Cigarette smoking as a risk factor for type 2 diabetes in women compared with men: a systematic review and meta-analysis of prospective cohort studies

2018 ◽  
Vol 41 (2) ◽  
pp. e169-e176 ◽  
Author(s):  
Shuai Yuan ◽  
Hong-liang Xue ◽  
Hong-jie Yu ◽  
Yao Huang ◽  
Bo-wen Tang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Current Smoking ◽  
Random Effects Models ◽  
Prospective Cohorts ◽  
Former Smokers ◽  
Incident Cases ◽  
Similar Risk

Abstract Background Few studies have investigated the effect of smoking on type 2 diabetes in women compared with men, even though several epidemiological studies provided a clear picture of the risk among the entire population. Methods We systematically searched PubMed and Embase up to August 2017 for prospective studies that were stratified by sex with measures of the relative risk (RR) for type 2 diabetes and current smoking compared with non-smoking. The sex-specific RRs and their ratios (RRRs), comparing women with man, were pooled using random-effects models. Results Seventeen articles were identified including 20 prospective cohorts with 5 077 289 participants and 223 084 incident cases of type 2 diabetes. The pooled RRR suggested a similar risk of type 2 diabetes associated with smoking in women compared with men (RRR: 0.98, 95% confidence interval [CI]: 0.96–1.01). Furthermore, no significant sex difference in the RR was found between former smokers and those who had never smoked (RRR: 0.98, 95% CI: 0.92–1.04). Conclusions The findings of this meta-analysis indicate that female smokers had similar risk of type 2 diabetes with male smokers.

scholarly journals The association between insulin therapy and depression in patients with type 2 diabetes mellitus: a meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e020062 ◽  
Author(s):  
Xiaosu Bai ◽  
Zhiming Liu ◽  
Zhisen Li ◽  
Dewen Yan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Increased Risk

ObjectivesSeveral patients with type 2 diabetes mellitus (T2DM) have depressive disorders. Whether insulin treatment was associated with increased risk of depression remains controversial. We performed a meta-analysis to evaluate the association of insulin therapy and depression.DesignA meta-analysis.MethodsWe conducted a systematic search of PubMed, PsycINFO, Embase and the Cochrane Library from their inception to April 2016. Epidemiological studies comparing the prevalence of depression between insulin users and non-insulin users were included. A random-effects model was used for meta-analysis. The adjusted and crude data were analysed.ResultsTwenty-eight studies were included. Of these, 12 studies presented with adjusted ORs. Insulin therapy was significantly associated with increased risk of depression (OR=1.41, 95% CI 1.13 to 1.76, p=0.003). Twenty-four studies provided crude data. Insulin therapy was also associated with an odds for developing depression (OR=1.59, 95% CI 1.41 to 1.80, p<0.001). When comparing insulin therapy with oral antidiabetic drugs, significant association was observed for adjusted (OR=1.42, 95% CI 1.08 to 1.86, p=0.008) and crude (OR=1.61, 95% CI 1.35 to 1.93, p<0.001) data.ConclusionsOur meta-analysis confirmed that patients on insulin therapy were significantly associated with the risk of depressive symptoms.

Diabetes and cancer: Epidemiology and potential mechanisms

2014 ◽  
Vol 11 (6) ◽  
pp. 390-394 ◽  
Author(s):  
Hans-Georg Joost
Keyword(s):  
Breast Cancer ◽  
Type 2 Diabetes ◽  
Independent Risk Factor ◽  
Epidemiological Studies ◽  
Cancer Epidemiology ◽  
Biological Plausibility ◽  
The Metabolic Syndrome ◽  
Therapeutic Guidelines ◽  
Prospective Cohorts

Type 2 diabetes mellitus is an independent risk factor for cancer such as pancreatic, liver, colorectal and breast cancer. In addition, diabetes decreases the risk of prostate cancer. These associations have been found in numerous epidemiological studies, among them several prospective cohorts. However, such studies do not prove causality of the association and cannot exclude inadequate correction for known confounders (e.g. visceral fat) or the influence of unknown confounders. Thus, it is unclear whether the cancer risk is increased by the causes (e.g. the metabolic syndrome), the metabolic consequences (e.g. hyperglycaemia) or the therapy of diabetes; a question which is of major importance for therapeutic guidelines. Identification of the potential mechanisms by which the diabetes or its therapy accelerates or inhibits the development of cancer will help answering the question by providing biological plausibility. This review will summarize the evidence supporting the association of cancer and type 2 diabetes and discuss its potential causes.

Abstract P224: Sex Differences in the Risk of Stroke and HbA1c among Diabetic Patients

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Gang Hu ◽  
Peter Katzmarzyk ◽  
Ronald Horswell ◽  
Yujie Wang ◽  
Jolene Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Stroke Risk ◽  
Reference Group ◽  
Epidemiological Studies ◽  
Diabetic Patients ◽  
Hospital System ◽  
Incident Cases ◽  
Different Levels

Background: Epidemiological studies have reported that type 2 diabetes is an independent risk factor for stroke, but how much its effect varies by sex is uncertain. Aim: To better understand the relationship between glycemic control and stroke risk in men and women, we studied a large sample of patients with type 2 diabetes with long-term follow up. Methods: We prospectively investigated the sex-specific association of different levels of HbA1c with incident stroke risk among 10,876 male and 19,278 female diabetic patients within the Louisiana State University (LSU) Hospital System. Results: During a mean follow up of 6.7 years, 2,949 incident cases of stroke were identified. The multivariable-adjusted hazard ratios (HRs) of stroke associated with different levels of HbA1c at baseline (<6.0%, 6.0-6.9% [reference group], 7.0-7.9%, 8.0-8.9%, 9.0-9.9%, and ≥10.0%,) were 0.96 (95% confidence interval [CI] 0.80-1.14), 1.00, 1.04 (0.85-1.28), 1.11 (0.89-1.39), 1.10 (0.86-1.41), and 1.22 (0.92-1.35) (P trend =0.66) for males, and 1.03 (0.90-1.18), 1.00, 1.09 (0.94-1.26), 1.19 (1.00-1.42), 1.32 (1.09-1.59), and 1.42 (1.23-1.65) (P trend <0.001) for females, respectively. The graded association of HbA1c during follow-up with stroke risk was observed among female diabetic patients (P trend=0.066). When stratified by race, with glucose-lowering agents or not, this graded association of HbA1c with stroke was still present. When stratified by age, the adjusted HRs were significantly higher in women older than 55 years compared to younger women. Conclusions: The current study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.

scholarly journals Meta-analysis of the impact of alpha-glucosidase inhibitors on incident diabetes and cardiovascular outcomes

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ruth L. Coleman ◽  
Charles A. B. Scott ◽  
Zhihui Lang ◽  
M. Angelyn Bethel ◽  
Jaakko Tuomilehto ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Incident Type ◽  
Glucosidase Inhibitors ◽  
Incident Type 2 Diabetes ◽  
Cv Disease ◽  
The Impact ◽  
Alpha Glucosidase

Abstract Background Alpha-glucosidase inhibitors (AGIs) have been shown to reduce incident type 2 diabetes but their impact on cardiovascular (CV) disease remains controversial. We sought to identify the overall impact of AGIs with respect to incident type 2 diabetes in individuals with impaired glucose tolerance (IGT), and CV outcomes in those with IGT or type 2 diabetes. Methods We used PubMed and SCOPUS to identify randomized controlled trials reporting the incidence of type 2 diabetes and/or CV outcomes that had compared AGIs with placebo in populations with IGT or type 2 diabetes, with or without established CV disease. Eligible studies were required to have ≥ 500 participants and/or ≥ 100 endpoints of interest. Meta-analyses of available trial data were performed using random effects models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and CV outcomes. Results Of ten trials identified, three met our inclusion criteria for incident type 2 diabetes and four were eligible for CV outcomes. The overall HR (95% CI) comparing AGI with placebo for incident type 2 diabetes was 0.77 (0.67–0.88), p < 0.0001, and for CV outcomes was 0.98 (0.89–1.10), p = 0.85. There was little to no heterogeneity between studies, with I2 values of 0.03% (p = 0.43) and 0% (p = 0.79) for the two outcomes respectively. Conclusions Allocation of people with IGT to an AGI significantly reduced their risk of incident type 2 diabetes by 23%, whereas in those with IGT or type 2 diabetes the impact on CV outcomes was neutral.

scholarly journals Sex-specific associations between type 2 diabetes incidence and exposure to dioxin and dioxin-like pollutants: a meta-analysis

2021 ◽  
Author(s):  
Noa Gang ◽  
Kyle Van Allen ◽  
Paul J. Villeneuve ◽  
Heather MacDonald ◽  
Jennifer E. Bruin
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Diabetes Risk ◽  
Diabetes Incidence ◽  
Dioxin Exposure ◽  
The Relationship ◽  
Disaster Exposure ◽  
Pcb Exposure

AbstractThe relationship between persistent organic pollutants (POPs), including dioxins and dioxin-like polychlorinated biphenyls (DL-PCBs), and diabetes incidence in adults has been extensively studied. However, significant variability exists in the reported associations both between and within studies. Emerging data from rodent studies suggest that dioxin exposure disrupts glucose homeostasis in a sex-specific manner. Thus, we performed a meta-analysis of relevant epidemiological studies to investigate whether there are sex-specific associations between dioxin or DL-PCB exposure and type 2 diabetes incidence. Articles were organized into the following subcategories: data stratified by sex (16%), unstratified data (56%), and data from only 1 sex (16% male, 12% female). We also considered whether exposure occurred either abruptly at high levels through a contamination event (“disaster exposure”) or chronically at background levels (“non-disaster exposure”). Only 8 studies compared associations between dioxin/DL-PCB exposure and diabetes risk in males versus females within the same population. When all sex-stratified or single sex studies were considered in the meta-analysis, the summary odds ratio (OR) for increased diabetes risk was similar between females and males (1.78 and 1.95, respectively) when comparing exposed to reference populations, suggesting that this relationship is not sex-specific. However, when we considered disaster-exposed populations separately, the association differed substantially between sexes, with females showing a much higher OR than males (2.86 and 1.59, respectively). Moreover, the association between dioxin/DL-PCB exposure and diabetes was stronger for females than males in disaster-exposed populations. In contrast, both sexes had significantly increased ORs in non-disaster exposure populations and the OR for females was lower than males (1.40 and 2.02, respectively). Our review emphasizes the importance of considering sex differences, as well as the mode of pollutant exposure, when exploring the relationship between pollutant exposure and diabetes in epidemiological studies.

Is diabetic neuropathy associated with vitamin D status? A meta-analysis

2021 ◽  
pp. 1-35
Author(s):  
Kaissar Yammine ◽  
Joelle Abi Kharma ◽  
Theodore Kaypekian ◽  
Chahine Assi ◽  
Nadine Zeeni
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Diabetic Neuropathy ◽  
Vitamin D Deficiency ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Random Effects Models

Abstract Several studies have been conducted to investigate the relation between 25-hydroxyvitamin D [25(OH)D] level and diabetic neuropathy (DN). However, there is still no clear conclusion due to differences in study design and cut-off values used in the published work, in addition to the absence of a comprehensive meta-analysis on the topic. The present systematic review and meta-analysis therefore aims at clarifying the association between vitamin D level and peripheral DN in patients with type 2 diabetes mellitus. Primary research studies that explored the association between 25(OH)D level and diabetic peripheral neuropathy in type 2 diabetes were located from Medline, EMBASE, Web of Science, Cochrane Library, CINHAL, and Google Scholar. Twenty-six studies met the inclusion criteria with 6277 participants where 2218 were diabetic with DN, 2959 were diabetic without DN and 406 were healthy. Diabetic patients with DN showed significantly lower serum 25(OH)D compared to patients without DN (standardized mean difference (SMD) of −0.92 (95% CI = −1.18 to −0.65, I2 = 93.3%, p < 0.0001). The pooled OR value of vitamin D deficiency was higher in patients with DN, 1.84 (95% CI = 1.46 to 2.33, p < 0.0001) and 2.87 (95% CI = 1.10 to 7.52, p = 0.03) when using fixed-effects and random-effects models, respectively. Vitamin D deficiency has been found to be highly prevalent among diabetic patients with neuropathy. Since 25(OH)D has been implicated in glucose hemostasis and showed benefit in reducing neuropathy symptoms, its supplementation is warranted for this population of patients.

scholarly journals Association of HDL-C and apolipoprotein A-I with the risk of type 2 diabetes in subjects with impaired fasting glucose

2014 ◽  
Vol 171 (1) ◽  
pp. 137-142 ◽  
Author(s):  
You-Cheol Hwang ◽  
Hong-Yup Ahn ◽  
Sung-Woo Park ◽  
Cheol-Young Park
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Metabolic Profiles ◽  
Current Smoking ◽  
Apolipoprotein A ◽  
Incident Cases

ObjectivesHDLs have many diverse functions. The goal of this study was to determine the association of HDL cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) with the development of type 2 diabetes (T2D). In particular, this study determined the association between the ratio of HDL-C to apoA-I (HA) and incident T2D.Design and methodsA total of 27 988 subjects with impaired fasting glucose (IFG) (18 266 men and 9722 women) aged 21–91 years (mean age 40.7 years) were followed for a mean duration of 2.81 years.ResultsStudy subjects were divided into quartiles according to the baseline HA ratio. Age, male sex, current smoking, BMI, waist circumference, and high-sensitivity C-reactive protein decreased across the quartiles, and all metabolic profiles, including blood pressure, fasting glucose, insulin resistance as determined by homeostasis model assessment of insulin resistance, and lipid measurements such as total cholesterol, LDL cholesterol, non-HDL-C, and apoB, improved as the HA ratio increased. In addition, incident cases of T2D decreased as the HA ratio increased, independent of age, sex, BMI, current smoking, systolic blood pressure, HbA1c, fasting serum insulin, family history of diabetes, and serum triglyceride concentrations (HR (95% CI) of fourth quartile vs first quartile; 0.76 (0.67–0.86), P<0.0001).ConclusionsA higher HA ratio was associated with favorable metabolic profiles and a lower risk of T2D development in subjects with IFG.

scholarly journals Egg consumption and risk of type 2 diabetes: findings from 3 large US cohort studies of men and women and a systematic review and meta-analysis of prospective cohort studies

2020 ◽  
Vol 112 (3) ◽  
pp. 619-630 ◽  
Author(s):  
Jean-Philippe Drouin-Chartier ◽  
Amanda L Schwab ◽  
Siyu Chen ◽  
Yanping Li ◽  
Frank M Sacks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Egg Consumption ◽  
Prospective Cohort Studies ◽  
Incident Cases

ABSTRACT Background Whether egg consumption is associated with the risk of type 2 diabetes (T2D) remains unsettled. Objectives We evaluated the association between egg consumption and T2D risk in 3 large US prospective cohorts, and performed a systematic review and meta-analysis of prospective cohort studies. Methods We followed 82,750 women from the Nurses’ Health Study (NHS; 1980–2012), 89,636 women from the NHS II (1991–2017), and 41,412 men from the Health Professionals Follow-up Study (HPFS; 1986–2016) who were free of T2D, cardiovascular disease, and cancer at baseline. Egg consumption was assessed every 2–4 y using a validated FFQ. We used Cox proportional hazard models to estimate HRs and 95% CIs. Results During a total of 5,529,959 person-years of follow-up, we documented 20,514 incident cases of T2D in the NHS, NHS II, and HPFS. In the pooled multivariable model adjusted for updated BMI, lifestyle, and dietary confounders, a 1-egg/d increase was associated with a 14% (95% CI: 7%, 20%) higher T2D risk. In random-effects meta-analysis of 16 prospective cohort studies (589,559 participants; 41,248 incident T2D cases), for each 1 egg/d, the pooled RR of T2D was 1.07 (95% CI: 0.99, 1.15; I2 = 69.8%). There were, however, significant differences by geographic region (P for interaction = 0.01). Each 1 egg/d was associated with higher T2D risk among US studies (RR: 1.18; 95% CI: 1.10, 1.27; I2 = 51.3%), but not among European (RR: 0.99; 95% CI: 0.85, 1.15; I2 = 73.5%) or Asian (RR: 0.82; 95% CI: 0.62, 1.09; I2 = 59.1%) studies. Conclusions Results from the updated meta-analysis show no overall association between moderate egg consumption and risk of T2D. Whether the heterogeneity of the associations among US, European, and Asian cohorts reflects differences in egg consumption habits warrants further investigation. This systematic review was registered at www.crd.york.ac.uk/prospero as CRD42019127860.

scholarly journals Effects of Plant-Based Diets on Weight Status in Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4099
Author(s):  
Grace Austin ◽  
Jessica J. A. Ferguson ◽  
Manohar L. Garg
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Dietary Patterns ◽  
Weight Status ◽  
Meta Analysis ◽  
Therapeutic Effects ◽  
Central Adiposity ◽  
Random Effects Models ◽  
Reduced Body

Excessive adiposity is a major risk factor for type 2 diabetes (T2D), and dietary patterns are important determinants of weight status. Plant-based dietary patterns (PBDs) are known for their therapeutic effects on T2D. The aim is to systematically review RCTs to investigate the effects of various PBDs compared to regular meat-eating diets (RMDs), in individuals who normally consume a RMD on body weight, BMI, and waist circumference in T2D. RCTs investigating PBDs and body weight, BMI, WC for ≥6 weeks in adults with T2D since 1980 were eligible for inclusion. Seven trials (n = 269) were included in the meta-analysis using random-effects models and expressed as MD (95%Cls). Compared to RMDs, PBDs significantly lowered body weight (−2.35 kg, 95% CI: −3.51, −1.19, p < 0.001), BMI (−0.90 kg/m2, 95% CI: −1.42, −0.38, p = 0.001) and WC (−2.41 cm, 95% CI: −3.72, −1.09, p < 0.001). PBDs alone significantly reduced body weight by 5.1% (−4.95 kg, 95% CI: −7.34, −2.55, p < 0.001), BMI by 5.4% (−1.87 kg/m2, 95% CI: −2.78, −0.95, p < 0.001) and WC by 4.3%(−4.23, 95% CI: −6.38, −2.07, p < 0.001). Interventions not limiting energy intake led to a significant reduction in body weight (−2.54 kg, 95% CI: −4.16, −0.92, p < 0.005) and BMI (−0.91 kg/m2, 95% CI: −1.56, −0.25, p < 0.005). Trials ≥16 weeks had a pronounced reduction in body weight (−2.93 kg, 95% CI: −5.00, −0.87, p = 0.005) and BMI (−1.13 kg/m2, 95% CI: −1.89, −0.38, p < 0.005). These findings provide evidence for the implementation of PBDs for better management of central adiposity in individuals with T2D.

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