Prediabetes and deprivation: A couple at high risk of diabetes

AimThe higher prevalence of diabetes in deprived populations is well documented but little is known about the risk of diabetes associated with deprivation among pre-diabetic subjects. The aim of the study was to evaluate the risk of diabetes in a population of deprived pre-diabetic patients.Methods2743 pre-diabetic subjects identified using the American Diabetes Association (ADA) criteria, 16 to 85 years old, 1656 non-deprived and 1087 deprived, had at least two health check-ups at an interval of 4.95 (2.04) vs 3.20 (1.71) years, P < 0.0001, respectively. At the first visit, socioeconomic status was assessed using the EPICES score to differentiate deprived and non-deprived subjects.ResultsAt the second visit, the prevalence of overt diabetes was 9.5% among deprived vs 5.1% in the non-deprived group (P < 0.001). After adjustment on confounding factors, deprivation was found independently associated with occurrence of diabetes [1.70 (1.15–2.51), P = 0.01]. Beyond social deprivation, Fasting Plasma Glucose and waist circumference were the main independent predictors of new-onset diabetes.ConclusionAfter 4 years of follow-up, among subjects with prediabetes, prevalence of diabetes was twice as high among deprived compared with non-deprived subjects. Deprived populations with pre-diabetes may require specific public health approaches to avoid the occurrence of overt diabetes.     

Hand grip strength: A reliable assessment tool of frailty status on the person with type 2 diabetes mellitus

ObjectiveThe aim was to assess the influence of specific type 2 diabetes Mellitus-related features on the hand grip strength in a diabetic outpatient-based population.Material and methodsA cross-sectional population-based study was conducted. Seventy-three individuals were included after excluding cases of refusal to participate or medical concerns that had potential to affect dominant hand strength. A calibrated dynamometer was used to assess dominant hand grip strength. Two multiple linear regression models were used to predict mean hand grip strength values. Spearman and Pearson correlations were calculated for all possible pairwise combinations of significant independent continuous variables and mean hand grip strength values.ResultsReduced hand grip strength prevalence was 54.8%, from which 70.8% people had ≥ 65 years. Twenty four percent of individuals aged < 65 years showed decreased hand grip strength. Increasing age, female gender and type 2 diabetes Mellitus duration were significantly associated with reduced hand grip strength (P < 0.001; P = 0.017; P = 0.001, respectively). For each 10 years of disease duration, individual mean hand grip strength decreased around 3 kg (P = 0.001).ConclusionsReduced hand grip strength prevalence was substantial in the geriatric subgroup and not negligible in younger patients with a contribution long-term Diabetes, increasing age and female gender as risk factors. This study displays a unique, practical and reliable approach to select at-risk patients who need close screening programs and clinical surveillance concerning frailty status.     

Dietary selenium intake and risk of type 2 diabetes in a female population of western Algeria

Several studies have raised possible associations between high selenium exposure and type 2 diabetes. Here we investigate the association between dietary selenium intake and the risk of type 2 diabetes in a female population from western Algeria. The analytical study included a total sample of 290 women, 140 type 2 diabetics and 150 controls. The dietary selenium intake has been measured by a 72-hour dietary recall. The odds ratio (OR) and the corresponding 95% confidence interval (CI) were used to determine the relationship between dietary selenium intake and diabetes through logistic regression. The quartile in the range of recommended dietary selenium intake was considered as a reference. The average level of dietary selenium intake was 72.40 μg/day in diabetics and 70.30 μg/day in controls (P > 0.05). The odds ratio for diabetes, comparing the highest quartile of dietary selenium intake to the reference quartile was 2.21 (95% CI 1.06–4.38; P = 0.036). While the lowest quartile had an odds ratio of 2.52 (95% CI 1.25–5.09; P = 0.010). In conclusion, this study indicates that there is a significant association between the risk of type 2 diabetes and both high and low dietary selenium intake.     

运动对儿童青少年1型糖尿病患者骨骼的影响

1型糖尿病发病高峰期与骨量积累关键期重合。1型糖尿病会引发患者生长激素/胰岛素样生长因子-1轴改变,导致成年后峰值骨量偏低,增加未来发生骨质疏松和脆性骨折的风险。本研究通过查阅国内外文献,对儿童和青少年阶段1型糖尿病患者骨密度、骨代谢、骨结构、骨材料性特征、运动改善该阶段患者骨量的主要机制以及不同运动方式的干预特点进行综述。     

There is a positive association between vitamin B12 deficiency and serum total cholesterol in Iranian type 2 diabetic patients on Metformin

Introduction

Considering the low level of vitamin B₁₂ in diabetic patients on Metformin and also the importance of this vitamin in lipid metabolism, the aim of the present study was assessing the possible relationship between vitamin B₁₂ deficiency, lipid profile and atherogenic indices in Iranian diabetic patients.

Coping and resilience in adolescents with type 1 diabetes

Background Adolescents with type 1 diabetes (T1D) must cope with the ongoing stress of treatment management, so it is important to identify the most adaptive coping strategies. Previous studies, however, have typically measured broad categories of coping (e.g. approach/avoidance) and few used instruments specifically designed for this population. Objective This article aimed to use a developmentally sensitive coping measure to explore how the use of specific coping strategies impacts resilience (i.e. quality of life, competence and metabolic control) in adolescents with T1D. Methods Thirty adolescents with T1D between the ages of 10 and 16 and their mothers completed questionnaires on adolescents' coping strategy use, competence and quality of life. Clinical data (i.e. HbA1c) were obtained from adolescents' medical records. Results Greater use of primary control coping strategies (e.g. problem solving, emotional expression) was associated with higher competence scores, better quality of life and better metabolic control. Secondary control coping strategies (e.g. acceptance, distraction) were related to higher social competence, better quality of life and better metabolic control. Finally, the use of disengagement coping strategies (e.g. withdrawal or denial) was linked with lower competence and poorer metabolic control. Conclusions The results of this study support the use of developmentally sensitive coping measures by researchers and clinicians to determine the most effective coping strategies for adolescents with T1D.     

1型糖尿病患者勃起功能障碍的患病情况及相关因素分析

目的探讨1型糖尿病（T1DM）患者勃起功能障碍（ED）的患病情况及相关影响因素。方法收集182例已婚男性T1DM患者，用无记名问卷形式根据国际勃起功能指数问卷进行自我评分。并对年龄、病程、糖化血红蛋白（HbA1c）、睾酮、尿微量白蛋白排泄量、肾功能、血压、吸烟史、饮酒史、应用药物等因素进行调查，分析其与ED的关系。结果T1DM患者ED患病率为37．36％（68／182）。Logistic逐步回归分析结果显示，病程、年龄、HbA1c、收缩压、尿微量白蛋白排泄量与T1DM患者ED发生独立相关，病程增加5年、年龄增加10岁、HbA1c增加2％、收缩压增加4kPa及尿微量白蛋白排泄量的OR值分别为1．6275、1．1613、2．4211、2．3715、1．5234，P均〈0．01。结论加强对T1DM患者ED高危因素的关注和定期检测，有助于早期发现ED。     

The role of nutritional status in the relationship between diabetes and health-related quality of life

BACKGROUND/OBJECTIVESThe association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM.SUBJECTS/METHODSStructured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age.RESULTSThis study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished.CONCLUSIONSThe study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.     

青岛地区1型糖尿病儿童及青少年血糖管理状况和生存质量的调查研究

目的 通过调查青岛地区1型糖尿病儿童及青少年血糖管理状况和生存质量,为儿童糖尿病的综合治疗提供依据。方法 采用儿童生存质量测定量表对2015年参加青岛大学附属医院内分泌儿科糖尿病营会活动的89名1型糖尿病儿童问卷调查,评价其血糖管理状况和生存质量。结果 1型糖尿病儿童糖化血红蛋白总体控制水平不良,血糖水平与年龄、病程、饮食、血糖监测频率、参加营会次数、居住地、母亲文化程度、家庭经济收入显著相关(P<0.05)。1型糖尿病儿童生存质量总得分是(80.73±12.68)分。血糖水平、居住地、父母婚姻状况、亲子交流情况是糖尿病儿童生存质量的相关因素(P<0.05),其中血糖水平是对生存质量发挥主导作用的因素。结论 青岛地区1型糖尿病儿童及青少年血糖控制水平总体欠佳,生存质量下降。医护人员需及早发现影响患儿血糖控制管理状况和生存质量的相关因素,积极干预,提高其血糖控制水平和生存质量。     

对氧磷脂酶1与2型糖尿病血管并发症的关系研究

目的探讨血清对氧磷脂酶1活性与2型糖尿病血管并发症的关系。方法以对氧磷为底物测定2型糖尿病各组患者及健康老年人血清对氧磷脂酶1活性。结果 2型糖尿病组与健康对照组血清对氧磷脂酶1活性差异有统计学意义（P〈0.01）;2型糖尿病合并血管病变组与2型糖尿病组血清对氧磷脂酶1活性差异有统计学意义（P〈0.01）。结论对氧磷脂酶1活性在2型糖尿病及并发血管病变患者中均显著降低,提示对氧磷脂酶1活性的降低参与了糖尿病血管并发症的发生。     

2型糖尿病患者睡眠质量及其危险因素调查

目的探讨2型糖尿病(T2DM)患者的睡眠质量及其危险因素。方法采用多阶段整群抽样方法,抽取徐州市944例T2DM患者,使用统一调查表及匹兹堡睡眠质量指数量表(PSQI)、生存质量特异性量表(DSQL)、抑郁自评量表(SDS)等进行调查,采用多因素logistic回归分析睡眠异常的危险因素。结果 T2DM患者睡眠异常比例为33.6%,PSQI平均(6.87±3.84)分,异常组PSQI总分(11.19±2.80)高于良好组(4.59±1.59),DSQL各维度及总分也高于良好组,以上差异均有统计学意义(P值均0.01)。PSQI总分与DSQL总分呈正相关,相关系数为0.38。logistic回归分析显示,性别、婚姻、并发症、病程和抑郁与T2DM患者的睡眠异常有关,其OR值及95%CI分别为1.427(1.050~1.939)、1.801(1.234~2.628)、1.537(1.083~2.181)、1.391(1.164~1.662)、2.527(1.883~3.390)。结论 T2DM患者的睡眠质量与其生存质量相关。女性、未婚/离婚/丧偶、有并发症、病程长及合并抑郁可能是T2DM患者睡眠异常的危险因素。     

学龄期1型糖尿病儿童生存质量差异的因素分析

目的 分析学龄期1型糖尿病(T1DM)儿童生存质量差异的因素,为制定改善TIDM患儿生存质量的治疗方案提供依据。方法 对2016年6月-2018年6月至西安市中心医院进行治疗的106例学龄期TIDM患儿进行问卷调查,问卷采用郑玲玲等编制的《重庆地区儿童青少年糖尿病患者生存质量调查量表》,观察调查问卷中患儿在影响领域、满意度领域得分,以及总体得分情况。观察不同的空腹血糖、糖化血红蛋白(HbA1c)等指标的患儿问卷得分差异,以及影响患儿生存质量的因素。结果 患儿生存质量量表分为影响领域和满意度领域两部分,106名学龄期T1DM患儿影响领域量表得分为(82.37±11.44)分,满意度领域(25.41±5.77)分,总体得分(110.54±18.89)分。空腹血糖≤6.1 mmol/L患儿的生存质量量表得分(105.16±14.88)明显低于空腹血糖>6.1 mmol/L的患儿(142.26±20.61)(t=10.064,P=0.001);HbA1c≤7.6%患儿的生存质量量表得分(103.67±19.26)明显低于HbA1c＞7.6%的患儿得分(144.58±22.27)(t=9.572,P<0.001)。不同性别、住址、家庭收入的患儿,其生存质量评分差异无统计学意义(P>0.05),但是糖尿病饮食遵守情况、胰岛素注射方式、注射次数、血糖监测次数以及病程会导致生存质量评分差异有统计学意义(P<0.001)。结论 1型糖尿病学龄期儿童的生存质量受多种因素影响,因此对此类儿童应制定严格的饮食方案,采用胰岛素泵进行注射,以维持患儿血糖和糖化血红蛋白在较长时间内的稳定。     

Health-related quality of life in type 1 diabetes without or with symptoms of long-term complications

Objective: To measure subjective health-related quality of life (HRQoL) of patients with type 1 diabetes and describe the influence of symptoms of diabetes-related long-term complications on HRQoL. Methods: The 15-D health-related quality of life measure (15D) was used to measure HRQoL of a representative sample of Finnish insulin-treated patients expected to have type 1 diabetes. Background data were gathered with a separate questionnaire. A tobit (censored regression) model was constructed to estimate the effects of symptoms of complications on HRQoL and to separate these effects from those of other health problems and aging. Results: The 15D scores declined markedly with increasing age, and the prevalence of symptoms of long-term complications increased. The tobit regression model showed that these symptoms have a significant negative influence on HRQoL. The model explained over 50% of the variation in the 15D scores. Conclusions: High prevalence of symptoms of long-term complications combined with their significant negative influence on HRQoL causes substantial losses in terms of quality of life and utility from both individual and societal perspectives. Thus, the importance of secondary prevention, i.e., prevention of complications by better metabolic control, and also the so-far theoretic possibility to prevent type 1 diabetes itself is emphasized.     

1型糖尿病病因流行病学研究进展

1型糖尿病作为一种病因尚未明确的疾病,在人群中分布有其独有的特征。大型的流行病学调查表明该病的发病率大约以每年2％～3％的速度在增长,各地区之间分布特征差异较大,近年来有发病低龄化趋势。相关环境因素与疾病的关系未明,遗传背景及风险较明确但存在多数患者一级亲属未发病的现象。中国范围内该病的流行病学分布尚不清楚,但相关研究提示该病对中国人群的影响不容忽视。     

An audit of diabetes control, dietary management and quality of life in adults with type 1 diabetes mellitus, and a comparison with nondiabetic subjects

OBJECTIVES: The study's objective was to audit current diet and disease management in a community-based sample of people with type 1 diabetes. METHODS: The study involved adults with type 1 diabetes and control subjects. Reported amounts of dietary intake were collected. Indices of diabetes control were determined by standard methods. Quality of life of both groups was assessed with appropriate measures. Results were compared between two groups. RESULTS: Mean HbA(1c) concentration was 8.5% (SD 2.21%) for women with diabetes and 8.6% (SD 1.91%) for men. There was no significant difference between the diabetic and control subjects in self-reported energy intake and macronutrient intake, with the exception that the contribution of saturated fatty acid to energy intake was higher in male controls than in male diabetics. There was no association between dietary intakes and glycemic control in diabetic subjects. Anthropometric measurements, blood pressure and plasma lipids in patients were within normal range and not significantly different from the controls. Plasma fibrinogen concentration was higher in patients. Diabetic subjects did not have a diminished quality of life. CONCLUSIONS: Dietary management in these patients was generally focused on controlling carbohydrate intake. Most had suboptimal diabetes control.