Use of Diabetes Registry Data for Comparing Indices of Diabetes Management: A Comparison of 2 Urban Sites in Canada and Colombia.

OBJECTIVES: To demonstrate the use of a multinational diabetes registry for comparing indices of diabetes management among countries with differing levels of income, healthcare systems and ethnic backgrounds. METHODS: A cross-sectional study was conducted among 1742 people with type 2 diabetes attending diabetes clinics in London, Ontario, Canada, and Bogota, Colombia. The data were extracted from the Global Registry and Surveillance System for Diabetes (GRAND). RESULTS: Canadian patients were diagnosed with diabetes at significantly younger ages than Colombian patients (49 years and 53 years, respectively) and were heavier (body mass indices of 33 and 28, respectively). The Colombian patient population had significantly higher mean glycated hemoglobin (A1C) levels (9.4% vs. 8.6%) and fewer patients (22% vs. 26%) at the glycemic target (A1C <7.0%) than Canadian patients. In Colombia, 1 or more diabetes-related complications were present in 51% of the study population compared with 37% in Canada. Newly diagnosed Colombians had higher mean A1C levels (9.1% vs. 8.7%) and low-density lipoprotein-C levels (3.3 mmol/L vs. 2.5 mmol/L) than did newly diagnosed Canadians. CONCLUSIONS: A multination diabetes registry collecting standardized data facilitates transnational comparison of diabetes clinical parameters for the purpose of identifying potential gaps in care.

Nontraditional cardiovascular risk factors in pediatric metabolic syndrome.

OBJECTIVE: To study the relationships between nontraditional cardiovascular (CV) risk factors and components of the metabolic syndrome in Native Canadian children, a population at risk of future CV disease. STUDY DESIGN: CV risk factors were evaluated in a population-based study of a Canadian Oji-Cree community, involving 236 children aged 10 to 19 years. RESULTS: Using an age- and sex-specific case definition, 18.6% of the children met criteria for pediatric metabolic syndrome. As the number of metabolic syndrome component criteria increased, C-reactive protein, leptin, and ratio of apolipoprotein B to apolipoprotein A1 levels rose (all P < .0001) and adiponectin concentration decreased (P = .0006). Principal factor analysis using both traditional and nontraditional CV risk factors revealed 5 underlying core traits, defined as follows: adiposity, lipids/adiponectin, inflammation, blood pressure, and glucose. CONCLUSIONS: Nontraditional CV risk factors accompany the accrual of traditional risk factors early in the progression to pediatric metabolic syndrome. Furthermore, inclusion of these factors in factor analysis suggests that 5 core traits underlie the early development of an enhanced CV risk factor profile in Native children.