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Topical Collection "Health Care and Diabetes"

Editor

Guest Editor
Dr. Omorogieva Ojo

Faculty of Education and Health, University of Greenwich, Avery Hill Campus, Avery Hill Road, London. SE9 2UG, UK
Website | E-Mail
Fax: +44(0)20 8331 8060
Interests: diabetes, structured education in diabetes for ethnic minorities, evaluation of the glycaemic index of some carbohydrate rich ethnic minority foods in the uk, clinical nutrition, enteral tube feeding in the community, multi-morbidity

Topical Collection Information

Dear Colleagues,

A Topical Collection on health care and diabetes, in the International Journal of Environmental Research and Public Health, is being organized. For detailed information on the journal, I refer you to http://www.mdpi.com/journal/ijerph.
According to the World Health Organisation (WHO, 2015), 347 million people are currently living with diabetes worldwide. This number is expected to rise to 592 million by 2035, with the number of people with type 2 diabetes increasing in every country (International Diabetes Federation, 2015). As a result, the problem of diabetes has drawn interest from different strata of health care provisions, including primary, secondary, tertiary care and public health.
Researchers and practitioners in this field have also been looking at advances in diabetes care and management, including diagnosis, prevention, treatment and multi-morbidity. Developing strategies for reducing the risk factors, which predispose the population to diabetes, the acute and long term complications, and understanding the cost of diabetes in terms of health expenditure are crucial in decreasing the full impact of the condition.
This Topical Collection is open to the subject area of health care and diabetes. The keywords listed below provide an outline of some of the possible areas of interest.

Dr. Omorogieva Ojo
Collection Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

• recent advances in diagnosis
• prevention
• treatment
• acute complications
• long term complications
• living with diabetes
• epidemiology
• multi-morbidity
• pregnancy and diabetes
• structured education
• cost of diabetes
• risk factors
• elderly and diabetes
• health care settings
• experience and perception (patients, carers, and practitioners)
• diabetes training

Published Papers (33 papers)

2017

Jump to: 2016, 2015

Open AccessArticle Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus
Int. J. Environ. Res. Public Health 2017, 14(9), 1073; doi:10.3390/ijerph14091073
Received: 31 August 2017 / Revised: 11 September 2017 / Accepted: 14 September 2017 / Published: 16 September 2017
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Abstract
An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index,
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An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes. Full article
Open AccessArticle Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes
Int. J. Environ. Res. Public Health 2017, 14(9), 1074; doi:10.3390/ijerph14091074
Received: 15 August 2017 / Revised: 9 September 2017 / Accepted: 13 September 2017 / Published: 16 September 2017
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Abstract
American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and
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American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients. Full article
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2016

Jump to: 2017, 2015

Open AccessArticle Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes
Int. J. Environ. Res. Public Health 2016, 13(11), 1103; doi:10.3390/ijerph13111103
Received: 24 May 2016 / Revised: 15 October 2016 / Accepted: 30 October 2016 / Published: 8 November 2016
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Abstract
Peripheral arterial disease (PAD) belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI). The purpose of this research was to determine independent factors of changes of ABI in elderly
[...] Read more.
Peripheral arterial disease (PAD) belongs to the commonly-occurring pathologies associated with elderly age. A simple tool for defining the severity of PAD is the ankle-brachial index (ABI). The purpose of this research was to determine independent factors of changes of ABI in elderly patients with occlusive PAD disease (PAOD) with and without diabetes. The research was carried out on 49 elderly patients with PAOD, including 29 patients with type 2 diabetes, and 20 patients without diabetes. The concentration of interleukin-6 (IL-6), E-selectin, fibrinogen, and C-reactive protein (CRP) in the blood serum was marked. In all patients, the independent factors of changes of ABI were determined with the use of the multiple logistic regression analysis. Our results show that in the group of patients with PAOD suffering from diabetes, it was demonstrated that the ABI was related to age, the duration of the symptoms of PAD, body mass index (BMI), low-density lipoprotein cholesterol, fibrinogen, and sex (determination coefficient R2 = 0.699). In patients with PAOD without diabetes, the ABI was related to age, the duration of the symptoms of PAD, the levels of CRP, E-selectin, high-density lipoprotein cholesterol, and the glomerular filtration rate(determination coefficient R2 = 0.844). We conclude that in elderly patients with PAOD with and without diabetes, the participation of independent factors related to the ABI is diversified; in patients with diabetes, the concentration of IL-6 and fibrinogen is lower, and the concentration of E-selectin is higher than in patients without diabetes. Full article
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Open AccessArticle Non-Obese Diabetes and Its Associated Factors in an Underdeveloped Area of South China, Guangxi
Int. J. Environ. Res. Public Health 2016, 13(10), 976; doi:10.3390/ijerph13100976
Received: 27 July 2016 / Revised: 6 September 2016 / Accepted: 20 September 2016 / Published: 30 September 2016
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Abstract
Background: Little research has been conducted on the prevalence of diabetes mellitus in underdeveloped areas in China, especially stratified into obesity and non-obese diabetes. The aim of the present study was to investigate the prevalence and associated factors of non-obese diabetes in an
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Background: Little research has been conducted on the prevalence of diabetes mellitus in underdeveloped areas in China, especially stratified into obesity and non-obese diabetes. The aim of the present study was to investigate the prevalence and associated factors of non-obese diabetes in an underdeveloped area in South China, Guangxi. Methods: Data derived from the Chinese Health and Nutrition Survey 2010–2012 involved a sample of 3874 adults from Guangxi. Questionnaires and oral glucose-tolerance tests were conducted, and fasting and 2-h glucose levels and serum lipids were measured. Logistic regression analysis was performed to assess associated factors for non-obese diabetes. Results: 68.2% and 62.2% of instances of newly detected diabetes were those of non-obese diabetes based on BMI (NODB) and based on WC (NODW), respectively. The male sex, an age older than 50 years, lower education, hypertension, and hypertriglyceridemia were significantly associated with a higher risk of both NODB and NODW, while some associated factors for NODB were found different from those associated with NODW, and an interaction effect was found to increase the risk of NODW. Conclusions: Our study indicated that non-obese diabetes was highly prevalent in an underdeveloped area of South China. Non-obese diabetes should be considered for increased public attention in these areas. Full article
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Open AccessReview The Use of Exenatide in Managing Markers of Cardiovascular Risk in Patients with Type 2 Diabetes: A Systematic Review
Int. J. Environ. Res. Public Health 2016, 13(10), 941; doi:10.3390/ijerph13100941
Received: 18 June 2016 / Revised: 3 September 2016 / Accepted: 20 September 2016 / Published: 23 September 2016
Cited by 1 | PDF Full-text (292 KB) | HTML Full-text | XML Full-text
Abstract
Objective: This review examines the use of exenatide twice daily in managing changes in markers of cardiovascular risk in patients with type 2 diabetes. Background: Type 2 diabetes is a progressive metabolic disorder, which results from defects in insulin secretion and/or
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Objective: This review examines the use of exenatide twice daily in managing changes in markers of cardiovascular risk in patients with type 2 diabetes. Background: Type 2 diabetes is a progressive metabolic disorder, which results from defects in insulin secretion and/or insulin action leading to chronic hyperglycaemia and associated cardiovascular complications. Despite the use of diet, exercise, oral antihyperglycaemic agents and insulin, the progressive nature of the condition means that the levels of the preventive and treatment measures would have to be increased and/or new therapies have to be developed in order to address the long term impact of type 2 diabetes. The advent of exenatide, a glucagon-like peptide-1 receptor agonist provides a useful basis for managing type 2 diabetes and related cardiovascular complications without the side effects of regular diabetes therapies. However, exenatide twice daily is often used in combination with other therapies, although the mechanism of exenatide in managing diabetes and and associated cardiovascular risks and complications remain complex and still evolving. Method: A range of databases including EBSCOhost online research database were used to access articles based on PICO (Population, Interventions, Comparative Interventions, Outcomes) framework and Boolean operators. Results: Eleven randomised controlled studies which met the inclusion criteria were selected for this review. Nine of the eleven studies showed significant decrease in body weight among participants in the exenatide group compared with placebo or control group while the other two studies did not report statistically significant differences in body weight. In adition, all the studies showed statistically significant decrease in glycated haemoglobin (HbA1c) in the exenatide group compared to controls except in one study. In the present review, the seven studies, which looked at the effect of exenatide twice daily on lipid profile, did not find any significant difference between the exenatide group and the control group except for High density lipoprotein-cholesterol in two of the studies. However, statistically significant decrease was observed between exenatide group and controls with respect to blood pressure (systolic and/or diastolic) in these studies. Discussion: It would appear that exenatide is more effective in reducing body weight in patients with type 2 diabetes when used in combination with metformin than when used alone or in combination with thiazolidinedione. The findings of this review would suggest that exenatide twice daily may be useful in managing cardiovascular risks and complications by reducing body weight, HbA1c and blood pressure. Full article
Open AccessArticle The Effects of Intensive Nutrition Education on Late Middle-Aged Adults with Type 2 Diabetes
Int. J. Environ. Res. Public Health 2016, 13(9), 897; doi:10.3390/ijerph13090897
Received: 1 July 2016 / Revised: 29 August 2016 / Accepted: 5 September 2016 / Published: 8 September 2016
Cited by 1 | PDF Full-text (588 KB) | HTML Full-text | XML Full-text
Abstract
Objective: Many patients with type 2 diabetes find it difficult to maintain good glycemic control. Undesirable glycemic control occurs greatly due to deficiencies of nutritional knowledge and difficulty in obtaining dietary prescriptions. The late middle-aged and elder individuals are the main populations
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Objective: Many patients with type 2 diabetes find it difficult to maintain good glycemic control. Undesirable glycemic control occurs greatly due to deficiencies of nutritional knowledge and difficulty in obtaining dietary prescriptions. The late middle-aged and elder individuals are the main populations that are affected by type 2 diabetes. The main purpose of this study was to investigate whether intensive nutrition education would make benefits for late middle-aged patients with type 2 diabetes. Method: 196 patients between 50 to 65 years old meeting type 2 diabetes criteria and eligible for the program were included in a single-blinded, 30-day centralized management of an education program in China. Participants in the program were randomly divided into a usual nutrition education group or an intensive nutrition education group. The usual nutrition education group was used as a control group and received only basic health advice and principles of diabetic diets at the beginning and the end of the study. Participants in the intensive nutrition education group were arranged to receive intensive nutritional lectures about diabetes for 30 days. The primary outcomes were the changes in weight, body mass index (BMI), fasting plasma glucose (FPG), 2-h postprandial plasma glucose (PG), glycosylated hemoglobin (HbA1c), total glycerin (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c). Results: After 30 days of intervention, FPG, PG, and HbA1c in the treatment group decreased significantly than the control group (p < 0.05). HbA1c reduced significantly by 0.6% in the intervention group. No significant differences in the change of blood lipids were observed between groups. However, TG, TC, and HDL-c made improvements compared with the baseline in the experimental group. Both groups had a reduction in weight and BMI within groups, especially in intensive nutrition education group. However, there was no statistical significance between groups. Conclusions: Intensive nutrition education has significant effects on blood glucose control in late middle-aged adults with type 2 diabetes. Intensive education can cultivate good diet habits and increase physical activity, which are important for diabetes patients in the short and long terms. These findings may contribute to improving education methodology and nutrition therapy in patients with type 2 diabetes. Full article
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Open AccessArticle Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes
Int. J. Environ. Res. Public Health 2016, 13(9), 870; doi:10.3390/ijerph13090870
Received: 29 April 2016 / Revised: 9 August 2016 / Accepted: 23 August 2016 / Published: 1 September 2016
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Abstract
Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation.
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Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. Full article
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Open AccessReview Evaluation of the Accuracy of Capillary Hydroxybutyrate Measurement Compared with Other Measurements in the Diagnosis of Diabetic Ketoacidosis: A Systematic Review
Int. J. Environ. Res. Public Health 2016, 13(9), 837; doi:10.3390/ijerph13090837
Received: 18 June 2016 / Revised: 13 August 2016 / Accepted: 17 August 2016 / Published: 23 August 2016
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Abstract
A complication of diabetes is diabetic ketoacidosis (DKA), which if left untreated is a life threatening condition. Prompt and accurate diagnosis of DKA is required for the commencement of life saving interventions. Measurements of ketone bodies in DKA have usually been through nitroprusside
[...] Read more.
A complication of diabetes is diabetic ketoacidosis (DKA), which if left untreated is a life threatening condition. Prompt and accurate diagnosis of DKA is required for the commencement of life saving interventions. Measurements of ketone bodies in DKA have usually been through nitroprusside urine acetoacetate testing. The aim of this systematic review was to examine whether capillary β-hydroxybutyrate (β-OHB) testing is more accurate compared to other diagnostic methods of DKA. The following electronic databases were searched: EBSCO Host, MEDLINE, PSYCHInfo, CINAHL and Science Direct for publications from 1 January 2005 and up to and including 1 January 2016. Inclusion criteria were: Adults 18 years and over and known type 1 or type 2 diabetes. Retrospective and prospective observation studies were included. A total of nine studies met the inclusion criteria. Capillary β-OHB was found to have high sensitivity, specificity, positive predictive value and negative predictive value in identifying DKA compared to urinary ketone testing. Full article
Open AccessArticle Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus
Int. J. Environ. Res. Public Health 2016, 13(8), 836; doi:10.3390/ijerph13080836
Received: 8 June 2016 / Revised: 15 August 2016 / Accepted: 18 August 2016 / Published: 22 August 2016
Cited by 2 | PDF Full-text (301 KB) | HTML Full-text | XML Full-text
Abstract
This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation
[...] Read more.
This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman’s correlation coefficient (rs). The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51)) and self-perceived health (excellent (6.5%), very good (42.3%), good (38.7%), fair (11.3%) and poor (1.2%)). Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7)) and sense of coherence (SOC-13: 68.9 (9.7), moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8)) and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9)). A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = −0.41, p < 0.0001) and well-being (rs = 0.34, p < 0.0001) as well as negative correlations with diabetes distress (rs = −0.51, p < 0.0001) and hypoglycemia worries (rs = −0.27, p = 0.0009). Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales “goal achievement” in SWE-DES (p = 0.0028) and “comprehensibility” in SOC (p = 0.016). Well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this. Full article
Open AccessArticle Prevalence of Pre-Diabetes and Its Associated Risk Factors in Rural Areas of Ningbo, China
Int. J. Environ. Res. Public Health 2016, 13(8), 808; doi:10.3390/ijerph13080808
Received: 20 May 2016 / Revised: 4 August 2016 / Accepted: 5 August 2016 / Published: 10 August 2016
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Abstract
Objective: The aims of the study were to investigate the prevalence of pre-diabetes and explore its associated risk factors in rural areas of Ningbo, China. Methods: A cross-sectional survey was conducted with 4583 adult residents in rural areas of Ningbo, China
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Objective: The aims of the study were to investigate the prevalence of pre-diabetes and explore its associated risk factors in rural areas of Ningbo, China. Methods: A cross-sectional survey was conducted with 4583 adult residents in rural areas of Ningbo, China between March and May 2013. The survey used a multi-stage, stratified, cluster sampling method. Data collected included demographics and medical history, anthropometric measurements, blood pressure, blood lipid, and plasma glucose. After at least 10 h of overnight fasting, participants underwent an oral glucose tolerance test (OGTT) to identify pre-diabetes. Univariate and multivariate logistic regression analyses were used to evaluate the associated risk factors for pre-diabetes, and to estimate the effect of interaction between the factors. Results: There were 1307 survey participants having pre-diabetes (28.52%) and the age-standardized prevalence was 30.53%. Multivariate logistic regression results showed that overweight/obesity, hypertension, and higher triglycerides were the risk factors for developing pre-diabetes. There were positive interactions between overweight/obesity and triglycerides, and also between hypertension and triglycerides on the multiplicative scale, suggesting that they synergistically influenced the development of pre-diabetes. Conclusions: The rural areas in Ningbo had a high prevalence of pre-diabetes. Overweight and obesity, hypertension, and elevated triglycerides were the major risk factors. There is a need of early intervention for preventing pre-diabetes. Full article
Open AccessArticle Expression of Hepcidin and Ferroportin in the Placenta, and Ferritin and Transferrin Receptor 1 Levels in Maternal and Umbilical Cord Blood in Pregnant Women with and without Gestational Diabetes
Int. J. Environ. Res. Public Health 2016, 13(8), 766; doi:10.3390/ijerph13080766
Received: 13 April 2016 / Revised: 5 July 2016 / Accepted: 19 July 2016 / Published: 28 July 2016
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Abstract
Background: Regulation of iron transfer from mother to fetus via the placenta is not fully understood and the relationship between stored iron status in the mothers’ serum and gestational diabetes (GDM) in case–control studies is controversial. The present study aimed to detect
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Background: Regulation of iron transfer from mother to fetus via the placenta is not fully understood and the relationship between stored iron status in the mothers’ serum and gestational diabetes (GDM) in case–control studies is controversial. The present study aimed to detect circulating soluble transferrin receptor (sTfR) and ferritin levels in maternal and umbilical cord blood. We also examined the expression of hepcidin (Hep), transferrin receptor (TfR1), and ferroportin (FPN) in the placenta in pregnant women with and without GDM at full term. Methods: Eighty-two women participated (42 with GDM and 40 without GDM [controls]). Maternal samples were collected at 37–39 weeks’ gestation. Umbilical cord blood was collected at birth. Ferritin and sTfR levels in maternal serum and umbilical cord blood, and Hep, TfR1, and FPN protein expression in plac enta were compared between the GDM and non-GDM groups. Serum ferritin (SF) was measured by electrochemiluminescence assay and sTfR was measured by ELISA. Hep, TfR1, and FPN expression was measured by immunohistochemistry. Results: Maternal serum sTfR levels were significantly elevated in the GDM group compared with the non-GDM group (p = 0.003). SF levels in cord blood in the GDM group were significantly higher than those in the non-GDM group (p = 0.003). However, maternal hemoglobin and SF, and umbilical cord sTfR levels were not different between the groups. In placental tissue, FPN expression was higher and hepcidin expression was lower in the GDM group compared with the non-GDM group (p = 0.000 and p = 0.044, respectively). There was no significant difference in TfR1 between the groups (p = 0.898). Conclusions: Women with GDM transport iron more actively than those without GDM at term pregnancy. Maternal iron metabolism in GDM may play a role in fetal/placental iron demand and in the overall outcome of pregnancy. Full article
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Open AccessArticle Multilevel Analysis of Socioeconomic Determinants on Diabetes Prevalence, Awareness, Treatment and Self-Management in Ethnic Minorities of Yunnan Province, China
Int. J. Environ. Res. Public Health 2016, 13(8), 751; doi:10.3390/ijerph13080751
Received: 16 April 2016 / Revised: 14 July 2016 / Accepted: 19 July 2016 / Published: 25 July 2016
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Abstract
Objectives: The objective of this manuscript is to investigate socioeconomic differences in prevalence, awareness, treatment and self-management of diabetes among ethnic minority groups in Yunnan Province, China. Methods: We conducted a cross-sectional survey in a sample of 5532 Na Xi, Li
[...] Read more.
Objectives: The objective of this manuscript is to investigate socioeconomic differences in prevalence, awareness, treatment and self-management of diabetes among ethnic minority groups in Yunnan Province, China. Methods: We conducted a cross-sectional survey in a sample of 5532 Na Xi, Li Su, Dai and Jing Po ethnic minorities. Multilevel modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes prevalence, as well as the other outcomes. Results: Higher individual educational level was associated with a higher rate of awareness, treatment, adherence to medicines and monitoring of blood glucose (OR = 1.87, 4.89, 4.83, 6.45; 95% CI: 1.26–2.77, 1.87–12.7, 1.95–11.9, 2.23–18.6, respectively). Diabetic respondents with better household assets tended to receive more treatment (OR = 2.81, 95% CI: 1.11–7.12) and to monitor their blood glucose (OR = 3.29, 95% CI: 1.48–7.30). Diabetic patients with better access to medical services were more likely to treat (OR = 7.09, 95% CI: 2.46–20.4) and adhere to medication (OR = 4.14, 95% CI: 1.46–11.7). Income at the contextual level was significantly correlated with diabetes prevalence, treatment and blood glucose monitoring (OR = 1.84, 3.04, 4.34; 95% CI: 1.20–2.83, 1.20–7.73, 1.45–13.0, respectively). Conclusions: Future diabetes prevention and intervention programs should take both individual and township-level socioeconomic factors into account in the study regions. Full article
Open AccessArticle Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2016, 13(7), 628; doi:10.3390/ijerph13070628
Received: 20 April 2016 / Revised: 13 June 2016 / Accepted: 20 June 2016 / Published: 23 June 2016
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Abstract
Background: Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Methods: Data came from the first health service household interview of
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Background: Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Methods: Data came from the first health service household interview of Hunan province, China, in 2013. A Rao–Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. Results: In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45–64 years, 46%; 18–44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1–3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7–6.5) for young adults aged 18–44 years. The associations were not statistically significant for age groups 45–64 years and 65 years or older. Conclusion: The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey. Full article
Open AccessArticle Association between IGF2BP2 Polymorphisms and Type 2 Diabetes Mellitus: A Case–Control Study and Meta-Analysis
Int. J. Environ. Res. Public Health 2016, 13(6), 574; doi:10.3390/ijerph13060574
Received: 20 February 2016 / Revised: 26 May 2016 / Accepted: 1 June 2016 / Published: 9 June 2016
Cited by 2 | PDF Full-text (530 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: Genome-wide association studies (GWAS) found that IGF2BP2 rs4402960 and rs1470579 polymorphisms were associated with type 2 diabetes mellitus (T2DM) risk. Many studies have replicated this association, but yielded inconsistent results. Materials and Methods: A case-control study consisting of 461 T2DM patients and
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Background: Genome-wide association studies (GWAS) found that IGF2BP2 rs4402960 and rs1470579 polymorphisms were associated with type 2 diabetes mellitus (T2DM) risk. Many studies have replicated this association, but yielded inconsistent results. Materials and Methods: A case-control study consisting of 461 T2DM patients and 434 health controls was conducted to detect the genetic susceptibility of IGF2BP2 in a northern Han Chinese population. A meta-analysis was to evaluate the association more precisely in Asians. Results: In the case-control study, the carriers of TT genotype at rs4402960 had a higher T2DM risk than the G carriers (TG + GG) (adjusted odd ratio (AOR) = 1.962, 95% confidence interval (95% CI) = 1.065–3.612, p = 0.031]; CC carriers at rs1470579 were more susceptible to T2DM than A carriers (CA + AA) (AOR = 2.014, 95% CI = 1.114–3.642, p = 0.021). The meta-analysis containing 36 studies demonstrated that the two polymorphisms were associated with T2DM under the allele comparison, genetic models of dominant and recessive in Asians (p < 0.05). The rs4402960 polymorphisms were significantly associated with the T2DM risk after stratification by diagnostic criterion, size of sample and average age and BMI of cases, while there’re no consistent results for rs1470579. Conclusions: Our data suggests that IGF2BP2 polymorphisms are associated with T2DM in Asian populations. Full article
Open AccessArticle Situation of Diabetes and Related Disease Surveillance in Rural Areas of Jilin Province, Northeast China
Int. J. Environ. Res. Public Health 2016, 13(6), 538; doi:10.3390/ijerph13060538
Received: 15 March 2016 / Revised: 18 May 2016 / Accepted: 23 May 2016 / Published: 27 May 2016
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Abstract
Background: Several studies have investigated the prevalence and awareness of diabetes mellitus (DM) in China, but little is known about the situation of DM in the northeastern rural areas. Our present study investigated the prevalence, awareness and associated characteristics of DM in rural
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Background: Several studies have investigated the prevalence and awareness of diabetes mellitus (DM) in China, but little is known about the situation of DM in the northeastern rural areas. Our present study investigated the prevalence, awareness and associated characteristics of DM in rural areas of Jilin Province, aiming to suggest more efforts for the prevention and control of DM. Methods: A multistage stratified random cluster sampling design was used in this cross-sectional study which took place in 2012. Data were collected by face-to-face interviews and physical examinations. Rao-Scott Chi-square test, t test and multivariate logistic regression analysis were used. Results: The estimated prevalence of DM in rural areas of Jilin province was 7.2%. DM was positively associated with age, Body mass index (BMI), hypotension, dyslipidemia and was high in participants with a family history of diabetes and those who exercise frequently, but low for high education level and married participants. 69.0% participants with DM were aware of their diabetes status, 88.2% of whom received treatment and 34.4% of whom had received treatment controlled their DM status. Conclusions: We observed a high prevalence and low awareness status of DM among the rural residents in Jilin Province, but the rate of effective control in those who have received treatment was considerable. The low rate of disease surveillance should draw health authority’s attention. Full article
Open AccessArticle Preconceptional Iron Intake and Gestational Diabetes Mellitus
Int. J. Environ. Res. Public Health 2016, 13(6), 525; doi:10.3390/ijerph13060525
Received: 15 March 2016 / Revised: 9 May 2016 / Accepted: 16 May 2016 / Published: 24 May 2016
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Abstract
Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008
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Our objective was to assess the impact of preconceptional heme and non-heme iron on gestational diabetes mellitius (GDM) in the Boston University Slone Epidemiology Birth Defects Study (BDS). This retrospective cohort analysis included 7229 participants enrolled in the BDS between 1998 and 2008 who gave birth to non-malformed infants and were free of pre-existing diabetes. All data were collected through structured interviews conducted within 6 months of delivery. Calorie-adjusted and multivariable odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. Preconceptional dietary heme iron was modestly associated with an elevated risk of GDM among those (multivariable OR comparing the fifth quintile to the first: 1.55; 95% CI 0.98, 2.46). Conversely, preconceptional dietary non-heme iron was associated with a decreased risk of GDM among those in the fifth quintile of intake compared to the first (multivariable OR: 0.48; 95% CI 0.28, 0.81). Women who consumed supplemental iron during preconception also had a decreased risk of GDM (multivariable OR: 0.78; 95% CI 0.60, 1.02). In conclusion, our data support a positive association between preconceptional heme iron intake and GDM and an inverse association between preconceptional non-heme iron intake from foods and preconceptional intake from supplements. Full article
Open AccessArticle Prevalence, Awareness, Treatment and Control of Diabetes Mellitus—A Population Based Study in Shanghai, China
Int. J. Environ. Res. Public Health 2016, 13(5), 512; doi:10.3390/ijerph13050512
Received: 16 March 2016 / Revised: 27 April 2016 / Accepted: 9 May 2016 / Published: 19 May 2016
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Abstract
In this study, we aimed to investigate the prevalence, awareness, treatment, and control of diabetes in Shanghai, China. A sample of 3600 residents aged from 18 to 80 years selected by a randomized stratified multiple-stage sampling method in Shanghai was investigated, with blood
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In this study, we aimed to investigate the prevalence, awareness, treatment, and control of diabetes in Shanghai, China. A sample of 3600 residents aged from 18 to 80 years selected by a randomized stratified multiple-stage sampling method in Shanghai was investigated, with blood samples collected. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L, or glycated haemoglobin (HbA1c) ≥ 6.5% (48 mmol/mol), or previous diagnosis by a physician. Adequate control of diabetes was taken as a level of HbA1c < 7.0% (53 mmol/mol) among people with treated diabetes. Multivariable regression analysis was used to explore associated factors for diabetes and prediabetes. In the 3136 participants suitable for analysis, the prevalences of diabetes, prediabetes, and previously diagnosed diabetes were 15.91%, 37.37%, and 4.46%, respectively. Among those with diabetes, only 28.06% were aware of their condition, 25.85% were currently undergoing medication treatment, and 12.42% achieved glycaemic control. Logistic regression showed that old age, preobesity, obesity, elevated triglyceride (TG), elevated C-reactive protein (CRP), and lower education level were associated with an increased risk of diabetes; old age, obesity, elevated TG, and elevated low-density lipoprotein (LDL) were associated with an increased risk of prediabetes, while male sex and rural residence were associated with a decreased risk of prediabetes. In summary, the state of diabetes in China is alarming; the rates of awareness, treatment, and control were relatively low. More efforts should be made to promote the prevention and control of diabetes in china. Full article
Open AccessArticle Brazilian Green Propolis Improves Antioxidant Function in Patients with Type 2 Diabetes Mellitus
Int. J. Environ. Res. Public Health 2016, 13(5), 498; doi:10.3390/ijerph13050498
Received: 23 March 2016 / Revised: 27 April 2016 / Accepted: 9 May 2016 / Published: 13 May 2016
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Abstract
Propolis contains a variety of bioactive components and possesses many biological properties. This study was designed to evaluate potential effects of Brazilian green propolis on glucose metabolism and antioxidant function in patients with type 2 diabetes mellitus (T2DM). In the 18-week randomized controlled
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Propolis contains a variety of bioactive components and possesses many biological properties. This study was designed to evaluate potential effects of Brazilian green propolis on glucose metabolism and antioxidant function in patients with type 2 diabetes mellitus (T2DM). In the 18-week randomized controlled study, enrolled patients with T2DM were randomly assigned to Brazilian green propolis group (900 mg/day) (n = 32) and control group (n = 33). At the end of the study, no significant difference was found in serum glucose, glycosylated hemoglobin, insulin, aldose reductase or adiponectin between the two groups. However, serum GSH and total polyphenols were significantly increased, and serum carbonyls and lactate dehydrogenase activity were significantly reduced in the Brazilian green propolis group. Serum TNF-α was significantly decreased, whereas serum IL-1β and IL-6 were significantly increased in the Brazilian green propolis group. It is concluded that Brazilian green propolis is effective in improving antioxidant function in T2DM patients. Full article
Open AccessArticle Hospitalisation Resulting from Medicine-Related Problems in Adult Patients with Cardiovascular Diseases and Diabetes in the United Kingdom and Saudi Arabia
Int. J. Environ. Res. Public Health 2016, 13(5), 479; doi:10.3390/ijerph13050479
Received: 28 February 2016 / Revised: 13 April 2016 / Accepted: 3 May 2016 / Published: 9 May 2016
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Abstract
Cardiovascular diseases (CVDs) and diabetes (DM) are two interrelated conditions that have a heavy morbidity and mortality burden worldwide. Patients with the two conditions usually take multiple medicines and thus are more susceptible to medicine-related problems (MRPs). MRPs can occur at any stage
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Cardiovascular diseases (CVDs) and diabetes (DM) are two interrelated conditions that have a heavy morbidity and mortality burden worldwide. Patients with the two conditions usually take multiple medicines and thus are more susceptible to medicine-related problems (MRPs). MRPs can occur at any stage of the treatment process and in many cases can lead to unplanned hospitalisations. The aim of the study was to determine the prevalence of hospitalisation resulting from MRPs in adult patients with CVDs and/or DM and to identify the main causes, risk factors, and medicine classes involved. A retrospective study included 300 adult patients from two hospitals, one in the United Kingdom and one in Saudi Arabia. To identify MRPs, medical records were reviewed for demographic data, clinical data, laboratory assay, and prescription records. A total of 197 (65.7%) patients had MRPs, of which less than 10% were severe. The main problems were lack of treatment effectiveness and adverse drug reactions. Moreover, polypharmacy and patient non-adherence were the main risk factors contributing to MRPs. The main medicine classes associated with MRPs were insulin and antihypertensive medicines. Further research should address the pharmaceutical care processes employed in treating CVDs and DM, and to empower patients/healthcare providers in tackling MRPs. Full article
Open AccessArticle Protective Action of Carica papaya on β-Cells in Streptozotocin-Induced Diabetic Rats
Int. J. Environ. Res. Public Health 2016, 13(5), 446; doi:10.3390/ijerph13050446
Received: 21 February 2016 / Revised: 11 April 2016 / Accepted: 19 April 2016 / Published: 27 April 2016
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Abstract
The aim of the present study was to investigate the effect of C. papaya L. leaf extract (CPLE) on pancreatic islets in streptozotocin (STZ)-induced diabetic rats, as well as on cultured normal pancreatic cells with STZ in the medium. CPLE (3–125 mg/Kg) was
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The aim of the present study was to investigate the effect of C. papaya L. leaf extract (CPLE) on pancreatic islets in streptozotocin (STZ)-induced diabetic rats, as well as on cultured normal pancreatic cells with STZ in the medium. CPLE (3–125 mg/Kg) was administered orally for 20 days, while a group of diabetic rats received 5 IU/Kg/day of insulin. At the end of the treatment the rats were sacrificed. Blood was obtained to assess glucose and insulin levels. The pancreas was dissected to evaluate β cells by immunohistochemistry. In addition, normal pancreatic cells were cultured in a medium that included CPLE (3–12 mg). One half of the cultured cells received simultaneously CPLE and STZ (6 mg), while the other half received CPLE and five days later the STZ. After three days of incubation, insulin was assayed in the incubation medium. The CPLE administered to diabetic rats improved the fasting glycemia and preserved the number and structure of pancreatic islets. However, when CPLE was added to pancreatic cells in culture along with STZ, the insulin concentration was higher in comparison with the cells that only received STZ. In conclusion, the CPLE preserves the integrity of pancreatic islets, improves the basal insulin secretion and protects cultured cells from the adverse effects of STZ. Full article
Open AccessArticle Analysis of Blood Glucose Distribution Characteristics and Its Risk Factors among a Health Examination Population in Wuhu (China)
Int. J. Environ. Res. Public Health 2016, 13(4), 392; doi:10.3390/ijerph13040392
Received: 22 January 2016 / Revised: 18 March 2016 / Accepted: 28 March 2016 / Published: 31 March 2016
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Abstract
Background: Diabetes mellitus (DM) and Impaired Fasting Glucose (IFG) represent serious threats to human health, and as a result, this study was aimed at understanding the blood glucose distribution characteristics and the risk factors among a large health examination population in China.
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Background: Diabetes mellitus (DM) and Impaired Fasting Glucose (IFG) represent serious threats to human health, and as a result, this study was aimed at understanding the blood glucose distribution characteristics and the risk factors among a large health examination population in China. Methods: An investigation with physical and biochemical examinations and questionnaires was conducted in the physical examination center from 2011 to 2014 and as a result 175,122 physical examination attendees were enrolled in this study. Multivariate logistic regression was used to explore the factors influencing blood sugar levels. Results: The rates of IFG and DM were 6.0% and 3.8%. Prevalence were 7.6%/5.1% in males and 5.1%/2.8% in females for IFG and DM, respectively. The prevalence of IFG and DM were thus higher in males than in females. In the normal group, except high density lipoprotein (HDL) that was significantly higher than in the IFG and DM group, the other indexes (age, body mass index (BMI), glucose (Glu), total cholesterol (TC) and total glycerides (TG) were lower than those in the IFG and DM group. The proportion of IFG and DM also increased with the increases in proportion of abnormal blood pressure, smoking and alcohol consumption. Multivariate logistic regression analysis showed that increasing age, high BMI, high TC, high TG and low HDL increased the risk of diabetes, while in males, in addition to the above factors, the smoking and drinking factors also increased the risk of diabetes. After the age of 65, the blood glucose level reached a peak in males, while in females, the increasing trends was on the rise. The inflexion age of the fast rise was younger in males than in females. Conclusion: The study population showed a high prevalence of DM and IFG among the adults. Regular physical examination for the early detection of diabetes is recommended in the high-risk population. Full article
Open AccessArticle Polymorphisms in Four Genes (KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963) and Their Correlation with Type 2 Diabetes Mellitus in Han Chinese in Henan Province, China
Int. J. Environ. Res. Public Health 2016, 13(3), 260; doi:10.3390/ijerph13030260
Received: 15 September 2015 / Revised: 24 January 2016 / Accepted: 16 February 2016 / Published: 26 February 2016
Cited by 2 | PDF Full-text (984 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Genetic variants at KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963 have been associated with type 2 diabetes mellitus (T2DM), but the results are contradictory in Chinese populations. The aim of the present study was to investigate the association of these four
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Genetic variants at KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963 have been associated with type 2 diabetes mellitus (T2DM), but the results are contradictory in Chinese populations. The aim of the present study was to investigate the association of these four SNPs with T2DM in a large population of Han Chinese at Henan province, China. Seven-hundred-thirty-six patients with T2DM (cases) and Seven-hundred-sixty-eight healthy glucose-tolerant controls were genotyped for KCNQ1 rs151290, KLF14 rs972283, GCKR rs780094 and MTNR1B rs10830963. The association of genetic variants in these four genes with T2DM was analyzed using multivariate logistic regression. Genotypes and allele distributions of KCNQ1 rs151290 were significantly different between the cases and controls (p < 0.05). The AC and CC genotypes and the combined AC + CC genotype of rs151290 in KCNQ1 were associated with increases risk of T2DM before (OR = 1.482, 95% CI = 1.062–2.069; p = 0.021; OR = 1.544, 95% CI = 1.097–2.172, p = 0.013; and OR = 1.509, 95% CI = 1.097–2.077, p = 0.011, respectively) and after (OR = 1.539, 95% CI = 1.015–2.332, p = 0.042; OR = 1.641, 95% CI = 1.070–2.516, p = 0.023; and OR = 1.582, 95% CI = 1.061–2.358, p = 0.024; respectively) adjustment for sex, age, anthropometric measurements, biochemical indexes, smoking and alcohol consumption. Consistent with results of genotype analysis, the C allele of rs151290 in KCNQ1 was also associated with increased risk of T2DM (OR = 1.166, 95% CI = 1.004–1.355, p = 0.045). No associations between genetic variants of KLF14 rs972283, GCKR rs780094 or MTNR1B rs10830963 and T2DM were detected. The AC and CC genotypes and the C allele of rs151290 in KCNQ1 may be risk factors for T2DM in Han Chinese in Henan province. Full article
Open AccessComment Comments on Meo et al. Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus. Int. J. Environ. Res. Public Health, 2015, 12, 14519–14528
Int. J. Environ. Res. Public Health 2016, 13(3), 261; doi:10.3390/ijerph13030261
Received: 21 January 2016 / Revised: 21 January 2016 / Accepted: 23 February 2016 / Published: 26 February 2016
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Abstract
With great interest and enthusiasm, we have read the article by Meo et al. entitled “Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus” that is
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With great interest and enthusiasm, we have read the article by Meo et al. entitled “Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus” that is published in the latest issue of the International Journal of Environmental Research and Public Health [1].[...] Full article
Open AccessReply Response to Comments on Meo et al. Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus. Int. J. Environ. Res. Public Health, 2015, 12, 14519–14528
Int. J. Environ. Res. Public Health 2016, 13(3), 262; doi:10.3390/ijerph13030262
Received: 21 January 2016 / Revised: 12 February 2016 / Accepted: 23 February 2016 / Published: 26 February 2016
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Abstract
We highly appreciate the readers’ interest [1] in our article [2] titled “Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus” published in the International Journal
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We highly appreciate the readers’ interest [1] in our article [2] titled “Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus” published in the International Journal of Environmental Research and Public Health [2].[...] Full article
Open AccessReview Diabetes Mellitus, ArterialWall, and Cardiovascular Risk Assessment
Int. J. Environ. Res. Public Health 2016, 13(2), 201; doi:10.3390/ijerph13020201
Received: 2 December 2015 / Accepted: 1 February 2016 / Published: 6 February 2016
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Abstract
Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial
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Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. Full article

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Open AccessArticle Factors Affecting the Quality of Life and the Illness Acceptance of Pregnant Women with Diabetes
Int. J. Environ. Res. Public Health 2016, 13(1), 68; doi:10.3390/ijerph13010068
Received: 21 November 2015 / Revised: 9 December 2015 / Accepted: 11 December 2015 / Published: 22 December 2015
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Abstract
The paper contains an analysis of the factors affecting the quality of life (QoL) and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk
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The paper contains an analysis of the factors affecting the quality of life (QoL) and the illness acceptance of diabetic pregnant women. The study was performed between January and April, 2013. It included 114 pregnant women with diabetes, hospitalized in the High Risk Pregnancy Wards of several hospitals in Lublin, Poland. The study used a diagnostic survey with questionnaires. The research instruments used were: The WHOQOL-Bref questionnaire and the Acceptance of Illness Scale (AIS). The women’s general quality of life was slightly higher than their perceived general health. A higher quality of life was reported by women with a very good financial standing, very good perceived health, moderate self-reported knowledge of diabetes, and also by those only treated with diet and stating that the illness did not interfere with their lives (p < 0.05). Women with a very good financial standing (p < 0.009), high self-reported health (p < 0.002), and those treated with by means of a diet (p < 0.04) had a higher acceptance of illness. A higher acceptance of illness contributes to a higher general quality of life and a better perception of one’s health. Full article
Open AccessArticle Prevalence of Diabetes and Impaired Fasting Glucose in Hypertensive Adults in Rural China: Far from Leveling-Off
Int. J. Environ. Res. Public Health 2015, 12(11), 14764-14779; doi:10.3390/ijerph121114764
Received: 22 July 2015 / Revised: 11 November 2015 / Accepted: 11 November 2015 / Published: 19 November 2015
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Abstract
In recent years data from many investigations has shown a leveling–off trend in diabetes incidence. In order to explain the diabetes epidemic in rural China during the past ten years, we conducted a survey from July 2012 to August 2013. Data from comprehensive
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In recent years data from many investigations has shown a leveling–off trend in diabetes incidence. In order to explain the diabetes epidemic in rural China during the past ten years, we conducted a survey from July 2012 to August 2013. Data from comprehensive questionnaires, physical examinations, and blood tests were obtained from 5919 residents with hypertension, aged ≥ 35 years. Diabetes and impaired fasting glucose (IFG) were defined according to the American Diabetes Association (ADA) criteria. The overall prevalence of diabetes and IFG were 15.3% (13.6% in men, 16.8% in women) and 40.7% (44.1% in men, 34.7% in women) in the hypertensive rural Chinese population. The prevalence of previously diagnosed diabetes was 6.5% (4.6% in men, 8.4% in women). The prevalence of undiagnosed diabetes was 8.7% (9.0% in men, 8.5% in women). Multivariate logistic regression revealed that increasing age, drinking, overweight or obesity, systolic blood pressure, low HDL-C, high total cholesterol and triglycerides increased the risk of diabetes (p < 0.05). Diabetes is thus still prevalent in rural areas of China and is manifesting an accelerating trend. It remains an important public health problem in China, especially in rural areas and routine assessment for the early detection and treatment of diabetes should be emphasized. Full article
Open AccessArticle Association of Exposure to Radio-Frequency Electromagnetic Field Radiation (RF-EMFR) Generated by Mobile Phone Base Stations with Glycated Hemoglobin (HbA1c) and Risk of Type 2 Diabetes Mellitus
Int. J. Environ. Res. Public Health 2015, 12(11), 14519-14528; doi:10.3390/ijerph121114519
Received: 15 September 2015 / Revised: 7 November 2015 / Accepted: 11 November 2015 / Published: 13 November 2015
Cited by 6 | PDF Full-text (667 KB) | HTML Full-text | XML Full-text
Abstract
Installation of mobile phone base stations in residential areas has initiated public debate about possible adverse effects on human health. This study aimed to determine the association of exposure to radio frequency electromagnetic field radiation (RF-EMFR) generated by mobile phone base stations with
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Installation of mobile phone base stations in residential areas has initiated public debate about possible adverse effects on human health. This study aimed to determine the association of exposure to radio frequency electromagnetic field radiation (RF-EMFR) generated by mobile phone base stations with glycated hemoglobin (HbA1c) and occurrence of type 2 diabetes mellitus. For this study, two different elementary schools (school-1 and school-2) were selected. We recruited 159 students in total; 96 male students from school-1, with age range 12–16 years, and 63 male students with age range 12–17 years from school-2. Mobile phone base stations with towers existed about 200 m away from the school buildings. RF-EMFR was measured inside both schools. In school-1, RF-EMFR was 9.601 nW/cm2 at frequency of 925 MHz, and students had been exposed to RF-EMFR for a duration of 6 h daily, five days in a week. In school-2, RF-EMFR was 1.909 nW/cm2 at frequency of 925 MHz and students had been exposed for 6 h daily, five days in a week. 5–6 mL blood was collected from all the students and HbA1c was measured by using a Dimension Xpand Plus Integrated Chemistry System, Siemens. The mean HbA1c for the students who were exposed to high RF-EMFR was significantly higher (5.44 ± 0.22) than the mean HbA1c for the students who were exposed to low RF-EMFR (5.32 ± 0.34) (p = 0.007). Moreover, students who were exposed to high RF-EMFR generated by MPBS had a significantly higher risk of type 2 diabetes mellitus (p = 0.016) relative to their counterparts who were exposed to low RF-EMFR. It is concluded that exposure to high RF-EMFR generated by MPBS is associated with elevated levels of HbA1c and risk of type 2 diabetes mellitus. Full article
Open AccessArticle Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China
Int. J. Environ. Res. Public Health 2015, 12(10), 12662-12678; doi:10.3390/ijerph121012662
Received: 27 June 2015 / Revised: 17 September 2015 / Accepted: 8 October 2015 / Published: 12 October 2015
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Abstract
Background: Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to
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Background: Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to explore risk factors affecting IFG and diabetes in patients from Northeast China. Methods: A population-based, cross-sectional survey of chronic diseases and related risk factors was conducted in Jilin Province of Northeast China. All adult residents, aged 18–79, were invited to participate in this survey using the method of multistage stratified random cluster sampling. One hundred thirty-four patients with IFG or DM and 391 healthy control subjects were recruited. We compared demographic factors, body size measurements, healthy-related behaviors, and hair metallic element contents between IFG/diabetes patients and healthy individuals. Results: IFG/diabetes patients had a greater weight, waist, hip, and body mass index (BMI) than control subjects. Significant differences in the content of zinc (Zn), potassium (K), copper (Ca), and sodium (Na) as well as Cu/Zn ratios between IFG or DM patients and control subjects (p < 0.05) were also observed. Hair Cu, selenium (Se), and Na contents were positively correlated with blood glucose levels (Cu: rs = 0.135, p = 0.002; Se: rs = 0.110, p = 0.012; Na: rs = 0.091, p = 0.038). Polytomous logistic regression adjusting for age, sex, family history of diabetes and BMI, showed that subjects with high BMI were more likely to develop IFG and DM (IFG: OR = 1.15, OR 95% CI = 1.02–1.29; DM: OR = 1.15, OR 95% CI = 1.01–1.33). Moreover, rarely or never eating fruits was a risk factor for DM (OR = 5.46, OR 95% CI = 1.87–15.98) but not for IFG (OR = 1.70, OR 95% CI = 0.72–4.02). Subjects with abdominal obesity or DM history were more susceptible to DM (abdominal obesity: OR = 2.99, OR 95% CI = 1.07–8.37; DM history: OR = 2.69, OR 95% CI = 1.01–7.20). We found that subjects living in Changling County had a significantly lower chance to suffer from IFG (OR and 95% CI for OR: 0.25, 0.08–0.74). Men and 60–69 years old subjects were at increased risk for IFG (male: OR = 3.51, OR 95% CI = 1.34–9.18; age 60–69: OR = 6.64, OR 95% CI = 1.36–32.47). We did not find significant associations of IFG or DM with certain lifestyles (such as eating more meat, exercise or physical activity, smoking, or alcohol drinking) or the content of some metallic elements (such as iron (Fe), Zn , K, calcium (Ca), Na, or magnesium (Mg)). Conclusions: This study demonstrated that less or no fruit eating, DM family history, abdominal obesity conferred vulnerability to DM. Living in Changling County, men and 60–69 years old subjects were found to be risk factors for IFG. Subjects with high BMI were more likely to develop IFG and DM. Full article
Open AccessArticle Association of TCF7L2 Genetic Polymorphisms with Type 2 Diabetes Mellitus in the Uygur Population of China
Int. J. Environ. Res. Public Health 2015, 12(9), 11797-11814; doi:10.3390/ijerph120911797
Received: 15 July 2015 / Revised: 30 August 2015 / Accepted: 6 September 2015 / Published: 18 September 2015
Cited by 5 | PDF Full-text (695 KB) | HTML Full-text | XML Full-text
Abstract
Background: Genetic polymorphisms of the transcription factor 7-like 2 (TCF7L2) gene have been reported to be strongly associated with type 2 diabetes mellitus (T2DM) in Icelandic, Danish and American populations and further replicated in other European populations, African Americans, Mexican Americans, and Asian
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Background: Genetic polymorphisms of the transcription factor 7-like 2 (TCF7L2) gene have been reported to be strongly associated with type 2 diabetes mellitus (T2DM) in Icelandic, Danish and American populations and further replicated in other European populations, African Americans, Mexican Americans, and Asian populations. The aim of the present study was to investigate the association of TCF7L2 gene polymorphisms with T2DM in a Uygur population of China. Methods: 877 T2DM patients and 871 controls were selected for the present study. Two single nucleotide polymorphisms (SNPs) (rs12255372 and rs7901695) were genotyped by using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. The associations of SNPs and haplotypes with T2DM and linkage disequilibrium (LD) structure of the TCF7L2 gene were analyzed. Results: For total participants and male, the distribution of rs12255372 alleles and the dominant model (Guanine Guanine (GG) genotype vs. Guanine Thymine (GT) genotype + Thymine Thymine (TT) genotype) showed significant difference between T2DM and control subjects (for allele: p = 0.013 and p = 0.002, respectively; for dominant model: p = 0.028 and p = 0.008, respectively). The distribution of rs7901695 alleles and the dominant model (TT genotype vs. Thymine Cytosine (TC) genotype + Cytosine Cytosine (CC) genotype) for total participants and male showed significant difference between T2DM and control subjects (for allele: both p = 0.001; for dominant model: p = 0.006 and p = 0.008, respectively). Conclusions: Our data suggested that the genetic polymorphisms of the TCF7L2 gene were associated with T2DM in the Uygur population of China. Full article
Open AccessArticle Factors Influencing Self-Management in Chinese Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2015, 12(9), 11304-11327; doi:10.3390/ijerph120911304
Received: 27 July 2015 / Revised: 26 August 2015 / Accepted: 2 September 2015 / Published: 10 September 2015
Cited by 3 | PDF Full-text (882 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management
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Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population. Full article
Open AccessArticle Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy
Int. J. Environ. Res. Public Health 2015, 12(8), 10009-10019; doi:10.3390/ijerph120810009
Received: 9 July 2015 / Revised: 13 August 2015 / Accepted: 18 August 2015 / Published: 21 August 2015
Cited by 4 | PDF Full-text (244 KB) | HTML Full-text | XML Full-text
Abstract
Background: Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of blindness in adults. DR pathogenesis has not been fully elucidated, but inflammation is widely accepted to play an important role. Emerging evidence suggests
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Background: Diabetic retinopathy (DR) is a common complication of type 2 diabetes mellitus (T2DM) and the leading cause of blindness in adults. DR pathogenesis has not been fully elucidated, but inflammation is widely accepted to play an important role. Emerging evidence suggests that the platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) are novel potential markers of inflammatory responses. The present study aimed to evaluate the associations between DR and the PLR, MLR, and NLR. Patients and Methods: We performed a case-control study involving 247 patients with T2DM. The patients were divided into three groups: 125 control subjects with T2DM, 63 diabetic subjects with non-proliferative diabetic retinopathy (NPDR), and 59 patients with proliferative diabetic retinopathy (PDR). Results: The mean PLR and NLR were significantly higher in patients with DR compared with patients without DR (p < 0.01, p = 0.02, respectively). The mean MLR in the NPDR group was higher than that of patients without DR, but there were no significant differences among the three groups (p = 0.07). Logistic regression showed that the MLR was an independent risk factor for DR (odds ratio [OR]: 54.574, 95% confidence interval [CI]: 2.708–1099.907). Based on the receiver operating characteristic (ROC) curve, use of the MLR as an indicator for DR diagnosis was projected to be 2.25, and yielded a sensitivity and specificity of 47.1% and 69.6%, respectively, with an area under the curve of 0.581 (95% CI: 0.510–0.653). Conclusions: The PLR and NLR are significantly increased in the setting of DR. After correcting for possible confounding factors, the MLR was found to be a risk factor for DR. Although the MLR may be pathophysiologically and clinically relevant in DR, its predictive ability was limited. Full article
Open AccessReview Evaluating the Association between Diabetes, Cognitive Decline and Dementia
Int. J. Environ. Res. Public Health 2015, 12(7), 8281-8294; doi:10.3390/ijerph120708281
Received: 28 May 2015 / Revised: 12 July 2015 / Accepted: 14 July 2015 / Published: 17 July 2015
Cited by 12 | PDF Full-text (675 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary
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The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary research articles that met the inclusion criteria were selected for this review paper. These articles were selected using a number of search strategies and electronic databases, such as EBSCOhost Research and SwetsWise databases. The duration of diabetes, glycated haemoglobin levels and glycaemic fluctuations were associated with cognitive decline and dementia. Similarly, hypoglycaemia was significantly related to increased risk of developing cognitive decline and dementia. Furthermore, cognitive decline and dementia were associated with poorer diabetes management. There is evidence of the association between diabetes, cognitive decline and dementia including the shared pathogenesis between diabetes and Alzheimer’s disease. In addition, the self management of diabetes is affected by dementia and cognitive decline. It could be suggested that the association between diabetes and dementia is bidirectional with the potential to proceed to a vicious cycle. Further studies are needed in order to fully establish the relationship between diabetes, cognitive decline and dementia. Patients who have diabetes and dementia could benefit from structured education strategies, which should involve empowerment programmes and lifestyle changes. The detection of cognitive decline should highlight the need for education strategies. Full article

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