scholarly journals Ethnic differences in participation in diabetes education programmes

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Juul ◽  
C Glümer ◽  
S S Jervelund ◽  
N F Hempler
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Social Relations ◽  
Diabetes Education ◽  
Household Composition ◽  
Participation Rates ◽  
Increased Risk ◽  
Depth Analysis ◽  
Study Population

Abstract Background Immigrants from non-Western countries have a higher prevalence of type 2 diabetes. In addition, immigrants have an increased risk of developing diabetes complications, compared with the general population. Diabetes education programmes facilitate essential knowledge and skills that enable people to manage their condition in daily life. However, fewer immigrants attend and complete diabetes education compared with the general population. The aim of this study is to explore what characterises those who decline and accept participation in diabetes education in relation to ethnicity, household composition and diabetes burden in the family. Methods The study population consisted of adults with type 2 diabetes referred to a municipal diabetes centre (n = 1819). Individual medical record data was linked to national registry data. Descriptive statistics and logistic regression models were applied. Results Preliminary results showed that 23% of individuals from the study population participated in diabetes education. We found no overall differences in participation rates between the general population and non-Western immigrants (24% vs. 18%, P = 0.12). However, when examining the immigrant groups by language (Arabic, Urdu and Turkish), the results indicated a non-significant tendency: Urdu speaking groups’ participation was similar to the general population (24%), whereas Arabic and Turkish speaking groups had lower participation rates (17% and 11%, P = 0.25/0.40). Conclusions The results suggest that there are differences in participation between some immigrant groups and the general population. Increased knowledge about which mechanisms affecting participation in diabetes education programme is required to ensure equal access. Further studies and analyses will explore how immigrants’ social relations enable and/or hamper participation in diabetes education and investigate which factors can be changed to improve participation rates. Key messages There are differences in participation in diabetes education programmes across different ethnic groups, which suggests a need for in-depth analysis into which mechanisms that affect participation. The results will be used to give input for future practices that can increase immigrant’s participation and retention in diabetes education programmes.

scholarly journals Type 2 diabetes risk in sarcoidosis patients untreated and treated with corticosteroids

2021 ◽  
pp. 00028-2021
Author(s):  
Joshua P. Entrop ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Kerstin Brismar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Sex Education ◽  
Cox Regression ◽  
Parametric Models ◽  
Family History Of Diabetes ◽  
Drug Register ◽  
Increased Risk ◽  
Icd Codes

BackgroundThe rate of type 2 diabetes mellitus (T2D) is increased in sarcoidosis patients but it is unknown if corticosteroid treatment plays a role. We investigated whether the T2D risk is higher in untreated and corticosteroid-treated sarcoidosis patients compared to the general population.MethodsIn this cohort study individuals with ≥2 ICD codes for sarcoidosis were identified from the Swedish National Patient Register (NPR; n=5754). Corticosteroid dispensations ±3 months from first sarcoidosis diagnosis were identified from the Prescribed Drug Register (PDR). General population comparators without sarcoidosis were matched to cases 10:1 on age, sex and region of residence (n=61 297). Incident T2D was identified using ICD codes (NPR) and antidiabetic drug dispensations (PDR). Follow-up was from second sarcoidosis diagnosis/matching date until T2D, emigration, death or study end (Dec 2013). Cox regression models adjusted for age, sex, education, country of birth, healthcare regions and family history of diabetes estimated hazard ratios (HR 95%CI). We used flexible parametric models to examine the T2D risk over time.Results40% of sarcoidosis patients were corticosteroid-treated at diagnosis. The T2D rate was 7.7/1000 person-years in untreated sarcoidosis, 12.7 in corticosteroid-treated sarcoidosis and 5.5 in comparators. The HR for T2D was 1.4 (95%CI 1.2–1.8) associated with untreated sarcoidosis and 2.3 (95%CI 2.0–3.0) associated with corticosteroid-treated sarcoidosis. The T2D risk was highest for corticosteroid-treated sarcoidosis in the first 2 years after diagnosis.ConclusionSarcoidosis is associated with an increased risk of T2D especially in older, male, corticosteroid-treated patients at diagnosis. Screening for T2D for these patients is advisable.

scholarly journals Serum Soluble CD163 Predicts Risk of Type 2 Diabetes in the General Population

2011 ◽  
Vol 57 (2) ◽  
pp. 291-297 ◽  
Author(s):  
Holger J Møller ◽  
Ruth Frikke-Schmidt ◽  
Søren K Moestrup ◽  
Børge G Nordestgaard ◽  
Anne Tybjærg-Hansen
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Low Grade ◽  
Reactive Protein ◽  
Soluble Cd163 ◽  
Hazard Ratios ◽  
Heart Study ◽  
Increased Risk ◽  
Study Participants

BACKGROUND Activation of adipose tissue macrophages with concomitant low-grade inflammation is believed to play a central role in the development of type 2 diabetes. We tested whether a new macrophage-derived biomarker, soluble CD163 (sCD163), identifies at-risk individuals before overt disease has developed. METHODS A prospective cohort study of 8849 study participants from the general population, the Copenhagen City Heart Study, was followed for 18 years for incidence of type 2 diabetes. Risk of disease was calculated according to age- and sex-adjusted percentile categories of serum sCD163 concentrations: 0%–33%, 34%–66%, 67%–90%, 91%–95%, and 96%–100%. RESULTS A total of 568 participants developed type 2 diabetes. The cumulative incidence increased with increasing baseline sCD163 (trend P < 0.001), and sCD163 was strongly associated with known risk factors such as physical inactivity, body mass index, C-reactive protein, and triglycerides (all P < 0.001). Multifactorially adjusted hazard ratios for type 2 diabetes were 1.4 (95% CI, 1.0–1.9), 2.4 (1.8–3.2), 3.8 (2.6–5.5), and 5.2 (3.6–7.6) for categories 34%–66%, 67%–90%, 91%–95%, and 96%–100%, respectively, vs the 0%–33% category. In overweight men 50–70 and >70 years of age, serum sCD163 concentrations in the top 5% group predicted an absolute 10-year risk of type 2 diabetes of 29% and 36% vs 7% and 8% in the lowest percentile group. Equivalent values in women were 19% and 24% vs 4% and 5%. CONCLUSIONS Increased concentrations of sCD163 predict increased risk of type 2 diabetes in the general population and may be useful for identification of high-risk overweight individuals.

scholarly journals Low 25-Hydroxyvitamin D and Risk of Type 2 Diabetes: A Prospective Cohort Study and Metaanalysis

2013 ◽  
Vol 59 (2) ◽  
pp. 381-391 ◽  
Author(s):  
Shoaib Afzal ◽  
Stig E Bojesen ◽  
Børge G Nordestgaard
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Smoking Status ◽  
Hdl Cholesterol ◽  
Hazard Ratio ◽  
Blood Draw ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
25 Hydroxyvitamin D

BACKGROUND Vitamin D deficiency has been implicated in decreased insulin secretion and increased insulin resistance, hallmarks of type 2 diabetes mellitus. We tested the hypothesis that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with increased risk of type 2 diabetes in the general population. METHODS We measured 25(OH)D in 9841 participants from the general population, of whom 810 developed type 2 diabetes during 29 years of follow-up. Analyses were adjusted for sex, age, smoking status, body mass index, income, physical activity, HDL cholesterol, and calendar month of blood draw. RESULTS Lower 25(OH)D concentrations, by clinical categories or seasonally adjusted quartiles, were associated with higher cumulative incidence of type 2 diabetes (trend, P = 2×10−7 and P = 4×10−10). Multivariable adjusted hazard ratios of type 2 diabetes were 1.22 (95% CI 0.85–1.74) for 25(OH)D <5 vs ≥20 μg/L and 1.35 (1.09–1.66) for lowest vs highest quartile. Also, the multivariable adjusted hazard ratio of type 2 diabetes for a 50% lower concentration of 25(OH)D was 1.12 (1.03–1.21); the corresponding hazard ratio for those ≤58 years old was 1.26 (1.15–1.41). Finally, in a metaanalysis of 16 studies, the odds ratio for type 2 diabetes was 1.50 (1.33–1.70) for the bottom vs top quartile of 25(OH)D. CONCLUSIONS We observed an association of low plasma 25(OH)D with increased risk of type 2 diabetes. This finding was substantiated in a metaanalysis.

scholarly journals Patients with type 2 diabetes have an increased demand for pacemaker treatment - a comparison with age- and sex matched controls from the general population.

2020 ◽  
Author(s):  
Elina Rautio ◽  
Fredrik Gadler ◽  
Soffia Gudbjörnsdottir ◽  
Stefan Franzén ◽  
Lars Rydén ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
General Population ◽  
Diabetes Duration ◽  
Lipid Lowering ◽  
Increased Risk ◽  
Age And Sex

<b><i>Objective</i></b><i>: </i>Patients with type 2<i> </i>diabetes mellitus have an increased risk for cardiovascular disease including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PM) is less well explored in a contemporary patient population. The present study explores 1) whether patients with type 2 diabetes mellitus have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes mellitus; 2) Patient characteristics associated with increased demand of receiving a PM. <p><b><i>Methods</i></b><b>:</b> In this population-matched registry study a total of 416 247 patients with type 2 diabetes mellitus from the Swedish National Diabetes Registry (NDR) and 2 081 235 age and sex-matched controls selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox’s proportional hazard regression analyses were performed to estimate the demand of PM-treatment and factors identifying patients with such demand.</p> <p><b><i>Results:</i></b> Type 2 diabetes mellitus was associated with increased need of PM-treatment (Hazard ratio (HR) 1.65, 95% CI 1.60-1.69; p<0.0001) which remained (HR 1.56, 95% CI 1.51-1.60; p<0.0001) after adjustments for age, sex, educational level, marital status, country of birth and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA1c, BMI, diabetes duration, blood pressure- and lipid lowering medication.</p> <p><b><i>Conclusion</i></b><i>: </i>The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based controls. Age, diabetes duration and HbA1c seem to be risk factors for PM treatment. </p>

scholarly journals Type 2 Diabetes-Related Variants Influence on the Risk of Developing Multiple Myeloma: Results from the Immense Consortium

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2044-2044
Author(s):  
Juan Sainz ◽  
Carmen Belén Lupiañez ◽  
Daniele Campa ◽  
Gabriele Buda ◽  
Hernan Jose Moreno ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Multiple Myeloma ◽  
General Population ◽  
Blood Donors ◽  
Conflicts Of Interest ◽  
Association Studies ◽  
Genome Wide Association Studies ◽  
Population Total ◽  
Increased Risk

Abstract Type 2-diabetes (T2D) is thought to be a relevant risk factor for multiple myeloma (MM), but the relationship between both traits is still not well understood. Thus, we decided to conduct a population-based case-control study in a population of 1420 MM patients (705 women and 715 men) and 1858 controls (916 women and 942 men) to evaluate whether 58 genome-wide association studies (GWAS)-identified common variants for T2D influence the risk of developing MM. Logistic regression analyses showed that carriers of the KCNQ1rs2237892T allele or CDKN2A-2Brs2383208G/G, IGF-1rs35767T/T and MADDrs7944584T/T genotypes had an increased risk of MM (OR=1.32, 95%CI 1.01-1.71, P=0.039; OR=1.86, 95%CI 1.12-3.11, P=0.016; OR=2.13, 95%CI 1.35-3.37, P=0.001 and OR=1.33, 95%CI 1.06-1.67, P=0.014, respectively) whereas those carrying the KCNJ11rs5215C, KCNJ11rs5219T and THADArs7578597C alleles or the FTOrs8050136A/A and LTArs1041981C/C genotypes showed a decreased risk for the disease (OR=0.85, 95%CI 0.73-0.99, P=0.38; OR=0.84, 95%CI 0.72-0.99, P=0.034; OR=0.81, 95%CI 0.68-0.98, P=0.032; OR=0.78, 95%CI 0.64-0.95, P=0.013; and OR=0.76, 95%CI 0.58-0.99, P=0.042, respectively). The associations of these T2D-related variants with an increased or decreased risk of MM were due to non-diabetogenic alleles, which suggests a non-diabetogenic mechanism underlying the effect of these variants to determine the risk of the disease. A gender-stratified analysis also revealed a significant gender effect modification for ADAM30rs2641348, and NOTCH2rs10923931 SNPs (Pinteraction=0.001 and 0.0004 and Phet=0.19 and 0.60, respectively), which also underlies the importance of considering gender as a factor modifying the risk for MM. Men harbouring the ADAM30rs2641348C and NOTCH2rs10923931T alleles had a decreased risk of MM (OR=0.71, 95%CI 0.54-0.94, P=0.015 and OR=0.66, 95%CI 0.50-0.86, P=0.0019) whereas an opposite but not significant effect was observed in women. Finally, SNP-SNP interaction analysis revealed overall significant two- and three-locus interaction models to increase the risk of MM (FAM148Brs11071657-KCNJ11rs5219, and SLC30A8rs13266634-KCNJ11rs5219-FTOrs8050136; P=0.01 and 0.001, respectively) whereas a significant four-locus model was also found to increase the risk of MM in men (FADS1rs174550-TSPAN8rs7961581-PROX1rs340874-KCNJ11rs5219, P=0.001). Although further studies in independent populations are warranted to replicate these findings, these results suggest that TD2-related variants may influence the risk of developing MM, likely through non-diabetogenic mechanisms. Abstract 2044. Table 1. Demographical characteristics of IMMEnSE cases and controls. CASES CONTROLS Region* Gender M/F (Total) Mean Age (± STD) Gender M/F (Total) Mean Age (± STD) Control type Italy 117/107 (224) 62.60±9.90 127/105 (232) 58.75±10.92 General population Poland 173/198 (371) 62.35±10.39 124/226 (350) 50.68±19.43 Blood donors Spain 139/133 (272) 63.06±11.04 218/192 (410) 63.12±11.94 Hospitalized subjects France 42/33 (75) 55.80±9.04 95/89 (184) 44.07±15.22 Blood donors Portugal 32/35 (67) 65.79±11.16 52/42 (94) 60.88±07.88 Blood donors Hungary 49/87 (136) 65.83±11.19 50/51 (101) 73.18±10.10 Hospitalized subjects Denmark 163/112 (275) 55.20±07.32 276/211 (487) 43.26±11.84 General population Total 715/705 (1420) 61.06±10.57 942/916 (1858) 53.56±16.45 Table 2. Selected type-2 diabetes-related polymorphisms Gene name dbSNP rs# Gene name dbSNP rs# ADAM30 rs2641348 JAZF1 rs864745 ADAMTS9 rs4607103 KCNJ11 rs5215 ADCY5 rs11708067 rs5219 ADRA2A rs10885122 KCNQ1 rs2237897 ARAPI, CENTD2 rs1552224 rs2074196 BCL11A rs10490072 rs2237892 CDC123 rs12779790 rs2237895 CDKAL1 rs7754840 KCNQ1OT1 rs231362 CDKN2A-2B rs564398 LTA rs1041981 rs10811661 MADD rs7944584 rs2383208 MCR4 rs12970134 COL5A1 rs4240702 MTNR1B rs1387153 CRY2 rs11605924 NOTCH2 rs10923931 DCD rs1153188 PKN2 rs6698181 EXT2 rs1113132 PPARG rs1801282 FADS1 rs174550 PRC1 rs8042680 FAM148B rs11071657 PROX1 rs340874 FLJ39370 rs17044137 RBMS1 rs7593730 FTO rs8050136 SLC2A2 rs11920090 G6PC2 rs560887 SLC30A8 rs13266634 GCK rs1799884 TCF2 rs7501939 GCKR rs1260326 TCF7L2 rs7903146 HHEX rs1111875 TCF7L2 rs12255372 HMGA2 rs1531343 THADA rs7578597 HNF1A, TCF1 rs7957197 TP53INP1 rs896854 IGF1 rs35767 TSPAN8 rs7961581 IGF2BP2 rs4402960 VEGFA rs9472138 IL13 rs20541 WFS1 rs734312 IRS1 rs2943641 rs10010131 Disclosures No relevant conflicts of interest to declare.

scholarly journals Prenatal diethylstilbestrol exposure and risk of diabetes, gallbladder disease, and pancreatic disorders and malignancies

2020 ◽  
pp. 1-8
Author(s):  
Rebecca Troisi ◽  
Marianne Hyer ◽  
Linda Titus ◽  
Julie R. Palmer ◽  
Elizabeth E. Hatch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pancreatic Cancer ◽  
General Population ◽  
Proportional Hazards ◽  
Gallbladder Disease ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
Pancreatic Disorders

Abstract Prenatal diethylstilbestrol (DES) exposure is associated with increased risk of hormonally mediated cancers and other medical conditions. We evaluated the association between DES and risk of pancreatic cancer and pancreatic disorders, type 2 diabetes, and gallbladder disease, which may be involved with this malignancy. Our analyses used follow-up data from the US National Cancer Institute DES Combined Cohort Study. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for age, sex, cohort, body mass index, smoking, and alcohol for the association between prenatal DES exposure and type 2 diabetes, gallbladder disease (mainly cholelithiasis), pancreatic disorders (mainly pancreatitis), and pancreatic cancer among 5667 exposed and 3315 unexposed individuals followed from 1990 to 2017. Standardized incidence rate (SIR) ratios for pancreatic cancer were based on age-, race-, and calendar year-specific general population cancer incidence rates. In women and men combined, the hazards for total pancreatic disorders and pancreatitis were greater in the prenatally DES exposed than the unexposed (HR = 11, 95% CI 2.6–51 and HR = 7.0, 95% CI 1.5–33, respectively). DES was not associated overall with gallbladder disease (HR = 1.2, 95% CI 0.88–1.5) or diabetes (HR = 1.1, 95% CI 0.9–1.2). In women, but not in men, DES exposure was associated with increased risk of pancreatic cancer compared with the unexposed (HR: 4.1, 95% CI 0.84–20) or general population (SIR: 1.9, 95% CI 1.0–3.2). Prenatal DES exposure may increase the risk of pancreatic disorders, including pancreatitis in women and men. The data suggested elevated pancreatic cancer risk in DES-exposed women, but not in exposed men.

Apolipoprotein M and Risk of Type 2 Diabetes

2020 ◽  
Vol 105 (9) ◽  
pp. 3046-3057
Author(s):  
Stefan Hajny ◽  
Mette Christoffersen ◽  
Nawar Dalila ◽  
Lars B Nielsen ◽  
Anne Tybjærg-Hansen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Population ◽  
Meta Analysis ◽  
Inverse Correlation ◽  
Nucleotide Polymorphisms ◽  
General Population Study ◽  
Apolipoprotein M ◽  
Increased Risk ◽  
Prospective Study Design

Abstract Context Recent studies have discovered a role of apolipoprotein M (apoM) in energy metabolism, and observational analyses in humans suggest an association with type 2 diabetes. The causal relationship remains however elusive. Objective To investigate whether reduced plasma apoM concentrations are causally linked to increased risk of type 2 diabetes. Design Prospective study design analyzed by Mendelian randomization. Setting and participants Two cohorts reflecting the Danish general population: the Copenhagen City Heart Study (CCHS, n = 8589) and the Copenhagen General Population Study (CGPS; n = 93 857). Observational analyses included a subset of participants from the CCHS with available plasma apoM (n = 725). Genetic analyses included the complete cohorts (n = 102 446). During a median follow-up of 16 years (CCHS) and 8 years (CGPS), 563 and 2132 participants developed type 2 diabetes. Main outcome measures Plasma apoM concentration, genetic variants in APOM, and type 2 diabetes. Results First, we identified an inverse correlation between plasma apoM and risk of type 2 diabetes in a subset of participants from the CCHS (hazard ratio between highest vs lowest quartile (reference) = 0.32; 95% confidence interval = 0.1-1.01; P for trend = .02). Second, genotyping of specific single nucleotide polymorphisms in APOM further revealed a 10.8% (P = 6.2 × 10–5) reduced plasma apoM concentration in participants with variant rs1266078. Third, a meta-analysis including data from 599 451 individuals showed no association between rs1266078 and risk of type 2 diabetes. Conclusions The present study does not appear to support a causal association between plasma apoM and risk of type 2 diabetes.

scholarly journals The Impact of Obesity on Adverse Cardiovascular Outcomes in the General Population and in patients with Type 2 Diabetes

2009 ◽  
Vol 2 ◽  
pp. CMED.S3479 ◽  
Author(s):  
Jayne Palmer ◽  
Anupama Kalsekar ◽  
Kristina Boye ◽  
Gordon Goodall
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
General Population ◽  
Causal Link ◽  
Cardiovascular Outcomes ◽  
Asia Pacific ◽  
Increased Risk ◽  
General Populations ◽  
The Impact

Objectives There is an established causal link between obesity and cardiovascular outcomes. The aim of this review was to determine whether an independent relationship exists between anthropometric measurements of weight (typically body mass index [BMI]) and cardiovascular outcomes (e.g. angina, myocardial infarction, congestive heart failure, stroke, and mortality due to cardiovascular disease) in the general population and in patients with type 2 diabetes. Methods A review of the medical literature published between 1988 and May 2008 was conducted using the PubMed, EMBASE, Cochrane and Center for Review and Dissemination databases. Studies longer than 12 months, with ≥500 adult subjects and published in English were included. Results In studies conducted in general populations there was an overall trend towards increased risk for adverse cardiovascular outcomes with increasing BMI. The nature and strength of this relationship varied according to the measurement used (e.g. BMI, waist circumference, waist-to-hip ratio) and the population studied, with notable differences observed in Asian/Asia-Pacific compared with European or North American-based studies. However, data from diabetes-specific populations are limited. Conclusions In general, the degree of being overweight or obese was associated with an elevated risk of adverse cardiovascular events and mortality. Although inextricable links exist between obesity, type 2 diabetes and cardiovascular disease in the general population, the extent to which findings can be extrapolated to a diabetes-specific population is limited.

Sign in / Sign up

Export Citation Format

Share Document