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1.
Aims
The aim of this study was to clarify the relationship between drinking and metabolically healthy status in men with normal weight, overweight and obesity.Methods
The subjects were Japanese men aged from 35 to 60 years (n = 31781) and they were divided by daily amount of drinking (g ethanol) into light (< 22), moderate (≥22 and <44), heavy (≥44 and <66) and very heavy (≥66) drinkers. Metabolically healthy subjects were defined as those without hypertension, dyslipidemia and diabetes.Results
The percentage of metabolically healthy subjects was much lower in the overweight (BMI ≥25 and <30) and obese (BMI ≥ 30) groups than in the normal weight group (BMI ≥ 18.5 and <25) and was much lower in the obese group than in the overweight group. In each of the normal weight and overweight groups, percentages of metabolically healthy subjects were significantly lower in heavy and very heavy drinkers than in nondrinkers and were marginally significantly higher in light drinkers than in nondrinkers. The above associations between drinking and metabolically healthy status were confirmed by logistic regression analysis. In the obese group, the percentage of metabolically healthy subjects was significantly lower in regular drinkers (including all drinker categories) than in nondrinkers, and metabolically healthy subjects were rare (0.56%) among regular drinkers.Conclusions
Regardless of absence and presence of overweight or obesity, excessive alcohol drinking is inversely associated with metabolically healthy status and should be avoided for prevention of cardiovascular disease. 相似文献2.
Hayford Mawuli Avedzi Nonsikelelo Mathe Kate Storey Jeffrey Allen Johnson Steven Thomas Johnson 《Primary Care Diabetes》2018,12(1):71-79
Aim
We examined self-reported dietary behaviours and actual food intakes among adult men and women with type 2 diabetes participating in Alberta’s Caring for Diabetes (ABCD) Study.Methods
Participants completed 3-day food records and questions about glycemic index (GI) concept knowledge and dietary behaviours. Daily average GI and glycemic load (GL) were calculated for all carbohydrates consumed. Dietary intake was analyzed using ESHA FoodPro (version 10.13.1). Sex differences in nutrient intakes were explored across categories of GI knowledge and dietary practices.Results
Participants (N = 170) mean (SD) age 65.8 (9.6) years were 46.5% women, 90.6% Caucasian with a mean BMI of 31.3 (7.0) kg/m2 and diabetes duration of 13.4 (8.6) years. Overall, 60% of men versus 40% of women consumed carbohydrates in quantities below Acceptable Macronutrient Distribution Ranges (AMDR). About 80% of men versus 90% of women consumed proteins above AMDR whereas 60% versus 65% of women consumed fats above AMDR. Fibre intake among men was lower than recommended (p < 0.01). Men who reported having knowledge of the GI-concept also reported lower GI intake versus men who did not (p = 0.03).Conclusion
Sex differences exist in low-GI diabetes self-care dietary behaviours among adults with type 2 diabetes participating in this study. Gender-sensitive approaches for enhancing diabetes self-care low-GI dietary behaviour should be explored. 相似文献3.
Jaya Prasad Tripathy B.M. Prasad 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):251-255
Aim
Diabetes is a growing public health problem in India which is soon going to become the ‘diabetes capital’ of the world. It requires regular care and follow up. We aimed to estimate the household out-of-pocket (OOP) expenditure and catastrophic expenditure due to hospitalization and outpatient care as a result of diabetes.Materials and methods
Secondary analysis of nationally representative data for India collected by National Sample Survey Organization in 2014, reporting on health service utilization and health care related OOP expenditure by income quintiles and by type of health facility (public or private).Results
The median household OOP expenditure from hospitalization due to diabetes was USD 151, and was 3 times higher among the richest quintile compared to the poorest quintile (p < 0.001). There was a significantly higher prevalence (p < 0.001) of catastrophic expenditure among the poorest quintile (36%) compared to the richest (14%). Median private sector OOP hospitalization expenditure was four times higher than the public sector (p < 0.001). Medicines accounted for 41% and 69% of public sector hospitalization and outpatient care respectively. Concentration indices show gross inequity in hospitalization expenditure, prevalence of catastrophic expenditure and utilization of public health facility.Conclusion
Households with diabetic patients incur a high risk of catastrophic expenditure, particularly for those in the lowest income quintiles and those seeking care in the private sector. Increased availability and access to essential drugs and strengthening of public facilities will significantly reduce OOP expenditure. 相似文献4.
Vinni Faber Rasmussen Esben Thyssen Vestergaard Ole Hejlesen Camilla Urup Noe Andersson Simon Lebech Cichosz 《Primary Care Diabetes》2018,12(5):453-459
Aim
This study investigates the prevalence of smell and taste impairment in adults with diabetes and potential risk factors for sense deterioration and its influence of daily food intake.Methods
Data from the NHANES 2013-2014 were analyzed. Smell impairment was defined as failing to identify?≥3 of 8 odors in NHANES Pocket Smell Test. Taste impairment was defined as being unable to identify quinine or NaCl in NHANES Tongue Tip and Whole-mouth Test.Results
A total of 3204 people (428 patients with diabetes, 2776 controls) were suitable to be included. The prevalence of smell impairment in patients with diabetes was higher compared to the controls: 22% versus 15% (p < 0.001). The difference prevailed after adjustment for age, BMI, alcohol misuse and smoking status. Taste was not impaired in patients with diabetes (p = 0.29). Patients with diabetes and smell impairment had a lower daily calorie intake compared to patients with diabetes and normal smell function. The duration of diabetes, diabetic complications and other potential risk factors were not associated with smell dysfunction.Conclusions
Smell dysfunction appears with a higher prevalence in patients with diabetes, and this seems to negatively affect daily food intake. 相似文献5.
Siyu Chen Xuhong Hou Yu Sun Gang Hu Xiaoyan Zhou Huijuan Xue Peizhu Chen Jingzhu Wu Yuqian Bao Weiping Jia 《Primary Care Diabetes》2018,12(3):231-237
Aims
To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.Methods
985 adults with diabetes in the Shanghai Taopu community health service center were enrolled at baseline and 907 subjects completed the follow-up. The follow-up levels of the metabolic profiles were assessed by their averages during the follow up period.Results
After a mean 7-year follow-up period, heamoglobin A1c, systolic and diastolic blood pressure levels decreased by 0.6%, 5.7 mmHg, and 1.5 mmHg, respectively (all P < 0.001). There was a non-significant difference in low-density lipoprotein cholesterol, while high-density lipoprotein cholesterol increased 1.9 mg/dL and triglycerides decreased 28.3 mg/dL, respectively (all P < 0.001). The percentage of patients with diabetes who met any one of three Chinese Diabetes Society goals (heamoglobin A1c <7.0%, blood pressure <140/80 mmHg, and low-density lipoprotein cholesterol <100 mg/dL) increased from 58.2% to 70.1%. The chronic diabetes complication screening rates (diabetic retinopathy, diabetic neuropathy, diabetic nephropathy) have significantly increased, from almost zero to 12–78%.Conclusions
This long-term program has increased the proportions of attaining major cardiovascular risk factors control goals and diabetic chronic complication screening rates among patients with diabetes. 相似文献6.
Leonardo Lorente María M. Martín Pedro Abreu-González Antonia Pérez-Cejas Raquel Ortiz López José Ferreres Jordi Solé-Violán Lorenzo Labarta César Díaz Celina Llanos Alejandro Jiménez 《Enfermedades infecciosas y microbiología clínica》2018,36(9):544-549
Objective
Higher serum melatonin levels have previously been found in patients with severe sepsis who died within 30 days of diagnosis than in survivors. The objective of our study were to determine whether serum melatonin levels during the first seven days of severe sepsis diagnosis could be associated with sepsis severity and mortality.Methods
Multicentre study in eight Spanish Intensive Care Units which enrolled 308 patients with severe sepsis. We determined serum levels of melatonin, malondialdehyde (as biomarker of lipid peroxidation) and tumor necrosis factor-alpha at days 1, 4 and 8 of severe sepsis diagnosis. The study's primary endpoint was 30-day mortality.Results
A total of 103 patients had died and 205 survived at 30 days of severe sepsis diagnosis, with the non-survivors presenting higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001) and 8 (p < 0.001) of severe sepsis diagnosis than the survivor patient group. The multiple logistic regression analysis found that serum melatonin levels at days 1, 4 and 8 of severe sepsis diagnosis (p < 0.001, p = 0.01 and p = 0.001, respectively) were associated with mortality adjusted for age, serum lactic acid, SOFA score and diabetes mellitus.Conclusions
The novel and more interesting findings of our study were that serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality. 相似文献7.
Aims
Vitamin D is associated with diabetes mellitus (DM) occurrence by affecting insulin secretion and resistance. However, variations exist due to differences in vitamin D sensitivity among individuals. We investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] status and various indices of DM in a Korean population without DM.Methods
Large-scaled population-based analysis was conducted from the Korea National Health and Nutrition Examination Survey data (2010–2012) were analyzed. Adult survey participants >20 years without diabetes (n = 15,169) were included.Results
The mean 25(OH)D levels were lower in females, subjects aged 20–39 years, and subjects with body mass index <21.1 kg/m2 and less physical activity (p < 0.001). Further, the mean 25(OH)D levels tended to be lower in subjects with FBG >126 mg/dL. After adjustment for potential confounders, 25(OH)D was not correlated with FBG (p = 0.925) or HbA1c (p = 0.336); however, fasting insulin (β = ?0.072, p = 0.011) and homeostasis model assessment of β-cell function (β = ?0.007, p < 0.001) showed significant negative correlations with 25(OH)D levels.Conclusion
Although 25(OH)D status was not significantly associated with FBG or HbA1c, low 25(OH)D levels were associated with compensative insulin increase and ongoing increase in insulin resistance. Thus, vitamin D deficiency is assumed to influence DM occurrence. 相似文献8.
Farhad Gholizadeh Jalal Moludi Ned Lotfi Yagin Mohammad Alizadeh Seyed Mostafa Nachvak Hadi Abdollahzad Khadijeh Mirzaei Mostafa Mostafazadeh 《Primary Care Diabetes》2018,12(4):338-344
Introduction
Prediabetes is considered as an increased risk factor for cardiovascular disease and overt diabetes and is the precursor stage of diabetes. Dietary Diversity Score (DDS) is recognized as an essential factor of a high-quality diet. However, diets with more varieties of food items might increase calorie intake and body weight. Therefore, this study was carried out to determine the association of DDS with metabolic syndrome features in adults with prediabetes.Methods
Three hundred subjects were randomly selected from participants who were undergone diabetes test screening program. Dietary intake was assessed by using a validated semi-quantitative food frequency questionnaire. DDS was calculated by scoring food intake as nine food groups. The 18-items USDA household food securities and International Physical Activity (IPAQ) were also measured. The metabolic syndrome was defined according to the Adult Treatment Panel III.Results
DDS mean for cases and controls were 4.43 and 4.9, respectively (p < 0.005). The prevalence of food insecurity was 67/3% in cases and 55/4% in controls group. The decrease in metabolic syndrome probability was compatible with quartiles of DDS (the quartiles odds ratios: 0.6, 0.5, 0.4, 0.19, P = 0.05). A higher DDS was associated with lower level of fasting blood glucose, HDL-cholesterol, TG and Waist circumference.Conclusion
Lower DDS was associated with high probability of metabolic syndrome and with some features of it, like high fasting blood glucose. Therefore, it seems that increase in dietary diversity scores could prevent the pre diabetes development to overt diabetes. 相似文献9.
10.
Aim
This study investigates the role of muscle strength as a predictive factor for reduced pulmonary function in diabetes.Methods
Data from the NHANES 2011–2012 were analyzed. Lung function was assessed with spirometry (FEV1, FVC). Diabetes was assessed with an oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), or fasting plasma glucose (FPG). Muscle strength was measured by a grip test using a handgrip dynamometer.Results
A total of 3521 people were suitable to be included for analysis in this study. Lung function was reduced in diabetes—after adjustment for covariates, the impact of diabetes on FVC was estimated as ?331 mL (SE 48) for known diabetes and ?282 mL (SE 41) for undiagnosed diabetes (P < 0.001). Grip strength was also reduced in diabetes. After adjustment for covariates, the impact of diabetes was estimated as ?5.9 kg (SE 0.8) for known diabetes (P < 0.001). An association between lung capacity and grip strength in people with known diabetes was observed (R = 0.7, P < 0.001). The adjusted impact on FVC from grip strength was estimated as 13.1 mL (SE 3.4) per kg (P < 0.001).Conclusions
Muscle strength appears to be reduced in people with known diabetes, and this seems to affect the respiratory muscles as an independent factor. 相似文献11.
Almudena Pérez-Torres M. Elena González Garcia Belén San José-Valiente M. Auxiliadora Bajo Rubio Olga Celadilla Diez Ana M. López-Sobaler Rafael Selgas 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(2):141-151
Introduction
Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%.Objective
To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA).Patients and methods
Cross-sectional study of 186 patients (101 men) with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis.Results
The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p < 0.005), while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio.The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001) and cell mass index (OR: 0.995; 95% CI: 0.992–0.998).Conclusion
Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. 相似文献12.
Joseph Jonathan Lee Matthew James Thompson Juliet Alexandra Usher-Smith Constantinos Koshiaris Ann Van den Bruel 《Primary Care Diabetes》2018,12(3):254-264
Background
The epidemiology of type 1 diabetes mellitus (T1DM) suggests diagnostic delays may contribute to children developing diabetic ketoacidosis at diagnosis. We sought to quantify opportunities for earlier diagnosis of T1DM in primary care.Methods
A matched case-control study of children (0–16 years) presenting to UK primary care, examining routinely collected primary care consultation types and National Institute for Health and Care Excellence (NICE) warning signs in the 13 weeks before diagnosis.Results
Our primary analysis included 1920 new T1DM cases and 7680 controls. In the week prior to diagnosis more cases than controls had medical record entries (663, 34.5% vs 1014, 13.6%, odds ratio 3.46, 95% CI 3.07–3.89; p < 0.0001) and the incidence rate of face-to-face consultations was higher in cases (mean 0.32 vs 0.11, incidence rate ratio 2.90, 2.61–3.21; p < 0.0001). The preceding week entries were found in 330 cases and 943 controls (17.2% vs 12.3%, OR 1.49, 1.3–1.7, p < 0.0001), but face-to-face consultations were no different (IRR 1.08 (0.9–1.29, p = 0.42)).Interpretation
There may be opportunities to reduce time to diagnosis for up to one third of cases, by up to two weeks. Diagnostic opportunities might be maximised by measures that improve access to primary care, and public awareness of T1DM. 相似文献13.
Katja Vince Tamara Poljičanin Marko Brkić Urelija Rodin Ratko Matijević 《Primary Care Diabetes》2018,12(4):325-330
Aims
The aim of this study was to determine the prevalence of diabetes among women 5 years after having gestational diabetes during pregnancy. Also, we sought to determine whether women who develop diabetes after GD during pregnancy differ from women who do not develop diabetes after GD during pregnancy.Methods
This longitudinal study was performed using data from medical birth certificates and CroDiab diabetes registry. Women burdened with gestational diabetes in Croatia in 2011 were followed up until year 2016. Those registered in CroDiab registry were recognised as new patients with diabetes.Results
Among 40,641 deliveries in 2011, gestational diabetes was reported in 1181 (2.9%) women. Among them 853 (72.23%) were followed up in CroDiab diabetes registry and 32 (3.75%) were identified as new patients with diabetes. Median time from childbirth to onset of diabetes was 29.12 months. The diabetes group did not significantly differ to the group without diabetes according to age (p = 0.587), level of education (p = 0.549) or marital status (p = 0.849) except that the diabetes group was significantly more obese than the group without diabetes (p = 0.002).Conclusions
Based on CroDiab diabetes registry data prevalence of diabetes 5 years after pregnancy complicated with gestational diabetes is 3.75% in Croatia. Women with gestational diabetes during pregnancy, and especially those with higher BMIs, are an important risk group for developing diabetes later in life so screening and preventive measures should be oriented toward them in primary care settings. 相似文献14.
Francesco Fici Elif Ali Bakir Sengul Beyaz Wim Makel Nicolas Roberto Robles 《Primary Care Diabetes》2018,12(6):558-564
Background
Albuminuria is an early marker of kidney disease in patients with diabetes and/or hypertension undetected or untreated albuminuria is a leading cause of chronic kidney disease and cardiovascular events, The purpose of the present survey was to assess the prevalence of albuminuria in patients with diabetes and hypertension, treated with a combinations of renin angiotensin aldosterone system inhibitors and dihydropyridine calcium channel blockers.Methods
The survey was performed in 105 Primary Care Units in Turkey and involved outpatients, routinely visited by either a specialist or a non-specialist physician.Albuminuria was evaluated in a spot morning urine sample, as albumin–creatinine ratio, using the Multistic-Clinitek-device analyzer (Siemens), that has a strong correlation with 24-h urinary albumin excretion. Microalbuminuria was defined as a loss of 3.4–33.9 mg albumin/mmol creatinine and macroalbuminuria as a loss of >33.9 mg albumin/mmol creatinine. Diabetes was assessed through documented blood glucose concentration or use antidiabetic drugs, whereas hypertension through blood pressure measurement and current antihypertensive treatment.Results
The survey enrolled 1708 subjects with a prevalence of type 2 diabetes (87.6%). Albuminuria was detected in 52.0% of patients. Blood pressure was controlled in 37.0% and diabetes in 56.7%. The risk of albuminuria was significantly high in patients with uncontrolled diabetes (p < 0.001) and blood pressure (p = 0.009).Conclusions
In a large cohort of treated hypertensive patients with diabetes, albuminuria was present in about 50% and was correlated with poor diabetes and blood pressure control. Systematic screening of albuminuria, particularly in Primary Care, is an important tool for the early diagnosis of nephropathy. 相似文献15.
Caroline King Sidney Atwood Chris Brown Adrianne Katrina Nelson Mia Lozada Jennie Wei Maricruz Merino Cameron Curley Olivia Muskett Samantha Sabo Vikas Gampa John Orav Sonya Shin 《Primary Care Diabetes》2018,12(3):212-217
Objectives
To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States.Methods
Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses.Results
Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider.Conclusions
Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. 相似文献16.
N. Behniafard A.A. Amirzargar M. Gharagozlou F. Delavari S. Hosseinverdi S. Sotoudeh E. Farhadi M. Mahmoudi M. Khaledi Z.G. Moghaddam A. Aghamohammadi N. Rezaei 《Allergologia et immunopathologia》2018,46(2):155-159
Background
Atopic dermatitis is an inflammatory skin disease in which both genetic and environmental factors interact to determine the susceptibility and severity of the disease.Objective
The aim of this study was to determine the association between atopic dermatitis and IL-10 and TGF-β1 gene polymorphisms.Methods
The allele and genotype frequencies of genes encoding for IL-10 and TGF-β1 were investigated in 89 patients with atopic dermatitis in comparison with 138 in the control group using the PCR-SSP method.Results
A significant increase was found in the frequency of the TGF-β1 codon 10/C allele among patients (p < 0.001, OR = 6.77), whereas a significant decrease was observed in the frequency of the T allele at the same position (p < 0.001, OR = 0.14). The frequency of the TGF-β1 codon 25/G allele in the control group was significantly higher than among patients (p < 0.001, OR = 0.08). A significant positive correlation was seen between CC (p < 0.001, OR = 15.10) and CG (p < 0.001) genotypes and AD at codons 10 and 25, respectively. The most frequent haplotypes among patients was TGF-β1 CG which was significantly higher than in the control subjects (50% in patients vs. 39.9% in controls, p = 0.042). A significant increase was found in the frequency of TGF-β CC (36% in patients vs. 7.6% in controls, p < 0.001) and TC (14% in patients vs. 0% in controls, p < 0.001) haplotypes among patients compared to controls. By contrast, the TGF-β1 TG haplotype was significantly lower in patients than controls (0% in patients vs. 52.5% in controls, p < 0.001). There were no significant differences in the frequency of alleles, genotypes and haplotypes of the IL-10 gene.Conclusions
We found a strong association between the polymorphisms of the TGF-β1 gene at codon 10 and codon 25 positions and atopic dermatitis. 相似文献17.
Andrii Dudnyk Svitlana Blyzniuk Oleksandr Pavel’chuk Olena Zakharchenko Dmytro Butov Sergiі Zaіkov 《The Indian journal of tuberculosis》2018,65(1):63-69
Tuberculosis (TB) may have a similar spirometry findings as a chronic obstructive pulmonary disease but the prevalence of TB-induced airflow obstruction (AO) is still unknown.
Objectives
To measure frequency of AO in new TB cases at the beginning of treatment and to evaluate factors associated with obstructive abnormalities following TB diagnosis.Materials and Methods
317 patients that have no history of prior AO were recruited into the study with a median age of 39.0 years (IQR, 30.0–49.0). AO was defined using the FEV1/F(VC) < LLN.Results
AO was detected in 29.97% (95/317) new TB cases. These patients had a more severe clinical manifestation of TB with a greater likelihood of cough, OR = 5.47 (95%CI 1.90–15.70) and wheezing, OR = 10.51 (95%CI 5.72–19.27), p < 0.001. The frequency of AO was positively associated with bronchoscopic evidence of narrowing of the main airways. Furthermore, from multiple logistic regression analysis we would assume that higher FEV1 value in TB patients with AO was related to greater BMI and inversely associated with older age, female sex and radiographic extent (p < 0.05).Conclusions
Obstructive pattern on spirometry frequently occurs in new TB cases without previously detected AO. This category of patients should be targeted for detailed follow-up, particularly, in high TB burden countries. 相似文献18.
19.
Sharon H. Saydah Edward W. Gregg Henry S. Kahn Mohammed K. Ali 《Primary Care Diabetes》2018,12(1):3-12
Aims
Determine the mortality experience among adults with diabetes in meeting and not meeting less intense control for glycated hemoglobin (HbA1c), blood pressure (BP), and cholesterol.Methods
National Health and Nutrition Examination Survey 1999–2010 participants with self-report of diagnosed diabetes (N = 3335), measured HbA1c, BP and non-HDL cholesterol were linked to the National Death Index through December 31, 2011. Proportional hazards models were used to estimate hazard ratios (HR) of meeting HbA1c < 9% and BP < 160/110, and non-HDL cholesterol < 190 mg/dL. Models used age as the time scale and adjusted for demographics (sex, race/ethnicity, education), diabetes duration, history of cardiovascular and chronic kidney disease, and treatments for elevated glucose, BP, and cholesterol.Results
Over a mean 5.4 person-years of follow-up, participants meeting all less intense control had a 37% lower mortality (HR = 0.63, 95% CI 0.54, 0.74) relative to those who did not meet the goals. Of approximately 306,000 deaths per year that occur among Americans with diabetes, we estimate 39,400 might have been averted by improving the care of those who have not met these less intense control goals.Conclusions
Meeting the less intense control goals is associated with 37% reduction in mortality and could lead to 39,400 fewer deaths per year. 相似文献20.
Mahsa Nazari Saeed Hashemi Nazari Farid Zayeri Mehrzad Gholampour Dehaki Alireza Akbarzadeh Baghban 《Primary Care Diabetes》2018,12(3):245-253