HbA1c AND BLOOD PRESSURE MEASUREMENTS: RELATION WITH GENDER, BODY MASS INDEX, STUDY FIELD, AND LIFESTYLE IN LEBANESE STUDENTS

The impact of obesity epidemic on type 2 diabetes in children and adolescents: A systematic review and meta-analysis

AIM

To assess the impact of the obesity epidemic on type 2 diabetes (T2D), prediabetes and glycometabolic indices in children and adolescents.

METHODS

We searched four electronic databases (PubMed, Embase, Cochrane and Web of Science). Cross-sectional or cohort studies that reported on obesity and the prevalence of T2D or prediabetes in children and adolescents were reviewed. The study design, sample size and clinical outcomes were extracted from each study. The prevalence of T2D and prediabetes from the studies were pooled using meta-analysis methods.

RESULTS

Meta-analysis of 228184 participants showed that the prevalence of T2D was 1.3% (95% confidence interval (CI), 0.6-2.1%) in obese subjects, which was 13 times that in normal weight subjects (0.1%, 95% CI, 0.01-0.2%). The prevalence of prediabetes in obese subjects was 3 times that in normal subjects at 17.0% (13.0-22.0%) vs. 6.0% (0.01-11.0%). Moreover, BMI was positively correlated with the prevalence of T2D, prediabetes and glycometabolic indices in obese children and adolescents.

CONCLUSION

The pooled results confirm that obesity in children and adolescents leads to statistically significant increases in the prevalence of T2D and prediabetes and in glycometabolic indicator levels.

Investigation Into the Risk Factors Related to In-stent Restenosis in Elderly Patients With Coronary Heart Disease and Type 2 Diabetes Within 2 Years After the First Drug-Eluting Stent Implantation

Background

The present study aims to explore risk factors related to in-stent restenosis (ISR) in elderly patients with coronary heart disease and type 2 diabetes within 2 years after the first drug-eluting stent (DES) implantation.

Methods

This case-control study retrospectively analyzed the clinical data of patients with coronary heart disease and diabetes undergoing percutaneous coronary intervention (PCI) in Shenzhen Sun Yat-sen Cardiovascular Hospital between January 2010 and March 2020. Univariate and multivariate models were used to assess independent factors for DES-ISR. Categorical principal component analysis of clinical variables was performed to determine important components for DES-ISR. Nomogram was constructed to quantitatively predict the probability of DES-ISR development. The diagnostic potential of clinical variables was determined by receiver operating characteristic curve.

Results

In the derivation cohort, 1,741 cases were included in this study, and a total of 227 pairs of cases and controls were generated by propensity score matching. In the validation cohort, 102 cases were included with 19 cases (18.6%) with DES-ISR. Glomerular filtration rate <60 ml/min/1.73 m2, fasting blood glucose ≥6.5 mmol/L, multivessel coronary artery disease, coronary artery diffuse disease, PCI operation time (≥60 min), emergency PCI were associated with ISR. High Nomogram score was associated with the increased risk of ISR. Further analysis of the validation cohort showed that higher levels of HbA1c-coefficient of variation (CV) were significantly associated with the increased risk of ISR. HbA1c-CV exhibited good predictive ability for ISR in the validation cohort.

Conclusions

In conclusion, the fasting blood glucose level during the perioperative period of emergency PCI and the long-term variation of HbA1c during the follow-up period are related to the incidence of DES-ISR and the degree of stenosis. Reducing blood glucose fluctuations may decrease the risk of DES-ISR.

Does the SDMQ-9 Predict Changes in HbA1c Levels? An Ecuadorian Cohort

Background and Objectives: Diabetes mellitus affects 422 million people around the world, positioning it as a major health problem. According to the WHO(World Health Organization), 90% corresponds to type 2. The shared-decision making (SDM) is a method used to facilitate patient control, medication, maintenance, and assessment of health status according to their priorities and preferences. With the application of SDM in patients with diabetes, it is expected there will be an increase in treatment adherence and a reduction in HbA1c levels. The aim of this study is to determine the predictors of the change in HbA1c. Material and Methods: A sample of 76 participants attending as endocrinology outpatients was obtained. Data collected within the sample included: sex, age, educational level, body mass index, and the level of SDM using the SDMQ-9. In addition, HbA1c levels were measured twice: at baseline and three months after the first measurement. Results: The linear regression indicates that the level of SDM is a significant predictor of the change in HbA1c, specifically in men. However, the direction of the relationship was a somewhat opposite trend than we expected. Higher levels of SDM imply an increase in HbA1c rather than a reduction. Conclusions: Contrary to the literature, our results shows that elevated levels of perceived SDM may be associated with worse diabetic control. However, more investigation is needed as these results are not generalizable, due to the specific population used and the sample size. Furthermore, to better understand the effect of SDM on the change in HbA1c in patients with poorly controlled diabetes.

NURSING STUDENTS’ LIFESTYLE AND RELATED FACTORS

ABSTRACT Objective: to determine nursing students’ lifestyle at a university in Mexico, according to personal factors and previous behaviors of Nola J. Pender’s Health Promotion Model. Method: this is a cross-sectional study developed at a public university of Minatitlán, Veracruz, Mexico, in 2019, with nursing students enrolled in the curricular internship course, totaling 130. Data were collected that include sociodemographic, clinical and lifestyle and behavior characteristics through the Health-Promoting Lifestyle Profile I. We used Student’s t-tests, ANOVA and Pearson’s correlation for the analyses. Results: of the 130 participants, 92 (70.8%) were classified as healthy lifestyle and 38 (29.2%) had a moderately healthy lifestyle. Among the scale domains, the physical activity domain was the one with the lowest score. Negative correlations were found between the self-actualization domain and clinical variables, such as blood pressure, Body Mass Index and waist circumference, and also between this domain and the time of cell phone and television use. Conclusion: the lifestyle general classification of most participants was healthy, but the analyzes of the individual domains demonstrate the need for political and clinical interventions that influence nursing students’ health-promoting behaviors.

ESTILO DE VIDA DE ESTUDANTES DE ENFERMAGEM E FATORES RELACIONADOS

RESUMO Objetivo: determinar o estilo de vida de estudantes de enfermagem de uma Universidade no México, segundo fatores pessoais e comportamentos anteriores do Modelo de Promoção da Saúde de Nola J. Pender. Método: estudo transversal desenvolvido em uma Universidade Pública de Minatitlán, Veracruz, México, no ano 2019, com os estudantes de enfermagem matriculados na disciplina de estágio curricular, totalizando 130. Coletaram-se dados que incluem características sociodemográficas, clínicas e de estilo de vida e comportamento por meio da Health-Promoting Lifestyle Profile I. Utilizaram-se os testes T de Student, Anova e correlação de Pearson para as análises. Resultados: dos 130 participantes, 92 (70,8%) foram classificados com estilo de vida saudável e 38 (29,2%) obtiveram estilo de vida moderadamente saudável. Entre os domínios da escala, o de exercício foi o de menor pontuação. Constataram-se correlações negativas entre o domínio autorrealização e variáveis clínicas, tais como pressão arterial, índice de massa corpórea e circunferência abdominal, e também entre esse domínio e o tempo de uso de celular e televisão. Conclusão: a classificação geral do estilo de vida da maioria dos participantes foi saudável, todavia as análises dos domínios individuais demonstram a necessidade de intervenções políticas e clínicas que influenciem os comportamentos promotores de saúde dos estudantes de enfermagem.

Reproductive Health and Risk Factors of Non-Comunicable Disease in Female Student Population (Stepwise Approach)

University students are a specific adolescent population which is preparing to take participation in different domains of a society as its integral and creative part. Chronic noncommunicable diseases have a major impact on women’s reproductive health, so their adverse epidemiological situation has significant effects on reproductive health in general. Since non-communicable chronic diseases have been a growing burden on reproductive health, the aim of this paper is asses of reproductive behavior and risk factors of non-communicable disease in female student population on Faculty of Medical Sciences University of Kragujevac. This study was conducted as a prospective cross-sectional study. The sample includes 59 female students of The Faculty of Medical Sciences, University of Kragujevac. The study was conducted in three stages based on the methodology and instruments recommended by STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance of the World Health Organization (STEPS). About 71.2 % of the participants reported that they had a sexual intercourse. In average, the respondents were 18 years old (SD±1.222) at the time of their first sexual intercourse. At that point, a little less than one third of them did not use any type of protection (31.7%). During the last sexual intercourse, about 65.5% did not use protection. About 22.5% of our subjects have morning glycemia with prediabetes values (glycemia cut off ≥ 5.5mmol/L). Hypercholesterolemia is present in 3.4% of the respondents (cut off ≥ 5,2mmol/l). Most respondents are eutrophic (18.8% preobese and 2.1% obese). The android obesity type is the least frequent (about 10%). This results indicates that female students has unhealthy habits in terms of their reproductive health and preventive measures. This activity indicaty a wide array of preventive action which will aim at preserving reproductive health and health in general.