Diet,lifestyle factors and hypercholesterolemia in elderly men and women from Cyprus

Background  

We sought to investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and non-smoking on clinical status of 150 elderly people from Cyprus.     

Effects of black and green tea consumption on blood glucose levels in non-obese elderly men and women from Mediterranean Islands (MEDIS epidemiological study)

Background Obesity and diabetes are metabolic disorders that affect a large amount of the elderly population and are related to increased cardiovascular risk. Tea intake has been associated with lower risk of mortality and morbidity in some, but not all studies. We evaluated the association between tea intake, blood glucose levels, in a sample of elderly adults. Methods During 2005–2006, 300 men and women from Cyprus, 142 from Mitilini and 100 from Samothraki islands (aged 65–100 years) were enrolled. Dietary habits (including tea consumption) were assessed through a food frequency questionnaire. Among various factors, fasting blood glucose and body mass index (BMI) were measured. Results Fifty-four percent of the participants reported that they consume tea at least once a week (mean intake 1.6 ± 1.1 cup/day). A significant interaction was observed between tea intake, obesity status on glucose levels (P < 0.001). After adjusting for various confounders, tea intake was associated with lower blood glucose levels in non-obese (P for trend <0.001), but not in obese people (P = 0.24). Multiple logistic regression analysis revealed that moderate tea consumption (1–2 cups/day) was associated with 88% (95% CI 76–98%) lower odds of having diabetes among non-obese participants, irrespective of age, sex, smoking, physical activity status, dietary habits and other clinical characteristics. Conclusion Tea consumption is associated with reduced levels of fasting blood glucose only among non-obese elderly people.     

中国2型糖尿病防治指南(2017年版)

目的了解上海市徐汇区社区血糖异常人群情况及相关因素,为糖尿病早期干预提供依据。方法采用多阶段人口规模比例(PPS)随机抽样方法,分别于2010年、2015年对同一地区15岁及以上约5 000户居民开展调查,分别调查10 130、9 085人,并进行血糖检测。单因素分析采用t检验和χ²检验,用logistic回归分析相关因素。结果2010和2015年所涉社区糖尿病发病率分别为2.21%、1.93%,高血糖发生率分别为12.63%、15.28%,两者均随年龄增长和BMI值增加呈上升趋势, 2015年高血糖发生率较2010年上升。文化程度较低者、血压值异常者、自报高血压患者、自报冠心病患者和吸烟者糖尿病和高血糖发生率较高;logistic回归分析结果显示,糖尿病的发病率与年龄、BMI、血压值异常、吸烟呈正相关;高血糖的发生与调查年份、性别、年龄、BMI、血压值异常呈正相关;两者均与文化程度呈负相关。结论高血糖发生率较高,应着力开展糖尿病高危筛查,重点干预文化程度较低、超重和肥胖、合并高血压以及具有不良生活行为的重点人群。     

社区45岁及以上糖尿病高危人群的筛查分析

目的筛查某社区糖尿病高危人群,早发现糖尿病患者和糖尿病前期人群,探讨糖尿病发展的影响因素。方法采用问卷调查、空腹血糖测量和口服葡萄糖耐量试验(OGTT)确诊试验筛查高危人群,分析高危人群向糖尿病患者和糖尿病前期人群转化的影响因素。结果糖尿病高危人群中,舒张压、糖尿病家族史和既往糖调节受损(IGR)史是高危人群向糖尿病患者发展的影响因素。结论通过筛查可以及时发现糖尿病及糖尿病前期人群,有利于尽早预防,合理控制血压、血脂,降低糖尿病及糖尿病前期的发病率。     

糖尿病慢性并发症的适宜筛查技术

目的测算2型糖尿病三种并发症筛查的成本,包括糖尿病肾病、周围神经病变和下肢动脉病变,并分析成本构成。方法基于2015—2017年“上海市代谢性疾病(糖尿病)预防和诊治服务体系建设”项目,调查了上海市16个区县的社区糖尿病并发症筛查的各项投入,并采用微观成本法计算糖尿病并发症筛查成本。结果到2017年8月,已经筛查了203 040个糖尿病患者,共计花费3 890.28万元,三种慢性并发症的次均总筛查成本约为191.60元,其中糖尿病肾病的次均筛查成本约为170.90元,周围神经病变与下肢动脉病变次均筛查成本约为13.59元和7.11元;三种慢性并发症的人均总筛查成本约为16.54元,糖尿病肾病的人均筛查成本约为14.75元;实验室检查是筛查中最主要的成本支出,其次是人力支出。结论糖尿病并发症筛查的成本不高,有潜在的推广价值;实验室检查是决定筛查成本高低的关键因素。     

中国糖尿病的流行特点及变化趋势

  目的  了解北京市东城区糖尿病患者治疗和控制现状及其影响因素,为制定糖尿病防控措施提供参考依据。  方法  于2016年6 — 10月采用多阶段分层整群随机抽样方法在北京市东城区抽取7177名18～79岁常住居民进行问卷调查、体格检查和实验室检测,对其中854例糖尿病患者的治疗和控制现状及其影响因素进行分析。  结果  北京市东城区854例糖尿病患者中,采用药物治疗者532例,糖尿病治疗率为62.30 %;血糖控制者272例,糖尿病控制率为31.85 %。多因素非条件logistic回归分析结果显示,年龄 ≥ 40岁、文化程度高中/中专及以上和高血压的北京市东城区糖尿病患者的糖尿病治疗率较高,饮酒的北京市东城区糖尿病患者的糖尿病治疗率较低;年龄 ≥ 60岁、文化程度高中/中专及以上和采用药物治疗的北京市东城区糖尿病患者的糖尿病控制率较高,中心性肥胖的北京市东城区糖尿病患者的糖尿病控制率较低。  结论  北京市东城区糖尿病患者的糖尿病治疗率较高、控制率较低,但采用药物治疗的糖尿病患者血糖控制率较高;年龄、文化程度、饮酒情况、是否有高血压和是否中心性肥胖是该地区糖尿病患者治疗和控制的主要影响因素。     

Cigarette smoking and risk of type 2 diabetes mellitus among middle-aged and elderly Japanese men and women

For examination of sex- and age-specific relations between smoking and risk of type 2 diabetes mellitus, 39,528 nondiabetic men and 88,613 nondiabetic women aged 40-79 years who underwent health checkups in Ibaraki-ken, Japan, in 1993 were followed through 2002. Risk ratios for diabetes according to smoking habits were calculated using a Cox proportional hazards model. Compared with never smokers, the risk ratio for diabetes among current smokers, after adjustment for age, systolic blood pressure, antihypertensive mediation use, alcohol intake, parental history of diabetes, body mass index, fasting status, blood glucose concentration, total and high density lipoprotein cholesterol levels, and log-transformed triglyceride level, was 1.27 (95% confidence interval (CI): 1.16, 1.38) in men and 1.39 (95% CI: 1.20, 1.61) in women. The excess risk was more pronounced among men with a parental history of diabetes than among men without one. The excess risk among current smokers was observed in both age subgroups (40-59 and 60-79 years). Respective multivariate risk ratios for the age subgroups were 1.37 (95% CI: 1.18, 1.60) and 1.20 (95% CI: 1.08, 1.34) in men and 1.45 (95% CI: 1.18, 1.79) and 1.34 (95% CI: 1.09, 1.66) in women. Smoking was independently associated with increased risk of type 2 diabetes among both middle-aged and elderly men and women.     

Lifestyle and emotional well-being in men and women with type 2 diabetes (e-VitaDM-4; ZODIAC-48)

Background: Whether lifestyle is associated with well-being in patients with type 2 diabetes (T2D) is largely unknown. Uncovering and clarifying associations between these constructs may lead to new strategies for improving both.

Objectives: The aim was to investigate the relationship between lifestyle and well-being, focussing on gender differences.

Methods: This cross-sectional study included 1085 patients with T2D that participated in the e-Vita part of the Zwolle outpatient diabetes project integrating available care (ZODIAC) study. Patients were included from May 2012 until September 2014 from 52 general practices. Emotional well-being was assessed with the World Health Organization-5 well-being index (WHO-5). Lifestyle information on body mass index, smoking, physical activity and alcohol use was extracted from self-reported questionnaires. Multiple linear regression analyses were used.

Results: After adjustment for other lifestyle factors, physical activity, smoking and drinking 22–35 alcohol consumptions per week were associated with the WHO-5 score in men and physical activity and smoking were associated with the WHO-5 score in women. In the fully adjusted analyses for the total study population, physical activity and smoking were still associated with the WHO-5 score (b?=?1.1, P?P?=?.018, respectively). In the fully adjusted analyses stratified to gender only physical activity was associated with the WHO-5 score (in men: b?=0.8, P?=?.006, in women: b?=?1.4, P?=?.001).

Conclusion: This study shows a negative, non-clinically relevant association between smoking and emotional well-being in the total population with T2D and a positive, non-clinically relevant association between physical activity and emotional well-being in both men and women with T2D.     

身体活动与2型糖尿病的关联性研究进展

2型糖尿病（T2DM）已成为影响我国居民健康的重要公共卫生问题。身体活动不足是包括T2DM在内的主要慢性病发生、发展的重要危险因素,适宜的身体活动模式及水平对T2DM的防治有积极的意义。本文就近年来国内外针对身体活动与T2DM发生、发展和死亡之间关系的研究进展及成果进行综述,以期为完善我国一般和高危人群T2DM预防及T2DM患者管理的策略和措施提供支持。     

Promoting and maintaining physical activity in people with type 2 diabetes

BACKGROUND: Limited research has investigated how to promote physical activity in people with type 2 diabetes. This study evaluated physical activity counseling over 12 months in people with type 2 diabetes. DESIGN: Participants were given standard exercise information and randomly assigned to receive physical activity counseling or not. Data were collected from September 2000 through to September 2002 and analyzed from October 2002 to February 2003. SETTING/PARTICIPANTS: Diabetes outpatient clinic. Seventy inactive people with type 2 diabetes. INTERVENTION: Physical activity counseling, based on the transtheoretical model, combined motivational theory and cognitive behavioral strategies into an individualized intervention to promote physical activity. Consultations were delivered at baseline and 6 months, with phone calls at 1 and 3 months post-consultation. MAIN OUTCOME MEASURES: Changes from baseline at 12 months in physical activity (7-day recall and accelerometer), stages and processes of exercise behavior change. RESULTS: Between-group differences were recorded in physical activity (recall and accelerometer) at 12 months (p <0.01). Experimental participants significantly increased total activity (median difference, 115 minutes; 95% confidence interval [CI]=73-150 minutes). Control participants recorded no significant change (median difference, -15 minutes; 95% CI=-53-13 minutes). The accelerometer experimental participants recorded no significant change (mean difference, 416,632 counts; 95% CI=-27,743, 1,051,007 counts/week), while control participants recorded a significant decrease (mean difference, -669,061 counts; 95% CI=-1,292,285, -45,837 counts/week). At 12 months, more experimental participants compared to controls were in active stages of behavior(6-month chi(2)=26.4, p <0.01; 12-month chi(2)=19.9, p <0.01, respectively). Between-group differences were recorded at 12 months for the frequency of using all processes (p <0.01), except dramatic relief and stimulus control. CONCLUSIONS: Physical activity counseling was effective for promoting physical activity over 12 months in people with type 2 diabetes.     

Motives for regular physical activity in women and men: a qualitative study in French adults with type 2 diabetes, belonging to a patients' association

Patients' associations are an integral but often overlooked component of the French healthcare system dominated by the medical profession. Very few patients' associations exist to enable patients to self-manage into physical activity programmes. The aim of this qualitative study was to examine perceived motives for regular physical activity in male and female individuals, with type 2 diabetes involved in one French patients' association, called 'Move for Health'. Twenty-three adults (14 women and 9 men) with type 2 diabetes ranging in age from 35 to 78 volunteered to participate. The participants undertook regular physical activities autonomously with some medico-sporting educators' help. Results showed that participants reported intrinsic motives such as enjoyment, interest, fun, stimulation and highlighted gender differences. Female participants were more likely than male participants to emphasise the importance of emotional support obtained from the group meetings, and the pleasure of doing something together, and male participants emphasised the knowledge acquisition and skill development for disease control. Moreover, female participants indicated the importance of the sense of well-being and the positive body image related to regular physical activity, and male participants underlined the strength of the relationship between physical activity and health-promoting behaviours. This study provides insights into how gender motives are related to the interest and usefulness of physical activities in the management of diabetes. Findings lend support to the setting up of this type of patients' association in the French healthcare system and underline its contribution to self-determination and the behaviour change process in people with diabetes.     

The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women

Purpose

Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years.

Methods

During the years 2000–2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality.

Results

A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71–6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25–3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01).

Conclusions

Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.

     

南京市居民体力活动与2型糖尿病关系

目的 探讨江苏省南京市居民体力活动状况及与2型糖尿病(T2DM)发病的关系。方法 选取南京市的3个城区和2个乡村,调查年满35周岁并在当地居住满5年的常住人口5 978人,采用自行编制的《南京市慢病防制社区居民健康相关调查表》进行调查,收回有效调查表5 616份。结果 全市总的2型糖尿病现患率为4.6%,其中城区为6.9%,乡村为1.5%。与不太活动者相比,轻度、中度、重度体力活动者罹患2型糖尿病的风险分别降低24.5%,83.5%和73.0%。经多因素调整后,从事中度体力活动的人群糖尿病现患率仍明显低于不太活动者(调整OR值为0.280,95%CI=0.162~0.484)。结论 中等强度的体力活动可明显降低2型糖尿病发病危险,体力活动是2型糖尿病的保护因素。