scholarly journals Sleep Quality and Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes: A Cross-sectional Survey in Jordan.

2020 ◽  
Author(s):  
Jawad Ahmad Abu-Shennar ◽  
Hatice Bebis Bebis ◽  
Nurhan Bayraktar Bayraktar
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Glycemic Control ◽  
Sleep Quality ◽  
Categorical Variables ◽  
Regression Analyses ◽  
Cross Sectional ◽  
The Mean

Abstract Objective: The aims of this study were to quantify the prevalence of DPN as was assessed by the MNSI, and to evaluate sleep quality as was assessed by the PSQI. Also, to assess the relevance of other factors to sleep quality and DPN among patients with T2DM.Methods: A cross-sectional study was carried out at the Jordanian Ministry of Health in Amman, Jordan, during the period from the 1 st of June 2018 to the 1 st of September 2018. A total of 549 (269 male and 280 female) patients with type 2 diabetes were recruited. Data were collected using the MNSI to assess DPN a cutoff point of MNSI based on history score of ≥ 7, and physical examination based on the score of ≥ 2. While the PSQI to assess sleep quality with a cutoff point of PSQI ≥8. Participants' demographic background data were also recorded. Statistical analysis was conducted using SPSS version 20. Mean and standard deviation values were used to summarize continuous variables, and proportions were used for categorical variables. Chi-square was used to test the independent distribution of categorical variables where appropriate. Binary logistic regressions were used to examine the net effect for each of the proposed variables. A p-value of less than 0.05 was considered statistically significant.Results: The sample comprised 269 male and 280 female T2DM patients with a mean (SD) age of 2.00 (±0.574) years. Mean (SD) BMI was 3.58 (±0.617) kg/m2, and the mean (SD) duration of diabetes was 1.74 (±0.806) years. The prevalence of DPN based on a history score of ≥ 7 was 31.7% and 33.7% based on physical examination based on the score of ≥ 2 using MNSI. Besides, the results of the study revealed that the mean (SD) PSQI score of the study patients was 6.11(±7.01), with 32.8% who had a PSQI score ≥8. While, logistic regression analyses were conducted to identify factors independently related to DPN were marital status, working status, smoking status, diet regimen, physical activity, regularly visit treatment physicians, cardiovascular disease, dyslipidemia, retinopathy, hypertension, type of treatment (such as insulin and oral hypoglycemia agents or both), with the type of medications (such as a statin, and metformin). Also, uncontrolled diabetes, HDL-cholesterol levels, and duration of diabetes. On the other hand, multivariate logistic regression analyses were conducted to identify factors independently related to sleep quality were cardiovascular disease, dyslipidemia, retinopathy, hypertension, type of treatment (such as insulin and oral hypoglycemia agents or both), with the type of medications (such as a statin, and metformin). The study showed that subjective sleep quality and quantity, night sleep disturbance, and daytime dysfunction were the risk factors for poor glycemic control.Conclusions and recommendations: The high prevalence of DPN and poor sleep quality and patients with T2DM in addition to unawareness and poor management of DPN require more physician and health care professionals’ better management of DPN and improve sleep quality at the Jordanian Ministry of Health. Also, the results highlighted the need for intensive programs targeting early detection and prompt implementation of health education. Also, more attention is needed to prevent late-onset DPN complications, even in asymptomatic patients. Old patients with long-standing DM should be screened continuously for DPN. Moreover, the initial measures to prevent DPN and improves sleep quality include glycemic control and implementation with modification of lifestyle and behavioral changes such as appropriate diet, exercise, and regularly visit treating physician.

scholarly journals Association of usual sleep quality and glycemic control in type 2 diabetes in Japanese: A cross sectional study. Sleep and Food Registry in Kanagawa (SOREKA)

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0191771 ◽  
Author(s):  
Rika Sakamoto ◽  
Tadashi Yamakawa ◽  
Kenichiro Takahashi ◽  
Jun Suzuki ◽  
Minori Matsuura Shinoda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Sleep Quality ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Correlation Between HbA1c and Albuminuria in Type 2 Diabetes Mellitus

2020 ◽  
Vol 52 (3) ◽  
pp. 125-130
Author(s):  
Jesika Merlin ◽  
Pusparini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Female Gender ◽  
Cross Sectional ◽  
Type 2 Dm ◽  
The Mean

In patients with type 2 diabetes mellitus (Type 2 DM), glycemic control plays an essential role in reducing macro- and microvascular complications. The earliest marker for diabetic nephropathy is the presence of albuminuria. Meanwhile, HbA1c has been recognized as a marker of glycemic control in the blood. This study aimed to identify the correlation between HbA1c and albuminuria in type 2 DM. This was a cross-sectional study involving 100 patients with type 2 DM aged 40–70 years visiting Dr. Soetomo Hospital, Surabaya, Indonesia. Secondary data from medical records of type 2 DM patients undergoing HbA1c and albuminuria examinations from January to December 2015 were used. The mean age of subjects was 55.4 ±8.7 years, with the majority (55%) being of female gender. The mean HbA1c concentration was 9.8±2.4%. Most subjects (83%) had an HbA1c level of ≥7 %. Albuminuria was found in the majority of the subjects (78%), where 33% of them had positive 1 albuminuria. The Spearman correlation test showed a positive strong significant correlation between HbA1c and albuminuria, with r=0.865 and p<0.001. Thus, it can be concluded that there is a significant correlation between HbA1c and albuminuria in type 2 DM.

scholarly journals Challenges and factors associated with poor glycemic control among type 2 diabetes mellitus patients at Nekemte referral hospital, western Ethiopia: cross-sectional study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Kejela Bula ◽  
Getu Bayisa
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Fasting Blood Glucose ◽  
Cross Sectional Study ◽  
Poor Glycemic Control ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Mean

Abstract Background: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics’ lives in developing countries. Similar to the rest of sub Saharan African countries, Ethiopia is experiencing significant burden of diabetes with increased prevalence, complications and mortality as well as life threatening disabilities. Reasons for poor glycemic control in type 2 diabetes are complex and multivariable. Hence, this study was aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. Method: A hospital based cross sectional study was conducted on type 2 diabetic patients attending diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose of last three clinic visits were obtained and the mean fasting blood glucose measurements was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable with P< 0.05 was considered statistically significant. Result: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of participants was 43±12.4 years and 154(67.5%) were found not following their general dietary program correctly. Nearly one third, 73(32%) of participants never attended diabetic education and 52(22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148(64.9%) of patients had poor blood glucose control. Age range of 40-60 years (AOR=2.01, 95% CI 0.04-0.06, P=0.044), being illiterate (AOR = 3.12, 95 % CI 1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI 2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR = 3.94, 95 % CI 1.51-27.83, P=0.012), inadequate physical exercise (AOR = 3.19, 95 % CI 1.05-19.84, P=0.019), smoking (AOR = 4.51, 95 % CI 0.00-0.50, p=0.022) were independent predictors of poor glycemic control up on a multivariable logistic regression analysis. Conclusion: Nearly two third of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education as well as barriers of glycemic control should be explored with further research.

Relative risk of cardiovascular disease is higher in women with type 2 diabetes, but not in those with prediabetes, as compared with men

2020 ◽  
Author(s):  
Elena Succurro ◽  
Teresa Vanessa Fiorentino ◽  
Sofia Miceli ◽  
Maria Perticone ◽  
Angela Sciacqua ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Longitudinal Study ◽  
Relative Risk ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Normal Glucose

<b>Objective</b>: Most, but not all studies suggested that women with type 2 diabetes have higher relative risk (RR) for cardiovascular disease (CVD) than men. More uncertainty exists on whether the RR for CVD is higher in prediabetic women compared to men. <p><b>Research Design and Methods</b>: In a cross-sectional study, in 3540 normal glucose tolerant (NGT), prediabetic, and diabetic adults, we compared the RR for prevalent non-fatal CVD between men and women. In a longitudinal study including 1658 NGT, prediabetic, and diabetic adults, we compared the RR for incident major adverse outcomes, including all-cause death, coronary heart disease, and cerebrovascular disease events after 5.6 years follow-up. </p> <p><b>Results:</b> Women with prediabetes and diabetes exhibited greater relative differences in BMI, waist circumference, blood pressure, total, LDL and HDL cholesterol, triglycerides, fasting glucose, hsCRP, and white blood cell count than men with prediabetes and diabetes when compared with their NGT counterparts. We found a higher RR for prevalent CVD in diabetic women (RR 9.29; 95% CI 4.73-18.25; <i>P</i><0.0001) than in men (RR 4.56; 95% CI 3.07-6.77; <i>P</i><0.0001), but no difference in RR for CVD was observed comparing prediabetic women and men. In the longitudinal study, we found that diabetic, but not prediabetic women have higher RR (RR 5.25; 95% CI 3.22-8.56; <i>P</i><0.0001) of incident major adverse outcomes than their male counterparts (RR 2.72; 95% CI 1.81-4.08; <i>P</i><0.0001).</p> <p><b>Conclusions:</b> This study suggests that diabetic, but not prediabetic, women have higher RR for prevalent and incident major adverse outcomes than men. </p>

scholarly journals Impact of type 2 diabetes and microvascular complications on mortality and cardiovascular outcomes in a multiethnic Asian population

2021 ◽  
Vol 9 (1) ◽  
pp. e001413
Author(s):  
Jonathan Yap ◽  
Kamalesh Anbalakan ◽  
Wan Ting Tay ◽  
Daniel Ting ◽  
Carol Yim Cheung ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Population Based ◽  
Cardiovascular Outcomes ◽  
Microvascular Complication ◽  
The Impact ◽  
Hba1c Levels

IntroductionDiabetes mellitus is a growing public health epidemic in Asia. We examined the impact of type 2 diabetes, glycemic control and microvascular complications on mortality and cardiovascular outcomes in a multiethnic population-based cohort of Asians without prior cardiovascular disease.Research design and methodsThis was a prospective population-based cohort study in Singapore comprising participants from the three major Asian ethnic groups: Chinese, Malays and Indians, with baseline examination in 2004–2011. Participants with type 1 diabetes and those with cardiovascular disease at baseline were excluded. Type 2 diabetes, Hemoglobin A1c (HbA1c) levels and presence of microvascular complications (diabetic retinopathy and nephropathy) were defined at baseline. The primary outcome was all-cause mortality and major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular mortality, myocardial infarction, stroke and revascularization, collected using a national registry.ResultsA total of 8541 subjects were included, of which 1890 had type 2 diabetes at baseline. Subjects were followed for a median of 6.4 (IQR 4.8–8.8) years. Diabetes was a significant predictor of mortality (adjusted HR 1.74, 95% CI 1.45 to 2.08, p<0.001) and MACE (adjusted HR 1.64, 95% CI 1.39 to 1.93, p<0.001). In those with diabetes, higher HbA1c levels were associated with increased MACE rates (adjusted HR (per 1% increase) 1.18, 95% CI 1.11 to 1.26, p<0.001) but not mortality (p=0.115). Subjects with two microvascular complications had significantly higher mortality and MACE compared with those with only either microvascular complication (adjusted p<0.05) and no microvascular complication (adjusted p<0.05).ConclusionDiabetes is a significant predictor of mortality and cardiovascular morbidity in Asian patients without prior cardiovascular disease. Among patients with type 2 diabetes, poorer glycemic control was associated with increased MACE but not mortality rates. Greater burden of microvascular complications identified a subset of patients with poorer outcomes.

scholarly journals Appropriateness of aspirin prescribing for primary and secondary prevention of cardiovascular disease in type 2 diabetes in different care settings

2021 ◽  
Author(s):  
Shi Ying Tan ◽  
Heather Cronin ◽  
Stephen Byrne ◽  
Adrian O’Donovan ◽  
Antoinette Tuthill
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Shared Care ◽  
University Hospital ◽  
Cross Sectional ◽  
Prevention Of Cardiovascular Disease

Abstract Background Type 2 diabetes is associated with an increased cardiovascular risk. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven. Aims This study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care. Design Cross-sectional study Methods The medical records of individuals with type 2 diabetes aged over 18 years and attending Elmwood Primary Care Centre and Cork University Hospital Diabetes outpatient clinics (n = 400) between February and August 2017 were reviewed. Results There were 90 individuals exclusively attending primary care and 310 persons attending shared care. Overall, 49.0% (n = 196) of those were prescribed aspirin, of whom 42.3% were using it for secondary prevention. Aspirin was used significantly more in people attending shared care (p < 0.001). About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin. Conclusion A significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.

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