scholarly journals Latent Class Trajectory Analysis of Risk Factors Uncovers Progression to Type 2 Diabetes

2021 ◽  
Vol 3 (1) ◽  
pp. 26-35
Author(s):  
Qilu Yu ◽  
Maurice C. Johnson ◽  
Howard A. Fishbein ◽  
Rebecca J. Birch ◽  
Xiaoshu Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Trajectory Analysis ◽  
Latent Class ◽  
P Value ◽  
Blood Pressures ◽  
Adjusted Rate ◽  
Rate Ratios ◽  
Latent Class Trajectory Analysis

We identified trajectories of diabetes risk factors in the Longitudinal Epidemiologic Assessment of Diabetes Risk (LEADR) cohort analyzing 8 years of electronic health records on 1.4 million patients, and investigated associations between trajectories and progression to new onset Type 2 diabetes. Design and Methods: Analyzing LEADR data (2010-2016), we applied Latent Class Trajectory Analysis (LCTA) to classify patterns of risk factor change. There were 824,043 patients with BMIs; 955,128 patients with systolic blood pressures; 957,491 patients with diastolic blood pressures; 300,137 patients with HDLs; 267,553 patients with non-HDL cholesterols; and 297,026 patients with triglycerides. Patients had to have data for all risk factors being assessed. Association between trajectories and incidence of type 2 diabetes for 94,551 patients was assessed using negative binomial regression analysis. Results: Compared to a static BMI trajectory, those with a sustained weight increase (25%+ from starting BMI) were at higher risk of type 2 diabetes over 4.8 years of follow-up (range 2.0 to 8.0 years) (adjusted rate ratios ranged 1.53-1.62, p-value<0.05). Patients with a BMI decrease trajectory (of ~10%), were at reduced risk of diabetes (adjusted rate ratios ranged 0.54-0.74, p-value<.05). BP and lipid trajectories had significant associations with diabetes onset. Conclusions: Regardless of the starting BMI, those who increased their BMI by 25% within two years and maintained the higher weight were significantly at increased risk of type 2 diabetes. Monitoring BMI change and other known risk factor trajectories, BP and lipids, are additional tools for identifying patients at risk for type 2 diabetes.

scholarly journals Faktor Risiko Keturunan Diabetes dengan Variabel Perancunya Meningkatkan Prevalensi Diabetes Tipe 2 (Studi Estimasi)

2017 ◽  
Vol 10 (2) ◽  
pp. 109
Author(s):  
Riyanto Riyanto
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Central Obesity ◽  
Healthy Lifestyle ◽  
P Value ◽  
Analysis Model ◽  
Cross Sectional ◽  
Observation Methods ◽  
Hereditary Factors

<strong><strong></strong></strong><strong><em>Background:</em></strong><em> Type 2 diabetes is a disorder that is influenced by multifactors, involving both genetic and environmental factors. <strong>Purpose:</strong> This study aims to find a large estimate of hereditary risk factors for type 2 events by controlling controlling for other confounding variables. <strong>Methods:</strong> This study used a cross sectional design analysis model estimation with the main variable heredity. The research sample of at least 249 respondents. Measurement and observation of research variables using interview and observation methods. Multivariate analysis of estimation models uses multiple logistic regression tests and calculated attributable fraction percent (AF%). <strong>Results:</strong> The results of the final multivariate modeling analysis showed heredity was associated with the incidence of type 2 Diabetes (p value 0,000), after being controlled by confounding factors for BMI, occupation, age and central obesity with ORadjusted 19.8; 95% CI: 1,911-9,459). Calculation of the potential impact size (AF%) results of the analysis obtained 48.15%. <strong>Conclusion:</strong> The estimated magnitude of respondents who have inherited risk factors is 19.8 times more likely to have diabetes than those without heredity after being controlled by confounders of BMI, occupation and age and central obesity. People with Type 2 Diabetes who have a history of diabetes, live a healthy lifestyle, so that around 48.15% of diabetes can be prevented through hereditary factors.</em>

scholarly journals Aortic plaques in patients with atrial fibrillation: an often-forgotten risk factor for thromboembolism

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A.F Esteves ◽  
L Parreira ◽  
M Fonseca ◽  
J.M Farinha ◽  
J Ferreira ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
P Value ◽  
Af Ablation ◽  
Aortic Plaques ◽  
Af Recurrence

Abstract Background CHA2DS2-VASc risk score is the main determinant for maintaining anticoagulation after atrial fibrillation (AF) ablation, irrespective of the procedure outcome. The presence of aortic plaques is included in the score, but isn't regularly assessed previously to AF ablation. This way, risk factors for coronary artery disease (CAD) other than arterial hypertension and diabetes mellitus may influence stroke risk in patients with AF, albeit not being included in the CHA2DS2-VASc score. Purpose We sought to evaluate the prevalence of aortic plaques diagnosed during transesophageal echocardiography (TOE) in patients submitted to AF ablation and to assess its determinants and clinical impact on the CHA2DS2-VASc score. Methods Retrospective study of patients submitted to AF ablation that performed TOE prior to the procedure, with assessment of aortic plaques. CHA2DS2-VASc risk score was evaluated in the pre-ablation patient evaluation and reassessed after TOE. Demographic, clinical and echocardiographic data, including cardiovascular risk factors, were analyzed. We assessed AF recurrence rate, cerebrovascular events and death during follow-up. Results 120 patients were submitted to TOE prior to AF ablation from November 2015 to December 2020, mean age 66.6 (±9.55) years, 48% male. In 30 (25%) patients aortic plaques were identified in TOE. Mean CHA2DS2-VASc was 2.2 (±1.47) in pre-ablation evaluation and 2.5 (±1.69) post-TOE, increasing in all patients with aortic plaques and prompting beginning of oral anticoagulation in 5 patients. AF was paroxysmal in 74% and persistent in 26% of patients, mean duration of 6.28 (±3.76) years. Arterial hypertension was present in 79 (66%) of patients, type 2 diabetes mellitus in 24 (20%) and dyslipidemia in 67 (56%). 17 (14%) patients had a prior stroke. During a mean follow-up of 30 (±18.3) months, 32 (27%) patients had AF recurrence and 10 (8%) were submitted to redo procedures. 107 (89%) patients remained under oral anticoagulation, stroke occurred in 1 patient and 2 patients died. In univariate analysis, age, type 2 diabetes mellitus and dyslipidemia predicted an increase in CHA2DS2-VASc score after TOE (respectively, OR 1.113, 95% CI 1.041–1.190, p-value 0.002; OR 2.907, 95% CI 1.145–7.379, p-value 0.025; and OR 2.442, 95% CI 1.016–5.868, p-value 0.046). In multivariate analysis, age is the only independent predictor of increased CHA2DS2-VASc score after TOE (OR 1.095, 95% CI 1.013–1.185, p-value 0.023). No risk factor for CAD was independently associated with the presence of aortic plaques (Table 1). Conclusion In this population, single CAD risk factors were not independent predictors of aortic plaques. If TOE had not been performed prior to AF ablation, 25% of patients would have had an underestimated CHA2DS2-VASc score and would be off anticoagulation after the procedure, unprotected from thromboembolic events. FUNDunding Acknowledgement Type of funding sources: None. Table 1

scholarly journals Risk Perception for Developing Erectile Dysfunction among Malaysian Men with Type 2 Diabetes Mellitus

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Anuar Mohamad ◽  
Hizlinda Tohid ◽  
Saharuddin Ahmad ◽  
Seng Fah Tong ◽  
Mahadir Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Erectile Dysfunction ◽  
Risk Perception ◽  
Tertiary Education ◽  
Health Clinic ◽  
P Value

Risk perception for developing erectile dysfunction (ED) is an appreciation of the susceptibility to having ED and its severity. This study examined this risk perception and its associated factors among 180 men with type 2 diabetes mellitus (T2DM), who claimed not to have ED. This cross sectional study was conducted at a public health clinic using a validated self-administered questionnaire, which assessed participant characteristics, perceived susceptibility to developing ED, perceived severity of ED, and knowledge on risk factors for ED. About 71.1% had an inaccurate perception of susceptibility to developing ED and their perception on its severity was moderate (median (IQR) score: 10.0 (6.0); range score: 3–15; midpoint: 9). In multiple linear regression, having ED symptoms (p-value < 0.001) and secondary (p-value = 0.045) or tertiary education (p-value: 0.022) significantly contributed to a higher perception of susceptibility. A higher perception of severity was significantly found in Malays (p-value < 0.001), the employed (p-value = 0.026), and those with better knowledge on risk factors for ED (p-value < 0.001). Risk perception for developing ED among men with T2DM appears poor and it was significantly influenced by sociocultural factors, educational attainment, ED symptoms, and knowledge on risk factors for ED. Thus, to improve their risk perception, they should be provided appropriate counseling and education.

scholarly journals Diabetic Polyneuropathy Early in Type 2 Diabetes Is Associated With Higher Incidence Rate of Cardiovascular Disease: Results From Two Danish Cohort Studies

2021 ◽  
Author(s):  
Lasse Bjerg ◽  
Sia K Nicolaisen ◽  
Diana H Christensen ◽  
Jens S Nielsen ◽  
Signe T Andersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Incidence Rate ◽  
Diabetic Polyneuropathy ◽  
Diabetes Diagnosis ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Rate Ratios

Objective <br>Symptoms indicative of diabetic polyneuropathy (DPN) early in type 2 diabetes may act as a marker for cardiovascular disease (CVD) and death. <br>Research Design and Methods <br>We linked data from two Danish type 2 diabetes cohorts, ADDITION-Denmark and DD2, to national healthcare registers. The Michigan Neuropathy Screening Instrument questionnaire (MNSIq) was completed at diabetes diagnosis in ADDITION-Denmark and at a median of 4.6 years after diagnosis of diabetes in DD2. An MNSIq score ≥ 4 was considered as indicative of DPN. Using Poisson regressions, we computed incidence rate ratios of CVD and all-cause mortality comparing MNSIq scores ≥ 4 with scores < 4. Analyses were adjusted for a range of established CVD risk factors. <br>Results <br>In total, 1,445 (ADDITION-Denmark) and 5,028 (DD2) individuals were included in the study. Compared with MNSIq scores < 4, MNSIq scores ≥ 4 were associated with higher incidence rate of CVD, with incidence rate ratios (IRRs) of 1.79 [95% confidence interval (CI) 1.38-2.31] in ADDITION-Denmark, 1.57 (CI: 1.27-1.94) in the DD2, and a combined IRR of 1.65 (CI: 1.41-1.95) in a fixed-effect meta-analysis. MNSIq scores ≥ 4 did not associate with mortality; combined mortality rate ratio 1.11 (CI: 0.83-1.48). <br>Conclusions <br>The MNSIq may be a tool to identify a subgroup within individuals with newly diagnosed type 2 diabetes who has a high incidence rate of subsequent CVD. MNSIq scores ≥ 4, indicating DPN, were associated with a markedly higher incidence rate of CVD, beyond that conferred by established CVD risk factors. <br>

scholarly journals Analysis of the Influence of Risk Factors of Type 2 DM on Outpatients at DKT Bandar Hospital Lampung, 2020

2021 ◽  
Vol 4 (2) ◽  
pp. 4-14
Author(s):  
Feby Esmiralda ◽  
Aila Karyus ◽  
Kodrat Pramudho
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Univariate Analysis ◽  
Bivariate Analysis ◽  
P Value ◽  
History Of

DM is a chronic metabolic disease characterized by hyperglycemia and cause serious complications with an increasing prevalence rate. Control of risk factors that affect the incidence of DM is needed to prevent the emergence of DM and delay disease complications. The purpose of this study is to determine the risk factors that influence the incidence of type 2 diabetes outpatients at the DKT Bandar Lampung Hospital. This type of research is quantitative observational analytic with a case control approach. The population came from all patients undergoing outpatient treatment at the Internal Medicine Department of the DKT Hospital in Bandar Lampung with 44 case samples and 44 control samples. Data analysis used univariate analysis with percentages, bivariate analysis with Chi Square and multivariate analysis with multiple logistic regression. The results showed that there was a significant influence between the risk factors for age (p value 0.017), hereditary history of diabetes (p value 0.03), physical activity (p value 0.002) and obesity (p value 0.001) with the incidence of type 2 diabetes, while a history of hypertension has no effect on the incidence of type 2 diabetes mellitus (p value 0.135). Meanwhile, the most dominant variable influencing the incidence of outpatient type 2 diabetes mellitus at DKT Bandar Lampung Hospital is physical activity with OR 5.29. Maximum promotive, preventive, curative and rehabilitative efforts are needed to control risk factors for type 2 diabetes

scholarly journals Diabetic Polyneuropathy Early in Type 2 Diabetes Is Associated With Higher Incidence Rate of Cardiovascular Disease: Results From Two Danish Cohort Studies

2021 ◽  
Author(s):  
Lasse Bjerg ◽  
Sia K Nicolaisen ◽  
Diana H Christensen ◽  
Jens S Nielsen ◽  
Signe T Andersen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Incidence Rate ◽  
Diabetic Polyneuropathy ◽  
Diabetes Diagnosis ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Rate Ratios

Objective <br>Symptoms indicative of diabetic polyneuropathy (DPN) early in type 2 diabetes may act as a marker for cardiovascular disease (CVD) and death. <br>Research Design and Methods <br>We linked data from two Danish type 2 diabetes cohorts, ADDITION-Denmark and DD2, to national healthcare registers. The Michigan Neuropathy Screening Instrument questionnaire (MNSIq) was completed at diabetes diagnosis in ADDITION-Denmark and at a median of 4.6 years after diagnosis of diabetes in DD2. An MNSIq score ≥ 4 was considered as indicative of DPN. Using Poisson regressions, we computed incidence rate ratios of CVD and all-cause mortality comparing MNSIq scores ≥ 4 with scores < 4. Analyses were adjusted for a range of established CVD risk factors. <br>Results <br>In total, 1,445 (ADDITION-Denmark) and 5,028 (DD2) individuals were included in the study. Compared with MNSIq scores < 4, MNSIq scores ≥ 4 were associated with higher incidence rate of CVD, with incidence rate ratios (IRRs) of 1.79 [95% confidence interval (CI) 1.38-2.31] in ADDITION-Denmark, 1.57 (CI: 1.27-1.94) in the DD2, and a combined IRR of 1.65 (CI: 1.41-1.95) in a fixed-effect meta-analysis. MNSIq scores ≥ 4 did not associate with mortality; combined mortality rate ratio 1.11 (CI: 0.83-1.48). <br>Conclusions <br>The MNSIq may be a tool to identify a subgroup within individuals with newly diagnosed type 2 diabetes who has a high incidence rate of subsequent CVD. MNSIq scores ≥ 4, indicating DPN, were associated with a markedly higher incidence rate of CVD, beyond that conferred by established CVD risk factors. <br>

scholarly journals HUBUNGAN ANTARA PENYAKIT ARTERI PERIFER DENGAN FAKTOR RISIKO KARDIOVASKULAR PADA PASIEN DM TIPE 2

e-CliniC ◽  
2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Maria Simatupang ◽  
Karel Pandelaki ◽  
Agens L. Panda
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ldl Cholesterol ◽  
Ankle Brachial Index ◽  
Chi Square ◽  
Cross Sectional ◽  
Blood Pressures

Abtract: Peripheral arterial disease (PAD) is one of the complications that occurs in patients with type 2 diabetes mellitus due to the process of atherosclerosis. Age, hypertension, obesity, LDL cholesterol, and smoking are the cardiovascular risk factors that can be found in diabetes patients. Ankle brachial index (ABI) is a simple way to confirm the diagnosis of PAD. This study used a cross sectional design. The subjects numbered 100 patients with type 2 diabetes mellitus who were examined in the Metabolic Endocrine Clinic of Prof. Dr. R.D Kandou Hospital. Data of variables were based on the patients’ medical records, interviews about smoking, and blood pressures measured on ​​legs and arms in a supine position. A Chi-square test showed that there was a correlation between blood pressure and ABI values ​​(P = 0.049). Moreover, there was no correlation between risk factors of age (P = 0.144), obesity (P = 0.488), LDL cholesterol (P = 0.197), and smoking (P = 0.512) with ABI values. Multivariate analysis showed that there was a significant correlation between blood pressures and ABI values ​​(P = 0.037). Conclusion: From all the examined cardiovascular risks, the most correlated with the incidence of PAD in patients with type 2 diabetes mellitus was blood pressure. Keywords: cardiovascular risk factors, PAD, type 2 diabetes mellitus Abstrak: Penyakit Arteri Perifer (PAP) merupakan salah satu komplikasi yang terjadi pada pasien diabetes melitus tipe 2 (DMT2) akibat proses aterosklerosis. Usia, hipertensi, obesitas, kadar kolesterol LDL dan merokok merupakan faktor risiko kardiovaskular yang dapat ditemukan pada pasien diabetes. Ankle Brachial Index (ABI) merupakan cara sederhana untuk mendiagnosis PAP. Penelitian ini menggunakan desain cross sectional. Subjek dalam penelitian ini berjumlah 100 pasien DMT2 yang melakukan pemeriksaan di Poliklinik Endokrin Metabolik RSUP Prof.Dr.R.D. Kandou Manado. Pengukuran variabel berdasarkan pada catatan rekam medik pasien, anamnesis riwayat merokok, dan pengukuran nilai tekanan darah kaki maupun tangan dalam posisi berbaring. Uji chi-square menunjukkan bahwa terdapat hubungan bermakna antara tekanan darah dan nilai ABI (P = 0,049), sedangkan faktor risiko usia (P = 0,144), obesitas (P = 0,488), kolesterol LDL (P = 0,197) dan riwayat merokok (P = 0,512) tidak didapati adanya hubungan. Analisis multivariat, menunjukkan bahwa terdapat hubungan yang sangat bermakna antara tekanan darah dengan nilai ABI (P = 0,037). Simpulan: Dari semua faktor risiko kardiovaskular yang di teliti, tekanan darah yang paling berhubungan dengan kejadian PAP pada pasien DMT2. Kata kunci: DMT2, faktor risiko kardiovaskular, PAP

scholarly journals Risk assessment of type 2 diabetes mellitus among fisherman community in Beypore area of Kozhikode

2017 ◽  
Vol 4 (9) ◽  
pp. 3196 ◽  
Author(s):  
Anirudh V. Mutalik ◽  
Shankar Bapu Bhosale ◽  
Anant T. Pawar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Educational Status ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Random Blood Sugar

Background: In the past decade it has become obvious that the prevalence of type 2 diabetes is increasing very rapidly. Unless necessary and appropriate action is taken, it is predicted that there will be at least 350 million people in the world with type 2 diabetes by the year 2030. The aim of the study was to assess the risk for type 2 diabetes mellitus (T2DM) among fisherman community in Beypore area of Kozhikode.The objectives of the study were to identify the total number of participants with abnormal random blood sugar among Beypore fisherman community of Calicut; to identify risk factors associated with type 2 diabetes mellitus patients among Beypore fisherman community of Calicut. Methods: A cross sectional study was conducted among fisherman colony of Beypore area, Calicut. All the eligible participants according to inclusion and exclusion criteria were included in the study. An pretested and piloted Finnish Diabetes questionnaire modified according to local settings was used to map the screened participants. As the first step, history and basic anthropometry measurements was taken. Then each participant underwent physical examination. Further random blood glucose was calculated using strip glucometric method. Once confirmed, the treatment for type 2 diabetes was started. Results: Overall prevalence was found to be 29.23%. Prevalence of T2DM was significantly associated with age i.e. as age increases there is the risk of developing T2DM and p value was found to be significant. Conclusions: Age, educational status, central obesity and addiction are major risk factors for type 2 diabetes mellitus. 

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