Pub Date : 2009-07-02DOI: 10.2174/1876524600902010044
Gulnar Shahid, T. Hussain
We have reported that G protein coupled receptor kinase-2 (GRK2) negatively regulates insulin receptor signaling leading to glycogen synthesis in mouse liver derived FL83B cells. Since insulin is a potent cellular growth hormone, present study investigated the effect of GRK2 on insulin-stimulated MAP kinase pathway leading to mitogenesis. Specific GRK2 siRNA was used to knock-down (>90%) GRK2 in FL83B cells. Effect of insulin on ERK1/2 activation and [ 3 H]-methyl thymidine incorporation were determined in GRK2 siRNA-treated and control cells. Insulinstimulated ERK1/2 activation was attenuated in GRK2-deficient as compared to control cells. Basal and insulinstimulated [ 3 H]-methyl thymidine incorporation, a measure of mitogenesis, was lower in GRK2-deficient cells. The data suggest that GRK2 may have positive regulatory role in insulin-stimulated MAP kinase pathway and mitogenesis. The present study together with our earlier report on insulin-induced glycogen synthesis indicates a dual role of GRK2 in insulin receptor signaling/function.
{"title":"GRK2-Deficiency Reduces Insulin Activation of ERK1/2 and Mitogenesis in Mouse Liver FL83B Cells","authors":"Gulnar Shahid, T. Hussain","doi":"10.2174/1876524600902010044","DOIUrl":"https://doi.org/10.2174/1876524600902010044","url":null,"abstract":"We have reported that G protein coupled receptor kinase-2 (GRK2) negatively regulates insulin receptor signaling leading to glycogen synthesis in mouse liver derived FL83B cells. Since insulin is a potent cellular growth hormone, present study investigated the effect of GRK2 on insulin-stimulated MAP kinase pathway leading to mitogenesis. Specific GRK2 siRNA was used to knock-down (>90%) GRK2 in FL83B cells. Effect of insulin on ERK1/2 activation and [ 3 H]-methyl thymidine incorporation were determined in GRK2 siRNA-treated and control cells. Insulinstimulated ERK1/2 activation was attenuated in GRK2-deficient as compared to control cells. Basal and insulinstimulated [ 3 H]-methyl thymidine incorporation, a measure of mitogenesis, was lower in GRK2-deficient cells. The data suggest that GRK2 may have positive regulatory role in insulin-stimulated MAP kinase pathway and mitogenesis. The present study together with our earlier report on insulin-induced glycogen synthesis indicates a dual role of GRK2 in insulin receptor signaling/function.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"101 1","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2009-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86865688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-06-29DOI: 10.2174/1876524600902010038
A. Kanazawa, Tomoaki Shimizu, C. Ebato, Yuko Sakurai, N. Kumashiro, Shinya Miwa, T. Hirose, Yasushi Tanaka, R. Kawamori, H. Watada
Glimepiride is a potent sulfonylurea agent and is widely used for type 2 diabetic patients, however, the safety and efficacy of glimepiride in patients with fair diabetic control (HbA1c level: 6.5-7.9%) have not been investigated so far. Therefore, we investigated the safety and efficacy of glimepiride titration using self-monitoring blood glucose (SMBG) in the achievement of strict glycemic control in fairly controlled diabetic patients. Japanese type 2 diabetic patients who were diet-controlled or treated with alpha-glucosidase inhibitor or metformin, were randomly assigned into the SMBG group with titration of glimepiride using SMBG, or the conventional therapy group (control group) without SMBG. Glimepiride was initiated at a dose of 0.5 mg/day and plasma glucose, insulin, HbA1c, and glycoalbumin levels were evaluated for 6 months in both groups. The dose of glimepiride was titrated in the SMBG group according to the SMBG levels before breakfast and dinner. The mean dose of glimepiride at 6 months tended to be higher in the SMBG than the control group (1.0±0.8 vs 0.6±0.3mg/day), but not significant. At 6 months after glimepiride treatment, HbA1c levels were significantly lower than at baseline (SMBG: 7.2±0.5 vs 6.5±0.6%, n=23, P<0.01, control: 7.3±0.4 vs 6.5±0.7%, n=24, P<0.01), although they were similar at 6 months in the two groups. Only three hypoglycemic episodes were recorded among 50 subjects. We found no efficacy of glimepiride titration protocol in this study. However, glimepiride significantly improved glycemic control in fairly controlled diabetic patients without severe hypoglycemia.
格列美脲是一种有效的磺脲类药物,广泛用于2型糖尿病患者,然而,格列美脲在糖尿病控制良好(HbA1c水平:6.5-7.9%)患者中的安全性和有效性尚未得到研究。因此,我们研究了采用自我监测血糖(SMBG)的格列美脲滴定法在相当控制的糖尿病患者中实现严格血糖控制的安全性和有效性。将饮食控制或α -葡萄糖苷酶抑制剂或二甲双胍治疗的日本2型糖尿病患者随机分为使用SMBG滴定格列美脲的SMBG组和不使用SMBG的常规治疗组(对照组)。格列美脲起始剂量为0.5 mg/天,两组患者在6个月的时间内评估血糖、胰岛素、糖化血红蛋白和糖蛋白水平。SMBG组根据早餐和晚餐前的SMBG水平滴定格列美脲的剂量。6个月时,SMBG组格列美脲的平均剂量倾向于高于对照组(1.0±0.8 mg/天vs 0.6±0.3mg/天),但不显著。在格列美脲治疗6个月后,两组患者的HbA1c水平显著低于基线水平(SMBG: 7.2±0.5 vs 6.5±0.6%,n=23, P<0.01,对照组:7.3±0.4 vs 6.5±0.7%,n=24, P<0.01),尽管两组患者在6个月时的HbA1c水平相似。50名受试者中仅记录了3次低血糖发作。在本研究中,我们没有发现格列美脲滴定方案的疗效。然而,格列美脲显著改善血糖控制良好的糖尿病患者无严重低血糖。
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Pub Date : 2009-06-26DOI: 10.2174/1876524600902010035
P. Augstein, L. Vogt, E. Salzsieder
N of 1 trials are a new strategy to determine the best personal therapeutic choice for a diabetic patient. Here, we discuss the idea of performing N of 1 trials in silico using the knowledge-based decision support system KADIS ® . This Diabetes Management System acts as interactive computer program that first generates a personal in silico copy of the glucose/insulin metabolism of the patient and then allows in silico N of 1 trials in order to identify the optimal therapeutic choice for the patient. KADIS ® simulates and predicts therapeutic options as medication timing, dosage, and different formulas of oral anti-diabetic drugs or insulin, as well as life style changes like exercise and reduced carbohydrate intake by the patient to support drug therapy. Self control data are the data base for KADIS ® . Over the past year decision support was generated for 384 diabetic patients treated by 132 general practitioners and 30 diabetes specialists. Application of KADIS ® -based recommendations reduced HbA1c during the follow-up by 0.2% (7.1% to 6.9%) after 3 months and by 0.4% (7.1% to 6.7%) after 6 months in routine diabetes care. The reduction in HbA1c was strongly related to significantly improved 24-hour glucose profiles. Taken together, performing N of 1 trials in silico has the potential to determine the optimal patient-oriented therapy and to predict the clinical outcomes in the management of single patients.
N of 1试验是确定糖尿病患者最佳个人治疗选择的新策略。在这里,我们讨论了使用基于知识的决策支持系统KADIS®在计算机上进行N(1)次试验的想法。这个糖尿病管理系统作为一个交互式计算机程序,首先生成患者葡萄糖/胰岛素代谢的个人计算机副本,然后进行计算机N / 1试验,以确定患者的最佳治疗选择。KADIS®模拟和预测治疗方案,如用药时间、剂量、口服抗糖尿病药物或胰岛素的不同配方,以及患者的生活方式改变,如锻炼和减少碳水化合物摄入,以支持药物治疗。自我控制数据是KADIS®的数据库。在过去一年中,由132名全科医生和30名糖尿病专家治疗的384名糖尿病患者获得了决策支持。应用基于KADIS®的建议,在常规糖尿病护理中,3个月后HbA1c降低0.2%(7.1%至6.9%),6个月后HbA1c降低0.4%(7.1%至6.7%)。HbA1c的降低与24小时血糖谱的显著改善密切相关。综上所述,在计算机上进行N / 1项试验有可能确定最佳的以患者为导向的治疗方法,并预测单个患者的临床结果。
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Pub Date : 2009-05-15DOI: 10.2174/1876524600902010032
V. Wiwanitkit
Diabetes mellitus (DM) is the most common endocrine problem at present. Based on the concept of good laboratory investigation management, the full overage on quality of these tests are required. In this article, the author hereby discusses on some practical concerns for important laboratory investigations for DM.
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Pub Date : 2009-04-07DOI: 10.2174/1876524600902010024
A. Alguwaihes, B. Shah
The aim of this study was to examine the association between educational attainment and utilization of the health care system and self-care behavior by individuals with diabetes. The Barriers to Diabetes Care Survey asked indi- viduals with diabetes about their care. The questionnaire was completed using computer-assisted telephone interviewing techniques. Participants were found by random digit dialing across Ontario, Canada (eligible n = 1,031). We dichotomized educational attainment at high school. We examined the relationship of educational attainment with measures of health care system utilization and of self-care behavior. We adjusted for age, sex, income, health insurance status, and diabetes type, duration and treatment regimen. Individuals with high educational attainment were more likely to have had an oph- thalmologic examination during the previous year (odds ratio 1.37, 95% confidence interval 1.04-1.82), and were more likely to report having a specialist (OR 2.08, 95% CI 1.31-3.31) or other paramedical professional (OR 1.91, 95% CI 1.19-3.07) as their most responsible provider of care, rather than a family doctor. Smoking (OR 0.64, 95% CI 0.45-0.90) and blood sugar monitoring (OR 0.70, 95% CI 0.50-0.98) were associated with low educational attainment, while follow- ing a meal plan was associated with high educational attainment (OR 1.39, 95% CI 1.07-1.80). Since appropriate utiliza- tion of the health care system and self-care behavior are essential for diabetes management, our findings suggest that peo- ple with low educational attainment are independently at risk for worse diabetes care. Health care providers should ensure that their communications, teaching materials and instructions are suitable for these higher-risk patients.
摘要本研究旨在探讨糖尿病患者受教育程度、医疗照护系统使用与自我照护行为之间的关系。糖尿病护理障碍调查询问了糖尿病患者的护理情况。问卷采用计算机辅助电话访谈技术完成。参与者通过随机数字拨号在加拿大安大略省找到(符合条件的n = 1031)。我们把高中的受教育程度分为两类。我们研究了受教育程度与卫生保健系统利用和自我保健行为的关系。我们调整了年龄、性别、收入、健康保险状况、糖尿病类型、持续时间和治疗方案。受教育程度高的个体更有可能在前一年进行眼眼科检查(优势比1.37,95%可信区间1.04-1.82),并且更有可能报告专科医生(OR 2.08, 95% CI 1.31-3.31)或其他医疗辅助专业人员(OR 1.91, 95% CI 1.19-3.07)是他们最负责任的护理提供者,而不是家庭医生。吸烟(OR 0.64, 95% CI 0.45-0.90)和血糖监测(OR 0.70, 95% CI 0.50-0.98)与受教育程度低相关,而遵循膳食计划与受教育程度高相关(OR 1.39, 95% CI 1.07-1.80)。由于适当利用医疗保健系统和自我保健行为对糖尿病管理至关重要,我们的研究结果表明,受教育程度低的人独立地面临糖尿病护理不良的风险。卫生保健提供者应确保其沟通、教学材料和指导适合这些高危患者。
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Pub Date : 2009-04-07DOI: 10.2174/1876524600902010029
Joon Hyuck Choi, N. Kang
A simple formula for determining pre-diabetes (the very early stage of diabetes mellitus) was derived from the model of Ackerman et al. (Bull Math Biophys 1965; 27: s21-37) for very smoothly varying time course patterns of blood glucose level. The natural period of blood glucose level in a healthy subject calculated using the formula was in good agreement with the value obtained by computer work. Diabetes mellitus (DM) is a disease associated with dis- ordered metabolism of carbohydrates, and pre-diabetes mel- litus (PD) is a very early stage of mild DM caused by disor- dered secretion of insulin, glucagons and epinephrine. The study of PD is of great importance in opening a way to the early discovery of mild DM. Although quite many ap- proaches to DM and PD on mathematical basis have been reported thus far (1-6), most of them require advanced mathematical and computer work ability. The purpose of this report was to provide a simple method of determining PD in order to help general practitioners with limited mathematical and computer ability. This study was based on a simple model presented by Ackerman et al. (1, 7), which was based on the simple assumption that the blood glucose level tends to be regulatory and is influenced and controlled by a wide variety of hormones and other metabolites. In this model all these hormones are combined into a net hormonal concentration and the cumulative effect of them is taken into account. And thus the model centers attention on the concentration of glucose in the blood, labelled G and that of the net hormonal complex, labelled H. The hormones such as insulin which decrease G are considered to increase H. On the other hand, the materials such as glucagons, epinephrine and cortisol which increase G are considered to decrease H. Coupled linear differential equations for G and H can be established and these two first order equations can be com- bined into two separate forms of second order linear equa- tion. The solution for G, with t = 0 at the time the glucose loading has been completed, is generally given in three damped oscillation patterns. Among them, in analogy with mechanical vibration systems, the underdamped case seems to be more appropriate for PD, by assuming that there is no serious deficiency in the controlling system. Thus we have
从Ackerman等人的模型(Bull Math Biophys 1965;[27] 21-37)血糖水平非常平稳地随时间变化。用该公式计算的健康人自然周期血糖水平与计算机计算值吻合较好。糖尿病(DM)是一种与碳水化合物代谢紊乱有关的疾病,而前驱糖尿病(PD)是由胰岛素、胰高血糖素和肾上腺素分泌紊乱引起的轻度糖尿病的早期阶段。帕金森病的研究对于早期发现轻度糖尿病具有重要意义。虽然目前已经报道了很多基于数学的糖尿病和帕金森病的治疗方法(1-6),但这些方法大多需要较高的数学和计算机操作能力。本报告的目的是提供一种简单的确定PD的方法,以帮助数学和计算机能力有限的全科医生。本研究基于Ackerman等人(1,7)提出的一个简单模型,该模型基于一个简单的假设,即血糖水平倾向于受调节,受多种激素和其他代谢物的影响和控制。在这个模型中,所有这些激素被组合成一个净激素浓度,并考虑到它们的累积效应。因此,该模型将注意力集中在血液中葡萄糖的浓度(标记为G)和净激素复合物的浓度(标记为h)上。胰岛素等降低G的激素被认为会增加h。可以建立G和H的耦合线性微分方程,并将这两个一阶方程合并为两个独立的二阶线性方程。葡萄糖加载完成时,当t = 0时,G的解通常以三种阻尼振荡形式给出。其中,与机械振动系统类比,在假设控制系统不存在严重缺陷的情况下,欠阻尼情况似乎更适合于PD。因此我们有
{"title":"A Simple Method of Determining Pre-Diabetes","authors":"Joon Hyuck Choi, N. Kang","doi":"10.2174/1876524600902010029","DOIUrl":"https://doi.org/10.2174/1876524600902010029","url":null,"abstract":"A simple formula for determining pre-diabetes (the very early stage of diabetes mellitus) was derived from the model of Ackerman et al. (Bull Math Biophys 1965; 27: s21-37) for very smoothly varying time course patterns of blood glucose level. The natural period of blood glucose level in a healthy subject calculated using the formula was in good agreement with the value obtained by computer work. Diabetes mellitus (DM) is a disease associated with dis- ordered metabolism of carbohydrates, and pre-diabetes mel- litus (PD) is a very early stage of mild DM caused by disor- dered secretion of insulin, glucagons and epinephrine. The study of PD is of great importance in opening a way to the early discovery of mild DM. Although quite many ap- proaches to DM and PD on mathematical basis have been reported thus far (1-6), most of them require advanced mathematical and computer work ability. The purpose of this report was to provide a simple method of determining PD in order to help general practitioners with limited mathematical and computer ability. This study was based on a simple model presented by Ackerman et al. (1, 7), which was based on the simple assumption that the blood glucose level tends to be regulatory and is influenced and controlled by a wide variety of hormones and other metabolites. In this model all these hormones are combined into a net hormonal concentration and the cumulative effect of them is taken into account. And thus the model centers attention on the concentration of glucose in the blood, labelled G and that of the net hormonal complex, labelled H. The hormones such as insulin which decrease G are considered to increase H. On the other hand, the materials such as glucagons, epinephrine and cortisol which increase G are considered to decrease H. Coupled linear differential equations for G and H can be established and these two first order equations can be com- bined into two separate forms of second order linear equa- tion. The solution for G, with t = 0 at the time the glucose loading has been completed, is generally given in three damped oscillation patterns. Among them, in analogy with mechanical vibration systems, the underdamped case seems to be more appropriate for PD, by assuming that there is no serious deficiency in the controlling system. Thus we have","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"257 1","pages":"29-31"},"PeriodicalIF":0.0,"publicationDate":"2009-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77184458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-04-07DOI: 10.2174/1876524600902010005
Shaukat Mahmood, R. Borup, H. Tornqvist, K. O'Byrne, P. Meyts, S. Gray
A constant paradox for researchers working in the field of insulin and insulin-like growth factor-I (IGF-I), is to explain how these proteins despite binding to and activating highly homologous membrane receptors and triggering simi- lar signalling pathways, yet exert distinct physiological roles in the control of metabolism and growth. Despite extensive studies, the molecular basis for the specificity between insulin and IGF-I signaling is still poorly understood. In an attempt to reveal the gene expression profiles regulated by their divergent functions, we used Affymetrix microarrays to monitor gene expression patterns that are regulated by either insulin or IGF-I. A fully differentiated human adipocyte line, derived from the adipose tissue of a child with Simpson-Golabi-Behmel Syndrome (SGBS), was stimulated with either insulin or IGF-I. Following stimulation of the differentiated adipocytes with insulin for 24 h, we found 329 genes differentially regulated of which 215 were up-regulated and 114 were down-regulated. When SGBS adipocytes were stimulated with IGF-I, 103 genes were differentially expressed, of which 70 were up-regulated and 33 were down-regulated. Our results indicate that under the conditions used in the present study, insulin is a more potent regulator of gene expression in human adipocytes than IGF-I.
{"title":"Gene Expression Profiling of Human Adipocyte Responses to Insulin and IGF-I Signalling","authors":"Shaukat Mahmood, R. Borup, H. Tornqvist, K. O'Byrne, P. Meyts, S. Gray","doi":"10.2174/1876524600902010005","DOIUrl":"https://doi.org/10.2174/1876524600902010005","url":null,"abstract":"A constant paradox for researchers working in the field of insulin and insulin-like growth factor-I (IGF-I), is to explain how these proteins despite binding to and activating highly homologous membrane receptors and triggering simi- lar signalling pathways, yet exert distinct physiological roles in the control of metabolism and growth. Despite extensive studies, the molecular basis for the specificity between insulin and IGF-I signaling is still poorly understood. In an attempt to reveal the gene expression profiles regulated by their divergent functions, we used Affymetrix microarrays to monitor gene expression patterns that are regulated by either insulin or IGF-I. A fully differentiated human adipocyte line, derived from the adipose tissue of a child with Simpson-Golabi-Behmel Syndrome (SGBS), was stimulated with either insulin or IGF-I. Following stimulation of the differentiated adipocytes with insulin for 24 h, we found 329 genes differentially regulated of which 215 were up-regulated and 114 were down-regulated. When SGBS adipocytes were stimulated with IGF-I, 103 genes were differentially expressed, of which 70 were up-regulated and 33 were down-regulated. Our results indicate that under the conditions used in the present study, insulin is a more potent regulator of gene expression in human adipocytes than IGF-I.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"44 1","pages":"5-17"},"PeriodicalIF":0.0,"publicationDate":"2009-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86803568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-04-07DOI: 10.2174/1876524600902010018
C. Tseng
Diabetes prevalence studies show a female preponderance, especially in developed countries. This review summarizes the epidemiologic evidence for a possible transition in sexual preponderance in Taiwan. Major epidemiologic surveys of diabetes prevalence and studies on the incidence and mortality of diabetes in Taiwan over the past decades were reviewed. Diabetes prevalence increased from 5.1% in 1970 to 12.8% in 1996 with female preponderance. However, a 3-fold higher prevalence in men in the younger age of 19-44 years in contrast to a female preponderance in the older age was observed in the 1996 survey. The female preponderance could possibly be explained by a higher mortality due to higher prevalence of macrovascular complications and higher incidence of hypertension in the diabetic men. Although overall incidence of diabetes was higher in women (218.4 vs 187.1 per 100,000), age-specific incidence analyses sug- gested a higher incidence accompanied by obesity in men in the age groups below 45 years. In conclusions, increasing prevalence of diabetes with female preponderance had been observed for decades in Taiwan, which can be explained partly by the higher risk of morbidity and mortality in the diabetic men and an overall higher incidence in women of all ages. However, the sex preponderance in diabetes is expected to change from women to men rolling from the past decades to the future in Taiwan because of the increasing prevalence of obesity in the younger men. two factors. A close observation of the secular trends in the epidemiologic transition of such a chronic and health damag- ing disease is important for both the policymakers and clini- cal practitioners to take early measures in the prevention and treatment of the disease. To answer a series of these interrelated epidemiologic questions, it would be better if all data could be obtained from a large cohort of diabetic patients representative at a national level. The National Health Insurance (NHI) program in Taiwan is a unique and compulsory health care system which covers more than 96% of the total population. Only those who are serving in the military or subject to criminal sanction, etc. would be exempt from this program. A sys- tematic use of the data obtained from a cohort of diabetic patients within this health care system has been conducted since the implementation of the NHI in 1995. Therefore it is the purpose of this review to give a general description of the data and interpretation of the implications introduced by a series of epidemiologic analyses from the established NHI diabetes cohort along with the vital statistics and the series of prevalence surveys in this country over the past decades.
糖尿病患病率研究显示女性居多,尤其是在发达国家。本文综述了台湾性优势可能转变的流行病学证据。本文回顾台湾近几十年来糖尿病流行病学调查及糖尿病发病率与死亡率的研究。糖尿病患病率从1970年的5.1%上升到1996年的12.8%,其中以女性为主。然而,1996年的调查发现,在19-44岁的年轻年龄组中,男性的患病率比老年年龄组中女性的患病率高3倍。女性的优势可能是由于男性糖尿病患者大血管并发症和高血压发病率较高,死亡率较高。尽管糖尿病在女性中的总体发病率较高(218.4 / 100000 vs 187.1 / 100000),但特定年龄的发病率分析表明,45岁以下年龄组的男性发病率较高,同时伴有肥胖。综上所述,台湾女性糖尿病患病率的上升趋势已经持续了几十年,这可以部分解释为男性糖尿病患者的发病率和死亡率较高,而所有年龄段的女性总体发病率较高。然而,台湾糖尿病患者的性别优势预计将从过去几十年的女性转变为男性,因为年轻男性的肥胖患病率越来越高。两个因素。密切观察这种慢性和危害健康的疾病的流行病学转变的长期趋势,对决策者和临床从业人员在预防和治疗疾病方面采取早期措施都很重要。为了回答一系列相关的流行病学问题,最好能从全国范围内具有代表性的糖尿病患者的大队列中获得所有数据。国民健康保险(NHI)计划是台湾独特的强制性医疗保健制度,覆盖了96%以上的人口。只有那些在军队服役或受到刑事制裁等的人才可以免于这项计划。自1995年实施国民健康保险以来,系统地使用了该卫生保健系统内从糖尿病患者队列中获得的数据。因此,这篇综述的目的是对数据进行一般性描述,并对一系列流行病学分析所带来的影响进行解释,这些分析来自于已建立的国民健康保险糖尿病队列,以及过去几十年来该国的生命统计数据和一系列流行病学调查。
{"title":"The Epidemiologic Transition of Diabetes Mellitus in Taiwan: Implications for Reversal of Female Preponderance from a National Cohort","authors":"C. Tseng","doi":"10.2174/1876524600902010018","DOIUrl":"https://doi.org/10.2174/1876524600902010018","url":null,"abstract":"Diabetes prevalence studies show a female preponderance, especially in developed countries. This review summarizes the epidemiologic evidence for a possible transition in sexual preponderance in Taiwan. Major epidemiologic surveys of diabetes prevalence and studies on the incidence and mortality of diabetes in Taiwan over the past decades were reviewed. Diabetes prevalence increased from 5.1% in 1970 to 12.8% in 1996 with female preponderance. However, a 3-fold higher prevalence in men in the younger age of 19-44 years in contrast to a female preponderance in the older age was observed in the 1996 survey. The female preponderance could possibly be explained by a higher mortality due to higher prevalence of macrovascular complications and higher incidence of hypertension in the diabetic men. Although overall incidence of diabetes was higher in women (218.4 vs 187.1 per 100,000), age-specific incidence analyses sug- gested a higher incidence accompanied by obesity in men in the age groups below 45 years. In conclusions, increasing prevalence of diabetes with female preponderance had been observed for decades in Taiwan, which can be explained partly by the higher risk of morbidity and mortality in the diabetic men and an overall higher incidence in women of all ages. However, the sex preponderance in diabetes is expected to change from women to men rolling from the past decades to the future in Taiwan because of the increasing prevalence of obesity in the younger men. two factors. A close observation of the secular trends in the epidemiologic transition of such a chronic and health damag- ing disease is important for both the policymakers and clini- cal practitioners to take early measures in the prevention and treatment of the disease. To answer a series of these interrelated epidemiologic questions, it would be better if all data could be obtained from a large cohort of diabetic patients representative at a national level. The National Health Insurance (NHI) program in Taiwan is a unique and compulsory health care system which covers more than 96% of the total population. Only those who are serving in the military or subject to criminal sanction, etc. would be exempt from this program. A sys- tematic use of the data obtained from a cohort of diabetic patients within this health care system has been conducted since the implementation of the NHI in 1995. Therefore it is the purpose of this review to give a general description of the data and interpretation of the implications introduced by a series of epidemiologic analyses from the established NHI diabetes cohort along with the vital statistics and the series of prevalence surveys in this country over the past decades.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"130 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2009-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90228286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-03-06DOI: 10.2174/1876524600902010001
V. Barrios, C. Escobar, A. Calderón, R. Echarri
Objective: To determine gender differences in cardiovascular risk factors control and clinical management in hypertensive diabetics with chronic ischemic heart disease. Research design and methods: CINHTIA was a cross-sectional and multicenter survey aimed to evaluate the clinical profile and management of hypertensive outpatients with chronic ischemic heart disease attended by cardiologists in Spanish clinical practice setting. The aim of the present work was to examine the gender differences in the control and treatment of cardiovascular risk factors in the subgroup of patients with diabetes. Adequate blood pressure (BP), LDL-cholesterol and diabetes control rates were defined according to ESH-ESC 2003, NCEP-ATP III and ADA-2005 guidelines, respectively. Results: A total of 654 patients (42.4% women) were included for the present analysis. Women were older. Smoking, sed- entary lifestyle and peripheral arterial disease were more frequent in men; left ventricular hypertrophy and heart failure in women. The total number of lipid lowering and antihypertensive agents were similar between genders, but with a trend to use more antidiabetic drugs in women. There was a tendency to a better BP control in men (21.5% vs 17.0%, p=0.09). LDL-cholesterol and diabetes were better controlled in men (34.6% vs 26.6%, p=0.04 and 29.7% vs 22.3%, p=0.025, re- spectively). Conclusions: Diabetic women with hypertension and chronic ischemic heart disease exhibit lower control rates of cardio- vascular risk factors.
目的:探讨高血压糖尿病合并慢性缺血性心脏病患者心血管危险因素控制及临床管理的性别差异。研究设计和方法:CINHTIA是一项横断面和多中心调查,旨在评估西班牙临床实践环境中心脏病专家就诊的高血压合并慢性缺血性心脏病门诊患者的临床概况和管理。本研究的目的是研究糖尿病患者亚组在心血管危险因素的控制和治疗方面的性别差异。适当血压(BP)、低密度脂蛋白胆固醇和糖尿病控制率分别根据ESH-ESC 2003、NCEP-ATP III和ADA-2005指南进行定义。结果:本分析共纳入654例患者(42.4%为女性)。女性年龄更大。吸烟、不良生活方式和外周动脉疾病在男性中更为常见;女性左心室肥厚和心力衰竭。降脂和降压药物的总数量在两性之间相似,但在女性中有使用更多降糖药的趋势。男性有更好的血压控制趋势(21.5% vs 17.0%, p=0.09)。男性低密度脂蛋白胆固醇和糖尿病控制较好(分别为34.6%对26.6%,p=0.04和29.7%对22.3%,p=0.025)。结论:糖尿病女性合并高血压和慢性缺血性心脏病的心血管危险因素控制率较低。
{"title":"Gender Differences in the Management of Diabetic Patients with Hypertension and Chronic Ischemic Heart Disease","authors":"V. Barrios, C. Escobar, A. Calderón, R. Echarri","doi":"10.2174/1876524600902010001","DOIUrl":"https://doi.org/10.2174/1876524600902010001","url":null,"abstract":"Objective: To determine gender differences in cardiovascular risk factors control and clinical management in hypertensive diabetics with chronic ischemic heart disease. Research design and methods: CINHTIA was a cross-sectional and multicenter survey aimed to evaluate the clinical profile and management of hypertensive outpatients with chronic ischemic heart disease attended by cardiologists in Spanish clinical practice setting. The aim of the present work was to examine the gender differences in the control and treatment of cardiovascular risk factors in the subgroup of patients with diabetes. Adequate blood pressure (BP), LDL-cholesterol and diabetes control rates were defined according to ESH-ESC 2003, NCEP-ATP III and ADA-2005 guidelines, respectively. Results: A total of 654 patients (42.4% women) were included for the present analysis. Women were older. Smoking, sed- entary lifestyle and peripheral arterial disease were more frequent in men; left ventricular hypertrophy and heart failure in women. The total number of lipid lowering and antihypertensive agents were similar between genders, but with a trend to use more antidiabetic drugs in women. There was a tendency to a better BP control in men (21.5% vs 17.0%, p=0.09). LDL-cholesterol and diabetes were better controlled in men (34.6% vs 26.6%, p=0.04 and 29.7% vs 22.3%, p=0.025, re- spectively). Conclusions: Diabetic women with hypertension and chronic ischemic heart disease exhibit lower control rates of cardio- vascular risk factors.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"33 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2009-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87076383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2009-01-24DOI: 10.2174/1876524601407010014
F. Shaikh, Fariha Zeeshan, R. Hakeem, A. Basit, Prof. Dr. Asher. Fawwad, A. Hussain
Objective: To determine the association between maternal dietary intake and nutritional status during pregnancy with anthropometric measurements of the newborns at birth. Methods: An observational study was conducted in Karachi, Pakistan from December 2009 to April 2010. Expectant mothers were recruited from selected antenatal clinics after obtaining informed consent. On the basis of the expected weight-for-height of adult women during pregnancy, mothers were categorized into under- and well-nourished groups. Dietary profile of 100 mothers (48 from 1 st trimester and 52 from 3 rd trimester) was recorded by using "Food Frequency Questionnaire and 24 hour dietary recall". Deliveries of 3 rd trimester group of mothers were followed. Anthropometric measurements of newborns were recorded. Results: Dietary profile of mothers showed that most of the mothers, regardless of trimester and nutritional status were consuming less than the recommended dietary intake. Fruit and vegetable intake was very low, pertaining to 96% and 93% of mothers respectively. Eighty percent mothers were consuming less than a serving of meat per day whereas 94% had low milk consumption per day. A significant negative association was noted between milk intake in well-nourished group and sub scapular skin fold thickness of the newborns at birth. Similarly, consumption of milk in undernourished mothers was also found associated negatively with mid upper arm circumference of the newborns (p<0.05). Conclusion: Overall energy intake was low in undernourished compared to well-nourished mothers during early gestation. Moreover, maternal dietary intake and nutritional status during pregnancy have impact on fetal body composition.
{"title":"Maternal Dietary Intake and Anthropometric Measurements of Newbornat Birth","authors":"F. Shaikh, Fariha Zeeshan, R. Hakeem, A. Basit, Prof. Dr. Asher. Fawwad, A. Hussain","doi":"10.2174/1876524601407010014","DOIUrl":"https://doi.org/10.2174/1876524601407010014","url":null,"abstract":"Objective: To determine the association between maternal dietary intake and nutritional status during pregnancy with anthropometric measurements of the newborns at birth. Methods: An observational study was conducted in Karachi, Pakistan from December 2009 to April 2010. Expectant mothers were recruited from selected antenatal clinics after obtaining informed consent. On the basis of the expected weight-for-height of adult women during pregnancy, mothers were categorized into under- and well-nourished groups. Dietary profile of 100 mothers (48 from 1 st trimester and 52 from 3 rd trimester) was recorded by using \"Food Frequency Questionnaire and 24 hour dietary recall\". Deliveries of 3 rd trimester group of mothers were followed. Anthropometric measurements of newborns were recorded. Results: Dietary profile of mothers showed that most of the mothers, regardless of trimester and nutritional status were consuming less than the recommended dietary intake. Fruit and vegetable intake was very low, pertaining to 96% and 93% of mothers respectively. Eighty percent mothers were consuming less than a serving of meat per day whereas 94% had low milk consumption per day. A significant negative association was noted between milk intake in well-nourished group and sub scapular skin fold thickness of the newborns at birth. Similarly, consumption of milk in undernourished mothers was also found associated negatively with mid upper arm circumference of the newborns (p<0.05). Conclusion: Overall energy intake was low in undernourished compared to well-nourished mothers during early gestation. Moreover, maternal dietary intake and nutritional status during pregnancy have impact on fetal body composition.","PeriodicalId":22762,"journal":{"name":"The Open Diabetes Journal","volume":"3 1","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2009-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81662164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}