scholarly journals Lifetime risk to progress from pre-diabetes to type 2 diabetes among women and men: comparison between American Diabetes Association and World Health Organization diagnostic criteria

2020 ◽  
Vol 8 (2) ◽  
pp. e001529
Author(s):  
Thijs T W van Herpt ◽  
Symen Ligthart ◽  
Maarten J G Leening ◽  
Mandy van Hoek ◽  
Aloysius G Lieverse ◽  
...  
Keyword(s):  
High Risk ◽  
American Diabetes Association ◽  
Population Based ◽  
Lifetime Risk ◽  
World Health ◽  
Who Criteria ◽  
Risk Of Death ◽  
Overt Diabetes ◽  
Health Organization ◽  
The Impact

IntroductionPre-diabetes, a status conferring high risk of overt diabetes, is defined differently by the American Diabetes Association (ADA) and the WHO. We investigated the impact of applying definitions of pre-diabetes on lifetime risk of diabetes in women and men from the general population.Research design and methodsWe used data from 8844 women without diabetes and men aged ≥45 years from the prospective population-based Rotterdam Study in the Netherlands. In both gender groups, we calculated pre-diabetes prevalence according to ADA and WHO criteria and estimated the 10-year and lifetime risk to progress to overt diabetes with adjustment for competing risk of death.ResultsOut of 8844 individuals, pre-diabetes was identified in 3492 individuals (prevalence 40%, 95% CI 38% to 41%) according to ADA and 1382 individuals (prevalence 16%, 95% CI 15% to 16%) according to WHO criteria. In both women and men and each age category, ADA prevalence estimates doubled WHO-defined pre-diabetes. For women and men aged 45 years having ADA-defined pre-diabetes, the 10-year risk of diabetes was 14.2% (95% CI 6.0% to 22.5%) and 9.2% (95% CI 3.4% to 15.0%) compared with 23.2% (95% CI 6.8% to 39.6%) and 24.6% (95% CI 8.4% to 40.8%) in women and men with WHO-defined pre-diabetes. At age 45 years, the remaining lifetime risk to progress to overt diabetes was 57.5% (95% CI 51.8% to 63.2%) vs 80.2% (95% CI 74.1% to 86.3%) in women and 46.1% (95% CI 40.8% to 51.4%) vs 68.4% (95% CI 58.3% to 78.5%) in men with pre-diabetes according to ADA and WHO definitions, respectively.ConclusionPrevalence of pre-diabetes differed considerably in both women and men when applying ADA and WHO pre-diabetes definitions. Women with pre-diabetes had higher lifetime risk to progress to diabetes. The lifetime risk of diabetes was lower in women and men with ADA-defined pre-diabetes as compared with WHO. Improvement of pre-diabetes definition considering appropriate sex-specific and age-specific glycemic thresholds may lead to better identification of individuals at high risk of diabetes.

scholarly journals The Association of Retinopathy and Plasma Glucose and HbA1c: A Validation of Diabetes Diagnostic Criteria in a Chinese Population

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Rui Zhang ◽  
Yufeng Li ◽  
Simin Zhang ◽  
Xiaoling Cai ◽  
Xianghai Zhou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Plasma Glucose ◽  
Chinese Population ◽  
High Specificity ◽  
Population Based ◽  
World Health ◽  
Who Criteria ◽  
Receiver Operating Characteristic Curves ◽  
Health Organization ◽  
Low Sensitivity

Aims. This study aimed to evaluate the associations of diabetic retinopathy (DR) with fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG), and glycated hemoglobin A1c (HbA1c) in a Chinese population.Materials and Methods. A total of 3124 participants, identified from a population-based survey in Pinggu district, were examined by retinal photography (45°). DR was classified according to the Early Treatment Diabetic Retinopathy Study scale. FPG, 2hPG, and HbA1c were tested and categorized by deciles, with the prevalence of DR calculated in each decile.Results. The prevalence of DR increased sharply in the 10th deciles, when FPG exceeded 7.03 mmol/L and HbA1c exceeded 6.4%. Analysis of the receiver operating characteristic curves showed that the optimal cutoffs for detecting DR were 6.52 mmol/L and 5.9% for FPG and HbA1c, respectively. The World Health Organization (WHO) criteria for diagnosing diabetes showed high specificity (90.5–99.5%) and low sensitivity (35.3–65.0%). Further, 6 individuals with retinopathy had normal plasma glucose; however, their characteristics did not differ from those without retinopathy.Conclusions. Thresholds of FPG and HbA1c for detecting DR were observed, and the WHO criteria of diagnosing diabetes were shown to have high specificity and low sensitivity in this population.

scholarly journals COVID-19: Implications for Food, Water, Hygiene, Sanitation, and Environmental Safety in Africa: A Case Study in Ghana

2020 ◽  
Author(s):  
Courage Kosi Setsoafia Saba
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Environmental Safety ◽  
Population Based ◽  
World Health ◽  
Limited Information ◽  
Long Run ◽  
The World ◽  
Health Organization ◽  
The Impact

Governments all over the world are currently grappling with the COVID-19 pandemic. While some countries were very hard hit, others were only mildly hit but all are still taking measures to mitigate the consequences. The virus emerged in December 2019 in Wuhan, China and spread to most continents by the beginning of March 2020, which led to the World Health Organization declaring it as a pandemic on the 11th of March 2020. Since it was a novel disease, there was limited information on the virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) belongs to the same family as the Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Researchers all over the world started working simultaneously to understand the virus to provide the necessary treatment regime or vaccine in order to reduce the impact of the virus on its victims. Africa and other developing countries with limited resources and poor planning and management are expected to be among the worst hit in the long run. The implications of the COVID-19 on food, water, hygiene, sanitation, and the environment in Africa have been reviewed in this paper, as well as possible implications they may pose to the population, based on the existing common practices and their immediate impacts. This information can assist policymakers in Africa to adequately plan the management of the COVID-19 in order to lessen its impact on the population.

scholarly journals Comparison of the American Diabetes Association and World Health Organization criteria for gestational diabetes mellitus and the outcomes of pregnancy

2009 ◽  
Vol 2 (4) ◽  
pp. 149-153 ◽  
Author(s):  
Latika Sahu ◽  
R Satyakala ◽  
Reddi Rani
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
World Health Organization ◽  
American Diabetes Association ◽  
Mode Of Delivery ◽  
World Health ◽  
Oral Glucose ◽  
Who Criteria ◽  
Health Organization

Two to five percent of pregnancies are complicated by diabetes, of which 90% are classified as gestational diabetes mellitus.The aims and objectives of this study were to analyse the screening and diagnostic procedure for gestational diabetes mellitus (GDM) recommended by American Diabetes Association (ADA) in comparison with the World Health Organization (WHO) criteria and to study the outcome of GDM diagnosed by both the criteria. This prospective study was carried out in the Department of Obstetrics and Gynaecology, JIPMER between August 2006 and July 2008. Three-hundred-and-fifty antenatal cases of gestational age ≥24 weeks attending the outpatient department, with any one of the risk factors for GDM, were included in the study. A seventy-five gram oral glucose tolerance test (GTT) was performed on each subject. Results were interpreted using both ADA and WHO criteria. Antenatal complications of GDM, mode of delivery, intrapartum or postnatal maternal and neonatal complications in cases diagnosed with GDM by either criterion were noted. The data collected were analysed using the SPSS software program. The prevalence of GDM was 4% by ADA criteria versus 19.4% by WHO criteria. The diagnostic pick-up rate was approximately five times more with WHO than with ADA criteria. In total, 43% (ADA) and 29% (WHO) of GDM cases had antenatal complications. Seventy-four percent of mothers with macrosomic babies were identified by WHO criteria whereas only 26% of mothers with macrosomic babies were diagnosed by ADA criteria. ADA criteria identify more severe cases of GDM but mild cases diagnosed by WHO are missed. The GTT by WHO criteria was abnormal in a greater percentage of women with adverse outcomes especially macrosomia, than the GTT using ADA criteria.

scholarly journals Racial variation in the relationship of anemia with mortality and mobility disability among older adults

Blood ◽  
2007 ◽  
Vol 109 (11) ◽  
pp. 4663-4670 ◽  
Author(s):  
Kushang V. Patel ◽  
Tamara B. Harris ◽  
Marion Faulhaber ◽  
Sara B. Angleman ◽  
Stephanie Connelly ◽  
...  
Keyword(s):  
Adverse Events ◽  
Black Men ◽  
Proportional Hazards ◽  
Community Dwelling ◽  
World Health ◽  
Mobility Disability ◽  
Who Criteria ◽  
Risk Of Death ◽  
Increased Risk ◽  
Health Organization

Abstract Anemia is more common among older blacks than older whites. However, it is unclear whether anemia predicts adverse events similarly in both races. Data on 1018 black and 1583 white adults aged 71 to 82 years were analyzed. Anemia, as defined by World Health Organization (WHO) criteria, was used to predict mortality over 6 years and incidence of mobility disability over 4 years. In proportional hazards models of mortality in whites, the age-adjusted hazard ratio (HR) for anemia in men was 1.96 (95% confidence interval [CI]: 1.35, 2.83) and in women was 2.86 (95% CI: 1.69, 4.82). In contrast, anemia was not associated with mortality in black men (HR = 1.15 [95% CI: 0.77, 1.72]) or women (HR = 1.39 [95% CI: 0.91, 2.14]). Higher mortality rate was observed only in black men with hemoglobin values more than 20 g/L (2.0 g/dL) below the WHO cutoff, whereas mortality rates were elevated in white men with hemoglobin values 1 to 10, 11 to 20, and more than 20 g/L below the WHO cutoff. In conclusion, anemia was significantly associated with increased risk of death and mobility disability in community-dwelling older whites. Conversely, older blacks classified as anemic by WHO criteria were not at risk for adverse events, indicating that alternative criteria are warranted.

scholarly journals The population-based prevalence of trachomatous scarring in a trachoma hyperendemic setting: results from 152 impact surveys in Amhara, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tigist Astale ◽  
Caleb D. Ebert ◽  
Andrew W. Nute ◽  
Mulat Zerihun ◽  
Demelash Gessese ◽  
...  
Keyword(s):  
Large Population ◽  
Population Based ◽  
District Level ◽  
World Health ◽  
Multi Stage ◽  
Prevalence Estimates ◽  
History Of ◽  
Low Levels ◽  
Health Organization ◽  
The Impact

Abstract Background Trachomatous scarring (TS) results from repeated infection with the bacterium Chlamydia trachomatis. Pronounced scarring is an underlying cause of trachomatous trichiasis (TT) that can lead to blindness. Since the condition is irreversible, TS in adults has been considered a marker of past exposure to trachoma infection. The aim of this report was to estimate the population-based prevalence of TS within Amhara, Ethiopia, a region with a historically high burden of trachoma. Methods District-level multi-stage cluster surveys were conducted in all districts between 2010 and 2015 to monitor the impact of approximately 5 years of trachoma interventions. Approximately 40 households were sampled per cluster and all participants ages ≥ 1 year were graded for the 5 World Health Organization simplified signs. Before each survey round, trachoma graders participated in a 7-day training and reliability exam that included cases of TS. TS prevalence estimates were weighted to account for sampling design and adjusted for age and sex using post-stratification weighting. Results Across the 152 districts in Amhara, 208,510 individuals ages 1 year and older were examined for the signs of trachoma. Region-wide, the prevalence of TS was 8.2 %, (95 % Confidence Interval [CI]: 7.7–8.6 %), and the prevalence among individuals ages 15 years and older (n = 110,137) was 12.6 % (95 % CI: 12.0–13.3 %). District-level TS prevalence among individuals ages 15 years and older ranged from 0.9 to 36.9 % and was moderately correlated with district prevalence of TT (r = 0.31; P < 0.001). The prevalence of TS increased with age, reaching 22.4 % among those ages 56 to 60 years and 24.2 % among those ages 61 to 65 years. Among children ages 1 to 15 years TS prevalence was 2.2 % (95 % CI: 1.8–2.8 %), increased with age (P < 0.001), and 5 % of individuals with TS also had trachomatous inflammation-intense (TI). Conclusions These results suggest that Amhara has had a long history of trachoma exposure and that a large population remains at risk for developing TT. It is promising, however, that children, many born after interventions began, have low levels of TS compared to other known trachoma-hyperendemic areas.

Choosing Your Battles: Which Resistance Genes Warrant Global Action?

2019 ◽  
Author(s):  
An-Ni Zhang ◽  
Li-Guan Li ◽  
Xiaole Yin ◽  
Chengzhen L Dai ◽  
Mathieu Groussin ◽  
...  
Keyword(s):  
High Risk ◽  
Resistance Genes ◽  
Bacterial Infections ◽  
Antibiotic Resistance Genes ◽  
World Health ◽  
Policy Interventions ◽  
Homologous Genes ◽  
Global Action ◽  
Health Organization ◽  
The Impact

AbstractThe increasing accumulation of antibiotic resistance genes (ARGs) in pathogens poses a severe threat to the treatment of bacterial infections. However, not all ARGs do not pose the same threats to human health. Here, we present a framework to rank the risk of ARGs based on three factors: “anthropogenic enrichment”, “mobility”, and “host pathogenicity”. The framework is informed by all available bacterial genomes (55,000), plasmids (16,000), integrons (3,000), and 850 metagenomes covering diverse global eco-habitats. The framework prioritizes 3% of all known ARGs in Rank I (the most at risk of dissemination amongst pathogens) and 0.3% of ARGs in Rank II (high potential emergence of new resistance in pathogens). We further validated the framework using a list of 38 ARG families previously identified as high risk by the World Health Organization and published literature, and found that 36 of them were properly identified as top risk (Rank I) in our approach. Furthermore, we identified 43 unreported Rank I ARG families that should be prioritized for public health interventions. Within the same gene family, homologous genes pose different risks, host range, and ecological distributions, indicating the need for high resolution surveillance into their sequence variants. Finally, to help strategize the policy interventions, we studied the impact of industrialization on high risk ARGs in 1,120 human gut microbiome metagenomes of 36 diverse global populations. Our findings suggest that current policies on controlling the clinical antimicrobial consumptions could effectively control Rank I, while greater antibiotic stewardship in veterinary settings could help control Rank II. Overall, our framework offered a straightforward evaluation of the risk posed by ARGs, and prioritized a shortlist of current and emerging threats for global action to fight ARGs.

scholarly journals Comparison of metabolic syndrome prevalence using four different definitions – a population-based study in Finland

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Elsi Haverinen ◽  
Laura Paalanen ◽  
Luigi Palmieri ◽  
Alicia Padron-Monedero ◽  
Isabel Noguer-Zambrano ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Adult Population ◽  
Age Groups ◽  
International Diabetes Federation ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization ◽  
The Impact

Abstract Background Metabolic syndrome (MetS) is a public health problem in Europe, affecting all age groups. Several MetS definitions are available. The aim of this study was to compare four different MetS definitions in the Finnish adult population, to assess their agreement and to evaluate the impact of the choice of the definition on the prevalence of MetS. Methods Data from FinHealth 2017, a cross-sectional national population health survey, focusing on adults aged 25 years or older were used in the analysis (n=5687). Measured data on anthropometrics, blood pressure and biomarkers together with questionnaire data were used to classify the participants into the MetS categories according to the four definitions. The definitions chosen for the comparison were those by the World Health Organization (WHO) (1998), National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) (2004), International Diabetes Federation (IDF) (2005), and Joint Interim Statement (JIS) (2009). Results The four MetS definitions resulted in substantially different MetS prevalence: 17.7% by WHO, 33.3% by NCEP-ATP III, 41.5% by IDF, and 43.0% by JIS. Regardless of the definition used, the prevalence of MetS increased with age. The prevalence of the different components varied between the definitions, depending on the different cut-off points adopted. Out of all participants, only 13.6% were identified to have MetS according to all four definitions. Agreement between participants recognised by different MetS definitions, estimated through kappa coefficients, was almost perfect for IDF vs. JIS (0.97), strong for JIS vs. NCEP-ATP III (0.80), moderate for IDF vs. NCEP-ATP III (0.76) and weak for WHO vs. NCEP-ATP III (0.42), WHO vs. IDF (0.41) and WHO vs. JIS (0.40). Conclusions Differences between observed prevalence of MetS in Finnish men and women using different MetS definitions were large. For cross-country comparisons, as well as for trend analyses within a country, it is essential to use the same MetS definition to avoid discrepancies in classification due to differences in used definitions.

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