Pub Date : 2024-06-26DOI: 10.1016/j.deman.2024.100233
Dr. Julie Demoule , Dr. Paul Quindroit , Dr. Camille Frévent , Prof. Dr. Claire Collins , Prof. Dr. Emmanuel Chazard , Prof. Dr. Jean-Baptiste Beuscart , Prof. Dr. Christophe Berkhout , Dr. Matthieu Calafiore , Dr. François Quersin
Background
French health authorities recommend the testing of HbA1c every 3 to 6 months in patients with diabetes. The successive containments linked to the SARSCoV-2 pandemic may have had a profound impact on the follow-up of diabetic patients in primary care. The objective of this study was to investigate the effect of containments on the volume of HbA1c assays and on HbA1c values of type 2 diabetic patients monitored in primary care in Northern France compared to usual seasonal variations.
Methods
Epidemiological study of a multicentre retrospective cohort, collecting the number and the value of HbA1c assays from type 2 diabetic patients, carried out in 73 private medical analysis laboratories in Northern France region between October 1, 2018 and October 31, 2022.
Results
A total of 196,744 patients and 828,037 tests were included. The first and third containments were associated with a significant decrease in the mean number of performed HbA1c tests, the decrease in the 2nd containment did not reach significance. We observed a significant decrease in HbA1c testing during the winter holiday season and the summer months. The variations in HbA1c values were not substantial compared to seasonal variations.
{"title":"Primary care monitoring of HbA1c tests in type 2 diabetic patients in Northern France and impact of the successive COVID-19 pandemic containments","authors":"Dr. Julie Demoule , Dr. Paul Quindroit , Dr. Camille Frévent , Prof. Dr. Claire Collins , Prof. Dr. Emmanuel Chazard , Prof. Dr. Jean-Baptiste Beuscart , Prof. Dr. Christophe Berkhout , Dr. Matthieu Calafiore , Dr. François Quersin","doi":"10.1016/j.deman.2024.100233","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100233","url":null,"abstract":"<div><h3>Background</h3><p>French health authorities recommend the testing of HbA1c every 3 to 6 months in patients with diabetes. The successive containments linked to the SARSCoV-2 pandemic may have had a profound impact on the follow-up of diabetic patients in primary care. The objective of this study was to investigate the effect of containments on the volume of HbA1c assays and on HbA1c values of type 2 diabetic patients monitored in primary care in Northern France compared to usual seasonal variations.</p></div><div><h3>Methods</h3><p>Epidemiological study of a multicentre retrospective cohort, collecting the number and the value of HbA1c assays from type 2 diabetic patients, carried out in 73 private medical analysis laboratories in Northern France region between October 1, 2018 and October 31, 2022.</p></div><div><h3>Results</h3><p>A total of 196,744 patients and 828,037 tests were included. The first and third containments were associated with a significant decrease in the mean number of performed HbA1c tests, the decrease in the 2nd containment did not reach significance. We observed a significant decrease in HbA1c testing during the winter holiday season and the summer months. The variations in HbA1c values were not substantial compared to seasonal variations.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100233"},"PeriodicalIF":1.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000386/pdfft?md5=cd9b06e986a7d80d6a6750bae1c21f51&pid=1-s2.0-S2666970624000386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1016/j.deman.2024.100228
Ricko Damberg Nissen, Jesper Bo Nielsen
Background
In Denmark, the primary responsibility for treatment of patients with diabetes has shifted from hospitals to primary care. Thus, general practice has assumed responsibility for a complex and multifaceted disease. To address this situation a stratification tool to assist the nurses in primary care in their work with diabetes patients was developed.
Aim
In the present study we evaluated this stratification tool.
Method
The evaluation was based on 18 semi-structured interviews conducted with nurses employed in primary care across Denmark, and who had experience with the stratification tool. The data was subsequently analyzed by content and thematic analyses.
Results
The interviewees were generally positive towards the stratification tool. The analyses established three themes 1. Treatment, 2. Resources, and 3. Points of critique.
Conclusions
Our study indicates that a combined tool for risk stratification of patients with T2D and for subsequent risk communication is perceived as positive and supportive for quality in care. It is seen to potentially reduce the resources presently allocated to well-regulated and stable T2D patients. These resources will eventually be available for other patients. The positive reception by nurses supports that tools like the Diabetes Control Support Tool could be developed and implemented in general practice.
{"title":"Evaluation of a Support Tool for Diabetes Control in primary care – A Qualitative study with primary care staff","authors":"Ricko Damberg Nissen, Jesper Bo Nielsen","doi":"10.1016/j.deman.2024.100228","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100228","url":null,"abstract":"<div><h3>Background</h3><p>In Denmark, the primary responsibility for treatment of patients with diabetes has shifted from hospitals to primary care. Thus, general practice has assumed responsibility for a complex and multifaceted disease. To address this situation a stratification tool to assist the nurses in primary care in their work with diabetes patients was developed.</p></div><div><h3>Aim</h3><p>In the present study we evaluated this stratification tool.</p></div><div><h3>Method</h3><p>The evaluation was based on 18 semi-structured interviews conducted with nurses employed in primary care across Denmark, and who had experience with the stratification tool. The data was subsequently analyzed by content and thematic analyses.</p></div><div><h3>Results</h3><p>The interviewees were generally positive towards the stratification tool. The analyses established three themes 1. Treatment, 2. Resources, and 3. Points of critique.</p></div><div><h3>Conclusions</h3><p>Our study indicates that a combined tool for risk stratification of patients with T2D and for subsequent risk communication is perceived as positive and supportive for quality in care. It is seen to potentially reduce the resources presently allocated to well-regulated and stable T2D patients. These resources will eventually be available for other patients. The positive reception by nurses supports that tools like the Diabetes Control Support Tool could be developed and implemented in general practice.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100228"},"PeriodicalIF":1.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000337/pdfft?md5=9c4c5a22cb9a7b99acc7e735767daafd&pid=1-s2.0-S2666970624000337-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1016/j.deman.2024.100229
Mohamed Hassanein , M Yakoob Ahmedani , Inass Shaltout , Majid Alabbood , Mehmet Akif Buyukbese , Khadija Hafidh , Shehla Shaikh , Lobna F. El Toony , Rakesh Kumar Sahay , Mohammed Ali Batais , Eman Alfadhli , Md Farid Uddin , Abdulaziz F Alfadhly , Mohan T Shenoy , Adibah Salleh , Naweed Alzaman , Eman Sheshah , Benabed Kebira , Reem Alamoudi , Zanariah Hussein
Aims
The DAR 2020 survey summarised fasting practices and complications in people with type 2 diabetes (T2D) who fasted during Ramadan, and impact of pre-Ramadan diabetes education towards controlling the complications.
Methods
Eight week post-Ramadan, Muslim people with T2D from 13 countries of five regions (South Asia, Southeast Asia, Gulf Nations, Middle East and North Africa) consented to answer questionnaire on breaking fast, hypoglycaemia, hyperglycaemia, Ramadan-focused diabetes education and self-monitoring of blood glucose (SMBG).
Results
Among 4889 participants who observed Ramadan fast (>25 days), 51.1 % were females. Hypoglycaemia and hyperglycaemia was recorded mostly in North Africa (25.2 %) and Gulf Nations (30.2 %), respectively. In Middle East, 2.5 % and 3.1 % people required hospitalisation following hypoglycaemia and hyperglycaemia respectively. In South Asia, lowest incidents of hypoglycaemia (8.4 %) and hyperglycaemia (7.0 %) were noted. Pre-Ramadan diabetic education was received by total 45.9 % participants. SMBG was performed more frequently in North Africa (19.5 %). Metformin, Sulfonylureas and basal insulin were used most commonly in all regions.
Conclusions
Fasting complications occurred in each region, but well-managed by the participants, physicians and family members amidst difficult time of COVID-19. The findings promote the necessity of patient education programmes for more people with diabetes to ensure safe fasting during Ramadan.
{"title":"Ramadan fasting among adults with type 2 diabetes in five geographically different regions of the world: The DAR 2020 global survey","authors":"Mohamed Hassanein , M Yakoob Ahmedani , Inass Shaltout , Majid Alabbood , Mehmet Akif Buyukbese , Khadija Hafidh , Shehla Shaikh , Lobna F. El Toony , Rakesh Kumar Sahay , Mohammed Ali Batais , Eman Alfadhli , Md Farid Uddin , Abdulaziz F Alfadhly , Mohan T Shenoy , Adibah Salleh , Naweed Alzaman , Eman Sheshah , Benabed Kebira , Reem Alamoudi , Zanariah Hussein","doi":"10.1016/j.deman.2024.100229","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100229","url":null,"abstract":"<div><h3>Aims</h3><p>The DAR 2020 survey summarised fasting practices and complications in people with type 2 diabetes (T2D) who fasted during Ramadan, and impact of pre-Ramadan diabetes education towards controlling the complications.</p></div><div><h3>Methods</h3><p>Eight week post-Ramadan, Muslim people with T2D from 13 countries of five regions (South Asia, Southeast Asia, Gulf Nations, Middle East and North Africa) consented to answer questionnaire on breaking fast, hypoglycaemia, hyperglycaemia, Ramadan-focused diabetes education and self-monitoring of blood glucose (SMBG).</p></div><div><h3>Results</h3><p>Among 4889 participants who observed Ramadan fast (>25 days), 51.1 % were females. Hypoglycaemia and hyperglycaemia was recorded mostly in North Africa (25.2 %) and Gulf Nations (30.2 %), respectively. In Middle East, 2.5 % and 3.1 % people required hospitalisation following hypoglycaemia and hyperglycaemia respectively. In South Asia, lowest incidents of hypoglycaemia (8.4 %) and hyperglycaemia (7.0 %) were noted. Pre-Ramadan diabetic education was received by total 45.9 % participants. SMBG was performed more frequently in North Africa (19.5 %). Metformin, Sulfonylureas and basal insulin were used most commonly in all regions.</p></div><div><h3>Conclusions</h3><p>Fasting complications occurred in each region, but well-managed by the participants, physicians and family members amidst difficult time of COVID-19. The findings promote the necessity of patient education programmes for more people with diabetes to ensure safe fasting during Ramadan.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100229"},"PeriodicalIF":1.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000349/pdfft?md5=9c2db7d84c8876d6f20cadf5fff7d45d&pid=1-s2.0-S2666970624000349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetic ketoacidosis is a severe metabolic emergency often associated with the onset of Type 1 Diabetes Mellitus, with significant morbidity and mortality. Its incidence as the initial presentation of Type 1 Diabetes Mellitus varies widely by country. In Morocco, there is a lack of comprehensive research on the prevalence and risk factors of diabetic ketoacidosis in children with newly diagnosed Type 1 Diabetes Mellitus, highlighting the need for this study.
Objectives
The aim of our study was to analyze the predictive factors of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus in children and adolescents at a single medical center in Morocco to develop prevention and management strategies.
Methods
A retrospective, single-center study including 200 patients aged between 1 and 18 years at Type 1 Diabetes Mellitus onset, between September 2019 and September 2023. The population was divided into two groups according to the presence or absence of diabetic ketoacidosis. Medical records provided data for analysis with SPSS v21, employing Chi-square and Student's t-tests, followed by logistic regression to identify predictors of diabetic ketoacidosis.
Results
Multivariate regression identified several factors that were significantly associated with diabetic ketoacidosis at presentation, including age below 5 years (OR: 3.98; p = 0.021 compared to 6–10 years and OR: 5.07; P = 0.003 compared to 11–18 years), rural living (OR: 2.95; p = 0.032), low family income (OR: 9.22; p < 0.001), delayed diagnosis (OR: 21.27; p < 0.001), longer symptom duration before diagnosis (OR: 1.02; p = 0.010), preceding infections (OR: 2.72; p = 0.019), and lower vitamin D levels (OR: 0.90; p = 0.011).
Conclusion
Our findings underscore the critical need for increased awareness, education, use of point-of-care glucose testing, and targeted interventions in rural areas, in order to reduce the incidence of diabetic ketoacidosis. We also highlight the potential role of vitamin D in increasing the risk of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus. This study provides important information on the present state of pediatric diabetes care in our country, and suggests target points for future interventions and research.
{"title":"Predictive factors of diabetic ketoacidosis in patients with newly onset type 1 diabetes: A single center study","authors":"Siham Benouda , Imane Ziani , Imane Assarrar , Siham Rouf , Hanane Latrech","doi":"10.1016/j.deman.2024.100231","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100231","url":null,"abstract":"<div><h3>Background</h3><p>Diabetic ketoacidosis is a severe metabolic emergency often associated with the onset of Type 1 Diabetes Mellitus, with significant morbidity and mortality. Its incidence as the initial presentation of Type 1 Diabetes Mellitus varies widely by country. In Morocco, there is a lack of comprehensive research on the prevalence and risk factors of diabetic ketoacidosis in children with newly diagnosed Type 1 Diabetes Mellitus, highlighting the need for this study.</p></div><div><h3>Objectives</h3><p>The aim of our study was to analyze the predictive factors of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus in children and adolescents at a single medical center in Morocco to develop prevention and management strategies.</p></div><div><h3>Methods</h3><p>A retrospective, single-center study including 200 patients aged between 1 and 18 years at Type 1 Diabetes Mellitus onset, between September 2019 and September 2023. The population was divided into two groups according to the presence or absence of diabetic ketoacidosis. Medical records provided data for analysis with SPSS v21, employing Chi-square and Student's <em>t</em>-tests, followed by logistic regression to identify predictors of diabetic ketoacidosis.</p></div><div><h3>Results</h3><p>Multivariate regression identified several factors that were significantly associated with diabetic ketoacidosis at presentation, including age below 5 years (OR: 3.98; <em>p</em> = 0.021 compared to 6–10 years and OR: 5.07; <em>P</em> = 0.003 compared to 11–18 years), rural living (OR: 2.95; <em>p</em> = 0.032), low family income (OR: 9.22; <em>p</em> < 0.001), delayed diagnosis (OR: 21.27; <em>p</em> < 0.001), longer symptom duration before diagnosis (OR: 1.02; <em>p</em> = 0.010), preceding infections (OR: 2.72; <em>p</em> = 0.019), and lower vitamin D levels (OR: 0.90; <em>p</em> = 0.011).</p></div><div><h3>Conclusion</h3><p>Our findings underscore the critical need for increased awareness, education, use of point-of-care glucose testing, and targeted interventions in rural areas, in order to reduce the incidence of diabetic ketoacidosis. We also highlight the potential role of vitamin D in increasing the risk of diabetic ketoacidosis at the onset of Type 1 Diabetes Mellitus. This study provides important information on the present state of pediatric diabetes care in our country, and suggests target points for future interventions and research.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100231"},"PeriodicalIF":1.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000362/pdfft?md5=6889502f31f8240668f7424c96c609ae&pid=1-s2.0-S2666970624000362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-18DOI: 10.1016/j.deman.2024.100230
Víctor Juan Vera-Ponce , Fiorella E. Zuzunaga-Montoya , Luisa Erika Milagros Vásquez-Romero , Joan A. Loayza-Castro , Cori Raquel Iturregui Paucar , Carmen Inés Gutiérrez De Carrillo , Mario J. Valladares-Garrido , Maritza Placencia Medina
Introduction
Several previous studies have provided evidence that obesity is a significant risk factor for the increase in prediabetes, but there are discrepancies regarding whether all the classic ways of measuring obesity, the body mass index (BMI), the waist circumference (WC) or the Waist to height ratio (WHtR) present the same level of risk.
Objective
to carry out a systematic review (SR) with meta-analysis to determine the association between indicators of obesity and prediabetes.
Methods
A systematic review (SR) with a meta-analysis of observational studies was performed. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. Association measures were presented as odds ratios (OR), relative risk (RR), or hazard ratio (HR), together with their 95% confidence intervals (95% CI).
Results
Of the total number of manuscripts chosen, 12 had an analytical cross-sectional design, and 4 were cohort studies. For the cross-sectional studies, together they presented a statistically significant association for BMI (OR: 1.99; 95% CI 1.65 – 1.34), WC (OR: 1.41; 95% CI 1.30 – 1.54), and WHtR (OR: 2.47 IC 95 % 1.50 – 4.06). In the meta-analysis of the cohort studies, an association was found with WC (RR: 4.95; 95% CI 3.42 – 7.17) but not with BMI (HR: 1.22; 95% CI 0.81 – 1.85). There were no studies with WHtR.
Conclusions
According to the results, considering cohort studies, WC could be the best risk indicator for prediabetes. There is a high degree of heterogeneity between the studies about the way obesity is measured, including the cut-off points used, so further longitudinal studies are needed to evaluate the association and confirm the results found.
导言：以往的一些研究证明，肥胖是糖尿病前期发病率上升的一个重要风险因素，但对于所有测量肥胖的经典方法，即体重指数（BMI）、腰围（WC）或腰围与身高比（WHtR）是否具有相同的风险水平，却存在分歧。方法 对观察性研究进行了系统回顾（SR）和荟萃分析。在四个数据库中进行了检索：Pubmed/Medline、SCOPUS、Web of Science 和 EMBASE。结果 在所有被选中的稿件中，12 篇采用横断面分析设计，4 篇为队列研究。在横断面研究中，BMI（OR：1.99；95% CI 1.65 - 1.34）、WC（OR：1.41；95% CI 1.30 - 1.54）和 WHtR（OR：2.47 IC 95 % 1.50 - 4.06）在统计学上有显著关联。在队列研究的荟萃分析中，发现了与体重指数（BMI）（HR：1.22；95% CI 0.81 - 1.85）的关联（RR：4.95；95% CI 3.42 - 7.17）。结论根据研究结果，考虑到队列研究，WC 可能是糖尿病前期的最佳风险指标。不同研究对肥胖的测量方法（包括所用的截断点）存在很大程度的异质性，因此需要进一步的纵向研究来评估两者之间的关联并证实所发现的结果。
{"title":"Anthropometric measures of obesity as risk indicators for prediabetes. A systematic review and meta-analysis","authors":"Víctor Juan Vera-Ponce , Fiorella E. Zuzunaga-Montoya , Luisa Erika Milagros Vásquez-Romero , Joan A. Loayza-Castro , Cori Raquel Iturregui Paucar , Carmen Inés Gutiérrez De Carrillo , Mario J. Valladares-Garrido , Maritza Placencia Medina","doi":"10.1016/j.deman.2024.100230","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100230","url":null,"abstract":"<div><h3>Introduction</h3><p>Several previous studies have provided evidence that obesity is a significant risk factor for the increase in prediabetes, but there are discrepancies regarding whether all the classic ways of measuring obesity, the body mass index (BMI), the waist circumference (WC) or the Waist to height ratio (WHtR) present the same level of risk.</p></div><div><h3>Objective</h3><p>to carry out a systematic review (SR) with meta-analysis to determine the association between indicators of obesity and prediabetes.</p></div><div><h3>Methods</h3><p>A systematic review (SR) with a meta-analysis of observational studies was performed. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. Association measures were presented as odds ratios (OR), relative risk (RR), or hazard ratio (HR), together with their 95% confidence intervals (95% CI).</p></div><div><h3>Results</h3><p>Of the total number of manuscripts chosen, 12 had an analytical cross-sectional design, and 4 were cohort studies. For the cross-sectional studies, together they presented a statistically significant association for BMI (OR: 1.99; 95% CI 1.65 – 1.34), WC (OR: 1.41; 95% CI 1.30 – 1.54), and WHtR (OR: 2.47 IC 95 % 1.50 – 4.06). In the meta-analysis of the cohort studies, an association was found with WC (RR: 4.95; 95% CI 3.42 – 7.17) but not with BMI (HR: 1.22; 95% CI 0.81 – 1.85). There were no studies with WHtR.</p></div><div><h3>Conclusions</h3><p>According to the results, considering cohort studies, WC could be the best risk indicator for prediabetes. There is a high degree of heterogeneity between the studies about the way obesity is measured, including the cut-off points used, so further longitudinal studies are needed to evaluate the association and confirm the results found.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100230"},"PeriodicalIF":1.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000350/pdfft?md5=f6755fe212739b3c2af790ce9df1b1af&pid=1-s2.0-S2666970624000350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prevalence of Type 2 Diabetes Mellitus (T2DM) is expected to rise, increasing the risk of cardiovascular disease. This study explores the relationship between high-density lipoprotein cholesterol (HDL) and glycemic control in T2DM patients, measured by hemoglobin A1c (HbA1c). While HDL is known to confer cardiovascular benefits, its impact on glycemic control remains unclear.
Methods
This cross-sectional study analyzed 30,195 Thai adults with T2DM data from the 2018 Thailand DM/HT database. Well-controlled HbA1c was defined as less than 53 mmol/mol (7 %). The study utilized multivariable linear, piecewise linear, and logistic regression analyses to investigate the relationship between HDL levels and glycemic control.
Results
The impact of HDL on HbA1c levels was nonlinear, showing a U-shaped relationship among the study participants with an HDL inflection point of 59 mg/dl. In females, a U-shaped relationship was also observed at the same inflection point, where increased HDL above this level was associated with a rise in HbA1c (Adjusted β = 0.205, P < 0.001). In contrast, a linear model better explained the consistent negative relationship between HDL and HbA1c in males (Adjusted β = –0.076, P < 0.001). Furthermore, in the poorly controlled HbA1c group, a significant U-shaped pattern was observed with an inflection point at 59 mg/dl.
Conclusion
This study found a nonlinear, gender-specific relationship between HDL and HbA1c in T2DM patients. Males with higher HDL are more likely to achieve glycemic control, while a U-shaped relationship is observed in females. Further research is needed to understand the differing correlation between well-controlled and poorly controlled groups.
{"title":"The association between serum high-density lipoprotein and hemoglobin A1c in T2DM: Evidence from a nationwide cross-sectional study in diabetic patients","authors":"Methavee Poochanasri , Sethapong Lertsakulbunlue , Chutawat Kookanok , Ram Rangsin , Wisit Kaewput , Boonsub Sakboonyarat , Mathirut Mungthin , Parinya Samakkarnthai","doi":"10.1016/j.deman.2024.100232","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100232","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of Type 2 Diabetes Mellitus (T2DM) is expected to rise, increasing the risk of cardiovascular disease. This study explores the relationship between high-density lipoprotein cholesterol (HDL) and glycemic control in T2DM patients, measured by hemoglobin A1c (HbA1c). While HDL is known to confer cardiovascular benefits, its impact on glycemic control remains unclear.</p></div><div><h3>Methods</h3><p>This cross-sectional study analyzed 30,195 Thai adults with T2DM data from the 2018 Thailand DM/HT database. Well-controlled HbA1c was defined as less than 53 mmol/mol (7 %). The study utilized multivariable linear, piecewise linear, and logistic regression analyses to investigate the relationship between HDL levels and glycemic control.</p></div><div><h3>Results</h3><p>The impact of HDL on HbA1c levels was nonlinear, showing a U-shaped relationship among the study participants with an HDL inflection point of 59 mg/dl. In females, a U-shaped relationship was also observed at the same inflection point, where increased HDL above this level was associated with a rise in HbA1c (Adjusted β = 0.205, <em>P</em> < 0.001). In contrast, a linear model better explained the consistent negative relationship between HDL and HbA1c in males (Adjusted β = –0.076, <em>P</em> < 0.001). Furthermore, in the poorly controlled HbA1c group, a significant U-shaped pattern was observed with an inflection point at 59 mg/dl.</p></div><div><h3>Conclusion</h3><p>This study found a nonlinear, gender-specific relationship between HDL and HbA1c in T2DM patients. Males with higher HDL are more likely to achieve glycemic control, while a U-shaped relationship is observed in females. Further research is needed to understand the differing correlation between well-controlled and poorly controlled groups.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100232"},"PeriodicalIF":1.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000374/pdfft?md5=6925a89cb7b18007b10d54f8ce35a2c3&pid=1-s2.0-S2666970624000374-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Measuring what it tends to measure makes a tool powerful and useful for decision-making. As the Amharic version summary of the diabetes self-care activity scale construct hasn't yet been validated, there is an urgent need for validation. This study aims to validate the Amharic version of the summary of the diabetes self-care activity scale among type 2 diabetes mellitus patients in Addis Ababa hospitals.
Methods
A facility-based cross-sectional study design was used to recruit 600 participants. The data was collected using open-data-kit and exported to SPSS and STATA for analysis. Both exploratory and confirmatory factor analysis was performed on 300 randomly allocated separate samples.
Result
A total of four factors with an eigenvalue greater than one, constituting nine items, were identified. The average variance executed (AVE) becomes 0.78, with a composite reliability of 0.97. Hence there is convergence between the items and the new construct. The overall internal consistency of the new construct was 0.853, which is greater than 0.7, affirming the reliability of the construct.
Conclusion
We can conclude that this 4-factor structure with a 9-item Amharic version of SDSCA is highly valid and reliable. Researchers and clinicians are highly recommended to use this validated tool.
{"title":"Validation of the Amharic version of the summary of diabetes self-care activity scale among type 2 diabetes patients in Addis Ababa, Ethiopia, 2023","authors":"Molla Gashu , Yimer Seid Yimer , Ayele Belachew , Berhanu Semra Mulat","doi":"10.1016/j.deman.2024.100222","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100222","url":null,"abstract":"<div><h3>Introduction</h3><p>Measuring what it tends to measure makes a tool powerful and useful for decision-making. As the Amharic version summary of the diabetes self-care activity scale construct hasn't yet been validated, there is an urgent need for validation. This study aims to validate the Amharic version of the summary of the diabetes self-care activity scale among type 2 diabetes mellitus patients in Addis Ababa hospitals.</p></div><div><h3>Methods</h3><p>A facility-based cross-sectional study design was used to recruit 600 participants. The data was collected using open-data-kit and exported to SPSS and STATA for analysis. Both exploratory and confirmatory factor analysis was performed on 300 randomly allocated separate samples.</p></div><div><h3>Result</h3><p>A total of four factors with an eigenvalue greater than one, constituting nine items, were identified. The average variance executed (AVE) becomes 0.78, with a composite reliability of 0.97. Hence there is convergence between the items and the new construct. The overall internal consistency of the new construct was 0.853, which is greater than 0.7, affirming the reliability of the construct.</p></div><div><h3>Conclusion</h3><p>We can conclude that this 4-factor structure with a 9-item Amharic version of SDSCA is highly valid and reliable. Researchers and clinicians are highly recommended to use this validated tool.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000271/pdfft?md5=3df0dd8d7783f38fad0cda1707374a4d&pid=1-s2.0-S2666970624000271-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141264003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1016/j.deman.2024.100221
Samer Younes
Background
The rising prevalence of type 2 diabetes (T2D) in Syria emphasizes the urgent requirement for effective management approaches. The ABC goals, which include maintaining glycated hemoglobin levels below 7 %, blood pressure below 140/90 mmHg, and low-density lipoprotein cholesterol levels below 100 mg/dl, serve as crucial benchmarks for managing T2D and its associated comorbidities.
Methods
In this cross-sectional study, the achievement of ABC goals was retrospectively examined among 681 clinically diagnosed T2D patients (not on Insulin) who participated in a six-year online lifestyle intervention program for diabetes management at the Freedom from Diabetes Clinic in Syria between January 2016 and December 2022.
Results
Out of the participants, 152 (22.3 %) successfully achieved all three ABC goals, while 306 (45.0 %) and 183 (26.9 %) achieved two or one goal(s) respectively. The factors influencing the attainment of all three ABC goals revealed a significant association with older age (>50 years), lower body mass index (<25 kg/m2), and lower insulin resistance (Homeostatic Model Assessment of Insulin Resistance < 2.5). Furthermore, patients who successfully achieved all three ABC goals exhibited lower insulin resistance, improved lipid profiles, and higher insulin sensitivity and beta cell function.
Conclusion
This study offers new insights into the relationship between insulin resistance/sensitivity and the achievement of ABC goals in the Syrian population with T2D, underscoring the necessity for tailored strategies to enhance comprehensive diabetes management.
{"title":"The correlation of ABC goal attainment with insulin resistance/sensitivity in Syrian type 2 diabetes patients","authors":"Samer Younes","doi":"10.1016/j.deman.2024.100221","DOIUrl":"10.1016/j.deman.2024.100221","url":null,"abstract":"<div><h3>Background</h3><p>The rising prevalence of type 2 diabetes (T2D) in Syria emphasizes the urgent requirement for effective management approaches. The ABC goals, which include maintaining glycated hemoglobin levels below 7 %, blood pressure below 140/90 mmHg, and low-density lipoprotein cholesterol levels below 100 mg/dl, serve as crucial benchmarks for managing T2D and its associated comorbidities.</p></div><div><h3>Methods</h3><p>In this cross-sectional study, the achievement of ABC goals was retrospectively examined among 681 clinically diagnosed T2D patients (not on Insulin) who participated in a six-year online lifestyle intervention program for diabetes management at the Freedom from Diabetes Clinic in Syria between January 2016 and December 2022.</p></div><div><h3>Results</h3><p>Out of the participants, 152 (22.3 %) successfully achieved all three ABC goals, while 306 (45.0 %) and 183 (26.9 %) achieved two or one goal(s) respectively. The factors influencing the attainment of all three ABC goals revealed a significant association with older age (>50 years), lower body mass index (<25 kg/m2), and lower insulin resistance (Homeostatic Model Assessment of Insulin Resistance < 2.5). Furthermore, patients who successfully achieved all three ABC goals exhibited lower insulin resistance, improved lipid profiles, and higher insulin sensitivity and beta cell function.</p></div><div><h3>Conclusion</h3><p>This study offers new insights into the relationship between insulin resistance/sensitivity and the achievement of ABC goals in the Syrian population with T2D, underscoring the necessity for tailored strategies to enhance comprehensive diabetes management.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266697062400026X/pdfft?md5=f5fd82ac6f31fec02870d126545664a8&pid=1-s2.0-S266697062400026X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mellitus diabetes is an endocrine trouble characterized by chronic high glycemia caused by a relative or absolute insulin deficiency. It is a public health problem because of its frequency associated with high morbi-mortality. The objective of this research was to determine the frequency of mellitus diabetes in under 15-year-old patients in Butembo Town.
Method
it was a cross-sectional descriptive study realized at the University Clinics of Graben from January 1st, 2017 to December 31st, 2021.
Results
Between 2017 and 2021, 3,681 children and adolescents were hospitalized at the University Clinics of the Graben Pediatrics Department. Out of them, 49 were diagnosed with mellitus diabetes, which indicates a prevalence of 1.331 %. The majority of patients were males, with high frequencies observed between the ages of 2 to 12 years. Common complaints included coma, polyurea-polydipsia, vision troubles, fever, weight loss, and growth retardation. Complications in infants and adolescents with diabetes included retinopathies, neuropathies, coma, infection, and ketoacidosis. The patients were admitted with extreme glycemia, with many suffering from hypoglycemia. Forty-three out of the 49 patients received insulin, and five of them died.
Conclusion
Mellitus diabetes in young remains a health problem in Butembo. Effective healthcare must include medical professionals, the population, and the state.
{"title":"Hospital prevalence of diabetes mellitus among under 15 children in Butembo: A retrospective study at the University Clinics of Graben","authors":"Roland Muyisa , Emile Watumwa , Apollinaire SaaSita , Judith Kithonga , Judith Malembe , Wivine Kitasuvirwa , Ghyslaine Kalivanda , Mupenzi Mumbere , Francois Mbahweka , Soly Kamwira","doi":"10.1016/j.deman.2024.100218","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100218","url":null,"abstract":"<div><h3>Introduction</h3><p>Mellitus diabetes is an endocrine trouble characterized by chronic high glycemia caused by a relative or absolute insulin deficiency. It is a public health problem because of its frequency associated with high morbi-mortality. The objective of this research was to determine the frequency of mellitus diabetes in under 15-year-old patients in Butembo Town.</p></div><div><h3>Method</h3><p>it was a cross-sectional descriptive study realized at the University Clinics of Graben from January 1st, 2017 to December 31st, 2021.</p></div><div><h3>Results</h3><p>Between 2017 and 2021, 3,681 children and adolescents were hospitalized at the University Clinics of the Graben Pediatrics Department. Out of them, 49 were diagnosed with mellitus diabetes, which indicates a prevalence of 1.331 %. The majority of patients were males, with high frequencies observed between the ages of 2 to 12 years. Common complaints included coma, polyurea-polydipsia, vision troubles, fever, weight loss, and growth retardation. Complications in infants and adolescents with diabetes included retinopathies, neuropathies, coma, infection, and ketoacidosis. The patients were admitted with extreme glycemia, with many suffering from hypoglycemia. Forty-three out of the 49 patients received insulin, and five of them died.</p></div><div><h3>Conclusion</h3><p>Mellitus diabetes in young remains a health problem in Butembo. Effective healthcare must include medical professionals, the population, and the state.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000234/pdfft?md5=3983443ffc27baa3220ce1f0574b1df0&pid=1-s2.0-S2666970624000234-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140649591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21DOI: 10.1016/j.deman.2024.100219
Sathish Thirunavukkarasu
{"title":"Epidemiology of isolated impaired fasting glucose among Asian Indians","authors":"Sathish Thirunavukkarasu","doi":"10.1016/j.deman.2024.100219","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100219","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"15 ","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000246/pdfft?md5=0b764abe89c0fb35014317b553ad8f8a&pid=1-s2.0-S2666970624000246-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140637941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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