scholarly journals Ethnic differences in mortality and hospital admission in a New Zealand population with type 2 diabetes

2020 ◽  
Author(s):  
Mathew Hobbs ◽  
Annabel Ahuriri-Driscoll ◽  
Philip J Schluter
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Hospital Admission ◽  
Ethnic Differences ◽  
Zealand Population

Mortality in individuals with Type 2 diabetes and heart disease in a unique New Zealand population

2006 ◽  
Vol 23 (12) ◽  
pp. 1313-1318 ◽  
Author(s):  
G. D. Kerr ◽  
G. D. Gamble ◽  
R. N. Doughty ◽  
D. Simmons ◽  
J. Baker
Keyword(s):  
Type 2 Diabetes ◽  
Heart Disease ◽  
New Zealand ◽  
Zealand Population

scholarly journals The prevalence and treatment of metformin associated Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus in New Zealand

2021 ◽  
Author(s):  
◽  
Sylvan Haeusler
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Vitamin B12 ◽  
Treatment Options ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Zealand Population ◽  
B12 Deficiency

<p>With an ever increasing incidence of type 2 diabetes in the New Zealand population, continual assessment must be made to ensure the ongoing evaluation of treatment options to ensure patient care is not compromised. Previous research has shown higher prevalence of Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus who have had long term metformin treatment. An investigation into patients attending secondary care clinics at the Diabetes Clinic at Wellington Regional Hospital as well as primary health care patients has explored the prevalence of this interaction in the New Zealand population as well as assessed the factors that may contributed to such an effect. It was found that there is a high prevalence of decreased serum Vitamin B12 level in patients with type 2 Diabetes exposed to metformin treatment. Factors such as age and ethnicity were seen to be key predictors of this interaction and have shown a unique view of how the population of New Zealand may be affected. Treatment of decreased serum Vitamin B12 levels was seen to be effective through both sublingual and intramuscular methods with variations in both short and long term effects. The use of sublingual treatment administration of Vitamin B12 supplementation is unique in the scope of metformin induced Vitamin B12 deficiency and has shown potential to be a therapeutic route for patients affected by such an interactions. Current views on the interaction between metformin and serum Vitamin B12 levels are currently under debate in regards to physiological relevance and clinical outcomes. This paper provides a first look at the effect of this interaction in a New Zealand population and evaluates treatment options for such. Furthermore a proposal is made for an alternate mechanism of metformin action on Vitamin B12 levels which may aid understanding of observations made in both in this paper and previous studies.</p>

scholarly journals The prevalence and treatment of metformin associated Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus in New Zealand

2021 ◽  
Author(s):  
◽  
Sylvan Haeusler
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Vitamin B12 ◽  
Treatment Options ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Zealand Population ◽  
B12 Deficiency

<p>With an ever increasing incidence of type 2 diabetes in the New Zealand population, continual assessment must be made to ensure the ongoing evaluation of treatment options to ensure patient care is not compromised. Previous research has shown higher prevalence of Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus who have had long term metformin treatment. An investigation into patients attending secondary care clinics at the Diabetes Clinic at Wellington Regional Hospital as well as primary health care patients has explored the prevalence of this interaction in the New Zealand population as well as assessed the factors that may contributed to such an effect. It was found that there is a high prevalence of decreased serum Vitamin B12 level in patients with type 2 Diabetes exposed to metformin treatment. Factors such as age and ethnicity were seen to be key predictors of this interaction and have shown a unique view of how the population of New Zealand may be affected. Treatment of decreased serum Vitamin B12 levels was seen to be effective through both sublingual and intramuscular methods with variations in both short and long term effects. The use of sublingual treatment administration of Vitamin B12 supplementation is unique in the scope of metformin induced Vitamin B12 deficiency and has shown potential to be a therapeutic route for patients affected by such an interactions. Current views on the interaction between metformin and serum Vitamin B12 levels are currently under debate in regards to physiological relevance and clinical outcomes. This paper provides a first look at the effect of this interaction in a New Zealand population and evaluates treatment options for such. Furthermore a proposal is made for an alternate mechanism of metformin action on Vitamin B12 levels which may aid understanding of observations made in both in this paper and previous studies.</p>

scholarly journals Treatment with a DPP-4 inhibitor at time of hospital admission for COVID-19 is not associated with improved clinical outcomes: data from the COVID-PREDICT cohort study in The Netherlands

2021 ◽  
Author(s):  
Rick I. Meijer ◽  
Trynke Hoekstra ◽  
Niels C. Gritters van den Oever ◽  
Suat Simsek ◽  
Joop P. van den Bergh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Primary Outcome ◽  
Infectious Complications ◽  
Glucose Lowering ◽  
Diabetes Severity ◽  
Outcome Mortality

Abstract Purpose Inhibition of dipeptidyl peptidase (DPP-)4 could reduce coronavirus disease 2019 (COVID-19) severity by reducing inflammation and enhancing tissue repair beyond glucose lowering. We aimed to assess this in a prospective cohort study. Methods We studied in 565 patients with type 2 diabetes in the CovidPredict Clinical Course Cohort whether use of a DPP-4 inhibitor prior to hospital admission due to COVID-19 was associated with improved clinical outcomes. Using crude analyses and propensity score matching (on age, sex and BMI), 28 patients using a DPP-4 inhibitor were identified and compared to non-users. Results No differences were found in the primary outcome mortality (matched-analysis = odds-ratio: 0,94 [95% confidence interval: 0,69 – 1,28], p-value: 0,689) or any of the secondary outcomes (ICU admission, invasive ventilation, thrombotic events or infectious complications). Additional analyses comparing users of DPP-4 inhibitors with subgroups of non-users (subgroup 1: users of metformin and sulphonylurea; subgroup 2: users of any insulin combination), allowing to correct for diabetes severity, did not yield different results. Conclusions We conclude that outpatient use of a DPP-4 inhibitor does not affect the clinical outcomes of patients with type 2 diabetes who are hospitalized because of COVID-19 infection.

scholarly journals Indigenous health worker support for patients with poorly controlled type 2 diabetes: study protocol for a cluster randomised controlled trial of the Mana Tū programme

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e019572
Author(s):  
Vanessa Selak ◽  
Tereki Stewart ◽  
Yannan Jiang ◽  
Jennifer Reid ◽  
Taria Tane ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Determinants Of Health ◽  
Pacific People ◽  
Cluster Randomised ◽  
Randomised Controlled

IntroductionType 2 diabetes mellitus (T2DM) and its complications are more common among Māori and Pacific people compared with other ethnic groups in New Zealand. Comprehensive and sustained approaches that address social determinants of health are required to address this condition, including culturally specific interventions. Currently, New Zealand has no comprehensive T2DM management programme for Māori or Pacific people.Methods and analysisThe Mana Tū programme was developed by a Māori-led collaborative of primary healthcare workers and researchers, and codesigned with whānau (patients and their families) in order to address this gap. The programme is based in primary care and has three major components: a Network hub, Kai Manaaki (skilled case managers who work with whānau with poorly controlled diabetes) and a cross-sector network of services to whom whānau can be referred to address the wider determinants of health. The Network hub supports the delivery of the intervention through training of Kai Manaaki, referrals management, cross-sector network development and quality improvement of the programme. A two-arm cluster randomised controlled trial will be conducted to evaluate the effectiveness of the Mana Tū programme among Māori, Pacific people or those living in areas of high socioeconomic deprivation who also have poorly controlled diabetes (glycated haemoglobin, HbA1c, >65 mmol/mol (8%)), compared with being on a wait list for the programme. A total of 400 participants will be included from 10 general practices (5 practices per group, 40 participants per practice). The primary outcome is HbA1c at 12 months. Secondary outcomes include blood pressure, lipid levels, body mass index and smoking status at 12 months. This protocol outlines the proposed study design and analysis methods.Ethics and disseminationEthical approval for the trial has been obtained from the New Zealand Health and Disability Ethics Committee (17/NTB/249). Findings will be presented to practices and their patients at appropriate fora, and disseminated widely through peer-reviewed publications and conference presentations.Trial registration numberACTRN12617001276347; Pre-result.

Abstract P352: Racial/Ethnic Differences in Cardiovascular Disease Outcomes among Patients with Hypertension or Type 2 Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jia Pu ◽  
Sukyung Chung ◽  
Beinan Zhao ◽  
Vani Nimbal ◽  
Elsie J Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Asian Indian ◽  
Ethnic Differences ◽  
Elevated Risk ◽  
Stroke Incidence ◽  
Men And Women ◽  
Hazard Ratios ◽  
Race Ethnicity ◽  
Racial Ethnic

Background: This study assesses racial/ethnic differences in CVD outcomes among patients with hypertension (HTN) or type 2 diabetes (T2DM) across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese), Mexican, non-Hispanic black (NHB), and non-Hispanic White (NHW) in a large, mixed payer ambulatory care setting in northern California. Study Design: We estimated the rate of CVD incidence among adult patients with HTN (N=171,864) or T2DM (N=10,570), or both (N=36,589) using electronic health records between 2000-2013. Average follow-up was 4.5 years. CVD, including CHD (410-414), PVD (415, 440.2, 440.3, 443.9, 451, 453), and stroke (430-434), was defined by ICD-9 codes; HTN and T2DM were defined by ICD-9 codes, medication history, or two or more elevated blood pressure measures/abnormal glucose lab test results. Cox proportional hazard models were used to estimate hazard ratios for CHD, PVD, and stroke across race/ethnicity. Results: Among these patients, 10.5% developed CVD by the end of year 2013 (5.4% CHD, 3.4%PVD, 3.6% stroke). There was a gender difference in the risk of incident CHD. Among males, the age-adjusted hazard ratios for CHD were significantly higher for Asian Indians (HR: 1.3, 95% CI: 1.2-1.5) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.8, CI: 0.6-0.9) compared to NHWs. Among females, the age-adjusted hazard ratios for CHD were significantly higher for Mexican (HR: 1.3, CI: 1.1-1.5) and NHBs (HR: 1.7, CI: 1.4-2.0) and significantly lower for Chinese (HR: 0.6, CI: 0.5-0.7) and Japanese (HR: 0.5, CI: 0.4-0.7). NHB men and women also had significantly higher age-adjusted hazard ratios for PVD (men: HR: 1.5, CI: 1.2-1.9; women: HR: 1.6, CI: 1.3-1.9) and stroke (men: HR: 1.3, CI: 1.1-1.7; women: HR: 1.3, CI: 1.1-1.6) compared to NHWs. The age-adjusted hazard ratios for PVD and stroke were lower or equivalent to NHWs for all Asian subgroups and Mexican men and women. Patients with both HTN and T2DM were at elevated risk to develop CVD compared to patients with only one of the two conditions, regardless of their race/ethnicity. Conclusions: Compared to previous studies, we found less racial/ethnic variation in CVD outcomes, in particular stroke, among patients with HTN or T2DM. Our finding suggests the higher stroke incidence rates in several races/ethnicities are likely to be explained by the higher prevalence of HTN and T2DM among these groups. However, Asian Indian men and NHB and Mexican women with HTN or T2DM were at elevated risk for CHD compared to NHWs. Since the majority of patients in the study cohort had health insurance, further studies are needed to better understand the reasons for the observed racial/ethnic differences beyond disparities in access to health care. Special attention needs to be paid to patients with multiple conditions.

scholarly journals Making the Transition to Insulin Therapy: The Experiences of Samoan People with Type 2 Diabetes in New Zealand

2021 ◽  
Author(s):  
◽  
Sera Tapu-Ta'ala
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
New Zealand ◽  
Insulin Therapy ◽  
Health Care Professionals ◽  
Pacific People ◽  
Qualitative Descriptive

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>

Sign in / Sign up

Export Citation Format

Share Document