Work-related factors related to forgetting to take oral diabetes medication during the working day among Japanese male employees with diabetes.

AIM: This study aimed to explore the work-related factors related to forgetting to take oral diabetes medication during the working day among Japanese employees with diabetes. METHODS: This worksite-based study was designed to clarify the important work-related factors for preventing the aggravation of diabetes among working-age people and support for coexisting diabetes treatment and work (Ryoritsu Shien). This cross-sectional survey was conducted in 2018. The participants were full-time employees with type 2 diabetes aged over 40 years who took oral diabetes medication during the working day. The participants were classified into forgetting and non-forgetting groups. Their characteristics and work-related factors were evaluated using a self-administered questionnaire and specific health checkup data. RESULTS: Of the 93 employees with diabetes, 22 (23.7%) were classified into the forgetting group. After adjusting for confounding factors, irregular meal times during the working day was positively associated with forgetting to take oral diabetes medication during the working day [multivariable-adjusted odds ratio (OR), 7.08; 95% confidence interval (CI): 1.38-36.32, irregular vs. regular]. Skipping meals during the working day was positively associated with forgetting to take oral diabetes medication during the working day (multivariable-adjusted OR 3.55, 95% CI 1.14-11.09 presence vs. absence). CONCLUSIONS: Our findings suggest that irregular meal times and skipping meals during the working day are important factors related to forgetting to take oral diabetes medication during the working day among Japanese male employees with diabetes.

Association of abdominal obesity with crossing capillaries in the finger nailfold in type 2 diabetes mellitus.

AIM: Increased crossing of finger nailfold capillaries could be a novel visual marker of early microvascular damage among type 2 diabetes mellitus patients. Although abdominal obesity is an important driver of early microvascular damage, its association with an increase in the percentage of crossing capillaries remains uncertain. We investigated the association between abdominal obesity and an increase in the percentage of crossing capillaries in the finger nailfold in patients with type 2 diabetes mellitus. METHODS: This cross-sectional study enrolled 123 type 2 diabetes mellitus patients (age 40-75 years) who visited the outpatient diabetic clinic at Osaka University Hospital between May and October 2019. Abdominal obesity was defined as a waist circumference ≥ 90 cm in women and ≥ 85 cm in men. Capillary morphology was assessed by nailfold capillaroscopy based on the simple capillaroscopic definitions of the European League Against Rheumatism Study Group. The association between abdominal obesity and a high percentage of crossing capillaries in the finger nailfold (defined as the highest tertile of crossing capillaries) was analyzed using multivariable logistic regression. RESULTS: After adjusting for age, sex, smoking status, regular exercise, duration of diabetes, glycated hemoglobin, hypertension, and dyslipidemia, abdominal obesity was significantly associated with a high percentage of crossing capillaries (multivariable-adjusted odds ratios [95% confidence interval] = 2.70 [1.05-6.90], p = 0.038). CONCLUSIONS: Abdominal obesity may play an important role in the increase in the percentage of crossing capillaries in the finger nailfold in patients with type 2 diabetes mellitus.

Association of crossing capillaries in the finger nailfold with diabetic retinopathy in type 2 diabetes mellitus.

AIMS/INTRODUCTION: Crossing capillaries in the finger nailfold might potentially be a novel diabetic retinopathy (DR) biomarker that could be assessed non-invasively in the clinical setting. However, the association between crossing capillaries and DR is controversial. This study aimed to investigate the association between the percentage of crossing capillaries in the finger nailfold and DR in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: This cross-sectional study enrolled 108 type 2 diabetes mellitus patients (aged 40-75 years) who visited the outpatient diabetic clinic at Osaka University Hospital, Osaka, Japan, between May and October 2019. Capillary morphology was assessed using nailfold capillaroscopy based on the simple capillaroscopic definitions of the European League Against Rheumatism Study Group. Details of DR and other laboratory data were obtained from medical records. The association between the tertile of the percentage of the crossing capillary and DR was analyzed using multivariable logistic regression. RESULTS: After adjusting for age, sex, diabetes duration, glycated hemoglobin, systolic blood pressure, body mass index, and use of renin-angiotensin system inhibitor and antihyperlipidemic medication, the percentage of crossing capillaries was significantly associated with DR (multivariable-adjusted odds ratios for increasing tertiles of the percentage of crossing capillary: 1 [reference], 2.05 [95% confidence interval 0.53-7.94], and 4.33 [95% confidence interval 1.16-16.21]; P-trend = 0.028). CONCLUSIONS: A higher percentage of crossing capillaries in the nailfold was associated with a higher risk of DR, independent of traditional risk and inhibiting factors, in patients with type 2 diabetes mellitus.

Work-related, personal, and diabetes-related factors relevant to dropout from outpatient diabetes treatment visits among Japanese male employees with diabetes.

AIM: In recent years, support for coexisting diabetes treatment and work (Ryoritsu Shien) has become increasingly important for employees with diabetes. It is important to identify factors associated with dropout from outpatient visits for diabetes treatment among employees with diabetes to determine appropriate support to prevent dropout. Therefore, we explored work-related, personal, and diabetes-related factors relevant for dropout from outpatient diabetes treatment visits among Japanese employees with diabetes. METHODS: This cross-sectional study was conducted in 2018. Participants were 140 full-time employees with type 2 diabetes aged over 40 years. Participants were classified into two groups: a dropout group and a continuation group. Work-related, personal, and diabetes-related factors were evaluated using a self-administered questionnaire and specific health checkup data. RESULTS: Of the 140 employees with diabetes, 12 (8.6%) were classified in the dropout group. Multivariable logistic regression analysis revealed three factors associated with a lower risk for dropout from diabetes treatment outpatient visits. These were: high supervisor support, as measured by the Job Content Questionnaire (multivariable-adjusted odds ratio [OR] 0.71, 95% confidence interval [CI] 0.52-0.97, per 1 score); older age (multivariable-adjusted OR 0.79, 95% CI: 0.66-0.95, per 1 year); and presence of metabolic syndrome (multivariable-adjusted OR 0.04, 95% CI 0.01-0.28, presence vs. absence). CONCLUSIONS: Our findings suggest that supervisor support, age, and metabolic syndrome are important factors related to dropout from outpatient diabetes treatment visits among Japanese male employees with diabetes.

Associations among work-related stress and mental fatigue, and regular exercise in Japanese employees with or without diabetes.

AIM: Understanding work-related factors associated with regular exercise in employees could be useful for determining appropriate interventions to prevent the onset and aggravation of diabetes. This study aimed to assess the associations among work-related stress and mental fatigue, and regular exercise in Japanese employees with or without diabetes. METHODS: This cross-sectional study was conducted in 2018, and included 2916 full-time employees aged older than 40 years without cardiovascular disease, cancer, respiratory disease, kidney disease, disc herniation, and depression. Work-related stress was measured by the Job Content Questionnaire and work-related mental fatigue was measured using the Numerical Rating Scale (NRS). RESULTS: Regular exercise was present in 23.9% of 117 employees with diabetes and in 21.3% of 2799 employees without diabetes. In employees with diabetes, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for regular exercise were 0.26 (0.07-0.96) in those with an NRS score of 4-6 (moderate) and 0.22 (0.06-0.85) in those with an NRS score of 7-10 (severe) compared with those with an NRS score of 0-3 (none or mild), after adjusting for confounding factors. Similarly, in employees without diabetes, the multivariable-adjusted ORs (95% CIs) for regular exercise were 0.77 (0.62-0.97) in those with an NRS score of 4-6 and 0.75 (0.59-0.94) in those with an NRS score of 7-10 compared with those with an NRS score of 0-3. CONCLUSIONS: Work-related mental fatigue was negatively associated with regular exercise in employees with and without diabetes.

Development of Personalized Fitting Device With 3-Dimensional Solution for Prevention of NIV Oronasal Mask-Related Pressure Ulcers.

BACKGROUND: Pressure ulcers related to oronasal masks used with noninvasive ventilation (NIV), along with patient discomfort, occur due to improper fit of the mask. We developed a personalized fitting device using a 3-dimensional (3D) scanning solution to prevent the formation of NIV mask-related pressure ulcers. This study aimed to evaluate the effectiveness of the proposed personalized fitting device. METHODS: We conducted a randomized crossover experimental study of 20 healthy participants to study the use of this personalized fitting device between the face and an NIV mask designed with 3D solutions. The fitting device was not used under the NIV mask for the control. The outcome measures were the presence of blanchable erythema, standardized redness intensity, discomfort level, and contact pressure. RESULTS: The incidence of blanchable erythema and standardized redness intensity values were significantly lower for subjects who used the fitting device when worn for 30 min (P < .001). The discomfort levels at the forehead, nasal bridge, and both cheeks, as well as leakage, were significantly reduced as well (P = .008, P < .001, P = .001, P = .002, P = .001, P = .02, P < .001, P < .001, P < .001). Contact pressure at the nasal bridge, where pressure ulcers most frequently develop, was significantly decreased with the fitting device (P < .001). CONCLUSIONS: Personalized fitting devices that incorporate 3D scanning solutions may contribute to the prevention of NIV mask-related pressure ulcers and the reduction of discomfort.