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Yun JS, Han K, Kim B, Ko SH, Kwon HS, Ahn YB, Park YMM, Lee SH. All-cause and cause-specific mortality risks in individuals with diabetes living alone: A large-scale population-based cohort study. Diabetes Res Clin Pract 2024; 217:111876. [PMID: 39343144 DOI: 10.1016/j.diabres.2024.111876] [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: 06/25/2024] [Revised: 09/02/2024] [Accepted: 09/26/2024] [Indexed: 10/01/2024]
Abstract
AIMS The rise in one-person households is a global trend. We aimed to investigate mortality risk in individuals with diabetes living alone (IDLA) using a large-scale population-based database. METHODS A total of 2,447,557 adults with type 2 diabetes were identified from the Korean National Health Information Database. One-person households were defined based on the number of registered family members. The risks of all-cause and cause-specific mortalities were estimated using a multivariable Cox proportional hazards regression model. RESULTS During a median follow-up period of 6.0 years, 191,084 deaths (7.8 %) occurred. IDLA had a higher risk of mortality compared to those not living alone after adjusting for potential confounders (HR 1.20, 95 % CI: 1.18-1.22). This association was more prominent in younger individuals, men, and those with low income, and it was dependent on the duration of living alone. The risks of cause-specific mortality were all significantly higher in the IDLA group compared with the non-IDLA group. Adherence to favorable lifestyle behaviors was associated with a significant reduction in all-cause mortality, particularly in IDLA. CONCLUSIONS The elevated risk of mortality in IDLA highlights the need for tailored medical interventions and social assistance, particularly for those with unhealthy lifestyles or low income.
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Affiliation(s)
- Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-Moon Mark Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Fu L, Zhou Y, Sun J, Xing Z, Wang Y, Tai S. Significantly Increased Risk of All-Cause Mortality Among Type 2 Diabetes Patients Living Alone. Front Med (Lausanne) 2022; 9:782751. [PMID: 35155492 PMCID: PMC8826243 DOI: 10.3389/fmed.2022.782751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is a lack of studies evaluating the association between living status and subsequent outcomes in patients with type 2 diabetes (T2DM). Objectives This study aimed to assess the association between living alone and the risk of all-cause mortality in T2DM patients. Methods We performed a secondary analysis in patients with long-lasting T2DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The primary outcome was all-cause mortality. Multivariable Cox proportional hazard models was used to analyze and compare the hazard ratios (HRs) in patients living alone and with one or more adults. Results This study included 10,249 patients with T2DM. Of these, 2,078 (20.28%) were living alone and 8,171 (79.72%) lived with one or more adults. Over a median total follow-up of 8.8 years, 1,958 patients developed the primary endpoint. The all-cause mortality rates in patients living alone or living with one or more adults were 23.24 and 18.05%, respectively. Cox proportional hazard analysis showed that T2DM patients living alone had significantly higher rate of all-cause mortality than those living with others (HR, 1.34; 95% confidence interval [CI], 1.20–1.48; p < 0.001). After multivariable adjustment, living alone was an independent risk factor for all-cause mortality in patients with T2DM (adjusted HR, 1.27; 95% CI, 1.14–1.41; p < 0.001). Furthermore, the risks of both congestive heart failure (CHF) and fatal coronary heart disease (CHD) among 4,050 propensity score-matched patients were higher for patients living alone (respectively HR, 1.37; 95% CI, 1.08–1.74; p = 0.010; and HR, 1.16; 95% CI, 1.00–1.34; p = 0.047). Conclusions The risk of all-cause mortality was significantly higher in T2DM patients living alone than in those living with one or more adults.
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Affiliation(s)
- Liyao Fu
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ying Zhou
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China.,Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiaxing Sun
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhenhua Xing
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yongjun Wang
- Department of Blood Transfusion, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shi Tai
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
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Lopez-Herranz M, Jiménez-García R, Ji Z, de Miguel-Diez J, Carabantes-Alarcon D, Maestre-Miquel C, Zamorano-León JJ, López-de-Andrés A. Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case-Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116088. [PMID: 34200056 PMCID: PMC8200218 DOI: 10.3390/ijerph18116088] [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: 04/30/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 12/15/2022]
Abstract
Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. Results: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. Conclusions: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.
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Affiliation(s)
- Marta Lopez-Herranz
- Nursing Department, Faculty of Nursing, Physiotherapy and Podology, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Rodrigo Jiménez-García
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
- Correspondence:
| | - Zichen Ji
- Respiratory Care Department, Health Research Institute of the Hospital General Universitario Gregorio Marañón (IiSGM), Complutense University of Madrid, 28007 Madrid, Spain; (Z.J.); (J.d.M.-D.)
| | - Javier de Miguel-Diez
- Respiratory Care Department, Health Research Institute of the Hospital General Universitario Gregorio Marañón (IiSGM), Complutense University of Madrid, 28007 Madrid, Spain; (Z.J.); (J.d.M.-D.)
| | - David Carabantes-Alarcon
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Clara Maestre-Miquel
- School of Health Sciences, University of Castilla–La Mancha, 45600 Talavera de la Reina, Spain;
| | - José J. Zamorano-León
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
| | - Ana López-de-Andrés
- Department of Public Health & Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (D.C.-A.); (J.J.Z.-L.); (A.L.-d.-A.)
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Takahashi F, Hashimoto Y, Kaji A, Sakai R, Miki A, Okamura T, Kitagawa N, Okada H, Nakanishi N, Majima S, Senmaru T, Ushigome E, Hamaguchi M, Asano M, Yamazaki M, Fukui M. Habitual Miso (Fermented Soybean Paste) Consumption Is Associated with Glycemic Variability in Patients with Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2021; 13:1488. [PMID: 33924846 PMCID: PMC8145170 DOI: 10.3390/nu13051488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
Glycemic control, including glycemic variability, is important for the prevention of diabetic vascular complications in patients with type 2 diabetes mellitus (T2DM). There was an association between miso soup intake and insulin resistance. However, the relationship between habitual miso consumption and glycemic control, including glycemic variability, in patients with T2DM remains unknown. We defined people without habitual miso consumption if they did not consume miso soup at all in a day. The average, standard deviation (SD), and coefficient of variation (CV), calculated as CV = (SD/average HbA1c) × 100 (%), of hemoglobin (Hb) A1c levels were evaluated. The proportions of habitual miso consumption of male and female were 88.1% and 82.3%, respectively. The average (7.0 [6.4-7.5] vs. 7.3 [6.8-8.4] %, p = 0.009), SD (0.21 [0.12-0.32] vs. 0.37 [0.20-0.72], p = 0.004), and CV (0.03 [0.02-0.04] vs. 0.05 [0.03-0.09], p = 0.005) of HbA1c levels in female with habitual miso consumption were lower than those of female without. Moreover, habitual miso consumption correlated with average (β = -0.251, p = 0.009), SD (β = -0.175, p = 0.016), and CV (β = -0.185, p = 0.022) of HbA1c levels after adjusting for covariates. However, no association between habitual miso consumption and any glycemic parameters was shown among male. This study clarified the association between habitual miso consumption and good glycemic control, including glycemic variability, in female, but not in male.
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Affiliation(s)
- Fuyuko Takahashi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Ayumi Kaji
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Akane Miki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
- Department of Diabetology, Kameoka Municipal Hospital, 1-1 Noda, Shinochoshino, Kameoka 621-8585, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Saori Majima
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Takafumi Senmaru
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Mai Asano
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (F.T.); (A.K.); (R.S.); (A.M.); (T.O.); (N.K.); (H.O.); (N.N.); (S.M.); (T.S.); (E.U.); (M.H.); (M.A.); (M.Y.); (M.F.)
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