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Satman I, Bayirlioglu S, Okumus F, Erturk N, Yemenici M, Cinemre S, Gulfidan G, Arga KY, D Merih Y, Issever H. Estimates and Forecasts on the Burden of Prediabetes and Diabetes in Adult and Elderly Population in Turkiye. Eur J Epidemiol 2023; 38:313-323. [PMID: 36696072 PMCID: PMC9875179 DOI: 10.1007/s10654-022-00960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 12/27/2022] [Indexed: 01/26/2023]
Abstract
AIMS Diabetes mellitus is a chronic disease that limits the quality and duration of life. We aimed to estimate the impact of demographic change on the burden of prediabetes and diabetes between 2010 and 2021, and the projections to 2030 and 2045 in Turkiye. MATERIALS AND METHODS Prediabetes and diabetes estimates were calculated by direct standardization method using age- and sex-specific prevalence data from the previous 'Turkish Epidemiology Survey of Diabetes, Hypertension, Obesity and Endocrine Disease' (TURDEP-II) as reference. The 2010-2021 population demographics were obtained from TurkStat. Comparative age-adjusted diabetes prevalence was estimated using the standard population models of world and Europe. RESULTS Estimates depicted that the population (20-84 years) of any degree of glucose intolerance in Turkiye increased by over 5.7 million (diabetes: 2.4 million and prediabetes: 3.3 million) from 2010 to 2021. While the increase in prediabetes and diabetes prevalence was 24.3% and 35.2% in overall population, corresponding increase were 46.5% and 51.3% in the elderly. Estimated prevalence of prediabetes and diabetes in 2021 was significantly higher in women than in men (prediabetes: 32.6% vs. 25.2%; diabetes: 17.1% vs. 14.2%). The comparative age-adjusted diabetes prevalence to the European population model was higher than that of the world population model (19.4% vs. 15.0%). According to the projections the prevalence of diabetes will reach 17.5% in 2030 and 19.2% in 2045. CONCLUSION Assuming age- and sex-specific diabetes prevalence of TURDEP-II survey remained constant, this study revealed that the number of people with diabetes in the general population (particularly in the elderly) in the last 11 years in Turkiye has increased in parallel with the population growth and aging; it will continue to grow over the coming decades. This means the burden of diabetes on the social, economic and health services will remain to increase. The fact suggests that there is an urgent need for re-organization of care as well as to develop and implement a country-specific prevention program to reduce this burden.
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Affiliation(s)
- Ilhan Satman
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turgut Ozal Millet Caddesi, 34093, Capa, Istanbul, Turkey.
| | - Safak Bayirlioglu
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
| | - Funda Okumus
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
| | - Nazli Erturk
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
| | - Merve Yemenici
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
| | - Sedanur Cinemre
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
| | - Gizem Gulfidan
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - K Yalcin Arga
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
- Genetic and Metabolic Diseases Research and Investigation Centre, Marmara University, Istanbul, Turkey
| | - Yeliz D Merih
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
- Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey
| | - Halim Issever
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkiye, Istanbul, Turkey
- Department of Public Health, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yuenyongchaiwat K, Boonsinsukh R. Type 2 Diabetes Mellitus Related to Decreased Peripheral and Respiratory Muscle Strength in Sarcopenic Thai Elderly. Curr Aging Sci 2021; 14:235-241. [PMID: 34269671 PMCID: PMC9912336 DOI: 10.2174/1874609814666210715141903] [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: 03/07/2021] [Revised: 05/11/2021] [Accepted: 05/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Age is related to a decline in muscle mass and physical function in both respiratory and peripheral muscle strength, which could lead to mobility and mortality. In addition, older people have suffered from one or multiple chronic conditions in particular in type 2 Diabetes Mellitus (type 2 DM). However, a few studies have reported the relationship between sarcopenic elderly and respiratory and peripheral muscle strengths in type 2DM. OBJECTIVE To explore the prevalence of sarcopenia in type 2 DM elderly people among community- dwelling patients and the relationships with peripheral and respiratory muscle loss in sarcopenic type 2 DM older patients. METHODS A total of 330 older individuals were recruited from community-dwelling centers. Respiratory muscle and quadriceps muscle were assessed. According to the defined criteria for sarcopenia (defined by Asian Working Group for Sarcopenia), muscle mass, gait speed (six-meter walk test), and handgrip strength were examined. RESULTS Of 330 elderly people, 82 volunteers had a history of type 2 DM. Participants with type 2DM had a risk for sarcopenia (odds ratio= 2.324, 95% CI=1.251-4.317). The prevalence of sarcopenia was 25.61% among older participants with type 2 DM. In addition, decreased respiratory muscle strength and quadriceps muscle strength were observed in type 2 DM with sarcopenia compared to type 2 DM with non-sarcopenia. These relationships also remained after controlling for age and sex. CONCLUSION Sarcopenia in type 2 DM leads to a decrease in respiratory muscle and peripheral muscle strength.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18, Paholyothin Road, Klong Luang, Rangsit, Pathumthani, 12120, Thailand;,Research Unit for Physical Therapy in Cardio-Respiratory System, Thammasat University, Pathumthani, Thailand; ,Address correspondence to this author at the Department of Physiotherapy, Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18, Paholyothin Road, Klong Luang, Rangsit, Pathumthani, 12120, Thailand; Tel: +66 (0)29869213; Fax+66 (0)2516-5379; E-mail
| | - Rumpa Boonsinsukh
- Faculty of Physical Therapy, Srinakharinwirot University, Bangkok, Thailand
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Sahingoz Erdal G, Kocoglu H, Karandere F, Kasapoglu P, Isiksacan N, Hursitoglu M. The Effect of Polypharmacy on the Charlson Comorbidity Index and Katz Index in Aging People with and without Diabetes Mellitus. Eurasian J Med 2021; 53:85-89. [PMID: 34177288 DOI: 10.5152/eurasianjmed.2021.20070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The prevalence of diabetes mellitus is growing worldwide, as well as in the aging population, and its comorbidity and mortality rates are higher in aging people than they are in young people. It has been observed that the number of drugs used increases in aging patients, especially in diabetic patients. This study aimed to investigate the relationship between polypharmacy and modified Charlson Comorbidity Index (CCI) and Katz Index of Independence in Activities of Daily Living (Katz ADL) scores in aging diabetic and non-diabetic patients. Materials and Methods This prospective study included 184 diabetic and 62 non-diabetic subjects who were ≥65 years old. Comorbidity was determined with CCI, and dependency on daily basic activities was assessed with Katz ADL. Results CCI and the number of drugs were significantly higher in diabetic groups (P = .001). In all subjects and in the diabetic group, there was a negative correlation between CCI and Katz ADL (r = -0.343, P = .001; r = -0.383, P = .001, respectively); there was a positive correlation between CCI and number of drugs (r = 0.430, P = .001; r = 0.248, P = .001, respectively). Conclusion We found an increase in the number of drugs taken by the aging patients, positively correlated with the CCI score. The increase in the number of drugs used is closely related to the insufficiency in daily life activity and comorbidity, and this predicts 10-year survival. Patients should be directed to special centers or physicians who will be scheduled for multidisciplinary treatment for the prevention of polypharmacy, especially in the aging.
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Affiliation(s)
- Gulcin Sahingoz Erdal
- Department of Internal Medicine, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
| | - Hakan Kocoglu
- Department of Internal Medicine, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
| | - Faruk Karandere
- Department of Internal Medicine, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
| | - Pinar Kasapoglu
- Department of Biochemistry, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
| | - Nilgun Isiksacan
- Department of Biochemistry, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
| | - Mehmet Hursitoglu
- Department of Internal Medicine, Bakırköy Dr Sadi Konuk Training And Research Hospital, İstanbul, Turkey
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Andreeva VA, Egnell M, Handjieva-Darlenska T, Talati Z, Touvier M, Galan P, Hercberg S, Pettigrew S, Julia C. Bulgarian consumers' objective understanding of front-of-package nutrition labels: a comparative, randomized study. ACTA ACUST UNITED AC 2020; 78:35. [PMID: 32528678 PMCID: PMC7282118 DOI: 10.1186/s13690-020-00416-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 11/11/2022]
Abstract
Background Bulgaria continues to lag behind other EU Member States with respect to chronic disease morbidity and mortality prevention. Methods In line with efforts targeting the improvement of dietary practices, this comparative study assessed objective understanding of five different front-of-package labels (FOPL) (Reference Intakes, Multiple Traffic Lights, Warning label, Nutri-Score, and Health Star Rating) in a sample of 1010 Bulgarian adults. Objective understanding was assessed by comparing the results of two nutritional quality ranking tasks (with and without FOPL) in an online randomized experiment featuring three food categories (pizza, cakes, breakfast cereals). Multivariable ordinal logistic regression models within and across food categories were fit. Results Compared with the Reference Intakes group, participants randomized to Nutri-Score exhibited the largest improvement in product ranking ability across food categories (OR = 2.33; 95% CI: 1.55–3.51), followed by those randomized to Health Star Rating (OR = 1.99; 95% CI: 1.32–3.00). Nutri-Score also performed best within two (pizza and breakfast cereals) of the three food categories. The Multiple Traffic Lights and Warning label groups did not display any significant improvement in objective understanding either within or across food categories compared with the Reference Intakes group. Conclusion Nutri-Score, which is a summary, interpretive, polychromatic FOPL, emerged as the most effective model in the Bulgarian context, with the potential to help consumers better understand the nutritional quality of food. The findings are of particular interest to public health policymakers in the region and across Europe, as the debate about an EU-wide FOPL model continues to gather momentum. Trial registration Registration number ACTRN12618001221246. Trial registered at the Australian New Zealand Clinical Trials Registry.
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Affiliation(s)
- Valentina A Andreeva
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France
| | - Manon Egnell
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France
| | - Teodora Handjieva-Darlenska
- Department of Pharmacology and Toxicology, Medical University, 1431 Sofia, Bulgaria.,Bulgarian Association for the Study of Obesity and Related Disorders, 1233 Sofia, Bulgaria
| | - Zenobia Talati
- School of Psychology, Curtin University, Bentley, WA 6102 Australia
| | - Mathilde Touvier
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France.,Department of Public Health, Avicenne Hospital, 93017 Bobigny, France
| | - Simone Pettigrew
- School of Psychology, Curtin University, Bentley, WA 6102 Australia.,The George Institute for Global Health, Newtown, NSW 2042 Australia
| | - Chantal Julia
- Nutritional Epidemiology Research Group (EREN), Sorbonne Paris Nord University/INSERM U1153/INRAE U1125/CNAM), Epidemiology and Statistics Research Centre - University of Paris (CRESS), 74 rue Marcel Cachin, 93017 Bobigny, France.,Department of Public Health, Avicenne Hospital, 93017 Bobigny, France
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Tachkov K, Mitov K, Koleva Y, Mitkova Z, Kamusheva M, Dimitrova M, Petkova V, Savova A, Doneva M, Tcarukciev D, Valov V, Angelova G, Manova M, Petrova G. Life expectancy and survival analysis of patients with diabetes compared to the non diabetic population in Bulgaria. PLoS One 2020; 15:e0232815. [PMID: 32392235 PMCID: PMC7213739 DOI: 10.1371/journal.pone.0232815] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 04/22/2020] [Indexed: 12/05/2022] Open
Abstract
Aims To evaluate the expected life expectancy in patients with diabetes in Bulgaria and to compare it to the expected life expectancy of the non-diabetic population in the country. Methods It is a retrospective observational population study on individuals diagnosed with diabetes, compared to the non-diabetic population in Bulgaria for the period 2012–2015. Data from the national diabetes register and national statistical institute were used to construct life-tables with probability of survival with t-test and Chi Square test. Confounder analysis was done by age, sex, and type of diabetes. All-cause mortality and deaths in diabetic patients were analyzed. Kaplan-Meier survival curves were constructed for each age group and a log-rank analysis was conducted. Results Average life expectancy in the non-diabetic population, patients with Type 1 DM and with Type 2 DM is 74.8; 70.96 and 75.19 years, respectively. For 2012–2015 the mortality in the non-diabetic population remained constant and lower (average—1.48%) compared to type-1 DM (5.25%) and Type-2 (4.27%). Relative risk of death in diabetics was higher overall (12%), after the age of 70 before which the relative risk was higher for the non-diabetic population. This was observed as a trend in all analyzed years. Conclusion Patients with type 2 DM have a longer life-expectancy than patients with type-1 DM and overall Diabetics life expectancy equals that of the non-diabetic population, which could suggest improved disease control and its associated complications in Bulgaria. Male diabetics show slightly longer life expectancy than their counterparts in the non-diabetic population, by a marginal gain of 0.6 years for the entire observed period. Life expectancy in diabetic women increased by 1.3 years, which was not observed in the non-diabetic population. Prevalence of diabetes was higher for women. Improved diabetes control may explain this gain in life; however other studies are needed to confirm this.
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Affiliation(s)
| | - Konstantin Mitov
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Yordanka Koleva
- Tulane University, New Orleans, Louisianna, United States of America
| | - Zornitsa Mitkova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Kamusheva
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Dimitrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | | | - Alexandra Savova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Miglena Doneva
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Dimitar Tcarukciev
- University endocrinology hospital, Medical University of Sofia, „Ivan Penchev“, Sofia, Bulgaria
| | | | - Galia Angelova
- Institute of informatics and informational technologies, Bulgarian academy of sciences, Sofia, Bulgaria
| | - Manoela Manova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
- * E-mail:
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Gebremedhin G, Enqueselassie F, Deyessa N, Yifter H. Urban-Rural Differences in the Trends of Type 1 and Type 2 Diabetes Among Adults Who Received Medical Treatment from Public Hospitals in Resource-Poor Community Tigray, Ethiopia. Diabetes Metab Syndr Obes 2020; 13:859-868. [PMID: 32273737 PMCID: PMC7106991 DOI: 10.2147/dmso.s238275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/04/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This study carried out to describe urban-rural differences in the trend of type 1 and type 2 diabetes among adults who have received medical treatment from public hospitals over the last five years. METHODS The trends of adult diabetes assessed from September 1, 2013, to August 31, 2018, using hospital-based retrospective medical records of 299,806 adult patients in the adult medical outpatient and emergency units. Data were collected using a uniform data abstraction format. An extended Mantel-Haenszel chi-square test of the linear trend used to examine the trend over time. RESULTS Of the total 299,806 adult patients, 3056 (1.02% (95% CI: 0.98-1.06)) patients were confirmed diabetes patients. The overall trend in the proportion of diabetes had increased from 6.8 to 14.3 per 1000 adult patients. The trend of type 1 diabetes increased for both urban from 1.0 to 2.2 per 1000 adult urban residents and rural from 1.2 to 2.6 per 1000 adult rural residents, with statistically a significant increase (χ2= 9.1, P=0.002) and (χ2=17.8, P<0.001) for linear trend, respectively. The trend of type 2 diabetes increased for both urban from 6.9 to 14.0 per 1000 adult urban residents and rural from 4.0 to 9.5 per 1000 adult rural residents, with a statistically significant increase (χ2=68.4, P<0.001) and (χ2=74.2, P<0.001) for linear trend, respectively. The higher increase in the proportion of both type 1 and type 2 diabetes observed among women patients. CONCLUSION The trend in the proportion of type 1 and type 2 diabetes increasing for both urban and rural residents, with a higher increase observed among women. These findings highlight health-care professionals and policymakers to design effective public health policies to treat each type of disease.
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Affiliation(s)
- Getachew Gebremedhin
- College of Medicine and Health Sciences, Department of Nursing, Adigrat University, Adigrat, Ethiopia
- College Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Getachew Gebremedhin Email
| | - Fikre Enqueselassie
- College Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negussie Deyessa
- College Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Helen Yifter
- College Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Strategic investment in tuberculosis control in the Republic of Bulgaria. Epidemiol Infect 2019; 147:e304. [PMID: 31736454 PMCID: PMC6873158 DOI: 10.1017/s0950268819001857] [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] [Indexed: 11/07/2022] Open
Abstract
As Bulgaria transitions away from Global Fund grant, robust estimates of the comparative impact of the various response strategies under consideration are needed to ensure sustained effectiveness of the tuberculosis (TB) programme. We tailored an established mathematical model for TB control to the epidemic in Bulgaria to project the likely outcomes of seven intervention scenarios. Under existing programmatic conditions projected forward, the country's targets for achieving TB elimination in the coming decades will not be achieved. No interventions under consideration were predicted to accelerate the baseline projected reduction in epidemiological indicators significantly. Discontinuation of the 'Open Doors' program and activities of non-governmental organisations would result in a marked exacerbation of the epidemic (increasing incidence in 2035 by 6-8% relative to baseline conditions projected forward). Changing to a short course regimen for multidrug-resistant TB (MDR-TB) would substantially decrease MDR-TB mortality (by 21.6% in 2035 relative to baseline conditions projected forward). Changing to ambulatory care for eligible patients would not affect TB burden but would be markedly cost-saving. In conclusion, Bulgaria faces important challenges in transitioning to a primarily domestically-financed TB programme. The country should consider maintaining currently effective programs and shifting towards ambulatory care to ensure program sustainability.
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Levterova BA, Orbetzova M, Levterov G, Dimitrova D, Todorov P. Assessment of the impact of type 2 diabetes on the quality of life by Audit of Diabetes-Dependent Quality-of-Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2018. [DOI: 10.1080/13102818.2018.1532319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Maria Orbetzova
- Second Department of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Georgi Levterov
- Clinic of Endocrinology and Metabolic Diseases, University Hospital “Kaspela” Ltd., Plovdiv, Bulgaria
| | - Donka Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Plamen Todorov
- Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
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Levterova BA, Levterov GE, Dragova EA, Grudeva TS, Kostourkov YL. Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19). BIOTECHNOL BIOTEC EQ 2017. [DOI: 10.1080/13102818.2017.1297689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Boryana Angelova Levterova
- Department of Health Management and Healthcare Еconomics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Dzhambov AM, Dimitrova DD. Exposures to road traffic, noise, and air pollution as risk factors for type 2 diabetes: A feasibility study in Bulgaria. Noise Health 2016; 18:133-42. [PMID: 27157686 PMCID: PMC4918667 DOI: 10.4103/1463-1741.181996] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a growing public health problem in Bulgaria. While individual and lifestyle determinants have been researched; till date there has been no study on environmental risks such as road traffic, noise, and air pollution. As a first step toward designing a large-scale population-based survey, we aimed at exploring the overall associations of prevalent T2DM with exposures to road traffic, noise, and air pollution. A total of 513 residents of Plovdiv city, Bulgaria were recruited. Individual data on self-reported doctor-diagnosed T2DM and confounding factors were linked to objective and self-rated exposure indicators. Logistic and log-link Poisson regressions were conducted. In the fully adjusted logistic models, T2DM was positively associated with exposures to L(den) 71-80 dB (odds ratio (OR) = 4.49, 95% confidence interval (CI): 1.38, 14.68), fine particulate matter (PM) 2.5 25.0-66.8 μg/m 3 (OR = 1.32, 95% CI: 0.28, 6.24), benzo alpha pyrene 6.0-14.02 ng/m 3 (OR = 1.76, 95% CI: 0.52, 5.98) and high road traffic (OR = 1.40, 95% CI: 0.48, 4.07). L(den) remained a significant risk factor in the: Poisson regression model. Other covariates with consistently high multivariate effects were age, gender, body mass index, family history of T2DM, subjective sleep disturbance, and especially bedroom location. We concluded that residential noise exposure might be associated with elevated risk of prevalent T2DM. The inferences made by this research and the lessons learned from its limitations could guide the designing of a longitudinal epidemiological survey in Bulgaria.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Health Economics and general Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Donka D Dimitrova
- Department of Health Management, Health Economics and general Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
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Abstract
Diabetes mellitus (DM) frequency is a growing problem worldwide, because of long life expectancy and life style modifications. In old age (≥60-65 years old), DM is becoming an alarming public health problem in developed and even in developing countries as for some authors one from two old persons are diabetic or prediabetic and for others 8 from 10 old persons have some dysglycemia. DM complications and co-morbidities are more frequent in old diabetics compared to their young counterparts. The most frequent are cardiovascular diseases due to old age and to precocious atherosclerosis specific to DM and the most bothersome are visual and cognitive impairments, especially Alzheimer disease and other kind of dementia. Alzheimer disease seems to share the same risk factors as DM, which means insulin resistance due to lack of physical activity and eating disorders. Visual and physical handicaps, depression, and memory troubles are a barrier to care for DM treatment. For this, old diabetics are now classified into two main categories as fit and independent old people able to take any available medication, exactly as their young or middle age counterparts, and fragile or frail persons for whom physical activity, healthy diet, and medical treatment should be individualized according to the presence or lack of cognitive impairment and other co-morbidities. In the last category, the fundamental rule is "go slowly and individualize" to avoid interaction with poly medicated elder persons and fatal iatrogenic hypoglycemias in those treated with sulfonylureas or insulin.
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Affiliation(s)
- Farida Chentli
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
| | - Said Azzoug
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
| | - Souad Mahgoun
- Department of Endocrine and Metabolic Diseases, Bab El Oued Teaching Hospital, Algiers, Algeria
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