Prevalence Of Self-reported Diabetes Research Articles

Prevalence of and risk factors for diabetes mellitus in the school-attending adolescent population of the United Arab Emirates: a large cross-sectional study

ObjectivesThe prevalence of diabetes has reportedly increased among adolescents in low-income and middle-income countries of the Middle East and may be linked to social, demographic and economic contextual factors. This...

Self-Reported Modifiable Risk Factors of Cardiovascular Disease among Older Adults in Malaysia: A Cross-Sectional Study of Prevalence and Clustering.

The co-occurrence of multiple modifiable risk factors increases the risk of cardiovascular disease (CVD) morbidity or mortality. This study examines the prevalence and clustering of self-reported modifiable CVD risk factors among older adults in Malaysia. A total of 7117 adults aged ≥50 years participated in the National Health and Morbidity Survey (NHMS) 2018: Elderly Health, a community-based cross-sectional survey. Data were collected using a standardized structured questionnaire. Multivariable logistic regression was used to determine the factors associated with the clustering of self-reported modifiable CVD risk factors. The prevalence of self-reported diabetes, hypertension, hypercholesterolemia, overweight/obesity, and current smoking was 23.3%, 42.2%, 35.6%, 58.4%, and 17.5%, respectively. Overall, the prevalence of clustering of ≥1, ≥2, and ≥3 modifiable CVD risk factors was 83.3%, 75.4%, and 62.6%, respectively. Multivariable logistic regression analysis showed that men, 60–69 age group, urban dwellers, having no formal education, unemployed/retirees/homemakers, and being physically inactive were independently associated with self-reported modifiable CVD risk factors clustering. There are also ethnic differences in self-reported modifiable CVD risk factors clustering. Our findings underscore the necessity of targeted interventions and integrated strategies for early detection and treatment of modifiable CVD risk factors among older adults, considering age, sex, ethnicity, and socioeconomic status.

Self-Reported Diabetes Prevalence in Asian American Subgroups: Behavioral Risk Factor Surveillance System, 2013-2019.

Diabetes mellitus (DM) is a leading contributor to morbidity and mortality in the United States (US). Prior DM prevalence estimates in Asian Americans are predominantly from Asians aggregated into a single group, but the Asian American population is heterogenous. To evaluate self-reported DM prevalence in disaggregated Asian American subgroups to inform targeted management and prevention. Serial cross-sectional analysis. Respondents to the US Behavioral Risk Factor Surveillance System surveys who self-identify as non-Hispanic Asian American (NHA, N=57,001), comprising Asian Indian (N=11,089), Chinese (N=9458), Filipino (N=9339), Japanese (N=10,387), and Korean Americans (N=2843), compared to non-Hispanic White (NHW, N=2,143,729) and non-Hispanic Black (NHB, N=215,957) Americans. Prevalence of self-reported DM. Univariate Satterthwaite-adjusted chi-square tests compared the differences in weighted DM prevalence by sociodemographic and health status. Self-reported fully adjusted DM prevalence was 8.7% (95% confidence interval 8.2-9.3) in NHA, compared to 14.3% (14.0-14.6) in NHB and 10.0% (10.0-10.1) in NHW (p<0.01 for difference). In NHA subgroups overall, DM prevalence was 14.4% (12.6-16.3) in Filipino, 13.4% (10.9-16.2) in Japanese, 10.7% (9.6-11.8) in Asian Indian, 5.1% (4.2-6.2) in Chinese, and 4.7% (3.4-6.3) in Korean Americans (p<0.01). Among those aged ≥65 years, DM prevalence was highest in Filipino (35.0% (29.4-41.2)) and Asian Indian (31.5% (25.9-37.8)) Americans. Adjusted for sex, education, and race/ethnicity-specific obesity category, NHA overall had a 21% higher DM prevalence compared to NHW (prevalence ratio 1.21 [1.14-1.27]), while prevalence ratios were 1.42 (1.24-1.63) in Filipinos and 1.29 (1.14-1.46) in Asian Indians. Adjusted self-reported DM prevalence is higher in NHA compared with NHW. Disaggregating NHA reveals heterogeneity in self-reported DM prevalence, highest in Filipino and Asian Indian Americans.

Estimates of drug treated diabetes incidence and prevalence using Australian administrative pharmaceutical data.

IntroductionThe incidence and prevalence of diabetes within a population are important public health metrics. Pharmaceutical administrative data may offer a resource that can contribute to quantifying these measures using the recorded signals derived from the drugs used to treat people with diabetes.ObjectiveTo estimate the longitudinal incidence and prevalence of drug treated (DT) diabetes in Australia utilising an Australian Pharmaceutical Benefits Scheme (PBS) dataset and compare estimates with community survey data for all diabetes reported in the Australian National Health Survey (NHS).MethodsPersons with DT diabetes were identified within the PBS dataset using assigned Anatomic Therapeutic Chemical codes for ‘Drugs used in diabetes’. Prevalent persons with DT diabetes were determined by a single annual treatment, and incident cases from the earliest treatment with diabetes medications. Counts were aggregated by age group and utilised Australian national census data as a denominator to calculate diabetes disease frequencies for the period 2004–14. Comparison of PBS prevalence data was made with NHS surveys over equivalent years.ResultsThe age adjusted incidence of DT diabetes was 3.4/1000 in 2006 and increased to 3.8/1000 in 2011 and 5.1/1000 in 2014. Age adjusted prevalence of DT diabetes in Australia also rose from 26.7/1000 in 2006 to 32.1/1000 in 2011 and 42.1/1000 in 2014. DT diabetes prevalence estimates correlated with NHS estimates of self-reported diabetes prevalence across age groups and in 2014 was r = 0.987. However, PBS estimates of DT diabetes prevalence generally underestimated NHS values of self-reported diabetes in older age groups with mean percentage differences of –22% to –3%. In contrast, PBS data captured more younger persons with diabetes in comparison to NHS data. These differences were then used to adjust DT diabetes incidence rates to provide age specific estimates that could potentially reflect diabetes incidence estimates acquired by community survey.ConclusionsPBS data representing dispensed medications prescribed to persons with diabetes offers a perspective for the assessment of diabetes incidence and prevalence. PBS derived DT diabetes prevalence estimates correlate well with community survey estimates of self-reported diabetes, but underestimate NHS data in older age groups. Calibrated DT incidence estimates may potentially reflect community survey derived diabetes incidence estimates and may offer a method for longitudinal monitoring.

Access to healthcare services between insured and uninsured adults aged ≥50 years with diabetes in Mexico: the Mexican Health and Aging Study (MHAS-2018)

ObjectivesAnalyze the association between health insurance coverage and the use of health care services, dentist visits, and self-medication in a national sample of Mexican adults aged ≥50 years with diabetes. MethodsParticipants with diabetes taken from a subsample of the Mexican Health and Aging Study (MHAS-2018) (n = 3667) were examined, with data pertaining to the frequency of their doctor and dentist visits, residence, years of education, self-medication, and health insurance coverage (insured/uninsured) also collected. A logistic regression model was used to identify the association between independent variables and health insurance coverage, whereas Poisson regression models were also estimated to ascertain whether health insurance coverage was associated with the number of doctor and dentist visits. ResultsThe prevalence of self-reported diabetes was 24.6%, whereas approximately 93.3% of subjects had visited a doctor, 40.6% had visited a dentist, and 20.3% self-medicated. Individuals with insurance coverage were 75% (Odds ratio [OR] = 1.75 [95% confidence interval {CI}1.32–2.31]; P < 0.001) more likely to have visited a doctor and 57% more likely to have visited a dentist (OR = 1.57 [95% CI 1.35–1.83]; P < 0.001) than uninsured adult subjects, while adults living in rural areas were 77% less likely to be insured than adults living in urban areas. Doctor and dentist visits [rate ratio {RR} = 1.32 (95% CI 1.28–1.35); P < 0.001] and [RR = 1.47 (95% CI 1.37–1.58); P < 0.001, respectively] were found to be positively associated with the insured members of the study population. ConclusionA positive association was found between doctor and dentist visits in the population insured with diabetes. A major public health challenge is the population of diabetics who report being uninsured, wherein this population requires coverage to access the necessary clinical follow-up and control to prevent complications.

Self-reported diabetes and quality of life: findings from a general population survey with the Short Form-12 (SF-12) Health Survey.

IntroductionThe aim of the study was to compare health-related quality of life (HRQoL) in subjects with and without self-reported diabetes in a representative sample of the Polish general adult population.Material and methodsMembers of the general Polish population, selected with multi-stage stratified sampling, filled in the Short Form-12 (SF-12) questionnaire and answered a question about the diagnosis of diabetes. We estimated four types of outcomes: eight domain scores, physical component (PCS-12) and mental component (MCS-12) summaries, and a measure of overall health status weighted according to societal health preferences – SF-6D. We used multiple linear regression to examine the associations of sociodemographic characteristics with SF-12 summary indices.ResultsAmong 2938 respondents with complete SF-12 data, the prevalence of self-reported diabetes was 8.5% (95% CI: 7.5–9.6). Respondents with diabetes differed significantly from non-diabetic subjects in all SF-12 dimensions, with the most significant differences in physical functioning, general health, role physical and bodily pain (differences of means 31.9, 24.9, 24.1 and 22.3 points, respectively). Analysis across age groups showed that diabetes was associated with a mean decrease in PCS-12 and MCS-12 by 4.6 and 1.4 points, respectively. Female sex, advanced age, low education levels and treatment with insulin were independently associated with the impaired physical health of respondents with diabetes.ConclusionsWe provided a consistent description of HRQoL, measured using the SF-12 questionnaire, in subjects with self-reported diabetes and respondents without diabetes in a nationally representative sample of Polish adults. Identifying factors independently associated with worse HRQoL in respondents with diabetes may help healthcare providers target intervention programmes more effectively.

Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI.

To compare prevalence of self-reported diabetes between U.S. state-born, Puerto Rico-born, Mexico-born, Cuba-born, and South/Central America-born Hispanic groups, and examine whether risk for diabetes differs by country of origin and experiences with discrimination when accounting for BMI. Data from 6223 Hispanic respondents from the nationally representative NESARC-III study was used. Sociodemographic characteristics were compared across nativity groups, and adjusted odds of self-reported diabetes diagnosis (past year) tested. Differences by perceived discrimination (using endorsement of individual items assessing specific experiences) and by nativity were examined when accounting for sociodemographic characteristics, acculturation, and BMI. Prevalence of self-reported diabetes diagnosis was significantly higher among the Puerto Rico-born Hispanics, and remained significantly elevated when adjusting for perceived discrimination, acculturation, and health risk behaviors. When adjusting further for BMI, there were no significant differences in the odds of diabetes by nativity. Prevalence of lifetime perceived discrimination was significantly lower among Cuba-born Hispanics. Mean BMI was significantly lower in South/Central America-born Hispanic individuals relative to U.S. state-, Mexico-, and Puerto Rico-born Hispanic groups. Higher BMI was associated with significantly greater risk of diabetes diagnosis across groups. Marked heterogeneity exists in prevalence and in factors associated with diabetes risk and weight status across Hispanic groups in the U.S. Experiences with discrimination may play an important role in accounting for these differences. This should be considered when planning future research to inform the most optimal patient-centered prevention efforts. Level III, Evidence obtained from well-designed cohort analytic study.

Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland.

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.

Risk factor control across the spectrum of cardiovascular risk: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

BackgroundPresence of cardiovascular disease (CVD) risk factors (RFs) should prompt patients and their providers to work aggressively towards controlling those that are modifiable. The extent to which a greater CVD RF burden is related to CVD RF control in a contemporary and diverse Hispanic/Latino population is not well-understood. MethodsUsing multicenter community-based data from the Hispanic Community Health Study/Study of Latinos, we assessed the self-reported prevalence of hypertension, hypercholesterolemia, diabetes, and prevalent CVD (ischemic heart disease or stroke). We used contemporaneous guidelines to define RF control. Multivariable logistic regression for complex survey sampling was used to examine whether having more CVD RFs was associated with CVD RF control (adjusting for age, sex, Hispanic background group, education, and health insurance). ResultsOur sample included 8521 participants with at least one CVD RF or prevalent CVD. The mean age in HCHS/SOL target population was 49 (SE 0.3) years and 56% were women. Frequency of one, two, or three self-reported CVD RFs was 57%, 26%, 8%, respectively, and overall 9% of participants had prevalent CVD. After adjusting for sociodemographic factors, compared to those reporting one CVD RF, individuals with three CVD RFs were the least likely to have blood pressure, cholesterol, and glucose optimally controlled (odds ratio [OR]: 0.56; 95% confidence interval [CI]: 0.40–0.80). However, those with prevalent CVD were more likely to have all three risk factors controlled, (OR: 1.43; 95% CI: 1.01–2.01). ConclusionHispanic/Latino adults with three major CVD RFs represent a group with poor overall CVD RF control. Secondary CVD prevention fares better. The potential contributors to inadequate CVD RF control in this highly vulnerable group warrants further investigation.

Prevalence of Diabetes and Its Determinants in the Young Adults Indian Population-Call for Yoga Intervention.

BackgroundThe young Indian population, which constitutes 65% of the country, is fast adapting to a new lifestyle, which was not known earlier. They are at a high risk of the increasing burden of diabetes and associated complications. The new evolving lifestyle is not only affecting people’s health but also mounting the monetary burden on a developing country such as India.AimWe aimed to collect information regarding the prevalence of risk of diabetes in young adults (<35 years) in the 29 most populous states and union territories (7 zones) of India, using a validated questionnaire.MethodsA user-friendly questionnaire-based survey using a mobile application was conducted on all adults in the 29 most populous states/union territories of India, after obtaining ethical clearance for the study. Here, we report the estimation of the prevalence of the risk of diabetes and self-reported diabetes on 58,821 young individuals below the age of 35 years. Risk for diabetes was assessed using a standardized instrument, the Indian diabetes risk score (IDRS), that has 4 factors (age, family history of diabetes, waist circumference, and physical activity). Spearman’s correlation coefficient was used to check the correlations.ResultsThe prevalence of high (IDRS score > 60), moderate (IDRS score 30–50), and low (IDRS < 30) diabetes risk in young adults (<35 years) was 10.2%, 33.1%, and 56.7%, respectively. Those with high-risk scores were highest (14.4%) in the Jammu zone and lowest (4.1%) in the central zone. The prevalence of self-reported diabetes was 1.8% with a small difference between men (1.7%) and women (1.9%), and the highest (8.4%) in those with a parental history of diabetes. The south zone had the highest (2.5%), and the north west zone had the lowest (4.4%) prevalence.ConclusionsIndian youth are at high risk for diabetes, which calls for an urgent action plan through intensive efforts to promote lifestyle behavior modifications during the pandemics of both communicable and noncommunicable diseases.

Abstract 14813: Cardiovascular Stroke Nursing Best Abstract Award: Heterogeneity of Cardiovascular Disease Risk Factors Among Asian Immigrants: Insights From the 2010 - 2018 National Health Interview Survey

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the US. Asians are the fastest-growing immigrant group in the US and are disproportionately affected by CVD risk factors, compared to Whites. Studies on CVD risk aggregate Asians into a homogenous group. It is unclear how Asian immigrants (Indian subcontinent, Southeast Asia, Asia) differ with respect to CVD risks and in comparison, to Whites. Hypothesis: We hypothesize that there will be significant heterogeneity in CVD risk factors among Asian immigrant subgroups as compared to Non-Hispanics Whites. Methods: A cross-sectional comparative analysis of the 2010 to 2018 National Health Interview Survey was conducted among 508,941 participants. A generalized linear model using Poisson distribution was fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and smoking among Asian immigrants to Whites, adjusting for known confounders. Results: In this sample, 33,973 were Asian immigrants (26% Indian subcontinent; 45% Southeast Asia; 29% Asia) and 474,968 Whites; Indian subcontinent were the youngest (39 years; SE: 0.36). Compared to Whites, the Indian subcontinent had the highest prevalence of overweight/obesity (PR:1.22; 95% CI:1.19-1.25) and Southeast Asian had highest in high cholesterol (PR:1.16; 95% CI:1.10-1.23). Both, the Indian subcontinent (PR:1.69; 95% CI:1.49 - 1.93) and Southeast Asian (PR:1.38; 95%:1.26-1.52), reported a higher prevalence of diabetes. All Asian subgroups were more likely to be physically inactive and less likely to smoke than Whites (Table). Conclusion: Significant heterogeneity in CVD risk factors among Asian immigrants was observed compared to Whites. Providers caring for Asians should consider health behaviors and cultural beliefs influencing health outcomes and provide tailored and culturally informed care to improve the cardiovascular health of diverse populations.

Temporal changes in diabetes prevalence and achievement of care goals in urban South Asia from 2010 to 2016 - The Center for Cardio-metabolic Risk Reduction in South Asia Study.

Achievement of treatment targets among individuals with diabetes remains suboptimal in many parts of the globe. We aimed to assess changes in diabetes prevalence and achievement of diabetes care goals in South Asia using two consecutive cross-sectional population-based surveys. Two representative samples of South Asian adults were recruited using identical methods from Chennai, Delhi, and Karachi in 2010-11 (n=16,288; response rate-94.7%) and 2015-16 (n=14,587; response rate-94.0%) through the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) Study. Quality of care goals were defined as HbA1c <53mmol/mol (7.0%), blood pressure (BP) control: <140/90mmHg, lipid control: LDL cholesterol <2.56mmol/l (100mg/dl), and self-reported non-smoking. Weighted prevalence of self-reported diabetes increased by 9.0% [13% (95%CI: 13-14) to 15% (14-15)] while that of newly diagnosed diabetes decreased by 16% [6.1% (5.7-6.6) to 5.1% (4.6-5.6)]. There were improvements in achieving glycaemic (25% to 30%, p=0.002) and lipid (34% to 45%, p<0.001) goals, but no notable improvements in BP control or smoking status. The proportion of individuals with self-reported diabetes meeting more than one target also increased. Diabetes prevalence continues to grow among urban South Asians and large gaps still exist in the attainment of treatment targets. Concerted policy, systemic, clinical and individual efforts are needed to close these care gaps.

Access to Care and Prevalence of Hypertension and Diabetes Among Syrian Refugees in Northern Jordan

The management of noncommunicable diseases in humanitarian crises has been slow to progress from episodic care. Understanding disease burden and access to care among crisis-affected populations can inform more comprehensive management. To estimate the prevalence of hypertension and diabetes with biological measures and to evaluate access to care among Syrian refugees in northern Jordan. This cross-sectional study was undertaken from March 25 to April 26, 2019, in the districts of Ramtha and Mafraq, Jordan. Seventy clusters of 15 households were randomly sampled, and chain referral was used to sample Syrian households, representative of 59 617 Syrian refugees. Adults were screened and interviewed about their access to care. Data analysis was performed from May to September 2019. Primary care delivered through a humanitarian organization since 2012. The main outcomes were self-reported prevalence of hypertension and diabetes among adults aged 18 years or older and biologically based prevalence among adults aged 30 years or older. The secondary outcome was access to care during the past month among adults aged 18 years or older with a diagnosis of hypertension or diabetes. In 1022 randomly sampled households, 2798 adults aged 18 years or older, including 275 with self-reported diagnoses (mean [SD] age, 56.5 [13.2] years; 174 women [63.3%]), and 915 adults aged 30 years or older (608 women [66.5%]; mean [SD] age, 46.0 [12.8] years) were screened for diabetes and hypertension. Among adults aged 18 years or older, the self-reported prevalence was 17.2% (95% CI, 15.9%-18.6%) for hypertension, 9.8% (95% CI, 8.6%-11.1%) for diabetes, and 7.3% (95% CI, 6.3%-8.5%) for both conditions. Among adults aged 30 years or older, the biologically based prevalence was 39.5% (95% CI, 36.4%-42.6%) for hypertension, 19.3% (95% CI, 16.7%-22.1%) for diabetes, and 13.5% (95% CI, 11.4%-15.9%) for both conditions. Adjusted for age and sex, prevalence for all conditions increased with age, and women had a higher prevalence of diabetes than men (adjusted prevalence ratio, 1.3%; 95% CI, 1.0%-1.7%), although the difference was not significant. Complications (57.4%; 95% CI, 51.5%-63.1%) and obese or overweight status (82.8%; 95% CI, 79.7%-85.5%) were highly prevalent. Among adults aged 30 years or older with known diagnoses, 94.1% (95% CI, 90.9%-96.2%) currently took medication. Among adults aged 18 years or older with known diagnoses, 26.8% (95% CI, 21.3%-33.1%) missed a medication dose in the past week, and 49.1% (95% CI, 43.3%-54.9%) sought care in the last month. During this protracted crisis, obtaining care for noncommunicable diseases was feasible, as demonstrated by biologically based prevalence that was only moderately higher than self-reported prevalence. The high prevalence of complications and obese or overweight status, however, suggest inadequate management. Programs should focus on reinforcing adherence and secondary prevention to minimize severe morbidity.

Diabetes and acculturation in African immigrants to the United States: analysis of the 2010–2017 National Health Interview Survey (NHIS)

ABSTRACT Objective: This study sought to assess the association between unidimensional acculturation and diabetes, and analyze mediating pathways of the association in African immigrants to the United States (U.S.). Hypothesis: Acculturation would be positively associated with diabetes and that BMI (Body mass index), physical activity, and psychological distress would mediate this association. Methods: An analysis of cross-sectional data from the 2010–2017 National Health Interview Surveys was performed. Adults aged ≥ 18 years who were born in Africa (African immigrants) and residing in the U.S. were considered. The outcome was self-reported diabetes, and acculturation was defined by percent of life spent in the U.S. and citizenship. Multivariable logistic regression analysis was used to assess the association between acculturation and diabetes, and mediation analysis was used to examine the mediating effects of BMI, physical activity, and psychological distress on this association. Results: The analytic sample included 1648 African immigrants with mean (SD) age of 41.3 ± 0.45 years; 56.4% male. Additionally, 46% had ≥ college education, and 21.4% lived below the poverty threshold. About two-thirds were overweight/obese. Less than 50% exercised at adequate levels of physical activity levels. A small percentage (1.8%) reported psychological distress. The prevalence of self-reported diabetes was 6.1%, and 76.5% reported being acculturated. In the multivariate logistic regression analysis, higher levels of acculturation were associated with higher odds of diabetes diagnosis (Odds Ratio (OR) = 2.2; 95% CI = 1.1–4.4). Although BMI mediated the association between acculturation and diabetes ( = 2.11, p = 0.036), only 18.9% of the total effect of acculturation on diabetes was explained by BMI. Conclusions: Acculturation increased the odds of diabetes diagnosis, and BMI mediated the association. Thus, tailoring culturally-appropriate interventions to control BMI may contribute to preventing diabetes within African immigrant communities to the U.S.

Are recently arrived migrants at higher risk of developing diabetes in Scania, Sweden?

Abstract Background The world is facing increased migration as well as increased diabetes prevalence including earlier disease debut than ever before. Sedentary lifestyle and obesity constitute risk factors for development of diabetes type 2, the most common diabetes type among adults. It is thus important to increase the awareness of diabetes prevalence and of those being at risk for the disease. The aim was to focus on self-reported diabetes and weight in recently arrived migrants (RAM) in comparison with the rest of the population of Scania. Methods A cross-sectional study was used to collect data through random sampling using a self-administrated questionnaire. 10 000 questionnaires in Arabic were sent to adult RAM in Scania born in Syria or Iraq and 10 000 questionnaires to a random sample of the Scania population as a control group. The overall response rate was 32.8 %, 3461 were male and 3105 were female and the overall mean age was 44.7 (range 22 -70). Results 170 RAM and 147 controls reported diabetes, 741 RAM and 585 controls reported a body mass index (BMI) ≥ 30 kg/m2. A significantly higher prevalence of self-reported diabetes was observed among RAM (6.2% compared to 4.9%, p-value = 0.02). In comparison with age, significantly (p-value &amp;lt; 0.05) higher prevalence was present in RAM as compared to the control group in all age categories except the age category 65-80 where the difference was borderline significant (p-value = 0.056). With regard to BMI no significant difference was observed between the RAM and the control group having diabetes, but independently of diabetes the prevalence of BMI 25-30 kg/m2 and BMI ≥ 30 kg/m2 was significantly higher in RAM (p-value &amp;lt; 0.01). Conclusions Self-reported diabetes is more prevalent in RAM as compared to a control group representing the rest of the population in Scania. Considerably large amount of the respondents in both groups are overweight or obese and are therefore to be considered at risk for developing diabetes type 2. Key messages Self-reported diabetes in Scania is more prevalent in RAM from Iraq and Syria than in the rest of the population in Scania. Health care services need to address that a large number of the population in Scania is being overweight or obese, which is even more prominent in RAM from Iraq and Syria.

Changes in health inequalities for patients with diabetes among middle-aged and elderly in China from 2011 to 2015

BackgroundThe purpose of this paper is to measure income-related health inequality among middle-aged and elderly patients with diabetes in China from 2011 to 2015 and to investigate factors that might be related to this inequality.MethodsThe data for this study were obtained from the China Health and Retirement Longitudinal Study that was carried out in 2011, 2013 and 2015. In total, 48,519 Chinese middle-aged and elderly population were included (15,457 in 2011, 16,576 in 2013 and 16,486 in 2015). A principal component analysis was performed to measure asset-based economic status. The concentration index was used to measure income-related inequality in patients with diabetes. Additionally, by used generalized linear model, we decomposed the concentration index to identify factors that explained wealth-related inequality in patients with diabetes.ResultsThe prevalence of self-reported diabetes among middle-aged and elderly Chinese was 5.61, 7.49 and 8.99% in 2011, 2013 and 2015, respectively. The concentration indices and 95% confidence intervals for diabetes were 0.1359 (0.0525–0.0597), 0.1207 (0.0709–0.0789), 0.1021 (0.0855–0.0942) in 2011, 2013, and 2015, respectively, which are indicative of inequality that favors the rich. The decomposition of the concentration index showed that residence (39.38%), BMI (31.16%), education (7.28%), and region (6.09%) had positive contributions to the measured inequality in diabetes in China in 2015. Age (− 29.93%) had a negative contribution to inequality.ConclusionThe findings confirm a health inequality in diabetes that favor the rich. Furthermore, the inequality declined from 2011 to 2015. We suggest that policy and intervention strategies should be developed to alleviate this health inequality, such as narrow the gap between urban and rural areas by improving the urban-rural medical insurance scheme, implementing strategies to enhance hygiene health education, control obesity rate.

A nationwide analysis of the excess death attributable to diabetes in Brazil.

BackgroundData on mortality burden and excess deaths attributable to diabetes are sparse and frequently unreliable, particularly in low and middle-income countries. Estimates in Brazil to date have relied on death certificate data, which do not consider the multicausal nature of deaths. Our aim was to combine cohort data with national prevalence and mortality statistics to estimate the absolute number of deaths that could have been prevented if the mortality rates of people with diabetes were the same as for those without. In addition, we aimed to estimate the increase in burden when considering undiagnosed diabetes.MethodsWe estimated self-reported diabetes prevalence from the National Health Survey (PNS) and overall mortality from the national mortality information system (SIM). We estimated the diabetes mortality rate ratio (rates of those with vs without diabetes) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), an ongoing cohort study. Joining estimates from these three sources, we calculated for the population the absolute number and the fraction of deaths attributable to diabetes. We repeated our analyses considering both self-reported and unknown diabetes, the latter estimated based on single point-in-time glycemic determinations in ELSA-Brasil. Finally, we compared results with diabetes-related mortality information from death certificates.ResultsIn 2013, 65 581 deaths, 9.1% of all deaths between the ages of 35-80, were attributable to known diabetes. If cases of unknown diabetes were considered, this figure would rise to 14.3%. In contrast, based on death certificates only, 5.3% of all death had diabetes as the underlying cause and 10.4% as any mentioned cause.ConclusionsIn this first report of diabetes mortality burden in Brazil using cohort data to estimate diabetes mortality rate ratios and the prevalence of unknown diabetes, we showed marked underestimation of the current burden, especially when unknown cases of diabetes are also considered.

Prevalence of risk factors for non-communicable diseases in a rural population of Bangladesh: a cross-sectional study

BackgroundNon-communicable diseases (NCDs) account for 67% of annual deaths in Bangladesh. Behavioural and clinical risk factors such as high blood pressure, high blood glucose concentrations, dietary habits, physical inactivity, tobacco use, and alcohol consumption contribute to the prevalence of NCDs. In this study, we aim to estimate the prevalence of NCD risk factors and relevant characteristics in rural adult residents of Bangladesh. MethodsIn this cross-sectional survey, we included participants aged 18 years and older who resided in Parbatipur subdistrict of Bangladesh. We used a modified WHO STEPS tool to collect data. Additionally, questions were included on hypertension and diabetes within the questionnaire to evaluate participants' knowledge about NCDs and health-care-seeking practice. Standard bowl, teaspoon, and show cards were shown to respondents while asking about fruit, vegetables, salt, tobacco, and alcohol consumption. We used calibrated instruments to measure blood pressure, height, weight, and waist-hip circumference and asked respondents to self-report information about diabetes and lipid profile. To calculate the prevalence of hypertension, we considered participants with a previous diagnosis of hypertension and also those who had diastolic blood pressure ≥90 mm Hg or systolic blood pressure ≥140 mm Hg, or both, measured during the study. We used STATA (version 13.0) for data analysis. FindingsBetween Nov 17 and Dec 4, 2018, we collected data from 421 participants; median age was 41·9 years (SD 15·7) and 50·1% of participants (n=211) were women. Nearly half (41·6%) of respondents had hypertension. Self-reported prevalence of diabetes and high cholesterol was 4·3% and 1·0% respectively. Prevalence of physiological risk factors such as overweight (BMI 25·0–29·9 kg/m2), obesity (BMI ≥30 kg/m2), high waist circumference (≥100 cm for men and ≥90 cm for women), and high waist-hip ratio (≥0·90 for men and ≥0·80 for women) were 32·5%, 10·5%, 11·6%, and 87·4%, respectively. Other risk factors included smoking or consumption of smokeless tobaccos, or both (49·9%), inadequate physical activity (56·3%), inadequate consumption of fruits and vegetables (76·0%), and intake of extra salt in food (35·1%). Although most respondents had heard about hypertension (93·1%) and diabetes (94·3%), knowledge and practice of NCD prevention were found to be poor. Regarding the risk factors of developing hypertension and diabetes, most respondents mentioned that they did not know (46·8% and 64·4%, respectively) about this. InterpretationEven in a rural setting, lifestyle and dietary habits may be responsible for the high prevalence of NCDs that hinders people's quality of life and productivity. A comprehensive behaviour modification intervention should be undertaken by the public and private sectors to address the reduction of risk factors for NCDs. A limitation of this study was that it took place in the harvesting season when respondents were mostly busy and anxious about collecting their crops. FundingMasters dissertation funded by BRAC James P Grant School of Public Health, BRAC University.

Characteristics of undiagnosed diabetes in men and women under the age of 50 years in the Indian subcontinent: the National Family Health Survey (NFHS-4)/Demographic Health Survey 2015–2016

ObjectivePrior studies examining diabetes prevalence in India have found that nearly 50% of the diabetes population remains undiagnosed; however, the specific populations at risk are unclear.Research design and methodsFirst, we...

Health, wellbeing and access to care of undocumented migrants in Geneva, Switzerland

Abstract Background Switzerland hosts 50’000 to 100’000 undocumented migrants but hardly any evidence exist about their health and wellbeing. A pilot regularization policy took place in Geneva (2017-2018). Methods Parchemins is a mixed-methods prospective study assessing the impact of legal status regularization on undocumented migrants’ health and wellbeing. The quantitative data collection uses yearly face-to-face health questionnaire. Wellbeing is measured by self-reported satisfaction with life on a 10-point Likert scale. We present the results of the first wave of data collection conducted before regularization. Results Participants were mainly women (71.9%) from Latin America (63.2%), aged 44.2 (SD 10.4) years, with secondary or higher education (77.3%), living in Geneva with a partner (47.6%) and minor children (22.3%) for an average of 11.8 (SD 5.4) years. While 82.2% reported good to excellent health, 54% presented overweight or obesity and 21% suffered 3 or more chronic conditions. Self-reported prevalence of hypertension, hypercholesterolemia and diabetes were 17.6%, 7.6% and 4.9%, respectively. Screening for depression and anxiety using PHQ-9 and GAD-7 scales was positive in 45.2% and 35.9% of participants. Only 29.9% had a health insurance. In the previous year, 74.8% had at least one medical consultation and 30.4% consulted in emergency but 27% had renounced to seek care for economic reasons. Overall, 97.3% were exposed to health hazards at the workplace and 5.9% suffered an accident leading to work interruption in the last 6 months. Overall, life satisfaction level amounted to 7.4 (SD 2.2) out of 10. Conclusions The baseline results show a contrast between good self-reported health and fair wellbeing with frequent comorbid health conditions notably of mental origin, exposure to occupational hazards and economic limitations in the ability to respond to one’s health care needs. Next study waves will shade light on the public health and clinical impact of regularization. Key messages Legal status may act as a key determinant of health therefore regularization is likely to produce significant health effects. Undocumented migrants good wellbeing and self-reported health contrasts with high morbidity notably of mental origin.