Type 2 Diabetes Mellitus In Men Research Articles

Distress and Coping Strategy among Indonesian Men with Type-2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) can have a notable impact on the psychological and physical well-being of individuals, which, in turn, affects the management of the condition. Both men and women experience stress and adopt distinct coping strategies. However, research focusing specifically on T2DM in men is still limited. Purpose: The present study aimed to investigate the distress and coping strategies adopted by outpatient men with T2DM in Malang, East Java, Indonesia.Methods: This study employed a qualitative research design and conducted in-depth interviews with 24 outpatient men with T2DM. The interview guidelines were formulated using the Bahasa Indonesia version of the Diabetes Distress Scale (DDS17) questionnaire, which includes four domains: physician distress, emotional burden, regimen distress, and interpersonal distress. Thematic analysis was performed to analyze the results gathered during the research and compile them into a final report. Results: The study revealed that individuals diagnosed with T2DM experienced a range of emotional and practical difficulties, including feelings of fear, anxiety, and a lack of understanding. Disease burden, a lack of understanding of healthcare services, difficulties managing their diet, routine medication, financial concerns, and fatigue also contributed to the distress. To cope with distress, the informants identified eight distinct coping strategies. Among these, the most effective was receiving support from family members. Additionally, acceptance of the condition, self-management, a positive attitude, understanding of the illness, participation in the diabetes community, spiritual solace, and gaining further knowledge of T2DM were also identified. Conclusion: The findings of this research indicate that men experience eight distinct types of stress and utilize comparable coping strategies associated with T2DM. Emotional distress represents the predominant pressure, while family support constitutes the primary coping strategy. These results are important for nurses and other healthcare professionals in supporting patients.

Mercury Exposure and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Methods Scopus and PubMed databases were systematically searched from their inception to November 2021 to obtain pertinent studies. Standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the difference in Hg levels between people with and without T2DM. The association of the Hg exposure with T2DM was assessed using a random-effects model by pooling the odds ratios (ORs) and 95% CIs. Results A total of 17 studies, with 42,917 participants, aged ≥18 years, were analyzed. Overall, Hg levels were significantly higher in T2DM patients compared with non-T2DM controls (SMD = 1.07; 95%CI = 0.59 to 1.55, P ≤ 0.001), with significant heterogeneity across studies (I2 = 96.1%; P=≤0.001). No significant association was found between Hg exposure and risk of T2DM in the overall analysis and subgroup analysis based on the source of sample and study design. However, higher exposure to Hg was related to reduced risk of T2DM in men (OR = 0.71; 95%CI = 0.57 to 0.88), but not in women. No significant evidence for publication bias was detected. Conclusions Although the Hg level in T2DM is significantly higher than that of nondiabetics, there was no association between Hg exposure and the overall risk of T2DM. Nevertheless, our study shows that higher exposure to Hg might reduce the risk of T2DM in men.

Psychosocial factors in adherence to pharmacological treatment and diabetes mellitus control in patients over 65

AimTo explore the influence of anxiety/depression symptoms and social risk in patients older than 65 years with type 2 diabetes mellitus (T2DM) both in non-adherence to pharmacological treatment (Non-AdhT) and in poor control of T2DM. DesignCross-sectional study. Setting and participantsAdults over 65 years of age with T2DM treated at the Madrid Primary Care Service. Main measurementsData collection: Electronic Health Record database. Variables: Poor control of T2DM (HBA1c) and Non-AdhT (Morisky-Green test); main clinical variables: symptoms of depression/anxiety and social risk. Global multivariate logistic regression models and disaggregated by sex were used to Non-AdhT and poor T2DM control. ResultsData were obtained on 884 subjects. Non-AdhT prevalence: 4.4%; prevalence of poor T2DM control: 37.2%. Multivariate logistic regression models for No-AdhT in men showed a higher risk if they had symptoms of anxiety/depression (OR: 3.88; 95%CI: 1.15–13.07); and in women, if they had social risk (OR: 5.61; 95%CI: 1.86–16.94). Multivariate logistic regression models for poor control of T2DM in men revealed a higher risk if they did not have AdhT (OR: 3.53; 95%CI: 1.04–12.02). ConclusionsIn people over 65 years with T2DM, although Non-AdhT is low, the prevalence of poor T2DM control is high. Symptoms of depression or anxiety are a risk factor to Non-AdhT in men, while social risk has the same effect in women. Non-AdhT in men increases the risk of poor T2DM control. From a gender perspective, it is important to detect social and mental health problems in older adults with diabetes and to reinforce strategies to improve their adherence to drug treatment in these patients.

Association of serum creatinine levels and risk of type 2 diabetes mellitus in Korea: a case control study

BackgroundReduced skeletal muscle has been suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in skeletal muscle. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea.MethodsWe analyzed a total of 264,832 nondiabetic adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2015 in the Korean National Health Insurance Service Cohort. Hazard ratios for T2DM were calculated.ResultsIn men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association. This association was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose.ConclusionsReduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women with serum creatinine below 1.1 mg/dl, although this result was not statistically significant.

Comparison of different obesity indices associated with type 2 diabetes mellitus among different sex and age groups in Nantong, China: a cross-section study

BackgroundObesity is associated with type 2 diabetes mellitus (T2DM). However, the obesity index that is most closely related to type 2 diabetes remains controversial. Therefore, the aim of this study was to compare the associations of five anthropometric indices (body mass index [BMI], body adiposity index, waist circumference [WC], waist-to-hip ratio, and waist-to-height ratio [WHtR]) with T2DM among Chinese adults divided into four groups according to sex and age.MethodsA total of 4007 adult participants (1669 men and 2338 women) were included in the study. Odds ratios (ORs) and 95% confidence intervals were used with binary logistic regression models to estimate the risk of T2DM for each obesity index. Furthermore, we compared the area under the receiver operating characteristic curve (AUC) of each obesity index for the criterion of T2DM under the influence of risk factors.ResultsWC had the highest OR (3.211 and 1.452) and AUC (0.783 and 0.614) in both age groups of men. However, WHtR (OR = 2.366, AUC = 0.771) and BMI (OR = 1.596, AUC = 0.647) were the optimal criteria for predicting T2DM among females in the 18–59 and ≥ 60 years age groups, respectively.ConclusionsThis study suggests that there is a positive association between obesity-related anthropometric indices and T2DM in different sex and age groups. WC appears to be the optimal anthropometric index for predicting T2DM in men. The optimal obesity indices related to T2DM were WHtR and BMI for women aged 18–59 and ≥ 60 years, respectively.

The mediating effect of quality of life on alcohol consumption and the 10-year type 2 diabetes mellitus risk score in adult Korean men

Background: The rate of high-risk drinking, a major cause of type 2 diabetes mellitus (T2DM), is increasing among Korean men. This study descriptive survey whether quality of life (QoL) mediates the relationship between drinking and 10-year T2DM risk scores in adult Korean men. Methods: We further analyzed data from the 7th Korea National Health and Nutrition Examination Survey 7th (KNHANES VII) from 2016 to 2018, selecting 4134 men aged 40–69 years who were not diagnosed with T2DM. The data were analyzed using complex sample regression; after analyzing the mediation. Results: In step 1 of the regression, the drinking rate significantly predicted QoL (β = 0.08, p < 0.001), and in step 2, the drinking rate significantly predicted the 10-year T2DM risk score (β = 0.08, p < 0.001). In step 3, the drinking rate (β = 0.08, p < 0.001) and QoL (β = –0.09, p < 0.001) were found to significantly predict the 10-year T2DM risk score, confirming that QoL partially mediates the 10-year T2DM risk score (z = –3.62, p < 0.001). QoL was found to mediate the relationship between the drinking rate and 10-year T2DM risk score. Conclusions: Sex-specific risk factors must be considered to reduce the incidence of T2DM, and measures to promote healthy drinking habits need to be implemented to reduce the incidence of T2DM in men. Furthermore, these findings highlight the need to develop and actively implement various practical intervention strategies to enhance QoL.

Sex-Specific Differences in the Associations Between Omega-6 Polyunsaturated Fatty Acids and Type 2 Diabetes in Chinese People.

Background: Some evidence indicates a potential beneficial effect of omega-6 polyunsaturated fatty acids (n-6 PUFAs) on type 2 diabetes mellitus (T2DM); however, the findings to date remains inconclusive and little is known about whether sex modifies these associations. Therefore, this study aimed to investigate potential sex-specific differences in this associations among Chinese adults.Methods: We conducted a cross-sectional study in an area of Dalian city, China; Chinese men and women who attended the Department of Clinical Nutrition and Metabolism between January and December 2020 were invited to participate in this study. All participants were assessed for basic demographic characteristics, fasting blood glucose, HbA1c, and other serum biomarkers and serum phospholipid FAs.Results: In total, 575 Chinese adult participants (270 men and 305 women) were included in the analysis. Hypertension and dyslipidaemia were more common among men than women, but there were no significant differences between the sexes in fatty acid composition, except for eicosadienoic acid (EA; 20:2n-6) and total monounsaturated fatty acids (MUFA). The age-adjusted OR for having T2DM in the highest quartile of arachidonic acid (20:4n-6) level was 0.47 (95% CI, 0.22, 0.98) in men, and this association remained consistently significant in the fully adjusted multivariate models. In contrast, no significant associations between n-6 PUFAs and T2DM risk were observed in women, regardless of model adjustment.Conclusions: In conclusion, these results demonstrate a notable sex-specific differences in the associations between n-6 PUFAs and T2DM. Higher n-6 PUFA status may be protective against the risk of T2DM in men.

Combined effects of progesterone and SOCS3 DNA methylation on T2DM: a case\u2013control study

BackgroundThis study aims to investigate the independent and combined effects of progesterone and suppressor of cytokine signaling (SOCS)-3 DNA methylation on type 2 diabetes mellitus (T2DM) among men and postmenopausal women in rural China.MethodsA case–control study with 914 participants (329 T2DM, 585 controls) was conducted. Serum progesterone was detected with liquid chromatography-tandem mass spectrometry. DNA methylation of SOCS3 was determined by MethylTarget™. Linear regression was applied to evaluate the associations of progesterone and SOCS3 methylation with marks of glucose metabolism. Logistic regression was employed to investigate the independent and combined effects of progesterone and SOCS3 methylation with T2DM in men and postmenopausal women.ResultsAfter multiple adjustment, progesterone was positively associated with T2DM in both men (odds ratio (OR) (95% confidence interval (CI)): 2.77 (1.79, 4.29)) and postmenopausal women (OR (95% CI): 1.85 (1.26, 2.72)). Methylation level of Chr17:76,356,190 or Chr17:76,356,199 (SOCS3) was negatively associated with T2DM in both men (OR (95% CI): 0.58 (0.39, 0.86) or 0.27 (0.14, 0.51)) and postmenopausal women (OR (95% CI): 0.43 (0.29, 0.65) or 0.53 (0.28, 0.99)). Subjects with high progesterone and low Chr17:76,356,190 or Chr17:76,356,199 methylation were more susceptible to have a higher prevalence of T2DM (men: OR (95% CI): 5.20 (2.49, 10.85) or 5.62 (2.74, 11.54); postmenopausal women: OR (95% CI): 3.66 (1.85, 7.26) or 3.27 (1.66, 6.45)).ConclusionsThe independent and combined effects of progesterone and SOCS3 methylation on T2DM were found among men and postmenopausal women, suggesting that ensuring low levels of progesterone and high methylation of SOCS3 could reduce the prevalence of T2DM.Trial registration The Chinese Clinical Trial registration: The Henan Rural Cohort Study, ChiCTR-OOC-15006699. Registered 06 July 2015, http://www.chictr.org.cn/showproj.aspx?proj=11375

Comparison of obesity indices and triglyceride glucose-related parameters to predict type 2 diabetes mellitus among normal-weight elderly in China.

Although a significant proportion of type 2 diabetes mellitus (T2DM) cases arose from normal-weight individuals, studies on indicators of T2DM in normal-weight people are limited. Accordingly,this study aims to investigate the predictive value of obesity indices and triglyceride glucose-related parameters (TyG-related parameters) in T2DM among normal-weight Chinese elderly. A total of 24,215 normal-weight Chinese elderly (age ≥ 60years) [body mass index-BMI (18.5-23.9kg/m2)] were included. Obesity indices and triglyceride glucose-related parameters (TyG-related parameters) included waist circumference (WC), waist-to-height ratio (WHtR), visceral adiposity index (VAI), lipid accumulation product (LAP), and TyG-related parameters (TyG, TyG-BMI, TyG-WC, and TyG-WHtR). Multivariate logistic regression analysis was performed to examine the associations between obesity- and TyG-related indices and T2DM. The areas under the curve (AUC) of the receiver-operating characteristic (ROC) curve analyses were used to evaluate and compare the predictive value of the different indices. The prevalence of T2DM was 14.2% in normal-weight individuals. Among the indices, TyG was significantly associated with T2DM among men and women, respectively, (adjusted odds ratio-aOR per SD 3.46; 95% CI 3.23-3.71) and (aOR per SD 3.64; 95% CI 3.43-3.86). Compared with other indices, TyG had the highest AUC value for T2DM in men (AUC: 0.818, 95% CI 0.810-0.825) and women (AUC: 0.824, 95% CI 0.814-0.833). TyG is an effective marker and outperforms other indices when predicting T2DM in the normal-weight Chinese elderly population. Level V: Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

ESRα Promoter Methylation May Modify the Association Between Lipid Metabolism and Type 2 Diabetes in Chinese Farmers.

Objective: This study is aimed to explore the potential association among the estrogen receptor alpha (ESRα) promoter methylation, lipid metabolism and the risk of type 2 diabetes mellitus (T2DM).Methods: A total of 1143 rural residents were recruited randomly from Henan Province, China. The circulating methylation levels in ESRα promoter region were determined by quantitative methylation-specific polymerase chain reaction. Serum high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and fasting plasma-glucose (FPG) were measured.Results: The ESRα promoter methylation levels were negatively associated with HDL-C levels whether gender stratification was performed (P < 0.05) and positively correlated with LDL-C in men (P < 0.05). Each unit standard deviation (SD) increment in TG was associated with a 43% increase (95% CI: 1.25, 1.64) in the risks of T2DM in all participants, a 36% increase (95% CI: 1.13, 1.64) in the risks of T2DM in men and a 49% increase (95% CI: 1.21, 1.83) in the risks of T2DM in women. Furthermore, each SD increment in HDL-C was associated with a reduction of 25% (OR = 0.75, 95% CI: 0.58, 0.97) in the risks of T2DM in men, and the risk of T2DM in men may be more susceptible to HDL-C than that in women (P for interaction < 0.05). Additionally, we found that the risk of T2DM in participants with lower methylation levels (≤4.07%) were more susceptible to HDL-C (P for interaction < 0.05).Conclusions: These findings suggested that lipid metabolism was associated with ESRα promoter methylation levels and the risk of T2DM. Besides, the levels of ESRα promoter methylation and gender can modify the association of HDL-C and T2DM.

1458-P: Association of Serum Creatinine Levels and Risk of Type 2 Diabetes Mellitus in Korea

Low skeletal muscle is known to be associated with insulin resistance and suggested as a potential risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is the primary metabolite of creatine in the skeletal muscle and used as a surrogate of muscle mass. Therefore, low serum creatinine levels may be associated with the risk of T2DM. However, there were few studies about the association between serum creatinine levels and the risk of T2DM in Korea. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM in Korea. We analyzed a total of 264,832 nondiabetic adults older than 30 years of age who had undergone a national health examination from 2002 to 2012 in the Korean National Health Insurance Service Cohort. The serum creatinine was divided into four categories (&amp;lt;0.70, 0.70∼0.89, 0.90∼1.19, ≥1.20 mg/dl for men, &amp;lt;0.60, 0.60∼0.79, 0.80∼1.09, ≥1.10 mg/dl for women). Hazard ratios for T2DM were calculated using Cox proportional hazards models. In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association, with the lowest risk among men with serum creatinine between 0.90 and 1.19 mg/dl. This inverse J-shaped association between serum creatinine level and the risk for T2DM was confirmed after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, subjects with highest serum creatinine level had the highest risk of T2DM. However, serum creatinine was not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Lower serum creatinine was significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl even after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Highest creatinine level was significantly associated with an increased risk of T2DM in women, however, this association disappeared after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Disclosure D. Song: None. H. Lee: None. Y. Hong: None. Y. Sung: None.

Association of polymorphisms in LEPR with type 2 diabetes and related metabolic traits in a Chinese population

BackgroundLeptin acts as a mediator of inflammation and energy homeostasis by activating leptin receptor (LEPR). We conducted this study to explore the association of polymorphisms in LEPR with type 2 diabetes mellitus (T2DM) and its related metabolic traits.MethodsWe performed a case–control study to investigate the association of polymorphisms in LEPR with T2DM and related metabolic traits in a Chinese population, with a total of 922 T2DM patients and 1031 nondiabetic subjects. Polymorphisms were genotyped using MassARRAY assay.ResultsThe G allele of rs1327118 was associated with a decreased risk of T2DM in men (P = 0.044, odds ratio = 0.707, 95% confidence interval = 0.504–0.991) and the G allele of rs3806318 was associated with increased systolic blood pressure (SBP) in men with T2DM. Besides, the women patients carrying the G allele of rs1327118 showed increased SBP and diastolic blood pressure (DBP) levels, but decreased high density lipoprotein cholesterol (HDL-C) level.ConclusionOur results suggest that rs1327118 may be associated with SBP, DBP and HDL-C levels in women with T2DM, and rs3806318 may be associated with T2DM and SBP level in men with T2DM. Further studies with larger sample size or functional experiments focused on exact mechanism are required to verify our observations.

Adiposity phenotypes are associated with type-2 diabetes: LAP index, body adiposity index, and neck circumference

Background and aimsAdiposity phenotypes can be detected by anthropometric indexes associated with type-2 diabetes mellitus (T2DM). Besides body mass index (BMI) and waist circumference (WC), new indices seem to be able to identify T2DM. This study aimed to evaluate independent associations of T2DM with lipid accumulation product (LAP index), neck circumference (NC) and body adiposity index (BAI) in patients with hypertension. MethodsA cross-sectional study was carried out among 430 patients with hypertension. The T2DM diagnosed was standardized. WC and NC (cm) were measured and BMI was calculated. LAP index was calculated separately for men [(WC-65) × TG] and women [(WC-58) × TG]; BAI was evaluated in percentiles according to hip (cm)/[height (m)1.5]-18. ResultsParticipants were aged 58.3 ± 11.7 years, had systolic blood pressure (SBP) 154.2 ± 24.9 mmHg, diastolic blood pressure (DBP) 89.0 ± 14.7 mmHg, and BMI 30.1 ± 6.0 kg/m2. There was 145 men and 285 women, and 142 participants had T2DM. Analyses carried out separately by gender showed that among men, BAI at the 75th percentile increased about 60% the risk of T2DM, while among women, those in the upper quartile of LAP and NC had increased risk of T2DM (prevalence ratio (PR): 2.93; 95%CI: 1.62–5.28 and 3.30; 95%IC: 1.78–6.14, respectively), after adjustment for potential confounders. ConclusionsAdiposity phenotypes such as LAP index and neck circumference were independently associated with T2DM in hypertensive women, and BAI was associated with T2DM in men.

Periodontitis and incident type 2 diabetes: a prospective cohort study.

The aim of this study was to investigate periodontitis as a risk factor for incident type 2 diabetes mellitus (T2DM) in a group of men aged 58-72years. One thousand three hundred and thirty-one dentate, diabetes-free men in Northern Ireland underwent a detailed periodontal examination during 2001-2003. Follow-up was by bi-annual questionnaire and for those reporting diabetes their general medical practitioner was contacted to validate diabetes type, treatment and diagnosis date. Cox's proportional hazard models were used to estimate the effect of periodontitis on incident diabetes. Multivariable analysis included adjustment for various known confounders. The mean age of the men was 63.7 (SD 3.0) years. There were 80 cases (6.0%) of incident T2DM. Follow-up was for a median period of 7.8years (IQR 6.7-8.3). After adjusting for confounding variables, the hazard ratio (HR) for incident T2DM in men with moderate/severe periodontitis versus those with no/mild periodontitis was 1.69 (95% CI 1.06-2.69), p=0.03. There was evidence in this homogenous group of dentate men, that those with moderate to severe periodontitis had a significantly increased risk of incident T2DM.

Delayed heart rate recovery after exercise as a risk factor of incident type 2 diabetes mellitus after adjusting for glycometabolic parameters in men

BackgroundSome studies have reported that delayed heart rate recovery (HRR) after exercise is associated with incident type 2 diabetes mellitus (T2DM). This study aimed to investigate the longitudinal association of delayed HRR following a graded exercise treadmill test (GTX) with the development of T2DM including glucose-associated parameters as an adjusting factor in healthy Korean men. Material and methodsAnalyses including fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c as confounding factors and known confounders were performed. HRR was calculated as peak heart rate minus heart rate after a 1-min rest (HRR 1). Cox proportional hazards model was used to quantify the independent association between HRR and incident T2DM. ResultsDuring 9082 person-years of follow-up between 2006 and 2012, there were 180 (10.1%) incident cases of T2DM. After adjustment for age, BMI, systolic BP, diastolic BP, smoking status, peak heart rate, peak oxygen uptake, TG, LDL-C, HDL-C, fasting plasma glucose, HOMA-IR, HOMA-β, and HbA1c, the hazard ratios (HRs) [95% confidence interval (CI)] of incident T2DM comparing the second and third tertiles to the first tertile of HRR 1 were 0.867 (0.609–1.235) and 0.624 (0.426–0.915), respectively (p for trend=0.017). As a continuous variable, in the fully-adjusted model, the HR (95% CI) of incident T2DM associated with each 1 beat increase in HRR 1 was 0.980 (0.960–1.000) (p=0.048). ConclusionsThis study demonstrated that delayed HRR after exercise predicts incident T2DM in men, even after adjusting for fasting glucose, HOMA-IR, HOMA-β, and HbA1c. However, only HRR 1 had clinical significance.

Fitness, Body Habitus, and the Risk of Incident Type 2 Diabetes Mellitus in Korean Men

The relative contributions of cardiorespiratory fitness (CRF) and body habitus to predict incident type 2 diabetes mellitus (T2DM) remain unclear. We prospectively investigated the relation of CRF and body habitus on the risk of developing T2DM in men. Participants included 3,770 apparently healthy men who initially presented without baseline evidence of diabetes, cardiovascular disease, and hypertension. Participants were divided into 3 groups as normal weight (18.5 to 24.9 kg/m(2)), obese I (25.0 to 29.9 kg/m(2)), and obese II (≥30.0 kg/m(2)). CRF was directly measured by peak oxygen uptake (VO2peak) and categorized into unfit and fit cohorts based on the median value of age-specific VO2peak. Diabetes was defined as a glycated hemoglobin >6.5% and/or a fasting glucose >126 mg/dl at baseline and follow-up examinations. During a median follow-up of 5 years, 170 men (4.5%) developed diabetes. After adjusting for age and fasting glucose, the relative risk and 95% confidence interval (CI) for incident T2DM were 1.52 (95% CI 1.11 to 2.07) for obese I and 3.11 (95% CI 1.35 to 7.16) for obese II versus normal weight and 0.69 (95% CI 0.51 to 0.95) for fit versus unfit. However, these associations were no longer statistically significant after adjusting for potential confounders with VO2peak (1.32; 95% CI 0.96 to 1.83 for obese I and 1.61, 95% CI 0.64 to 4.06 for obese II vs normal weight) or body mass index (0.75, 95% CI 0.54 to 1.05 for fit vs unfit). In the joint analysis, obese-unfit men had 1.81 times (95% CI 1.22 to 2.69) greater risk of incident T2DM, but obese-fit men were not at increased risk of incident T2DM (0.95, 95% CI 0.57 to 1.58) compared with fit-normal weight men. In conclusion, these results suggest that both CRF and obesity predict the incidence of T2DM independent of potential confounders; however, CRF appears to attenuate the risk of developing diabetes in obese men.

Absolute cardiovascular risk in a Fiji medical zone.

BackgroundThe population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years.MethodsA mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25–64 years (response 73 %). Hypertension (HT) was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg or on medication for HT; type 2 diabetes mellitus (T2DM) as fasting plasma glucose ≥7.0 mmol/L or on medication for T2DM; and obesity as a body mass index (kilograms/height(metres)2) ≥30. Data were age-adjusted to 2007 Fiji Census. Associations between RFs and ethnicity/education were investigated. Comparisons with Fiji STEPS surveys were undertaken, and the absolute risk of a cardiovascular disease (CVD) event/death in 10 years was estimated from multiple RF charts.ResultsNCD/RFs increased with age except excessive alcohol intake and daily smoking (women) which declined. Daily smoking was higher in men 33 % (95 % confidence interval: 31–36) than women 14 % (12–116); women were more obese 40 % (37–43) than men 23 % (20–26); HT was similar in men 37 % (34–40) and women 34 % (31–36), as was T2DM in men 15 % (13–17) and women 17 % (15–19). i-Taukei men had an odds ratio (OR) of 0.41 (0.28–0.58) for T2DM compared to Indians (1.00); and i-Taukei (both sexes) had a higher OR for obesity and low fruit/vegetable intake, daily smoking, excessive alcohol intake and HT in females. Increasing education correlated with lesser smoking, but with higher obesity and lower fruit/vegetable intake. Compared to the 2011 Fiji STEPS survey, no significant differences were evident in obesity, HT or T2DM prevalences. The proportion (40–64 years) classified at high or very high risk (≥20 %) of a CVD event/death (over 10 years) based on multiple RFs was 8.3 % for men (8.1 % i-Taukei, 8.5 % Indian), and 6.7 % for women (7.9 % i-Taukei, 6.0 % Indian).ConclusionsThe results of the survey highlight the need for individual and community interventions to address the high levels of NCD/RFs. Evaluation of interventions is needed in order to inform NCD control policies in Fiji and other Pacific Island nations.

Aspects of androgen replacement therapy for the treatment of hypogonadism in men with diabetes and metabolic syndrome.

The article presents the results of studies of efficacy and safety of androgen therapy for hypogonadism, metabolic syndrome and type 2diabetes mellitus in men. In the study was used testosterone undecanoate therapy which causes reduction of obesity, a decrease in theseverity of the other components of the metabolic syndrome, improving glycemic profile without significant side effects. Nevertheless,this therapy requires monitoring and management for risk factors.

Association of abdominal obesity, hypertriglyceridemia, and hypertriglyceridemic waist phenotype with hypertension and type 2 diabetes mellitus

The present study tested the hypothesis that simple variables, such as waist circumference, hypertriglyceridemia (eTG), and hypertriglyceridemic waist (eTGWC) phenotype could be used as screening tools for the identification of those at high risk in hypertension (HT) and type 2 diabetes mellitus (T2DM). Based on data from our health survey, check of 4206 participants (997 men and 3209 women) were 420 (42.1 %) and 2394 (74.6 %) AO men and women, 370 (37.1 %) and 1340 (41.8 %) eTG men and women, and 236 (23.7 %) and 1131 (35.2 %) eTGWC men and women. We demonstrated that AO, eTG, and eTGWC phenotype associated with increased risk of HT and T2DM. In men, the largest area under curve (AUC) of the receiver operating characteristic (ROC) curves demonstrated that AO was the best marker for HT and eTG was the best marker for T2DM in men, while eTGWC was the best marker for both HT and T2DM in women. In conclusion, it is suggested AO may serve as the early phenotype-associated sequel to eTG reach to eTGWC. Waist circumference measurements and fasting triglycerides can serve as inexpensive screening tools for HT and T2DM to identify those at high risk of HT and T2DM.

The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study.

Aims/IntroductionThe incidence and prevalence of type 2 diabetes mellitus (T2DM) and related macrovascular complications in Korea were estimated using the Health Insurance Review and Assessment (HIRA) database from 2007–2011, which covers the claim data of 97.0% of the Korean population.Materials and MethodsT2DM, coronary artery disease (CAD), cerebrovascular disease (CVD), and peripheral artery disease (PAD) were defined according to ICD-10 codes. We used the Healthcare Common Procedure Coding System codes provided by HIRA to identify associated procedures or surgeries. When calculating incidence, we excluded cases with preexisting T2DM within two years before the index year. A Poisson distribution was assumed when calculating 95% confidence intervals for prevalence and incidence rates.ResultsThe prevalence of T2DM in Korean adults aged 20–89 years was 6.1–6.9% and the annual incidence rates of T2DM ranged from 9.5–9.8/1,000 person-year (PY) during the study period. The incidence rates of T2DM in men and women aged 20–49 years showed decreasing patterns from 2009 to 2011 (P<0.001); by contrast, the incidence in subjects aged 70–79 years showed increased patterns from 2009 to 2011 (P<0.001). The incidence rates of CAD and CVD in patients newly diagnosed with T2DM were 18.84/1,000 PY and 11.32/1,000 PY, respectively, in the year of diagnosis. Among newly diagnosed individuals with T2DM who were undergoing treatment for PAD, 14.6% underwent angioplasty for CAD during the same period.ConclusionsOur study measured the national incidences of T2DM, CAD, CVD, and PAD, which are of great concern for public health. We also confirmed the relatively higher risk of CAD and CVD newly detected T2DM patients compared to the general population in Korea.