scholarly journals Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study

Diabetologia ◽  
2021 ◽  
Author(s):  
Joline W. J. Beulens ◽  
Josan S. Yauw ◽  
Petra J. M. Elders ◽  
Talitha Feenstra ◽  
Ron Herings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Data Extraction ◽  
External Validation ◽  
Foot Ulcer ◽  
Predictive Performance ◽  
Prognostic Models ◽  
Bias Assessment

Abstract Aims/hypothesis Approximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10–20 times higher than that of people without type 2 diabetes. Prognostic models can aid in targeted monitoring but an overview of their performance is lacking. This study aimed to systematically review prognostic models for the risk of foot ulcer or amputation and quantify their predictive performance in an independent cohort. Methods A systematic review identified studies developing prognostic models for foot ulcer or amputation over minimal 1 year follow-up applicable to people with type 2 diabetes. After data extraction and risk of bias assessment (both in duplicate), selected models were externally validated in a prospective cohort with a 5 year follow-up in terms of discrimination (C statistics) and calibration (calibration plots). Results We identified 21 studies with 34 models predicting polyneuropathy, foot ulcer or amputation. Eleven models were validated in 7624 participants, of whom 485 developed an ulcer and 70 underwent amputation. The models for foot ulcer showed C statistics (95% CI) ranging from 0.54 (0.54, 0.54) to 0.81 (0.75, 0.86) and models for amputation showed C statistics (95% CI) ranging from 0.63 (0.55, 0.71) to 0.86 (0.78, 0.94). Most models underestimated the ulcer or amputation risk in the highest risk quintiles. Three models performed well to predict a combined endpoint of amputation and foot ulcer (C statistics >0.75). Conclusions/interpretation Thirty-four prognostic models for the risk of foot ulcer or amputation were identified. Although the performance of the models varied considerably, three models performed well to predict foot ulcer or amputation and may be applicable to clinical practice. Graphical abstract

scholarly journals Pharmacogenetics of Type 2 diabetes mellitus: A Systematic Review Protocol (Preprint)

2019 ◽  
Author(s):  
Hamid Reza Aghaei Meybodi ◽  
Negar Sarhangi ◽  
Anoosh Naghavi ◽  
Marzieh Rahbaran ◽  
Maryam Hassani Doabsari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Data Extraction ◽  
Relevant Information ◽  
Risk Of Bias ◽  
Cochrane Database ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Review Protocol

UNSTRUCTURED The objective of this systematic review is to determine the effect of genetic variants that associate with antidiabetic medications and their efficacy and toxicity in T2DM patients. The understanding may allow interventions for improving management of T2DM and later systematically evaluated in more in-depth studies. We will have performed a comprehensive search using PubMed, Scopus, EMBASE, Web of Sciences and Cochrane database from 1990 to 2018. Relevant journals and references of all included studies will be hand searched to find the additional studied. Eligible studies such as pharmacogenetics studies in terms of drug response and toxicity in the type 2 diabetes patients and performed just on human will be included. Data extraction and quality assessment will be carried out by two independent reviewers and disagreements will be resolved through third expert reviewer. Risk of bias will be assessed with the Cochrane Risk of Bias tool for randomized studies and Newcastle-Ottawa Scale (NOS) for observational Studies. Narrative synthesis will be conducted by the combination of key findings. The results of this study will be submitted to a peer-reviewed journal for publication and also presented at PROSPERO. We expect this review will provide highly relevant information for clinicians, pharmaceutical industry that will benefit from the summary of the best available data regarding the efficacy of antidiabetic medication in the aspect of pharmacogenetics. PROSPERO Registration number (CRD42018104843)

scholarly journals A Systematic Review of the Economic Burden of Type 2 Diabetes in Malaysia

2020 ◽  
Vol 17 (16) ◽  
pp. 5723
Author(s):  
Kurubaran Ganasegeran ◽  
Chee Peng Hor ◽  
Mohd Fadzly Amar Jamil ◽  
Hong Chuan Loh ◽  
Juliana Mohd Noor ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Economic Burden ◽  
Data Extraction ◽  
Policy Decision ◽  
Economic Evaluations ◽  
Total Annual Cost ◽  
Adult Type

Diabetes causes significant disabilities, reduced quality of life and mortality that imposes huge economic burden on societies and governments worldwide. Malaysia suffers a high diabetes burden in Asia, but the magnitude of healthcare expenditures documented to aid national health policy decision-making is limited. This systematic review aimed to document the economic burden of diabetes in Malaysia, and identify the factors associated with cost burden and the methods used to evaluate costs. Studies conducted between 2000 and 2019 were retrieved using three international databases (PubMed, Scopus, EMBASE) and one local database (MyCite), as well as manual searches. Peer reviewed research articles in English and Malay on economic evaluations of adult type 2 diabetes conducted in Malaysia were included. The review was registered with PROSPERO (CRD42020151857), reported according to PRISMA and used a quality checklist adapted for cost of illness studies. Data were extracted using a data extraction sheet that included study characteristics, total costs, different costing methods and a scoring system to assess the quality of studies reviewed. The review identified twelve eligible studies that conducted cost evaluations of type 2 diabetes in Malaysia. Variation exists in the costs and methods used in these studies. For direct costs, four studies evaluated costs related to complications and drugs, and two studies were related to outpatient and inpatient costs each. Indirect and intangible costs were estimated in one study. Four studies estimated capital and recurrent costs. The estimated total annual cost of diabetes in Malaysia was approximately USD 600 million. Age, type of hospitals or health provider, length of inpatient stay and frequency of outpatient visits were significantly associated with costs. The most frequent epidemiological approach employed was prevalence-based (n = 10), while cost analysis was the most common costing approach used. The current review offers the first documented evidence on cost estimates of diabetes in Malaysia.

scholarly journals Prognostic models for predicting in-hospital paediatric mortality in resource-limited countries: a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035045
Author(s):  
Morris Ogero ◽  
Rachel Jelagat Sarguta ◽  
Lucas Malla ◽  
Jalemba Aluvaala ◽  
Ambrose Agweyu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Assessment Tool ◽  
Data Extraction ◽  
Model Development ◽  
Risk Of Bias ◽  
Prognostic Models ◽  
Risk Scores ◽  
Eligibility Criteria ◽  
Bias Assessment

ObjectivesTo identify and appraise the methodological rigour of multivariable prognostic models predicting in-hospital paediatric mortality in low-income and middle-income countries (LMICs).DesignSystematic review of peer-reviewed journals.Data sourcesMEDLINE, CINAHL, Google Scholar and Web of Science electronic databases since inception to August 2019.Eligibility criteriaWe included model development studies predicting in-hospital paediatric mortality in LMIC.Data extraction and synthesisThis systematic review followed the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies framework. The risk of bias assessment was conducted using Prediction model Risk of Bias Assessment Tool (PROBAST). No quantitative summary was conducted due to substantial heterogeneity that was observed after assessing the studies included.ResultsOur search strategy identified a total of 4054 unique articles. Among these, 3545 articles were excluded after review of titles and abstracts as they covered non-relevant topics. Full texts of 509 articles were screened for eligibility, of which 15 studies reporting 21 models met the eligibility criteria. Based on the PROBAST tool, risk of bias was assessed in four domains; participant, predictors, outcome and analyses. The domain of statistical analyses was the main area of concern where none of the included models was judged to be of low risk of bias.ConclusionThis review identified 21 models predicting in-hospital paediatric mortality in LMIC. However, most reports characterising these models are of poor quality when judged against recent reporting standards due to a high risk of bias. Future studies should adhere to standardised methodological criteria and progress from identifying new risk scores to validating or adapting existing scores.PROSPERO registration numberCRD42018088599.

scholarly journals Periodontal Therapy for Improving Lipid Profiles in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 20 (15) ◽  
pp. 3826 ◽  
Author(s):  
Siddharth Garde ◽  
Rahena Akhter ◽  
Mai Anh Nguyen ◽  
Clara K. Chow ◽  
Joerg Eberhard
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Clinical Trials ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Profiles ◽  
Periodontal Therapy ◽  
Inflammatory Disorder

Periodontitis is a chronic inflammatory disorder often seen in patients with diabetes mellitus (DM). Individuals with diabetes are at a greater risk of developing cardiovascular complications and this may be related, in part, to lipid abnormalities observed in these individuals. The objective of this systematic review is to compile the current scientific evidence of the effects of periodontal treatment on lipid profiles in patients with type 2 diabetes mellitus. Through a systematic search using MEDLINE, EMBASE, PubMed, and Web of Science, 313 articles were identified. Of these, seven clinical trials which met all inclusion criteria were chosen for analysis. Between baseline and 3-month follow-up, there was a statistically significant reduction in the levels of total cholesterol (mean differences (MD) −0.47 mmol/L (95% confidence interval (CI), −0.75, −0.18, p = 0.001)), triglycerides (MD −0.20 mmol/L (95% CI −0.24, −0.16, p < 0.00001)) favouring the intervention arm, and a statistically significant reduction in levels of high density lipoprotein (HDL) (MD 0.06 mmol/L (95% CI 0.03, 0.08, p < 0.00001)) favouring the control arm. No significant differences were observed between baseline and 6-month follow-up levels for any lipid analysed. The heterogeneity between studies was high. This review foreshadows a potential benefit of periodontal therapy for lipid profiles in patients suffering from type 2 DM, however, well designed clinical trials using lipid profiles as primary outcome measures are warranted.

A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. II: treatment

1999 ◽  
Vol 16 (11) ◽  
pp. 889-909 ◽  
Author(s):  
J. Mason ◽  
C. O'Keeffe ◽  
A. Hutchinson ◽  
A. McIntosh ◽  
R. Young ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Foot Ulcer

scholarly journals Temporal Trends in Incident Hospitalization for Diabetes-Related Foot Ulcer in Type 2 Diabetes: The Fremantle Diabetes Study

2021 ◽  
Author(s):  
Emma J Hamilton ◽  
Wendy A Davis ◽  
Ranita Siru ◽  
Mendel Baba ◽  
Paul E Norman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Proportional Hazards ◽  
Temporal Trends ◽  
Age Groups ◽  
Foot Ulcer ◽  
Cox Proportional Hazards ◽  
Diabetes Diagnosis ◽  
Incident Rate

Objective:<b> </b>To determine whether, reflecting trends in other chronic complications, incident hospitalization for diabetes-related foot ulcer (DFU) has declined over recent decades in type 2 diabetes. <p>Research design and methods:<b> </b>Participants with type 2 diabetes from the community-based Fremantle Diabetes Study Phases I (FDS1; 1,296 participants, mean age 64.0 years, 48.6% males, recruited 1993-1996) and II (FDS2; 1,509 participants, mean age 65.4 years, 51.8% males, recruited 2008-2011) were followed from entry to first hospitalization for/with DFU, death or 5 years (whichever came first). Incident rate ratios (IRRs) and incident rate differences (IRDs) were calculated for FDS2 versus FDS1 overall and in 10-year age-groups. Cox proportional hazards modelling determined independent predictors of first DFU hospitalization in the combined cohort.</p> <p>Results:<b> </b>Incident DFU hospitalization (95% CI) was 1.9 (0.9-3.3) /1,000 person-years in FDS1 during 5,879 person-years of follow-up, and 4.5 (3.0-6.4) /1,000 person-years in FDS2 during 6,915 person-years of follow-up. The crude IRR (95% CI) was 2.40 (1.17-5.28), <i>P</i>=0.013) and IRD 2.6 (0.7-4.5) /1,000 person-years (<i>P</i>=0.010). The highest incidence rate (IR) for any age-group was 23.6/1,000 person-years in FDS2 participants aged 31-40 years. Age at diabetes diagnosis (inverse), HbA<sub>1c</sub>, insulin use, height, ln(urinary albumin:creatinine), absence of any foot pulse, previous peripheral revascularization and peripheral sensory neuropathy (PSN) were independent predictors of incident hospitalization for/with DFU.</p> <p>Conclusions:<b> </b>Incident DFU hospitalizations complicating type 2 diabetes increased between FDS Phases, especially in younger participants, and were more likely in those with PSN, peripheral arterial disease and suboptimal glycemic control at baseline.</p>

scholarly journals Use of Dental Practices for the Identification of Adults With Undiagnosed Type 2 Diabetes Mellitus or Nondiabetic Hyperglycemia: Protocol for a Systematic Review (Preprint)

2018 ◽  
Author(s):  
Zehra Yonel ◽  
Praveen Sharma ◽  
Laura J Gray
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Data Extraction ◽  
Meta Analysis ◽  
Evidence Base ◽  
Statistical Analysis Plan ◽  
Dental Services

BACKGROUND Type 2 diabetes mellitus (T2DM) is a growing global health burden and is expected to affect more than 590 million people by the year 2035. Evidence exists to demonstrate that dental settings have been used for risk assessment and identification of individuals who may be at high risk for T2DM or who may already unknowingly have the condition. OBJECTIVE This protocol aims to outline the methodology that will be undertaken to synthesize the literature relating to the use of primary care (nonhospital-based) dental services for the identification of undiagnosed T2DM or prediabetes—often termed nondiabetic hyperglycemia—in adult patients. METHODS This paper outlines the protocol that will be followed to conduct a systematic review and meta-analysis of the available literature. The protocol outlines the aims, objectives, search strategy, data extraction and data management methods, as well as the statistical analysis plan. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines were followed in developing the protocol as were elements of the Cochrane handbook. RESULTS We expect the systematic review to be completed within 18 months of publication of this protocol and expect to see a high degree of heterogeneity in the existing literature. CONCLUSIONS This review is of importance as it will synthesize the existing evidence base and inform future studies in the field. Following the publication of the protocol, the review will be registered on Prospective Register of Systematic Reviews. Following the completion of the review, results will be published in a suitable peer-reviewed journal. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11843

scholarly journals The effect of sodium-glucose link transporter 2 inhibitors on heart failure end points in people with type 2 diabetes mellitus: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Thomas Simon James Crabtree ◽  
Robert EJ Ryder
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Data Extraction ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Cardiovascular Outcomes ◽  
Bias Assessment

Sodium-glucose linked transporter 2 inhibitors (SGLT2i) have been demonstrated to improve cardiovascular outcomes. In particular, SGLT2i appear to be beneficial in improving heart failure outcomes in people with and without diabetes. The aim of this review was to synthesis current evidence from randomised controlled trials (RCTs) comparing SGLT2i to placebo in adults with type 2 diabetes mellitus. The outcomes of interest were rate hospitalisation due to heart failure (primary), death due to heart failure (secondary) and incidence rates of heart failure (secondary).Methods: Searches were performed using recognised terms in MedLine, EMBASE, Pubmed and CINAHL. Studies were included if they compared an SGLT2i to inhibitor in an RCT and contained data for an outcome of interest. Studies were reviewed for inclusion by two people (TSJC and REJR) and data extraction and bias assessment were performed using a modified Cochrane’s data extraction tool and bias assessment tool. Meta-analysis of hazard ratios was performed in RevMan 5.4 using generic inverse variance and a fixed effects model where possible.Results: 2,850 records were identified of which 11 were eventually included, covering 9 clinical studies. Eight of these were suitable for meta-analysis for the outcome of hospitalisation due to heart failure – the pooled hazard ratio was found to be 0.69 (95% CI 0.63, 0.75). Interstudy heterogeneity was minimal (I2 0%) Only one study contained outcomes for death specifically due to heart failure, but its results were not significant. No current studies report incidence rates of new heart failure diagnosis.Conclusion: SGLT2is reduce the rates of hospitalisation due to heart failure in people with type 2 diabetes. This may help mediate the improvements seen in all cardiovascular outcomes, especially when assessed as a composite. More evidence is needed to support their use in reduce mortality due to heart failure and incidence rates of new heart failure in this high-risk cohort.

scholarly journals Risk of all-cause and CHD mortality in women versus men with type 2 diabetes: a systematic review and meta-analysis

2019 ◽  
Vol 180 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Guodong Xu ◽  
Dingyun You ◽  
Liping Wong ◽  
Donghui Duan ◽  
Fanqian Kong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Web Of Science ◽  
Meta Analysis ◽  
Prospective Cohort Studies ◽  
Hazard Ratios ◽  
Inverse Variance ◽  
All Cause Mortality

Objective Previous studies have shown sex-specific differences in all-cause and CHD mortality in type 2 diabetes. We performed a systematic review and meta-analysis to provide a global picture of the estimated influence of type 2 diabetes on the risk of all-cause and CHD mortality in women vs men. Methods We systematically searched PubMed, EMBASE and Web of Science for studies published from their starting dates to Aug 7, 2018. The sex-specific hazard ratios (HRs) and their pooled ratio (women vs men) of all-cause and CHD mortality associated with type 2 diabetes were obtained through an inverse variance-weighted random-effects meta-analysis. Subgroup analyses were used to explore the potential sources of heterogeneity. Results The 35 analyzed prospective cohort studies included 2 314 292 individuals, among whom 254 038 all-cause deaths occurred. The pooled women vs men ratio of the HRs for all-cause and CHD mortality were 1.17 (95% CI: 1.12–1.23, I2 = 81.6%) and 1.97 (95% CI: 1.49–2.61, I2 = 86.4%), respectively. The pooled estimate of the HR for all-cause mortality was approximately 1.30 in articles in which the duration of follow-up was longer than 10 years and 1.10 in articles in which the duration of follow-up was less than 10 years. The pooled HRs for all-cause mortality in patients with type 2 diabetes was 2.33 (95% CI: 2.02–2.69) in women and 1.91 (95% CI: 1.72–2.12) in men, compared with their healthy counterparts. Conclusions The effect of diabetes on all-cause and CHD mortality is approximately 17 and 97% greater, respectively, for women than for men.

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