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

Ethnic-Specific Obesity Cutoffs for Diabetes Risk: Cross-sectional Study of 490,288 UK Biobank Participants

Diabetes Care June 29, 2014

OBJECTIVE To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed on white populations in terms of diabetes prevalence.

RESEARCH DESIGN AND METHODS UK Biobank recruited 502,682 U.K. residents aged 40–69 years. We used baseline data on the 490,288 participants from the four largest ethnic subgroups: 471,174 (96.1%) white, 9,631 (2.0%) South Asian, 7,949 (1.6%) black, and 1,534 (0.3%) Chinese. Regression models were developed for the association between anthropometric measures (BMI, waist circumference, percentage body fat, and waist-to-hip ratio) and prevalent diabetes, stratified by sex and adjusted for age, physical activity, socioeconomic status, and heart disease. Read More

Food-Insecure Dietary Patterns Are Associated With Poor Longitudinal Glycemic Control in Diabetes: Results From the Boston Puerto Rican Health Study

Diabetes Care June 26, 2014

OBJECTIVE To determine whether dietary patterns associated with food insecurity are associated with poor longitudinal glycemic control.

RESEARCH DESIGN AND METHODS In a prospective, population-based, longitudinal cohort study, we ascertained food security (Food Security Survey Module), dietary pattern (Healthy Eating Index 2005 [HEI 2005]), and hemoglobin A1c (HbA1c) in Puerto Rican adults aged 45–75 years with diabetes at baseline (2004–2009) and HbA1c at ∼2 years follow-up (2006–2012). We determined associations between food insecurity and dietary pattern and assessed whether those dietary patterns were associated with poorer HbA1c concentration over time, using multivariable-adjusted repeated subjects mixed-effects models. Read More

Self-care and Subjectivity among Mexican Diabetes Patients in the United Statesa

Wiley: 19 JUN 2014

Type 2 diabetes is considered a public health crisis, particularly among people of Mexican descent in the United States. Clinical approaches to diabetes management increasingly emphasize self-care, which places responsibility for illness on individuals and mandates self-regulation. Using narrative and free-list data from a two-phase study of low-income first- and second-generation Mexican immigrants living with diabetes, we present evidence that self-care among our participants involves emotion regulation as well as maintenance of and care for family. These findings suggest, in turn, that the ideology of selfhood on which these practices are based does not correspond with the ideology of selfhood cultivated in the U.S. clinical sphere. Divergence between these ideologies may lead to self-conflict for patients and the experience of moral blame. We argue that our participants use their explanations of diabetes causality and control as a form of self-making, which both resists such blame and asserts an alternative form of selfhood that may align more closely with the values held by our Mexican-American participants. Read More

Differing Effects of Metformin on Glycemic Control by Race-Ethnicity

Metformin is considered first-line treatment for type 2 diabetes mellitus. However, little is known about its effects in African American individuals.

The objective of the study was to assess whether metformin’s effect on glycemic control differs by race-ethnicity

Electronic health records were used to identify adults who had a diagnosis of diabetes, two or more fills of metformin, and two or more glycated hemoglobin (HbA1c) measurements. Pharmacy claims were used to estimate metformin exposure based on fill frequency and dose dispensed. Regression analyses modeled the relationship between metformin exposure and HbA1c levels. Analyses were stratified by race-ethnicity and baseline HbA1c values. Read More

Diabetes-Related Mortality Among American Indians and Alaska Natives, 1990–2009

American Journal of Public Health Feb 25, 2014

Pyone Cho, Linda S. Geiss, and Nilka Rios Burrows are with the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Diana L. Roberts is with Alaska Area Native Health Service, Indian Health Service (IHS), Anchorage. Ann K. Bullock is with Division of Diabetes Treatment and Prevention, IHS, Albuquerque, NM. Michael E. Toedt is with Cherokee Indian Hospital, Cherokee, NC. Read more

FDA Gives Latinas Tools to Fight Diabetes

Nearly 1 million Latinas aren’t aware that they are at risk of developing diabetes. Many will likely not get the preventive or other care they need because they won’t visit a physician or medical clinic, where they could take a simple screening test for the disease.

To help prevent the spread of diabetes, the Food and Drug Administration (FDA) offers resources to help women of Latin American ancestry and all Americans reduce their risk or to find the most effective treatment.

About 5.5 million Latinas have elevated fasting plasma glucose, and of those, nearly 4 million weren’t told by a health care professional that they were at risk for diabetes, according to a study in the March 2014 edition of Hispanic Health Care International. Read More

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