health problem. A large proportion of patients with T2DM are unaware of their condition. People with undiagnosed T2DM are at a greater risk of developing complications, whereas prediabetes has an elevated risk of becoming T2DM. The aim of this study is to estimate the prevalence of impaired fasting glucose (IFG), undiagnosed and prior-diagnosed T2DM in Kazakhstan. A cross-sectional study was conducted in four geographically remote regions using the WHO STEP survey instrument. The status of T2DM of 4,753 participants was determined using the WHO diagnostic criteria based on fasting plasma glucose (FPG) level. As a result, the survey-weighted prevalence of IFG was 1.9% (95% CI 1.1%; 3.5%) and of T2DM was 8.0% (95% CI 3.8; 15.9). A total of 54% of T2DM have been newly diagnosed with T2DM. Being 55–64 years old (OR = 2.71, 95% CI 1.12; 6.60) and having lowered HDL-C level (OR = 3.72, 95% CI 1.68; 8.23) were found to be independent predictors for IFG. Being older than 45 years, a female (OR = 0.57, 95% CI 0.39; 0.83), having high waist circumference, was associated with newly diagnosed T2DM. Whereas, the age older than 45 years, high waist circumference, and family history of diabetes (OR = 2.42, 95% CI 1.64; 3.54) were associated with preexisting T2DM. This study shows a high prevalence of IFG and a high proportion of newly diagnosed T2DM in Kazakhstan. A series of risk factors identified in the study may be used to strengthen appropriate identification of IFG or undiagnosed patients in healthcare settings to deliver either preventive or therapeutic interventions aimed to reduce the incidence of T2DM or the delay of their complications. Further longitudinal studies are needed to confirm these associations in our population.
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Affiliation(s)
- Binur Orazumbekova
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Alpamys Issanov
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
- Alpamys Issanov
| | - Kuralay Atageldiyeva
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Salim Berkinbayev
- Department of Cardiology, Kazakh National Medical University, Almaty, Kazakhstan
- Department of Postgraduate Education, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - Gulnara Junusbekova
- Department of Postgraduate Education, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
- Department of Research and Innovations, Kazakh Medical University of Continuing Education, Almaty, Kazakhstan
| | - Laura Danyarova
- Department of Cardiology, Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanmedet Shyman
- Department of Cardiology, Kazakh National Medical University, Almaty, Kazakhstan
| | - Akmaral Tashmanova
- Department of Postgraduate Education, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - Antonio Sarria-Santamera
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
- *Correspondence: Antonio Sarria-Santamera
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Atallah AA, Morsy OM, Abbas W, Khater ESG. Microstructural, Physicochemical, Microbiological, and Organoleptic Characteristics of Sugar- and Fat-Free Ice Cream from Buffalo Milk. Foods 2022; 11:foods11030490. [PMID: 35159640 PMCID: PMC8833986 DOI: 10.3390/foods11030490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/05/2023] Open
Abstract
Ice cream is a popular dessert product across the world. Structure, body, taste, and odor properties are created by adding non-milk ingredients and milk ingredients. The main aim of the study is to decrease the caloric value of ice cream by using sugar and fat replacements. Ice cream treatments were investigated based on microstructural, chemical, physical, microbiological, sensory, and calorific values. Four different ice creams were used (control ice cream (SC1), ice cream with stevia (SC2), ice cream with sucralose (SC3), and ice cream with sorbitol (SC4)). The chemical properties in all treatments of ice cream were significantly recorded (p < 0.05). The highest sucrose and fat levels were detected in the SC1 treatment compared with the other treatments (p < 0.05). The lowest fat and sugar amounts were observed in the SC2, SC3, and SC4 treatments (p < 0.05). The highest viscosity, overrun, and hardness values (p < 0.05) were detected in the control ice cream. Total aerobic mesophilic bacterial counts were not significantly recorded between different ice cream treatments (p < 0.05). The sensory scores were not significantly affected by sweeteners and bulk agents in the different treatments. The highest calorific value was calculated in the SC1 samples (p < 0.05). On the other hand, the lowest calorific value was calculated in SC2, followed by the SC3 and SC4 treatments. In scanning electron microscopy (SEM), the gel exhibited a homogeneous structure with a fine network within the SC2, SC3, and SC4 treatments, as it contained a cohesive structure with small-sized pores.
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Affiliation(s)
- Atallah A. Atallah
- Department of Dairy Science, Faculty of Agriculture, Benha University, Toukh P.O. Box 13736, Egypt
- Correspondence: (A.A.A.); Tel.: +20-1225-922-632; Fax: +20-132-467-786
| | - Osama M. Morsy
- Department of Basic and Applied Sciences, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Cairo P.O. Box 2033, Egypt; (O.M.M.); (W.A.)
| | - Wael Abbas
- Department of Basic and Applied Sciences, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Cairo P.O. Box 2033, Egypt; (O.M.M.); (W.A.)
| | - El-Sayed G. Khater
- Department of Agricultural and Biosystems Engineering, Faculty of Agriculture, Benha University, Toukh P.O. Box 13736, Egypt;
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Puri P, Shil A, Shetty A, Dhar B, Singh SK, Pati S, Billah B. Contribution of modifiable risk factors on the burden of diabetes among women in reproductive age-group in India: a population based cross-sectional study. J Public Health Policy 2022; 43:89-108. [PMID: 35042964 DOI: 10.1057/s41271-021-00334-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 01/24/2023]
Abstract
The diabetes burden is rapidly accelerating in India, particularly since the 2000s. We explore the burden and contribution of modifiable risk factors in diabetes among reproductive women across geographic regions of India. The study uses data from the National Family Health Survey in India 2015-2016, Census of India 2011, and World Population Prospects 2015. We computed Population Attributable Fractions and the number of total and estimated avoidable diabetic cases across regions. The prevalence of diabetic cases in India were 24.4 per 1000 women, varying across geographic regions. Diabetes affected around 8.2 million women (15-49 years) in India. Overweight (PAF = 19.5%) and obesity (PAF = 18.3%) contributed to the diabetes burden; if mitigated optimally, these can reduce diabetic cases by 2.8 million in India. Controlling diabetes should be region specific for maximum impact. Extending chronic disease screening during maternal and child health consultations might help decelerate the growing menace of diabetes in the country.
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Affiliation(s)
- Parul Puri
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India.
| | - Apurba Shil
- International Institute for Population Sciences, Mumbai, Maharashtra, India.,Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Aishwarya Shetty
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bidita Dhar
- International Institute for Population Sciences, Mumbai, Maharashtra, India.,Department of Migration and Urban Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shri Kant Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Sanghamitra Pati
- Department of Health Research Chandrasekharpur, ICMR Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Bhatt G, Goel S, Gupta R, Grover S, Medhi B. Evaluating the impact of culturally specific patient-centric behavioral intervention package versus usual care for tobacco cessation among patients attending noncommunicable disease clinics in North India: A single-blind trial pilot study protocol. Tob Use Insights 2022; 14:1179173X211056622. [PMID: 34987297 PMCID: PMC8721367 DOI: 10.1177/1179173x211056622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 10/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background In a low and middle-income country (LMIC) like India, non—communicable diseases (NCDs) contribute a major proportion (61.8%) of all causes of death. Out of this, 48% of cardiovascular diseases , 23% of Chronic Respiratory Diseases , and 10% of Cancer deaths are attributable to tobacco use. Tobacco use is a major risk factor for NCDs and thus, the tobacco cessation approach is a high priority intervention to combat complications and death among NCD patients. While several interventions are available for tobacco cessation, in resource constraint countries like India, the effectiveness of low-cost, culturally specific patient-centric tobacco cessation behavioral intervention holds a potential that needs to be evaluated. A newly developed evidence-based tobacco cessation intervention package will be compared with the existing/usual care provided under the National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) at NCD clinics. Methods and design 2 arm, parallel-group randomized controlled trial. Participants Patients aged ≥30 years suffering from NCD, currently using tobacco, and attending NCD clinics in 2 districts of Punjab, India. Sample size A total of 200 participants meeting the selection criteria will be recruited. They will be allocated either to the intervention arm or control (usual care) arm (100 each) using block randomization. Intervention For the participants, there will be 4 face-to-face disease-specific cessation counseling sessions, disease-specific pamphlets, short text messages in vernacular language, that is, Punjabi. Follow-ups will be done at the third, sixth, ninth, and 12th months. Primary outcome Seven-day abstinence, biochemically verified by plasma cotinine levels. Secondary outcome Quit attempts, number of sticks/number of times of smokeless tobacco usage in a day, and stage of behavior change in tobacco users. Discussion This multicomponent culturally specific-patient-centric behavioral intervention package for tobacco cessation at NCD clinic settings focusing on the individual, family, and social environment could increase the outreach of cessation services using existing resources, thereby strengthening health systems and enhancing the quality of life of NCD patients. Trial registration The protocol for the study has been registered with the Clinical Trials Registry in India under the registration number CTRI/2018/01/011643.
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Affiliation(s)
- Garima Bhatt
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Gupta
- Honorary Consultant, Tobacco Cessation, Department of Deaddiction, Santokba Durlabhji Memorial Hospital and Medical Research Institution, Jaipur, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Bikash Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Rahini S, Pathak B, Manapurath R. The proportion of hand and knee osteoarthritis and its associated risk factors among an urban diabetic population. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2022. [DOI: 10.4103/ijam.ijam_115_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Anand A, Singh AA, Elhence A, Vaishnav M, Biswas S, Gunjan D, Gamanagatti SR, Nayak B, Kumar R, Shalimar. Prevalence and Predictors of Nonalcoholic Fatty Liver Disease in Family Members of Patients With Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol 2022; 12:362-371. [PMID: 35535086 PMCID: PMC9077183 DOI: 10.1016/j.jceh.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/25/2021] [Indexed: 12/12/2022] Open
Abstract
Background and aims Nonalcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease worldwide. Despite the high prevalence, no screening recommendations yet exist. We designed a prospective observational study to estimate the prevalence of NAFLD in the family of patients with NAFLD and develop a predictive model for identifying it. Methodology The prevalence of NAFLD in patients' family members was estimated using ultrasonography, and univariate and multivariate odds were calculated for its predictors. A model was created using the significant parameters on multivariate odds, and its performance was tested using the area under the receiver operating characteristic (AUROC). Results Among 447 family members of 191 patients with NAFLD, the prevalence of NAFLD was 55.9%. Family members with NAFLD were younger and had lower serum levels of aspartate aminotransferase, alanine aminotransferase (ALT), triglycerides. The liver stiffness measurement and controlled attenuation parameter values were also lesser in family members compared to the index cases. Age, body mass index (BMI), and ALT were independent predictors of NAFLD in the family members. A model combining age and BMI had an AUROC of 0.838 [95% confidence interval (CI) 0.800-0.876, P < 0.001]. Age ≥30 years and BMI ≥25 kg/m2 had an odds ratio of 33.5 (95% CI 17.0-66.0, P < 0.001) for prediction of NAFLD, in comparison to BMI <25 kg/m2 and age <30 years. Conclusion Family members of patients with NAFLD are at increased risk of NAFLD. Screening strategies using BMI and age ensure early identification and could be beneficial in clinical practice.
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Key Words
- ALT, Alanine aminotransferase
- APRI, AST to platelet ratio index
- AST, Aspartate aminotransferase
- AUROC, Area under ROC
- BMI
- BMI, Body mass index
- CAP, Controlled attenuation parameter
- CI, Confidence interval
- EASL, European Association for the Study of the Liver
- FAST, FibroScan-AST
- FDRs, First-degree relatives
- FIB-4, Fibrosis-4
- HDL-C, High-density lipoprotein-cholesterol
- HbA1C, Glycosylated hemoglobin
- LSM, Liver stiffness measure
- MetS, Metabolic syndrome
- NAFLD, Non-alcoholic fatty liver disease
- NASH, Non-alcoholic steatohepatitis
- NCEP-ATP, National Cholesterol Education Program- Adult Treatment Panel
- NFS, NAFLD fibrosis score
- OR, Odds ratio
- ROC, Receiver operating curve
- family members
- nonalcoholic fatty liver disease
- predictors
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Affiliation(s)
- Abhinav Anand
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Amit A. Singh
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Anshuman Elhence
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Manas Vaishnav
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Sagnik Biswas
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Gunjan
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | | | - Baibaswata Nayak
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Kumar
- Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shalimar
- Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Dr Shalimar, Additional Professor, Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, 110029, India. Tel.: +91 9968405815; Fax: +91 11 26588663, +91 11 26588641.
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Theivasigamani K, Palaniappan S. Drug Utilization Evaluation of Antidiabetic Agents in Primary Care Clinics of a South Indian Rural Province. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2022. [DOI: 10.51847/7rujh8q1hg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kumar P, Patel R, Muhammad T, Srivastava S. Does engagement in frequent physical activity improve diabetes mellitus among older adults in India? A propensity score matching approach. Diabetes Metab Syndr 2022; 16:102353. [PMID: 34920198 DOI: 10.1016/j.dsx.2021.102353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Diabetes is a major chronic condition and was identified as one of the four priority non-communicable diseases that the United Nations targeted because of its increasing disease burden. The present study aims to examine the impact of physical activity on improving diabetes mellitus among older adults in India. METHODS This study utilizes data from India's first nationally representative longitudinal ageing survey (2017-18). Descriptive along with bivariate analysis was used to present the preliminary results. Additionally, Propensity score matching (PSM) analysis was used. RESULTS About 14% of older adults suffered from diabetes. Eighteen percent of older adults did frequent physical activity. The estimated average treatment effect on the treated (ATT) values in treated and control groups were 0.123 and 0.147, respectively, indicating that the prevalence of diabetes among older adults was reduced by 2.5% points because of frequent physical activity. The average treatment effect on the untreated (ATU) results indicates that among older adults who did not do frequent physical activity, if they did frequent physical activity, the prevalence of diabetes is likely to decrease by 2.2% points. CONCLUSION Our findings show that frequent physical activity is associated with a lower risk of diabetes in older adults. The results underscore the need to develop strategies of promoting an active lifestyle by maintaining physical activity to combat the diabetes epidemic in the older population.
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Affiliation(s)
- Pradeep Kumar
- Population Council, India Country Office, 5A, GF, India Habitat Centre, New Delhi, Delhi, 110003, India.
| | - Ratna Patel
- International Institute for Population Sciences, Mumbai, Maharashtra, 110048, India.
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 110048, India.
| | - Shobhit Srivastava
- Department of Research and Innovation, Mamta Health Institute for Mother and Child, New Delhi, 110048, India.
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Syed W, Alharbi MK, Samarkandi OA, Alsadoun A, Al-Rawi MBA, Iqbal A, Samreen S. Evaluation of Knowledge, Awareness, and Factors Associated with Diabetes: A Cross-Sectional Community-Based Study. Int J Endocrinol 2022; 2022:1921010. [PMID: 35879976 PMCID: PMC9308543 DOI: 10.1155/2022/1921010] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/08/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
METHODS A cross-sectional study was carried out for over 4 months from May to August 2020 using a self-administered, anonymous online questionnaire. All adults of both genders were invited to participate in the study. Individuals who are able to read and understand the English language were included in the study. Data were descriptively analyzed using a statistical package for social science version 26 (SPSS). RESULTS A total of 427 subjects responded to the questionnaires. More than half of them were male 253 (59.3%), while 174 (40.7%) were female, approximately 49% had a university degree, and 196 (45.9%) were postgraduates. The mean age of the participants was 25.7 ± 6.2 (mean ± SD). Most of them were single 230 (53.9%). The majority of the respondents 367 (85.9%) had heard of hyperglycemia, while a comparable number of 366 (85.7%) were aware of it being a lifelong disease. About 305 (71.4%) of participants knew that genetic factors were associated with hyperglycemia, and more than half of 250 (58.5%) knew that diabetes causes foot problems. There was a significant association between the cause of diabetes with income and educational status (p < 0.05) and diabetic complications with age, education, and family income (p < 0.05). CONCLUSION In conclusion, there is a need for greater awareness and additional education regarding hyperglycemia among the general community in the state of Telangana, India, to reduce the incidence of diabetes and associated risk factors. Public health campaigns that encourage healthier lifestyles might help achieve this aim.
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Affiliation(s)
- Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammad K. Alharbi
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Osama A. Samarkandi
- Nursing Informatics Vice Dean for Academic Affairs, Prince Sultan College for Emergency Medical Services, King Saud University, Riyadh 11466, Saudi Arabia
| | - Ahmed Alsadoun
- Department of Medical Surgical College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Mahmood Basil A. Al-Rawi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ayesha Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University Park Campus, University of Nottingham, Nottingham NG7 2RD, UK
| | - Sana Samreen
- Aurobindo College of Pharmacy, Warangal, Telangana, India
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Trends in the diabetes incidence and mortality in India from 1990 to 2019: a joinpoint and age-period-cohort analysis. J Diabetes Metab Disord 2021; 20:1725-1740. [PMID: 34900822 DOI: 10.1007/s40200-021-00834-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
Introduction Globally, a metabolic disorder like Diabetes is considered as one of the largest global health issues, as it accounts for the majority of the disease burden and happens to be one of the leading causes of mortality as well as reduced life expectancy across the world. As in 2019, India is home to the second-largest number (77 million) of Diabetic adults and the number of people affected has been increasing rapidly over the years. Termed as "the diabetes capital of the world," with every fifth diabetic in the world being an Indian, there is an urgent need to address many critically significant challenges posed by Diabetes in India, like, increasing prevalence among young people in urban areas, less awareness among people, high cost of disease management, limited healthcare facilities, suboptimal diabetes control etc. In Indian context, not enough attempts have been made to observe and understand the long-term pattern of diabetes incidence and mortality. This study aims to provide deep insights into the recent trends of diabetes incidence and mortality in India from 1990 to 2019. Materials and methods This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of diabetes (from 1990 to 2019) from the Global Health Data Exchange. The average annual percentage changes in incidence and mortality were analysed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results During the study period, age-standardized incidence and mortality rates of diabetes in India experienced an upsurge in numbers, the incidence rate increased from 199.14 to 317.02, and consequently, mortality increased from 22.30 to 27.35 per 100,000 population. The joinpoint regression analysis showed that the age-standardized incidence significantly rose by 1.63 % (95 % CI: 1.57 %, 1.69 %) in Indian males and 1.56 % in Indian females (95 % CI: 1.49 %, 1.63 %) from 1990 to 2019. On the other hand, the age-standardized mortality rates rose by 0.77 % (95 % CI: 0.24 %, 1.31 %) in Indian males and 0.57 % (95 % CI: -0.54 %, 1.70 %) in Indian females. For age-specific rates, incidence increased in most age groups, with exception of age groups 5-9, 70-74, 75-79 and 80-84 in male, and age groups 5-9, 75-79 and 80-84 in female. Mortality in male saw a decreasing trend till age group 20-24, whereas in female, the rate decreased till age group 35-39. The age effect on incidence showed no obvious changes with advancing age, but the mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period; cohort effect on diabetes incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts, while incidence showed no material changes from 1975 to 1979 to 2000-2004 birth cohort. Conclusions Mortality of diabetes decreased in younger age groups but increased in older age groups; however, Incidence increased in most age groups for both male and female. The net age or period effect showed an unfavourable trend while the net cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of diabetes. Timely population-level interventions aiming for health education, lifestyle modification with special emphasis on the promotion of physical activity and healthy diet should be conducted, especially for male and earlier birth cohorts at high risk of diabetes.
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Bhattacharjee H, Javeri H. Commentary: Burden of diabetic retinopathy. Indian J Ophthalmol 2021; 69:3138. [PMID: 34708756 PMCID: PMC8725129 DOI: 10.4103/ijo.ijo_2644_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chahal D, Marquez V, Hussaini T, Kim P, Chung SW, Segedi M, Chartier-Plante S, Scudamore CH, Erb SR, Salh B, Yoshida EM. End stage liver disease etiology & transplantation referral outcomes of major ethnic groups in British Columbia, Canada: A cohort study. Medicine (Baltimore) 2021; 100:e27436. [PMID: 34678872 PMCID: PMC8542110 DOI: 10.1097/md.0000000000027436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 09/17/2021] [Indexed: 01/15/2023] Open
Abstract
Liver disease etiology and transplantation outcomes may vary by ethnicity. We aimed to determine if disparities exist in our province.We reviewed the provincial database for liver transplant referrals. We stratified cohorts by ethnicity and analyzed disease etiology and outcomes.Four thousand nine hundred sixteen referrals included 220 South Asians, 413 Asians, 235 First Nations (Indigenous), and 2725 Caucasians. Predominant etiologies by ethnicity included alcohol (27.4%) and primary sclerosing cholangitis (PSC) (8.8%) in South Asians, hepatitis B (45.5%) and malignancy (13.9%) in Asians, primary biliary cholangitis (PBC) (33.2%) and autoimmune hepatitis (AIH) (10.8%) in First Nations, and hepatitis C (35.9%) in Caucasians. First Nations had lowest rate of transplantation (30.6%, P = .01) and highest rate of waitlist death (10.6%, P = .03). Median time from referral to transplantation (268 days) did not differ between ethnicities (P = .47). Likelihood of transplantation increased with lower body mass index (BMI) (hazard ratio [HR] 0.99, P = .03), higher model for end stage liver disease (MELD) (HR 1.02, P < .01), or fulminant liver failure (HR 9.47, P < .01). Median time from referral to ineligibility status was 170 days, and shorter time was associated with increased MELD (HR 1.01, P < .01), increased age (HR 1.01, P < .01), fulminant liver failure (HR 2.56, P < .01) or South Asian ethnicity (HR 2.54, P < .01). Competing risks analysis revealed no differences in time to transplant (P = .66) or time to ineligibility (P = .91) but confirmed increased waitlist death for First Nations (P = .04).We have noted emerging trends such as alcohol related liver disease and PSC in South Asians. First Nations have increased autoimmune liver disease, lower transplantation rates and higher waitlist deaths. These data have significance for designing ethnicity specific interventions.
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Affiliation(s)
- Daljeet Chahal
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vladimir Marquez
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trana Hussaini
- Faculty of Pharmaceutical Sciences, University of British Columbia, British Columbia, Canada
| | - Peter Kim
- Department of Surgery, Section of Hepatobiliary Pancreatic Surgery, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, British Columbia, Canada
| | - Stephen W. Chung
- Department of Surgery, Section of Hepatobiliary Pancreatic Surgery, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, British Columbia, Canada
| | - Maja Segedi
- Department of Surgery, Section of Hepatobiliary Pancreatic Surgery, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, British Columbia, Canada
| | - Stephanie Chartier-Plante
- Department of Surgery, Section of Hepatobiliary Pancreatic Surgery, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, British Columbia, Canada
| | - Charles H. Scudamore
- Department of Surgery, Section of Hepatobiliary Pancreatic Surgery, University of British Columbia and the Liver Transplant Program, Vancouver General Hospital, British Columbia, Canada
| | - Siegfried R. Erb
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Baljinder Salh
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric M. Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
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Ho YCL, Lee VSY, Ho MHR, Lin GJ, Thumboo J. Towards a Parsimonious Pathway Model of Modifiable and Mediating Risk Factors Leading to Diabetes Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010907. [PMID: 34682644 PMCID: PMC8536137 DOI: 10.3390/ijerph182010907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/23/2022]
Abstract
Modifiable risk factors are of interest for chronic disease prevention. Few studies have assessed the system of modifiable and mediating pathways leading to diabetes mellitus. We aimed to develop a pathway model for Diabetes Risk with modifiable Lifestyle Risk factors as the start point and Physiological Load as the mediator. As there are no standardised risk thresholds for lifestyle behaviour, we derived a weighted composite for Lifestyle Risk. Physiological Load was based on an index using clinical thresholds. Sociodemographics are non-modifiable risk factors and were specified as covariates. We used structural equation modeling to test the model, first using 2014/2015 data from the Indonesian Family Life Survey. Next, we fitted a smaller model with longitudinal data (2007/2008 to 2014/2015), given limited earlier data. Both models showed the indirect effects of Lifestyle Risk on Diabetes Risk via the mediator of Physiological Load, whereas the direct effect was only supported in the cross-sectional analysis. Specifying Lifestyle Risk as an observable, composite variable incorporates the cumulative effect of risk behaviour and differentiates this study from previous studies assessing it as a latent construct. The parsimonious model groups the multifarious risk factors and illustrates modifiable pathways that could be applied in chronic disease prevention efforts.
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Affiliation(s)
- Yi-Ching Lynn Ho
- Office of Regional Health, Singapore Health Services, 167 Jalan Bukit Merah, Singapore 150167, Singapore; (V.S.Y.L.); (G.J.L.); (J.T.)
- Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Rd., Singapore 169857, Singapore
- Correspondence:
| | - Vivian Shu Yi Lee
- Office of Regional Health, Singapore Health Services, 167 Jalan Bukit Merah, Singapore 150167, Singapore; (V.S.Y.L.); (G.J.L.); (J.T.)
| | - Moon-Ho Ringo Ho
- School of Social Sciences, Nanyang Technological University, 48 Nanyang Ave., Singapore 639818, Singapore;
| | - Gladis Jing Lin
- Office of Regional Health, Singapore Health Services, 167 Jalan Bukit Merah, Singapore 150167, Singapore; (V.S.Y.L.); (G.J.L.); (J.T.)
- Programme in Health Services and Systems Research, Duke-NUS Medical School, 8 College Rd., Singapore 169857, Singapore
| | - Julian Thumboo
- Office of Regional Health, Singapore Health Services, 167 Jalan Bukit Merah, Singapore 150167, Singapore; (V.S.Y.L.); (G.J.L.); (J.T.)
- Department of Rheumatology and Immunology, Singapore General Hospital, Outram Rd., Singapore 169608, Singapore
- Medicine Academic Clinical Programme, Duke-NUS Medical School, 8 College Rd., Singapore 169857, Singapore
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Gumashta J, Gumashta R. COVID19 associated mucormycosis: Is GRP78 a possible link? J Infect Public Health 2021; 14:1351-1357. [PMID: 34538732 PMCID: PMC8431836 DOI: 10.1016/j.jiph.2021.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/07/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022] Open
Abstract
This review aimed to study molecular mechanisms for high incidence of life-threatening mucormycosis infection in COVID19 cases during second wave of SARS CoV2 pandemic in India. Hyperglycaemia, impaired immunity, acidosis, raised ferritin, glucocorticoid therapy, and COVID19 specific other factors have been implicated in pathogenesis of COVID19 associated mucormycosis (CAMM). Endoplasmic reticulum chaperone 'Glucose Related Protein 78' (GRP78), also involved in SARS CoV2 entry, is the host receptor for invasion by Mucorales. GRP78 is over-expressed by SARS CoV2, hyperglycaemia and ferritin. Delta variant of SARS CoV2 and indiscriminate use of steroids were distinguishing features of second wave and appear to upregulate GRP78 through intricate interplay between internal and external milieu. Common invasive fungal infections like candidiasis and aspergillosis, not utilizing GRP78 as receptor, were inconspicuous. Further molecular research to unravel mechanisms involved in the pathogenesis of CAMM shall effectively complement existing strategies for its prevention and treatment.
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Affiliation(s)
- Jyotsna Gumashta
- Department of Physiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India.
| | - Raghvendra Gumashta
- Department of Community Medicine, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India.
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Mphekgwana PM, Mabila LN, Maimela E. Indirect and direct effects of factors associated with diabetes amongst the rural black population in the Dikgale Health and Demographic Surveillance System, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e6. [PMID: 34342480 PMCID: PMC8335786 DOI: 10.4102/phcfm.v13i1.2819] [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: 10/22/2020] [Revised: 03/17/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally. Aim To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey. Methods This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L. Results A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (−0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status. Conclusion The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).
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Affiliation(s)
- Peter M Mphekgwana
- Department of Research Administration and Development, University of Limpopo, Polokwane.
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Grover S, Verma M, Singh T, Dahiya N, Nehra R. Screening for Abuse of Older Adults: A Study Done at Primary Health Care Level in Punjab, India. Indian J Psychol Med 2021; 43:312-318. [PMID: 34385724 PMCID: PMC8327867 DOI: 10.1177/0253717620928782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Little is known about elder abuse in the domestic environment. In lower-middle income countries like India, the demographic transition is throwing novel challenges. The older adults are relatively more vulnerable because of coexisting medical and psychological problems. Any form of abuse affects mental health and increases the chances of anxiety and depression among the older adults. The study aimed to assess the burden of abuse amongst older adults visiting a primary health care center of north India. METHODS This is secondary data analysis conducted on the data collected in the primary study between September 2017 and June 2018 in northern India among 311 older adult patients attending the noncommunicable disease clinic. Diabetes mellitus and hypertension were diagnosed as per standard guidelines. Vulnerability to Abuse Screening Scale (VASS) was used to assess elder abuse. Depression, anxiety, and loneliness were assessed by using the Patient Health Questionnaire (PHQ)-9, Generalized Anxiety Disorder (GAD)-7, and University of California, Los Angeles (UCLA) loneliness 20-item scale, respectively. Multiple logistic regression was carried out to explore the factors associated with elder abuse after ruling out collinearity between independent variables. RESULTS About 24% of older adults experienced abuse in the last 12 months. One-fourth of the older adults reported vulnerability, nearly half reported coercion and dejection, and most of them reported experiencing dependence. Participants also had a high prevalence of anxiety (39%), depression (54%), and features suggestive of loneliness (38.6%). Multiple logistic regression analysis showed that abuse was predicted by educational status, per-capita income, and loneliness. CONCLUSION About one-fourth of the older adults experience abuse. This highlights the importance of routine screening of older adults at the primary care level.
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Affiliation(s)
- Sandeep Grover
- Dept. of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhur Verma
- Dept. of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
- Dept. of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarundeep Singh
- Dept. of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neha Dahiya
- Dept. of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Nehra
- Dept. of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Chauhan S, Gupte SS, Kumar S, Patel R. Urban-rural differential in diabetes and hypertension among elderly in India: A study of prevalence, factors, and treatment-seeking. Diabetes Metab Syndr 2021; 15:102201. [PMID: 34265493 DOI: 10.1016/j.dsx.2021.102201] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
AIMS This study estimates the prevalence of hypertension and diabetes among older adults and brings forth the urban-rural differentials in the said morbidities. The treatment-seeking approach of older adults is also looked at with regard to hypertension and diabetes. METHODS Study utilized Longitudinal Ageing Study in India (LASI) data. Logistic regression was used to check the likelihood of hypertension and diabetes with socioeconomic and demographic variables. Fairlie's decomposition technique was applied to check the difference in the probability of hypertension and diabetes between rural and urban areas by estimating contributions of a group (rural-urban) differences. RESULTS Study noted a higher prevalence of hypertension and diabetes among elderly residing in urban areas than their rural counterparts. Prevalence of hypertension and diabetes was higher among those aged 70+, elderly females, less educated, and non-poor. Education status alone accounts for more than four-fifths (88.62%) and more than half (52.02%) of the inequality in the prevalence of urban-rural hypertension and diabetes, respectively. CONCLUSIONS Since treatment-seeking is relatively low among elderly in poor households, practices must be identified for a poverty-stricken elderly population to overcome the financial barriers that may prevent the elderly from seeking and complying with treatment.
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Affiliation(s)
- Shekhar Chauhan
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, India
| | - Samriddhi S Gupte
- Max Institute of Healthcare Management, Indian School of Business, Mohali, India.
| | - Shubham Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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Ramya S, Anand A, Bhaskar S, Prasad S. Clinical audit on assessment of non-glycemic parameters in diabetic patients by physicians. J Family Med Prim Care 2021; 10:1917-1921. [PMID: 34195125 PMCID: PMC8208193 DOI: 10.4103/jfmpc.jfmpc_2305_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/24/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a major health problem in family practice causing multiple micro and macrovascular complications; the prevention of which should be the main aim of treating physicians. Lack of proper assessment can hasten the complications and a meticulous screening system is a prerequisite in every diabetic patient's evaluation. OBJECTIVE The aim of this study was to assess the pattern of screening for non-glycemic parameters in type 2 DM patients by physicians in an outpatient setting. METHODS A cross-sectional study was conducted in a teaching hospital during December 2019. A total of 254 patients with type 2 DM without any complications were randomly selected for screening as per the criteria developed by RSSDI [Research Society for the Study of Diabetes in India]. RESULTS Complete history and physical examination were done by physicians in all the participants. Measurement of blood pressure at every visit was done in about 95% of patients and 90% of them were counseled for cessation of smoking. But only about 60% or less of patients were screened for microalbuminuria, diabetic retinopathy, and peripheral neuropathy. Advice on comprehensive foot care was also not a regular practice among physicians. CONCLUSION This clinical audit showed that 90% of the patients had undergone only 4 of the 9 RSSDI recommended screening. The other parameters had been carried out in only among 40 to 60% of the patients. Thus, primary care physicians have to emphasize on the subtle but important criteria like ophthalmic examination, peripheral neuropathy and microalbuminuria during regular outpatient visits.
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Affiliation(s)
- S Ramya
- Department of Family Medicine, St Philomena's Hospital, Bangalore, Karnataka, India
| | - Arjun Anand
- Final Year MBBS, Basaweshwara Medical College, Chitradurga, Karnataka, India
| | - Swapna Bhaskar
- Department of Family Medicine, St Philomena's Hospital, Bangalore, Karnataka, India
| | - Shankar Prasad
- Department of Internal Medicine, St Philomena's Hospital, Bangalore, Karnataka, India
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Sharma A, Baldi A, Kumar Sharma D. Economic costs of hospitalisation and length of stay in diabetes with coexisting hypertension with correlation to laboratory investigations: Where does India stand? A 5-year ground report. Int J Clin Pract 2021; 75:e13990. [PMID: 33400350 DOI: 10.1111/ijcp.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The coexistence of diabetes mellitus (DM) and hypertension (HTN) worsens clinical outcomes and contributes to increased morbidity and mortality. OBJECTIVE This study aims to analyse the length of stay and healthcare costs by calculating the direct and indirect costs of diabetes with coexisting hypertension in North India. METHODS A prospective observational study was conducted at the medicine department of the three different hospitals. RESULTS The patients' mean age was (M = 53.8, SD = 11.5) years. Out of 1914 patients, 53.65% were female. Our study revealed that the median cost of medical supplies and equipment was 21.2 $. The median cost of dialysis was 47.5 $; the median cost of hospitalisation was 142.6 $. The treatment's median direct cost was 188.5 $, followed by the overall median cost of 295.6 $. The maximum overall cost of treatment was observed at 603.9 $. It was observed that maximum LOS was 14 days for patients having BPS between 140 and 159 mmHg and BPD between 110 and 119 mmHg, and minimum LOS was found 3.5 days. CONCLUSION The present study highlighted that diabetes coexisting hypertension poses a high-economic burden on patients. This study explored that highly significant result for BPS, BPD, FBS and HbA1 c, whereas the significant results were obtained when RBS is compared with LOS and treatment costs. Our study concluded that mean difference of 9.24 $ in patients having FBS was 261-290 mg/dL and >290 mg/dL. The LOS is increased by 6.57 days for patients with BPS between 140 and 159 mmHg compared with BPS between 180 and 209 and above mmHg, which lowers treatment costs by -21.31$.
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Affiliation(s)
- Amit Sharma
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
- Uttarakhand Technical University, Dehradun, Uttarakhand, India
| | - Ashish Baldi
- Department of Pharmaceutical Science and Technology, Maharaja Ranjit Singh Punjab Technical University, Bathinda, Punjab, India
| | - Dinesh Kumar Sharma
- Department of Pharmaceutics, Himalayan Institute of Pharmacy and Research, Selakui, Uttarakhand, India
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Das S, Gupta AK, Bandyopadhyaya B, Darla BH, Arya V, Abhyankar M, Revankar S. Data on vildagliptin and vildagliptin plus metformin combination in type-2 diabetes mellitus management. Bioinformation 2021; 17:413-423. [PMID: 34092962 PMCID: PMC8131578 DOI: 10.6026/97320630017413] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 11/23/2022] Open
Abstract
It is of interest to evaluate the clinical effectiveness and safety of vildagliptin as monotherapy and combination therapy of vildagliptin and metformin for the management of type 2 diabetes mellitus (T2DM) patients in Indian settings. The study included patients with T2DM (aged >18 years) receiving vildagliptin monotherapy and vildagliptin in combination with metformin therapy of various strengths. Data related to demographics, risk factors, medical history, glycated hemoglobin (HbA1c) levels, and medical therapies were retrieved from medical records. Out of 9678 patients (median age, 52.0 years), 59.1% were men. A combination of vildagliptin and metformin (50/500 mg) was the most commonly used therapy (54.8%), and the median duration of therapy was 24.0 months. The predominant reason for selecting vildagliptin therapy was to improve HbA1c levels (87.8%). A total of 87.5% of patients required dosage up-titration. Vildagliptin therapy was used in patients with T2DM and associated complications (peripheral neuropathy, CAD, nephropathy, retinopathy, autonomous neuropathy, stroke/TIA, and peripheral artery disease). Among 5175 patients who experienced body weight changes, a majority of patients showed a loss of weight (68.6%). The target glycemic control was achieved in 95.3% of patients. The mean HbA1c levels were significantly decreased post-treatment (mean change: 1.34%; p<0.001). Adverse events were reported in 0.4% of patients. Physicians rated the majority of patients as good to excellent on the global evaluation of efficacy and tolerability scale (98.9%, each). Vildagliptin as monotherapy and combination therapy of vildagliptin and metformin was an effective therapy in reducing HbA1c helps in achieving target glycemic control, and was well tolerated in Indian patients with T2DM continuum.
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Affiliation(s)
| | - AK Gupta
- Rahas Medical Store Hospital, Lucknow, India
| | | | | | - Vivek Arya
- Center for Endocrine and Diabetes, Ahmedabad, India
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Al-Mawali A, Al-Harrasi A, Jayapal SK, Morsi M, Pinto AD, Al-Shekaili W, Al-Kharusi H, Al-Balushi Z, Idikula J. Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017. BMC Endocr Disord 2021; 21:42. [PMID: 33673840 PMCID: PMC7934365 DOI: 10.1186/s12902-020-00655-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Type 2 diabetes in the Gulf Cooperation Council countries, including Oman, is currently the fastest growing health crisis and is a significant cause of premature mortality and disability. There is currently insufficient up-to-date information available on prevalence of type 2 diabetes. This study aimed to assess the latest prevalence of type 2 diabetes mellitus and its associated demographic, behavioural, and clinical risk factors. METHODS Using the WHO STEPwise approach to chronic disease surveillance, a nationally representative population-based survey was conducted from January to April 2017 of adults aged 18 years and above. A multi-stage, stratified, geographically clustered random sampling surveyed 9053 households including Omani nationals and non-Omani residents. Univariate and multiple logistic regression analysis was performed to determine the predictors of diabetes. RESULTS Overall prevalence of diabetes among the population was 15.7% (95% CI: 14.0-17.5%) whereas prevalence of prediabetes was 11.8% (95% CI: 11.4-12.2%). Age, educational level, raised blood pressure, family history of diabetes, abnormal waist-to-hip ratio, and hypertriglyceridemia were found to be significantly associated with diabetes mellitus. Of the cases of diabetes mellitus, 17% were newly diagnosed and 13.2% were on medication and had an uncontrolled glucose level while 55.5% were not taking medication (although diagnosed) and had an uncontrolled blood glucose level. CONCLUSIONS The present study provides reliable information regarding the high prevalence of diabetes mellitus among the adult population in Oman with urgent attention needed to address this significant burden on the health system. The high proportion of uncontrolled cases warrants further research, awareness programmes, and community interventions.
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Affiliation(s)
- Adhra Al-Mawali
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman.
- Strategic Research Program for Non-Communicable Diseases, Ministry of Higher Education, Research and Innovation, Muscat, Sultanate of Oman.
| | - Ayaman Al-Harrasi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | | | - Magdi Morsi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | | | - Waleed Al-Shekaili
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - Hilal Al-Kharusi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - Zainab Al-Balushi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - John Idikula
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
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Raman R, Ramasamy K, Rajalakshmi R, Sivaprasad S, Natarajan S. Diabetic retinopathy screening guidelines in India: All India Ophthalmological Society diabetic retinopathy task force and Vitreoretinal Society of India Consensus Statement. Indian J Ophthalmol 2021; 69:678-688. [PMID: 33269742 PMCID: PMC7942107 DOI: 10.4103/ijo.ijo_667_20] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/13/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022] Open
Abstract
Diabetic retinopathy (DR) is an emerging preventable cause of blindness in India. All India Ophthalmology Society (AIOS) and Vitreo-Retinal Society of India (VRSI) have initiated several measures to improve of DR screening in India. This article is a consensus statement of the AIOS DR task force and VRSI on practical guidelines of DR screening in India. Although there are regional variations in the prevalence of diabetes in India at present, all the States in India should screen their population for diabetes and its complications. The purpose of DR screening is to identify people with sight-threatening DR (STDR) so that they are treated promptly to prevent blindness. This statement provides strategies for the identification of people with diabetes for DR screening, recommends screening intervals in people with diabetes with and without DR, and describes screening models that are feasible in India. The logistics of DR screening emphasizes the need for dynamic referral pathways with feedback mechanisms. It provides the clinical standards required for DR screening and treatment of STDR and addresses the governance and quality assurance (QA) standards for DR screening in Indian settings. Other aspects incorporate education and training, recommendations on Information technology (IT) infrastructure, potential use of artificial intelligence for grading, data capture, and requirements for maintenance of a DR registry. Finally, the recommendations include public awareness and the need to work with diabetologists to control the risk factors so as to have a long-term impact on prevention of diabetes blindness in India.
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Affiliation(s)
- Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India
| | - Kim Ramasamy
- Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Ramachandran Rajalakshmi
- Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | | | - S Natarajan
- Aditya Jyot Eye Hospital Pvt. Ltd., Mumbai, Maharashtra, India
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Medhi GK, Dutta G, Borah P, Lyngdoh M, Sarma A. Prevalence of Diabetes and Its Relationship With Body Mass Index Among Elderly People in a Rural Area of Northeastern State of India. Cureus 2021; 13:e12747. [PMID: 33614345 PMCID: PMC7886600 DOI: 10.7759/cureus.12747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Diabetes and its complications are a major public health concern in elderly populations. However, there is little population-based data on diabetes and its risk factors among the elderly population living in rural areas of India. The objective of this population-based study was to assess the prevalence of diabetes in the elderly population and its relationship with body mass index (BMI). Methodology A population-based, cross-sectional study was conducted among elderly individuals (≥60 years) during the period 2013-2016 in rural areas of Dibrugarh district of Assam. Multi-stage sampling design was adopted to select the study participants. Data on socio-demographic profile and diagnosis/treatment history of diabetes were collected using pre-designed and pre-tested questionnaire. Fasting blood sugar was tested. Weight and height were measured to calculate BMI. Multivariate logistic regression analysis was performed to assess the relationship between diabetes and BMI. Results Data were collected from 430 (male: 210, female: 220) individuals. The overall prevalence of diabetes was 7.9% (male: 7.1%, female: 8.6%). Higher level of education was associated with increased prevalence of diabetes. Prevalence of diabetes increased as the BMI of participants increased. Prevalence of diabetes among obese individuals (BMI ≥25 kg/m2) was 30.4% compared to only 5% among normal weight individuals. Obesity was associated with eight-fold higher risk of diabetes compared with the individuals of normal weight in multivariate analysis. Conclusions The study reveals nearly 8% population-based prevalence of diabetes in rural elderly people in the study district. Our study provides epidemiological evidence that obesity is a major driver of diabetes among rural elderly people.
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Affiliation(s)
- Gajendra K Medhi
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Gitashree Dutta
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Prasanta Borah
- Epidemiology and Nutrition, ICMR-Regional Medical Research Centre, Northeast (NE) Region, Dibrugarh, IND
| | - Markordor Lyngdoh
- Community Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
| | - Amitav Sarma
- Anatomy, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, IND
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Gupta R, Gaur K. Epidemiology of Ischemic Heart Disease and Diabetes in South Asia: An Overview of the Twin Epidemic. Curr Diabetes Rev 2021; 17:e100620186664. [PMID: 33023450 DOI: 10.2174/1573399816666201006144606] [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: 04/25/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND & OBJECTIVES Ischemic heart disease (IHD) is one of the most important causes of death and disability in the world and diabetes is an important risk factor. This review was performed to describe the mortality and morbidity burden from this twin epidemic in South Asian countries. METHODS Country-level data on the epidemiology of IHD and diabetes were obtained from the Global Burden of Disease (GBD) study. Sub-national data were available only for India. We also retrieved epidemiological studies from published reviews on IHD and diabetes in India. These were supplemented with MEDLINE search. RESULTS GBD study and regional epidemiological studies have reported that there are significant regional variations in IHD mortality and disease burden within South Asian countries. IHD burden has increased significantly from 2000 to 2017. Prospective Urban Rural Epidemiology study has reported that diabetes is an important IHD risk factor in the South Asian region. GBD Study and International Diabetes Federation have reported increasing diabetes-related mortality and disease burden in South Asian countries, especially India. There are regional variations in diabetes-related mortality, disease burden, and prevalence in South Asia. At the macrolevel, rapid food and nutrition transition along with increasing physical inactivity is responsible for this twin epidemic. CONCLUSION Increasing trends in IHD and diabetes-related mortality and disease burden with regional variations are observed in South Asian countries.
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Affiliation(s)
- Rajeev Gupta
- Department of Preventive Cardiology & Internal Medicine, Eternal Heart Care Centre and Research Institute, Jaipur, India
| | - Kiran Gaur
- Department of Statistics, Mathematics and Computer Science, Government SKN Agriculture College, SKN Agriculture University, Jobner, Jaipur, India
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Tripathi R, Tripathi S, Pandey N, Srivastava A, Usman K, Ali W, Tiwari S. Cognitive status of older adults with diabetes mellitus, hypertension, and dyslipidemia on Hindi Cognitive Screening Test and Saint Louis University Mental State. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_43_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Talukdar N, Das K, Barman I. A review on ethanobotanical survey of medicinal plants available in North-East India against microbes involved in diabetic foot ulcer. JOURNAL OF DIABETOLOGY 2021. [DOI: 10.4103/jod.jod_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kumar S, Anand A, Nagarathna R, Kaur N, Sivapuram MS, Pannu V, Pal DK, Malik N, Singh AK, Nagendra HR. Prevalence of prediabetes, and diabetes in Chandigarh and Panchkula region based on glycated haemoglobin and Indian diabetes risk score. Endocrinol Diabetes Metab 2021; 4:e00162. [PMID: 33532605 PMCID: PMC7831224 DOI: 10.1002/edm2.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/17/2020] [Indexed: 01/12/2023] Open
Abstract
There is a rapid increase in the prevalence of diabetes in India. We wanted to review the status of prediabetes and diabetes in the combined population of Chandigarh and Panchkula region based on both Indian Diabetes Risk Score (IDRS) and Glycated Haemoglobin (HbA1c). A total of 1215 subjects were recruited during the screening process, out of which 444 i subjects have been analysed for the current study on the basis of high risk for IDRS (≥60) and their known diabetes status. This study included 431 subjects having high risk for IDRS (≥60) and 13 known subjects with diabetes (IDRS < 60) which were further analysed for biochemical and anthropometric parameters. The prevalence of diabetes was found to be 12.67% and prediabetes 11.69% in the combined population of Chandigarh and Panchkula. There was an increased level of fasting blood glucose (183.12 ± 68.61), postprandial blood glucose (262.57 ± 96.92), triglyceride (193.84 ± 119.88), very low-density lipoprotein (VLDL) (34.87 ± 15.42) and High Density Lipoprotein(HDL) (4.61 ± 1.39) in the said diabetes population. Mean HDL was found to be decreased in subjects having diabetes. Glucose-induced lipid intolerance study revealed significant alteration in triglyceride, HDL and VLDL. The study has revealed that high prevalence of diabetes in the sampled population when compared with the national average of 8.8%.
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Affiliation(s)
- Saurabh Kumar
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Akshay Anand
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | | | - Navneet Kaur
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
- Department of Physical EducationPanjab UniversityChandigarhIndia
| | - Madhava Sai Sivapuram
- Department of General MedicineDr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research FoundationChinna‐AvutapalliIndia
| | - Viraaj Pannu
- Government Medical College and Hospital Sector‐32ChandigarhIndia
| | - Deepak Kumar Pal
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Neeru Malik
- Dev Samaj College of EducationChandigarhIndia
| | - Amit Kumar Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S‐VYASA)BengaluruIndia
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Bragg-Gresham J, Thakur JS, Jeet G, Jain S, Pal A, Prasad R, Pennathur S, Saran R. Population-based comparison of chronic kidney disease prevalence and risk factors among adults living in the Punjab, Northern India and the USA (2013-2015). BMJ Open 2020; 10:e040444. [PMID: 33318117 PMCID: PMC7737106 DOI: 10.1136/bmjopen-2020-040444] [Citation(s) in RCA: 4] [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] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES India is witnessing a disturbing growth in non-communicable diseases (NCDs), including chronic kidney disease (CKD). Recently, a WHO STEPS survey was conducted in the state of Punjab, India to collect data from the adult population on NCD risk factors. We sought to compare the prevalence of CKD and its risk factors between this large state in northern India and the USA. SETTING Samples were drawn from both locations, Punjab, India and the USA, using multistage stratified sampling designs to collect data representative of the general population. PARTICIPANTS Data from 2002 participants in the Punjab survey (2014-2015) and 5057 in the USA (National Health and Nutrition Examination Survey (NHANES; 2013-2014), between the ages of 18-69 years were examined. PRIMARY AND SECONDARY OUTCOME MEASURES Modified Poisson regression was employed to compare prevalence between the two samples for markers of CKD and its risk factors. All analyses used sampling weights. RESULTS The average age in the Punjab sample was significantly lower than the USA (38.3 vs 42.5 years, p<0.0001). While smoking and obesity were higher in the USA, hypertension was much more common in Punjab (48.2% vs 33.4%, p<0.0001). Significant differences were seen in the prevalence of CKD, with lower prevalence of eGFR <60 mL/min/1.73 m2 (2.0% vs 3.8%, p<0.0001), but markedly higher prevalence of albuminuria (46.7% vs 8.9%, p<0.0001) in Punjab. These differences could not be explained by traditional risk factors such as diabetes and hypertension. CONCLUSIONS We report a strikingly high prevalence of albuminuria in Punjab, India, compared with the USA. This requires further study and may have enormous public health implications for future burden of progressive CKD, end-stage kidney disease, morbidity, mortality and specifically for elevated risk or presence of cardiovascular disease in the northern state of Punjab, India.Funding came from the National Health Mission, Punjab, India, JST and the Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Affiliation(s)
- Jennifer Bragg-Gresham
- Internal Medicine-Division of Nephrology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - J S Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Gursimer Jeet
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Sanjay Jain
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Arnab Pal
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Rajendra Prasad
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - Subramaniam Pennathur
- Internal Medicine and Molecular and Integrative Physiology, Division of Nephrology, University of Michigan School of Public Health, Ann Arbor, India
| | - Rajiv Saran
- Internal Medicine-Division of Nephrology, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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