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Diabetes Epidemiology, Prevention and Treatment

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (25 January 2022) | Viewed by 28768

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Special Issue Editor

Dr. Alberto Barcelo

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Guest Editor

1. Epidemiology and Public Health, Department of Public Health Science, University of Miami School of Medicine, University of Miami, Miami, FL, USA
2. Department of Medical Clinic, University of Juiz de Fora, São Pedro, Minas Geais, Brazil
Interests: diabetes prevalence; cost of diabetes; diabetes care; diabetes management improvement; diabetes self-management education; diabetes mortality
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes continue to be one of the most common chronic diseases globally, with an estimated 463 million affected people in 2019; its prevalence is expected to reach the 578 million mark by 2030. The importance of diabetes lays in its demand for continued care, access to technology, and patient participation in disease control strategies. Diabetes increases the risk for important co-morbidities which are invalidating and sometimes deadly. Eye disease and blindness, kidney disease, peripheral vascular disease and amputation, and cardiovascular disease are among the most frequent complications related to poor glycemic control, in many cases due to defective management. Conversely, diabetes may worsen the prognosis of concurrent unrelated diseases. For example, people with diabetes are also at a greater risk of infections than their peers without diabetes. The novel SARS-CoV-2 is an example of how diabetes affects the risk and the prognosis of concurrent deadly diseases. The management of type 1 and type 2 diabetes remains a challenge for physicians and patients around the globe, especially in developing countries where access to care and medication is still suboptimal. Impaired glucose tolerance, gestational diabetes, and diabetes in pregnancy are additional disturbances of the glucose tolerance that affects millions of people in both the developed and developing world, challenges our health providers day-to-day, and affects our populations. Because of the challenge that diabetes and diabetes management represents for the scientific community and health providers worldwide, this Special Issue of the Journal of Clinical Medicine will be dedicated to publishing the best articles reflecting efforts and innovation aiming to better diagnose, measure the impact, develop treatments and education for diabetes and related issues. In the present Special Issue, we expect to collect the best original and review articles on a number of aspects related to diabetes, diabetes prevention, control, treatment, epidemiology, education and other matters related to this prevalent disease. All submissions will be screened and peer-reviewed to ensure the quality and the relevance of manuscripts.

Prof. Alberto Barcelo
Guest 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 submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue 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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

Diabetes prevalence
Incidence of type 1 diabetes
Genetic factors for diabetes
Diabetes risk factors
Diabetes mortality
The cost of diabetes
Diabetes care
Diabetes care quality improvement
Measuring quality of diabetes care
Diabetes treatment
Strategies to prevent diabetes
Diabetes self-management education
Diabetes and the novel SARS-CoV-2
Diabetes complications and comorbidities
Diabetes and tuberculosis

Published Papers (13 papers)

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Research

17 pages, 660 KiB

Open AccessArticle

Impact of Type 2 Diabetes Mellitus on the Incidence and Outcomes of COVID-19 Needing Hospital Admission According to Sex: Retrospective Cohort Study Using Hospital Discharge Data in Spain, Year 2020

by Jose M. de Miguel-Yanes, Rodrigo Jimenez-Garcia, Javier de Miguel-Diez, Valentin Hernández-Barrera, David Carabantes-Alarcon, Jose J. Zamorano-Leon, Ricardo Omaña-Palanco and Ana Lopez-de-Andres

J. Clin. Med. 2022, 11(9), 2654; https://doi.org/10.3390/jcm11092654 - 9 May 2022

Cited by 6 | Viewed by 1705

Abstract

(1) Background: To analyze incidence and in-hospital mortality (IHM) of COVID-19 needing hospital admission in Spain (2020) in patients with T2DM. (2) Methods: We conducted a retrospective cohort study. Using the Spanish Register of Specialized Care-Basic Minimum Database we estimated age-adjusted incidence rates (IR). (3) Results: We included 203,488 patients (56.77% men), of whom 45,620 (22.41%) had T2DM. Age-adjusted IRs/1000 for men with and without T2DM was 12.90 and 5.87, respectively (IRR 2.20; 95% CI 2.18–2.22; p < 0.001), and for women with and without T2DM was 9.23 and 4.27, respectively (IRR 2.16; 95% CI 2.13–2.19; p < 0.001). Crude IHM was 23.86% in people with T2DM, and 15.94% in non-T2DM people (p < 0.001). After matching, intensive-care admission (7.37% vs. 6.15%; p < 0.001) and IHM (23.37% vs. 20.41%; p < 0.001) remained higher in women with T2DM. After matching, IHM among T2DM men was 1.5% higher than among non-T2DM men (24.27% vs. 22.72%; p < 0.001). Men with T2DM had a 34% higher IHM than women with T2DM. Prevalent T2DM increased IHM among women (1.09; 95% 1.03–1.16) and men (1.05; 95% 1.01–1.10). (4) Conclusions: Incidence rates of COVID-19 needing hospital admission were higher in men vs. women, and for people with T2DM vs. non-T2DM. Men had higher IHM beside T2DM status. Prevalent T2DM was associated with higher IHM for both sexes. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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10 pages, 628 KiB

Open AccessCommunication

An Exploratory Study of Itolizumab on the Preservation of Beta Cell Function in Adults with Recent-Onset Type 1 Diabetes

by Eduardo Cabrera-Rode, Ileana Cubas-Dueñas, Janet Rodríguez-Acosta, Yudith García-García, Yelena Torres-López, Claudia Prieto-Noa, Bárbara M. Vázquez-Izada, Maité Ruíz-Reinoso, Ragmila Echevarría-Valdés, Aimee Álvarez-Álvarez, Emma Domínguez-Alonso, Ana Ibis Conesa-González, Teresa González-Calero, Erick Robles-Torres, Silvia Elena Turcios-Tristá, Elizabeth Senra-Estévez, Patricia Hernández-Casaña and Luis Sarmiento

J. Clin. Med. 2022, 11(7), 1789; https://doi.org/10.3390/jcm11071789 - 24 Mar 2022

Viewed by 1794

Abstract

We conducted a phase I-IIa, randomized, monocentric, double-blind, placebo-controlled clinical trial to evaluate the safety and impact of the combination treatment of Itolizumab and insulin on preserving beta cell function in adults with recent-onset type 1 diabetes. Twelve patients were randomly assigned to three treatment groups, each receiving a different Itolizumab dose (0.4/0.8/1.6 mg/kg body weight, respectively) and a placebo group. All patients received concomitant intensive multiple-dose insulin therapy. Endogenous insulin secretion was assessed by the measurement of C-peptide during the mixed-meal tolerance test. No serious adverse events were reported. No changes in the total daily insulin doses, glycated hemoglobin levels, and stimulated C-peptide were observed between the Itolizumab and placebo groups at 52 weeks. A significant decrease in stimulated C-peptide was observed during the follow-up period (p = 0.012). One subject treated with 1.6 mg of Itolizumab showed a marked increase in the levels of stimulated C-peptide three years after completion of the trial. Taken together, this is the first study to demonstrate that combination treatment with Itolizumab and insulin is safe in humans and does not affect the residual function of beta cells up to 52 weeks. The findings from our study show preliminary evidence that high doses of Itolizumab could potentially arrest the loss of beta cell function in the long term. Further studies with a longer follow-up and larger numbers of patients are envisaged to assess the effect with high dose Itolizumab. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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14 pages, 1249 KiB

Open AccessArticle

The GenoDiabMar Registry: A Collaborative Research Platform of Type 2 Diabetes Patients

by Adriana Sierra, Sol Otero, Eva Rodríguez, Anna Faura, María Vera, Marta Riera, Vanesa Palau, Xavier Durán, Anna Costa-Garrido, Laia Sans, Eva Márquez, Vladimir Poposki, Josep Franch-Nadal, Xavier Mundet, Anna Oliveras, Marta Crespo, Julio Pascual and Clara Barrios

J. Clin. Med. 2022, 11(5), 1431; https://doi.org/10.3390/jcm11051431 - 5 Mar 2022

Cited by 4 | Viewed by 1784

Abstract

The GenoDiabMar registry is a prospective study that aims to provide data on demographic, biochemical, and clinical changes in type 2 diabetic (T2D) patients attending real medical outpatient consultations. This registry is also used to find new biomarkers related to the micro- and macrovascular complications of T2D, with a particular focus on diabetic nephropathy. With this purpose, longitudinal serum and urine samples, DNA banking, and data on 227 metabolomics profiles, 77 immunoglobulin G glycomics traits, and other emerging biomarkers were recorded in this cohort. In this study, we show a detailed longitudinal description of the clinical and analytical parameters of this registry, with a special focus on the progress of renal function and cardiovascular events. The main objective is to analyze whether there are differential risk factors for renal function deterioration between sexes, as well as to analyze cardiovascular events and mortality in this population. In total, 650 patients with a median age of 69 (14) with different grades of chronic kidney disease—G1–G2 (eGFR > 90–60 mL/min/1.73 m²) 50.3%, G3 (eGFR; 59–30 mL/min/1.73 m²) 31.4%, G4 (eGFR; 29–15 mL/min/1.73 m²) 10.8%, and G5 (eGFR < 15 mL/min/1.73 m²) 7.5%—were followed up for 4.7 (0.65) years. Regardless of albuminuria, women lost 0.93 (0.40–1.46) fewer glomerular filtration units per year than men. A total of 17% of the participants experienced rapid deterioration of renal function, 75.2% of whom were men, with differential risk factors between sexes—severe macroalbuminuria > 300 mg/g for men OR [IQ] 2.40 [1.29:4.44] and concomitant peripheral vascular disease 3.32 [1.10:9.57] for women. Overall mortality of 23% was detected (38% of which was due to cardiovascular etiology). We showed that kidney function declined faster in men, with different risk factors compared to women. Patients with T2D and kidney involvement have very high mortality and an important cardiovascular burden. This cohort is proposed as a great tool for scientific collaboration for studies, whether they are focused on T2D, or whether they are interested in comparing differential markers between diabetic and non-diabetic populations. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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13 pages, 1053 KiB

Open AccessArticle

Mobile Telemedicine Screening for Diabetic Retinopathy Using Nonmydriatic Fundus Photographs in Burgundy: 11 Years of Results

by Anthony Charlot, Florian Baudin, Mélanie Tessier, Sarah Lebrize, Victoire Hurand, Déborah Megroian, Louis Arnould, Inès Ben-Ghezala, Alain Marie Bron, Pierre-Henry Gabrielle and Catherine Creuzot-Garcher

J. Clin. Med. 2022, 11(5), 1318; https://doi.org/10.3390/jcm11051318 - 27 Feb 2022

Cited by 3 | Viewed by 1592

Abstract

We analyzed the results of mobile screening for diabetic retinopathy (DR) using retinal photographs, comparing these results between rural and periurban areas, and before and after the first national COVID-19 pandemic lockdown. The Burgundy Union Régionale des Professionnels de Santé (URPS) has organized an annual DR screening since 2004. The examination, performed by an orthoptist, consisted of taking the patient′s history, intraocular pressure measurement, and taking retinal photographs. After remote transmission, the examinations were interpreted by participating ophthalmologists at the Dijon University Hospital. In September 2016, the screening was open to periurban townships. In 11 years, 10,220 patients were screened: 1420 patients (13.9%) had DR of any type, with an average age of 68.5 (±11.3) years, and 59.2% were men. These patients had a statistically significantly higher glycated hemoglobin level (7.4% vs. 7.0%) and a longer duration of diabetes (13.8 vs. 9.3 years) than patients without DR. When comparing rural and periurban areas and periods before and after the beginning of the COVID-19 pandemic, we did not find any significant difference in the screening results. The results of this study are in line with the average findings of similar studies comparing screening strategies for DR. The early detection of DR can benefit from mobile telemedicine screening, identifying a considerable number of patients at an elevated risk, especially in rural areas where access to ophthalmological care is limited. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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14 pages, 1319 KiB

Open AccessArticle

Trends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001–2019

by Ana Lopez-de-Andres, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Javier de Miguel-Diez, Jose M. de Miguel-Yanes, Ricardo Omaña-Palanco and David Carabantes-Alarcon

J. Clin. Med. 2022, 11(5), 1246; https://doi.org/10.3390/jcm11051246 - 25 Feb 2022

Cited by 6 | Viewed by 1913

Abstract

(1) Background: To examine trends in the incidence (2001–2019), clinical characteristics and in-hospital outcomes following major and minor non-traumatic lower-extremity amputations (LEAs) among people with type 2 diabetes mellitus (T2DM) in Spain, assessing possible sex differences. (2) Methods: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. Joinpoint regression was used to estimate incidence trends, and multivariable logistic regression to estimate factors associated with in-hospital mortality (IHM). (3) Results: LEA was coded in 129,059 patients with T2DM (27.16% in women). Minor LEAs accounted for 59.72% of amputations, and major LEAs comprised 40.28%. The adjusted incidences of minor and major LEAs were higher in men than in women (IRR 3.51; 95%CI 3.46–3.57 and IRR 1.98; 95%CI 1.94–2.01, respectively). In women, joinpoint regression showed that age-adjusted incidence of minor LEAs remained stable over time, and for major LEAs, it decreased from 2006 to 2019. In men, incidences of minor and major LEAs decreased significantly from 2004 to 2019. In-hospital mortality (IHM) increased with age and the presence of comorbidity, such as heart failure (OR 5.11; 95%CI 4.61–5.68, for minor LEAs and OR 2.91; 95%CI 2.71–3.13 for major LEAs). Being a woman was associated with higher IHM after minor and major LEA (OR 1.3; 95%CI 1.17–1.44 and OR 1.18; 95%CI 1.11–1.26, respectively). (4) Conclusions: Our data showed major sex differences indicating decreasing and increasing LEA trends among men and women, respectively; furthermore, women presented significantly higher IHM after minor and major LEA procedures than men. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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11 pages, 284 KiB

Open AccessArticle

Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020

by Jose J. Zamorano-Leon, Rodrigo Jimenez-Garcia, Ana Lopez-de-Andres, Javier de-Miguel-Diez, David Carabantes-Alarcon, Romana Albaladejo-Vicente, Rosa Villanueva-Orbaiz, Khaoula Zekri-Nechar and Sara Sanz-Rojo

J. Clin. Med. 2022, 11(1), 68; https://doi.org/10.3390/jcm11010068 - 23 Dec 2021

Cited by 6 | Viewed by 2084

Abstract

(1) Background: In this work, we aim to describe influenza vaccine uptake among the diabetic population in Spain to assess the time trend from 2011 to 2020 and identify predictors of vaccine uptake among diabetes patients. (2) Methods: We conducted a descriptive cross-sectional study using the European Health Interview Survey for Spain (2014 and 2020) and the Spanish National Health Surveys (2011 and 2017). The independent variables analysed included socio-demographic characteristics, health-related variables and lifestyle variables. We matched each participant with diabetes with a non-diabetic participant based on age, sex, place of residence and year of survey. (3) Results: The overall coverage among diabetic adults was 52.1% compared to 40.6% for matched participants without diabetes (p < 0.01). The vaccine uptake among adults with diabetes was 52.6% in 2011, 54.38% in 2014 and 53.4% in 2017. The adjusted OR of having been vaccinated in 2020, with respect to 2011, was not significant at 0.87 (95% CI: 0.72–1.06). Factors such as being male, higher age, being affected by respiratory disease or cancer and being physically active were identified as positive predictors for influenza vaccination uptake, while smoking was a negative predictor. (4) Conclusions: The influenza vaccine uptake is below desirable levels among the adult diabetic population in Spain and has not improved from 2011 to 2020. More efforts should be made to increase influenza vaccine uptake in this high-risk group, especially for women, those aged 18–64 years, without other high-risk conditions and smokers. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

9 pages, 272 KiB

Open AccessArticle

Association between the Level of Physical Activity and Health-Related Quality of Life in Type 1 Diabetes Mellitus. A Preliminary Study

by Adrián Domínguez-Domínguez, Ismael Martínez-Guardado, Francisco Javier Domínguez-Muñoz, Sabina Barrios-Fernandez, Jesús Morenas-Martín, Miguel Angel Garcia-Gordillo and Jorge Carlos-Vivas

J. Clin. Med. 2021, 10(24), 5829; https://doi.org/10.3390/jcm10245829 - 13 Dec 2021

Cited by 5 | Viewed by 1963

Abstract

Type 1 Diabetes Mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of the beta cells of the pancreas causing an absolute deficiency of insulin for life. This pathology carries associated risks so that it is essential to measure Health-Related Quality of Life (HRQoL) in this population. The aim was to analyse associations between the level of physical activity and HRQoL in people with T1D. The sample consisted of 172 participants with T1D diagnoses, between 18 and 49 years (31.29 ± 8.17). The participants answered different questionnaires related to physical activity (IPAQ) and HRQoL (EsDQOL, ViDa1, 15D, and EQ-5D-5L). The results showed significant correlations between the level of physical activity and HRQoL. Vigorous physical activity had an impact on the HRQoL questionnaires, such as the well-being dimension (rho = 0.349; p < 0.001) of the ViDa1 questionnaire. A significant correlation between total physical activity and levels of anxiety and depression was observed: anxiety (15D) (rho = 0.328; p < 0.001) and anxiety/depression (EQ-5D-5L) (rho = 0.324; p < 0.001). The present study showed associations between higher levels of physical activity and higher HRQoL parameters in the population with T1D, which can be erected as a reason for exercise prescription in these patients. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

15 pages, 1574 KiB

Open AccessArticle

Predictors of Rehospitalization and Mortality in Diabetes-Related Hospital Admissions

by Milena Kozioł, Iwona Towpik, Michał Żurek, Jagoda Niemczynowicz, Małgorzata Wasążnik, Yaroslav Sanchak, Waldemar Wierzba, Edward Franek and Magdalena Walicka

J. Clin. Med. 2021, 10(24), 5814; https://doi.org/10.3390/jcm10245814 - 12 Dec 2021

Cited by 5 | Viewed by 2883

Abstract

The risk factors of rehospitalization and death post-discharge in diabetes-related hospital admissions are not fully understood. To determine them, a population-based retrospective epidemiological survey was performed on diabetes-related admissions from the Polish national database. Logistic regression models were used, in which the dependent variables were rehospitalization due to diabetes complications and death within 90 days after the index hospitalization. In 2017, there were 74,248 hospitalizations related to diabetes. A total of 11.3% ended with readmission. Risk factors for rehospitalization were as follows: age < 35 years; male sex; prior hospitalization due to acute diabetic complications; weight loss; peripheral artery disease; iron deficiency anemia; kidney failure; alcohol abuse; heart failure; urgent, emergency, or weekend admission; length of hospitalization; and hospitalization in a teaching hospital with an endocrinology/diabetology unit. Furthermore, 7.3% of hospitalizations resulted in death within 90 days following discharge. Risk factors for death were as follows: age; neoplastic disease with/without metastases; weight loss; coagulopathy; alcohol abuse; acute diabetes complications; heart failure; kidney failure; iron deficiency anemia; peripheral artery disease; fluid, electrolytes, and acid–base balance disturbances; urgent or emergency and weekend admission; and length of hospitalization. We concluded that of all investigated factors, only hospitalization within an experienced specialist center may reduce the frequency of the assessed outcomes. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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15 pages, 2464 KiB

Open AccessArticle

Educational Differences in Diabetes Mortality among Hispanics in the United States: An Epidemiological Analysis of Vital Statistics Data (1989–2018)

by Alberto Barcelo, Alfredo Valdivia, Angelo Sabag, Juan Pablo Rey-Lopez, Arise Garcia de Siqueira Galil, Fernando A.B. Colugnati and María Pastor-Valero

J. Clin. Med. 2021, 10(19), 4498; https://doi.org/10.3390/jcm10194498 - 29 Sep 2021

Cited by 1 | Viewed by 2174

Abstract

Background: Diabetes accounted for approximately 10% of all-cause mortality among those 20–79 years of age worldwide in 2019. In 1986–1989, Hispanics in the United States of America (USA) represented 6.9% of the national population with diabetes, and this proportion increased to 15.1% in 2010–2014. Recently published findings demonstrated the impact of attained education on amenable mortality attributable to diabetes among Non-Hispanic Whites (NHWs) and Non-Hispanic Blacks (HNBs). Previous cohort studies have shown that low education is also a detrimental factor for diabetes mortality among the Hispanic population in the USA. However, the long-term impact of low education on diabetes mortality among Hispanics in the USA is yet to be determined. Aims and methods: The aim of this study was to measure the impact of achieving a 12th-grade education on amenable mortality due to diabetes among Hispanics in the USA from 1989 to 2018. We used a time-series designed to analyze death certificate data of Hispanic-classified men and women, aged 25 to 74 years, whose underlying cause of death was diabetes, between 1989 and 2018. Death certificate data from the USA National Center for Health Statistics was downloaded, as well as USA population estimates by age, sex, and ethnicity from the USA Census Bureau. The analyses were undertaken using JointPoint software and the Age–Period–Cohort Web Tool, both developed by the USA National Cancer Institute. Results: The analyses showed that between 1989 to 2018, age- and sex-standardized diabetes mortality rates among the least educated individuals were higher than those among the most educated individuals (both sexes together, p = 0.036; males, p = 0.053; females, p = 0.036). The difference between the least and most educated individuals became more pronounced in recent years, as shown by independent confidence intervals across the study period. Sex-based analyses revealed that the age-adjUSAted diabetes mortality rate had increased to a greater extent among the least educated males and females, respectively, than among the most educated. Conclusions: The results of the analyses demonstrated a powerful effect of low education on amenable mortality attributable to diabetes among the Hispanic population in the USA. As an increasing prevalence of diabetes among the least educated Hispanics has been reported, there is a great need to identify and implement effective preventive services, self-management, and quality care practices, that may assist in reducing the growing disparity among those most vulnerable, such as minority populations. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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14 pages, 1837 KiB

Open AccessArticle

Control of Glucose, Blood Pressure, and Cholesterol among Adults with Diabetes: The Brazilian National Health Survey

by Rodrigo Citton P. dos Reis, Bruce B. Duncan, Célia Landmann Szwarcwald, Deborah Carvalho Malta and Maria Inês Schmidt

J. Clin. Med. 2021, 10(15), 3428; https://doi.org/10.3390/jcm10153428 - 31 Jul 2021

Cited by 8 | Viewed by 3069

Abstract

ABC (glucose, blood pressure and LDL-cholesterol) goals are basic standards of diabetes care. We aimed to assess ABC control and related factors in a representative sample of Brazilian adults with diabetes. We analyzed 465 adults with known diabetes in the Brazilian National Health Survey. The targets used were <7% for glycated hemoglobin (A1C); <140/90 mmHg for blood pressure; and <100 mg/dL for LDL-C, with stricter targets for the latter two for those with high cardiovascular (CVD) risk. Individual goals were attained by 46% (95% CI, 40.3–51.6%) for A1C, 51.4% (95% CI, 45.7–57.1%) for blood pressure, and 40% (95% CI, 34.5–45.6%) for LDL-C. The achievement of all three goals was attained by 12.5% (95% CI, 8.9–16.2%). Those with high CVD risk attained blood pressure and LDL-C goals less frequently. A1C control improved with increasing age and worsened with greater duration of diabetes. Achievement of at least two ABC goals decreased with increasing BMI and greater duration of diabetes. In sum, about half of those with known diabetes achieved each ABC goal and only a small fraction achieved all three goals. Better access and adherence to treatment and strategies to personalize goals according to specific priorities are of the essence. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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9 pages, 617 KiB

Open AccessArticle

Arterial Stiffness: Its Relation with Prediabetes and Metabolic Syndrome and Possible Pathogenesis

by Juan J. Gagliardino, Martin R. Salazar, Walter G. Espeche, Paula E. Tolosa Chapasian, Daniela Gomez Garizoain, Ricardo D. Olano, Rodolfo N. Stavile, Eduardo Balbín, Camilo Martinez, Betty C. Leiva Sisnieguez, Carlos E. Leiva Sisnieguez and Horacio A. Carbajal

J. Clin. Med. 2021, 10(15), 3251; https://doi.org/10.3390/jcm10153251 - 23 Jul 2021

Cited by 12 | Viewed by 1820

Abstract

Aims: To evaluate arterial stiffness indicators in people with prediabetes (PreD) and its possible pathogenesis. Materials and methods: Pulse wave velocity (PWV) was measured in 208 people with FINDRISC ≥ 13 (57 ± 8 years old, 68.7% women) and thereafter divided into those having either normal glucose tolerance (NGT) or PreD. In each subgroup we also identified those with/out insulin resistance (IR) measured by the triglyceride/HDL-c ratio (normal cut off values previously established in our population). Clinical and metabolic data were collected for all participants. PWV was compared between subgroups using independent t test. Results: Women and men had comparable clinical and metabolic characteristics with obesity (BMI ≥ 30) and antihypertensive-statin treatment, almost half with either NGT or PreD. Whereas 48% of NGT people presented IR (abnormally high TG/HDL-c ratio), 52% had PreD. PWV was significantly higher only in those with a complete picture of metabolic syndrome (MS). Conclusions: Since PWV was significantly impaired in people with a complete picture of MS, clinicians must carefully search for early diagnosis of this condition and prescribe a healthy life-style to prevent development/progression of CVD. This proactive attitude would provide a cost-effective preventive strategy to avoid CVD’s negative impact on patients’ quality of life and on health systems due to their higher care costs. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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11 pages, 1319 KiB

Open AccessArticle

Physical Activity Intensity and Type 2 Diabetes: Isotemporal Substitution Models in the “Seguimiento Universidad de Navarra” (SUN) Cohort

by María Llavero-Valero, Javier Escalada-San Martín, Miguel A. Martínez-González, Francisco Javier Basterra-Gortari, Alfredo Gea and Maira Bes-Rastrollo

J. Clin. Med. 2021, 10(13), 2744; https://doi.org/10.3390/jcm10132744 - 22 Jun 2021

Cited by 4 | Viewed by 1676

Abstract

Which intensity of physical activity (PA) is associated with type 2 diabetes (T2D) prevention remains unclear. Isotemporal substitution models assess the relationship of replacing the amount of time spent in one activity for another. We aimed to assess T2D incidence associated with light-to-moderate physical activity (LMPA) and vigorous physical activity (VPA) using isotemporal substitution models of one hour (1 h) sitting by 1 h of LMPA or VPA. Furthermore, we evaluated the effect on T2D of an isotemporal substitution of 1 h sitting by 1 h of slow (light physical activity) or brisk–very brisk walking (moderate physical activity). In total, 20,060 participants (both sexes) of the SUN cohort (Spain) initially free of T2D followed-up during a median of 12 years were included. Cox regression models were fitted to assess the association between the substitution of 1 h LMPA, VPA, slow and brisk–very brisk pace by 1 h sitting and T2D. The replacement of 1 h sitting time by 1 h of VPA was associated with an adjusted HR of 0.52 (95% CI: 0.34–0.80), not observed for the substitution by 1 h of LMPA (HR 0.93; 95% CI: 0.73–1.20). An apparent inverse association was observed for the replacement of 1 h sitting time by 1 h of brisk/very brisk walking (HR: 0.69; 95% CI: 0.46–1.04), not observed by 1 h of slow pace. From equal conditions of duration and frequency of PA, the higher the intensity of PA, the greater the T2D prevention. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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11 pages, 732 KiB

Open AccessArticle

Clinical Characteristics and Degree of Glycemic and Cardiovascular Risk Factor Control in Patients with Type 1 Diabetes in Catalonia (Spain)

by Gabriel Gimenez-Perez, Josep Franch-Nadal, Emilio Ortega, Manel Mata-Cases, Albert Goday, Jordi Real, Angel Rodriguez, Bogdan Vlacho and Dídac Mauricio

J. Clin. Med. 2021, 10(7), 1536; https://doi.org/10.3390/jcm10071536 - 6 Apr 2021

Cited by 9 | Viewed by 2116

Abstract

Background: This study aims to evaluate the clinical characteristics, complications, degree of glycemic control, and cardiovascular risk factor control in patients with type 1 diabetes in Catalonia (Northwest of Spain). Methods: Cross-sectional study using a database including clinical, laboratory, and treatment data. Patients with an ICD10 diagnosis of type 1 diabetes were included, excluding those treated with glucose-lowering agents other than insulin, or treated only with basal insulin two years after diagnosis. Results: 15,008 patients were analysed. Median IQR age was 42 (31–53) years, diabetes duration 11.8 (6.8–16.0) years, 56.5% men. Median (IQR) HbA1c was 7.9% (7.1–8.8). Microvascular complications were present in 24.4% of patients, 43.6% in those with a diabetes duration >19 years. In presence of known cardiovascular disease 69.3% of patients showed an LDL-C concentration >70 mg/dL, 37% had a systolic blood pressure >135 mmHg and 22.4% were smokers. Conclusions: This study provides a reliable snapshot about the clinical situation of a large population of patients with T1D in Catalonia, which is similar to that of other western areas. The lack of adequate control of cardiovascular risk factors in a significant proportion of patients with cardiovascular disease deserves a more detailed analysis and urges the need for improvement strategies. Full article

(This article belongs to the Special Issue Diabetes Epidemiology, Prevention and Treatment)

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