Current Issue : July - September Volume : 2014 Issue Number : 3 Articles : 6 Articles
Background: The present study was designed to evaluate association of psychosocial distress with cardio\r\nmetabolic risk factors and liver enzymes in Iranian children and adolescents.\r\nMethod: This nationwide study was conducted as the third survey of the school-based surveillance system that was\r\nconducted among 5593 school students, 10ââ?¬â??18 years in Iran. High triglyceride (TG), high fasting blood sugar (FBS), high\r\ntotal cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C),\r\nhypertension (HTN), generalized obesity and abdominal obesity were considered as cardio metabolic risk factors and\r\nalanine transaminase (ALT) and aspartate aminotransferase (AST) were considered as liver enzymes. Data were analyzed\r\nusing multiple logistic regression (MLR) analysis.\r\nResult: Psychosocial distress was detected in2027 (71.2%) of boys and 1759 (63.3%) of girls. Among boys, the mean of\r\nLDL, AST and DBP were higher and the mean FBS and HDL were lowering those with psychiatric distress than their\r\nother counterparts. Girls with psychosocial distress had significantly higher mean of HDL and FBS than those without\r\npsychiatric distress. Psychosocial distress significantly increased the odds of high LDL (OR = 2.36, 95%CI 1.53, 3.64), high\r\nFBS (OR = 1.23, 95%CI 1.02, 1.49) and low HDL (OR = 1.65, 95%CI 1.41, 1.95).\r\nConclusion: Psychosocial distress in adolescents is associated with increased risk of some cardio metabolic risk factors....
Background: Type 2 diabetes along with chronic hyperglycemia may result in cognitive impairment. This can\r\nnegatively affect the patientââ?¬â?¢s adherence to diabetes treatment. The purpose of this study was to compare the\r\ncognitive status and foot self care practice in overweight type 2 diabetic patients who exercised regularly and\r\nthose who did not.\r\nMethods: The comparative study was conducted on 160 consecutive patients from an outpatient diabetes clinic.\r\nThey were divided into two groups: The active group comprised of 80 patients engaged in regular exercise for at\r\nleast 15ââ?¬â??30 minutes, three times per week during the past 6 months. The control group included 80 patients who\r\nhad not exercised regularly for the past 12 months, matched for sex, age, education, diabetes duration, hemoglobin\r\nA1C and body mass index (BMI: 25ââ?¬â??29.9Kg/m2). Data on the patientsââ?¬â?¢ demographic information, foot care practice\r\nand physical activity habits were gathered using a questionnaire. The Mini Mental Status examination (MMSE) was\r\napplied to assess cognitive status.\r\nResults: MMSE score was significantly higher in the active group. A significant negative correlation was noted\r\nbetween MMSE scores and BMI in the control group (r = -0.2, P =0.03). A significant difference was noted in the\r\nfour domains of foot self care practice between the active (4.77 Ã?± 0.77) and control (4.45 Ã?± 0.83) groups (P <0.01).\r\nConclusions: Regular physical activity can help promote cognitive status and foot self care practice in overweight\r\npatients with type 2 diabetes....
Background: One of the consequences of the generational paradigm shift of lifestyle from the traditional African\r\nmodel to a more \"western\" standard is a replacement of communicable diseases by non-communicable or life style\r\nrelated diseases like diabetes. To address this trend, diabetes education along with continuous assessment of diabetes\r\nrelated knowledge has been advocated. Since most of the Nigerian studies assessing knowledge of diabetes were\r\nhospital-based, we decided to evaluate the diabetes related knowledge and its sociodemographic determinants in a\r\ngeneral population of diabetics.\r\nMethods: Diabetics (n = 184) attending the 2012 world diabetes day celebration in a Nigerian community were\r\nsurveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and\r\nparticipation in update courses, and exercise, while section B assessed knowledge of diabetes using the 14 item\r\nMichigan Diabetes Research and Training Centre''s Brief Diabetes Knowledge Test.\r\nResults: We found that Nigerian diabetics had poor knowledge of diabetes, with pervasive fallacies. Majority did not\r\nhave knowledge of \"diabetes diet\", \"fatty food\", \"free food\", effect of unsweetened fruit juice on blood glucose, treatment\r\nof hypoglycaemia, and the average duration glycosylated haemoglobin (haemoglobin A1) test measures blood glucose.\r\nAttaining tertiary education, falling under the 51-60 years age group, frequent attendance at seminars/updates and\r\nsatisfaction with education received, being employed by or formerly working for the government, and claiming an\r\nintermediate, or wealthy income status was associated with better knowledge of diabetes.\r\nConclusion: Nigerian diabetics'' knowledge of diabetes was poor and related to age, level of education, satisfaction with\r\neducation received, employment status and household wealth....
Background: Low-grade vascular inflammation is believed to initiate early atherosclerotic process by inducing\r\ninsulin resistance (IR), with significant gender differences in adults. We evaluated the relationship between surrogate\r\nmeasures of inflammation and IR in obese adolescents.\r\nMethods: The association among markers of inflammation [high-sensitivity c-reactive protein (hs-CRP)] and IR,\r\ncardiometabolic risk factors and body composition was retrospectively examined in 199 obese adolescents\r\n[(111 F/88 M), aged 15.5 �± 1.2 years]. Insulin resistance was assessed using homeostatic model assessment for\r\ninsulin resistance (HOMA-IR).\r\nResults: Males had higher body mass index SD-score (BMI-SDS), fat mass (FM), glucose, insulin, HOMA-IR, HbA1c,\r\nhs-CRP, triglycerides: HDL-C (TG:HDL-C) ratio than females (p < 0.05), whereas females had higher c-peptide: insulin\r\nratio than males (p < 0.05). Also, 50.8% of subjects were identified with metabolic syndrome with similar gender\r\ndistribution (M: 57.9% vs. F: 45.1%, p = 0.32). Hs-CRP was correlated with HOMA-IR in the cohort, even when controlling\r\nfor FM (r = 0.26; p < 0.0001). However, hs-CRP and HOMA-IR displayed a significant correlation only in females (r = 0.37;\r\np < 0.0001) when adjusting for FM and pubertal status. Also, c-peptide: insulin ratio was inversely correlated with\r\nhs-CRP (r = -0.32; p < 0.001) and HOMA-IR (r = -0.62; p < 0.0001) and partially mediated the relationship between\r\nthese biomarkers only among females (�Ÿ = 0.36, p < 0.001 to �Ÿ = 0.18, p < 0.05; Sobel Test: p < 0.01).\r\nConclusions: A positive association between hs-CRP and HOMA-IR was observed only in adolescent girls which\r\nwas influenced by altered hepatic insulin clearance. This implies that obese adolescent girls may be at greatest risk\r\nof developing early atherosclerosis and diabetes....
Background: To evaluate the cost of diabetes related micro- and macrovascular complications in Iranian people\r\nwith type 2 diabetes mellitus.\r\nMethods: In routine clinical practice, people with type 2 diabetes mellitus were assessed for 10 years at a diabetes\r\ncare center. The type of medications and clinical data were extracted from patientsâ�� documents. Mortality rate and\r\nthe incidence of micro- and macrovascular complications recorded in patientsâ�� documents were analyzed. Cost\r\nanalysis was comprised of 1) para clinic costs as well as laboratory, medications, clinical visits and nonmedical costs\r\n2) inpatient costs as well as hospital admission costs, disability, and mortality costs.\r\nResults: From 1562 people with type 2 diabetes mellitus, a total of 1000 patients with mean duration disease of\r\n11.2 years, who had completed information in their documents, were studied. All people were free from complications\r\nat baseline. Mean cumulative incidence of diabetes-related complications over 10 years were 10.9 �± 3.5%, 8.0 �± 3.1%,\r\n4.6 �± 1.7%, 9.1 �± 3.6% and 2.3 �± 0.9% for peripheral neuropathy and diabetic foot ulcer, nephropathy, ophthalmic\r\ncomplications, cardiovascular disease and death, respectively. People with better glycemic control had less complication\r\nand also related expenditures. Average para clinic cost per patient was 393.6 �± 47.8 and average inpatient cost per\r\npatient was 1520.7 �± 104.5 USD.\r\nConclusions: Our findings demonstrate considerable incidence of diabetes chronic complications and also high health\r\ncare expenditure for related complications among our patients. As the number of people with diabetes continues to\r\nrise, early detection of the disease and implementation of timely and appropriate therapeutic strategies could decrease\r\nthe burden of diabetes chronic complications and also huge related expenditures....
Background: Diagnosis of the metabolic syndrome (MS) is crucial for health care practitioners to identify at risk\r\npeople for early treatment. Visceral obesity may make unnecessary other laborious measures of insulin resistance.\r\nThe aim of this study was to see whether waist circumference (WC) can predict insulin resistance as well as MS in a\r\ngroup of Iranian elderly.\r\nMethods: Out of 94 nondiabetic elderly, thirty three subjects were recognized with MS. MS diagnosis was based on\r\nNCEP ATP III (National Cholesterol Education Program Adult Treatment Panel III) and IDF (International Diabetes\r\nFederation) definitions. HOMA (Homeostasis Model Assessment) index was used to measure insulin sensitivity.\r\nInsulin resistance (IR) was defined as top quartile of HOMA.\r\nResults: In both sexes, WC and HOMA index were significantly positively correlated. The optimal waist\r\ncircumference (OWC) cutoff point was 94.5 cm for men and 90.5 cm for women. The high sensitivity (0.80) and\r\nspecificity (0.84) of WC in males indicates the proportion of IR which is correctly identified and recognizes all non-IR\r\nmales as such. In regression model only the TG level was associated with WC. But the WC is strongly associated\r\nwith HOMA-IR.\r\nConclusions: While OWC is very likely a good measure to exclude non-IR subjects in our study, determination of\r\noptimal WC to identify elderly IR subjects warrants further study in a larger sample of the general population....
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