Diabetes Prevalence (diabetes + prevalence)

Distribution by Scientific Domains

Selected Abstracts

Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka,Sri Lanka Diabetes, Cardiovascular Study (SLDCS)

P. Katulanda
Abstract Aims To determine the prevalence of diabetes mellitus and pre-diabetes (impaired fasting glucose and impaired glucose tolerance) in adults in Sri Lanka. Projections for the year 2030 and factors associated with diabetes and pre-diabetes are also presented. Methods This cross-sectional study was conducted between 2005 and 2006. A nationally representative sample of 5000 adults aged , 18 years was selected by a multi-stage random cluster sampling technique. Fasting plasma glucose was tested in all participants and a 75-g oral glucose tolerance test was performed in non-diabetic subjects. Prevalence was estimated for those > 20 years of age. Results Response rate was 91% (n = 4532), males 40%, age 46.1 15.1 years (mean standard deviation). The age,sex standardized prevalence (95% confidence interval) of diabetes for Sri Lankans aged , 20 years was 10.3% (9.4,11.2%) [males 9.8% (8.4,11.2%), females 10.9% (9.7,12.1%), P = 0.129). Thirty-six per cent (31.9,40.1%) of all diabetic subjects were previously undiagnosed. Diabetes prevalence was higher in the urban population compared with rural [16.4% (13.8,19.0%) vs. 8.7% (7.8,9.6%); P < 0.001]. The prevalence of overall, urban and rural pre-diabetes was 11.5% (10.5,12.5%), 13.6% (11.2,16.0%) and 11.0% (10.0,12.0%), respectively. Overall, 21.8% (20.5,23.1%) had some form of dysglycaemia. The projected diabetes prevalence for the year 2030 is 13.9%. Those with diabetes and pre-diabetes compared with normal glucose tolerance were older, physically inactive, frequently lived in urban areas and had a family history of diabetes. They had higher body mass index, waist circumference, waist,hip ratio, systolic/diastolic blood pressure, low-density lipoprotein cholesterol and triglycerides. Insulin was prescribed to 4.4% (2.7,6.1%) of all diabetic subjects. Conclusions One in five adults in Sri Lanka has either diabetes or pre-diabetes and one-third of those with diabetes are undiagnosed. [source]

Diabetes prevalence in England, 2001

C. J. Currie
No abstract is available for this article. [source]

Hospital in-patients with diabetes: increasing prevalence and management problems

M. E. Wallymahmed
Abstract Aims To re-assess the prevalence, management problems, clinical outcomes and discharge summaries of hospital in-patients with diabetes. Methods Case records of all patients occupying in-patient beds were audited on a single weekday in 2003 in a large urban hospital and repeated after 3 months. Data was compared with an identical audit 12 years previously. Results Over 12 years the number of beds available for admission (1191) had reduced by 25% with a bed occupancy of 97%. Diabetes prevalence had increased from 7.0% to 11.1% (P < 0.01) (97% Type 2). Diabetes management was considered inappropriate in 29%, more than in 1991 (20%). After 3 months, discharge summaries had been completed on 75% of patients but diabetes was mentioned in only 53%. Conclusion The prevalence of in-patient diabetes (11.1%) was over 50% greater and diabetes management was suboptimal in more patients than in 1991. In many length of stay was prolonged and almost half of the discharge summaries did not mention diabetes. These findings have major implications for service delivery and resource planning. [source]

Childhood body mass index (BMI), breastfeeding and risk of Type 1 diabetes: findings from a longitudinal national birth cohort

R. M. Viner
Abstract Aims To perform a longitudinal analysis of the association between childhood body mass index (BMI) and later risk of Type 1 diabetes, controlling for socio-economic status, birthweight, height in early and late childhood, breastfeeding history and pubertal status. Methods Analysis of the 1970 British Birth Cohort, followed up at age 5, 10 and 30 years (n = 11 261). Data were available on birthweight, breastfeeding; height, weight, pubertal status, socio-economic status at age 10 years; self-report data on history of diabetes (type, age at onset) at age 30 years. Cox proportional hazards models were used to examine relations of childhood growth, socio-economic status and breastfeeding history to the incidence of Type 1 diabetes between 10 and 30 years of age. Results Sixty-one subjects (0.5%) reported Type 1 diabetes at 30 years of age; 47 (77%) reported onset , age 10 years. Higher BMI z -score at 10 years predicted higher risk of subsequent Type 1 diabetes (hazard ratio 1.8, 95% confidence interval 1.2 to 2.8, P = 0.01) when adjusted for birthweight, pubertal status, breastfeeding history and socio-economic status. Repeating the model for childhood obesity, the hazard ratio was 3.1 (1.0, 9.3; P = 0.05). Birthweight, breastfeeding, height growth and pubertal timing were not associated with incidence of Type 1 diabetes. Conclusions Higher BMI in childhood independently increased the risk of later Type 1 diabetes, supporting suggestions that obesity may provide a link between Type 1 and Type 2 diabetes. This supports observations of a rise in Type 1 diabetes prevalence. Reduction in childhood obesity may reduce the incidence of Type 1 as well as Type 2 diabetes. [source]

Screening for diabetes in Indigenous populations using glycated haemoglobin: sensitivity, specificity, post-test likelihood and risk of disease

K. G. Rowley
Abstract Aims Screening for diabetes using glycated haemoglobin (HbA1c) offers potential advantages over fasting glucose or oral glucose tolerance testing. Current recommendations advise against the use of HbA1c for screening but test properties may vary systematically across populations, according to the diabetes prevalence and risk. We aimed to: (i) characterize the properties of test cut-offs of HbA1c for diagnosis of diabetes relative to a diagnosis based on a fasting plasma glucose concentration of 7.0 mmol/l for high-risk Indigenous populations; and (ii) examine test properties across a range of diabetes prevalence from 5 to 30%. Methods Data were collected from Aboriginal and Torres Strait Islander communities in Australia and a Canadian First Nations community (diabetes prevalence 12,22%) in the course of diabetes diagnostic and risk factor screening programmes (n = 431). Screening test properties were analyzed for the range of HbA1c observed (3,12.9%). Results In separate and pooled analyses, a HbA1c cut point of 7.0% proved the optimal limit for classifying diabetes, with summary analysis results of sensitivity = 73 (56,86)%, specificity = 98 (96,99)%, overall agreement (Youden's index) = 0.71, and positive predictive value (for an overall prevalence of 18%) = 88%. For diabetes prevalence from 5 to 30% the post-test likelihood of having diabetes given HbA1c = 7.0% (positive predictive value) ranged from 62.7 to 93.2%; for HbA1c < 7.0%, the post-test likelihood of having diabetes ranged from 4.5 to 27.7%. Conclusions The results converge with research on the likelihood of diabetes complications in supporting a HbA1c cut-off of 7.0% in screening for diabetes in epidemiological research. Glycated haemoglobin has potential utility in screening for diabetes in high-risk populations. [source]

Glycaemia and insulinaemia in elderly European subjects (70,75 years)

A. U. Teuscher
SUMMARY Aims To determine glycaemia and insulinaemia in elderly subjects aged 70,75 years, living across Europe, who participated in the EURONUT-SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action) study. Methods Fasting plasma glucose (FPG) and fasting insulin concentrations were measured in 1830 subjects aged 70,75 years living in 15 traditional towns in 11 European countries. For the diagnosis of diabetes, the recommendations of the 1997 report of the American Diabetes Association ,Expert Committee on the diagnosis and classification of diabetes mellitus' were used. Results A total of 31.6% of the study subjects had either diabetes (17.5%) or impaired fasting plasma glucose (FPG) (14.1%). Fifty-one per cent of the subjects with diabetes were unaware of the disease. No difference in diabetes prevalence was found for sex, but male subjects were more likely to have impaired FPG than female subjects (16.8 vs. 11.5%, P = 0.001). Hyperinsulinaemia (fasting insulin levels in the highest quartile) was associated with increased FPG, body mass index, and waist-to-hip ratio. Conclusions It was found that a substantial number of elderly Europeans have impaired glucose homeostasis, with diabetes and impaired FPG being present in almost a third of European subjects aged 70,75 years. [source]

Socio-economic status, obesity and prevalence of Type 1 and Type 2 diabetes mellitus

J. M. M. Evans
Summary Aims ,The influence of socio-economic status on the prevalence of Type 1 and Type 2 diabetes mellitus, and on obesity, was explored using routinely collected healthcare data for the population of Tayside, Scotland. Methods ,Among 366 849 Tayside residents, 792 and 5474 patients with Type 1 and Type 2 diabetes, respectively, were identified from a diabetes register. The Carstairs Score was used as a proxy for socio-economic status. This is a material deprivation measure derived from the UK census, using postcode data for four key variables. Odds ratios for diabetes prevalence, adjusted for age, were determined for each of six deprivation categories (1 , least deprived, 6/7 , most deprived). The mean body mass index (BMI) in each group was also determined, and the effect of deprivation category explored by analysis of covariance, adjusting for age and sex. Results ,The prevalence of Type 2 diabetes, but not Type 1 diabetes, varied by deprivation. People in deprivation category 6 and 7 were 1.6-times (95% confidence interval 1.4,1.8) more likely to have Type 2 diabetes than those least deprived. There was no relationship between deprivation and BMI in Type 1 diabetes (P = 0.36), but there was an increase in BMI with increasing deprivation in Type 2 diabetes (P < 0.001; test of linearity P < 0.001). Conclusions ,The study confirms the relationship between deprivation and the prevalence of Type 2 diabetes. There are more obese, diabetic patients in deprived areas. They require more targeted resources and more primary prevention. [source]

A health protection model for Hispanic adults with Type 2 diabetes

Christine L Latham RN
Aims., The Hispanic Health Protection Model (HHPM) was designed to assist practitioners' systematic assessment of Hispanic people to establish baselines and evaluate the success of early diabetes treatment. This article provides the research basis of the HHPM and related assessment tools. Background., The treatment of diabetes incorporates lifestyle change, and this adjustment is particularly important to follow with vulnerable groups. One such group is the Hispanic population, since the impact of diabetes is greatest on economically disadvantaged segments of this population, who suffer disproportionately higher Type 2 diabetes prevalence and higher levels of morbidity and mortality as compared with other populations. Traditional Hispanic health beliefs are often in conflict with Western medicine, so the adjustments to the lifestyle demands of this disease need to be evaluated. Methods., To understand this discrepancy fully in patient outcomes, a culturally sensitive assessment framework was developed based on health protection theories and research with Hispanic people with diabetes and, based on this framework, assessment tools were translated for use during interviews with low literacy, Spanish-speaking patients. Conclusions., The HHPM translated measures of premorbid lifestyle, health beliefs, support, self-efficacy, quality of life, knowledge of diabetes, and physiological parameters can be used during consecutive clinic visits during the first six months of therapy to map the success of patients' understanding of and psychological adjustment to diabetes. Relevance to clinical practice., The HHPM is a culturally-relevant, systematic, and holistic approach to assessing adjustment of Hispanic people to a new diagnosis of diabetes, including their psychological, cognitive, and physiological outcomes. Using this type of systematic approach will allow practitioners to target barriers to therapy, such as a lack of self-efficacy or incomplete knowledge of the disease and its treatment in a strategic manner to improve patient success in managing the complex lifestyle changes of diabetes mellitus. [source]

A socio-historical hypothesis for the diabetes epidemic in Chinese,Preliminary observations from Hong Kong as a natural experiment

C.M. Schooling
It has been hypothesized that the emerging epidemic of diabetes in economically transitioning or recently transitioned populations is due to mismatch between developmental and mature environments. We took advantage of migration within an ethnically homogenous population to investigate this hypothesis, and the potentially modifying role of postnatal growth conditions, proxied by greater height. We used multivariable logistic regression in a population-based cross-sectional study from 1994 to 1996 of 2,341 long-term Hong Kong residents aged 25,74 years, either born in contemporaneously developed Hong Kong or migrants from economically undeveloped Guangdong. Migrant status was not associated with clinically diagnosed diabetes, odds ratio 1.05 (95% confidence interval 0.69,1.58) in adult migrants compared to Hong Kong-born natives and 1.22 (0.83,1.80) in preadult migrants, adjusted for age, sex, socio-economic position, and lifestyle. However, the association of diabetes with migrant status varied with height, suggesting a potentially complex relationship between indicators of prenatal and postnatal nutritional exposures. Compared to tall Hong Kong-born natives, the odds ratio of diabetes was 2.36 (1.20,4.61) in tall migrants, 1.94 (1.07,3.53) in short Hong Kong-born natives, but 1.04 (0.48,2.23) in short adult migrants. Additionally adjusting for body mass index and waist-hip ratio had little effect, apart from attenuating the association between short height and diabetes prevalence in Hong Kong-born natives. Whether the current epidemic of diabetes is a long-standing effect of such mismatch or a "first-generation through effect" generated by rapid economic development causing disproportionate growth remains to be determined. Am. J. Hum. Biol., 2009. 2009 Wiley-Liss, Inc. [source]

Socio-economic gradients in self-reported diabetes for Indigenous and non-Indigenous Australians aged 18,64

Joan Cunningham
Abstract Objective: To examine and compare socio-economic gradients in diabetes among Indigenous and non-Indigenous Australians. Methods: I analysed weighted data on self-reported diabetes and a range of socio-economic status (SES) measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18,64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004,05. Results: After adjusting for age, diabetes prevalence was significantly higher among those of lower SES in both Indigenous and non-Indigenous populations. The age- and sex-adjusted odds ratios (OR) for diabetes for the lowest versus the highest SES group were similar for the two populations on many variables. For example, the OR for the lowest quintile of equivalised household income (compared with quintiles 3,5 combined) was 2.3 (95% CI 1.6,3.4) for the Indigenous population and 2.0 (95% CI 1.5,2.8) for the non-Indigenous population. However, Indigenous people of high SES had greater diabetes prevalence than low SES non-Indigenous people on every SES measure examined. Conclusion: Socio-economic status explains some but not all of the difference in diabetes prevalence between Indigenous and non-Indigenous Australians. Other factors that may operate across the socio-economic spectrum, such as racism, stress, loss and grief, may also be relevant and warrant further examination. Implications: Indigenous Australians do not constitute a homogeneous group with respect to socio-economic status or diabetes prevalence, and this diversity must be recognised in developing measures to redress Indigenous health disadvantage. [source]

Projecting the burden of diabetes in Australia , what is the size of the matter?

Dianna J. Magliano
Abstract Objective: To analyse the implications of using different methods to predict diabetes prevalence for the future. Approach: Different methods used to predict diabetes were compared and recommendations are made. Conclusion: We recommend that all projections take a conservative approach to diabetes prevalence prediction and present a ,base case' using the most robust, contemporary data available. We also recommend that uncertainty analyses be included in all analyses. Implications: Despite variation in assumptions and methodology used, all the published predictions demonstrate that diabetes is an escalating problem for Australia. We can safely assume that unless trends in diabetes incidence are reversed there will be at least 2 million Australian adults with diabetes by 2025. If obesity and diabetes incidence trends, continue upwards, and mortality continues to decline, up to 3 million people will have diabetes by 2025, with the figure closer to 3.5 million by 2033. The impact of this for Australia has not been measured. [source]