scholarly journals Type 2 diabetes burden among migrants in Europe: unravelling the causal pathways

Diabetologia ◽  
2021 ◽  
Author(s):  
Charles Agyemang ◽  
Eva L. van der Linden ◽  
Louise Bennet

AbstractEuropean populations are ethnically and culturally diverse due to international migration. Evidence indicates large ethnic inequalities in the prevalence of type 2 diabetes. This review discusses the burden of type 2 diabetes and its related complications, and the potential explanatory mechanisms among migrants in Europe. The current available data suggest that the rate of type 2 diabetes is higher in all migrant groups and that they develop this disease at an earlier age than the host European populations. The level of diabetes awareness among migrant populations is high, but glycaemic control remains suboptimal compared with Europeans. The culturally adapted lifestyle modification intervention trials to prevent type 2 diabetes mainly focus on South Asian adults in Europe. Diabetes-related microvascular and macrovascular complications remain a major burden among migrant populations in Europe. Earlier studies found higher mortality rates among migrants, but recent studies seem to suggest a shifting trend in favour of first-generation migrants. However, the extent of the burden of type 2 diabetes varies across migrant groups and European countries. Despite the higher burden of type 2 diabetes among migrants, the key underlying factors are not well understood mainly due to limited investment in basic science research and development of prospective cohort studies. We hypothesise that the underlying risk factors for the high burden of type 2 diabetes and its related complications in migrants are multifaceted and include pre-migration factors, post-migration factors and genetic predispositions. Given the multi-ethnic nature of the current European population, there is a clear need for investment in research among migrant populations to gain insight into factors driving the high burden of type 2 diabetes and related complications to facilitate prevention and treatment efforts in Europe. Graphical abstract

2020 ◽  
Author(s):  
Daniel B. Ibsen ◽  
Marinka Steur ◽  
Fumiaki Imamura ◽  
Kim Overvad ◽  
Matthias B. Schulze ◽  
...  

OBJECTIVE <p>There is sparse evidence for suitable food substitutions for red and processed meat on risk of type 2 diabetes. We modelled the association between replacing red and processed meat with other protein sources and the risk of type 2 diabetes and estimated its population impact.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>The European Prospective Investigation into Cancer (EPIC)-InterAct case-cohort included 11,741 type 2 diabetes cases and a subcohort of 15,450 participants in eight countries. We modelled the replacement of self-reported red and processed meat with poultry, fish, eggs, legumes, cheese, cereals, yogurt, milk and nuts. Country-specific hazard ratios (HR) for incident type 2 diabetes were estimated by Prentice-weighted Cox regression and pooled using random-effects meta-analysis. </p> <p>RESULTS</p> <p>There was a lower hazard for type 2 diabetes for the modelled replacement of red and processed meat (50 g/day) with cheese (HR 0.90, 95% confidence interval 0.83–0.97; 30 g/day), yogurt (0.90, 0.86–0.95; 70 g/day), nuts (0.90, 0.84–0.96; 10 g/day) or cereals (0.92, 0.88–0.96; 30 g/day) but null for replacements with poultry, fish, eggs, legumes or milk. Assuming a causal association, replacing red and processed meat with cheese, yogurt or nuts could prevent 8.8%, 8.3% or 7.5%, respectively, of new cases of type 2 diabetes.</p> <p>CONCLUSIONS</p> <p>Replacement of red and processed meat with cheese, yogurt, nuts or cereals was associated with a lower rate of type 2 diabetes. Substituting red and processed meat by other protein sources may contribute to the prevention of incident type 2 diabetes in European populations.</p>


Author(s):  
Chunsong Hu ◽  
Tengiz Tkebuchava ◽  
Qinghua Wu

This article introduces briefly current status in managing type 2 diabetes (T2D) and an updated classical standardized comprehensive program which combines optimal medical treatment (OMT) with lifestyle modification, that is, intervention of RT-ABCDEFG (iRT-ABCDEFG) for control and prevention of T2D, and discusses its advantages and prospects. Here, G means goals; F means follow-up; E means examination; D means disease & risk factors control; C means changing unhealthy “environment-sleep-emotion-exercise-diet” intervention [E(e)SEEDi] lifestyle & Chinese medicine or control the source of infection & cutting genetic or spreading pathways during the COVID-19 pandemic; B means biohazard control; And A means antagonistic treatment, such as optimal anti-diabetic agents, the glucagon-like peptide-1 receptor (GLPR) agonists, the sodium-glucose cotransporter 2 (SGLT2) inhibitors, and the ultralong-acting, once-daily basal insulin. As a novel strategy for Intervention of diabetes, this program can be used as a Reverse, Right, and Routine Treatment in clinical practice. Moreover, the vital goals which include less major adverse cardiocerebrovascular events (MACCE) and diabetic complications, less medical costs, longer life expectancy, lower morbidity and mortality, and higher quality of life, will be realized by consistently practicing this program due to early diagnosis, OMT, and overall prevention. Whatever, this program is very helpful to manage or self-manage T2D and improve its outcomes since it highly links to cardiovascular disease (CVD), stroke, cancer, and other MACCEs.


2021 ◽  
Author(s):  
Mohammadhosain Afrand ◽  
Mohammad Afkhami-Ardekani ◽  
Ahmad Shojaoddiny-Ardekani ◽  
Azita Ariaeinejad

Metabolic syndrome is defined as the co-occurrence of metabolic risk factors for both type 2 diabetes and cardiovascular disease (i.e. abdominal obesity, hyperglycemia, dyslipidemia, and hypertension). Indeed, metabolic syndrome is an important risk factor for subsequent development of type 2 diabetes and/or CVD. Thus, the key clinical implication of a diagnosis of metabolic syndrome is the identification of a patient who needs aggressive lifestyle modification focused on weight reduction and increased physical activity. Multiple different phenotypes and ethnic-specific values for waist circumference are included within metabolic syndrome, with indications for differing treatment strategies. This book covers several aspects of metabolic syndrome, including its definition, diagnostic criteria, preventive measures, and treatment, as well as the possible association between ethnicity and the occurrence of metabolic syndrome.


Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1373 ◽  
Author(s):  
Kazue Yamaoka ◽  
Asuka Nemoto ◽  
Toshiro Tango

Background: Many clinical trials have been conducted to verify the effects of interventions for prevention of type 2 diabetes (T2D) using different treatments and outcomes. The aim of this study was to compare the effectiveness of lifestyle modifications (LM) with other treatments in persons at high risk of T2D by a network meta-analysis (NMA). Methods: Searches were performed of PUBMED up to January 2018 to identify randomized controlled trials. The odds ratio (OR) with onset of T2D at 1 year in the intervention group (LM, dietary, exercise, or medication) versus a control group (standard treatments or placebo) were the effect sizes. Frequentist and Bayesian NMAs were conducted. Results: Forty-seven interventions and 12 treatments (20,113 participants) were used for the analyses. The OR in the LM was approximately 0.46 (95% CI: 0.33 to 0.61) times lower compared to the standard intervention by the Bayesian approach. The effects of LM compared to other treatments by indirect comparisons were not significant. Conclusions: This meta-analysis further strengthened the evidence that LM reduces the onset of T2D compared to standard and placebo interventions and appears to be at least as effective as nine other treatments in preventing T2D.


2003 ◽  
Vol 1253 ◽  
pp. 231-236 ◽  
Author(s):  
G. Riccardi ◽  
R. Giacco ◽  
M. Parillo

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