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Glover LM, Martin CL, Green-Howard A, Adatorwovor R, Loehr L, Staley-Salil B, North KE, Sims M. Cumulative socioeconomic status and incident type 2 diabetes among African American adults from the Jackson heart study. SSM Popul Health 2023; 22:101389. [PMID: 37168250 PMCID: PMC10165449 DOI: 10.1016/j.ssmph.2023.101389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/25/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Background The cumulative socioeconomic status (SES) model posits that childhood and adult experiences accumulate to influence disease risk. While individual SES indicators such as education and income are independently associated with incident type 2 diabetes (T2D), the association of cumulative SES and incident T2D is unclear, especially in African American adults. Methods We utilized cohort data of African American participants (n = 3681, mean age 52.6 years) enrolled in the Jackson Heart Study from 2000 to 2013 free of T2D or cardiovascular disease at baseline (2000-2004). Cumulative SES scores at baseline were derived using six SES indicators (education, wealth, income, occupation, employment status, and mother's education) categorized as low, middle, and high. Incident T2D was defined at exam 2 (2005-2008) or exam 3 (2009-2013) based on fasting glucose ≥126 mg/dL, HbA1c ≥ 6.5, reported diabetic medication use, or self-reported physician diagnosis. Proportional hazards regression, allowing for interval censoring, was used to estimate the association between cumulative SES and incident T2D (hazard ratio(HR), 95% confidence interval (CI)) after adjustment for covariates. Sex and age differences were tested using interaction terms. Results There were 544 incident T2D cases. The association between low (versus high) cumulative SES and incident T2D was not significant (HR 1.04 [95% CI 0.85, 1.28]) and did not differ by sex (p value for interaction>0.05). However, there were differences by (age p value for interaction = 0.0052 for middle-aged adults and 0.0186 for older adults). Low (versus high) cumulative SES was associated a greater hazard of incident T2D among those 20-46 years (HR 1.12 [95% CI 1.03, 1.21]), 47-59 years (HR 1.25 [95% CI 1.06, 1.47]) and those 60-93 years (HR 1.39 [95% CI 1.09, 1.78]) after adjustment for sex and family history of diabetes. Associations attenuated after adding behavioral and lifestyle risk factors. Conclusion The association of low cumulative SES and incident T2D differed by age, which may suggest interventionist should consider impacts of SES on T2D by age.
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Menekli T, Yaprak B, Türeyen A, Şentürk S. Investigation of COVID-19 fear, treatment compliance, and metabolic control of patients with type 2 diabetes mellitus during the pandemic. Prim Care Diabetes 2022; 16:658-663. [PMID: 36030171 PMCID: PMC9376335 DOI: 10.1016/j.pcd.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 01/08/2023]
Abstract
AIMS This study was carried out to investigate fear levels, treatment compliance, and metabolic control of type II Diabetes Mellitus patients during the COVID-19 pandemic. METHODS The study employed a single-center, observational design and was conducted between January and April 2021. The study consisted of 303 patients who attended the internal medicine outpatient clinic of a university hospital in Turkey. For data collection, the Patient Identification Form, COVID-19 Fear Scale, and the Type II Diabetes Treatment Compliance Scale were used. The study complied with the Helsinki Declaration criteria. IBM SPSS v25.0 statistics package program was used for data analysis. RESULTS The mean age of the patients was 45.8 ± 7.5 years, the mean duration of illness was 8.2 ± 3.6 years. Moreover, 40.6% of patients presented with poor levels of treatment compliance. In addition, the mean FCV-19S score of the patients was 29.1 ± 3.05. It was noticeable that those with high mean scores of FCV-19S had poor compliance with treatment and metabolic control during the pandemic (p < 0.05). PRACTICE IMPLICATIONS Fear of COVID-19 negatively affects treatment compliance and metabolic control of type II diabetes patients. The patients avoided attending their regular follow-ups at the hospital due to fear of contracting COVID-19. In order to reduce the fear of COVID-19 it is paramount to maintain optimum metabolic control and treatment compliance.
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Affiliation(s)
- Tuğba Menekli
- Department of Internal Medicine Nursing, Malatya Turgut Özal University, Faculty of Health Sciences, Battalgazi, Malatya, Turkey.
| | - Bülent Yaprak
- Department of Internal Medicine, Malatya Turgut Özal University, Faculty of Medicine, Battalgazi, Malatya, Turkey.
| | - Aynur Türeyen
- Department of Internal Medicine Nursing, Faculty of Nursing, Ege University, Bornova, İzmir, Turkey.
| | - Sibel Şentürk
- Department of Internal Medicine Nursing, Burdur Mehmet Akif Ersoy University, Bucak Health School, Bucak, Burdur, Turkey.
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3
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Brar AS, Sahoo J, Behera UC, Jonas JB, Sivaprasad S, Das T. Prevalence of diabetic retinopathy in urban and rural India: A systematic review and meta-analysis. Indian J Ophthalmol 2022; 70:1945-1955. [PMID: 35647959 PMCID: PMC9359280 DOI: 10.4103/ijo.ijo_2206_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A systematic review and meta-analysis were conducted to estimate the prevalence of diabetic retinopathy (DR) in India’s urban and rural areas. Medline, Scopus, and ScienceDirect databases were searched for population-based studies published in English between January 1990 and April 2021, wherein the prevalence of DR among Indian residents with type 2 diabetes mellitus (DM) was reported. A random-effects model was used to estimate the overall, rural, and urban prevalence. Data from 10 eligible studies were aggregated for meta-analysis. The prevalence of DR was 17.44% (95% confidence interval [CI], 14.33–20.55) in urban and 14.00% (95% CI: 9.13–18.86) in rural population (P = 0.24). The overall DR prevalence was 16.10% (95% CI: 13.16–24.32), and the population prevalence was 1.63% [95% CI: 0.94–2.32]. Prevalence of DR in people with diabetes was lower in the age group of 40–49 years [13.57% (95% CI: 7.16–19.98)] than in the age group of 50–59 years [16.72% (95% CI: 12.80–20.64)] and the age group of 60 years and above [16.55% (95% CI: 12.09–21.00)]. Variability in studies was high: urban (I2 = 88.90%); rural (I2 = 92.14%). Pooled estimates indicate a narrow difference in DR prevalence among people with diabetes in rural and urban India. The fast urbanization and increasing diabetes prevalence in rural areas underscore the need for providing equitable eye care at the bottom of the health pyramid.
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Affiliation(s)
- Anand Singh Brar
- Department of Retina and Vitreous, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, Odisha, India
| | - Jyotiranjan Sahoo
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Umesh Chandra Behera
- Department of Retina and Vitreous, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, Odisha, India
| | - Jost B Jonas
- Department of Ophthalmology, Institute of Molecular and Clinical Ophthalmology Basel, Switzerland
| | - Sobha Sivaprasad
- Department of Ophthalmology, NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK
| | - Taraprasad Das
- Srimati Kanuri Santhamma Center for Vitreoretinal Diseases, L V Prasad Eye Institute (Kallam Anji Reddy Campus), Hyderabad, Telangana, India
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4
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Love O, Peter D, Julie ST. Systematic review: Perceptions of type 2 diabetes of people of African descent living in high-income countries. J Adv Nurs 2022; 78:2277-2289. [PMID: 35441727 PMCID: PMC9546182 DOI: 10.1111/jan.15266] [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: 01/22/2021] [Revised: 03/04/2022] [Accepted: 04/05/2022] [Indexed: 11/29/2022]
Abstract
AIMS To describe how people of African descent perceive and understand type 2 diabetes, and to examine the impact of their perceptions and beliefs on the uptake of diet, exercise, weight control and adherence to medication recommendations. DESIGN Systematic literature review of quantitative and qualitative studies. DATA SOURCES We searched MEDLINE, CINAHL Complete, Psych INFO, Academic Search Premier, Education Research Complete, Web of Science and Scopus, World Health Organization (WHO), Diabetes UK and American Diabetes Association for articles published from January 1999 to December 2019. REVIEW METHODS Informed by the PRISMA guidelines, we independently reviewed titles and abstracts, identified articles for full-text review that met inclusion criteria, conducted a quality assessment and extracted data. Findings were synthesized using a thematic approach. RESULTS Twenty-six studies met the inclusion criteria. Knowledge and understanding of diabetes were poor. Beliefs and behaviours about diet, exercise, weight and health care were erroneous. Most diabetic participants could not recognize diabetes symptoms, failed to take their diagnosis seriously and did not adhere to medication recommendations. The resultant effect was an increased risk of complications with undesirable outcomes. CONCLUSION Poor diabetes perceptions are linked to negative consequences and may be responsible for poorer outcomes among people of African descent. This review highlights the need to consider this population's beliefs and practices in structuring culturally sensitive programmes for diabetes management. IMPACT This systematic literature review is the first to exclusively explore perceptions of people of African descent in relation to diabetes. It is important to consider people of African descents' diabetes perceptions and practices before formulating interventions for their diabetes management.
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Affiliation(s)
| | | | - Santy-Tomlinson Julie
- Odense University Hospitals, Odense, Denmark.,University of Southern Denmark, Odense, Denmark
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5
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Relating sociodemographic factors and glycemic control among inpatients with type 2 diabetes. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01303-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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6
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Kaveh MH, Noori K, Nazari M, Khademi K. Quality of Life and Metabolic Indicators of Patients with Type 2 Diabetes: A Cross-Sectional Study in Iran. Int J Endocrinol 2022; 2022:4046012. [PMID: 36618903 PMCID: PMC9812594 DOI: 10.1155/2022/4046012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/17/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) has considered type 2 diabetes mellitus (T2DM) a major global health challenge because of its high prevalence worldwide. T2DM can affect patients' personal, social, and economic statuses. On the other hand, due to the increasing prevalence of T2DM, Quality of Life (QOL) has received more attention in recent years. OBJECTIVE The present study was conducted to investigate the relationships between QOL and physical activity level, body mass index, fasting blood sugar, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, total cholesterol, HbA1c, and systolic and diastolic blood pressure among Iranian patients with uncomplicated T2DM. METHODS This cross-sectional study was conducted on 135 participants selected through consecutive sampling. The study data were collected using International Physical Activity Questionnaire and Short-Form Health Survey Questionnaire. Then, the data were entered into the SPSS ver. 28 software, and Pearson's correlation was used to measure the correlation between the variables. Linear regression was also employed. The significance level was set at 0.05. RESULTS The significant association was observed between gender (p = 0.007), HDL level (p = 0.02), and gender-adjusted physical activity (p = 0.002) with QOL. CONCLUSIONS Due to the association between physical activity and HDL level with QOL in patients with uncomplicated T2DM, they should be given the necessary training to improve their physical activity and regulate HDL level. Also, empowering them in this matter improves their QOL.
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Affiliation(s)
- Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Keramat Noori
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahin Nazari
- Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadijeh Khademi
- Student Research Committee, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Khamseh ME, Sepanlou SG, Hashemi-Madani N, Joukar F, Mehrparvar AH, Faramarzi E, Okati-Aliabad H, Rahimi Z, Rezaianzadeh A, Homayounfar R, Moradpour F, Valizadeh N, Kheirandish M, Zaboli E, Moslem A, Ahmadi A, Hamzeh B, Harooni J, Pourfarzi F, Abolghasemi MR, Safarpour AR, Aminisani N, Mohammadi Z, Eghtesad S, Poustchi H, Malekzadeh R. Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study. Diabetes Ther 2021; 12:2921-2938. [PMID: 34595726 PMCID: PMC8521563 DOI: 10.1007/s13300-021-01152-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/07/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Over the past decades prevalence of diabetes has increased in Iran and other countries. This study aimed to update the prevalence of diabetes and prediabetes in Iran and to determine associated sociodemographic risk factors, as well as diabetes awareness and control. METHODS This is a nationally representative cross-sectional survey that included 163,770 Iranian adults aged 35-70 years, from different ethnic backgrounds, between 2014 and 2020. Diabetes was diagnosed at fasting blood sugar of ≥ 6.99 mmol/L (126 mg/dL), or receiving blood glucose-lowering treatment. Multivariable logistic regression was applied to detect determinants associated with prevalence of diabetes and prediabetes, as well as predictors of diabetes awareness and glycemic control. RESULTS Sex- and age-standardized prevalence of diabetes and prediabetes was 15.0% (95% CI 12.6-17.3) and 25.4% (18.6-32.1), respectively. Among patients with diabetes, 79.6% (76.2-82.9) were aware of their diabetes. Glycemic control was achieved in 41.2% (37.5-44.8) of patients who received treatment. Older age, obesity, high waist to hip ratio (WHR), and specific ethnic background were associated with a significant risk of diabetes and prediabetes. Higher awareness of diabetes was observed in older patients, married individuals, those with high WHR, and individuals with high wealth score. Moreover, glycemic control was significantly better in women, obese individuals, those with high physical activity, educational attainment, and specific ethnic background. CONCLUSIONS The prevalence of diabetes and prediabetes is increasing at an alarming rate in Iranian adults. High proportion of uncontrolled patients require particular initiatives to be integrated in the health care system.
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Affiliation(s)
- Mohammad E Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sadaf G Sepanlou
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Hashemi-Madani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, Hearing Research Center, School of Public Health, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Homayounfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Neda Valizadeh
- Maternal and Child Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ehsan Zaboli
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Moslem
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Ahmadi
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Epidemiology and Biostatistics Department, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Harooni
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Reza Abolghasemi
- Non-Communicable Research Center, Clinical Forensic Medicine and Toxicology Specialist, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nayyereh Aminisani
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sareh Eghtesad
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, N. Karegar Ave, 14117-13014, Tehran, Iran.
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8
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Leveraging vibration of effects analysis for robust discovery in observational biomedical data science. PLoS Biol 2021; 19:e3001398. [PMID: 34555021 PMCID: PMC8510627 DOI: 10.1371/journal.pbio.3001398] [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: 04/05/2021] [Revised: 10/12/2021] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
Hypothesis generation in observational, biomedical data science often starts with computing an association or identifying the statistical relationship between a dependent and an independent variable. However, the outcome of this process depends fundamentally on modeling strategy, with differing strategies generating what can be called "vibration of effects" (VoE). VoE is defined by variation in associations that often lead to contradictory results. Here, we present a computational tool capable of modeling VoE in biomedical data by fitting millions of different models and comparing their output. We execute a VoE analysis on a series of widely reported associations (e.g., carrot intake associated with eyesight) with an extended additional focus on lifestyle exposures (e.g., physical activity) and components of the Framingham Risk Score for cardiovascular health (e.g., blood pressure). We leveraged our tool for potential confounder identification, investigating what adjusting variables are responsible for conflicting models. We propose modeling VoE as a critical step in navigating discovery in observational data, discerning robust associations, and cataloging adjusting variables that impact model output.
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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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10
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Aga F, Dunbar SB, Kebede T, Higgins MK, Gary R. Relationships of diabetes self-care behaviours to glycaemic control in adults with type 2 diabetes and comorbid heart failure. Nurs Open 2020; 7:1453-1467. [PMID: 32802365 PMCID: PMC7424468 DOI: 10.1002/nop2.517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/13/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023] Open
Abstract
Aim To describe the relationship between diabetes self-care behaviours and glycaemic control in patients with type 2 diabetes and comorbid heart failure. Design A cross-sectional, correlational study. Method A secondary analysis of 180 participants' baseline data from a clinical trial that tested a 6-month integrated self-care intervention was performed. Correlational and hierarchical linear regression analysis was used to assess the relationships between diabetes self-care behaviours and glycaemic control. Result The Summary of Diabetes Self-Care Activities general diet and Summary of Diabetes Self-Care Activities exercise were negatively associated with glycated haemoglobin (HbA1c), while Summary of Diabetes Self-Care Activities specific diet was positively associated. Diabetic end-organ failure, taking insulin only and taking both oral antiglycaemic and insulin, predicted higher HbA1c and fasting blood glucose. African American race and dyslipidaemia predicted higher HbA1c while taking higher total daily medication predicted higher fasting blood glucose. Longer years lived with heart failure, lower ventricular ejection fraction and exposure to chemotherapy predicted lower fasting blood glucose.
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Affiliation(s)
- Fekadu Aga
- School of Nursing & MidwiferyCollege of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia
| | - Sandra B. Dunbar
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGAUSA
| | - Tedla Kebede
- Diabetes & Endocrinology UnitDepartment of Internal MedicineSchool of MedicineCollege of Health SciencesTikur Anbessa Specialized HospitalAddis Ababa UniversityAddis AbabaEthiopia
| | | | - Rebecca Gary
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGAUSA
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11
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Senteio CR, Akincigil A. Illuminating Racial Inequity in Diabetes Control: Differences Based on Gender and Geography. J Racial Ethn Health Disparities 2020; 8:704-711. [DOI: 10.1007/s40615-020-00830-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 06/25/2020] [Accepted: 07/23/2020] [Indexed: 01/19/2023]
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12
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Rahman M, Nakamura K, Hasan SMM, Seino K, Mostofa G. Mediators of the association between low socioeconomic status and poor glycemic control among type 2 diabetics in Bangladesh. Sci Rep 2020; 10:6690. [PMID: 32317650 PMCID: PMC7174358 DOI: 10.1038/s41598-020-63253-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 03/26/2020] [Indexed: 12/19/2022] Open
Abstract
Although low socioeconomic status (SES) is related to poor glycemic control, the underlying mechanisms remain unclear. We examined potentially modifiable factors involved in the association between low SES and poor glycemic control using data from the baseline survey of a multicenter, prospective cohort study. Five hundred adult type 2 diabetes patients were recruited from three diabetes centers. Glycemic control was poorer in diabetic individuals with low SES than in those with higher SES. Adverse health-related behaviors, such as non-adherence to medication (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] 1.04–1.13) and diet (AOR = 1.04, 95% CI 1.02–1.06); existing comorbidities, such as depressive symptoms (AOR = 1.05, 95% CI 1.04–1.09); and non-adherence to essential health service-related practices concerning diabetes care, such as irregular scheduled clinic visits (AOR = 1.04, 95% CI 1.03–1.06) and not practicing self-monitoring of blood glucose (AOR = 1.05, 95% CI 1.03–1.07), mediated the relationship between social adversity and poor glycemic control specially in urban areas of Bangladesh. Those identified factors provide useful information for developing interventions to mitigate socioeconomic disparities in glycemic control.
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Affiliation(s)
- Mosiur Rahman
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Keiko Nakamura
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - S M Mahmudul Hasan
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kaoruko Seino
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Environmental Health Sciences, School of Public Health, The University of Michigan, Michigan, USA
| | - Golam Mostofa
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh
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13
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Walker RJ, Garacci E, Campbell JA, Harris M, Mosley-Johnson E, Egede LE. Relationship Between Multiple Measures of Financial Hardship and Glycemic Control in Older Adults With Diabetes. J Appl Gerontol 2020; 40:162-169. [PMID: 32167406 DOI: 10.1177/0733464820911545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: To examine the relationship between multiple measures of financial hardship and glycemic control in older adults with diabetes. Methods: Using data from Health and Retirement Study (HRS), we investigated four measures of financial hardship: difficulty paying bills, ongoing financial strain, decreasing food intake due to money, and taking less medication due to cost. Using linear regression models, we investigated the relationship between each measure, and a cumulative score of hardships per person, on glycemic control (HbA1c). Results: After adjustment, a significant relationship existed with each increasing number of hardships associated with increasing HbA1c (0.09, [95%CI 0.04, 0.14]). Difficulty paying bills (0.25, [95%CI 0.14, 0.35]) and decreased medication usage due to cost (0.17, [95%CI 0.03, 0.31]) remained significantly associated with HbA1c. Conclusion: In older adults, difficulty paying bills and cost-related medication nonadherence is associated with glycemic control, and every additional financial hardship was associated with an increased HbA1c by nearly 0.1%.
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Affiliation(s)
- Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
| | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
| | - Jennifer A Campbell
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
| | - Melissa Harris
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
| | - Elise Mosley-Johnson
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, USA.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, USA
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14
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Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A, Dehghani Tafti AA. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health 2020; 20:166. [PMID: 32013917 PMCID: PMC6998152 DOI: 10.1186/s12889-020-8267-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/23/2020] [Indexed: 12/16/2022] Open
Abstract
Background Over the past few decades, the prevalence of Diabetes Mellitus (DM) has risen rapidly in Iran and other low and middle-income countries. We investigated the prevalence of DM, pre-diabetes, undiagnosed and uncontrolled diabetes and its relationship with some associated socioeconomic factors in the Yazd Greater Area in Iran. Methods Yazd Health Study is a longitudinal study conducted to determine the prevalence of non-communicable disease and related risk factors. In a two-step cluster sampling, 10,000 adults aged 20–69 years (200 clusters) were selected. In the recruitment phase, DM was considered if the patients had been either diagnosed DM by a physician or had fasting blood glucose ≥ 126 mg/dL. Chi square test was used for categorical variables to evaluate the differences and logistic regression model was applied to determine the predictors of diabetes.. P-value < 0.05 considered statistically significant. Results Of the 9965 individuals recruited, the crude self-reported prevalence of DM was 14.1% (95% CI: 13.4–14.7). The prevalence was higher in women than men (15.6 vs.12.4%), significantly. The age-standardized prevalence of DM was 8%. The prevalence was 14.9% in Yazd local people and 8.6% in those residents migrated from other provinces (P < 0.0001). We showed a significant association between DM prevalence and age, education, marital status, unemployment, insurance status, and positive family history (P < 0.0001). The prevalence of DM diagnosed by phycisians was 16.1% in participants (age-standardized prevalence: 8.3%). The subset analysis showed that 4.8% of patients were not aware of their disease. The prevalence of pre-diabetes was 25.8%. Of those with diabetes, 58.3% were not adequately controlled, which is not statistically significant with socio-economic status. Conclusion The current study showed a high prevalence of DM in Yazd Greater Area which is closely related to some socio-demographic factors. The high prevalence of pre-diabetes is alarming. Effective strategies for DM prevention should be introduced. The majority of people with diabetes are aware, but half of them are not controlled. The ineffective care plan currently in use, should be reviewed. Patients needs to be encouraged to improve their lifestyle. Active follow-up of patients is recommended to ensure continuity of care.
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Affiliation(s)
- Masoud Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Jomhuri Blvd., Afshar Hospital, Yazd, Iran
| | - Masoud Rahmaninan
- Yazd Diabetes Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Jomhuri Blvd., Afshar Hospital, Yazd, Iran.
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abbas Ali Dehghani Tafti
- Department of Health Education and Promotion, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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15
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Owolabi EO, Goon DT, Ajayi AI. Efficacy, acceptability and feasibility of daily text-messaging in promoting glycaemic control and other clinical outcomes in a low-resource setting of South Africa: A randomised controlled trial. PLoS One 2019; 14:e0224791. [PMID: 31774842 PMCID: PMC6881007 DOI: 10.1371/journal.pone.0224791] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/17/2019] [Indexed: 12/31/2022] Open
Abstract
South Africa is confronted with a high burden of diabetes, the majority of which are poorly controlled. The use of mHealth, specifically text messaging for fostering health, is evolving and studies on its efficacy, the majority of which were conducted in developed countries, have documented mixed findings. There is no such study done amongst patients living with diabetes in the resource-poor settings of South Africa. The aim of this study is to determine the efficacy, acceptability and feasibility of text-messaging in improving glycaemic control and other clinical outcomes among individuals living with diabetes in low-resource settings in Eastern Cape, South Africa. The study adopted a multi-centre, two-arm, parallel, randomised-controlled trial design. The study was conducted amongst patients with an uncontrolled glycaemic status. Participants were randomly assigned to the intervention (n = 108) and the control arm (n = 108). Participants in the intervention arm received daily educational text messages on diabetes for six months. Data was collected at baseline and six months post-intervention. Blood glucose, blood pressure and anthropometric measurements followed standard procedure. Mixed-model analysis was used to assess the impact of the text messages on blood glucose while linear regression was used to assess its effect on other clinical outcomes such as weight, body mass index, systolic and diastolic blood pressure. The mean age of the participants was 60.64 (SD± 11.58) years. The majority of the participants had a secondary level of education (95.3%) and earned 104.80 to 991.42 USD per month (67.7%). Both arms of the study showed improvement in their blood glucose levels, but the intervention did not have any significant effect, the mean adjusted change in blood glucose was 0.26 (-0.81 to 1.32), p = 0.634. Also, the intervention did not have any significant effect on weight, body mass index, systolic and diastolic blood pressure. Almost all participants (90.74%) were pleased with the intervention and felt it was helpful. Of those who participated in the intervention, 91% completed the follow-up after 6 months. Unidirectional text-messaging was acceptable and feasible amongst adults living with diabetes in this setting. However, its efficacy in improving glycaemic status and other clinical outcomes remains doubtful. Trial Registration: Pan African Clinical Trial Registry PACTR201810599931422.
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Affiliation(s)
- Eyitayo Omolara Owolabi
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Daniel Ter Goon
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Anthony Idowu Ajayi
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Centre, APHRC Campus, Nairobi, Kenya
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Muhammad MU, Jiadong R, Muhammad NS, Nawaz B. Stratified Diabetes Mellitus Prevalence for the Northwestern Nigerian States, a Data Mining Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4089. [PMID: 31652912 PMCID: PMC6928643 DOI: 10.3390/ijerph16214089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 01/09/2023]
Abstract
An accurate classification for diabetes mellitus (DBM) allows for the adequate treatment and handling of its menace, particularly in developing countries like Nigeria. This study proposes data mining techniques for the classification and identification of the prevalence of diagnosed diabetes cases, stratified by age, gender, diabetic conditions and residential area in the northwestern states of Nigeria, based on the real-life data derived from government-owned hospitals in the region. A K-mean assessment was used to cluster the instances, after 12 iterations the instances classified out of 3022: 2662 (88.09%) non-insulin dependent (NID), 176 (5.82%) insulin-dependent (IND) and 184 (6.09%) gestational diabetes (GTD). The total number of diagnosed diabetes cases was 3022: 1380 males (45.66%) and 1642 females (54.33%). The higher prevalence was found to be in females compared to males, and in cities and towns, rather than in villages (36.5%, 34.2%, and 29.3%, respectively). The highest prevalence among the age groups was in the age group 50-69 years, which constituted 43.9% of the total diagnosed cases. Furthermore, the NID condition had the highest prevalence of cases (88.09%). These were the first findings of the stratified prevalence in the region, and the figures have been of utmost significance to the healthcare authorities, policymakers, clinicians, and non-governmental organizations for the proper planning and management of diabetes mellitus.
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Affiliation(s)
- Musa Uba Muhammad
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao 066000, China.
| | - Ren Jiadong
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao 066000, China.
| | - Noman Sohail Muhammad
- Department of Information sciences and Technology, Yanshan University, Qinhuangdao 066000, China.
| | - Bilal Nawaz
- State Key Laboratory of Metastable Materials Science and Technology, Yanshan University, Qinhuangdao 066004, China.
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17
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Unique contribution of education to behavioral and psychosocial antecedents of health in a national sample of African Americans. J Behav Med 2019; 42:860-872. [PMID: 30607656 DOI: 10.1007/s10865-018-00009-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/22/2018] [Indexed: 01/01/2023]
Abstract
Education has demonstrated consistent links with many aspects of physical health and is theorized to relate to a variety of behavioral and psychosocial antecedents of health that may ultimately account for these associations. However, many of these associations and the extent to which they manifest specifically for African Americans have not been thoroughly tested. We examined associations of education-distinct from income-with established behavioral and psychosocial antecedents of health in a national sample of African Americans. Education favorably related to many behavioral (e.g., fruit/vegetable intake, lifetime smoking) and psychosocial (e.g., self-efficacy, personality traits, self-esteem, psychological well-being) antecedents of health, but not to all. Some evidence of stronger salutary relations of education for women was found. Results suggest that, for African Americans, education is generally favorably associated with an array of behavioral and psychosocial antecedents of physical health, partially explaining health disparities and providing a point of intervention moving forward.
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Yuan Y, Taneja M, Connor AE. The Effects of Social and Behavioral Determinants of Health on the Relationship Between Race and Health Status in U.S. Breast Cancer Survivors. J Womens Health (Larchmt) 2018; 28:1632-1639. [PMID: 30565965 DOI: 10.1089/jwh.2018.7360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: To examine the association between race and health outcomes among U.S. breast cancer (BC) survivors and explore to what extent do social and behavioral factors contribute to racial disparities for these associations. Materials and Methods: Four hundred forty-one female participants diagnosed with BC in the National Health and Nutrition Examination Survey from 2007 to 2016 were included in this study. Poisson regression with robust variance was used to estimate the prevalence ratio (PrR) and 95% confidence intervals for the associations between race, diabetes, hypertension, and other cancers. Results: The PrR for co-occurrence of diabetes and hypertension was 2.21 (p < 0.001) and 1.62 (p < 0.001) times, respectively, among African Americans (AA) compared with non-Hispanic whites. Body mass index (BMI) explained 17.5% of the association between AA race and diabetes prevalence; a smaller reduction (7.8%) was observed adjusting for type of health insurance coverage, only. A 23.5% reduction was observed in the association between AA race and diabetes prevalence with adjustment for BMI and insurance. The association between AA race and hypertension prevalence was reduced by <6% with addition of individual risk factors, including education, insurance, poverty, obesity, smoking, and physical activity, and with adjustment of the combination of these factors. Conclusions: The association between AA race and diabetes prevalence among BC survivors may be partially explained by BMI and insurance coverage to a lesser extent. Interventions to improve outcomes among AA survivors should focus on weight management strategies.
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Affiliation(s)
- Yao Yuan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Monica Taneja
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
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