scholarly journals Newly diagnosed type 2 diabetes in an ethnic minority population: clinical presentation and comparison to other populations

2018 ◽  
Vol 6 (1) ◽  
pp. e000568 ◽  
Author(s):  
Michael Morkos ◽  
Bettina Tahsin ◽  
Louis Fogg ◽  
Leon Fogelfeld
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Minority ◽  
Diabetes Complications ◽  
Clinical Presentation ◽  
Microvascular Complications ◽  
Macrovascular Complications ◽  
Minority Population ◽  
Newly Diagnosed ◽  
The Uk

ObjectiveTo characterize the clinical presentation of newly diagnosed type 2 diabetes of ethnic minority adults in Chicago and compare with other populations.Research design and methodsCross-sectional study examining the data of 2280 patients newly diagnosed with type 2 diabetes treated between 2003 and 2013 in a large Chicago public healthcare system.ResultsMean age of the patients was 49±11.3 years, men 54.4%, African-Americans 48.1%, Hispanics 32.5%, unemployed 69.9%, uninsured 82.2%, English-speaking 75.1%, and body mass index was 32.8±7.4 kg/m2. Microvascular complications were present in 50.1% and macrovascular complications in 13.4%. There was a presence of either macrovascular or microvascular complications correlated with older age, hypertension, dyslipidemia, inactivity, speaking English, and being insured (p<0.01). Glycosylated hemoglobin A1c (HbA1c) at presentation did not correlate with diabetes complications. In our cohort, when compared with a diverse population in the UK and insured population in the USA, HbA1c at presentation was 10.0% (86 mmol/mol), 6.6% (49 mmol/mol), and 8.2% (66 mmol/mol); nephropathy was 22.2%, 16.7%, and 5.7%; retinopathy was 10.7%, 7.9%, and 1.4%; and neuropathy was 27.7%, and 6.7% in the UK (p<0.001). There were no significant differences between groups in the prevalence of macrovascular complications.ConclusionThese results show the vulnerability of underserved and underinsured patients for developing diabetes complications possibly related to a delayed diagnosis.

scholarly journals Management of diabetes complications in youth

2019 ◽  
Vol 10 ◽  
pp. 204201881986322 ◽  
Author(s):  
Lara E. Graves ◽  
Kim C. Donaghue
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Diabetes Complications ◽  
Microvascular Complications ◽  
Macrovascular Disease ◽  
Macrovascular Complications ◽  
Invasive Treatment ◽  
Positive Effects

Type 1 and type 2 diabetes are increasing in prevalence and diabetes complications are common. Diabetes complications are rarely studied in youth, despite the potential onset in childhood. Microvascular complications of diabetes include retinopathy, diabetic kidney disease or nephropathy, and neuropathy that may be somatic or autonomic. Macrovascular disease is the leading cause of death in patients with type 1 diabetes. Strict glycaemic control will reduce microvascular and macrovascular complications; however, they may still manifest in youth. This article discusses the diagnosis and treatment of complications that arise from type 1 and type 2 diabetes mellitus in youth. Screening for complications is paramount as early intervention improves outcome. Screening should commence from 11 years of age depending on the duration of type 1 diabetes or at diagnosis for patients with type 2 diabetes. Diabetic retinopathy may require invasive treatment such as laser therapy or intravitreal antivascular endothelial growth factor therapy to prevent future blindness. Hypertension and albuminuria may herald diabetic nephropathy and require management with angiotensin converting enzyme (ACE) inhibition. In addition to hypertension, dyslipidaemia must be treated to reduce macrovascular complications. Interventional trials aimed at examining the treatment of diabetes complications in youth are few. Statins, ACE inhibitors and metformin have been successfully trialled in adolescents with type 1 diabetes with positive effects on lipid profile, microalbuminuria and measures of vascular health. Although relatively rare, complications do occur in youth and further research into effective treatment for diabetes complications, particularly therapeutics in children in addition to prevention strategies is required.

scholarly journals Prevalence of microvascular complications in newly diagnosed patients with Type 2 diabetes

2013 ◽  
Vol 29 (4) ◽  
Author(s):  
Alia Ali ◽  
Farrukh Iqbal ◽  
Azeem Taj ◽  
Zafar Iqbal ◽  
Muhammad Joher Amin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Newly Diagnosed

Effect of glycemic control on the Diabetes Complications Severity Index score and development of complications in people with newly diagnosed type 2 diabetes

2017 ◽  
Vol 10 (3) ◽  
pp. 192-199 ◽  
Author(s):  
Kevin M. Pantalone ◽  
Anita D. Misra-Hebert ◽  
Todd M. Hobbs ◽  
Brian J. Wells ◽  
Sheldon X. Kong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Diabetes Complications ◽  
Severity Index ◽  
Index Score ◽  
Newly Diagnosed ◽  
Severity Index Score

scholarly journals Type 2 diabetes risks and determinants in 2nd generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK

2019 ◽  
Author(s):  
Aliki-Eleni Farmaki ◽  
Victoria Garfield ◽  
Sophie V. Eastwood ◽  
Ruth E. Farmer ◽  
Rohini Mathur ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Minority ◽  
Second Generation ◽  
South Asians ◽  
Self Report ◽  
The Uk ◽  
First And Second Generation ◽  
Mixed Ethnicity ◽  
Second Generation Migrants

AbstractBackgroundType 2 diabetes mellitus (T2DM) risk is markedly higher in UK South Asians (SA) and African Caribbeans (AC) compared to Europeans. Explanations for this excess are unclear. We therefore compared risks and determinants of T2DM in first- and second-generation (born in the UK) migrants, and in those of mixed ethnicity populations.MethodsData from the UK Biobank, a large population-based cohort of volunteers aged 40-69, were used. T2DM was assigned using self-report and glycated haemoglobin. Ethnicity was self-assigned. Using logistic regression and mediation analysis, we compared T2DM between first- and second-generation migrants, and between mixed European/South Asians (MixESA), or mixed European/African Caribbeans (MixEAC) with both Europeans and SA or AC respectively.ResultsT2DM prevalence was three to five times higher in SA and AC compared with Europeans [OR (95%CI): 4·80(3·60,6·40) and 3·30(2·70,4·10) respectively]. T2DM was 20-30% lower in second versus first generation SA and AC migrants [0·78(0·60,1·01) and 0·71(0·57,0·87) respectively]. T2DM in mixed populations was lower than comparator ethnic minority groups [MixESA versus SA 0·29(0·21,0·39), MixEAC versus AC 0·48(0·37,0·62)] and higher than Europeans, in MixESA 1·55(1·11, 2·17), and in MixEAC 2·06 (1·53, 2·78). Improved adiposity patterns in second generation migrants made an important contribution to risk reduction. Greater socioeconomic deprivation accounted for 17% and 42% of the excess risk of T2DM in MixESA and MixEAC compared to Europeans, respectively.ConclusionExcess T2DM risks in South Asians and African Caribbeans compared with Europeans in the UK are attenuated by ∼20% in second-generation migrants, demonstrating the marked benefits of favourable changes in environmental risk factors. T2DM prevalence in people of mixed ethnicity was also raised compared with Europeans, but considerably less than in the ethnic minority group; persistent socioeconomic disadvantage accounted for some of the residual excess.

scholarly journals Association of vitamin D2 and D3 with type 2 diabetes complications

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lina H. M. Ahmed ◽  
Alexandra E. Butler ◽  
Soha R. Dargham ◽  
Aishah Latif ◽  
Amal Robay ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Diabetic Retinopathy ◽  
Diabetes Complications ◽  
Microvascular Complications ◽  
Middle Eastern ◽  
Middle Eastern Population ◽  
Diabetic Microvascular Complications ◽  
The Relationship

Abstract Aims Vitamin D measurement is a composite of vitamin D2 (25(OH)D2) and D3 (25(OH)D3) levels, and its deficiency is associated with the development of type 2 diabetes (T2DM) and diabetic complications; vitamin D deficiency may be treated with vitamin D2 supplements. This study was undertaken to determine if vitamin D2 and D3 levels differed between those with and without T2DM in this Middle Eastern population, and the relationship between diabetic microvascular complications and vitamin D2 and vitamin D3 levels in subjects with T2DM. Methods Four hundred ninety-six Qatari subjects, 274 with and 222 without T2DM participated in the study. Plasma levels of total vitamin D2 and D3 were measured by LC-MS/MS analysis. Results All subjects were taking vitamin D2 and none were taking D3 supplements. Vitamin D2 levels were higher in diabetics, particularly in females, and higher levels were associated with hypertension and dyslipidemia in the diabetic subjects (p < 0.001), but were not related to diabetic retinopathy or nephropathy. Vitamin D3 levels measured in the same subjects were lower in diabetics, particularly in females (p < 0.001), were unrelated to dyslipidemia or hypertension, but were associated with retinopathy (p < 0.014). Neither vitamin D2 nor vitamin D3 were associated with neuropathy. For those subjects with hypertension, dyslipidemia, retinopathy or neuropathy, comparison of highest with lowest tertiles for vitamin D2 and vitamin D3 showed no difference. Conclusions In this Qatari cohort, vitamin D2 was associated with hypertension and dyslipidemia, whilst vitamin D3 levels were associated with diabetic retinopathy. Vitamin D2 levels were higher, whilst vitamin D3 were lower in diabetics and females, likely due to ingestion of vitamin D2 supplements.

scholarly journals Cardiovascular Autonomic Neuropathy in Context of Other Complications of Type 2 Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anca Moţăţăianu ◽  
Rodica Bălaşa ◽  
Septimiu Voidăzan ◽  
Zoltán Bajkó
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Autonomic Neuropathy ◽  
Microvascular Complications ◽  
Demographic Data ◽  
Macrovascular Complications ◽  
Cardiac Autonomic Neuropathy ◽  
Group A

The aim of this study was to investigate the relationship between cardiac autonomic neuropathy (CAN) and other micro- and macrovascular complications and risk factors for type 2 diabetes. We included, in this study, 149 patients with type 2 diabetes. We evaluated their cardiovascular risk factors, demographic data, and any major micro- and macrovascular complications of their diabetes. Assessments of CAN were based upon Ewing’s battery.Results. CAN was present in 38.9% of patients. In the CAN group, the duration of diabetes, BMI, systolic blood pressure, lipid levels, and HBA1c were all significantly higher than those in the other group. A significant association was found between CAN and retinopathy, peripheral neuropathy, ABI, and IMT. Multivariate logistic regression demonstrated that, in type 2 diabetes, the odds of CAN (OR (95% confidence intervals)) increase with the age of the patients (1.68 (1,4129–2.0025)), the average diabetes duration (0.57 (0.47–0.67)), cholesterol (1.009 (1.00-1.01)), HbA1c levels (1.88 (1.31–2.72)), peripheral neuropathy (15.47 (5.16–46.38)), BMI (1.12 (1.05–1.21)), and smoking (2.21 (1.08–4.53)).Conclusions. This study shows that CAN in type 2 diabetes is significantly associated with other macro- and microvascular complications and that there are important modifiable risk factors for its development.

Sign in / Sign up

Export Citation Format

Share Document