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Liang YY, He Y, Wang J, Liu Y, Ai S, Feng H, Zhu C, Li H, Zhou Y, Zhang J, Zhang J, Qi L. Social Isolation, Loneliness, and Risk of Microvascular Complications Among Individuals With Type 2 Diabetes Mellitus. Am J Kidney Dis 2024:S0272-6386(24)00839-4. [PMID: 38925507 DOI: 10.1053/j.ajkd.2024.05.004] [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: 12/25/2023] [Revised: 04/20/2024] [Accepted: 05/01/2024] [Indexed: 06/28/2024]
Abstract
RATIONALE & OBJECTIVE Social disconnection has been associated with poor cardiometabolic health. This study sought to investigate the associations of social isolation and loneliness with diabetic microvascular complications (DMC) among individuals with type 2 diabetes mellitus (T2DM) and compare these associations to those related to traditional risk factors. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS A total of 24,297 UK Biobank participants with T2DM and no DMC at baseline. EXPOSURE Social isolation and loneliness measured using self-reported questionnaires. OUTCOME The incidence of DMC defined as a composite of diabetic kidney disease, diabetic retinopathy, or diabetic neuropathy. ANALYTICAL APPROACH Multivariable cause-specific hazards regression. To compare the relative importance of social disconnection with other established factors, the R2 values of the Cox models were calculated. RESULTS During a median follow-up of 12.6 years, 5,530 patients were documented to develop DMC (3,458 with diabetic kidney disease, 2,255 with diabetic retinopathy, and 1,146 with diabetic neuropathy). The highest level of social isolation was associated with an increased risk of any DMC component (most vs. least: HR: 1.13; 95% CI: 1.05-1.22), especially diabetic kidney disease (HR: 1.14, 95% CI: 1.04-1.25) and neuropathy (HR: 1.31, 95% CI: 1.11-1.53). Any level of loneliness was associated with an increased risk of any DMC component (HR: 1.12; 95% CI: 1.02-1.23) and diabetic kidney disease (HR: 1.16, 95% CI: 1.03-1.30). Social isolation and loneliness exhibited associations with DMC comparable to other conventional risk factors including smoking, blood pressure, and physical activity. LIMITATIONS Limited generalizability related to the composition of participants in the UK Biobank Study. CONCLUSIONS Social isolation and loneliness were independently associated with a higher risk of incident DMC among individuals with T2DM, with comparable importance to other traditional risk factors. These findings underscore social isolation and loneliness as novel and potentially modifiable risk factors for DMC.
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Affiliation(s)
- Yannis Yan Liang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China; Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu He
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jinyu Wang
- Department of Rehabilitation Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Yaping Liu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Changguo Zhu
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Haiteng Li
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yujing Zhou
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jun Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Division of Nephrology, Department of Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA.
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Flórez KR, Hwang NS, Hernández M, Verdaguer S, Derose KP, de la Haye K. Vulnerability or Resiliency? A Two-Wave Panel Analysis of Social Network Factors Associated with Glycemic Levels among Mexican Immigrants in the Bronx, NYC, Before and During COVID-19. J Urban Health 2024; 101:218-228. [PMID: 38347274 PMCID: PMC10897069 DOI: 10.1007/s11524-023-00825-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/28/2024]
Abstract
Latinos have high rates of type 2 diabetes mellitus (T2DM) yet are characterized as having health-promoting social networks. The impacts of COVID-19 on personal networks were complex, especially in urban areas with high proportion of immigrants such as the Bronx in NYC. Our objective was to test the extent to which network characteristics increase vulnerability or resiliency for glycemic control based on data gathered from Mexican-origin Bronx dwellers. We used two-wave panel study analyzing self-reported personal social networks (n=30participants; 600network members) and HbA1c levels via dried blood spots in 2019, before the COVID-19 pandemic, and in 2021, a time after initial lockdowns and when the pandemic was still ravaging the community of study. Regression models adjusted for individual-level variables including sociodemographic and health indicators (i.e., physical health including COVID-19 and mental health). We found that an increase in the proportion of network members with diabetes predicted an increase in participant's HbA1c levels from 2019 to 2021 (β=0.044, p < 0.05). Also, a greater proportion of network members consuming "an American diet" in 2019 predicted a decrease in participant's HbA1c levels (β=-0.028, p < 0.01), while a greater proportion of network members that encouraged participants' health in 2019 predicted an increase in participant's HbA1c levels (β=0.033, p < 0.05). Our study sheds light on specific social network characteristics relevant to individual diabetes outcomes, including potential longitudinal mechanistic effects that played out at the peak of the COVID-19 crisis.
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Affiliation(s)
- Karen R Flórez
- Environmental, Occupational and Geospatial Sciences Department, City University of New York (CUNY), CUNY Graduate School of Public Health and Heath Policy, 55 West 125th Street, New York, NY, 10027, USA.
- Center for Systems and Community Design, New York, NY, USA.
| | - Neil S Hwang
- Business and Information Systems Department, City University of New York, Bronx Community College, Bronx, NY, USA
| | - Maria Hernández
- El Instituto: Institute of Latina/o, Caribbean and Latin America Studies of College of Liberal Arts and Science, University of Connecticut, Storrs, CT, USA
| | - Sandra Verdaguer
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Kathryn P Derose
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Kayla de la Haye
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
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Guldager R, Nordentoft S, Bruun-Pedersen M, Hindhede AL. Social network trajectory of young adults aged 18-35 years diagnosed with a brain tumour: a protocol for a mixed methods study. BMJ Open 2023; 13:e076337. [PMID: 38154884 PMCID: PMC10759115 DOI: 10.1136/bmjopen-2023-076337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Research indicates that social networks and roles are disrupted throughout the entire trajectory of someone living with a brain tumour. Young adults aged 18-35 years are particularly vulnerable to such disruption because they are in a process of establishing themselves. Pre-existing social roles and support networks of young adults living with a primary brain tumour may change. This study aims to identify the social networks of young adults aged 18-35 years diagnosed with a primary brain tumour and to map how the diagnosis and disease course affects the social network in relation to changes in relationships and roles over time. METHODS AND ANALYSIS The study adopts a longitudinal design with a convergent mixed methods approach to describe the social network of young adults. The study utilizes a quantitative approach to social network analysis to measure network size, composition and density and a qualitative approach with interviews to gain insight into young adult's narratives about their network. Network maps will be produced, analysed and all the findings will then be compared and integrated. Interviews and network drawing will take place at the time of the diagnoses, with follow-up interviews 6 and 12 months later. This will shed light on transformations in network compositions and network support over time. ETHICS AND DISSEMINATION The study has been approved by the Danish Data Protection Agency (ID P-2022-733). Written informed consent will be obtained from all patients. The results will be disseminated through a peer-reviewed journal and reported at local, national and international conferences on brain cancer.
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Affiliation(s)
- Rikke Guldager
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Sara Nordentoft
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | | | - Anette Lykke Hindhede
- UCSF Center for Sundhedsfaglig Forskning, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Liang YY, Chen Y, Feng H, Xue H, Nie Y, Ai QYH, Ma J, Yang L, Zhang J, Ai S. Social isolation, loneliness and subsequent risk of major adverse cardiovascular events among individuals with type 2 diabetes mellitus. Gen Psychiatr 2023; 36:e101153. [PMID: 38170087 PMCID: PMC10759055 DOI: 10.1136/gpsych-2023-101153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Background Individuals with type 2 diabetes mellitus (T2DM) are more vulnerable to social disconnection compared with the general population; however, there are few relevant studies investigating this issue. Aims To investigate whether social isolation or loneliness may be associated with subsequent risk of developing major adverse cardiovascular events, whether these associations vary according to fatal and non-fatal outcomes and how behavioural, psychological and physiological factors mediate these associations. Methods This longitudinal analysis included data from 19 360 individuals with T2DM at baseline (2006-2010) from the UK Biobank. Social isolation and loneliness were measured using self-report questionnaires. The study outcomes included the first events of myocardial infarction (MI) or stroke (n=2273) and all-cause (n=2820) or cardiovascular disease-related mortality through linked hospital data or death registries. Results Over a median follow-up of 12.4 years (interquartile range (IQR): 11.6-13.3 years), participants who were more socially isolated (most social isolation vs least social isolation) experienced increased risks for all-cause (hazard ratio (HR) : 1.33, 95% confidence interval (CI): 1.19 to 1.47) and cardiovascular disease (HR: 1.36, 95% CI: 1.17 to 1.59) mortality but not first MI or stroke. Loneliness (yes vs no) was associated with a greater risk for a composite of incident MI or stroke (HR: 1.37, 95% CI: 1.19 to 1.57) but not mortality. Social isolation was associated with fatal MI and stroke, whereas loneliness was associated with non-fatal MI and stroke. The significant associations of social isolation and loneliness with outcomes were mainly mediated by behavioural factors (mediating proportion: 17.8%-28.2% and 17.6%-17.8%, respectively). Conclusions Among individuals with T2DM, social isolation and loneliness are associated with a greater risk of developing major adverse cardiovascular events, with differences in both risks stratified according to fatal and non-fatal events and underlying mediating factors.
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Affiliation(s)
- Yannis Yan Liang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Institute of Psycho-neuroscience, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yilin Chen
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongliang Feng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Huachen Xue
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu Nie
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qi-Yong H Ai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jiacheng Ma
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China
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Chen P, Callisaya M, Wills K, Greenaway T, Winzenberg T. Health Literacy predicts incident foot ulcers after 4 years - the SHELLED cohort study. J Foot Ankle Res 2023; 16:45. [PMID: 37501178 PMCID: PMC10373326 DOI: 10.1186/s13047-023-00644-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
AIMS/HYPOTHESIS To determine whether health literacy is associated with an index diabetes-related foot ulcer (DFU). METHODS The SHELLED Study is a 4-year prospective study of people with diabetes aged over 40 with no history of DFU. The primary outcome was development of a first foot ulcer. Health Literacy was measured using the short form Test of Functional Health Literacy in Adults (s-TOFHLA) and nine domains of the Health Literacy Questionnaire (HLQ). RESULTS Of 222 participants, 191 (86.0%) completed the study, of whom 13 (5.9%) developed an incident ulcer. In multivariable models, every unit increase in S-TOFHLA was associated with a reduced odds of foot ulcer development by 6% (OR 0.94, 95% CI 0.88 to 0.99). Better scores on two HLQ domains reduced the odds of foot ulcer (actively managing my health (OR 0.23, 95% CI 0.08 to 0.65) and understanding health information well enough to know what to do (OR 0.39, 95% CI 0.19 to 0.78). This was independent of baseline risk for foot disease. CONCLUSIONS/INTERPRETATION These data provide novel evidence that health literacy is an important clinical risk factor for index foot ulceration. This is an area of potential focus for research and development of educational programs or policy aimed at reducing development of incident foot ulceration.
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Affiliation(s)
- Pamela Chen
- School of Medicine, Faculty of Health, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia.
- Present Address: Joondalup Health Campus, Ramsay Healthcare Australia, Corner Shenton Ave and Grand Boulevard, Joondalup, WA, 6027, Australia.
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Timothy Greenaway
- School of Medicine, Faculty of Health, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
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Botchway M, Davis RE, Merchant AT, Appiah LT, Sarfo-Kantanka O, Moore S. Social networks, perceived social support, and HbA1c in individuals with type 2 diabetes mellitus in urban Ghana. ETHNICITY & HEALTH 2023; 28:281-298. [PMID: 35098827 DOI: 10.1080/13557858.2022.2033172] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Although links between social relationships and health are well established, few studies have concurrently examined the effects of compositional, structural, and functional dimensions of social networks on glycemic (HbA1c) control in low- and middle-income countries such as Ghana. In these settings where informal social relationships are critical for access to resources, evaluating the links between social network characteristics, social support, and glycemic control may provide clarity about important relationships that facilitate the well-being of individuals with type 2 diabetes mellitus (T2DM). DESIGN In 2018, we conducted a hospital-based, cross-sectional survey of noninstitutionalized adults with T2DM in Ghana. Using data from 247 study participants, multivariable linear regression models were used to estimate associations between: 1) HbA1c and three social network characteristics (kin composition, household composition, and network density); 2) social support and the three social network characteristics; and 3) HbA1c and social support. We also examined gender differences in these associations and applied mediation techniques to determine if network characteristics operated through social support to affect HbA1c. RESULTS Findings indicated that higher kin composition and higher household composition were each significantly associated with increased social support. Neither social support nor social network characteristics were significantly related to HbA1c, and there were no gender differences in any of these associations. CONCLUSION Although family and household members were identified as important sources of social support for diabetes management, the ways in which they influence HbA1c control among Ghanaians require further investigation. Future studies can examine whether changes in social support over time, social support satisfaction, or other dimensions of social relationships improve T2DM outcomes in countries like Ghana.
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Affiliation(s)
- Marian Botchway
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Lambert T Appiah
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Health & Society Group, Wageningen University & Research, Wageningen, Netherlands
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Stafl L, Benham JL, Frehlich L, Donovan LE, Yamamoto JM. Missed antenatal diabetes care appointments and neonatal outcomes for pregnancies with Type 1 and Type 2 diabetes. Diabet Med 2023; 40:e14950. [PMID: 36054517 DOI: 10.1111/dme.14950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is limited information regarding the association between missed appointments and neonatal outcomes for diabetes in pregnancy. STUDY METHODS This retrospective live birth cohort included pregnant women with Type 1 or 2 diabetes who attended specialized clinics from 2008 to 2020. The association between at least one missed antenatal diabetes appointments and outcomes were assessed using logistic regression and reported as adjusted odds ratios (aOR) (95% confidence interval). Mediation analyses were conducted to examine if above target HbA1c mediated these relationships. RESULTS The cohort included 407 and 902 women with Type 1 and 2 diabetes, respectively, of whom 25.1% and 34.5% missed at least one appointment. Women with Type 1 diabetes who missed an appointment were more likely to have a caesarean section (aOR 1.95 [1.15, 3.31]) and their babies more likely to be admitted to the neonatal intensive care unit (aOR 2.25 [1.35, 3.75]). Women with Type 2 diabetes who missed an appointment were more likely to have a large-for-gestational-age infant (aOR 1.61 [1.13, 2.28]), and an extreme large-for-gestational-age infant (aOR 1.69 [1.02, 2.81]) compared with women who did not miss appointments. Above target HbA1c mediated the relationship between missed appointments and caesarean delivery in Type 1 diabetes and large-for-gestational age and extreme large-for-gestational age in Type 2 diabetes. CONCLUSION In individuals with Type 1 and 2 diabetes, there are differences in neonatal outcomes between those who missed an appointment compared to those who did not. It remains unclear if missed diabetes appointments are causative or a marker of other health behaviours or risk factors leading to neonatal morbidity.
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Affiliation(s)
- Lenka Stafl
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lois E Donovan
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Jennifer M Yamamoto
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Internal Medicine, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Steijvers LCJ, Brinkhues S, Tilburg TGV, Hoebe CJPA, Stijnen MMN, Vries ND, Crutzen R, Dukers-Muijrers NHTM. Changes in structure and function of social networks of independently living middle-aged and older adults in diverse sociodemographic subgroups during the COVID-19 pandemic: a longitudinal study. BMC Public Health 2022; 22:2253. [PMID: 36463147 PMCID: PMC9719122 DOI: 10.1186/s12889-022-14500-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Social networks, i.e., all social relationships that people have, contribute to well-being and health. Governmental measures against COVID-19 were explicitly aimed to decrease physical social contact. We evaluated ego-centric social network structure and function, and changes therein, among various sociodemographic subgroups before and during the COVID-19 pandemic. METHODS Independently living Dutch adults aged 40 years and older participating in the SaNAE longitudinal cohort study filled in online questionnaires in 2019 and 2020. Changes in network size (network structure) and social supporters (network function) were assessed. Associations with risk for changes (versus stable) were assessed for sociodemographic subgroups (sex, age, educational level, and urbanization level) using multivariable regression analyses, adjusted for confounders. RESULTS Of 3,344 respondents 55% were men with a mean age of 65 years (age range 41-95 in 2020). In all assessed sociodemographic subgroups, decreases were observed in mean network size (total population: 11.4 to 9.8), the number of emotional supporters (7.2 to 6.1), and practical supporters (2.2 to 1.8), and an increase in the number of informational supporters (4.1 to 4.7). In all subgroups, the networks changed to being more family oriented. Some individuals increased their network size or number of supporters; they were more often women, higher-educated, or living in rural areas. CONCLUSION The COVID-19 pandemic impacted social networks of people aged 40 years and older, as they increased informational support and reduced the number of their social relationships, mainly in terms of emotional and practical supporters. Notably, some individuals did not show such unfavorable trends and managed to reorganize their networks to attribute social support roles more centrally.
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Affiliation(s)
- Lisanne CJ Steijvers
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands ,grid.491392.40000 0004 0466 1148Department of Sexual Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands
| | - Stephanie Brinkhues
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands ,grid.491392.40000 0004 0466 1148Department of Knowledge and Innovation, Public Health Service South Limburg, Heerlen, the Netherlands
| | - Theo G van Tilburg
- grid.12380.380000 0004 1754 9227Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Christian JPA Hoebe
- grid.5012.60000 0001 0481 6099Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands ,grid.491392.40000 0004 0466 1148Department of Sexual Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands ,grid.412966.e0000 0004 0480 1382Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Mandy MN Stijnen
- grid.491392.40000 0004 0466 1148Department of Knowledge and Innovation, Public Health Service South Limburg, Heerlen, the Netherlands ,grid.5012.60000 0001 0481 6099Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nanne de Vries
- grid.5012.60000 0001 0481 6099Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Rik Crutzen
- grid.5012.60000 0001 0481 6099Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicole HTM Dukers-Muijrers
- grid.491392.40000 0004 0466 1148Department of Sexual Health, Infectious Diseases, and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands ,grid.5012.60000 0001 0481 6099Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Effect of Chronic Heart Failure Complicated with Type 2 Diabetes Mellitus on Cognitive Function in the Elderly. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4841205. [PMID: 35800008 PMCID: PMC9256388 DOI: 10.1155/2022/4841205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/28/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the effect of chronic heart failure complicated with type 2 diabetes mellitus on cognitive function in the elderly. Methods 600 patients with chronic heart failure were selected from January 2018 to January 2021. All patients were divided into observation group (A) and control group (B). A was chronic heart failure complicated with type 2 diabetes mellitus group. B was chronic heart failure group. The clinical effects of the two groups were observed. Results Compared with the clinical indexes during and after operation, there were differences in operation time, postoperative recovery time, and treatment cost between A and B, but the difference is not significant (all P > 0.05). LVEF cardiac function index score, LVEF score of A compared with B, the difference was statistically significant (P < 0.05). The MMSE score and MoCA score of the two groups were compared. Before operation, the MMSE score and MoCA score of A were lower than those of B, and the difference was statistically significant (P < 0.05). After operation, the MMSE score and MoCA score in B were significantly higher than those in B, but the increasing trend of MMSE score and MoCA score in B was significantly higher than that in A (P < 0.05). Comparison of HAMA score and HAMD score: before operation, the HAMA score and HAMD score were higher in A, but the difference is not significant (P > 0.05). After operation, the scores of HAMA and HAMD in A and B decreased significantly, but the difference is not significant (P > 0.05). Multivariate analysis showed that the fasting blood glucose and glycosylated hemoglobin were the risk factors of cognitive impairment. Conclusion Type 2 diabetes mellitus in elderly patients with chronic heart failure will further aggravate cognitive impairment, and type 2 diabetes is an important independent risk factor affecting cognitive function, which accelerates cognitive impairment and significantly reduces the executive ability of elderly patients with chronic heart failure, resulting in a significant decline in patients' ability to understand and apply information.
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10
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Shang Y, Wu W, Dove A, Guo J, Welmer AK, Rizzuto D, Fratiglioni L, Xu W. Healthy behaviours, leisure activities, and social network prolong disability-free survival in older adults with diabetes. J Gerontol A Biol Sci Med Sci 2022; 77:2093-2101. [PMID: 35239961 PMCID: PMC9536441 DOI: 10.1093/gerona/glac054] [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: 10/07/2021] [Indexed: 11/22/2022] Open
Abstract
Background Diabetes has been related to disability and excess mortality. We estimated the extent to which diabetes shortens disability-free survival and identified modifiable factors that may prolong disability-free survival in older adults with diabetes. Methods Disability-free older adults (n = 2 216, mean age: 71 years, female: 61%) were followed for up to 15 years. Diabetes was ascertained through medical examinations, medication use, or glycated hemoglobin ≥6.5% (48 mmol/mol). Disability-free survival was defined as survival until the occurrence of disability. A favorable (vs unfavorable) lifestyle profile was defined as the presence of at least 1 of the following: healthy (vs unhealthy) behaviors, active (vs inactive) engagement in leisure activities, or moderate-to-rich (vs poor) social network. Data were analyzed using Cox regression and Laplace regression. Results During the follow-up, 1 345 (60.7%) participants developed disability or died. Diabetes, but not prediabetes, was related to the outcome (hazard ratio [HR] 1.29, 95% CI 1.06–1.57), and 2.15 (1.02–3.27) years shorter median disability-free survival. In joint exposure analysis, disability-free survival was shortened by 3.29 (1.21–5.36), 3.92 (2.08–5.76), and 1.66 (0.06–3.28) years for participants with diabetes plus unhealthy behaviors, inactive engagement in leisure activities, or poor social network. Among participants with diabetes, a favorable profile led to a nonsignificant HR of 1.19 (0.93–1.56) for disability/death and prolonged disability-free survival by 3.26 (2.33–4.18) years compared to those with an unfavorable profile. Conclusions A healthy and socially active lifestyle may attenuate the risk of diabetes on disability or death and prolong disability-free survival among people with diabetes.
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Affiliation(s)
- Ying Shang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Wei Wu
- School of Laboratory Medicine, Hubei University of Chinese Medicine, 16 Huangjia Lake West Road, Wuhan, China
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jie Guo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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11
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Sridhar VS, Yau K, Benham JL, Campbell DJT, Cherney DZI. Sex and Gender Related Differences in Diabetic Kidney Disease. Semin Nephrol 2022; 42:170-184. [PMID: 35718364 DOI: 10.1016/j.semnephrol.2022.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diversity in sex and gender are important considerations in the pathogenesis, prognostication, research, and management of diabetic kidney disease (DKD). Sex and gender differences in the disease risk, disease-specific mechanisms, and outcomes in DKD may be attributed to biological differences between males and females at the cellular and tissue level, inconsistencies in the diagnostic and assessment tools used in chronic kidney disease and DKD, as well societal differences in the way men, women, and gender-diverse individuals self-manage and interact with health care systems. This review outlines key considerations related to the impact of sex on DKD, specifically elaborating on how they contribute to observed differences in disease epidemiology, pathogenesis, and treatment strategies. We also highlight the effect of gender on DKD progression and care.
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Affiliation(s)
- Vikas S Sridhar
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Kevin Yau
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Jamie L Benham
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - David J T Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
| | - David Z I Cherney
- Division of Nephrology, Department of Medicine, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta; Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta
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12
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Han H, Cao Y, Feng C, Zheng Y, Dhana K, Zhu S, Shang C, Yuan C, Zong G. Association of a Healthy Lifestyle With All-Cause and Cause-Specific Mortality Among Individuals With Type 2 Diabetes: A Prospective Study in UK Biobank. Diabetes Care 2022; 45:319-329. [PMID: 34857534 DOI: 10.2337/dc21-1512] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/08/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the association of a healthy lifestyle, involving seven low-risk factors mentioned in diabetes management guidelines (no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary behavior, adequate sleep duration, and appropriate social connection), with all-cause and cause-specific mortality among individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS This study included 13,366 participants with baseline type 2 diabetes from the UK Biobank free of cardiovascular disease (CVD) and cancer. Lifestyle information was collected through a baseline questionnaire. RESULTS During a median follow-up of 11.7 years, 1,561 deaths were documented, with 625 from cancer, 370 from CVD, 115 from respiratory disease, 81 from digestive disease, and 74 from neurodegenerative disease. In multivariate-adjusted model, each lifestyle factor was significantly associated with all-cause mortality, and hazard ratios associated with the lifestyle score (scoring 6-7 vs. 0-2 unless specified) were 0.42 (95% CI 0.34, 0.52) for all-cause mortality, 0.57 (0.41, 0.80) for cancer mortality, 0.35 (0.22, 0.56) for CVD mortality, 0.26 (0.10, 0.63) for respiratory mortality, and 0.28 (0.14, 0.53) for digestive mortality (scoring 5-7 vs. 0-2). In the population-attributable risk analysis, 29.4% (95% CI 17.9%, 40.9%) of deaths were attributable to a poor lifestyle (scoring 0-5). The association between a healthy lifestyle and all-cause mortality was consistent, irrespective of factors reflecting diabetes severity (diabetes duration, glycemic control, diabetes-related microvascular disease, and diabetes medication). CONCLUSIONS A healthy lifestyle was associated with a lower risk of all-cause mortality and mortality due to CVD, cancer, respiratory disease, and digestive disease among individuals with type 2 diabetes.
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Affiliation(s)
- Han Han
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yaying Cao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Chengwu Feng
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China.,Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Klodian Dhana
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Shu Zhu
- Hefei National Laboratory for Physical Sciences at Microscale, CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Cong Shang
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Changzheng Yuan
- Department of Big Data in Health Science, Zhejiang University School of Public Health, Hangzhou, China.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.,Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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13
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Shen B, Guan T, Du X, Pei C, Zhao J, Liu Y. Medication Adherence and Perceived Social Support of Hypertensive Patients in China: A Community-Based Survey Study. Patient Prefer Adherence 2022; 16:1257-1268. [PMID: 35610983 PMCID: PMC9124465 DOI: 10.2147/ppa.s363148] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/13/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Previous studies suggested perceived social support has impact on medication adherence among hypertensive patients, but did not simultaneously elucidate the different contents or key providers of social support that patients perceived. This study was to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China, which could prove important for targeted interventions. PATIENTS AND METHODS Following a multi-stage stratified sampling framework, a total of 903 hypertensive patients from 12 primary health institutions across a middle-income city were recruited from April to June 2021. Medication adherence was measured using the Chinese version of the Morisky, Green and Levine scale; perceived social support was determined using the name generator method. A binary logistic regression model was performed to identify the association between medication adherence and perceived social support. The contents of support included informational, emotional, and instrumental support (finances and caregiving). The support providers included spouse/partner, children, parents, siblings, other relatives, and friends. RESULTS A total of 506 (56.04%) patients optimally adhered to their antihypertensive medication. Female, older, urban patients, patients with shorter duration of hypertension and antihypertensive medications used showed better adherence (P<0.05). Optimal medication adherence was positively associated with the overall score of caregiving support (adjusted odds ratio [AOR] = 1.128; 95% confidence interval [CI] = [1.013-1.257]), informational support from the spouse/partner (AOR = 1.574; 95% CI = [1.112-2.227]), emotional support from the spouse/partner (AOR = 1.430; 95% CI = [1.032-1.981]), financial support from the spouse/partner (AOR = 1.439; 95% CI = [1.069-1.937]) and caregiving support from the spouse/partner (AOR = 1.652; 95% CI = [1.130-2.414]), whereas optimal medication adherence was negatively associated with caregiving support from friends (AOR = 0.499; 95% CI = [0.286-0.872]). CONCLUSION Informational, emotional, financial and caregiving support from spouses/partners have positive impacts on optimal medication adherence of hypertensive patients of community-level. Community-based interventions designed to improve medication adherence of hypertensive patients should target both patients and their spouses/partners; spouses/partners could be encouraged to provide various support to improve the medication adherence of hypertensive patients.
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Affiliation(s)
- Bingjie Shen
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xinyu Du
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Chenyang Pei
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Yuanli Liu, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, 46 Xizongbu Hutong, Dongcheng District, Beijing, 100005, People’s Republic of China, Tel +86 13522592907, Fax +86 10 65105830, Email
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14
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Ledford CJ, Villareal C, Williams EW, Cafferty LA, Jackson JT, Seehusen DA. Patient Decision-Making About Self-Disclosure of a Type 2 Diabetes Diagnosis: A Qualitative Study. Diabetes Spectr 2022; 35:327-334. [PMID: 36082012 PMCID: PMC9396723 DOI: 10.2337/ds21-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Effective self-management of type 2 diabetes requires receiving support, which can result from disclosing the diagnosis to a support network, including coworkers, family, and friends. As a primarily invisible disease, diabetes allows people to choose whether to disclose. This study qualitatively explores the factors that influence a person's decision to disclose diabetes to others. METHODS Research coordinators recruited 22 interview participants, ranging in age from 32 to 64 years, whose medical records included a diagnosis code for type 2 diabetes. Participants received care from one of two U.S. medical centers. Semi-structured interviews lasted approximately 1 hour and were audio-recorded and professionally transcribed. Verification strategies such as memo-keeping and maintaining methodological coherence/congruence were used throughout analysis to promote rigor. RESULTS In patients' descriptions of their decision-making processes regarding whether to disclose their diagnosis, six themes emerged. Three motivations prompted open disclosure: 1) to seek information, 2) to seek social support, and 3) to end the succession of diabetes, and the other three motivations prompted guarded disclosure: 4) to prepare for an emergency, 5) to maintain an image of health, and 6) to protect employment. CONCLUSION Based on our findings, we recommend three communicative actions for clinicians as they talk to patients about a diabetes diagnosis. First, clinicians should talk about the benefits of disclosure. Second, they should directly address stereotypes in an effort to de-stigmatize diabetes. Finally, clinicians can teach the skills of disclosure. As disclosure efficacy increases, a person's likelihood to disclose also increases. Individuals can use communication as a tool to gain the knowledge and support they need for diabetes self-management and to interrupt the continuing multigenerational development of diabetes within their family.
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Affiliation(s)
- Christy J.W. Ledford
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | | | | | - Lauren A. Cafferty
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
- Military Primary Care Research Network, Bethesda, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD
| | - Jeremy T. Jackson
- Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
- Military Primary Care Research Network, Bethesda, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, MD
- Corresponding author: Jeremy T. Jackson,
| | - Dean A. Seehusen
- Department of Family Medicine, Medical College of Georgia, Augusta University, Augusta, GA
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15
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Ida S, Murata K. Social Isolation of Older Adults With Diabetes. Gerontol Geriatr Med 2022; 8:23337214221116232. [PMID: 35937276 PMCID: PMC9350511 DOI: 10.1177/23337214221116232] [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: 07/01/2022] [Accepted: 07/10/2022] [Indexed: 11/24/2022] Open
Abstract
We aimed to conduct a scoping review of social isolation in elderly
patients with diabetes and to clarify current knowledge and gaps and
future challenges. A literature search was conducted using Medline,
Web of Science, CINAHL, CiNii, and Ichushi, and included studies with
an eligibility criterion of a survey of social isolation in elderly
patients with diabetes and aged ≥60 years. Social isolation was
defined as limited or non-face-to-face contact with family and
community. A data extraction form describing characteristics of
studies incorporated in the present review was prepared. A total of
six studies met eligibility criterion (sample size, 451–3,500).
Subjects’ age averaged 67 years, and 42% were female. Social isolation
ranged from 9% to 49%. Factors related to social isolation included
vascular complications,decreased activities of daily living, death,
dementia, glycemic fluctuation, disturbance of lifestyle habits, and
poor self-management and -rated health. However, research on the cause
and mechanism of the relationship and impact of sex-based differences
was lacking. In conclusion, additional research is needed on the
definition of social isolation in elderly patients with diabetes, the
causal relationship with related factors and their mechanisms, and the
relationship with other outcomes.
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Prochnow T, Patterson MS. Assessing Social Network Influences on Adult Physical Activity Using Social Network Analysis: A Systematic Review. Am J Health Promot 2021; 36:537-558. [PMID: 34898289 DOI: 10.1177/08901171211060701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Social network analysis (SNA) can measure social connectedness and assess impact of interpersonal connections on health behaviors, including physical activity (PA). This paper aims to systematically review adult PA studies using SNA to understand important social network concepts relative to PA. DATA SOURCE A search was performed using PsycINFO, MEDLINE, PubMed, and Web of Science. STUDY INCLUSION AND EXCLUSION CRITERIA To be included in the search, articles needed to 1) include a measure of PA, 2) conduct an SNA in which specific relationships were measured, and 3) conduct an analysis between social network measures and PA. DATA EXTRACTION Key study elements including network design and results were extracted. DATA SYNTHESIS Data were synthesized to answer 2 questions: 1) how has adult PA been investigated using SNA approaches and 2) how is an adult's social network associated with PA behaviors? RESULTS A final sample of 28 articles remained from an initial 11 085 articles. Network size, homophily, network composition, and network exposure to PA were all associated with individual level PA across studies. Lastly, longitudinal and intervention studies showed a more complex picture of social influence and diffusion of PA behavior. CONCLUSIONS Adults' PA behaviors are influenced by their networks. Capitalizing on this influence, researchers should engage not just individual behavior change but also the social influences present within the person's life.
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Affiliation(s)
- Tyler Prochnow
- Department of Health and Kinesiology, 14736Texas A&M University, College Station, TX, USA
| | - Megan S Patterson
- Department of Health and Kinesiology, 14736Texas A&M University, College Station, TX, USA
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Yang K, Liu Y, Yin X, Wu S, Wu Q, Wang L, Li J. A survey of social network status and its related factors for older adults with type 2 diabetes in Beijing, China. Nurs Open 2021; 9:1005-1014. [PMID: 34850591 PMCID: PMC8859026 DOI: 10.1002/nop2.1138] [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: 03/31/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Aim To understand the social network status of older adults with type 2 diabetes mellitus (T2DM) in Beijing, China and explore its related factors. Design A cross‐sectional survey using a sample of convenience was conducted. Methods From April to September 2019, Lubben Social Network Scale‐6 (LSNS‐6) was used to evaluate the social network of 300 older adults with T2DM from the outpatient and inpatient departments of three hospitals and five communities in Beijing. Self‐designed demographics and clinical sheets, Summary of Diabetes Self‐Care Activities Scale, Social Support Rating Scale and Geriatric Depression Scale‐15 were used to investigate the related factors of their social networks. The Equator Research Checklist used in this study is STROBE checklist. Results The score of LSNS‐6 of the older adults was 16.75 ± 7.02 (scale: 0 ~ 30), the score of family network dimension was 8.32 ± 3.63 (scale: 0 ~ 15), and friends network dimension was 8.43 ± 4.74 (scale: 0 ~ 15). Additionally, 22.67% of the older adults had social isolation. Social support, medical payment, self‐assessed health status, residential arrangement and smoking status were associated with the social network level of the older adults with T2DM (p < .05).
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Affiliation(s)
- Kailian Yang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China.,Nursing Department, Zhaoqing Medical College, Zhaoqing, China
| | - Yu Liu
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Xing Yin
- Nursing Department, Zhaoqing Medical College, Zhaoqing, China
| | - Shishi Wu
- School of Nursing, Beijing University of Chinese Medicine, Beijing, China
| | - Quanying Wu
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Li Wang
- Nursing Department, Fangzhuang Community Health Service Center, Beijing, China
| | - Jiayue Li
- Department of Endocrinology, the Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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18
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Shen B, Guan T, Ma J, Yang L, Liu Y. Social network research hotspots and trends in public health: A bibliometric and visual analysis. PUBLIC HEALTH IN PRACTICE 2021; 2:100155. [PMID: 36101592 PMCID: PMC9461482 DOI: 10.1016/j.puhip.2021.100155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives To understand the research landscape and identify the research hotspots and trends of the application of social network theory and analysis to public health. Study design A bibliometric study of publications regarding application of social network theory and analysis to public health. Methods Choosing 1607 articles about the application of social network theory and analysis to public health from the core collection database of Web of Science published from 1991 to 2020 as the research sample. A bibliometric and visual analysis of publication quantity and content was performed to analyze time trends, spatial distribution, cooperation networks, influential references, and keyword co-occurrence, clusters, and emergence. Results There is an increasing trend in the use of social network theory and analysis in the public health field, with the United States taking the lead. Research focuses include on transmission of diseases or behavior through social networks and the influence of social networks on population health at different ages. Current research frontiers primarily include the role of social networks in tracking of emerging infectious diseases like COVID-19, preventing and controlling chronic diseases, and carrying out healthy behavioral interventions. Conclusions This study provides a comprehensive quantitative overview of the historic development of and latest topics in the application of social network theory and analysis method to public health. More attention should be paid to the important role of social networks in tracing the emergence of serious infectious diseases like COVID-19, as well as preventing and controlling chronic diseases and intervening in health behaviors, considering the increasing challenges and opportunities presented by online social networking. The use of social network theory and analysis (SNT/A) in public health has grown sharply since 2007. The United States has taken the lead in this field of research, with some active institutions in the U.S. and the Europe. The transmission of diseases or behaviors within social networks is a major research focus in this interdisciplinary field. Research frontiers primarily include using SNT/A to track, prevent and control diseases, like COVID-19.
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19
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Gianfredi V, Beran M, Koster A, Eussen SJ, Odone A, Signorelli C, Schaper NC, Köhler S, Bosma H, Dagnelie PC, Stehouwer CDA, Wesselius A, Amerio A, Brinkhues S, Dukers-Muijrers N, Schram MT. Association between social network characteristics and prevalent and incident depression: The Maastricht Study. J Affect Disord 2021; 293:338-346. [PMID: 34229287 DOI: 10.1016/j.jad.2021.06.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/09/2021] [Accepted: 06/19/2021] [Indexed: 11/30/2022]
Abstract
AIMS Social network characteristics may provide a novel non-pharmaceutical target for the prevention of depression. We investigated the temporal association of a broad range of structural and functional social network characteristics with incident depressive symptoms over 5 years of follow-up. METHODS We used data from The Maastricht Study, a population-based prospective cohort study (n=2,465, mean age 59.8±8.1 years, 49.1% women, 11,585 person-years of follow-up). Social network characteristics were assessed through a name generator questionnaire. Clinically relevant depressive symptoms (9-item Patient Health Questionnaire score≥10) were assessed at baseline and annually. We used multivariable logistic and Cox regression analyses, adjusted for sociodemographic, lifestyle and cardiovascular risk factors. RESULTS In cross-sectional analyses less emotional support for discomfort and with important decisions, and less informational support were associated with prevalent depressive symptoms (OR[95%CI] 1.19 [1.01-1.40]; 1.22 [1.05-1.43], and 1.20 [1.04-1.39], respectively). Every fewer 10% of family members was associated with prevalent depressive symptoms (1.11 [1.01-1.23]). In longitudinal analyses, less emotional support on important decisions was also associated with higher risk of incident depressive symptoms (HR[95%CI] 1.13 [1.03-1.25]). In addition, every fewer 10% of the network that was a family member was associated with a higher hazard of incident depressive symptoms (1.07 [1.01-1.13]). CONCLUSIONS This study shows that less emotional support and fewer family members in the network were associated with higher risk of both prevalent and incident depression. The importance of emotional support and the role that family plays should be considered in treatment and prevention of depression.
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Affiliation(s)
- Vincenza Gianfredi
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Magdalena Beran
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Simone Jpm Eussen
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology; Maastricht University, Maastricht, the Netherlands
| | - Anna Odone
- Department Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicolaas C Schaper
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; MHeNS School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Hans Bosma
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Pieter C Dagnelie
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Epidemiology; Maastricht University, Maastricht, the Netherlands
| | - Coen DA Stehouwer
- Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Department of Complex Genetics, Maastricht University, Maastricht, the Netherlands
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Mood Disorders Program, Tufts Medical Center, Boston, MA, USA
| | - Stephanie Brinkhues
- Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, the Netherlands
| | - Nicole Dukers-Muijrers
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; NUTRIM School for Nutrition and Translational Research in Metabolism, University of Maastricht, Department of Complex Genetics, Maastricht University, Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases, and Environmental Health, Heerlen, South Limburg Public Health Service, the Netherlands; Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Miranda T Schram
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; MHeNS School for Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, the Netherlands; Heart and Vascular Center, Maastricht University Medical Center+, Maastricht, the Netherlands.
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20
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Schram MT, Assendelft WJJ, van Tilburg TG, Dukers-Muijrers NHTM. Social networks and type 2 diabetes: a narrative review. Diabetologia 2021; 64:1905-1916. [PMID: 34189591 PMCID: PMC8241411 DOI: 10.1007/s00125-021-05496-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/09/2021] [Indexed: 12/24/2022]
Abstract
It has been known for decades that social networks are causally related to disease and mortality risk. However, this field of research and its potential for implementation into diabetes care is still in its infancy. In this narrative review, we aim to address the state-of-the-art of social network research in type 2 diabetes prevention and care. Despite the diverse nature and heterogeneity of social network assessments, we can draw valuable lessons from the available studies. First, the structural network variable 'living alone' and the functional network variable 'lack of social support' have been associated with increased type 2 diabetes risk. The latter association may be modified by lifestyle risk factors, such as obesity, low level of physical activity and unhealthy diet. Second, smaller network size and less social support is associated with increased risk of diabetes complications, particularly chronic kidney disease and CHD. Third, current evidence shows a beneficial impact of social support on diabetes self-management. In addition, social support interventions were found to have a small, favourable effect on HbA1c values in the short-term. However, harmonisation and more detailed assessment of social network measurements are needed to utilise social network characteristics for more effective prevention and disease management in type 2 diabetes.
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Affiliation(s)
- Miranda T Schram
- Department of Internal Medicine, Heart and Vascular Center, Maastricht University Medical Center+, School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, the Netherlands.
| | - Willem J J Assendelft
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Theo G van Tilburg
- Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, the Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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21
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Ninomiya H, Katakami N, Takahara M, Matsuoka TA, Shimomura I. Psychosocial conditions and the progression of diabetic nephropathy in Japanese with type 2 diabetes mellitus. Diabetol Int 2021; 12:336-341. [PMID: 34150442 DOI: 10.1007/s13340-020-00479-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022]
Abstract
We previously reported the association of positive psychosocial conditions with diabetic nephropathy (DN) in patients with type 2 diabetes in a cross-sectional setting. In the present study, we evaluated the association between six indicators related to psychosocial conditions and the progression of DN assessed by estimated glomerular filtration rate (eGFR) and albuminuria during 2-year observation period in 252 patients with type 2 diabetes. In unadjusted model, the subjects with higher happiness score attenuated reduced eGFR, and those with more social support attenuated increase in alubuminuria and decline eGFR. However, in adjusted model for happiness score and social support, only happiness score indicated the significant association with reduced eGFR. Gender-segregated analysis showed a significant association between happiness score and ΔeGFR in male but not in female subjects. On the other hand, decrease in eGFR was significantly attenuated in the subjects with more social support as compared to those with less social support in women but not in men. These results suggested that that psychosocial conditions could be related to the progression of DN, and that the psychosocial factors that influence in DN might differ between men and women, in Japanese patients with type 2 diabetes.
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Affiliation(s)
- Hiroyo Ninomiya
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan.,Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Taka-Aki Matsuoka
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
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22
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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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23
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Hu J, Mion LC, Tan A, Du Y, Chang MW, Miller C, Joseph JJ. Perceptions of African American Adults With Type 2 Diabetes on Family Support: Type, Quality, and Recommendations. Sci Diabetes Self Manag Care 2021; 47:302-311. [PMID: 34075831 DOI: 10.1177/26350106211018994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The overall purpose of the study was to explore perceptions of family support in diabetes self-management among African American adults with type 2 diabetes. METHODS A qualitative study using focus group methodology and individual interviews was conducted. Thirty-seven African American adults with type 2 diabetes were recruited in the Midwest, United States. Data were analyzed using qualitative content analysis. RESULTS Themes emerged from the perspectives of the social interdependence theory. Positive family support included emotional support, instrumental support, and specific information or advice on diabetes management strategies. Positivity, family communication, and healthy eating/meal planning were perceived as helpful family behaviors. Negative support was perceived as intentional or unintentional behaviors. Family members' help in decision-making included goal setting with family member(s) and help in making decisions on diet and exercise. Recommendations included exercise and nutritional programs, support groups, family involvement, and materials and resources. Motivations for attending diabetes programs included involving family members, sharing success stories, seeing positive results, encouraging and caring, and providing incentives. CONCLUSIONS Intervention programs for African Americans should specifically target challenges in family support, healthy eating, and physical activity at an interpersonal level. Health care providers should assess family roles and family support to facilitate diabetes self-management for African Americans.
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Affiliation(s)
- Jie Hu
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Lorraine C Mion
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Alai Tan
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Yang Du
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Mei-Wei Chang
- The Ohio State University, College of Nursing, Columbus, Ohio
| | - Carla Miller
- The Ohio State University, Department of Human Sciences, Human Nutrition, Ohio
| | - Joshua J Joseph
- The Ohio State University, College of Medicine, Columbus, OH
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24
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Blood Pressure Control and Associations with Social Support among Hypertensive Outpatients in a Developing Country. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7420985. [PMID: 33884271 PMCID: PMC8041521 DOI: 10.1155/2021/7420985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/30/2021] [Accepted: 03/20/2021] [Indexed: 11/17/2022]
Abstract
Relationships between social support characteristics with blood pressure control and recommended behaviors in Vietnamese hypertensive patients have not been investigated. This study is aimed at examining the role of social support characteristics in hypertension control and behaviors. Patients with hypertension (n = 220) in Hanoi, Vietnam, were recruited into a cross-sectional study. Both functional and structural characteristics of social support and network were examined. Results showed that increasing total network size was related to 52% higher odds of uncontrolled hypertension (adjusted OR = 1.52, 95%CI = 1.22 - 1.89). Higher network sizes on the provision of information support related to advice, emotional support related to decisions, and practical support related to sickness were associated with lower odds of uncontrolled hypertension. Every additional 1% of the percentage of network members having hypertension decreased 2% the odds of uncontrolled hypertension (adjusted OR = 0.98, 95%CI = 0.96 - 1.00). A 1% additional network members who were living in the same household was associated with a decrease of 0.08 point of behavioral adherence score (coef. = -0.08; 95%CI = -0.12 - 0.03). Meanwhile, a 1% increase of network members who were friends on the provision of practical support related to sickness and jobs was related to an increase of 0.10 point and 0.19 point of behavioral adherence score (coef. = 0.10; 95%CI = 0.04 - 0.17 and coef. = 0.19; 95%CI = 0.06 - 0.32, respectively). The current study suggested that further interventions to improve hypertension management should address the potential effects of social network characteristics.
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25
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Carrier MA, Beverly EA. Focus on the Positive: A Qualitative Study of Positive Experiences Living With Type 1 or Type 2 Diabetes. Clin Diabetes 2021; 39:176-187. [PMID: 33981131 PMCID: PMC8061556 DOI: 10.2337/cd20-0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to identify positive experiences associated with diabetes from the perspective of adults diagnosed with type 1 or type 2 diabetes. We conducted in-depth face-to-face and telephone interviews with adults with diabetes. Participants focused on positive and supportive experiences with their peers and community, improved health behaviors, personal growth, and engagement in diabetes advocacy. Communicating positive experiences about diabetes may help clinicians and educators reframe the negative messages commonly shared with people with diabetes.
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Affiliation(s)
- Molly A. Carrier
- Exercise Physiology, Department of Applied Health Sciences and Wellness, Ohio University, Athens, OH
- Honors Tutorial College, Ohio University, Athens, OH
| | - Elizabeth A. Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH
- The Diabetes Institute, Ohio University, Athens, OH
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26
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Shah NS, Huffman MD, Schneider JA, Khan SS, Siddique J, Kanaya AM, Kandula NR. Association of Social Network Characteristics With Cardiovascular Health and Coronary Artery Calcium in South Asian Adults in the United States: The MASALA Cohort Study. J Am Heart Assoc 2021; 10:e019821. [PMID: 33759541 PMCID: PMC8174337 DOI: 10.1161/jaha.120.019821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background South Asian adults have worse cardiovascular health (CVH) and more coronary artery calcium compared with other race/ethnicities. The impact of the social environment has not been examined as a potential driver of CVH or coronary artery calcium in this population. We evaluated associations of social network characteristics with CVH and coronary artery calcium in South Asian American adults to inform strategies for CVH promotion in this at‐risk population. Methods and Results Using data from the MASALA (Mediators of Atherosclerosis in South Asians Living in America) cohort study, multinomial and multivariable logistic regression were used to evaluate associations of participant social network size and density, proportion of network who are kin or South Asian ethnicity and reported health of participant's identified social network members (“alters”), with participant CVH and presence of coronary artery calcium. The 699 MASALA participants included were mean age 59.2 (SD, 9.2) years and 42.9% women. After adjustment, a 1‐person larger social network size was associated with 13% higher odds of ideal CVH (odds ratio [OR], 1.13; 95% CI, 1.01–1.27). Reporting an alter with high blood pressure was associated with lower odds of ideal CVH (OR, 0.51; 95% CI, 0.29–0.88), and reporting an alter with high cholesterol was associated with lower odds of ideal CVH (OR, 0.54; 95% CI, 0.30–0.94). Conclusions Social network characteristics are associated with CVH in South Asian American adults. Engaging social networks may help promote CVH in this population.
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Affiliation(s)
- Nilay S. Shah
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Mark D. Huffman
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
| | - John A. Schneider
- Department of Medicine and Public Health Sciences and the Chicago Center for HIV EliminationUniversity of ChicagoIL
| | - Sadiya S. Khan
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Juned Siddique
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Alka M. Kanaya
- Division of General Internal MedicineUniversity of California San FranciscoSan FranciscoCA
| | - Namratha R. Kandula
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Division of General Internal MedicineDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
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27
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Silverman-Retana O, Brinkhues S, Hulman A, Stehouwer CDA, Dukers-Muijrers NHTM, Simmons RK, Bosma H, Eussen S, Koster A, Dagnelie P, Savelberg HHCM, Schaper NC, van Dongen MCJM, Witte DR, Schram MT. Spousal concordance in pathophysiological markers and risk factors for type 2 diabetes: a cross-sectional analysis of The Maastricht Study. BMJ Open Diabetes Res Care 2021; 9:9/1/e001879. [PMID: 33597186 PMCID: PMC7893653 DOI: 10.1136/bmjdrc-2020-001879] [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] [Received: 09/03/2020] [Revised: 12/11/2020] [Accepted: 01/10/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION We compared the degree of spousal concordance in a set of detailed pathophysiological markers and risk factors for type 2 diabetes to understand where in the causal cascade spousal similarities are most relevant. RESEARCH DESIGN AND METHODS This is a cross-sectional analysis of couples who participated in The Maastricht Study (n=172). We used quantile regression models to assess spousal concordance in risk factors for type 2 diabetes, including four adiposity measures, two dimensions of physical activity, sedentary time and two diet indicators. We additionally assessed beta cell function and insulin sensitivity and glucose metabolism status with fasting and 2-hour plasma glucose and hemoglobin A1c. RESULTS The strongest spousal concordance (beta estimates) was observed for the Dutch Healthy Diet Index (DHDI) in men. A one-unit increase in wives' DHDI was associated with a 0.53 (95% CI 0.22 to 0.67) unit difference in men's DHDI. In women, the strongest concordance was for the time spent in high-intensity physical activity (HPA); thus, a one-unit increase in husbands' time spent in HPA was associated with a 0.36 (95% CI 0.17 to 0.64) unit difference in women's time spent in HPA. The weakest spousal concordance was observed in beta cell function indices. CONCLUSIONS Spousal concordance was strongest in behavioral risk factors. Concordance weakened when moving downstream in the causal cascade leading to type 2 diabetes. Public health prevention strategies to mitigate diabetes risk may benefit from targeting spousal similarities in health-related behaviors and diabetes risk factors to design innovative and potentially more effective couple-based interventions.
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Affiliation(s)
- Omar Silverman-Retana
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Stephanie Brinkhues
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Knowledge and Innovation, Public Health Service South Limburg, Heerlen, The Netherlands
| | - Adam Hulman
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Simone Eussen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Pieter Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Nicolaas C Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Martien C J M van Dongen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Daniel R Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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28
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Miao Jonasson J, Hendryx M, Shadyab AH, Kelley E, Johnson KC, Kroenke CH, Garcia L, Lawesson S, Santosa A, Sealy-Jefferson S, Lin X, Cene CW, Liu S, Valdiviezo C, Luo J. Social Support, Social Network Size, Social Strain, Stressful Life Events, and Coronary Heart Disease in Women With Type 2 Diabetes: A Cohort Study Based on the Women's Health Initiative. Diabetes Care 2020; 43:1759-1766. [PMID: 32499383 PMCID: PMC7372045 DOI: 10.2337/dc19-2065] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/26/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes. RESEARCH DESIGN AND METHODS From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD. RESULTS A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]). CONCLUSIONS Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes.
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Affiliation(s)
- Junmei Miao Jonasson
- School of Public Health and Community Medicine at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington, Bloomington, IN
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA
| | - Erika Kelley
- Department of Reproductive Biology, School of Medicine, Case Western Reserve University, Cleveland, OH.,Department of Obstetrics and Gynecology, University Hospitals MacDonald Women's Hospital, Cleveland, OH
| | - Karen C Johnson
- Department of Preventive Medicine, School of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Lorena Garcia
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA
| | - Sofia Lawesson
- Department of Health, Medicine and Caring Sciences, School of Medicine, Linköping University, Linköping, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine at the Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Shawnita Sealy-Jefferson
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA
| | - Xiaochen Lin
- School of Public Health, Brown University, Providence, RI
| | - Crystal W Cene
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Simin Liu
- School of Public Health, Brown University, Providence, RI
| | - Carolina Valdiviezo
- MedStar Heart & Vascular Institute, MedStar Georgetown University Hospital, Washington, DC
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN
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Oduro PK, Fang J, Niu L, Li Y, Li L, Zhao X, Wang Q. Pharmacological management of vascular endothelial dysfunction in diabetes: TCM and western medicine compared based on biomarkers and biochemical parameters. Pharmacol Res 2020; 158:104893. [PMID: 32434053 DOI: 10.1016/j.phrs.2020.104893] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/18/2020] [Accepted: 05/03/2020] [Indexed: 12/20/2022]
Abstract
Diabetes, a worldwide health concern while burdening significant populace of countries with time due to a hefty increase in both incidence and prevalence rates. Hyperglycemia has been buttressed both in clinical and experimental studies to modulate widespread molecular actions that effect macro and microvascular dysfunctions. Endothelial dysfunction, activation, inflammation, and endothelial barrier leakage are key factors contributing to vascular complications in diabetes, plus the development of diabetes-induced cardiovascular diseases. The recent increase in molecular, transcriptional, and clinical studies has brought a new scope to the understanding of molecular mechanisms and the therapeutic targets for endothelial dysfunction in diabetes. In this review, an attempt made to discuss up to date critical and emerging molecular signaling pathways involved in the pathophysiology of endothelial dysfunction and viable pharmacological management targets. Importantly, we exploit some Traditional Chinese Medicines (TCM)/TCM isolated bioactive compounds modulating effects on endothelial dysfunction in diabetes. Finally, clinical studies data on biomarkers and biochemical parameters involved in the assessment of the efficacy of treatment in vascular endothelial dysfunction in diabetes was compared between clinically used western hypoglycemic drugs and TCM formulas.
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Affiliation(s)
- Patrick Kwabena Oduro
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China
| | - Jingmei Fang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China
| | - Lu Niu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China
| | - Yuhong Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China; Tianjin Key Laboratory of Chinese medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China
| | - Lin Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China; Tianjin Key Laboratory of Chinese medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China
| | - Xin Zhao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China; Tianjin Key Laboratory of Chinese medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China
| | - Qilong Wang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China; Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin 301617, PR China; Tianjin Key Laboratory of Chinese medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, PR China.
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Al-Dwaikat TN, Rababah JA, Al-Hammouri MM, Chlebowy DO. Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes. West J Nurs Res 2020; 43:288-297. [PMID: 32419665 DOI: 10.1177/0193945920921101] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Social support improves self-efficacy, which in turns enhances self-management that lead to better psychological outcomes of persons with type 2 diabetes (T2D). The purpose of this study was to examine the relationship between social support and psychological outcomes of adults with T2D. A cross-sectional design was used to recruit a sample of 339 participants from a diabetes clinic. The participants responded to a series of questionnaires on demographics, social support dimensions, and self-management; self-efficacy; and psychological outcomes. The function and quality of social support were positively associated with self-efficacy. Self-efficacy was significantly associated with both self-management and psychological outcomes. In addition, self-efficacy demonstrated successful mediation role in the relationship between social support and psychological outcomes of T2D, however, self-management failed to mediate this relationship. The quality and functionality of social support are distinctive variables that should be recognized to promote social support interventions to reduce or prevent T2D-related psychological outcomes.
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Affiliation(s)
- Tariq N Al-Dwaikat
- Jordan University of Science and Technology Faculty of Nursing, Irbid, Jordan
| | - Jehad A Rababah
- Jordan University of Science and Technology Faculty of Nursing, Irbid, Jordan
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31
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Ha M, Chen J, Zhang X, Yang H, Liu C. Relationships of social support, health-promoting lifestyles, glycemic control, and bone turnover among adults with type 2 diabetes. Jpn J Nurs Sci 2019; 17:e12280. [PMID: 31286684 DOI: 10.1111/jjns.12280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/13/2019] [Accepted: 05/29/2019] [Indexed: 10/26/2022]
Abstract
AIM There is increasing evidence that hyperglycemia, oxidative stress, and the accumulation of advanced glycation end products in type 2 diabetes mellitus (T2DM) can lead to the deterioration of bone remodeling. The purpose of this study was to explore relationships of social support, health-promoting lifestyles, glycated hemoglobin (HbA1c) levels, and serum bone turnover markers (BTMs, including procollagen type I amino-terminal propeptide [PINP] and β-isomerised carboxy-terminal cross-linking telopeptide of type I collagen [β-CTX]) among individuals with T2DM. METHODS A total of 175 subjects were recruited by convenience sampling and divided into three groups based on their HbA1c levels. Statistical strategies of Spearman's correlation coefficient and multiple linear regression were used in this cross-sectional study. RESULTS There was a positive association between PINP and β-CTX, whereas the HbA1c level was inversely correlated with BTMs. Moreover, scores of both PINP and β-CTX were different in genders, males having lower levels of BTMs than females after adjustment for weight. Furthermore, both social support and health-promoting lifestyles were negatively correlated with HbA1c levels, whereas they did not significantly relate to declines in PINP and β-CTX. CONCLUSION High HbA1c levels detrimentally influence bone formation and bone resorption, and males with T2DM might be more susceptible to osteoporosis because of their relatively lower levels of BTMs. However, social support and health-promoting lifestyles could contribute to better glycemic control.
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Affiliation(s)
- Mei Ha
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Jun Chen
- Chenjiaqiao Hospital, the Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Xiaojuan Zhang
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Hong Yang
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Changjiang Liu
- NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing, China
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