Increasing Prevalence Of Diabetes Research Articles

Maternal PBDE exposure disrupts gut microbiome and promotes hepatic proinflammatory signaling in humanized PXR-transgenic mouse offspring over time.

Developmental exposure to the persistent environmental pollutant, polybrominated diphenyl ethers (PBDEs), is associated with increased diabetes prevalence. The microbial tryptophan metabolite, indole-3-propionic acid (IPA), is associated with reduced risk of type 2 diabetes and lower-grade inflammation and is a pregnane X receptor (PXR) activator. To explore the role of IPA in modifying the PBDE developmental toxicity, we orally exposed humanized PXR-transgenic (hPXR-TG) mouse dams to vehicle, 0.1 mg/kg/day DE-71 (an industrial PBDE mixture), DE-71+IPA (20 mg/kg/day), or IPA, from 4 weeks preconception to the end of lactation. Pups were weaned at 21 days of age and IPA supplementation continued in the corresponding treatment groups. Tissues were collected at various ages until 6 months of age (n = 5 per group). In general, the effect of maternal DE-71 exposure on the gut microbiome of pups was amplified over time. The regulation of hepatic cytokines and prototypical xenobiotic-sensing transcription factor target genes by DE-71 and IPA was age- and sex-dependent, where DE-71-mediated mRNA increased selected cytokines (Il10, Il12p40, Il1β [both sexes], and [males]). The hepatic mRNA of the aryl hydrocarbon receptor (AhR) target gene Cyp1a2 was increased by maternal DE-71 and DE-71+IPA exposure at postnatal day 21 but intestinal Cyp1a1 was not altered by any of the exposures and ages. Maternal DE-71 exposure persistently increased serum indole, a known AhR ligand, in age- and sex-dependent manner. In conclusion, maternal DE-71 exposure produced a proinflammatory signature along the gut-liver axis, including gut dysbiosis, dysregulated tryptophan microbial metabolism, attenuated PXR signaling, and elevated AhR signaling in postweaned hPXR-TG pups over time, which was partially corrected by IPA supplementation.

Transportation-related Environmental Mixtures and Diabetes Prevalence and Control in Urban/Metropolitan Counties in the United States.

Diabetes rates in the United States are staggering and climbing. Importantly, traditional risk factors fail to completely account for the magnitude of the diabetes epidemic. Environmental exposures, including urban and metropolitan transportation quality, are implicated as contributors to disease. Using data from the county-level Environmental Quality Index (EQI) developed for the United States, we analyzed associations between transportation and air quality environmental metrics with overall diabetes prevalence and control within urban/metropolitan counties in the United States from 2006 to 2012. Additionally, we examined effect modification by race/ethnicity through stratification based on the county-level proportion of minority residents. Last, we applied mixture methods to evaluate the effect of simultaneous poor transportation factors and worse air quality on the same outcomes. We found that increased county-level particulate matter air pollution and nitrogen dioxide along with reduced public transportation usage and lower walkability were all associated with increased diabetes prevalence. The minority proportion of the population influences some of these relationships as some of the effects of air pollution and the transportation-related environment are worse among counties with more minority residents. Furthermore, the transportation and air quality mixtures were found to be associated with increased diabetes prevalence and reduced diabetes control. These data further support the burgeoning evidence that poor environments amplify diabetes risk. Future cohort studies should explore the utility of environmental policies and urban planning as tools for improving metabolic health.

Quantifying the contribution of 31 risk factors to the increasing prevalence of diabetes among US adults, 2005-2018.

No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States. This study aimed to determine the extent to which an increase in the prevalence of diabetes was related to concurrent changes in the distribution of diabetes-related risk factors among US adults (aged 20 years or above and not pregnant). Seven cycles of series of cross-sectional National Health and Nutrition Examination Survey data between 2005-2006 and 2017-2018 were included. The exposures were survey cycles and seven domains of risk factors, including genetic, demographic, social determinants of health, lifestyle, obesity, biological, and psychosocial domains. Using Poisson regressions, percent reduction in the β coefficient (the logarithm used to calculate the prevalence ratio for prevalence of diabetes in 2017-2018 vs. 2005-2006) was computed to assess the individual and collective contribution of the 31 prespecified risk factors and seven domains to the growing burden of diabetes. Of the 16,091 participants included, the unadjusted prevalence of diabetes increased from 12.2% in 2005-2006 to 17.1% in 2017-2018 [prevalence ratio: 1.40 (95% CI, 1.14-1.72)]. Individually, genetic domain [17.3% (95% CI, 5.4%-40.8%)], demographic domain [41.5% (95% CI, 24.4%-76.8%)], obesity domain [35.3% (95% CI, 15.8%-70.2%)], biological domain [46.2% (95% CI, 21.6%-79.1%)], and psychosocial domain [21.3% (95% CI, 9.5%-40.1%)] were significantly associated with a different percent reduction in β. After adjusting for all seven domains, the percent reduction in β was 97.3% (95% CI, 62.7%-164.8%). The concurrently changing risk factors accounted for the increasing diabetes prevalence. However, the contribution of each risk factor domain varied. Findings may inform planning cost-effective and targeted public health programs for diabetes prevention.

Association of urinary iodine concentration with prediabetes/diabetes in adults: Analysis of the NHANES 2005–2016

Background & AimsIodine is required for synthesizing thyroid hormones and regulating human metabolism. Iodine deficiency can lead to thyroid function abnormalities, which are closely associated with disturbances in glucose-insulin homeostasis. Research on the relationship between iodine and diabetes/prediabetes in adults was sparse and inconsistent. We assessed trends in urinary iodine concentration (UIC) and diabetes/prediabetes prevalence and focused on the association between iodine and diabetes/prediabetes among U.S. adults. MethodsWe analyzed the National Health and Nutrition Examination Survey (NHANES) data from the 2005–2016 cycles. Linear regression was employed to evaluate UIC and prediabetes/diabetes prevalence trends over time. Both multiple logistic regression and restricted cubic splines (RCS) were performed to evaluate the association of UIC with diabetes/prediabetes. ResultsA distinctly declining trend in median UIC and a significant increase in diabetes prevalence in U.S. adults from 2005 to 2016 were observed. The fourth quartile of UIC was associated with a 30% lower risk for prediabetes, compared with the first quartile (OR=0.70, 95% CI: 0.56–0.86, Ptrend=0.001). However, UIC was not significantly associated with the prevalence of diabetes. The RCS model suggested a significant nonlinear relationship between UIC and the risk of diabetes (P for nonlinearity =0.0147). Stratification analysis showed that the negative associations of UIC with the risk of prediabetes were more pronounced in participants who were men, aged 46–65, overweight, light alcohol drinkers, and nonactive smokers. ConclusionsOverall, the adults’ median UIC in the U.S. population was a declining trend. However, diabetes prevalence increased significantly from 2005 to 2016. Higher UIC was associated with a lower risk of prediabetes.

Socioeconomic inequalities in diabetes prevalence: the case of South Africa between 2003 and 2016

BackgroundDiabetes is a growing epidemic worldwide and the effect of socioeconomic status (SES) is frequently acknowledged in the literature. This study aims to compare the effect of SES on diabetes prevalence in South Africa between 2003 and 2016. In addition, vulnerable groups regarding diabetes development in 2016 will be identified.MethodsUsing DHS data there were 8,006 participants (59.19% women) in 2003 and 10,292 participants (59.42% women) in 2016. Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for diabetes by age, gender, educational level and place of residence. To identify vulnerable groups with high risk of developing diabetes in 2016, the method of p-value based regression tree analysis was applied using “wealth index” and “weight perception” as additional variables.ResultsThere was an increase in diabetes prevalence from 3.86% in 2003 to 4.46% in 2016. Women had more risk of developing diabetes at both time points (27% in 2003 and 24% in 2016 more risk). Increase in age and living in urban areas were associated with more risk of developing diabetes at both time points. There was no specific pattern regarding risk of developing diabetes and educational level in case of women. However, men who completed secondary school or had a higher diploma or above had more risk of developing diabetes in 2016 (OR = 2.24 and 4.67 respectively). Vulnerable groups who have higher risk of developing diabetes in 2016 were participants aged “60 years or older” with a wealth index of “rich” or “richer”, followed by participants from the same age group who were “poor” or “poorer” and participants aged “40–59 years” with a wealth index of “rich” or “richer”. Subsequently were participants from the age group “15–39 years” with a weight perception of “overweight” or “obese”.ConclusionDiabetes prevalence increased in South Africa between 2003 and 2016. Main risk factors were age, gender and living in urban areas. Men with high educational level were more at risk of developing diabetes in 2016. Vulnerable groups in 2016 were participants 40 years and older, particularly with high SES. This was followed by younger participants who were obese or overweight.

Drug-induced mitochondrial toxicity: Risks of developing glucose handling impairments.

Mitochondrial impairment has been associated with the development of insulin resistance, the hallmark of type 2 diabetes mellitus (T2DM). However, the relationship between mitochondrial impairment and insulin resistance is not fully elucidated due to insufficient evidence to support the hypothesis. Insulin resistance and insulin deficiency are both characterised by excessive production of reactive oxygen species and mitochondrial coupling. Compelling evidence states that improving the function of the mitochondria may provide a positive therapeutic tool for improving insulin sensitivity. There has been a rapid increase in reports of the toxic effects of drugs and pollutants on the mitochondria in recent decades, interestingly correlating with an increase in insulin resistance prevalence. A variety of drug classes have been reported to potentially induce toxicity in the mitochondria leading to skeletal muscle, liver, central nervous system, and kidney injury. With the increase in diabetes prevalence and mitochondrial toxicity, it is therefore imperative to understand how mitochondrial toxicological agents can potentially compromise insulin sensitivity. This review article aims to explore and summarise the correlation between potential mitochondrial dysfunction caused by selected pharmacological agents and its effect on insulin signalling and glucose handling. Additionally, this review highlights the necessity for further studies aimed to understand drug-induced mitochondrial toxicity and the development of insulin resistance.

Common procedures and conditions leading to inpatient hospital admissions in adults with and without diabetes from 2015 to 2019 in Germany : Acomparison of frequency, length of hospital stay and complications.

To evaluate common surgical procedures and admission causes in inpatient cases with diabetes in Germany between 2015 and 2019 and compare them to inpatient cases without diabetes. Based on the German diagnosis-related groups (G-DRG) statistics, regression models stratified by age groups and gender were used to calculate hospital admissions/100,000individuals, hospital days as well as the proportion of complications and mortality in inpatient cases ≥ 40years with or without adocumented diagnosis of diabetes (type1 or type2). A total of 14,222,326 (21%) of all inpatient cases aged ≥ 40years had adiagnosis of diabetes. More middle-aged females with vs. without diabetes/100,000individuals [95% CI] were observed, most pronounced in cases aged 40-< 50years with myocardial infarction (305 [293-319] vs. 36 [36-37], p < 0.001). Higher proportions of complications and longer hospital stays were found for all procedures and morbidities in cases with diabetes. Earlier hospitalizations, longer hospital stays and more complications in inpatient cases with diabetes together with the predicted future increase in diabetes prevalence depict huge challenges for the German healthcare system. There is an urgent need for developing strategies to adequately care for patients with diabetes in hospital.

Trends in the Prevalence of Lean Diabetes Among U.S. Adults, 2015-2020.

To examine trends and prevalence of lean diabetes among adults in the U.S. from 2015 to 2020, overall and stratified by age, sex, and race/ethnicity. An exploratory study design evaluated the prevalence and trends of lean diabetes among 2,630,463 (unweighted) adults aged ≥18 years who responded to the Behavioral Risk Factor Surveillance System (BRFSS), years 2015 to 2020. Diabetes increased significantly among lean adults with BMI of <25 kg/m2 from 4.5% (95% CI 4.3-4.7) in 2015 to 5.3% (95% CI 5.0-5.7) in 2020, representing a 17.8% increase (odds ratio 1.21; 95% CI 1.12-1.31), with no significant change among overweight/obese adults. Increases in diabetes prevalence among lean adults varied by subgroup with Black, Hispanic, and female populations seeing the largest growth. The prevalence of lean diabetes among the U.S. adult population is increasing, with larger increases among women and populations of color.

A study protocol for a cluster randomized controlled trial to test the applicability of the South African diabetes prevention program in the Eastern Cape Province of South Africa

BackgroundConvincing evidence supports the effectiveness of lifestyle interventions in preventing the occurrence of diabetes in high-income countries, however little is known about appropriate interventions for use in African countries, where there are higher relative increases in diabetes prevalence. The South African Diabetes Prevention Programme (SA-DPP) was initiated with the aim of preventing or delaying the occurrence of diabetes among South Africans (SAs), through interventions, targeting lifestyle changes related to diet and physical activity. The purpose of the current project is to implement and evaluate the suitability and applicability of the SA-DPP developed and tailored in urban populations in the Western Cape Province, in peri-urban populations in the Eastern Cape Province of SA.MethodsThe SA-DPP, which is an cluster randomized control trial, will be implemented in adults aged 30–65 years residing in the OR Tambo district, Eastern Cape, SA. Participants will be recruited using self-selected sampling techniques and 24 clusters across peri-urban communities will be randomly allocated to participate in the lifestyle intervention, facilitated by non-professional health workers (NPHW). The diabetes risk screening will follow a two-staged approach, including the community-based screening, using the African diabetes risk score (ADRS), followed by a clinic-based risk status assessment by an oral glucose tolerance test (OGTT) to exclude unknown diabetes. The lifestyle-change objectives of the current programme relate to, 1) < 30% of total energy intake from fat; 2) < 10% of total energy intake from saturated fat; 3) > 15 g of fibre/1000 kcal; 4) > 4 h/week moderate level of physical activity; and 5) > 2% body mass index (BMI) reduction.DiscussionThe SA-DPP could represent a successful model for the prevention of diabetes and potentially other lifestyle-related diseases in SA and other countries in the region that are confronted with similar challenges.Trial registrationPACTR202205591282906.

The diabetes epidemic in Malta

Aim: The small European Mediterranean island state of Malta is a highly prevalent type 2 diabetes (T2DM) country. Over recent decades drastic environmental, cultural and ethnic changes occurred and it was considered timely to undergo a cross-sectional survey to establish up-to-date prevalence of T2DM, its socio-geographical distribution and ultimately estimating the economic burden of T2DM. Methods: A health examination survey was conducted (2014-16) including a representative sample of the adult population stratified by 18-70 years, gender and locality (n=3,947; males n=1,997 male). The survey consisted of a socio-demographic questionnaire, various health examination measurements and blood samples for fasting blood glucose (FBG). Prevalence for T2DM (depending on medical history, medication and FBG &gt;7mmol/L) were calculated for the general population as well as for each of the districts making up the Maltese Islands. The economic burden of T2DM for 2017 and projected burden for 2045 were calculated using secondary sources and by incorporating 2% compound interest per annum respectively. Results: A total response rate of 47.15% was obtained, with a mean age of 48 years for males and 46 years for females. Out of the total adjusted population (n=3,947, male n=1,998), the prevalence of T2DM was of 10.31%, with 6.31% already known to have T2DM while 4% were newly diagnosed. Females were diagnosed with T2DM at an earlier age than the males. No significant geographical T2DM prevalence differences were established. The total annual diabetes health care expenditure was approximately €107,316,517.82 for 2017, while the projected expenditure for 2045 was estimated at €244,136,040. Conclusion: Malta is a country with a high prevalence of diabetes. The females were observed to be at an earlier risk of developing undiagnosed diabetes compared to males. Although geographical location did not appear to have significant effect on T2DM distribution, this disease contributes to a high economic burden. The expected exponential increase in diabetes prevalence is subsequently expected to affect negatively the healthcare expenditure. This puts forward the recommendation for development of early screening programmes as part of preventive action strategies.

Prediction of diabetes prescription volumes of various geographies using regression techniques.

Background: Increasing diabetes prevalence is a major public health concern. In this study we ask whether linked open data can be used to predict prescription volumes of drugs used in the treatment of diabetes across small geographies of England. Methods: We propose and demonstrate a methodology of utilising publicly available open data to infer the geo-spatial distribution of prescribed drugs for diabetes, at the lower layer super output area level. Multiple datasets are acquired, processed, and linked together, enabling a more in-depth analysis. Combining these linked datasets with published deprivation factors of geographies across England, we build highly predictive regression models. Results: Regression models were trained and are capable of accurately predicting diabetes prescribing volumes based on deprivation indicators of various geographies across England. Models built with data covering the city of Bradford, England, produced a predicted against actual correlation value of R2 = 0.672 using multiple linear regression and 0.775 using Least Absolute Shrinkage and Selection Operator (LASSO). Median age and air quality factors proved to be significant markers for diabetes prescribing. Conclusions: The results of this study suggest our methodology is robust and accurate. Such predictive models are useful to health authorities in light of increasing costs and increasing prevalence of diabetes. While using publicly available open data negates any issues of data privacy.

Prevalence of type 1 and type 2 diabetes in children and adolescents in Germany from 2002 to 2020: A study based on electronic health record data from the DPV registry.

To provide estimates of the nationwide prevalence of type 1 diabetes (T1D) and type 2 diabetes (T2D) in individuals younger than 20 years of age in Germany from 2002 to 2020 and to identify trends. Data were obtained from the electronic health record "Diabetes Prospective Follow-up Registry (DPV)" specific to diabetes care. Prevalence was estimated based on prevalent cases at the end of each year for the years 2002, 2008, 2014, and 2020 per 100 000 persons assuming a Poisson distribution and directly age- and/or sex-standardized to the population in 2020. Individuals younger than 20 years of age with a clinical diagnosis of T1D or 10-19-year-olds with T2D were eligible for inclusion in the study. The standardized T1D prevalence per 100 000 persons was 138.9 (95% CI: 137.1; 140.6) in 2002 and 245.6 (243.1; 248.0) in 2020. The standardized T2D prevalence per 100 000 persons was 3.4 (3.1; 3.8) in 2002 and 10.8 (10.1; 11.5) in 2020. The annual percent change (APC) in prevalence declined over the three periods 2002-2008/2008-2014/2014-2020 (T1D: 6.3% [3.6%; 9.0%]/3.1% [0.7%; 5.5%]/0.5% [-1.7%; 2.85], T2D: 12.3% [5.3%; 20.8%]/4.7% [-0.6%; 10.3%]/3.0% [-1.8%; 8.0%]). From 2014 to 2020, the highest APCs were observed among 15-19-year-olds (T1D: 2.5% [1.3%; 3.6%], T2D: 3.4% [-0.5%; 7.5%]). The increase in diabetes prevalence has slowed, but medical care should be prepared for an increase in adolescents with diabetes.

Changes in prevalence and the cascade of care for type 2 diabetes over ten years (2005-2015): results of two nationally representative surveys in Mozambique

BackgroundSub-Saharan Africa is predicted to have the steepest increase in the prevalence of diabetes in the next 25 years. The latest Mozambican population-based STEPS survey (STEPS 2005) estimated a 2.9% prevalence of diabetes in the adult population aged 25-64 years. We aimed to assess the change in prevalence, awareness, and management of diabetes in the national STEPS survey from 2014/2015 compared to 2005.MethodsWe conducted an observational, quantitative, cross-sectional study following the WHO STEPS surveillance methodology in urban and rural settings, targeting the adult population of Mozambique in 2015. We collected sociodemographic data, anthropometric, and 12 hour fasting glucose blood samples in a sample of 1321 adults. The analysis consisted of descriptive measures of the prevalence of impaired fasting glucose (IFG), diabetes and related risk factors by age group, sex, and urban/rural residence and compared the findings to those of the 2005 survey results.ResultsThe prevalence of IFG and diabetes was 4.8% (95CI: 3.6-6.3) and 7.4% (95CI: 5.5-10.0), respectively. These prevalence of IFG and diabetes did not differ significantly between women and men. The prevalence of diabetes in participants classified with overweight/obesity [10.6% (95CI: 7.5-14.6)] and with central obesity (waist hip ratio) [11.0% (95CI: 7.4-16.1)] was almost double the prevalence of their leaner counterparts, [6.3% (95CI, 4.0-9.9)] and [5.2% (95CI: 3.2-8.6)], respectively. Diabetes prevalence increased with age. There were 50% more people with diabetes in urban areas than in rural. Only 10% of people with diabetes were aware of their disease, and only 44% of those taking oral glucose-lowering drugs. The prevalence of IFG over time [2.0% (95CI: 1.1-3.5) vs 4.8% (95CI: 3.6-6.3)] and diabetes [2.9% (95CI: 2.0-4.2) vs 7.4% (95CI: 5.5-10.0)] were more than twofold higher in 2014/2015 than in 2005. However, awareness of disease and being on medication decreased by 3% and by 50%, respectively. Though this was not statistically significant.ConclusionsWhile the prevalence of diabetes in Mozambique has increased from 2005 to 2015, awareness and medication use have declined considerably. There is an urgent need to improve the capacity of primary health care and communities to detect, manage and prevent the occurrence of NCDs and their risk factors.

Cardiometabolic Risk in Asian Americans by Social Determinants of Health: Serial Cross-sectional Analyses of the NHIS, 1999-2003 to 2014-2018.

Diabetes and hypertension are common in Asian Americans and vary by subgroup. There may be further variation by social determinants of health (SDOHs), but few studies have examined this previously. To examine the associations of SDOHs and diabetes and hypertension within and across Asian subgroups in the USA DESIGN: Series cross-sectional analyses SETTING: National Health Interview Surveys (NHIS) from 1999 to 2018 PARTICIPANTS: Asian-American adults (Chinese, Filipino, Asian Indian, and Other Asian [Korean, Vietnamese, Japanese, and other]) MEASUREMENTS: Self-reported diabetes and hypertension prevalence in pooled 5-year increments over 1999-2018 and multivariable regression models to assess the adjusted prevalence of diabetes or hypertension by poverty, marital status, education, and years in the USA, adjusting for age, sex, BMI, and health insurance status RESULTS: From 1999-2003 to 2014-2018, the age- and sex-adjusted prevalence of diabetes increased for Other Asians (absolute change: 4.6%) but not for other subgroups; age- and sex-adjusted hypertension prevalence significantly increased for Asian Indians and Other Asians (absolute change: 5-7.5%). For Filipinos, high school education or less was associated with an increase in diabetes prevalence over time (difference from 1999-2003 to 2014-2018: +6.0 (95% CI: 2.0-10.0)), while for Asian Indians, college education or higher was associated with an increase in diabetes prevalence for the same period (difference: +2.7 (95% CI: 0.01-5.4). Differences over the 2 time periods (1999-2003 and 2014-2018) show that Filipino and Other Asians, who lived in the USA for ≥10 years, increased in diabetes prevalence. Similar variations in associations of SDOHs by Asian subgroup were seen for hypertension. Self-reported primary outcomes and multi-year data were pooled due to small sample sizes. The influence of SDOHs on cardiometabolic risk is not uniform among Asian Americans, implying tailored strategies may be needed for different population subgroups. NIH.

Diabetes outcomes in heart failure patients with hypertrophic cardiomyopathy.

Aims: We aimed to assess diabetes outcomes in heart failure (HF) patients with hypertrophic cardiomyopathy (HCM). Methods: The National Inpatient Sample database was analyzed to identify records from 2005 to 2015 of patients hospitalized for HF with concomitant HCM. We examined the prevalence of diabetes in those patients, assessed the temporal trend of in-hospital mortality, ventricular fibrillation, atrial fibrillation, and cardiogenic shock and compared diabetes patients to their non-diabetes counterparts. Results: Among patients with HF, 0.26% had HCM, of whom 29.3% had diabetes. Diabetes prevalence increased from 24.8% in 2005 to 32.7% in 2015. The mean age of patients with diabetes decreased from 71 ± 13 to 67.6 ± 14.2 (p < 0.01), but the prevalence of cardiovascular risk factors significantly increased. In-hospital mortality decreased from 4.3% to 3.2% between 2005 and 2015. Interestingly, cardiogenic shock, VF, and AF followed an upward trend. Age (OR = 1.04 [1.03-1.05]), female gender (OR = 1.50 [0.72-0.88]), and cardiovascular risk factors were associated with a higher in-hospital mortality risk in diabetes. Compared to non-diabetes patients, the ones with diabetes were younger and had more comorbidities. Unexpectedly, the adjusted risks of in-hospital mortality (aOR = 0.88 [0.76-0.91]), ventricular fibrillation (aOR = 0.79 [0.71-0.88]) and atrial fibrillation (aOR 0.80 [0.76-0.85]) were lower in patients with diabetes, but not cardiogenic shock (aOR 1.01 [0.80-1.27]). However, the length of stay was higher in patients with diabetes, and so were the total charges per stay. Conclusion: In total, we observed a temporal increase in diabetes prevalence among patients with HF and HCM. However, diabetes was paradoxically associated with lower in-hospital mortality and arrhythmias.

Epidemiological characteristics of diabetes mellitus in Korea

Background: The estimated prevalence of diabetes mellitus has increased and become a burden among non-communicable diseases due to the accelerated aging population worldwide and the increased prevalence in low-income countries. In Korea, diabetes has become a serious public health concern.Current Concepts: There are four major concerns in diabetes epidemiology. First, the increased obesity rate is associated with increased diabetes prevalence. Second, a more than 40% increase in men and women with prediabetes has been observed. Prediabetes is not only a risk factor for diabetes but can also have pathophysiological effects. Third, one in three patients did not know that they had the disease. Three in four persons with diabetes experienced uncontrolled blood glucose even with treatment. Moreover, the treatment and awareness rates among people with diabetes in their 30s and 40s were lower than 50%. Unhealthy habits such as smoking, alcohol drinking, and inadequate physical activity persist in patients undergoing treatment. Finally, it has recently been found that the risk of developing diabetes is high among cancer survivors and patients recovering from coronavirus disease 2019.Discussion and Conclusion: A strategy should be developed to improve early detection and treatment rate in young people. We need to emphasize the seriousness of the increasing number of people with prediabetes and examine the effects of drug intervention for prediabetes, on the basis of academic research. We should also pay attention to patients who recovered from the newly emerging coronavirus disease 2019 and cancer survivors at risk of developing diabetes.

Estimating the changing burden of disease attributable to high fasting plasma glucose in South Africa for 2000, 2006 and 2012.

Worldwide, higher-than-optimal fasting plasma glucose (FPG) is among the leading modifiable risk factors associated with all- cause mortality and disability-adjusted life years (DALYs) due to the direct sequelae of diabetes and the increased risk for cardiovascular and chronic kidney disease. To report deaths and DALYs of health outcomes attributable to high FPG by age and sex for South Africa (SA) for 2000, 2006 and 2012. Comparative risk assessment methodology was used to estimate the burden attributable to high FPG. A meta-regression analysis was performed using data from national and small-area studies to estimate the population distribution of FPG and diabetes prevalence. Attributable fractions were calculated for selected health outcomes and applied to local burden estimates from the second South African National Burden of Disease Study (SANBD2). Age-standardised rates were calculated using World Health Organization world standard population weights. We estimated a 5% increase in mean FPG from 5.31 (95% confidence interval (CI) 5.18 - 5.43) mmol/L to 5.57 (95% CI 5.41 - 5.72) mmol/L and a 75% increase in diabetes prevalence from 7.3% (95% CI 6.7 - 8.3) to 12.8% (95% CI 11.9 - 14.0) between 2000 and 2012. The age-standardised attributable death rate increased from 153.7 (95% CI 126.9 - 192.7) per 100 000 population in 2000 to 203.5 (95% CI 172.2 - 240.8) per 100 000 population in 2012, i.e. a 32.4% increase. During the same period, age-standardised attributable DALY rates increased by 43.8%, from 3 000 (95% CI 2 564 - 3 602) per 100 000 population in 2000 to 4 312 (95% CI 3 798 - 4 916) per 100 000 population in 2012. In each year, females had similar attributable death rates to males but higher DALY rates. A notable exception was tuberculosis, with an age-standardised attributable death rate in males double that in females in 2000 (14.3 v. 7.0 per 100 000 population) and 2.2 times higher in 2012 (18.4 v. 8.5 per 100 000 population). Similarly, attributable DALY rates were higher in males, 1.7 times higher in 2000 (323 v. 186 per 100 000 population) and 1.6 times higher in 2012 (502 v. 321 per 100 000 population). Between 2000 and 2012, the age-standardised death rate for chronic kidney disease increased by 98.3% (from 11.7 to 23.1 per 100 000 population) and the DALY rate increased by 116.9% (from 266 to 578 per 100 000 population). High FPG is emerging as a public health crisis, with an attributable burden doubling between 2000 and 2012. The consequences are costly in terms of quality of life, ability to earn an income, and the economic and emotional burden on individuals and their families. Urgent action is needed to curb the increase and reduce the burden associated with this risk factor. National data on FPG distribution are scant, and efforts are warranted to ensure adequate monitoring of the effectiveness of the interventions.

Latent growth trajectories of county-level diabetes prevalence in the United States, 2004–2017, and associations with overall environmental quality

Background:The prevalence of type 2 diabetes (T2D) has increased in the United States, and recent studies suggest that environmental factors contribute to T2D risk. We sought to understand if environmental factors were associated with the rate and magnitude of increase in diabetes prevalence at the county level.Methods:We obtained age-adjusted diabetes prevalence estimates from the CDC for 3,137 US counties from 2004 to 2017. We applied latent growth mixture models to these data to identify classes of counties with similar trends in diabetes prevalence over time, stratified by Rural Urban Continuum Codes (RUCC). We then compared mean values of the US EPA Environmental Quality Index (EQI) 2006–2010, overall and for each of the five domain indices (air, water, land, sociodemographic, and built), with RUCC-specific latent class to examine associations of environmental factors and class of diabetes prevalence trajectory.Results:Overall diabetes prevalence trends between 2004 and 2017 were similar across all RUCC strata. We identified two classes among metropolitan urbanized (RUCC 1) counties; four classes among non-metro urbanized (RUCC 2) counties; and three classes among less urbanized (RUCC 3) and thinly populated (RUCC 4) counties. Associations with overall EQI values and class of diabetes prevalence trends differed by RUCC strata, with the clearest association between poor air EQI and steeper increases in diabetes prevalence among rural counties (RUCC 3 and 4).Conclusions:Similarities in county-level diabetes prevalence trends between 2004 and 2017 were identified for each RUCC strata, although associations with environmental factors varied by rurality.

Comparison the Role of Some Novel Biomarkers in Predicting Diabetic Nephropathy Between Diabetic Type 2 and Chronic Kidney Diseases Patients in Kirkuk City

Background: Diabetes mellitus most dangerous metabolic disorder and have high morbidity and mortality complications, the most DM complication is diabetic nephropathy. Diabetic nephropathy( DN) is an irreversible progressive disorder characterized by increased urine albumin excretion and/or impaired GFR. DM causes about 50 % of kidndiseasesase. An increase in prevalence of diabetes is projected to lead to a significant increase in patients with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), and up to 50% of the dialysis population is diabetic. We study 30 Diabetic patients with Chronic kidney diseases with hemodialysis ,30 diabetic patient with chronic kidney disease with out hemodialysis , 15 patient with diabetes only , and 15 control group .we measured kidney injury molecule-1 , liver type fatty acid binding protein ,zinc alpha 2 glycoprotein , serum creatinine ,uric acid .blood urea and random blood sugar .results showed that highest KIM-1 concentration in diabetic nephropathy with hemodialysis group (2.325± 1.095) followed by control group (1.842 ±0.866 ab )and followed with diabetes group (1.572 ±0.752 b ) and lowest mean level was diabetic nephropathy without hemodialysis group (1.344 ±0.623 b ) with highly significant differences (p &lt; 0.001) of KIM-1 among groups .The highest mean level of L-FABP was recorded in diabetic nephropathy with hemodialysis group (254.6 ± 29.6 a ) followed by the control group (235.8 ± 28.9) and followed by diabetic group ( 9210.3 ± 28.7 ab )and the lowest mean level was diabetic nephropathy without hemodialysis group (149.5 ±25.9 a) with significant difference (P&lt;0.002) of L-FABP among groups .The study showed that the highest mean level of ZAG recorded in diabetic nephropathy with hemodialysis group (140.1 ± 23.6 a) followed by control group( 130.9 ±11.5 a)and the lowest mean level was in diabetes group (88.3 ± 14.0 b ) and diabetic nephropathy without hemodialysis group (87.4 ± 19.60 b ) respectively with highly significant difference (P&lt;0.0003). Aims: Role of biomarkers (KIM-1, L-FABP, ZAG) in detection early development of diabetic nephropathy .Correlation between biomarkers (KIM-1, L-FABP, ZAG) and progression of diabetic nephropathy to end stage of renal disease .Estimate how much relationship between biomolecules (creatinine , urea and uric acid ) with diabetes and its complication Methodology :The study included 90 individuals from Kirkuk city / Blood sample collected from patient and analysis was conducted to estimate concentration using Enzyme Linked Immunosorbent Assay (ELISA),and biochemicals using spectrophotometers . Keywords: Diabetes, diabetic nephropathy , chronic kidney disease ,kidney biomarkers

Lifestyle and socioeconomic determinants of diabetes: Evidence from country-level data.

ObjectiveThe objectives of the study is to investigate the global socioeconomic risk factors associated with diabetes prevalence using evidence from available country-level data.DesignA cross-sectional study based on (2010 & 2019) countrywide Health Nutrition and Population Statistics data.PopulationPeople ages 20–79 who have diabetes.SettingOne hundred and thirty-two countries or territories in the world.Primary outcome measureDiabetes prevalence rates were determined from (2010 & 2019) countrywide Health Nutrition and Population Statistics (Health Stats, World Bank Group).ResultsIn 2010, a 1% increase in per capita income and total tobacco consumption is associated with a 0.92% (95% CI 0.64% to 1.19%) and 0.02% (95% CI 0.006% to 0.047%) increase in diabetes prevalence respectively; and a 1% increase in alcohol consumption is associated with a -0.85% (95% CI -1.17% to -0.53%) decrease in diabetes prevalence. Statistically significant socioeconomic and lifestyle indices positively associated with diabetes prevalence included gross national income; overweight prevalence (BMI>25 kg/m2); and tobacco consumption. Statistically significant inverse associations with global diabetes prevalence included total population size; unemployment and alcohol consumption. The 2019 data was removed due to sparsity of data.ConclusionStatistically significant global lifestyle and socioeconomic determinants of diabetes prevalence include alcohol consumption; tobacco consumption; overweight prevalence; per capita income; total population and unemployment rates. Determinants of diabetes include modifiable risk factors which are consistent at both the micro and macro level and include tobacco consumption and overweight prevalence. Factors which are non-modifiable and warrant further investigation include total population and unemployment rates, which were inversely associated with diabetes prevalence and are a product of other underlying factors. Other determinants such as alcohol consumption was also inversely associated with diabetes prevalence, but has been observed to have both negative and positive associations with diabetes at the micro-level. These associations were dependent upon the amount of alcohol consumed. Global cut-off point of alcohol consumption is critical to establish global policies to reduce diabetes prevalence. Overall, the use of cross-sectional based study for country level aggregate data is a critical tool that should be considered when making global joint strategies or policies against diabetes in both data analysis and decision making.