scholarly journals Sensitivity to change of the UK Diabetes and Diet Questionnaire in a specialist weight management service

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Clare England ◽  
Sam Leary ◽  
Catherine Thompson ◽  
Claire Lorimer ◽  
Rob Andrews
Keyword(s):  
Type 2 Diabetes ◽  
Binge Eating ◽  
Weight Management ◽  
Management Service ◽  
Sensitivity To Change ◽  
Diabetes Status ◽  
Initial Appointment ◽  
The Uk

AbstractThe UK Diabetes and Diet Questionnaire (UKDDQ) is a brief dietary questionnaire developed for people with, or at high risk of, type 2 diabetes(1). It consists of 20 items scored from 0–5 (0 healthiest, 5 least healthy). It has been demonstrated to be reliable and compares well with food diaries. A study evaluating sensitivity to change of the UKDDQ was undertaken at the specialist weight management service (WMS) at Musgrove Park Hospital, Taunton. WMS patients receive an initial appointment with an endocrinologist and dietitian, followed by referral to group sessions or dietary advice. Follow up appointments with a WMS specialist occur over the next 26 weeks. Adults attending the service were recruited for the study between September 2016-March 2017. Participants completed the UKDDQ in the waiting room at the initial appointment and the first follow-up. Diabetes status, binge eating assessment and weight at both timepoints were obtained from WMS records. UKDDQ scores from 0–5 were calculated for each participant by summing the score for each item and dividing by 20. Change in UKDDQ scores and absolute and percentage change in weight between appointments were calculated. Paired sample t-tests were used to test differences in means for UKDDQ scores and weight from baseline to follow up. Multivariable regression analysis was used to examine associations between changes in the UKDDQ scores and percentage change in weight. The model was adjusted for age, gender, follow up time, diabetes status and binge eating. Forty-eight White British participants completed the study (67% women, 37% type 2 diabetes, 29% binge eating). Baseline mean weight was 132.4 (29.4)kg, mean BMI 46.5(7.7)kg/m2 and mean UKDDQ score was 1.39 (0.49). Participants lost weight (-2.4 (6.9)kg, p = 0.006) and the UKDDQ score improved between baseline and follow up (-0.27(0.53), p = 0.001). The mean percentage weight change was -1.6 (5.0)%. There was some evidence that a one point deterioration in healthy eating was associated with a 2.4 (-0.2 to 5.1)% increase in weight (p = 0.072). The UKDDQ can measure dietary change in people attending a specialist WMS and there is some evidence that a change in score is associated with a change in weight. The UKDDQ could be used as an outcome measure in these services.

scholarly journals Type 2 diabetes is an independent predictor of weight loss in Tier 3 Weight Assessment and Management Services

2020 ◽  
Vol 20 (2) ◽  
pp. 117-121
Author(s):  
Aliya Syahreni Prihartadi* ◽  
Giovanna Impelliziere Licastro* ◽  
Harshal Deshmukh ◽  
Sufyan Benamer ◽  
Kyaw Linn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Management ◽  
Management Service ◽  
Adult Weight ◽  
Weight Management Service ◽  
Predictors Of Weight Loss ◽  
Tier 3

Introduction: A specialist weight management service provides an effective treatment option for severe obesity; however, there are limited data exploring the baseline predictors of response and effect on HbA1c following engagement with the service.Methods: We used prospective data from the regional weight management services within the Hull University Teaching Hospitals NHS Trust Tier 3 Obesity Programme. Data were available for 249 patients referred to the service. T-tests were used for univariate baseline characteristics of those with and without 5% weight loss after engagement with the service. Logistic regression analysis was used to identify independent predictors of weight loss at 12 months.Results: A total of 309 patients were referred to the Tier 3 adult weight management service, of which 249 (80.6%) participated in the programme and had at least one follow-up. The median age of the study population was 46 years (range 36–55) and consisted of 66% females with a median baseline body mass index of 44 kg/m2 (range 42–45). The prevalence of type 2 diabetes was 31%, hypertension was 35%, gastro-oesophageal reflux disease was 34% and osteoarthritis was 29%. The median baseline weight on enrolment in the programme was 126 kg (range 115–138). During the follow-up period of 1 year, the median weight fell to 120.5 kg at 3 months, 119.6 kg at 6 months, 117.7 kg at 9 months and 117.5 kg at 12 months. The median HbA1c fell from a baseline of 60.25 mmol/mol to 54.4 mmol/mol during the follow-up period. Sixty-four patients had a baseline HbA1c of >53 mmol/mol (7% HbA1c), which fell to <53 mmol/mol in 21% of patients during the follow-up period. In the logistic regression model, higher age (OR 1.05, p=0.0001), type 2 diabetes (OR 2.54, p=0.002) and dyslipidaemia (OR 2.21, p=0.03) were independently associated with more than 5% weight loss at 12 months follow-up.Conclusion: Engagement with Tier 3 adult weight management is associated with significant weight loss and improvement in glycaemic control in a large proportion of patients at one year. Higher age, diabetes and dyslipidaemia at baseline are independent predictors of weight loss on the Tier 3 weight management service.

scholarly journals The duration of obesity and the risk of type 2 diabetes

2010 ◽  
Vol 14 (1) ◽  
pp. 119-126 ◽  
Author(s):  
Asnawi Abdullah ◽  
Johannes Stoelwinder ◽  
Susan Shortreed ◽  
Rory Wolfe ◽  
Christopher Stevenson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cox Models ◽  
Family History Of Diabetes ◽  
Heart Study ◽  
Diabetes Status ◽  
Relevant Risk Factor ◽  
History Of

AbstractObjectiveThe evidence for the association between obesity and the risk of type 2 diabetes has been derived mainly from the analysis of the degree of obesity. The role of the duration of obesity as an independent risk has not been fully explored. The objective of the present study was to investigate the association between the duration of obesity and the risk of type 2 diabetes.DesignProspective cohort study.SettingThe Framingham Heart Study (FHS), follow-up from 1948 to 1998.SubjectsA total of 1256 FHS participants who were free from type 2 diabetes at baseline, but were obese on at least two consecutive of the study’s twenty-four biennial examinations, were included. Type 2 diabetes status was collected throughout the 48 years of follow-up of the study. The relationship between duration of obesity and type 2 diabetes was analysed using time-dependent Cox models, adjusting for a number of covariates.ResultsThe unadjusted hazard ratio (HR) for the risk of type 2 diabetes for men was 1·13 (95 % CI 1·09, 1·17) and for women was 1·12 (95 % CI 1·08, 1·16) per additional 2-year increase in the duration of obesity. Adjustment for sociodemographic variables, family history of diabetes, health behaviour and physical activity made little difference to these HR. For women the evidence of a dose–response relationship was less clear than for men, particularly for women with an older age at obesity onset.ConclusionsThe duration of obesity is a relevant risk factor for type 2 diabetes, independent of the degree of BMI.

scholarly journals External validation of the UK Prospective Diabetes Study (UKPDS) risk engine in patients with type 2 diabetes identified in the national diabetes program in Iran

2021 ◽  
Author(s):  
Mehrdad Valipour ◽  
Davood Khalili ◽  
Masoud Soleymani Dodaran ◽  
Seyed Abbas Motevalian ◽  
Mohammad Ebrahim Khamseh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Disease ◽  
External Validation ◽  
Accurate Estimation ◽  
C Statistic ◽  
Chd Risk ◽  
The Uk ◽  
Risk Engine

Abstract Background Cardiovascular diseases are the first leading cause of mortality in the world. Practical guidelines recommend an accurate estimation of the risk of these events for effective treatment and care. The UK Prospective Diabetes Study (UKPDS) has a risk engine for predicting CHD risk in patients with type 2 diabetes, but in some countries, it has been shown that the risk of CHD is poorly estimated. Hence, we assessed the external validity of the UKPDS risk engine in patients with type 2 diabetes identified in the national diabetes program in Iran. Methods The cohort included 853 patients with type 2diabetes identified between March 21, 2007, and March 20, 2018 in Lorestan province of Iran. Patients were followed for the incidence of CHD. The performance of the models was assessed in terms of discrimination and calibration. Discrimination was examined using the c-statistic and calibration was assessed with the Hosmer–Lemeshow χ2 statistic (HLχ2) test and a calibration plot was depicted to show the predicted risks versus observed ones. Results During 7464.5 person-years of follow-up 170 first Coronary heart disease occurred. The median follow-up was 8.6 years. The UKPDS risk engine showed moderate discrimination for CHD (c-statistic was 0.72 for 10-year risk) and the calibration of the UKPDS risk engine was poor (HLχ2=69.9, p<0.001) and overestimated the risk of heart disease. Conclusion This study shows that the ability of the UKPDS Risk Engine to discriminate patients who got CHD events from those who did not was moderate and the ability of the risk prediction model to accurately predict the absolute risk of CHD (calibration) was poor and it overestimated the CHD risk. To improve the prediction of CHD in patients with type 2 diabetes, this model should be updated in the Iranian diabetic population.

scholarly journals Association of serum 25-hydroxyvitamin D concentrations with risk of dementia among individuals with type 2 diabetes: A cohort study in the UK Biobank

PLoS Medicine ◽  
2022 ◽  
Vol 19 (1) ◽  
pp. e1003906
Author(s):  
Tingting Geng ◽  
Qi Lu ◽  
Zhenzhen Wan ◽  
Jingyu Guo ◽  
Liegang Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Lower Risk ◽  
Uk Biobank ◽  
Hydroxyvitamin D ◽  
Patients With Diabetes ◽  
25 Hydroxyvitamin D ◽  
The Uk

Background Several epidemiological studies have suggested that vitamin D status is associated with risk of dementia in general populations. However, due to the synergistic effect between diabetic pathology and neuroinflammation, and the prothrombotic profile in patients with diabetes, whether vitamin D is associated with risk of dementia among patients with diabetes is unclear. This study aimed to investigate the associations of circulating vitamin D levels with risks of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD) among adults with type 2 diabetes (T2D). Methods and findings This study included 13,486 individuals (≥60 years) with T2D and free of dementia at recruitment (2006–2010) from the UK Biobank study. Serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using the chemiluminescent immunoassay method at recruitment. Serum 25(OH)D ≥ 75 nmol/L was considered sufficient, according to the Endocrine Society Clinical Practice Guidelines. Incidence of all-cause dementia, AD, and VD cases was ascertained using electronic health records (EHRs). Each participant’s person-years at risk were calculated from the date of recruitment to the date that dementia was reported, date of death, date of loss to follow-up, or 28 February 2018, whichever occurred first. Among the 13,486 individuals with T2D (mean age, 64.6 years; men, 64.3%), 38.3% had vitamin D ≥ 50 nmol/L and only 9.1% had vitamin D ≥ 75 nmol/L. During a mean follow-up of 8.5 years, we observed 283 cases of all-cause dementia, including 101 AD and 97 VD cases. Restricted cubic spline analysis demonstrated a nonlinear relationship between serum 25(OH)D and risk of all-cause dementia (Pnonlinearity < 0.001) and VD (Pnonlinearity = 0.007), and the nonlinear association reached borderline significance for AD (Pnonlinearity = 0.06), with a threshold at around a serum 25(OH)D value of 50 nmol/L for all the outcomes. Higher serum levels of 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD. The multivariate hazard ratios and 95% confidence intervals for participants who had serum 25(OH)D ≥ 50 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.41 (0.29–0.60) for all-cause dementia (Ptrend < 0.001), 0.50 (0.27–0.92) for AD (Ptrend = 0.06), and 0.41 (0.22–0.77) for VD (Ptrend = 0.01). The main limitation of the current analysis was the potential underreporting of dementia cases, as the cases were identified via EHRs. Conclusions In this study, we observed that higher concentrations of serum 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD among individuals with T2D. Our findings, if confirmed by replication, may have relevance for dementia prevention strategies that target improving or maintaining serum vitamin D concentrations among patients with T2D.

Type 2 Diabetes as a Predictor of Muscle Strength Decline over 11 years among Men and Women Aged 55 Years and Older

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Kristina Tiainen ◽  
Jani Raitanen ◽  
Timo Strandberg ◽  
Seppo Koskinen ◽  
Sari Stenholm
Keyword(s):  
Type 2 Diabetes ◽  
Muscle Strength ◽  
Handgrip Strength ◽  
Population Based ◽  
Diabetes Group ◽  
Men And Women ◽  
Diabetes Status ◽  
Study Population

<b><i>Background:</i></b> Long-term associations between type 2 diabetes, prediabetes, and muscle strength are obscure in older adults. The aim of this study was to examine type 2 diabetes as a predictor of handgrip strength decline during an 11-year follow-up among men and women aged 55 years. <b><i>Methods:</i></b> We used Finnish population-based Health 2000 Survey and its follow-up measurements in 2011. The study population consisted of 1,200 individuals, aged 55–86 years at baseline. Baseline fasting glucose level or use of diabetes medication was used to categorize the participants into diabetes (≥7.0 mmol/L), prediabetes (≥6.1 mmol/L but &#x3c;7.0 mmol/L), and nondiabetes (&#x3c;6.1 mmol/L) groups. Handgrip strength was measured at baseline and during 11-year follow-up. <b><i>Results:</i></b> Mean handgrip strength at baseline did not differ between diabetes groups in men or women. Among men during the 11-year follow-up, decline in muscle strength was significantly greater among diabetes group (−131.5 Newtons [<i>N</i>], 95% confidence interval (CI) −182.7 to −80.4) than nondiabetes group (−98.9 N, 95% CI −139.5 to −58.3) after adjusting for age, education, lifestyle factors, chronic conditions, and diabetes status at follow-up. Among women, muscle strength decline did not differ between diabetes, prediabetes, or nondiabetes groups after adjusting for all potential covariates, the results being −45.0 N (95% CI −73.2 to −16.7), −29.4 N (95% CI −59.7 to 0.9), and −42.3 N (95% CI −70.5 to −14.1), respectively. <b><i>Conclusions:</i></b> The presence of type 2 diabetes was associated with greater muscle strength decline among older men but not among older women.

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