Epidemiology Of Diabetes Research Articles

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Guideline-Consistent Antidepressant Treatment Patterns Among Veterans With Diabetes and Major Depressive Disorder

Guideline-Consistent Antidepressant Treatment Patterns Among Veterans With Diabetes and Major Depressive Disorder

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Risk of Stroke, Heart Attack, and Diabetes Complications Among Veterans With Spinal Cord Injury

Banerjea R, Sambamoorthi U, Weaver F, Maney M, Pogach LM, Findley T. Risk of stroke, heart attack, and diabetes complications among veterans with spinal cord injury. Objectives To compare the rates of diabetes and macrovascular conditions in veterans with spinal cord injury (SCI) and to examine variations by patient-level demographic, socioeconomic, access, and health status factors. Design A retrospective analysis. Diabetes status was classified by merging with diabetes epidemiology cohort using a validated algorithm. Chi-square tests and logistic regressions used to compare rates in macro- and microvascular conditions in veterans with and without diabetes. Setting Veteran Health Administration clinic users in fiscal year (FY) 1999 to FY 2001. Participants SCI patients (N=8769) with diabetes (n=1333), in FY 2000, identified through the SCI registry. Interventions Not applicable. Main Outcome Measures Macrovascular and microvascular conditions in the next year (February 2001). Derived from International Statistical Classification of Diseases, 9th Revision, Clinical Modification, codes in the patient treatment files. Results Overall, 15% of SCI veterans were identified with diabetes but this was an underestimate due to high mortality (8%). Among SCI veterans with diabetes, 49% had at least one macrovascular condition and 54% had microvascular conditions compared with 24% and 25% of those without diabetes ( P<.001). Conclusions Our study highlights the highly significant relationship between diabetes and macro- and microvascular conditions in veterans with SCI. Neurologic deficit combined with increased insulin resistance has a greater macrovascular impact on SCI veterans than on those who do not have diabetes. Increasing age and physical comorbidities compound the problem.

BMI Compared With Central Obesity Indicators in Relation to Diabetes and Hypertension in Asians

To compare BMI with waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR) in association with diabetes or hypertension. Cross-sectional data from 16 cohorts from the DECODA (Diabetes Epidemiology: Collaborative Analysis of Diagnostic criteria in Asia) study, comprising 9,095 men and 11,732 women, aged 35-74 years, of different ethnicities were included in this meta-analysis. Age-adjusted odds ratios (ORs) for diabetes in men (women) for 1 s.d. increase in BMI, WC, WHR, and WSR were 1.52 (1.59), 1.54 (1.70), 1.53 (1.50), and 1.62 (1.70), respectively; and the corresponding ORs for hypertension were 1.68 (1.55), 1.66 (1.51), 1.45 (1.28), and 1.63 (1.50). Paired homogeneity tests (BMI with each of the three) adjusted for age and cohort showed that diabetes had stronger association with WSR than BMI (P=0.001) in men but with WC and WSR than BMI (both P<0.05) in women. Hypertension had stronger association with BMI than WHR in men (P<0.001) and had the strongest with BMI than the others (WHR P<0.001; WSR P<0.01; and WC P<0.05) in women. Areas under the receiver operating characteristic (ROC) curves adjusted for age and cohort were slightly larger for diabetes for WSR 0.735 (0.748) in men (women) and WC 0.749 (women only) than BMI 0.725 (0.742) while for hypertension larger for BMI 0.760 (0.766) than WHR 0.748 (0.751), but their 95% CIs were all overlapped. WSR was stronger than BMI in association with diabetes, but these indicators were equally strongly associated with hypertension in Asians.

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Implementing a national quality assurance system for diabetes care: the Scottish Diabetes Survey 2001–2006

To create a standardized systematic quality assurance system for diabetes care throughout Scotland. Each of 15 National Health Service (NHS) boards have submitted core diabetes data for a nationally agreed data specification on an annual basis since 2001. These data are collated to produce an annual national report. We describe the iterative progress of the work in obtaining and analysing this information. The setting was Scotland, with a population of 5 million. In Scotland in 2006, 196,801 people (3.9% of the population) were reported as having diabetes compared with 105,777 in 2001. In 2006 the prevalence of reported diabetes varied from 3.5 to 4.4% in different NHS board areas, reflecting variation in completeness of local registers as well as different demographic patterns. The completeness of recording of many clinical parameters has also increased. (2002 data n = 103,755: diagnosis date 77%, HbA(1c), blood pressure and cholesterol within 15 months 71, 67 and 60%, respectively, increasing to 98, 87, 89 and 85% by 2006, n = 196,801.) A national information management and technology solution (Scottish Collaborative Information-Diabetes Care), involving automatic daily collection of data from routinely used systems both in primary and secondary care, is now used to co-ordinate the collection of data in all NHS board areas. We have used routine data to estimate the prevalence of reported diabetes in Scotland, UK. This iterative approach to quality improvement has taken 6 years to achieve a baseline measure of care. There is potential to analyse these data further for a better understanding of the epidemiology of diabetes in Scotland. The national diabetes information technology system will contribute to this process.

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Changes in the diabetic retinopathy epidemiology after 14 years in a population of Type 1 and 2 diabetic patients after the new diabetes mellitus diagnosis criteria and a more strict control of the patients

Objective To determine the differences observed between two transversal studies separated 14 years. Methods The sample was obtained by randomized hazard selection of 1157 Type 2 and 93 Type 1 diabetic patients in the 2006 study, and 741 Type 2 and 76 Type 1 diabetic patients in the 1993 study. We evaluate the prevalence of diabetic retinopathy (DR), microalbuminuria, overt nephropathy, and its risk factors. Results In Type 2 diabetic patients, we observed a decrease of the prevalence of DR from 39.41% in the 1993 study to 27.48% in the 2006 study, but we did not observe it in Type 1 diabetic patients—35.52% in 1993 to 36.55% in 2006. The diabetic macular edema prevalence is similar in both studies—7.15% in 1993 and 7.86% in 2006 in Type 2 patients, and 11.84–12.90% in Type 1; microalbuminuria decreased in Type 2 but not in Type 1 patients (from 22.13% to 17.02% in Type 2, and 28.33–27.95% in Type 1); overt nephropathy decreased in both types of diabetic patients (in Type 1, decreased from 11.84% to 8.60% and, in Type 2, from 8.63% to 6.74%). We may observe a decrease in the number of patients with blindness, from 11.20% to 4.90% in Type 2, and from 9.21% to 7.52% in Type 1 patients. Conclusions We may observe a decrease in the prevalence of DR, overt nephropathy, and blindness in Type 1 and 2 patients and a decrease in the prevalence of microalbuminuria only in Type 2 patients.

Hilary Owen Meredith King

Hilary King, who died suddenly aged 58, was an internationally renowned epidemiologist specialising in diabetes. He was born in Leeds, England, on 31 July 1949, the son of an English...

Global diabetes landscape—type 2 diabetes mellitus in South Asia: Epidemiology, risk factors, and control

Background: Type 2 diabetes mellitus (DM) is a new epidemic in South Asia and is the result of societal influences and changing lifestyles. Epidemiologic studies suggest that the prevalence of DM has increased exponentially in urban and rural populations. Objective: This study was conducted to determine trends in the prevalence of DM in various countries in South Asia. Methods: We performed an extensive, systematic MEDLINE search for primary articles that reported on the epidemiology of DM in South Asia. Additional articles were obtained from personal collections and references cited in the primary articles. No formal meta-analysis was performed because of differing methodologies and diagnostic criteria. Results: Epidemiologic studies conducted in India during the 1960s and 1970s, using random and postload blood glucose estimations, reported DM in 1% to 4% of urban populations and 1% to 2% of rural populations. More standardized epidemiologic studies in adults since the late 1980s reported DM in 5% to 15% of urban populations, 4% to 6% of semiurban populations, and 2% to 5% of rural populations. A significantly increasing trend has been observed in urban populations (exponential trend R 2 = 0.74), whereas the increase is slower (R 2 = 0.29) in rural populations. The diabetes scenario is similar in other South Asian countries. Current prevalence rates are 5% to 16% in urban areas and 2% to 8% in rural areas. Risk factors for DM in this region are increasing sedentariness, dietary excess, obesity (especially high waist-to-hip ratio), low birth weight, and genetic influences. Conclusions: DM is a major public health problem in South Asia. The prevalence is higher in urban areas than in rural areas and is increasing. Population-based measures to control the epidemic of DM include avoidance of adiposity through enhanced physical activity and regulated calorie intake. A comprehensive national chronic care program is needed.

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Evidence-based Paediatric and Adolescent Diabetes

List of contributors. Foreword. Preface. 1 Methodology of evidence-based medicine. Jeremy Allgrove (Royal London Hospital). 2 Definition, epidemiology and classification of diabetes and structure. of the diabetes team. Maria Craig (Institute of Endocrinology & Diabetes), Sarah J. Glastras (Institute of Endocrinology and Diabetes) & Kim Donaghue (The Children's Hospital at Westmead). 3 Aetiology of type 1 diabetes mellitus - genetics, autoimmunity. and trigger factors. Loredana Marcovecchio (University of Cambridge), David B. Dunger (University of Cambridge),. Mark Peakman (King's College London) & Keith W. Taylor (Barts and the London). 4 Type 1 diabetes mellitus - management. Joanne J. Spinks (John Radcliffe Hospital), Julie A. Edge (John Radcliffe Hospital), Krystyna Matyka (Clinical Sciences Research Institute) & Shital Malik (Paediatric Specialist Registrar). 5 Type 1 diabetes mellitus in the very young child. Stuart Brink (Tufts University School of Medicine). 6 Adolescence and diabetes: clinical and social science perspectives. Alexandra Greene (University of Aberdeen) & Stephen Greene (Maternal and Child Health Sciences). 7 Management of special situations in diabetes. Fergus J. Cameron (Department of Endocrinology and Diabetes) & Jeremy Allgrove (Royal London Hospital). 8 Dietary management: optimising diabetes outcomes. Sheridan Waldron (Leicestershire Nutrition and Dietetic Service). 9 Education in childhood diabetes. Peter G.F. Swift (Leicester Royal Infirmary). 10 Psychological interventions in childhood diabetes. John W. Gregory (Cardiff University) & Sue Channon (Consultant Clinical Psychologist). 11 Screening for associated conditions and prevention of complications. Catherine Peters (SpR Paediatric Endocrinology) & Jeremy Allgrove (Royal London Hospital). 12 Type 2 diabetes mellitus - genetics, diagnosis and management. Polycystic ovarian syndrome. John Porter (Birmingham Children's Hospital) & Timothy G. Barrett (Institute of Child Health). 13 Rare forms of diabetes. Julian Shield (University of Bristol), Maciej T. Malecki (Jagiellonian University), Nicola A. Bridges (Chelsea and Westminster Hospital) & Jeremy Allgrove (Royal London Hospital). 14 Diabetes and information technology. Kenneth J. Robertson (Royal Hospital for Sick Children). Abbreviations. Index

Epidemiology of Diabetes Mellitus in German General Practitioners' Consultation - Results of the SESAM 2-study

The treatment of chronic diseases is of eminent importance in primary care, and type 2-diabetes mellitus is one of the most common dysfunctions. Its world-wide prevalence has been increasing from year to year. Thus, to estimate the prevalence and incidence of diabetes mellitus, we performed the SESAM (Sächsiche epidemiologische Studie in der Allgemeinmedizin) 2-study in cooperation with general practitioners (GPs) from the German state of Saxony; 270 of the 2510 (10.8%) solicited physicians participated. Cross-sectional data were collected from 1 October 1999 until 30 September 2000, from randomly selected patients previously known to the practitioner. From a total of 8877 consultations with 270 GPs, diabetes was prevalent in 14% (n = 1241) of the patients and the incidence was 0.3% (27 of 8877 cases). The consultation prevalence was estimated at 14.3% (n = 1268; CI 13.6-15%). Of the diabetic patients, 3.5% (n = 44) suffered from type 1-diabetes, while type 2-diabetes was found in 66.9% (n = 848) of the cases. "Other diabetes" was determined in 19.2% (n = 244), and "not further specified diabetes", in 10.4% (n = 132) of the cases. Related to the German population in general, the prevalence ranged from 7.9 to 9.2%. The estimated consultation prevalence is about four times higher than that in other European countries. These data are of importance in illustrating the epidemiology of diabetes in the population and the direct repercussions for GPs. They also point out the significance of diabetes as a major challenge to the German health care system.

Endocrine-Related Resources from the National Institutes of Health

Endocrine-Related Resources from the National Institutes of Health

Dissertation List

Dissertation List Jonathan Erlen and Jay Toth January 2006 Ackley, Kristina Lyn. "We are Oneida yet: Discourse in the Oneida land claim." PhD diss., SUNY at Buffalo, 2005. Alessi, Joseph P. "Settling America: Indians, Euroamericans, and the establishment of the frontier towns, 1600-1830." PhD diss., St. Louis University, 2005. Atine, Christine D. "The experience of Navajo families living with the stigma of mental illness: A phenomenological study." PhD diss., University of Denver, 2005. Davis, James Joe, Jr. "The effects of coalition building on Public Law 93-531: The Navajo and Hopi Land Settlement Act of 1974." PhD diss., University of Arizona, 2005. De Leon, Diana Fisher. "A study on forging a new front and building a new vision for tribal environmental health policy on the Colorado River Indian Reservation." PhD diss., University of Arizona, 2005. Denial, Catherine Jane. "A proper light before the country: The shifting politics of gender and kinship among the Dakota, Ojibwe and non-Native communities of the Upper Midwest, 1825-1845." PhD diss., University of Iowa, 2005. Evans, Lara M. "One of these things is not like the other: Works by Native performance artists James Luna, Greg Hill, and Rebecca Bemore." PhD diss., University of New Mexico, 2005. Fitzgerald, Barbara J. "Gender equity and technology use in K-5 classrooms in a Native American school." PhD diss., Walden University, 2005. Funk, Caroline L. "Evolutionary and cognitive influences on hunter-gatherer settlement location in the Yukon-Kuskokwim Delta of Alaska." PhD diss., University of Wisconsin, 2005. [End Page 549] George, Maggie L. "The promise of indigenous education: A case study of Navajo bilingual-bicultural teachers." PhD diss., University of Kansas, 2005. Green, Chris. "The epidemiology of diabetes in Manitoba: An exploration through time and space." PhD diss., University of Manitoba, 2005. Kipp, Billie Jo. "Crystallized versus fluid intelligence in American Indian children referred to developmental clinics: An examination of multiple measures and indicators." PhD diss., University of Montana, 2005. Krahe, Diane L. "Last refuge: The uneasy embrace of Indian lands by the national wilderness movement, 1937-1965." PhD diss., Washington State University, 2005. Labreche, Yves. "Appropriation et conservation des resources alimentaires chez les Inuit de Kangiqsujuaq-Salliuit, Québec arctique: Perspective ethnoarchéologique." PhD diss., Université de Montréal, 2005. Lambe, Jeffrey P. "We plant a tree of peace: Mohawk Chief Jake Swamp's narratives, dynamics of relationships, and principles of peace." PhD diss., Trent University, 2005. Lang, Martin Joeseph. "Conspicuous absence, quiet presence: Representations of American Indians and gaming in Minnesota's mainstream and Indian-produced newspapers." PhD diss., University of Minnesota, 2005. Larcombe, Linda Anne. "Native North American resistance and susceptibility to infectious diseases: An anthropological approach." PhD diss., University of Manitoba, 2005. Manuelito-Kervliet, Cassandra. "Widening the circle: Mentoring and the learning process for American Indian women in tribal college administration." PhD diss., University of Oregon, 2005. McGlennen, Molly Suzanne. "It is evidence of faith to create: Spirituality and contemporary Native American women's poetics." PhD diss., University of California, 2005. Milligan, Marianne I. "Menominee prosodic structure." PhD diss., University of Wisconsin, 2005. Pauli, Wayne E. "The Native American digital divide: A preliminary investigation of an undergraduate population in South Dakota." PhD diss., Capella University, 2005. Powell, Francis J. "Assessing the identity of black Indians in Louisiana: A quantitative and qualitative analysis." PhD diss., Louisiana State University and Agricultural and Mechanical College, 2004. Ramos, Frances Lourdes. "The politics of ritual in Puebla de los Angeles, Mexico, 1695-1775." PhD diss., University of Texas, 2005. Robertson, Carmen Lee. "Reel artists: National Film Board of Canada portrayals of contemporary Aboriginal and Inuit artists and their art." PhD diss., University of Calgary, 2005. [End Page 550] Stock, Karen S. E. "The Skownan First Nation model for sustainable development and Aboriginal stewardship." PhD diss., University of Manitoba, 2005. Tronsen, Beverly Kay. "The rhetoric of disappearances: Racialized discourse and the Cherokee Removal." PhD diss., Washington State University, 2005. Vermilion, Mary R. "The Loyd site (11 MS 74): A prehistoric Moorehead phase nodal site." PhD diss., University of Illinois, 2005. Wilmerding, Mary Elizabeth Gesek. "The cultural sequence at the Nunik site, Chernabura Island, Alaska." PhD diss., Washington State University, 2005. February 2006 Andersen, Christian. "Courting colonialism? The juridical construction...

Cardiovascular risk profile of subjects with known diabetes from the middle‐ and high‐income group population of Delhi: the DEDICOM survey

To determine the cardiovascular risk profile of known diabetic patients from the middle- and high-income group populace of Delhi. A cross-sectional survey was conducted using a probability proportionate to size (systematic) two-stage cluster design. Thirty areas were selected for a house-to-house survey to recruit a minimum of 25 subjects (known diabetes > or = 1 year; 35-65 years of age) per area. Data were collected by interview, blood sampling and from medical records. Scores from the Framingham, Joint British Society, United Kingdom Prospective Diabetes Study, Systematic Coronary Risk Evaluation, and Diabetes Epidemiology: Collaborative Analysis Of Diagnostic Criteria in Europe studies were used to calculate summary estimates of risk for coronary heart disease (CHD) and stroke. Eight hundred and nineteen subjects (25-30 per cluster) were enrolled. The mean age of the subjects was 53.6 years, the mean duration since diagnosis was 8.1 years, the mean body mass index was 28.1 kg/m(2), with 50.7% women; 74.3% had hypertension, 75.1% dyslipidaemia and 41.8% had poor glycaemic control (HbA(1c) > 8.0%); 8.4% had already had a myocardial infarction, whereas 2.3% had suffered a stroke. Only 17.6% were taking aspirin, 3.4% were on lipid-lowering drugs and 11.6% were taking antihypertensive agents. The risk engines estimated a 10-year CHD risk of 12.6-13.9% and a stroke risk of 5.1-5.7%. The study documents that the cardiovascular profile of known diabetes patients from the middle and higher income groups of Delhi is poor, strengthening the case for targeting interventions at patients, providers and other stakeholders for improvement.

Prevalence of Diabetes and Diabetes-related Complications in First Nations Communities in Northern Quebec (Eeyou Istchee), Canada

ABSTRACT OBJECTIVE This study presents an overview of the epidemiology and clinical management of diabetes in the Cree population of Eeyou Istchee, Eastern James Bay, Quebec, Canada. METHODS This descriptive study is based on data from the Cree Diabetes Information System, a unique diabetes management and surveillance system in the region that provides demographic and clinical data on physician-diagnosed cases of type 1 and 2 diabetes among the Cree of Eastern James Bay. RESULTS In July 2005, 1363 Cree were living with physician-diagnosed diabetes in Eeyou Istchee (17.3% crude prevalence age ≥ 20 years). The age-adjusted prevalence of diabetes among the Cree population (age ≥ 20 years) was 22.4%, 3.5 times higher than the Quebec age-adjusted diabetes prevalence of 6.4% (2003—2004). The crude prevalence of diabetes in Eeyou Istchee has increased by 330% in the past 16 years, from 5.2% of Cree adults (age ≥ 20 years) in 1989 to 17.3%. Those age CONCLUSION The increasing numbers of young adults with newly diagnosed diabetes in the Cree region of Eeyou Istchee and the high rates of existing diabetic nephropathy are alarming health concerns from clinical and public health perspectives.

162 - Active Dissemination of the Alberta Diabetes Surveillance System: Local Information for Local Planning.

Increasing Incidence and Prevalence of Diabetes Among Status Aboriginal Men in Rural and Urban Alberta, 1995 to 2006. JEFFREY A. JOHNSON, STEPHANIE U. VERMEULEN, GREG HUGEL, ELLEN TOTH, BRENDA R. HEMMELGARN, KELLI RALPH-CAMPBELL, MALCOLM KING. School of Public Health, University of Alberta, Edmonton, AB. Institute of Health Economics, Edmonton, AB, Department of Medicine, University of Alberta, Edmonton, AB, Department of Medicine, University of Calgary, Calgary, AB. The increase in diabetes rates among Status Aboriginal (SA) Canadians is well documented. Less is known about the epidemiology of diabetes for this population by location of residence. Trends of diabetes incidence and prevalence between SA men and women living in urban and rural areas of Alberta were compared. The Alberta Diabetes Surveillance System (ADSS) tracks diabetes population trends using diagnostic codes from administrative records from Alberta Health and Wellness (AHW) (1995 to 2006 in adults aged >20 years). Aboriginal Status was identified as registered Indians in the AHW Stakeholder Registry. Location of residence was defined by postal code. Multivariable logistic regression was used to compare prevalence and incidence rates over time, by sex and location of residence. Age-sex adjusted diabetes prevalence increased 35%, from 10.9% (10.4-11.5) in 1995 to 14.7% (14.2-15.2) in 2006 in rural SA and 22%, from 9.4% (8.5-10.3) in 1995 to 11.5% (10.9-12.1) in 2006 among urban SA. The greatest increases were for men, at 40% and 43% compared to 12% and 30% for women (p<0.0001), in urban and rural settings, respectively. SA men with urban residences had the greatest increase in diabetes incidence at 45%, from 7.4 (4.9-10.6) per 1000 in 1995 to 10.7 (8.3-13.5) per 1000 in 2006. Incidence increased 25% for SA women in urban locations, but did not significantly change for women in rural locations (p=0.109). Significant increases in incidence and prevalence of diabetes over the past decade were observed amongst the SA population in Alberta. Prevalence and incidence were highest in SA women, but these rates have increased faster in men over the past decade, regardless of where they lived. ABSTRACT #29