Prevalence Of Diabetes Risk Factors Research Articles

The future burden of type 2 diabetes in Belgium: a microsimulation model

ObjectiveTo forecast the annual burden of type 2 diabetes and related socio-demographic disparities in Belgium until 2030.MethodsThis study utilized a discrete-event transition microsimulation model. A synthetic population was created using 2018 national register data of the Belgian population aged 0–80 years, along with the national representative prevalence of diabetes risk factors obtained from the latest (2018) Belgian Health Interview and Examination Surveys using Multiple Imputation by Chained Equations (MICE) as inputs to the Simulation of Synthetic Complex Data (simPop) model. Mortality information was obtained from the Belgian vital statistics and used to calculate annual death probabilities. From 2018 to 2030, synthetic individuals transitioned annually from health to death, with or without developing type 2 diabetes, as predicted by the Finnish Diabetes Risk Score, and risk factors were updated via strata-specific transition probabilities.ResultsA total of 6722 [95% UI 3421, 11,583] new cases of type 2 diabetes per 100,000 inhabitants are expected between 2018 and 2030 in Belgium, representing a 32.8% and 19.3% increase in T2D prevalence rate and DALYs rate, respectively. While T2D burden remained highest for lower-education subgroups across all three Belgian regions, the highest increases in incidence and prevalence rates by 2030 are observed for women in general, and particularly among Flemish women reporting higher-education levels with a 114.5% and 44.6% increase in prevalence and DALYs rates, respectively. Existing age- and education-related inequalities will remain apparent in 2030 across all three regions.ConclusionsThe projected increase in the burden of T2D in Belgium highlights the urgent need for primary and secondary preventive strategies. While emphasis should be placed on the lower-education groups, it is also crucial to reinforce strategies for people of higher socioeconomic status as the burden of T2D is expected to increase significantly in this population segment.

The Joint Public Health Impact of Family History of Diabetes and Cardiovascular Disease among Adults in the United States: A Population-Based Study

Introduction: Family history is an established risk factor for both cardiovascular disease (CVD) and diabetes; however, no study has presented population-based prevalence estimates of family histories of CVD and diabetes and examined their joint impact on prevalence of diabetes, CVD, cardiometabolic risk factors, and mortality risk. Methods: We analyzed data from a representative sample of the US adult population including 29,440 participants from the National Health and Nutrition Examination Survey (2007–2018) and assessed self-reported first-degree family history of diabetes and CVD (premature heart disease before age of 50 years) as well as meeting criteria and/or having risk factors for CVD and diabetes. Results: Participants with joint family history exhibit 6.5 greater odds for having both diseases and are diagnosed with diabetes 6.6 years earlier than participants without family history. Healthy participants without prevalent CVD or diabetes but with joint family history exhibit a greater prevalence of diabetes risk factors compared to no family history counterparts. Joint family history is associated with an increase in all-cause mortality, but with no interactive effect. Conclusion: Over 44% of the US adult population has a family history of CVD and/or diabetes that is comparable in risk to common cardiometabolic risk factors. This wide presence of high-risk family history and its simplicity of ascertainment suggests that clinical and public health efforts should collect and act on joint family history of CVD and diabetes to improve population efforts in the prevention and early detection of these common chronic diseases.

Impact of rurality on diabetes screening in the US

BackgroundDue to the high prevalence of diabetes risk factors in rural areas, it is important to identify whether differences in diabetes screening rates between rural and urban areas exist. Thus, the purpose of this study is to examine if living in a rural area, rurality, has any influence on diabetes screening across the US.MethodsParticipants from the 2011, 2013, 2015, and 2017 nationally representative Behavioral Risk Factor Surveillance System (BRFSS) surveys who responded to a question on diabetes screening were included in the study (n = 1,889,712). Two types of marginal probabilities, average adjusted predictions (AAPs) and average marginal effects (AMEs), were estimated at the national level using this data. AAPs and AMEs allow for the assessment of the independent role of rurality on diabetes screening while controlling for important covariates.ResultsPeople who lived in urban, suburban, and rural areas all had comparable odds (Urban compared to Rural Odds Ratio (OR): 1.01, Suburbans compared to Rural OR: 0.95, 0.94) and probabilities of diabetes screening (Urban AAP: 70.47%, Suburban AAPs: 69.31 and 69.05%, Rural AAP: 70.27%). Statistically significant differences in probability of diabetes screening were observed between residents in suburban areas and rural residents (AMEs: − 0.96% and − 1.22%) but not between urban and rural residents (AME: 0.20%).ConclusionsWhile similar levels of diabetes screening were found in urban, suburban, and rural areas, there is arguably a need for increased diabetes screening in rural areas where the prevalence of diabetes risk factors is higher than in urban areas.

Impact of diabetes on healthcare costs in a population-based cohort: a cost analysis.

AimsTo estimate the healthcare costs attributable to diabetes in Ontario, Canada using a propensity‐matched control design and health administrative data from the perspective of a single‐payer healthcare system.MethodsIncident diabetes cases among adults in Ontario were identified from the Ontario Diabetes Database between 2004 and 2012 and matched 1:3 to control subjects without diabetes identified in health administrative databases on the basis of sociodemographics and propensity score. Using a comprehensive source of administrative databases, direct per‐person costs (Canadian dollars 2012) were calculated. A cost analysis was performed to calculate the attributable costs of diabetes; i.e. the difference of costs between patients with diabetes and control subjects without diabetes.ResultsThe study sample included 699 042 incident diabetes cases. The costs attributable to diabetes were greatest in the year after diagnosis [C$3,785 (95% CI 3708, 3862) per person for women and C$3,826 (95% CI 3751, 3901) for men], increasing substantially for older age groups and patients who died during follow‐up. After accounting for baseline comorbidities, attributable costs were primarily incurred through inpatient acute hospitalizations, physician visits and prescription medications and assistive devices.ConclusionsThe excess healthcare costs attributable to diabetes are substantial and pose a significant clinical and public health challenge. This burden is an important consideration for decision‐makers, particularly given increasing concern over the sustainability of the healthcare system, aging population structure and increasing prevalence of diabetic risk factors, such as obesity.

Diabetes mellitus in Jamaica: sex differences in burden, risk factors, awareness, treatment and control in a developing country

The objective of this study was to provide valid estimates of the burden of and risk factors for diabetes mellitus by sex in Jamaica, a predominantly Black, middle-income and developing country. The Jamaica Health and Lifestyle Survey 2008 examined a nationally representative sample of 2848 Jamaicans aged 15-74. Parameter estimates and 95% confidence intervals [CI] were weighted for non-response as well as age and sex of the source population. Sex differences in risk factors and diabetes prevalence, awareness, treatment and control were estimated in multivariable models. Population-attributable fractions (PAFs) of obesity on diabetes mellitus were estimated in both sexes. The prevalence of diabetes mellitus was 7.9% (95% CI: 6.7-9.1%), significantly higher in women than men 9.3% vs. 6.4% (P = 0.02) and increasing with age. Seventy-six percentage of persons with diabetes mellitus were aware of their status; urban women and rural men were less likely to be aware. Diabetes control (43% overall) was less common in higher-income men, but more common in higher-income women. Persons without health insurance were less likely to control their diabetes. The prevalence of diabetes risk factors was higher in women than men. Increased waist circumference (≥94 cm [men]/≥80 cm [women]), overweight/obesity (body mass index ≥ 25 kg/m(2)) and low physical activity/inactivity were associated with PAFs for diabetes mellitus of 27%, 37% and 15%, respectively, in men and 77%, 54% and 24%, respectively, in women. Prevalence of diabetes mellitus and its risk factors is high in Jamaica, especially among women, and national programmes to stem the diabetes mellitus epidemic should take these sex differences into consideration.

Type 2 Diabetes in Aboriginal Peoples

Type 2 Diabetes in Aboriginal Peoples

Economic Modelling of the Prevention of Type Diabetes in Australia – The Diabetes Model

This paper outlines the development of the Diabetes Model which projects the number of Australians 25 years of age and over who are expected to have pre-diabetes and type 2 diabetes over a 45 year simulation period. The model also simulates control of the disease in terms of glycaemic levels, cholesterol levels, weight and blood pressure control. The model produces a wide range of epidemiological and economic outputs to assess the current and projected impact of those with the disease. The number and cost of complications associated with type 2 diabetes, conditioning on the level of diabetes control, are also projected. The model also provides the capacity to quantify the effect of hypothetical public health initiatives in the management of type 2 diabetes and associated trends in risk factor prevalence and diabetes control over the simulation period. While the benefits of such programs often will not manifest until many years after implementation, the Diabetes Model simulation period enables long term benefits to be assessed beyond traditional government planning horizons. By comparing the results of the base case status quo projection to alternative simulations premised on interventions that either reduce the prevalence of diabetes risk factors or improve diabetes control among those known to have the disease, it is possible to identify the extent to which short run investments can reap long term benefits in both human and economic terms.

Differences in the prevalence of diabetes risk-factors among First Nation, Métis and non-Aboriginal adults attending screening clinics in rural Alberta, Canada

Populations that are developing (westernizing) are suffering the highest rates of increases in diabetes incidence and prevalence worldwide, with the most notable and documented increases in Canada seen among the First Nations. Less is known about the Métis (mixed blood) or the rural populations in general. To date, no studies have assessed the contributions of ethnicity to diabetes risk-factors. Our objective was to examine diabetes risk factors in First Nations, Métis and non-Aboriginal individuals residing in rural or remote locations, investigating whether ethnicity contributed to any differences. From the databases of three separate community-based diabetes screening projects in Alberta we created a unique subject pool of 3148 adults without diabetes (1790 First Nation, 867 Métis, and 491 non-Aboriginals). Age, body mass index (BMI), waist circumference, reported history of gestational diabetes (GDM) or babies over nine pounds (females only), hemoglobin A1c (A1c) fasting plasma glucose (FPG) or random plasma glucose (RPG) were assessed. Chi-square tests and logistic regression analysis were used to identify between-group differences. The highest mean values for waist circumference (104.7 cm) and BMI (31.2) were found in First Nations subjects (p<0.01). First Nations individuals had the highest prevalence of overweight/obesity (84.4%), abnormal waist circumference (76.8%) and history of GDM (9.0%) (p<0.01). The RPG was also higher in First Nations, but there were no differences between groups with respect to mean FPG and A1c levels, and there were no differences with respect to the prevalence of pre-diabetes or undiagnosed diabetes. Métis (OR 0.80; p = 0.01) and non-Aboriginal individuals (OR 0.62; p< 0.01) were less likely to be obese after age/gender adjustment, compared with First Nations. Métis (OR 0.70; p<0.01) and non-Aboriginals (OR 0.35; p<0.01) were also less likely than the First Nations group to have abnormal waist circumferences. Individuals in the non-Aboriginal group had a lower prevalence of pre-diabetes (OR 0.50; p = 0.01) compared with both the Métis and First Nations groups. First Nations individuals had more risk factors for diabetes than Métis and non-Aboriginal individuals, although Métis rates appeared intermediate. While these risk-factor differences did not translate to more undiagnosed diabetes or pre-diabetes, they are consistent with known rates of diagnosed diabetes in Alberta.

Risk factors for type 2 diabetes in a sixth- grade multiracial cohort: the HEALTHY study.

OBJECTIVEHEALTHY is a 3-year middle school intervention program designed to reduce risk factors for type 2 diabetes. The prevalence of diabetes risk factors at baseline in a cohort of 6,358 sixth-grade students is reported.RESEARCH DESIGN AND METHODSForty-two schools at seven U.S. sites were randomly assigned to intervention or control. Students participated in baseline data collection during fall of 2006.RESULTSOverall, 49.3% of children had BMI ≥85th percentile, 16.0% had fasting blood glucose ≥100 mg/dl (<1% had fasting blood glucose ≥126 mg/dl), and 6.8% had fasting insulin ≥30 μU/ml. Hispanic youth were more likely to have BMI, glucose, and insulin levels above these thresholds than blacks and whites.CONCLUSIONSSixth-grade students in schools with large minority populations have high levels of risk factors for type 2 diabetes. The HEALTHY intervention was designed to modify these risk factors to reduce diabetes incidence.

Risk Factors for Development of Diabetes in Undergraduate Students at a Midwestern University

To understand the prevalence of diabetes risk factors in a generally assumed low risk population of undergraduate university students and the relation of risk factors to reported diabetes symptoms.

Diabetes Management in San Diego’s Chamorro Community

The purpose of this study was to assess the diabetes risk status, incidence, and morbidity within San Diego's Chamorro community as a foundation to help community leaders and health care providers create culturally customized health promotion interventions. The Behavioral Risk Factor Surveillance Survey was used to query a randomly selected, convenience sample of San Diego Chamorros (N = 228) drawn from the Chamorro Directory International. Based on individual survey responses, participants were mailed personalized health-promoting information. Subsequently, they received information that addressed the most commonly observed overall threats to the Chamorro community's health. A higher than average prevalence of diabetes and gestational diabetes was reported by study participants along with a high prevalence of the risk factors associated with the premature onset of diabetes and its consequences. Collaborative partnerships between health professionals and community leaders can help identify opportunities and strategies for improving the health of the nation's population subgroups. San Diego's Chamorro community leaders now have a clearer understanding of the prevalence of diabetes risk factors within their community and can begin working with public health educators to create culturally aligned diabetes prevention and management programs. Given the willingness of Chamorro leaders to get involved in the development of a diabetes awareness campaign and the community's closely knit social network, it should be possible to promote (1) community participation in the intervention program, (2) an increase in the community's adherence to recommended behavioral changes, and (3) identification of additional program modifications that will further enhance the program's cultural relevance.

Opportunistic screening for diabetes in routine clinical practice.

Since 1997, the American Diabetes Association has recommended that nondiabetic individuals >/=45 years of age be screened for diabetes at least every 3 years. We sought to characterize the frequency, methods, and results of diabetes screening in routine clinical practice. We studied opportunistic screening in nondiabetic members of a health maintenance organization >/=45 years of age who were assigned to a large, integrated, academic health care delivery system. Screening was defined as the first glucose, HbA(1c), or oral glucose tolerance test (OGTT) performed between 1 January 1998 and 31 December 2000. Chart review was performed to determine the prevalence of diabetes risk factors and to describe follow-up. Of 8,286 nondiabetic patients >/=45 years of age, 69% (n = 5,752) were screened. The frequency of screening was greater in patients with one or more primary care visits and increased with age. Women were more likely to be screened than men, and patients with at least one diabetes risk factor were more likely to be screened than those without risk factors. Random plasma glucose was the most common screening test (95%). Four percent (n = 202) of those screened had abnormal results. Only 38% (n = 77) of those with abnormal results received appropriate follow-up, and 17% (n = 35) were diagnosed with diabetes within 6 months of screening. The yield of screening was very low (0.6%, 35 of 5,752). Despite frequent screening and appropriate targeting of high-risk patients, follow-up of patients with abnormal results is uncommon and the yield of screening is low. Interventions are needed to help physicians recognize and provide appropriate follow-up for patients with potentially abnormal random glucose levels.

Diabetes and impaired glucose tolerance in Aboriginal Australians: prevalence and risk

The prevalence and risk of having impaired glucose tolerance (IGT) and diabetes was estimated relative to body mass index (BMI) among Australian Aboriginal people. A stratified analysis was undertaken of community screening data. Measures included fasting and 2-h glucose concentrations, and BMI (five strata: <22, 22–24.9, 25–29.9, 30–34.9 and ≥35 kg/m 2). Age was stratified into three groups: 15–34.9, 35–44.9, and ≥45 years. Participants were men and women, ages 15–94 years ( n=2626). The prevalence of IGT and diabetes, respectively, adjusted for age and BMI, was 139 and 142 cases/1000 persons among men, and 157 and 152 cases/1000 persons among women. Odds ratios (95% CI) for IGT and diabetes for increasing BMI strata ≥22 kg/m 2 ranged from 1.7 (1.0 to 2.9) to 5.1 (2.4–10.5) for IGT, and from 2.0 (1.2–3.5) to 6.1 (3.3–11.1) for diabetes. For IGT and diabetes, across genders, the population attributable risk percentages (95% CI) for BMI ≥22 kg/m 2 were 34.1% (26.2–41.9%) for IGT, and 46.4% (38.5–54.5%) for diabetes. Diabetes and IGT have reached epidemic proportions among Australian Aboriginal people. An urgent need exists for programmes to reduce the prevalence of diabetes risk factors, especially BMI of 22 kg/m 2 or more, a limit lower than advocated for Euro-American populations.

Diabetes complications and risk factors in an Australian population. How well are they managed?

This study aimed to explore the relationship between complications and risk factors in the type 2 diabetes population, and to assess the level of assistance people with diabetes receive in controlling their risk factors. Participants were recruited from representative population surveys of South Australians aged over 18 years. Participants were asked a series of questions about their risk factors and the advice and assistance they received from their general practitioner (GP) in modifying their risk factors. Additionally, participants were clinically tested for a number of macro and microvascular complications. South Australians with type 2 diabetes have a high prevalence of risk factors, with the majority being overweight or obese, doing no vigorous exercise and having high blood pressure. They also have a high prevalence of complications, with 53% having at least one macrovascular complication and 66% having at least one microvascular complication. Additionally, participants reported high levels of GP advice and assistance on the risk factors where pharmacological controls were available, but low levels of assistance where non-pharmacological interventions were needed to control the risk factor. The prevalence of diabetes risk factors and complications among South Australians with type 2 diabetes is a cause for concern, as is the lack of assistance offered by GPs to modify risk factors. Multi-disciplinary approaches to the control of risk factors and patient self-management and education are critical to the progression and success of diabetes care.

Development of a primary prevention program: insight gained in the Zuni Diabetes Prevention Program.

Diabetes prevention programs are essential in Native American communities that are experiencing high rates of non-insulin dependent diabetes mellitus (NIDDM). These programs must be community based and supported in order to succeed. The Zuni Diabetes Prevention Program (Program) is a community-based primary prevention project designed to reduce the prevalence of diabetes risk factors among high-school-age youths. The Program strives to enhance knowledge of diabetes and to support increased physical activity, increased fruit and vegetable intake, and reduced soft drink consumption. The primary mechanisms of intervention are diabetes education, a school-based wellness center, supportive social networks, and modification of the food supply available to teens. Program evaluation uses a multiple cross-sectional model; assessment occurs at three points within the 4-year project. Midproject results indicate a significant reduction in soft drink consumption and an increase in glucose/insulin ratios, suggesting a decline in the incidence of hyperinsulinemia.