Prevalence of erectile dysfunction among Egyptian male patients with type 2 diabetes mellitus

Background and aimsThe relation between type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED) has been identified in multiple studies. The aim of this cross-sectional study was to estimate the prevalence and to determine some associated factors of ED among a sample of adult Egyptian male patients with T2DM.MethodsThis cross-sectional study included 150 adult male patients with T2DM (aged 40–60 years) who attended the outpatient clinic of Diabetes in Alexandria Main University hospital. They were evaluated for the presence of ED which was assessed by the validated Arabic-translated five-item version of the International Index of Erectile Function-5 (IIEF-5) questionnaire. Fasting blood glucose (FBG), HbA1c, total serum cholesterol, HDL-C, total serum testosterone (TT) and urinary albumin creatinine ratio (uACR) were measured for all study subjects.ResultsThe prevalence of ED was 80% among the studied sample. Significant negative correlation was found between IIEF-5 score and age, duration of diabetes, FBG and urinary ACR; while there was a significant positive correlation between IIEF-5 score and serum total testosterone. On performing multiple linear regression analysis for the parameters affecting IIEF-5 questionnaire score, TT, urinary ACR, age and FBG were the independent predictors of ED.ConclusionED was a common finding in our sample of Egyptian men with T2DM. Poor glycemic control and albuminuria may be considered as independent risk factors for ED.     

青岛地区20～74岁人群糖尿病患病率调查

目的　了解青岛地区成人糖尿病 (DM )的患病率。　方法　采用分层随机整群抽样方法 ,在 2 0 0 1年 5月～ 2 0 0 2年 6月期间 ,横断面调查青岛地区 2县 5区 2 0～ 74岁居民 14 6 0 6名。除市南区的 2 170名居民直接采用口服 75 g葡萄糖耐量试验 (OGTT)进行筛查外 ,其余各点的 12 4 36名被调查者需先行指血筛查 ,当毛细血管血糖≥ 6 1mmol/L时进行OGTT确定诊断。　结果　青岛地区 2 0～ 74岁人群DM标化的患病率为 5 5 % ,其中 6 4 5 %为新诊断的DM。其中市南区居民DM、糖耐量受损 (IGT)、空腹血糖受损 (IFG)和糖调节受损 (IGR)的标化患病率分别为 9 1%、6 6 %、4 5 %和 11 1%。乡村居民DM的患病率低于城镇居民 (5 0 %比 6 1% ,P <0 0 0 1)。乡村中 ,女性患病率高于男性 (5 7%比 4 0 % ,P <0 0 1)。随着年龄的增加 ,DM的患病率逐渐增加。　结论　青岛地区DM患病率与 1994年及 1996年全国流行病学调查结果相比 ,青岛地区DM的患病率明显升高。随着地区的城市化和人口的老龄化程度进一步增加 ,DM患病率将有更大幅度的升高     

2型糖尿病脂肪肝的筛查及相关因素分析

目的　探讨2 型糖尿病(T2DM)伴脂肪肝的患病率与相关因素。　方法　对400 例T2DM患者进行临床、生化、瘦素、C肽与肝脏超声检查。　结果　T2DM患者脂肪肝的患病率为46%,该组的体质指数(BMI)、舒张压显著高于无脂肪肝组(P<0.05),甘油三酯(TG)、1 h与2 h C肽、瘦素水平显著高于无脂肪肝组(P<0.01);Logistic逐步回归分析显示1 h C肽、瘦素、TG水平升高,与脂肪肝的发生呈正相关关系。　结论　T2DM患者脂肪肝患病率明显升高,且与BMI、TG、C肽、瘦素水平呈正相关。     

Prevalence of peripheral arterial disease among type 2 diabetes mellitus in coastal Karnataka

Peripheral Arterial Disease (PAD) is one of the leading complications of Type 2 Diabetes Mellitus (T2DM). According to American Heart Association, PAD is defined as, “a narrowing of peripheral arteries to the legs, stomach, arms and the head-most commonly the arteries of leg.” The global prevalence for PAD with age adjusted prevalence is approximately 12%, and it affects relatively 8 to 12 million British people. The prevalence of PAD is 2–3 times higher in person with v/s without type 2 diabetes mellitus (T2DM). Various subjective and objective methods are available to diagnose PAD, which includes questionnaires for pain and quality of life as subjective and Ankle Brachial Index (ABI), toe brachial index (TBI), arterial doppler for objective. ABI is one of the most reliable and easy to carry out method in clinical setups to diagnose PAD. The normal range for ABI is 0.9–1.29, 0.91 to 0.99 are considered as borderline, 0.41 to 0.91 are considered as mild to moderate diseased and below 0.4 is severe PAD. The objective of the study is to estimate the prevalence of peripheral arterial disease with type 2 diabetes mellitus in coastal Karnataka.MethodologyA total of 317 participants were recruited for the study based on inclusion criteria. Ethical clearance was taken from the Institutional Ethics Committee. Participants were explained about the study and informed consent was obtained from the participants. Inclusion criteria was any individual with T2DM on medication. A subjective questionnaire specific to PAD was administered to the participants. Along with this the objective measure, ABI was done on the individuals.ResultThe mean age of all the participants was 57.36 ± 10.43 in years. The average Body Mass Index (BMI) was 24.62 ± 11.80 in Kg/m2. The mean duration of diabetes was found to be 9.13 ± 6.56 in years. The prevalence of peripheral arterial disease was found to be 8.52% in the study population.ConclusionThe prevalence of peripheral arterial disease was found to be 8.52% in the study population.     

中国香港地区2型糖尿病患者阻塞性睡眠呼吸暂停的患病率和识别

目的探讨患糖尿病的中国香港地区阻塞性睡眠呼吸暂停（OSA）的患病率和相关临床因素。方法入选标准为18-75岁中国香港地区2型糖尿病患者且除外不稳定临床疾病、妊娠期糖尿病或正进行肾脏替代治疗者。结果估计糖尿患者群中OSA的患病率是17．5％（男性24．7％,女性10．3％）;睡眠呼吸暂停低通气指数（AHI）与BMI,老年,男性和舒张压独立相关;中重度OSA中需要≥3种抗高血压药物的校正优势比为2．48;血糖控制（HbA1c）和睡眠之间无明确关系。结论OSA在患糖尿病的中国香港地区人群中有较高的患病率。     

男性2型糖尿病患者性腺功能减退相关因素分析

目的探讨男性2型糖尿病（T2DM）患者血清总睾酮（TT）水平与肥胖、胰岛素抵抗（IR）、血糖、血脂间的关系。方法对120例男性T2DM患者进行性激素、FPG、Fins、FC—P、HbA，c、血脂水平测定。根据稳态模型评估法（HOMA）评价IR程度。结果120例男性T2DM患者中1vr低下者占14％，IR占71％，BMI≥23kg／m2者占52％。TT与BMI、Fins及WHR成负相关（r=-0．335，-0．307，-0．232，P〈0．01），与年龄、病程、血糖、FC-P、HbAtc水平等无相关性。BMI与WHR、Fins、FC-P及InHO—MA-IR成正相关（r=0．489，0．348，0．356，0．301P％0．01或P〈0．05），年龄与黄体生成素、卵泡刺激素成正相关（r=0．310，0．442，P〈0．01）。结论肥胖是男性T2DM患者TT水平低下的主要影响因素，通过肥胖的介导，TT与IR及脂代谢紊乱相关。     

Evaluation of unmet medical need among Japanese patients with type 2 diabetes mellitus and efficacy of Lixisenatide treatment among Asian type 2 diabetes mellitus patients

AimsThis study determined the unmet medical need of basal insulin therapy among type 2 diabetes patients who participated in the ALOHA study. Also a meta-analysis of the GetGoal-Duo1, -L, and -L-Asia trials was conducted to examine the impact of lixisenatide add-on treatment to basal insulin therapy ± OADs specifically among Asian type 2 diabetes patients.MethodsThe proportions of Japanese patients with an unmet need of diabetes management, defined as not achieving an HbA1c < 7% despite having a fasting plasma glucose (FPG) < 130 mg/dL, and without an unmet need, defined as having an endpoint HbA1c < 7%, regardless of FPG level, were determined for the ALOHA study population, which was conducted as a post-marketing survey for insulin glargine in Japan. For the meta-analysis, all Asian modified intent-to-treat patients with baseline and endpoint HbA1c measurements reported from the 3 GetGoal trials were included.ResultsAmong 1013 Japanese type 2 diabetes patients in the ALOHA study, 36% had an unmet need. In the GetGoal-Duo1, -L, and L-Asia trials, 237 Asian patients were treated with lixisenatide add-on treatment to basal insulin and 226 received placebo. Lixisenatide add-on treatment vs. placebo was associated with the following significant mean changes in efficacy outcomes at week 24: HbA1c: −0.6%, p = 0.005; FPG: −13.3 mg/dL, p = 0.004; PPG: −101.4 mg/dL, p < 0.001; weight: −0.5 kg, p = 0.018; basal insulin dose: −1.6 U, p < 0.001.ConclusionsLixisenatide add-on treatment may provide a viable option to address the unmet need of basal insulin therapy among Asian type 2 diabetes patients.     

Investigation on the association between diabetes distress and productivity among patients with uncontrolled type 2 diabetes mellitus in the primary healthcare institutions

AimsTo investigate associations between diabetes distress and productivity, and to identify the potential risk factors that could affect these particular associations.MethodsThis cross-sectional study was conducted in three outpatient healthcare institutions. Patients aged ≥21 years with uncontrolled T2DM and polypharmacy were included. The Problem Areas in Diabetes (PAID) measuring diabetes distress and Work Productivity and Activity Impairment General Health (WPAI-GH) measuring productivity were administered by trained interviewers.ResultsA total of 259 patients were analysed. Point prevalence of clinically severe diabetes distress, work productivity loss and life productivity loss were 7.7%, 45.0% and 35.1% respectively. Diabetes distress was positively associated with work productivity loss (p = 0.001) and life productivity loss (p < 0.001). Multiple linear regression analysis demonstrated that diabetes distress (p = 0.003), the total number of chronic medications (p = 0.012), insulin therapy (p = 0.027) and the presence of chronic kidney disease (p = 0.038) were significantly associated with work impairment. Diabetes distress (p = 0.001) and the presences of osteoarthritis (p = 0.039) were significantly associated with activity impairment.ConclusionHealthcare professionals should screen patients for diabetes distress to prevent productivity losses, especially in patients with polypharmacy and/or on insulin and with coexisting osteoarthritis or chronic kidney disease.     

Assessment of hypogonadism and its determinants among adult men with type 2 diabetes mellitus

Background and aimsThe impact of utilizing both symptoms as well as biochemically confirmed androgen deficiency in diagnosis of hypogonadism among type 2 diabetic men is relatively less studied. Furthermore, various determinants of hypogonadism in these men especially the role of insulin resistance and hypogonadism were studied.MethodsThis is a cross sectional study of 353 T2DM men aged 20–70 years of age. Hypogonadism was defined by taking both symptoms as well as calculated testosterone levels. Symptoms were defined using androgen deficiency in ageing male (ADAM) criteria. Various metabolic and clinical parameters were assessed and evaluated with regards to presence or absence of hypogonadism.ResultsAmong 353 patients, 60 had both symptoms as well as biochemical evidence of hypogonadism. Assessment of calculated free testosterone but not total testosterone identified all such patients. Body mass index, HbA1c, fasting triglyceride level and HOMA IR inversely correlated with calculated free testosterone. We found that insulin resistance (HOMA IR) was independently associated with hypogonadism (odds ratio=1.108).ConclusionAssessment of both symptoms of hypogonadism and calculated free testosterone represents a better way for correct identification of hypogonadal diabetic men. Insulin resistance has a strong association with hypogonadism independent of obesity and complication status of diabetes.     

Prevalence of urinary incontinence in males with type 2 diabetes mellitus

AimTo find the prevalence of Urinary Incontinence (UI) in males with Type 2 Diabetes Mellitus (T2DM) in Belagavi city and also to understand the severity of UI and the impact of variables like age, duration of diabetes, BMI (Body mass index), waist circumference, glycemic control (fasting blood glucose), and medications on the prevalence of UI in males with T2DM.MethodologyThis was a cross-sectional, observational study conducted in a tertiary hospital and medical research centre of Karnataka, India in which males aged 35 years or more and suffering with T2DM for at-least 10years were enrolled. UI was assessed using International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF).ResultsOut of 123 male subjects having T2DM screened for the prevalence of UI, 19 subjects were diagnosed to be having UI as per ICIQ-SF questionnaire, accounting to 15.4% of the total sample. The mean ICIQ score of the 19 subjects having UI was 9.2 ± 1.54 showing that the mean severity of UI was moderate in nature. Study also found that the duration of diabetes was significantly high (mean = 18 ± 4.6 years) and glycemic control was significantly poor (Mean FBS = 210 ± 64.21 mg/dL) in subjects with UI than in subjects without UI.ConclusionsPrevalence of UI among adult patients with T2DM was 15.4% and is of moderate severity, as assessed by ICIQ-SF. Long duration of Diabetes and poor glycemic control could possibly increase the risk of UI among T2DM patients.     

蚌埠市区第三次2型糖尿病患病现状调查

整群随机抽样调查蚌埠市区25-75岁常住居民3073人,发现人群中2型糖尿病、总糖耐量减低患病率呈快速增长趋势,2型糖尿病的发病趋于年轻化。肥胖高血压人群2型糖尿病、糖调节受损患病率明显高于正常人群。应注重早期2型糖尿病筛查。     

Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre

Background

Patients of diabetes mellitus experience psychological difficulties associated with their disease which remains unrecognized involving several states related to coping with diabetes. Diabetes distress is a distinct condition which is often mistaken for depression and is related to adverse disease outcomes.

Predictors of sleep disorders among patients with type 2 diabetes mellitus

AimsThis study examined the prevalence of sleep disorders (SD) and self-reported sleep symptoms and risk factors among adult patients diagnosed with T2DM.MethodsData were obtained from the 2012 US National Health and Wellness Survey, an annual Internet-based survey. A total of 7239 participants reported a diagnosis of T2DM. Patients also provided information on diagnosis of SD (e.g., insomnia, sleep breathing disorder, other sleep conditions, etc.) and regularly experienced sleep symptoms (e.g., difficulty falling asleep, sleep apnea, daytime sleepiness, difficulty staying awake, etc.). Logistic regressions were used to examine factors associated with SD and symptoms.ResultsThe average age was 59.9 (standard deviation = 12.2), 59.5% were male, 24.4% were diagnosed with SD, 76.8% reported experiencing any sleep symptom regularly (difficulty falling asleep, 30.5%; sleep apnea, 17.4%; daytime sleepiness, 26.8%; difficulty staying awake, 10.1%). Logistic regression models showed the strongest predictors of diagnosed SD were obesity class (OC) III (OR = 2.20), White (OR = 1.92), OC II (OR = 1.57), smoking (OR = 1.57), lower income (OR = 1.49–1.19), unemployment (OR = 1.38), and comorbidities (OR = 1.35), all p < 0.05. The strongest predictors of any sleep symptom were OC III (OR = 2.22), OC II (OR = 1.78), lower income (OR = 1.74–1.24), female gender (OR = 1.72), OC I (OR = 1.60), White (OR = 1.54), and smoking (OR = 1.47), all p < 0.05.ConclusionsAlmost 25% of patients with T2DM were diagnosed with SD and over 75% reported experiencing at least one sleep symptom regularly. SD and symptoms were strongly associated with obesity, White ethnicity, gender, low income, and smoking. Interventions focusing on weight management and smoking cessation have shown to improve T2DM and may improve SD.     

Known type 2 diabetes mellitus among the Kuwaiti population

The reported prevalence of type 2 diabetes among the Kuwaiti population varied from one source to another. This study was undertaken to define the magnitude of the problem and to suggest plans for future diabetic care. All type 2 Kuwaiti diabetic subjects registered and continuing to attend regularly in two health areas Mubarak Health Area (MHA) and Farwania Health Area (FHA)] were selected for the study. There were 3222 in MHA and 5114 in FHA among the Kuwaiti population aged 20 years and above, accounting for a total crude prevalance of 7.6% in both health areas and for a prevalence rate of 5.6% in MHA and 10.0% in FHA. The age-specific prevalence of type 2 diabetes in both areas combined rose from 2.639 per 100 population in the age group 20–39 years to 15.350% and 26.252% in the age groups 40–59 and 60 and above, respectively. The female to male ratio was 1.7, 1.6, 1.1, respectively, in MHA and 1.7, 2.0, 0.9 in FHA for the age groups 20–39, 40–59, and 60 and above. This study shows that type 2 diabetes is a major public health problem in Kuwait, with a female preponderance. Obesity is a characteristic feature of the population studied, with a mean body mass index of 31.8±6.3 and 28.5±5.1 in women and men, respectively. A positive family history of diabetes mellitus was reported in 63% of the diabetic subjects. There is a need to standardize methods of reporting and to plan a national screening survey.     

2型糖尿病合并衰弱和肌少症的机制与治疗

中国人群2型糖尿病总体患病率约9.1%。与正常人相比,60岁时确诊2型糖尿病的患者,其预期寿命减少7.3～9.5年,维持良好生命质量的时间减少11.1～13.8年。对于老年糖尿病患者,保持良好的功能状态至关重要。衰弱是一种常见的老年综合征,是影响老年人功能状态的重要因素,是老年人残疾、死亡和住院等不良健康结局的强预测因...     

对2型糖尿病患者启动胰岛素治疗的思考

在2型糖尿病的治疗中尽早启动胰岛素治疗,是血糖达标的需要,也是保护胰岛β细胞、恢复其功能,从而延缓糖尿病进展的需要。初诊2型糖尿病患者经过3个月的生活方式干预和优化的口服降糖药物治疗血糖仍不能达标时,即应启动胰岛素治疗。对代谢紊乱严重、血糖水平较高的患者,应及时启动胰岛素强化治疗。可供选择的胰岛素治疗方案很多,各有优缺点和适应人群,临床上应当因患者而异地选择适宜的起始治疗方案。如何依据糖化血红蛋白（Hb）A1c选择起始治疗方案,目前尚无定论。推荐当HbA1c≤8．5％时主要选择基础胰岛素,HbA1c〉8．5％时选择预混胰岛素或基础—餐时或持续皮下胰岛素输注（CSII）作为起始胰岛素治疗方案。     

2型糖尿病患者抑郁的患病率及相关危险因素分析

目的 调查2型糖尿病患者抑郁的患病率,分析与抑郁相关的危险因素.方法 2966例2型糖尿病患者,其中男姓1 463例,女性1 503例,年龄(56.4±11.2)岁,病程(6.3±5.7)年.用Beck抑郁问卷(BDI)进行抑郁评分进行分组,抑郁标准:≤4分,非抑郁组;5～13分,轻度抑郁组;14 ～20分,中度抑郁组;21分或更高,重度抑郁组.同时收集年龄、性别、体重指数、病程、相关生化代谢指标及与糖尿病有关的一般资料(如吸烟史、糖尿病教育、治疗等).计算抑郁的患病率,用logistic回归筛选抑郁的危险因素.结果 51％的患者存在不同程度抑郁症,其中轻度抑郁占38％,中度8％,重度5％.与非抑郁组相比,抑郁组患者中女性性别、合并周围神经病变、接受糖尿病教育及使用胰岛素治疗者比例高(P＜0.01),年收入大于20000元者比例低(P＜0.01).重度抑郁组中吸烟者比例较高,年龄偏低(P＜0.05).偏相关分析显示2型糖尿病患者,抑郁与女性性别、糖尿病教育、合并周围神经病变成正相关,与年龄成负相关(P＜0.05).条件logistic回归方程显示女性性别(OR=1.37),年龄(20～40岁,OR=1.52),糖尿病教育(OR=1.51),周围神经并发症(OR=1.87),均为抑郁发生的危险因素.结论 抑郁在2型糖尿病患者中普遍存在,临床实践中应重视对抑郁的筛查.     

The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012

DM type II is one of the most common chronic diseases. The objective of this study is to investigate the prevalence of DM and its association with other age-related diseases in Iran, 2012. In this cross-sectional study, people aged 60 years and over were selected using multistage sampling method. Mini-Nutritional Assessment (MNA), Activity of Daily Living (ADL), and Geriatric Depression Scale (GDS-15 items) questionnaires were used. History of common disorders was taken through self-report, medical records and the results of clinical examinations. A total of 1350 old people were studied. DM type II was found in 297 (22.0%) subjects and 371 (27.5%) of subjects were not aware of their DM status. Hypertension (55.6%), high serum cholesterol (51.8%), malnutrition (40.1%), Alzheimer's disease (16.9%), weight loss within past year (16.1%), weight gain within past year (11.7%), frailty (64.6%), insomnia (50.1%), and vision problems (62.6%) were significantly more common in diabetics. Those who were not aware of their status of DM either were between diabetics and non-diabetics or more similar to non-diabetics. Considering high prevalence of age-related diseases among Iranian elderly people, in particular women and those with DM type II, preventive measures are recommended so as to decrease and control DM type II and its consequent complications.     

Prevalence,correlates and management of type 2 diabetes mellitus in Lebanon: Findings from a national population-based study

Aims

This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region.

Methods

Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded.

Results

The prevalence of type 2 diabetes was 8.5% (95%CI = 7.3–9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR = 2.56; 95%CI = 1.07–5.42) compared to single, being obese (OR = 1.50, 95%CI = 1.00–2.57), and having a family history of diabetes (OR = 3.40;95%CI = 2.48–5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR = 0.42; 95%CI = 0.24–0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%).

Conclusions

Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates.