Stories written by Staff

Job Strain as a Risk Factor for Type 2 Diabetes: A Pooled Analysis of 124,808 Men and Women

Diabetes Care August 2014

Abstract

OBJECTIVE The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as “job strain,” is associated with incident type 2 diabetes independent of lifestyle factors.

RESEARCH DESIGN AND METHODS We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. Read More

Evaluating Diabetes Outcomes and Costs Within an Ambulatory Setting: A Strategic Approach Utilizing a Clinical Decision Support System

Clinical Diabetes July 2014

Diabetes affects 22.3 million people in the United States.1 It is a major cause of heart disease and stroke and is the seventh leading cause of death.2 Patients with diabetes are at two to four times greater risk of myocardial infarction (MI) than those without diabetes, and diabetes is the primary reason for renal failure, blindness, and nontraumatic limb amputations.3 Preventive care practices can reduce the development of severe vision loss by 50–60%, reduce foot amputations by 45–85%, and lower blood pressure to reduce proteinuria, a risk factor for developing kidney disease, by ~ 35%.2 Despite evidence that complications related to diabetes are preventable,4,5 only 52% of individuals with diabetes meet guidelines targeting an A1C of < 7.0%, and only 18% meet combined glycemic, lipid, and blood pressure goals. Read More

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

Diabetes Care August 2014

OBJECTIVE To investigate the relationship between adherence with statin therapy and the risk of developing diabetes.

RESEARCH DESIGN AND METHODS The cohort comprised 115,709 residents of the Italian Lombardy region who were newly treated with statins during 2003 and 2004. Patients were followed from the index prescription until 2010. During this period, patients who began therapy with an antidiabetic agent or were hospitalized for a main diagnosis of type 2 diabetes were identified (outcome). Adherence was measured by the proportion of days covered (PDC) with statins (exposure). A proportional hazards model was fitted to estimate hazard ratios (HRs) and 95% CIs for the exposure-outcome association, after adjusting for several covariates. A set of sensitivity analyses was performed to account for sources of systematic uncertainty. Read more

Genetic Testing and Type 2 Diabetes Risk Awareness

The Diabetes EducatorJuly/August 2014

Abstract

Purpose The purpose of this study was to examine the motivational, attitudinal, and behavioral predictors of interest in genetic testing (GT) in those with and without awareness of their risk for type 2 diabetes (T2DM).

Methods A convenience sample of adults visiting emergency departments, libraries, or an online research registry was surveyed. Responses from adults without diabetes who reported 1 or more risk factors for T2DM (eg, family history, body mass index > 25) were included in the analyses (n = 265). Read More

Prevalence of Diabetes Among Hispanics/Latinos From Diverse Backgrounds: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Diabetes Care August 2014

OBJECTIVE We examine differences in prevalence of diabetes and rates of awareness and control among adults from diverse Hispanic/Latino backgrounds in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

RESEARCH DESIGN AND METHODS The HCHS/SOL, a prospective, multicenter, population-based study, enrolled from four U.S. metropolitan areas from 2008 to 2011 16,415 18–74-year-old people of Hispanic/Latino descent. Diabetes was defined by either fasting plasma glucose, impaired glucose tolerance 2 h after a glucose load, glycosylated hemoglobin (A1C), or documented use of hypoglycemic agents (scanned medications). Read More

Prevalence of Metabolic Syndrome Among Hispanics/Latinos of Diverse Background: The Hispanic Community Health Study/Study of Latinos

Diabetes Care August 2014

OBJECTIVE Approximately one-third of the adult U.S. population has the metabolic syndrome. Its prevalence is the highest among Hispanic adults, but variation by Hispanic/Latino background is unknown. Our objective was to quantify the prevalence of the metabolic syndrome among men and women 18–74 years of age of diverse Hispanic/Latino background.

RESEARCH DESIGN AND METHODS Two-stage area probability sample of households in four U.S. locales, yielding 16,319 adults (52% women) who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central American, or South American. The metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. The main outcome measures were age-standardized prevalence of the metabolic syndrome per the harmonized American Heart Association/National Heart, Lung, and Blood Institute definition and its component abnormalities. Read More

Metabolic Syndrome, C-Reactive Protein, and Mortality in U.S. Blacks and Whites: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Diabetes Care August 2014

OBJECTIVE We evaluate associations of metabolic syndrome (MetS), C-reactive protein (CRP), and a CRP-incorporated definition of MetS (CRPMetS) with risk of all-cause mortality in a biracial population.

RESEARCH DESIGN AND METHODS We studied 23,998 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, an observational study of black and white adults ≥45 years old across the U.S. Elevated CRP was defined as ≥3 mg/L and MetS by the revised Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III; ATP III) criteria (three of five components). CRPMetS was defined as presence of three out of six components, with elevated CRP added to ATP III criteria as a sixth component. Cox models were used to calculate hazard ratios (HRs) for all-cause mortality, and population attributable risk (PAR) was calculated. Stratified analyses based on race and diabetes status were performed. Read More

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