Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20.114
Filtrar
1.
Angiology ; 71(1): 17-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31129986

RESUMO

The Middle East and North Africa (MENA) region has a high burden of morbidity and mortality due to premature (≤55 years in men; ≤65 years in women) myocardial infarction (MI) and acute coronary syndrome (ACS). Despite this, the prevalence of risk factors in patients presenting with premature MI or ACS is incompletely described. We compared lifestyle, clinical risk factors, and biomarkers associated with premature MI/ACS in the MENA region with selected non-MENA high-income countries. We identified English-language, peer-reviewed publications through PubMed (up to March 2018). We used the World Bank classification system to categorize countries. Patients with premature MI/ACS in the MENA region had a higher prevalence of smoking than older patients with MI/ACS but a lower prevalence of diabetes, hypertension, and dyslipidemia. Men with premature MI/ACS had a higher prevalence of smoking than women but a lower prevalence of diabetes and hypertension. The MENA region had sparse data on lifestyle, diet, psychological stress, and physical activity. To address these knowledge gaps, we initiated the ongoing Gulf Population Risks and Epidemiology of Vascular Events and Treatment (Gulf PREVENT) case-control study to improve primary and secondary prevention of premature MI in the United Arab Emirates, a high-income country in the MENA region.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Infarto do Miocárdio/epidemiologia , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/prevenção & controle , África do Norte/epidemiologia , Idade de Início , Idoso , Estudos de Casos e Controles , Comorbidade , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Mortalidade Prematura , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Prevalência , Prevenção Primária , Prognóstico , Projetos de Pesquisa , Fatores de Risco , Prevenção Secundária , Fatores Sexuais , Fumar/efeitos adversos , Fumar/epidemiologia
2.
Medicine (Baltimore) ; 98(50): e18100, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852069

RESUMO

INTRODUCTION: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. MATERIAL AND METHODS: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. RESULTS: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ±â€Š1.6 and 8.8 ±â€Š1.6 in the diabetic and nondiabetic groups, respectively (P = .003). CONCLUSION: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.


Assuntos
Assistência Ambulatorial , Pressão Sanguínea/fisiologia , Diabetes Mellitus/fisiopatologia , Hipertensão/fisiopatologia , Oscilometria/métodos , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Sístole
3.
MMWR Morb Mortal Wkly Rep ; 68(43): 961-966, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31671084

RESUMO

Diabetes affects approximately 12% of the U.S. adult population and approximately 25% of adults aged ≥65 years. From 2009 to 2017, there was no significant change in diabetes prevalence overall or among persons aged 65-79 years (1). However, these estimates were based on survey data with <5,000 older adults. Medicare administrative data sets, which contain claims for millions of older adults, afford an opportunity to explore both trends over time and heterogeneity within an older population. Previous studies have shown that claims data can be used to identify persons with diagnosed diabetes (2). This study estimated annual prevalence and incidence of diabetes during 2001-2015 using Medicare claims data for beneficiaries aged ≥68 years and found that prevalence plateaued after 2012 and incidence decreased after 2006. In 2015 (the most recent year estimated) prevalence was 31.6%, and incidence was 3.0%. Medicare claims can serve as an important source of data for diabetes surveillance for the older population, which can inform prevention and treatment strategies.


Assuntos
Diabetes Mellitus/epidemiologia , Medicare/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Prevalência , Estados Unidos/epidemiologia
4.
Orv Hetil ; 160(47): 1872-1880, 2019 Nov.
Artigo em Húngaro | MEDLINE | ID: mdl-31736343

RESUMO

Introduction: The problem of diabetes worldwide raises increasingly serious public health issues in Hungary. In recent years, the emphasis on obesity as a primary cause of diabetes has been driven by a complex understanding of the causes of civilization: the role of sleep problems and stress in the development of the disease and the aggravation of the condition has been proven and supported. Aim: The aim of the study was to investigate the relationship between stress, sleep problems and diabetes in the representative Hungarostudy 2013 survey. Method: In the cross-sectional questionnaire study, 2000 adults participated. Mean of age was 46.9 (SD = 18.24) years. The average BMI was 26.0 (SD = 4.97) kg/m2. Measures: socio-demographic data, question about the presence of treated diabetes, symptomatic list, Perceived Stress Scale. Results: The frequency of diabetes treated one year before the date of the survey was 8.2%. The levels of stress experienced by diabetic patients were significantly higher than those experienced by participants not treated with diabetes (t(1944) = -2.586, p = 0.010). After adjusting potential background variables, perceived stress shows a marginally significant relationship with diabetes (OR = 1.03, p = 0.052). 26.0% of the respondents reported sleep problems last month, while 40.2% of them reported fatigue and energy shortages. The presence of sleep problems (χ2(2) = 61.108, p<0.001) and feeling of fatigue or lack of energy (χ2(2) = 51.061, p<0.001) are significantly more frequent among people with diabetes. Treated diabetes also predicts the presence of sleep problems (OR = 1.77, p = 0.003) as well as fatigue and lack of energy (OR = 1.88, p = 0.004) under the control of potential background variables. Conclusion: Our results show that, according to trends in other parts of the world, both sleep problems and stress play a significant role in the development of diabetes in Hungary. This draws attention to the need for effective screening and treatment of these factors in the prevention and treatment of diabetes in accordance with international protocols. Orv Hetil. 2019; 160(47): 1872-1880.


Assuntos
Diabetes Mellitus/psicologia , Fadiga/complicações , Transtornos do Sono-Vigília/complicações , Estresse Psicológico/etiologia , Adulto , Estudos Transversais , Diabetes Mellitus/epidemiologia , Fadiga/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Masculino , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
5.
MMWR Morb Mortal Wkly Rep ; 68(45): 1020-1023, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31725705

RESUMO

Approximately 30 million persons in the United States have diabetes.* Persons with diabetes are at risk for vision loss from diabetic retinopathy and other eye diseases (1). Diabetic retinopathy, the most common diabetes-related eye disease, affects 29% of U.S. adults aged ≥40 years with diabetes (2) and is the leading cause of incident blindness among working-age adults (1). It is caused by chronically high blood glucose damaging blood vessels in the retina.† Annual dilated eye exams are recommended for persons with diabetes because early detection and timely treatment of diabetic eye diseases can prevent irreversible vision loss§,¶ (3,4). Studies have documented prevalence of annual eye exams among U.S. adults with diabetes (5,6); however, a lack of recent state-level data limits identification of geographic disparities in adherence to this recommendation. Medicare claims from the 50 states, the District of Columbia (DC), Puerto Rico, and U.S. Virgin Islands (USVI) were examined to assess the prevalence of eye exams in 2017 among beneficiaries with diabetes who were continuously enrolled in Part B fee-for-service insurance, which covers annual eye exams for beneficiaries with diabetes.** This report also examines disparities, by state and race/ethnicity, in receipt of eye exams. Nationally, 54.1% of beneficiaries with diabetes had an eye exam in 2017. Prevalence ranged from 43.9% in Puerto Rico to 64.8% in Rhode Island. Fewer than 50% of beneficiaries received an eye exam in seven states (Alabama, Alaska, Kentucky, Louisiana, Nevada, West Virginia, and Wyoming) and Puerto Rico. Non-Hispanic white (white) beneficiaries had a higher prevalence of receiving an eye exam (55.6%) than did non-Hispanic blacks (blacks) (48.9%) and Hispanics (48.2%). Barriers to receiving eye care (e.g., suboptimal clinical care coordination and referral, low health literacy, and lack of perceived need for care) might limit Medicare beneficiaries' ability to follow this preventive care recommendation. Understanding and addressing these barriers might prevent irreversible vision loss among persons with diabetes.


Assuntos
Diabetes Mellitus/epidemiologia , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Disparidades em Assistência à Saúde , Medicare Part B/economia , Seleção Visual , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Disparidades em Assistência à Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
6.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(10): 750-754, 2019 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-31594108

RESUMO

Objective: To analyzed the clinical characteristics and prognosis of patients with H7N9 avian influenza. Methods: The baseline characteristics, clinical manifestations, treatments, laboratory and imaging findings were collected and analyzed for 20 patients with H7N9 avian influenza admitted to the First Affiliated Hospital of Nanchang University from December 2016 to March 2017. According to the final clinical outcome, the patients were divided into the death group and the survival group. Ten patients in the death group died, and 10 patients in the survival group were discharged. The data with normal distribution were analyzed by t test. The data with non-normal distribution were analyzed by Wilcoxon rank sum test. Results: Of the 20 patients, 13 were males and 7 were females, aging 40-82 years, with a mean age of (60±12) years. Twelve patients had a definite history of poultry exposure and 10 had chronic underlying diseases such as hypertension and diabetes. The clinical manifestations were mainly fever, cough, hemoptysis, respiratory distress, fatigue, etc. In the survival group, the platelet count was(167-315)×10(9)/L, while it was (78-152)×10(9)/L in the death group. The average white blood cell count was (7.78-11.52)×10(9)/L and (9.91-15.93)×10(9)/L in the survival and death groups respectively. The average value of lymphocyte count was (0.69-1.59)×10(9)/L and (0.58-0.86)×10(9)/L in the survival and death groups respectively. In the death group the glutamic-pyruvic transaminase (ALT) value was (14.0-352.0) U/L, the total bilirubin value was (6.9-34.5) µmol/L, the creatine kinase MB (CK-MB) was (16.0-162.0) U/L, the serum calcium value was (1.4-2.0) mmol/L, the C-reactive protein value was (33.1-414.0) mg/L, and the calcium reduction prime value was (0.6-100.0) µg/L. In the survival group,the ALT value was (25.0-181.0) U/L, the total bilirubin value was (4.8-25.9) µmol/L, the CK-MB value was (15.0-40.0) U/L, the serum calcium value was (1.9-2.4) mmol/L, the C-reaction protein value was (12.8-52.5) mg/L, and the procalcitonin value was (0.3-23.3) µg/L. Sixteen cases suffered severe pneumonia. Twelve patients received extracorporeal membrane oxygenation (ECMO), and 4 survived. The cause of death was mainly related to factors such as age, chronic underlying diseases and severity of illness. Conclusions: Human infection with H7N9 avian influenza virus was highly pathogenic, and prone to progress into severe pneumonia, with a high mortality. Decreased platelet count was associated with mortality (t=4.07, P=0.001), predictive of patient outcome.


Assuntos
Antivirais/uso terapêutico , Subtipo H7N9 do Vírus da Influenza A/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/tratamento farmacológico , Síndrome do Desconforto Respiratório do Adulto/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Aves , China/epidemiologia , Tosse/etiologia , Diabetes Mellitus/epidemiologia , Exposição Ambiental , Feminino , Febre/etiologia , Humanos , Hipertensão/epidemiologia , Influenza Aviária , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Masculino , Pessoa de Meia-Idade , Pneumonia/epidemiologia , Pneumonia/etiologia , Pneumonia/virologia , Prognóstico , Resultado do Tratamento
7.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190006.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596377

RESUMO

OBJECTIVE: To analyze the prevalence of diabetes mellitus (DM) according to different diagnostic criteria, in the Brazilian adult population, according to laboratory results from the Brazilian National Health Survey. METHODS: Analysis of laboratory data from the National Health Survey, collected between 2014 and 2015. The prevalence of diabetes was calculated according to different diagnostic criteria. The prevalence of diabetes was calculated according to the criterion of glycosylated hemoglobin ≥ 6.5% or using medication, using Poisson regression and calculating crude and adjusted PR and 95%CI. RESULTS: The prevalence of diabetes according to different criteria varies from 6.6 to 9.4%. Intermediate or pre-diabetes hyperglycemia ranged from 6.8 to 16.9%. Considering laboratory criteria or medication use, the prevalence of DM was 8.4 (95%CI 7.65-9.11). The adjusted PR for gender, age, educational level and region was lower for males (PR 0.75; 95%CI 0.63 - 0.89), increased with age: 30 to 34 years (PR 2.32; 95% CI 1.33 - 4.07), 40 to 59 years PR 8.1; 95%CI 4.86 - 13.46), 60 years old or older (PR 12.6; 95%CI 7.1 - 21.0), and higher educational levels was protective (PR 0.8; 95%CI 0.6 - 0.9). Therewas a higher PR in the Central West Region (PR 1.3; 95%CI 1.04 - 1.7), in overweight people (PR 1.8; 95%CI 1.4 - 2.1), and in obese people (PR 3.3; 95%CI 2.6 - 4.1). CONCLUSION: The prevalence of diabetes was higher in females, people over 30 years of age, in populations with low educational levels, and people who were overweight and obese. The study advances in determining the diabetes situation in the country through laboratory criteria.


Assuntos
Diabetes Mellitus/epidemiologia , Hemoglobina A Glicada/análise , Inquéritos Epidemiológicos/métodos , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
8.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190014.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596385

RESUMO

OBJECTIVES: To analyze the socioeconomic and demographic differences in medication use to control hypertension and diabetes mellitus in Brazil. METHOD: Data from the National Health Survey (Pesquisa Nacional de Saúde - PNS) performed in Brazil in 2013 with a representative sample of the population aged 18years old or older were analyzed. The use of medications for hypertension and diabetes according to income, education, race, possession of a private health insurance plan and region of household were estimated. Theprevalence ratios adjusted for sex and age were also estimated using Poisson regression. RESULTS: 81.4% of the hypertensive population used medication to control the disease. The use was higher among females, white/Caucasian individuals and those with a private health plan. In the case of diabetes mellitus, 80.2% of the population used medication to control the disease and the use was higher in elderly patients, patients with a higher level of education, patients with a private health plan, and patients in the Southeast region. Inequalities according to income and health plan were small even in the strata of sex, age and geographic region analyzed. CONCLUSION: We found a high use of medication to control hypertension and diabetes. Socioeconomic inequalities in use were not expressive, probably due to medication policies that promote greater and equitable access to medicines in Brazil.


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inquéritos Epidemiológicos/métodos , Hipertensão/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Disparidades em Assistência à Saúde , Humanos , Hipertensão/epidemiologia , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Classe Social , Fatores Socioeconômicos , Adulto Jovem
9.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(8): 520-527, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184146

RESUMO

La diabetes mellitus presenta elevada prevalencia, complicaciones severas, repercusión clínica, costes e implicaciones laborales. Su valoración requiere el uso de la historia clínica y cuestionarios de apoyo. Se revisa en Medline la bibliografía sobre diabetes y la experiencia de los autores en valoración clínico-laboral, con resultados que muestran cuantiosas publicaciones en aspectos clínicos y terapéuticos relacionados con diabetes o con aspectos sociales y de salud pública, pero reducida en aspectos laborales. El uso de cuestionarios para valoración de la enfermedad es generalizado y cada autor debe seleccionar el que mejor se adapte a sus objetivos o experiencia. Se concluye que, para la valoración clínica y laboral en diabetes se recomienda la colaboración interespecialidades, partiendo de una historia clínica completa que incluya los riesgos del trabajo. Son de ayuda los cuestionarios, adaptados a objetivo, recomendándose los validados en español como Encuesta sobre el miedo a la hipoglucemia (EsHFS) y Calidad de vida relacionada con la diabetes (EsDQOL)


Diabetes mellitus presents high prevalence, severe complications, clinical repercussions, costs and occupational implications. Their assessment requires the use of the medical history and support questionnaires. A literature review was conducted on the topic of clinical and occupational evaluation aspects of diabetes; the database searched was Medline. The search showed numerous papers about diabetes clinical and therapeutic aspects as well as social or public health aspects but the results lacked occupational aspects. To assess the disease, the use of questionnaires is generalized and each author selects those which fit best to their purpose. It is concluded that to carry out a clinical and occupational evaluation related to diabetes, an inter-specialities cooperation, based on a complete medical history including occupational risk factors, is recommended. The questionnaires are useful, adapted to the objective, recommending those valued in Spanish as in Fear of hypoglycemia questionnaire (EsHFS) and Diabetes-related quality of life questionnaire (EsDQOL)


Assuntos
Humanos , Diabetes Mellitus/epidemiologia , Saúde do Trabalhador , Complicações do Diabetes/economia , Complicações do Diabetes/epidemiologia , Inquéritos e Questionários , Qualidade de Vida
10.
Pan Afr Med J ; 33: 140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558938

RESUMO

Introduction: The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. Methods: The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. Results: Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). Conclusion: These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.


Assuntos
Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Intolerância à Glucose/epidemiologia , Adulto , Fatores Etários , Doenças Cardiovasculares/etiologia , Comores/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Jejum , Feminino , Humanos , Hipertensão/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Circunferência da Cintura
11.
Pan Afr Med J ; 33: 100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489078

RESUMO

Introduction: Hypertension, among diabetic patients, is a worldwide public-health challenge and a leading modifiable risk factor for other cardiovascular diseases. The main purpose of this study was to identify determinants of hypertension among diabetic patients. Methods: Data were collected from January to March 2018 using an interviewer-administered structured questionnaire. Data collectors and supervisors were trained before the period of data collection. The questionnaire was pretested on 5% of the sample at Suhul hospital. Bivariable logistic regression was employed to examine the crude associations between the outcome variable and determinant variables. This was followed by multivariable analysis to examine the determinants of hypertension among diabetic patients by selecting variables which had p value ≤0.2 in the bivariable analysis. Results: The age range of the respondents was 18-80 years, with the median age of 51.56±14.92 years. Not attending diabetes mellitus education sessions (AOR=2.61, 95% CI (1.12,6.1), duration since diagnosis with diabetes (AOR=8.52; 95% CI (1.97, 36.84), poor glycemic control (AOR=22.99, 95CI (5.92,89.28), overweight (AOR=4.84, 95%CI (1.42,16.51), and non-adherence to diabetes medication (AOR=4.66, 95% CI (2.22,9.79), diet (AOR=9.70,95% CI (3.34,28.22), exercise (AOR= 5.47, 95% CI (2.35,12.75), and self-monitoring blood glucose (AOR=6.62, 95% CI (3.16, 13.86) were found to be the determinants of hypertension among diabetic patients. Conclusion: This research concludes that longer duration with diabetes, nonattendance of diabetes education sessions, poor glycemic control, and not-adherence to antidiabetic medications, diet, exercise and self-monitoring blood glucose were found to be the determinants of hypertension among diabetic patients.


Assuntos
Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Hipoglicemiantes/administração & dosagem , Adesão à Medicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Estudos de Casos e Controles , Diabetes Mellitus/tratamento farmacológico , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
12.
Eur J Endocrinol ; 181(5): 489-498, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31509802

RESUMO

Objective: Obesity and type 2 diabetes are becoming increasingly prevalent worldwide and are both associated with the increased incidence of kidney and bladder cancers. However, previous reports have provided conflicting results. We investigated the impact of body mass index (BMI) and diabetes on the incidence of both cancers in the general population. Methods: Using nationally representative data from the Korean National Health Insurance System, 9,777,133 subjects without any malignancy who underwent health examinations in 2009 were followed to the end of 2017. Results: After a median follow-up period of 8.32 years, 12,544 incidents of kidney cancer and 15,137 incidents of bladder cancer were identified. The hazard ratio (HR) for kidney cancer was the lowest in people with a BMI <18.5 kg/m2 (HR: 0.82, 95% confidence interval (CI): 0.72-0.94) and the highest in those with a BMI ≥30 kg/m2 (HR: 1.71, 95% CI: 1.57-1.87) compared to a reference BMI group (18.5-23 kg/m2). In subjects with diabetes, obesity was associated with increased risk of kidney cancer, although the HRs were lower than observed in those without diabetes. Otherwise, there was a reduction in risk of bladder cancer with obesity in men and the HR for bladder cancer was not affected by BMI increase in women. There was a strongly positive association between diabetes and bladder cancer in the total study population. Conclusions: Obesity was a strong risk factors for kidney cancer, whereas the association between obesity and bladder cancer differed by gender. The subjects with diabetes had a higher risk for both cancers than those without diabetes.


Assuntos
Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Neoplasias Renais/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Neoplasias da Bexiga Urinária/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Risco , Adulto Jovem
13.
BMC Infect Dis ; 19(1): 799, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510930

RESUMO

BACKGROUND: The accuracy of different laboratory tests for diagnosis of diabetes mellitus (DM) and prediabetes (preDM) in populations exposed to tuberculosis (TB) remains poorly understood. Here, we examined the prevalence of DM and preDM in TB affected people in Lima, Peru. METHODS: A prospective cohort study of patients affected TB and their household contacts (HHC), was conducted between February and November 2017 in Lima, Peru. Fasting plasma glucose (FPG), HbA1c and oral glucose tolerance test (OGTT) were used to detect DM and preDM in a prospective cohort of TB patients (n = 136) and household contacts (n = 138). Diagnostic performance of the laboratory tests was analyzed. Potential effects of sociodemographic and clinical factors on detection of dysglycemia were analyzed. RESULTS: In TB patients, prevalence of DM and preDM was 13.97 and 30.88% respectively. Lower prevalence of both DM (6.52%) and preDM (28.99%) were observed in contacts. FPG, HbA1c and OGTT had poor agreement in detection of preDM in either TB cases or contacts. TB-DM patients had substantially lower hemoglobin levels, which resulted in low accuracy of HbA1c-based diagnosis. Classic sociodemographic and clinical characteristics were not different between TB patients with or without dysglycemia. CONCLUSION: High prevalence of DM and preDM was found in both TB patients and contacts in Lima. Anemia was strongly associated with TB-DM, which directly affected the diagnostic performance of HbA1c in such population.


Assuntos
Diabetes Mellitus/diagnóstico , Estado Pré-Diabético/diagnóstico , Tuberculose/patologia , Adulto , Glicemia/análise , Complicações do Diabetes/patologia , Diabetes Mellitus/epidemiologia , Feminino , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Estado Pré-Diabético/complicações , Estado Pré-Diabético/epidemiologia , Prevalência , Estudos Prospectivos , Tuberculose/complicações
14.
Expert Rev Clin Pharmacol ; 12(9): 825-830, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474169

RESUMO

Introduction: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used for cardiovascular disease (CVD) prevention. Long-term use of statins has been linked to the development of diabetes mellitus (DM) which increases CVD risk. Areas covered: We discussed the reported incidence of DM in statin users, various possible mechanisms responsible for the development of DM and the clinical implications of this association on CVD risk. Relevant supporting literature was identified using MEDLINE/EMBASE search. Expert opinion: Data from available RCTs and observational studies suggest a 10-45% higher risk of new-onset DM with statin use compared to nonusers. Several cellular, molecular, and genetic mechanisms, and lifestyle changes have been studied and discussed as potential underlying mechanisms responsible for this elevated DM risk with statin therapy. The mode of the diabetogenic action of statins is still unclear and an interplay of pancreatic and peripheral effects in the pathogenesis of DM is a possibility. Despite these observations, the CVD preventative benefit of statin treatment outweighs the CVD risk associated with of development of new DM. There is a need for further research to identify the exact mechanisms involved so as to specifically target causative factors and individualize treatment.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/etiologia , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Diabetes Mellitus/epidemiologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Incidência , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
16.
Transplant Proc ; 51(7): 2339-2342, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31402251

RESUMO

PURPOSE: In comparison to cyclosporine (CsA), tacrolimus (Tac) seems to be more diabetogenic in renal transplant recipients, and post-transplant diabetes mellitus is more common in patients using Tac, especially during the first year after transplantation. However, at maintenance doses, there are no comparative data of insulin resistance (IR) in patients using Tac or CsA. The purpose of this study was to investigate the IR indexes in patients on maintenance doses of CsA or Tac. METHODS: Forty-five nondiabetic and nonobese renal transplant recipients participated in the study (M:F, 30:15; age, 36 ± 9 years); 27 patients were on CsA, and 18 were on Tac. All had stable graft function, were transplanted at least 6 months previously, and were receiving maintenance doses of steroids (5.0 mg/d), azathioprine or mycophenolate mofetil, and calcineurin inhibitors (CsA [2.14 ± 0.46 mg/kg/d] or Tac [0.06 ± 0.03 mg/kg/d]). IR was evaluated by the homeostasis model assessment (HOMA) index and composite body insulin sensitivity index. RESULTS: We did not determine any significant difference in the HOMA and composite body insulin sensitivity index levels among patients using CsA or Tac (1.5 ± 1.3 vs 1.5 ± 1.1, P > .05, and 9.9 ± 5.8 vs 14.6 ± 11.7, P > .05, respectively). There was a significant correlation between creatinine and HOMA values. CONCLUSION: There was no difference in IR indexes in renal transplant recipients receiving maintenance doses of either CsA or Tac.


Assuntos
Ciclosporina/efeitos adversos , Diabetes Mellitus/epidemiologia , Imunossupressores/efeitos adversos , Resistência à Insulina , Transplante de Rim , Tacrolimo/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplantados , Transplante Homólogo
17.
BMC Public Health ; 19(1): 1047, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31383022

RESUMO

BACKGROUND: The heavy workload of physicians in Taiwan may contribute to poor lifestyles and increased risk for diabetes mellitus (DM). We conducted this study to determine the risk for DM among physicians in Taiwan. METHODS: We used the Taiwan National Health Insurance Research Database to identify 28,440 physicians and 56,880 comparisons (general population) matched at a ratio of 1:2 by age and sex. Participants who had been diagnosed with DM before 2007 were excluded. We compared the risk for DM between physicians and comparisons by following up since 2007 to 2013. Comparisons among physician subgroups were also performed. RESULTS: After adjustment for hypertension, hyperlipidemia, hyperuricemia, coronary artery disease, congestive heart failure, hyperthyroidism, hypothyroidism, and polycystic ovary syndrome, physicians had a lower risk for DM than the comparisons (adjusted odds ratio [AOR]: 0.75; 95% confidence interval [CI]: 0.68-0.82). In comparisons among physicians, emergency physicians (AOR: 2.21; 95% CI: 1.44-3.40) and surgeons (AOR: 1.26; 95% CI: 1.05-1.52) had a higher risk for DM than other specialists. CONCLUSIONS: This study found that physicians have a lower risk for DM than the general population and emergency physicians and surgeons have a higher risk for DM than other specialists. Thus, more attention should be paid to the occupational health of these doctors.


Assuntos
Diabetes Mellitus/epidemiologia , Médicos/estatística & dados numéricos , Adulto , Idoso , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Medição de Risco , Taiwan/epidemiologia
18.
Complement Ther Clin Pract ; 36: 120-124, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383429

RESUMO

PURPOSE: To measure the frequency, type, purpose of complementary medicine (CM) use among people with diabetes mellitus. MATERIALS AND METHODS: The population of this descriptive study consisted of the patients hospitalized in the endocrine clinic of a university hospital in Eastern Turkey who were diagnosed with diabetes. Data were collected from 316 patients. RESULTS: 43.0% of the patients were using CM, and 97.0% of those using CM tried herbal methods. The patients who had variable glycated haemoglobin values (60.3%) and those who had DM-related complications (60.3%) used CM more. CONCLUSION: It was determined that CM usage was prevalent among the patients. The most frequently used CM method was herbal therapy. We found that the use of CM was more common in patients with poor metabolic control. Therefore, healthcare professionals must be assess use of CM and provide suitable counseling.


Assuntos
Terapias Complementares/estatística & dados numéricos , Diabetes Mellitus , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos , Turquia/epidemiologia
19.
West Afr J Med ; 36(2): 133-137, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385599

RESUMO

BACKGROUND: Anaemia is a common disorder occurring in about 33% of the global population. It is an important cardiovascular risk factor and a key indicator of some chronic complications of Diabetes Mellitus (DM). This study aimed to determine the burden of anaemia and its correlation with some clinical and biochemical parameters among patients with DM attending a tertiary health facility in Zaria, Northwestern Nigeria. SUBJECTS, MATERIALS AND METHODS: This was a case-control study in which 168 participants were enrolled (84 DM patients, 84 controls). It was conducted in the Endocrinology and Metabolic clinics of Ahmadu Bello University Teaching Hospital, Zaria. Consenting DM patients were enrolled consecutively and subsequently, sex- and age-matched with non-diabetic controls. Data on age, gender and Haemoglobin (Hb) concentrations were collated for all study participants. Additional data on type of DM, duration of DM once diagnosis, treatment, type of treatment, history of hypertension, chronic kidney disease, peripheral neuropathy, and Fasting Blood Sugar (FBS) were collated for all cases. Data were collated and analyzed using SPSS version 21. Level of significance was set at <0.05. Ethical approval for the study was obtained from the Institutional Health Research Ethics Committee and informed consent was obtained from the all the participants. RESULTS: Females constituted 39/84(46.4%) of each arm of the study. The mean ± SD of age for both cases and controls was 53.7 ± 8.9 years. The mean ± SD duration of DM, treatment for DM and FBS were 8.4 ± 5.7 years, 5.0 ± 3.6 years and 6.1 ± 2.5mmol/L respectively. Cases had significantly lower Hb concentration compared to controls (12.1±2.2g/dl vs. 13.1 ± 1.4g/dl, t= -3.446, p = 0.001). Overall prevalence of anaemia among cases and controls was 36/84(42.9%) vs. 26/84(31.0%) Z = 1.6, p = 0.110. Among cases, haemoglobin concentration had very weak, inverse and non-statistically significant relationships with age, duration of DM diagnosis, duration of therapy and FBS levels. There was a significant relationship between anaemia on one hand and type of DM and treatment on the other. The odds of DM patients with history of CKD or uncontrolled FBS having anaemia were OR= 0.600 (95% CI 0.196, 1.836) and OR=1.755 (95% CI 0.737, 4.181) respectively. CONCLUSION: The burden of anaemia amongst patients with DM is high in Zaria, Northwestern Nigeria, and it is associated with poor glycaemic control. Hence, the need to include haematological assessment as part of routine care of patients with DM.


Assuntos
Anemia/epidemiologia , Glicemia/análise , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobina A Glicada/análise , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Doenças do Sistema Nervoso Periférico/epidemiologia , Prevalência , Insuficiência Renal Crônica/epidemiologia
20.
Medicine (Baltimore) ; 98(32): e16687, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393370

RESUMO

Obstructive sleep apnea (OSA) has a high prevalence in patients with obesity. Only patients with clinical symptoms of OSA are admitted to polysomnography; however, many patients with OSA are asymptomatic. We aimed to create and validate a population-based risk score that predicts the severity of OSA in patients with obesity.We here report the cross-sectional analysis at baseline of an ongoing study investigating the long-term effect of bariatric surgery on OSA. One-hundred sixty-one patients of the Obesity Center of the Catholic University Hospital in Rome, Italy were included in the study. The patients underwent overnight cardiorespiratory monitoring, blood chemistry analyses, hepatic ultrasound, and anthropometric measurements. The patients were divided into 2 groups according OSA severity assessed by the apnea-hypopnea index (AHI): AHI < 15 = no or mild and AHI ≥ 15 moderate to severe OSA. A statistical prediction model was created and validated. C statistics was used to evaluate the discrimination performance of the model.The prevalence of OSA was 96.3% with 74.5% of the subjects having moderate/severe OSA. Sex, body mass index, diabetes, and age were included in the final prediction model that had excellent discrimination ability (C statistics equals to 83%). An OSA risk chart score for clinical use was created.Patients with severe obesity are at a very high risk for moderate or severe OSA in particular if they are men, older, more obese, and/or with type 2 diabetes. The OSA risk chart can be useful for general practitioners and patients as well as for bariatric surgeons to select patients with high risk of moderate to severe OSA for further polysomnography.


Assuntos
Obesidade Mórbida/fisiopatologia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Obesidade Mórbida/epidemiologia , Prevalência , Curva ROC , Análise de Regressão , Fatores de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Fatores Sexuais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA