The impact of inflammation-mediated stress reactivity in type 2 diabetes patients. Findings from the population-based KORA age study

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

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Long-term risk of stroke in type 2 diabetes patients with diabetic ketoacidosis: A population-based, propensity score-matched, longitudinal follow-up study

Diabetes & Metabolism ◽

10.1016/j.diabet.2016.11.003 ◽

2017 ◽

Vol 43 (3) ◽

pp. 223-228 ◽

Cited By ~ 4

Author(s):

Y.-L. Chen ◽

S.-F. Weng ◽

C.-Y. Yang ◽

J.-J. Wang ◽

K.-J. Tien

Keyword(s):

Type 2 Diabetes ◽

Propensity Score ◽

Diabetic Ketoacidosis ◽

Population Based ◽

Follow Up Study ◽

Diabetes Patients

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Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013

European Journal of Internal Medicine ◽

10.1016/j.ejim.2016.07.031 ◽

2017 ◽

Vol 37 ◽

pp. 64-68 ◽

Cited By ~ 1

Author(s):

Ana López-de-Andrés ◽

José M. de Miguel-Yanes ◽

Valentín Hernández-Barrera ◽

Manuel Méndez-Bailón ◽

Montserrat González-Pascual ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Transplant ◽

Population Based ◽

Population Based Study ◽

Diabetes Patients

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Use of calcium channel blockers and beta blockers as antihypertensives in relation to mortality in type 2 diabetes patients: a population-based observational study

Pharmacoepidemiology and Drug Safety ◽

10.1002/(sici)1099-1557(200003/04)9:2<127::aid-pds475>3.0.co;2-z ◽

2000 ◽

Vol 9 (2) ◽

pp. 127-131 ◽

Cited By ~ 1

Author(s):

Gunnar Lindberg ◽

Jonny Olsson ◽

Arne Melander

Keyword(s):

Type 2 Diabetes ◽

Observational Study ◽

Calcium Channel ◽

Calcium Channel Blockers ◽

Beta Blockers ◽

Population Based ◽

Channel Blockers ◽

Diabetes Patients

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Effect of nutrition education on dietary diversity score of type 2 diabetes patients

10.21203/rs.3.rs-51087/v1 ◽

2020 ◽

Author(s):

Robert Mutagwanya ◽

Christine Magala Nyago ◽

Fredrick Nelson Nakwagala

Keyword(s):

Type 2 Diabetes ◽

Nutrition Education ◽

Diabetes Management ◽

Dietary Diversity ◽

Control Group ◽

Mulago Hospital ◽

Diabetic Patients ◽

The Impact ◽

Diabetes Patients

Abstract Background: Consumption of a varied diet reduces the risk of developing a deficiency or excess of any one nutrient. One of the three corner stones of diabetes management is diet and therefore, dietary diversity is key among diabetes patients. Objective: The objective of this study was to establish the impact of nutrition education on the dietary diversity scores (DDS) among type 2 diabetes patients. Methods: Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 21). Pair sample t-test was used to compare total DDS after and before nutrition education. P< 0.05 was considered as statistically significant.Subjects: One hundred type 2 diabetic patients were randomly selected and divided into two groups of intervention and control (50 patients in each group) to participate in the study. Data were collected using a pre-tested questionnaire before and after intervention every after one month for a period of four months of intervention.Results: The average age of patients who participated in the study was 48 (40–51) years. Most of the patients were females (65.39%), compared to males (34.01%). At the end of the study period of four months, DDS in the control group decreased from 40.08% to 38.49% (p=0.064) while in the intervention group, DDS increased from 35.30 % to 54.20% (p<0.001). Conclusion: Dietary diversity increased after nutrition education among type 2 diabetes patients.Trial registration: The study was registered and approved on 17th April 2013 by the Research and Ethics committee of Mulago Hospital and Institutional Review Board of Mulago hospital (Protocol MREC 113).

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The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: A matched controlled population-based retrospective cohort study

10.2337/figshare.13075748.v1 ◽

2020 ◽

Author(s):

Pushpa Singh ◽

Nicola Adderley ◽

Anuradhaa Subramanian ◽

Krishna Gokhale ◽

Rishi Singhal ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Cohort Study ◽

Microvascular Complications ◽

Population Based ◽

Type2 Diabetes ◽

Foot Disease ◽

The Impact ◽

Surgical Group

Aim: To assess the impact of bariatric surgery (BS) on incident microvascular complications [diabetes-related foot disease (DFD), sight threatening diabetic retinopathy (STDR), chronic kidney disease (CKD)] in patients with type 2 diabetes and obesity. Methods: <a>A retrospective matched, controlled population-based cohort study of adults with type 2 diabetes between 1/1/1990 and 31/1/2018 using </a><a>IQVIA Medical Research Data (IMRD), </a>a database of primary care electronic records. <a>Each patient with type2 diabetes who subsequently had BS (surgical) was matched on index date with up to 2 patients with type 2 diabetes did not have BS (non-surgical) within the same general practice by age, sex, pre-index body mass index and diabetes duration</a>. Results: 1126 surgical and 2219 non-surgical participants were included. In the study population, 2261 (68%) were women; Mean (SD) age was 49.87 (9.3) vs 50.12 (9.3) years and BMI was 46.76 (7.96) kg/m2 vs 46.14 (7.49) kg/m2 in surgical vs non-surgical group respectively. In surgical group, 22.1%, 22.7%, 52.2% and 1.1% patients had gastric band, sleeve gastrectomy, gastric bypass & duodenal switch respectively. Over median (IQR) follow-up was 3.9 years (1.8-6.4), BS was associated with reduction in incident combined microvascular complications (adjusted HR 0.63, 95% CI 0.51 to 0.78, p<0.001), DFD (0.61, 0.50 to 0.75, p<0.001), STDR (0.66, 0.44 to 1.00, p<0.001), CKD (0.63, 0.51 to 0.78, p<0.001). Analysis based on the type of surgery showed that all types of surgery were associated with favourable impact on the incident of composite microvascular complications, greatest reduction RYGB. Conclusions: BS was associated with a significant reduction in incident diabetes-related microvascular complications.

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