scholarly journals The related risk factors of diabetic retinopathy in elderly patients with Type 2 diabetes mellitus: A cohort study

2020 ◽  
Author(s):  
Ying-Chu Chiu ◽  
Tien-Lung Tsai ◽  
Meiyin Su ◽  
Tsan Yang ◽  
Peng-Lin Tseng ◽  
...  

Abstract Background: Diabetic retinopathy (DR) caused by small vessel disease was the main cause of blindness in person with diabetes, and it mainly occurred in patients with Type 2 diabetes mellitus (T2DM). Taiwan was one of the Asian countries with the highest prevalence rate of DR, there were only few studies for the risk of DR in patients with T2DM in Taiwan. According to some studies have shown DR was a major cause of blindness on elderly both in developed and other developing countries. The purpose was to investigate the related risk factors of DR in elderly patients with T2DM. Methods: During July 2010 to December 2017, 4010 T2DM patients without DR were preselected for this study, but 792 patients completed the continuously follow-up evaluation. Patients were invited to have an outpatient visit at least every three months, and they were asked to fill out a brief questionnaire and collect their blood samples. Additionally, statistical methods used independent sample T-test, Chi-square tests and logistic regression in univariate analysis to analyze the relationships between onset DR and each related factor; and finally the optimal multivariate logistic regression model would be determined by stepwise model selection. Results: Of the 792 effective samples, 611 patients (77.1%) progressed to DR and 181 patients (22.9%) did not get DR during the follow-up period. According to the results, the significant factors were women (OR, 2.20; 95%CI, 1.52-3.17), longer diabetic duration (OR, 1.05; 95% CI, 1.03-1.08), family history of diabetes (OR, 1.55; 95% CI: 1.09-2.21), higher concentration glycated hemoglobin (HbA1c) (OR, 1.27; 95% CI: 1.12-1.44), higher mean low density lipoprotein cholesterol (LDL-c) (OR, 1.01; 95% CI: 1.00-1.01), and chewing betel nut (OR, 2.85; 95% CI: 1.41-5.77). Conclusions: This prospective cohort study showed that gender, behavior of chewing betel nut, diabetic duration, family history of diabetes, HbA1c, and LDL-c, were important factors for the development of DR in elderly patients with T2DM. It suggested that those patients should well control their HbA1c and LDL-c and quit chewing betel nut to prevent from DR, especially for female patients with family history of diabetes and longer duration of diabetes.

2017 ◽  
Vol 9 (9) ◽  
pp. 42
Author(s):  
Sana Arshad ◽  
Sania Tahir ◽  
Bilal Tahir ◽  
Nazia Tahir ◽  
Tahir Rasool ◽  
...  

BACKGROUND: Diabetes is the leading cause of morbidity and mortality amongst the people of Pakistan. In 2015, 7 million people had diabetes and the number is still on raise. Family history of diabetes, high body mass index, and other sociodemographic factors are the risk factors of diabetes. Persistent exposure to excessive glucose may be a reason behind diabetic complications like nephropathy, neuropathy, retinopathy, cardiomyopathy and gestational diabetes mellitus.METHODS: For the evaluation of laboratory parameters, 600 blood samples were collected at Akhuwat Diabetic Centre and from Jinnah Hospital, Lahore. Demographic data of the participants was collected by filling a questionnaire. Lipid profile, liver enzymes, and renal function tests were performed and statistical analysis was done.RESULTS: Type 2 diabetes mellitus among other types is the most prevalent form of diabetes in our population. Family history of diabetes (p=0.002), Body Mass Index (>25) p<0.001, high cholesterol (p=0.04), high triglyceride p<0.001, high LDL p<0.001 and low HDL p<0.001 are significantly associated with the incidence of diabetes. Hypertension among the other comorbidities is more common in diabetic patients.CONCLUSION: Type 2 Diabetes Mellitus is highly prevalent in the local population. Improved lifestyle and proper medical monitoring can help to manage diabetes in our population.


2007 ◽  
Vol 23 (5) ◽  
pp. 259-266 ◽  
Author(s):  
Marsha Howell Adams ◽  
Carol Ann Barnett Lammon

Type 2 diabetes mellitus is reaching epidemic proportions among children and adolescents. School health fairs offer an opportunity to identify children with risk factors for the development of type 2 diabetes mellitus. This study identified selected risk factors (i.e., high-risk racial/ethnic group, obesity, elevated blood pressure, elevated casual blood glucose, elevated total cholesterol, and the presence of acanthosis nigricans) for development of type 2 diabetes mellitus in rural children with or without a family history of diabetes during annual school health fairs. Of the children screened, 40% (673) presented with two or more of the identified risk factors for type 2 diabetes mellitus. The presence of multiple risk factors in participants reporting a positive family history of diabetes mellitus versus those with no family history was not statistically significant. Based on the study results, factors other than family history may be more predictive for the development of type 2 diabetes mellitus in rural school children.


1970 ◽  
Vol 42 (2) ◽  
pp. 137-141
Author(s):  
T Jaja ◽  
IE Yarhere

Background: The prevalence of Type 2 diabetes mellitus (T2 DM) in children and adolescents is on the increase, therefore, prevention and early detection are important.Objective: To assess for easily identifiable risk factors (overweight/obesity, hypertension, Impaired Fasting Glucose (IFG) and family history of diabetes) for T2DM in adolescents in public secondary schoolsResult: Eight hundred and eighty adolescents aged 10 to 19 years were screened and 124(14.1%) were overweight/obese. 457 (51.9%) of students had none of the risk factors while 272(30.9%) had at least one risk factor. Using the American Diabetes Association criteria for identification of those at risk for T2DM, 21(2.4%) were identified. The frequency of presence of risk factors was more in females (3.3%), mid adolescent age group (3.1%) and those with positive family history of diabetes. These findings were however not statistically significant. There was a statistically significant association between presence of hypertension and impaired fasting glucose and risk factor for type 2 DM.Conclusion: The significant risk factors identified in this study were prehypertension/hypertension and impaired fasting blood glucose.Key words: Adolescence, Risk factors, Type 2 diabetes mellitus


Author(s):  
Chukwuma J. Okafor ◽  
Said A. Yusuf ◽  
Salma A. Mahmoud ◽  
Salum S. Salum ◽  
Sonia C. Vargas ◽  
...  

Diabetes type 2 (T2D) had caused the loss of millions of lives all over the world. About 50% of the patients with T2D die because of cardiovascular disease (CVD), primarily myocardial infarction and stroke. Many of the leading risk factors for CVD coexist and act synergistically to increase cardiovascular events. The purpose of this descriptive cross-sectional study was to determine the prevalence, patterns, and certain predictive factors in the complications of T2D patients attending diabetic clinics at Mnazi Mmoja hospital. A total of 138 respondents made up of 58 females and 80 males within the age brackets of 30-40, 41-50, 51 – 60, and 61 above were recruited for this study. Data were analysed and interpreted based on certain predictive factors and variables, including smoking, alcohol, excessive salt intake, lipid intake, sedentary lifestyle, family history of diabetes, and hypertension, on how they relate to the development of complications of type 2 diabetes. Pearson Chi-Square test was used to compare the levels of significances. Probability values of less or equal to 0.05 were accepted to be significant. The combination of salt intake, sedentary lifestyle, family history of diabetes, and lipid intake was the commonest risk factor for developing complications of T2D. However, alcohol and cigarette smoking had the most negligible impact on developing complications in T2D. The result also shows the patients between the age bracket of 30 and 40 have more risk factors for developing complications. The result showed no gender difference in the number of risk factors. There was a statistically significant association between some of the risk factors (smoking, alcohol, sedentary lifestyle, and salt intake) and the gender of respondents (p<0.05). Males smoked (43.8%) and consumed alcohol (32.5%) than females, while females were prone to a sedentary lifestyle (63.8%) and consume salt (82.8%) than males. On the other hand, this research showed that the significant complication for both males and females are numbness, pain sensation, and dry skin (diabetic neuropathy). Gender and certain predictive risk factors like salt intake, sedentary lifestyle, and family history of diabetes, and lipid intake are fundamental parameters to be tackled to reduce the complications of type 2 diabetes mellitus. There is a greater need now for awareness of the risk factors through effective health promotion in Zanzibar. Also, secondary prevention through regular screening, early detection, and appropriate treatment of chronic complications could reduce the morbidity and mortality caused by diabetes mellitus.


2019 ◽  
Vol 4 (2) ◽  
pp. 10
Author(s):  
Ti En ◽  
Musyarrafah Musyarrafah ◽  
Andi Noor Kholidha ◽  
Pranita Aritrina ◽  
Ikhlasul Amal Abdal ◽  
...  

Background: Diabetes Mellitus is a metabolic disease characterized by chronic hiperglikemia and caused by the impairment of insulin secretion or insulin resistance or both. There are some risk factors in the process. They are obesity, lack of activity, nutritional deficiency, family history of diabetes, history of gestational diabetes, old age, and genetic. Research Purpose: This research purpose is to understand the relationship between risk factors including obesity and family history with the incident of type-2 DM in coastal area of Kendari. Research Methods: This research used analytical-observational study with case control approach. The independent variables used in this research are Body Mass Index (BMI) and family history while the the dependent variables are the incident of type-2 DM. The location of this research is working area of Puskesmas Mata, Puskesmas Benu-benua, Puskesmas Kandai, Puskesmas Abeli and Puskesmas Poasia located in the coastal area. There are 75 people choosen to be our samples by include and exclude criteria with cluster sampling method. Data are obtained by using questionnaire and laboratory analysis. The results are processed by applying Chi-Square test with p<0,050 and the Odd Ratio score. Research Result: This research showed that between BMI with the incident of type-2 DM has p=0,000 (OR=7,875), between family history with the incident of type-2 DM has p=0,030 (OR=2,800), between BMI and family history with the incident of type-2 DM has p=0,000 (OR=14,571). Conclusion: The conclusion of this research was that the relationship between BMI with the incident of type-2 DM in the coastal area of Kendari exists. The relationship between family history with the incident of type-2 DM in the coastal area of Kendari exists. The relationship between BMI and family history with the incident of type-2 DM in the coastal area of Kendari exists.


Author(s):  
Tsai-Tung Chiu ◽  
Tien-Lung Tsai ◽  
Mei-Yin Su ◽  
Tsan Yang ◽  
Peng-Lin Tseng ◽  
...  

Diabetic retinopathy (DR), caused by small vessel disease, is the main cause of blindness in persons with diabetes. Taiwan is one of the Asian countries with the highest prevalence rate of DR. The purpose was to investigate the related risk factors of DR in elderly patients with type 2 diabetes mellitus (T2DM), in Lee’s Endocrinology Clinic. 792 T2DM patients over 60 years old were invited to have an outpatient visit at least every three months, and all of them were asked to undergo a standardized interview and collect their blood samples. Significant factors were being female (adjusted hazard ratio (HR): 1.287; 95% CI, 1.082–1.531), higher glycated hemoglobin (HbA1c) (HR: 1.067; 95% CI: 1.016–1.119), higher mean low density of lipoprotein cholesterol (LDL-c) (HR: 1.004; 95% CI: 1.001–1.006), and chewing betel nut (HR: 1.788; 95% CI: 1.362–2.347). This study showed that gender, the behavior of chewing betel nut, HbA1c, and LDL-c are important factors for the development of DR in elderly patients with T2DM. It is suggested that patients should control their HbA1c and LDL-c and quit chewing betel nut to prevent DR. This suggestion applies especially to female patients.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Inés Urrutia ◽  
◽  
Alicia Martín-Nieto ◽  
Rosa Martínez ◽  
J Oriol Casanovas-Marsal ◽  
...  

AbstractThe aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.


2021 ◽  
Vol 9 (1) ◽  
pp. e001948
Author(s):  
Marion Denos ◽  
Xiao-Mei Mai ◽  
Bjørn Olav Åsvold ◽  
Elin Pettersen Sørgjerd ◽  
Yue Chen ◽  
...  

IntroductionWe sought to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and the risk of type 2 diabetes mellitus (T2DM) in adults who participated in the Trøndelag Health Study (HUNT), and the possible effect modification by family history and genetic predisposition.Research design and methodsThis prospective study included 3574 diabetes-free adults at baseline who participated in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys. Serum 25(OH)D levels were determined at baseline and classified as <50 and ≥50 nmol/L. Family history of diabetes was defined as self-reported diabetes among parents and siblings. A Polygenic Risk Score (PRS) for T2DM based on 166 single-nucleotide polymorphisms was generated. Incident T2DM was defined by self-report and/or non-fasting glucose levels greater than 11 mmol/L and serum glutamic acid decarboxylase antibody level of <0.08 antibody index at the follow-up. Multivariable logistic regression models were applied to calculate adjusted ORs with 95% CIs. Effect modification by family history or PRS was assessed by likelihood ratio test (LRT).ResultsOver 11 years of follow-up, 92 (2.6%) participants developed T2DM. A higher risk of incident T2DM was observed in participants with serum 25(OH)D level of<50 nmol/L compared with those of ≥50 nmol/L (OR 1.72, 95% CI 1.03 to 2.86). Level of 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in adults without family history of diabetes (OR 3.87, 95% CI 1.62 to 9.24) but not in those with a family history (OR 0.72, 95% CI 0.32 to 1.62, p value for LRT=0.003). There was no effect modification by PRS (p value for LRT>0.23).ConclusionSerum 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in Norwegian adults. The inverse association was modified by family history of diabetes but not by genetic predisposition to T2DM.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 613.2-614
Author(s):  
L. Kondrateva ◽  
T. Panafidina ◽  
T. Popkova ◽  
M. Cherkasova ◽  
A. Lila ◽  
...  

Background:Insulin resistance (IR) is considered as initial stage of diseases continuum from development of prediabetes to eventual progression to type 2 diabetes mellitus (T2DM). Individuals with prediabetes have also elevated leptin levels, so this adipocytokine along with IR can be considered as predictive laboratory markers of higher risk of T2DM. It is not yet clear whether presence of individual or multiple SLE-related and/or known traditional risk factors of T2DM (such as unhealthy diet, physical inactivity, family history of diabetes, or being overweight) can precipitate the development of IR.Objectives:To analyze the relationship between IR and increasing leptin levels rates. To identify the presence and evaluate the potential role of traditional and disease-related risk factors for IR in SLE patients without T2DM or hyperglycemia.Methods:A total of 49 SLE pts (46 women, 3 men, 40 [33;48] years old) without established DM and with normal fasting glucose levels (<6,1 mmol/l) were enrolled in the study. Median disease duration was 3,0[0,7;8,0] years, SLEDAI-2K was 5[2;8]. SLE pts were treated with glucocorticoids (GC) (84%), hydroxychloroquine (78%), immunosuppressive drugs (20%) and biological agents (10%). Insulin levels were measured using electrochemiluminescence assay Elecsys (Roche Diagnostics), serum leptin concentrations were estimated using ELISA (DBS-Diagnostics Biochem Canada Inc.). IR was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5.6 ng/ml for men. Eight traditional T2DM risk factors from the FINDRISK (Finnish Type 2 Diabetes Risk Assessment Form) questionnaire (older age, being overweight, abdominal obesity, family history of diabetes, sedentary lifestyle, lack of regular dietary fiber intake, taking antihypertensive medications as a surrogate marker of high blood pressure, documented episodes of hyperglycemia) were evaluated. This study used 5 risk categories for developing T2DM proposed by FINDRISK questionnaire: low, slightly elevated, moderate, high or very high.Results:Median HOMA-IR levels were 1,7 [1,2;2,5]. HOMA-IR correlated with leptin levels (r=0,7, p<0,001), body mass index (BMI) (r=0,6, p<0,001), waist circumference (WC) (r=0,5, p<0,001), T2DM risk categories by FINDRISK (r=0,3, p=0,03), SLEDAI-2K (r= -0,4, p<0,01), and duration of GCs therapy (r=0,3, p=0,03). Current GC use had no influence on HOMA-IR in SLE. IR was detected in 10 (20%) SLE pts. The traditional T2DM risk factors profiles were similar in pts with (Group 1) or without IR (Group 2) except for higher anthropometric parameters in group 1 (for BMI 27,2[24,8;32,2]kg/m2 vs 23,7[20,6;26,7]kg/m2, p<0,01; for WC: 93[86;102]cm vs 83[76;93]cm, p=0,02). Leptin levels were also higher in SLE pts with IR compared to pts without IR (74,2[30,4;112,7]ng/ml vs 25,0[6,7;42,4]ng/ml, p<0,01). Increased leptin levels were found in 35 (71%) pts, more often in pts with IR (100 vs 64%, p=0,04).Conclusion:IR was found in 20% of SLE pts without T2DM having normal serum fasting glucose concentration. Emergence of IR was commonly preceded by increased leptin levels. IR values were closely associated with accumulation of adipose tissue facilitated by long-term GCs use and disease activity decrease. Contribution of other traditional risk factors of T2DM seemed insignificant.Disclosure of Interests:None declared


Author(s):  
Noraidatulakma Abdullah ◽  
Nor Abdul Murad ◽  
John Attia ◽  
Christopher Oldmeadow ◽  
Mohd Kamaruddin ◽  
...  

The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia.


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