Prevalence Of Diabetes In Men Research Articles

The V-shaped curve relationship between fasting plasma glucose and human serum albumin in a large health checkup population in China

BackgroundThis study aimed to investigate the relationship between fasting plasma glucose (FPG) and human serum albumin (HSA) in a large health checkup population in China.MethodsIn this cross-sectional health checkup study, we enrolled a population of 284,635 subjects from Wuhu between 2011 and 2016. All participants completed the physical examination, blood biochemical examination, and blood routine examination.ResultsThe prevalence of diabetes in men and women was 6.11% and 2.98%, respectively. The average level of HSA and FPG was significantly higher in men than in women (48.44 ± 3.25 vs. 47.14 ± 3.22, P < 0.0001; 5.50 ± 1.26 vs. 5.26 ± 0.94, P < 0.0001). There were significant differences in blood biochemistry and blood routine values by gender. After adjusting for confounding factors, the results showed that FPG and HSA were a V-shaped curve, and the threshold value of HSA was 40.7 mmol/L. FPG and HSA still showed a V-shaped curve after stratification by gender and age. In the male group, FPG decreased with HSA when HSA<42.3 mmol/L, and increased when HSA ≥ 42.3 mmol/L. In the female group, FPG decreased with HSA when HSA<35.7 mmol/L, and increased when HSA ≥ 35.7 mmol/L. In the age<65 group, FPG decreased with HSA when HSA<37.5 mmol/L, and increased when HSA ≥ 37.5 mmol/L. In the age ≥ 65 group, FPG decreased with HSA when HSA<43.2 mmol/L, and increased when HSA ≥ 43.2 mmol/L.ConclusionsA V-shape relationship exists between fasting plasma glucose and human serum albumin among the Chinese health checkup population studied.

Investigation of Influencing Factors on the Prevalence of Retinopathy in Diabetic Patients Based on Medical Big Data.

As one of the most important organs of human beings, the eyes can receive external visual information and play an important role in perception. Therefore, the method of maintaining eye health is a problem that people pay attention to. Omental disease is one of the most serious microvascular complications in diabetic patients, and it is also the main cause of blindness in patients. The purpose of this article is to investigate the main factors that influence the prevalence of retinopathy in diabetic patients based on medical big data. In this article, a method for investigating the causes of the incidence of retinopathy in diabetic patients based on medical big data is proposed, and a questionnaire survey method and other methods are used for experimental investigation. Combining the data in the figure in the experiment in this article, it can be seen that among diabetic patients, the prevalence of diabetes in men is 12.4%, and the prevalence of diabetes in women is 8.4%. From the data in the figure, it can be known that the rate of retinopathy caused by various factors is between 5% and 7%, and the total prevalence of retinopathy is 47.5%. There are many factors affecting the prevalence of retinopathy in diabetic patients, such as the duration of diabetes, urinary albumin index, glycosylated hemoglobin index, and fasting blood glucose level; various factors lead to an increase in the prevalence of retinopathy in diabetic patients. The results show that there are many factors affecting the prevalence of retinopathy in diabetic patients, so patients should pay attention to exercise, control their diet, and prevent retinopathy.

RISK FACTORS AND PREVALENCE OF DIABETES MELLITUS AMONG RESIDENTS OF LAGOS, NIGERIA

This study investigated the type 1 and type 2 diabetes risk factors and prevalence among residents of Ikorodu Local Government Area, Lagos State, Nigeria. This research was a cross-sectional study involving Ehi, Pharcept and Divine Intervention Medical centers. The demographics of 106 patients living with diabetes were collected and analyzed to characterize people living with Type 1 and Type 2 diabetes mellitus (T1DM and T2DM) in Ikorodu LGA. Written ethical approval was obtained from the health facilities visited. Administrative personnel in the health facilities assisted with the medical files of participants. Participants were interviewed and their consent was sought. Cronbach Alpha value of 0.79 was obtained for the questionnaire’s reliability. Filled copies of questionnaires were collected and analyzed using frequency, percentages and regression analysis. The results showed the prevalence of diabetes in the study area increased with age and diet was the most risk factor. No significant difference was observed in the prevalence of diabetes in men and women with a P-value of 0.195. The study revealed that persons with T1DM and T2DM were predominantly between ages 41 and 60, although they were mostly middle class, non-smokers and Christians. Unhealthy diets (eating mostly carbohydrates) devoid of vegetables and proteins should be avoided by urban dwellers for good quality health; as revealed in the study that diet posed a key risk factor, especially for T2DM. The study recommends intensive efforts by healthcare professionals and stakeholders to put in place structured diabetes care and prevention program for residents.

Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey.

OBJECTIVESWe aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES).METHODSThe study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program.RESULTSThe prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC=1.9, p<0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC=-0.5, p<0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC=-0.9, p<0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC=1.6, p<0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC=8.2, p<0.001] and 21.4% in women [APC=7.1, p<0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change.CONCLUSIONSOver the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.

What factors explain the much higher diabetes prevalence in Russia compared with Norway? Major sex differences in the contribution of adiposity

IntroductionCompared with many other countries Russia has a high prevalence of diabetes in men and women. However, contrary to what is found in most other populations, the risk is greater...

Hyperuricemia is Associated With an Increased Prevalence of Metabolic Syndrome in a General Population and a Decreased Prevalence of Diabetes in Men

Objective. Elevated uric acid is associated with cardiovascular disease and metabolic syndrome. However, uric acid is also an antioxidant with beneficial effect on comorbidities. The aim of this study was to evaluate the relationship of serum uric acid with diabetes, metabolic syndrome, and cardiovascular disease in a Korean adult population. Methods. A total of 5,887 (weighted n=40,251,868) participants aged ≥19 years from the 2016 Korean National Health and Nutrition Examination Survey were included for analysis. Weighted prevalence and odds ratio (OR) of comorbidities were analyzed according to the presence of hyperuricemia and uric acid quartile. Results. Participants of both sexes with hyperuricemia showed higher prevalence of metabolic syndrome, hypertension, hypertriglyceridemia, and obesity than those without hyperuricemia. After adjusting for socioeconomic and lifestyle characteristics, hyperuricemia was associated with a decreased prevalence of diabetes mellitus in men (OR: 0.44, 95% confidence interval [CI]: 0.28∼0.72, p=0.001) and a decreased prevalence of myocardial infarction or angina (OR: 0.25, 95% CI: 0.08∼0.75, p=0.013) in women. Hyperuricemia was significantly associated with an increased prevalence of metabolic syndrome in both men (OR: 1.81, 95% CI: 1.33∼2.45, p＜0.001) and women (OR: 1.95, 95% CI: 1.22∼ 3.13, p=0.006). Conclusion. Hyperuricemia was associated with a decreased prevalence of diabetes mellitus in men and a decreased prevalence of myocardial infarction or angina in women. Hyperuricemia was associated with an increased prevalence of metabolic syndrome in both men and women. (J Rheum Dis 2020;27:247-260)

Klinefelter Syndrome and Diabetes.

Klinefelter syndrome (KS) is associated with increased insulin resistance and high rates of type 2 diabetes (T2DM). Our aim was to review what is known about the prevalence of diabetes in men with KS, potential mechanisms underlying the observed metabolic phenotype, and the data that are available to guide treatment decisions. The increased prevalence of T2DM seen in men with KS appears to be the result of multiple mechanisms including increased truncal adiposity and socioeconomic disadvantages, but it is likely not a direct consequence of hypogonadism alone. No randomized trials have been conducted to evaluate the impact of testosterone replacement therapy on T2DM in men with KS, but observational data suggest that testosterone replacement is not associated with lower rates of diabetes or improved glycemic control. Metabolic derangements are common in KS, but treatment strategies specific to this population are lacking. Early lifestyle and dietary interventions are likely important. Additional research is needed to dissect the complex interaction between genotype and metabolic phenotype. Collaboration between academic centers caring for men with KS is needed to facilitate the development of evidence-based clinical practice guidelines, which would inform optimal screening and treatment strategies for this patient population.

PFOA is associated with diabetes and metabolic alteration in US men: National Health and Nutrition Examination Survey 2003–2012

Exposure to perfluoroalkyl substances (PFAS) is associated with a range of adverse health effects. However, it remains unclear whether PFAS at environmentally relevant exposure levels are related to diabetes and metabolite concentrations in adults. Using cross-sectional data from 7904 adults (age≥20years) in the 2003–2012 National Health and Nutrition Examination Survey (NHANES), we examined the association of PFAS with the prevalence of diabetes and metabolite concentrations. A multivariate logistic regression was applied to investigate the associations of diabetes prevalence with serum perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorononanoate (PFNA) levels. A multivariate generalised linear regression was further performed to investigate the associations between PFAS exposure and some metabolites. We identified a strong positive association between serum PFOA and diabetes prevalence in men with an adjusted model (OR: 2.66, 95% CI: 1.63–4.35; P for trend=0.001). No significant association between serum PFOA and diabetes prevalence was observed in women (OR: 1.47, 95% CI: 0.88–2.46; P for trend=0.737). Furthermore, diabetes was not related to PFOS, PFHxS and PFNA, regardless of gender. In the gender-stratified generalised linear models, men and women with the highest PFOA levels demonstrated a 1.43% (95% CI: 0.62%–2.34%) and a 1.07% (95% CI: 0.27%–1.97%) greater increase in serum total cholesterol (P for trend=0.006 and 0.001) compared to those with the lowest PFOA levels. There were no significant associations between serum PFOA and other metabolites. These results provide epidemiological evidence that environment-related levels of serum PFOA may be positively associated with the prevalence of diabetes in men and with total cholesterol in adults. Further clinical and animal studies are urgently needed to elucidate putative causal relationships and shed light on the potential mode of action involved.

Prevalence of and secular trends in diagnosed diabetes in Italy: 1980–2013

Background and aimsThe aim of this research was to examine the prevalence of diabetes in Italy over a 34-year period. Methods and resultsSelf-reported diabetes was assessed in eight health interview surveys of representative samples of Italian population aged 20 years and over. Crude and standardised prevalence were calculated by age, sex, educational level and area of residence. Logistic models were fitted to calculate the contribution of age and BMI to the trend in prevalence. In 2013 nearly 3.4 million Italians had a diagnosis of diabetes, more than twice as many as in 1980. The crude prevalence of diabetes in men rose from 3.3% in 1980 to 7.1% in 2013 (+115%), and from 4.7% to 6.8% in women (+45%). The prevalence was almost stable during the eighties, and started to rise from the beginning of the nineties. One third of the increase in men and two thirds in women is due to the ageing of the population, since the age-standardised prevalence increased by 79% in men and 14% in women. The prevalence of overweight and obesity increased less steeply than diabetes, and their contribution to the trend in diabetes is less relevant than age. Prevalence rose more in the elderly, in low-educated men, and in high-educated women. ConclusionGiven that the ageing population plays a considerable role in explaining the trend, and that the number of people in the oldest age groups will continue to grow, the rise in the number of individuals with diabetes will represent a severe challenge for the national health system.

Proportion of Undercarboxylated Osteocalcin and Serum P1NP Predict Incidence of Myocardial Infarction in Older Men.

Undercarboxylated osteocalcin (ucOC) modulates insulin secretion and sensitivity in mice, and higher ucOC is associated with lower prevalence of diabetes in men. The influence of ucOC distinct from other markers of bone turnover on incidence of cardiovascular events is unclear. Community-dwelling men aged 70-89 years resident in Perth, Western Australia. Serum total osteocalcin (TOC), N-terminal propeptide of type I collagen (P1NP), and collagen type I C-terminal cross-linked telopeptide (CTX) were measured by immunoassay, and ucOC by hydroxyapatite binding. The ratio ucOC/TOC was calculated. Hospital admissions and deaths from myocardial infarction (MI) and stroke were ascertained. There were 3384 men followed for 7.0 years, during which 293 experienced an MI, 251 stroke, and 2840 neither. In multivariate analyses, higher ratio of ucOC/TOC (expressed as %) was associated with lower incidence of MI (quartiles Q2-4, ≥ 49% versus Q1,<49%, hazard ratio 0.70, 95% confidence interval = 0.54-0.91), but not of stroke (0.99, 0.73-1.34). Higher P1NP was associated with higher incidence of MI (Q2-4, ≥ 28.2 μg/L versus Q1, <28.2 μg/L, hazard ratio 1.45, 95% confidence interval = 1.06-1.97), but not of stroke (0.94, 0.70-1.26). CTX was not associated with incident MI or stroke. A reduced proportion of undercarboxylated osteocalcin or higher P1NP are associated with increased incidence of MI. UcOC/TOC ratio and P1NP predict risk of MI but not stroke, in a manner distinct from CTX. Further studies are needed to investigate potential mechanisms by which bone turnover markers related to metabolic risk and to collagen formation could modulate cardiovascular risk.

Diabetes mellitus and its risk factors among a middle-aged population of Iran, a population-based study

Diabetes is a major health problem around the world. The risk of diabetes is increasing worldwide, and its misdiagnosis may have significant public health implications. This study aimed to determine the prevalence of diabetes and its risk factors among the middle-aged population in Shahroud, north of Iran. In the present study, the plasma glucose levels in 5190 subjects aged 40–64 years, participating in the first phase of the Shahroud Eye Cohort Study in 2009, were measured. Non-fasting glucose level greater than or equal to 200 mg/dl and/or the use of blood glucose-lowering drugs were considered as criteria for the diagnosis of diabetes. To determine the risk factors associated with diabetes, simple and multivariate logistic regressions were used. The prevalence of diabetes in men, women, and the total population were 10.4, 13.6, and 12.3 %, respectively. The mean blood glucose levels in men and women were 116.7 and 117.3 mg/dl, respectively. Age (odds ratio (OR) = 1.04), hypertension (OR = 2.5), being overweight (OR = 1.5), and obesity (OR = 1.5) were positively associated with diabetes. In addition, having an insurance (OR = 0.48) and male gender (OR = 0.81) was associated with a reduced risk of diabetes. Based on the results of the present study, the prevalence of diabetes in the studied population is high, and according to the epidemiological transition of diseases, a high percentage of the Iranian population are at risk for cardiovascular diseases. Considering the risk factors identified in the present study, developing effective interventions is essential.

Global strategies for non-communicable disease in terms of predictive, preventive and personalised medicine

Human have encountered a pandemic of no-communicable disease. According to the WHO statistics [1], 36 million deaths (63% of total deaths) due to non-communicable diseases (NCDs) occurred globally in 2008. The NCDs comprise cardiovascular diseases (48%), cancers (21%), chronic respiratory disease (12%) and diabetes (3.5%). Approximately, 80% of NCD deaths occurred in low-income and middle-income countries, where a half of the deaths were premature (< 70 years of age) compared to high-income countries (a quarter). NCDs accounted for two-thirds of all years lived with disability in low-income and middle-income countries. The WHO global action plan for the prevention and control of NCDs for 2015 to 2025 is to integrate available preventive and curative interventions through a whole government, whole society and health-in-all policies approach in order to reduce their morbidity, disability and premature mortality [2]. The action plan comprises three main pillars, i.e. surveillance, prevention and health care, which correspond to predictive, preventive and personalised medicine. All membership states of the United Nations agreed that NCDs constitute a major challenge to socioeconomic development, environmental sustainability and poverty alleviation. The nine voluntary global targets by 2025 [3] are; 1) 25% relative reduction in overall mortality from NCDs (the 25 by 25 goal) 2) 10% or more relative reduction in the harmful use of alcohol, within the national context 3) 10% relative reduction in prevalence of insufficient physical activity 4) 30% relative reduction in mean population intake of salt/sodium intake 5) 30% relative reduction in the prevalence of current tobacco use in persons aged 15+ years 6) 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances 7) Halt the rise in diabetes and obesity 8) 50% or more of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes; Essential NCD medications and basic technologies to treat major NCDs 9) 80% availability of the affordable basic technologies and essential medicines, including genetics, required to treat major NCDs in both public and private facilities Japan is a unique country which has succeeded in the substantial reduction of stroke and the modest reduction of ischaemic heart disease, resulting in the elongation of life expectancy since the 1960s and madding Japan as one of the countries with longest longevity [4,5]. That success has been achieved by nation-wide reduction of sodium intake, blood pressure levels, tobacco use and substantial increase in drug therapy and counselling for the control of hypertension in the prevention of strokes and heart attacks under the insurance system since 1960 [5-7]. There is, however, an emerging public health issue of the increased prevalence of hypercholesterolemia and diabetes in men and women, and overweight in men although an increase in the increase of or mortality from ischaemic heart disease has been limited [8,9]. In Japan, the high sodium intake and the high prevalence of raised blood pressure in whole, insufficient physical activity in middle-aged men, the high tobacco use in men and the increased (although low) prevalence of diabetes in men and women are targets for the implantation of global action plan. Each county has its own emphasis on the targets depending on lifestyles, risk factor levels and profiles of NCDs. The WHO global action plan stimulates the membership states of the United Nations to implement cost-effective surveillance, preventive and personalised interventions to aim for the achievement of the global goal.

Marital quality and diabetes: results from the Health and Retirement Study.

Poor marital quality is associated with many different indicators of poor health, including immunologic and metabolic responses that have relevance for distal disease outcomes such as diabetes. We conducted this study to evaluate whether poor marital quality was associated with the prevalence of diabetes in a population-based sample of Americans over the age of 50. Participants were married adults from the 2006 (N = 3,898) and 2008 (N = 3,452) waves of the Health and Retirement Study. Participants completed an interview and a self-report questionnaire, and current use of diabetes medication and glycosylated hemoglobin obtained from blood spot samples were used to index diabetes status. Marital quality was assessed with items regarding perceived frequency of positive and negative exchanges with partner. Decreasing frequency of positive exchanges and increasing frequency of negative exchanges with one's spouse were associated with higher prevalence of diabetes among men, but not women at both waves; gender significantly moderated the associations between partner exchanges and diabetes status for the 2006 data. The association between frequency of partner exchanges and diabetes status generally remained significant in men after accounting for demographic characteristics and other risk factors (obesity, hypertension, low physical activity). Poor marital quality as operationalized by rates of positive and negative partner exchanges was associated with increased prevalence of diabetes in men. These results are consistent with prior work on marriage and health, and suggest that poor marital quality may be a unique risk factor for diabetes.

Explaining the Increase of Diabetes Prevalence and Plasma Glucose in Mauritius

OBJECTIVESecular trends in the epidemiology of diabetes are best described by studying the same population over time, but few such studies exist. Using surveys from Mauritius in 1987 and 2009, we examined 1) the change in the prevalence of diabetes, 2) the extent to which changes in traditional diabetes risk factors explained the increase, and 3) the change in the distribution of plasma glucose levels over time.RESEARCH DESIGN AND METHODSIndependent population-based surveys were undertaken in Mauritius in 1987 and 2009 using similar methodology in adults aged 20–74 years. Physical measurements and fasting blood samples were taken, and an oral glucose tolerance test was performed at both surveys.RESULTSThe age-standardized prevalence of diabetes in 2009 was 22.3% (95% CI 20.0–24.6) among men and 20.2% (18.3–22.3) among women, representing an increase since 1987 of 64 and 62% among men and women, respectively. Concurrent changes in the distribution of age, ethnicity, waist circumference, BMI, physical activity, smoking, family history of diabetes, and hypertension explained more of the increase in the prevalence of diabetes in men than in women. Increases in plasma glucose (especially fasting glucose) were seen across the population but were greater at the upper levels.CONCLUSIONSIn Mauritius, there has been a marked increase in diabetes prevalence over 22 years. This mainly results from changes in traditional risk factors, leading to population-wide increases in plasma glucose levels. Interventions to control this escalation of diabetes should focus on population-wide strategies.

Predicted coronary risk for adults with coronary heart disease and low HDL-C: an analysis from the US National Health and Nutrition Examination Survey

ABSTRACTPurpose: To assess the national prevalence of low levels of high-density lipoprotein cholesterol (HDL-C) among adults with coronary heart disease (CHD) and the relationship between low HDL-C and predicted rates of recurrent CHD events.Methods: This study used data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES) to examine the prevalence of risk factors for recurrent CHD events among survey respondents with existing CHD. The predicted probability of recurrent CHD events in the next 10 years was estimated using published Framingham Heart Study equations for secondary CHD prevention. All data analyses were weighted to produce national estimates using the NHANES sampling weights.Results: This study included 1291 survey participants aged ≥ 40 years who self-reported having coronary heart disease, angina, or heart attack. Of the study subjects with available HDL-C data, the percentage of respondents who had low HDL-C (< 40 mg/dL), intermediate HDL-C (40 to < 60 mg/dL), and high HDL-C (≥ 60 mg/dL) was 29%, 50%, and 21%, respectively, based on the national weighted population estimate. For respondents with low HDL-C, the prevalence of diabetes in men and the prevalence of smoking in women were significantly higher than those with high HDL-C ( p < 0.05). The predicted 10-year coronary risk for subjects with low HDL-C was considerably higher than for subjects with intermediate and high HDL-C. Although subjects with low HDL-C comprised only 29% of the population, they contributed approximately 38% of the subjects with predicted CHD events.Limitations: The assessment of certain CHD risk factors and the existence of CHD in the NHANES surveys relied on self-reports, which are subject to recall bias.Conclusions: Study results showed that US adults with CHD and low HDL-C will likely contribute a disproportionately high percentage to total CHD events in the next 10 years, suggesting the need for greater awareness of the consequences of low HDL-C.

Diabetes and impaired glucose tolerance in a rural area in Pakistan and associated risk factors

Summary Aims To determine the prevalence of diabetes and IFG and associated risk factors in a rural area of Pakistan. Methods Two thousand one hundred and nineteen rural individuals aged 20 years and above were included in the study. Fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), height, weight, waist, hips, body fat percentage (BF%), lipid profile and blood pressure were recorded. Results The prevalence of diabetes in men was 3.7% (95% CI: 2.3–5.1), in women 6.9% (95% CI: 5.5–8.3) and in total 5.8% (95% CI: 4.8–6.8). The prevalence of IFG in men, women and for the total was 4.7% (95% CI: 3.1–6.3), 5.8% (95% CI: 4.5–7.1) and 5.4% (95% CI: 4.4–6.4). Age, gender, waist/hip ratio, BF% and hypertension were significant risk factors for diabetes after controlling for potential confounding factors. Conclusions A relatively high prevalence of type 2 diabetes and impaired fasting plasma glucose was observed in the rural population of Pakistan. WHR was independently associated with the occurrence of diabetes.

Phimosis as a presenting feature of diabetes

To determine the prevalence of diabetes in men presenting with phimosis, and to establish the incidence of undiagnosed diabetes in men presenting with acquired or life-long phimosis. We prospectively collected data on 100 men (mean age 38.5 years, range 17-82) who presented to our department with phimosis during 2006. Urinary glucose levels and random serum glucose levels were analysed, and if abnormal, the patient had further diagnostic tests for diabetes. In all, 31 men presented with a life-long history of phimosis and 69 with a history of acquired phimosis. There was no history of diabetes and no abnormal serum glucose levels in those with life-long phimosis. Eighteen of 69 (26%) of those with acquired phimosis had a history of type 2 diabetes. Type 2 diabetes was newly diagnosed in four of 50 (8%) men presenting with acquired phimosis and no history of a glycaemic disorder. A further two (4%) were diagnosed with impaired fasting glycaemia and impaired glucose tolerance. Urine analysis was positive for glucose in all new diagnoses of glycaemic disorders, except in one man. Diabetes can be associated with acquired phimosis in almost a third of cases, and 12% of men presenting with acquired phimosis and no history of diabetes were diagnosed with a disorder of glycaemic control. Therefore it is important that serum glucose levels are analysed when assessing men with acquired phimosis.

Insulin dependant diabetes mellitus: implications for male reproductive function

Diabetes mellitus (DM) is increasing in men of reproductive age. Despite this, the prevalence of diabetes in men attending fertility clinics is largely unknown. Furthermore, studies examining the effects of DM on sperm fertility potential have been limited to conventional semen analysis. Conventional semen analysis (semen volume, sperm count, motility and morphology) was performed for 27 diabetic (mean age 34+/-2 years) and 29 non-diabetic subjects (control group, men undergoing routine infertility investigations, mean age 33+/-1 years). Nuclear DNA (nDNA) fragmentation was assessed using the alkaline Comet assay and mitochondrial DNA (mtDNA) deletions by Long-PCR. Other than a small, but significant, reduction in semen volume in diabetic men (2.6 versus 3.3 ml; P<0.05), conventional semen parameters did not differ significantly from control subjects. Diabetic subjects had significantly higher mean nDNA fragmentation (53 versus 32%; P<0.0001) and median number of mtDNA deletions (4 versus 3; P<0.05) compared with control subjects. Diabetes is associated with increased sperm nuclear and mtDNA damage that may impair the reproductive capability of these men.

Family history, diabetes and extension of coronary atherosclerosis are strong predictors of adverse events after PTCA: A one-year follow-up study

In this study we addressed some open questions in patients with coronary artery disease (CAD). First, we analysed which of the traditional risk factors was associated with the spreading of coronary stenosis and second, we aimed to identify if any variable was predictive of post-percutaneous transluminal coronary angioplasty (PTCA) clinical events. We collected a consecutive series of patients with CAD (n=301) and in the subgroup of patients undergoing PTCA (n=135) we performed a prospective one-year follow-up study recording cardiovascular morbidity and total mortality. According to the extension of coronary atherosclerosis, we found a significant relationship with the prevalence of diabetes in men and with plasma HDL-cholesterol concentrations in women. The follow-up was completed in 95% of patients; we did not document any death whereas clinical events were registered in 16% of patients. At univariate analysis, we found that patients with clinical events had a higher prevalence of family history of CAD (43% vs 14%, p<0.005), diabetes (52% vs 21%, p<0.005) and multivessel disease (52% vs 35%, p<0.05). Multivariate analysis (logistic regression) confirmed that family history of CAD (OR 4.6, 95% CI 1.7-12.8, p<0.005), diabetes (OR 4.0, 95% CI 1.5-10.6, p<0.01) and multivessel disease (OR 2.8, 95% CI 1.1-7.4, p<0.05) were the only variables predictive of clinical events. In this study, factors associated with the spreading of coronary stenosis were different according to the gender. Moreover, the presence of diabetes and multivessel disease had a negative impact on the long-term prognosis of patients undergoing PTCA. In addition, the family history of CAD represented in our study a strong predictor of clinical events. We suggest that in the management of post-PTCA patients, the role of individual baseline clinical characteristics must be taken into account and that subjects with a family history of premature CAD, diabetes and a wide extension of coronary disease represent those with the highest risk.

Relationships of fasting and postload glucose levels to sex and alcohol consumption. Are American Diabetes Association criteria biased against detection of diabetes in women?

To compare, in men and women, the prevalence of undiagnosed type 2 diabetes assessed using criteria from the American Diabetes Association (ADA) and the World Health Organization (WHO) and to investigate risk factors associated with fasting and 2-h postload plasma glucose. Data from two companion surveys of Europeans, South Asians, and Afro-Caribbeans in west London were used. A total of 4,367 men and women aged 40-64 years who were not known to have diabetes underwent an oral glucose tolerance test after an overnight fast. The prevalence of undiagnosed diabetes was estimated using the ADA (fasting plasma glucose > or = 7.0 mmol/l) and WHO (2-h postload glucose > or = 11.1 mmol/l) criteria for epidemiologic studies. The association of body fat and usual alcohol intake with plasma glucose and diabetes prevalence was assessed. Compared with the WHO criterion, the ADA criterion gave a higher prevalence of diabetes in men (6.4 vs. 4.7%) but a lower prevalence in women (3.3 vs. 4.2%). In Afro-Caribbeans, the sex difference in diabetes prevalence was reversed. Women had significantly lower fasting glucose than men despite higher 2-h glucose levels. Alcohol intake was positively associated with fasting glucose in men and women but not with 2-h glucose levels. The new ADA criterion, based on fasting glucose alone, does not take account of sex differences in metabolic response to fasting or possible artifactual effects on fasting glucose. With the ADA criterion, alcohol intake was a significant risk factor for diabetes in our study population; this was not the case with the WHO criterion.