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Diabetes Population (diabetes + population)
Selected AbstractsDoes ethnic origin have an independent impact on hypertension and diabetic complications?DIABETES OBESITY & METABOLISM, Issue 2 2006V. Baskar Aim:, The morbidity and mortality from cardiovascular complications in diabetes reputedly differ with ethnicity. We have evaluated the prevalence of hypertension and vascular complications amongst Afro-Caribbean (AC), Caucasian (C) and Indo-Asian (IA) ethnic subgroups of a district's diabetes population to estimate the impact of ethnic origin as an independent risk variable. Methods:, Of the 6485 registered adult individuals, 6047 had ethnic data available and belonged to one of the three ethnic groups described (AC 9%, C 70% and IA 21%). Statistical analyses were performed using spss version 11.5. Results:, Results are presented as mean ± s.d. or percentage. IAs were younger (AC 63 ± 13, C 61 ± 15 and IA 57 ± 13 years), were less obese (body mass index 30 ± 8, 29 ± 9, 28 ± 6 kg/cm2) and had lower systolic blood pressure (155 ± 25, 149 ± 24, 147 ± 24 mmHg) and lower prevalence of hypertension (82%, 74% and 68%) compared with C, who had lower values than AC (all p < 0.01). Relative to C group, the AC group had higher prevalence of hypertension and microvascular complications but lower macrovascular disease burden, while the IA group had lower hypertension and macrovascular complications but with comparable microvascular disease burden [microvascular (51%, 44% and 46%; p < 0.01) and macrovascular (33%, 40% and 32%; p < 0.001)]. On logistic regression, this effect of ethnic origin on diabetic complications was found to be significant and independent of other risk variables. Conclusion:, Hypertension and diabetic complication rates were different amongst ethnic subgroups. On logistic regression, it was found that the difference in distribution of age and diabetes duration largely accounted for this difference, although ethnic origin remained an independent risk factor. [source] Trends in bed occupancy for inpatients with diabetes before and after the introduction of a diabetes inpatient specialist nurse serviceDIABETIC MEDICINE, Issue 9 2006M. J. Sampson Abstract Aims, To compare diabetes bed occupancy and inpatient length of stay, before and after the introduction of a dedicated diabetes inpatient specialist nurse (DISN) service in a large UK Hospital. Methods, We analysed bed occupancy data for medical or surgical inpatients for 6 years (1998,2004 inclusive), with a DISN service in the final 2 years. Excess bed days per diabetes patient were derived from age band, specialty, and seasonally matched data for all inpatients without diabetes. We also analysed the number of inpatients with known diabetes who did not have diabetes recorded as a discharge diagnosis. Results, There were 14 722 patients with diabetes (9.7% of all inpatients) who accounted for 101 564 occupied bed days (12.4% of total). Of these, 18 161 days (17.8%) were excess compared with matched patients without diabetes, and were concentrated in those < 75 years old. Mean excess bed days per diabetes inpatient under 60 years of age was estimated to be 1.9 days before the DISN appointment, and this was reduced to 1.2 bed days after the appointment (P = 0.03). This is equivalent to 700 bed days saved per year per 1000 inpatients with diabetes under 60 years old, with an identical saving for those aged 61,75 years (P = 0.008), a saving of 1330 diabetes bed days per year by one DISN. Excess diabetes bed occupancy was 167 excess bed days per year per 1000 patients with diabetes in the local population after the DISN appointment. One quarter of the known Type 2 diabetes population were admitted annually, but one quarter of patients had no diagnostic code for diabetes. Conclusions, Diabetes excess bed occupancy was concentrated in patients < 75 years old, and this was reduced notably following the introduction of a DISN service. [source] Persistent poor glycaemic control in adult Type 1 diabetes.DIABETIC MEDICINE, Issue 12 2004A closer look at the problem Abstract Around 25% of the adult Type 1 diabetes population is in persistent poor glycaemic control and thus at increased risk of developing microvascular complications. We here discuss correlates of long-standing poor glycaemic control and review the efficacy of clinical strategies designed to overcome persistent poor control. Only a few studies have identified determinants and correlates of long-standing poor glycaemic control in Type 1 diabetes. There is some evidence implicating genetic factors, as well as lower economic status, and psychological factors, including lack of motivation, emotional distress, depression and eating disorders. Ways of improving glycaemic control include strategies to enable self-management, e.g. motivational strategies, coping-orientated education, psychosocial therapies, and/or intensifying insulin injection therapy plus continuous subcutaneous insulin infusion. Long-standing poor glycaemic control appears to be a heterogeneous and complex phenomenon, for which there is no simple, single solution. Comprehensive psycho-medical assessment in diabetes care may prove useful in tailoring interventions. Further research is warranted, to increase our understanding how psychosocial and biomedical factors, separately and in interaction, determine poor outcomes in Type 1 diabetes. [source] Classification of renal disease status using estimated glomerular filtration rates in diabetesPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 8 2007How do the Cockcroft's & Gault's, the Modification of Diet in Renal Disease (MDRD) study equations compare? Abstract The need for the incorporation of estimated glomerular filtration rates (eGFR) in diabetes renal risk assessment is increasingly recognised but the choice of equation to use is not clear. We evaluated the differential impact of eGFR, using the Cockcroft's & Gault's (C&G) and the Modification of Diet in Renal Disease (MDRD) study equations, on the prevalence of various stages of chronic renal disease in our diabetes population. A cross sectional evaluation was conducted amongst 4548 individuals who attended our centre over an 18-month period. SPSS was utilised for statistical analysis. Of 4171 with complete data, the prevalence of individuals with eGFR >90, 90,60, 60,30 and <30ml/min/1.73m2 were 25%, 46%, 27% and 2% respectively using the C&G equation and 9%, 62%, 27% and 2% respectively using the MDRD equation. The two equations were fully concordant in their classification of eGFR rank in 65%; in 20% of the cohort, the equations were discordant but not at an arbitrary eGFR threshold of 60ml/min/1.73m2; while in 15% of the population the two equations were discordant even at the threshold of 60ml/min/1.73m2, the majority of whom had normal values of serum creatinine and urine albumin:creatinine ratio. In conclusion, the prevalence of various stages of chronic renal disease in our diabetes cohort differed depending on the eGFR equation used, potentially impacting on service provision. To aid clarity and uniformity of practice, there is a need for organisations to decide on a single equation of choice before recommending it to routine diabetes care providers. Copyright © 2007 John Wiley & Sons. [source] Assessment of childhood diabetes-related quality-of-life in West SwedenACTA PAEDIATRICA, Issue 2 2009J E Chaplin Abstract Aim: To investigate health-related quality-of-life (HrQoL) in childhood diabetes and the level of agreement between West Sweden and European reference data for the new multi-cultural European questionnaire , DISABKIDS. Method: Twenty percent of the Swedish paediatric diabetes population was included in the survey. Child-parent pairs completed the DISABKIDS chronic generic (37 questions) and diabetes modules (10 questions) during their routine clinic visit. A one-page results summary, based on positive domains, was used to provide feedback to clinicians. Results: Three hundred and sixty-one child-parent pairs were included in the analysis. In Sweden, diabetes was perceived by the children as having less impact than the European average. Swedish parents rated the HrQoL of their children lower than did the European parents. Swedish girls had a lower HrQoL than boys and greater difficulty accepting their diabetes; adolescents had greater difficulty accepting the diagnosis than younger children. Parents reported greater impact of diabetes on their children than the children themselves but reported no difference between boys and girls. Parents reported better acceptance of treatment in boys. The child's reported quality-of-life (QoL) is related to age and gender. Conclusion: Our results confirm the applicability of DISABKIDS to the Swedish paediatric diabetes population. [source] Islet autoantibodies in cord blood: maternal, fetal, or neither?DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 1 2002Marian Rewers Abstract In high-risk type 1 diabetes populations, up to 3% of the general population newborns may express islet autoantibodies in cord blood and the vast majority of those appear to be maternal autoantibodies that disappear usually before the age of 9 months. Despite recent progress in standardization of autoantibody assays, some of the findings appear to be artifacts or non-IgG-mediated binding phenomena. It remains unclear whether transplacentally transmitted maternal autoantibodies play any role in protecting the offspring of diabetic women from diabetes. The evidence for fetal production of islet autoantibodies is very limited and remains to be validated in large prospective studies currently underway. Copyright © 2002 John Wiley & Sons, Ltd. [source] C-peptide microheterogeneity in type 2 diabetes populationsPROTEOMICS - CLINICAL APPLICATIONS, Issue 1 2010Paul E. Oran Abstract Purpose: The purpose of this study was to investigate naturally occurring C-peptide microheterogeneity in healthy and type 2 diabetes (T2D) populations. Experimental design: MS immunoassays capable of simultaneously detecting intact C-peptide and variant forms were applied to plasma samples from 48 healthy individuals and 48 individuals diagnosed with T2D. Results: Common throughout the entire sample set were three previously unreported variations of C-peptide. The relative contribution of one variant, subsequently identified as C-peptide (3-31), was found to be more abundant in the T2D population as compared to the healthy population. Dipeptidyl peptidase IV is suspected to be responsible for this particular cleavage product, which is consistent with the pathophysiology of T2D. Conclusions and clinical relevance: C-peptide does not exist in the human body as a single molecular species. It is qualitatively more heterogeneous than previously thought. These results lay a foundation for future studies devoted to a comprehensive understanding of C-peptide and its variants in healthy and diabetic populations. [source] | ||||||||||