scholarly journals Principle of Management of Type 2 Diabetes: From Clinical, Public Health and Research Perspectives

2018 ◽  
Author(s):  
Madhur Dev Bhattarai
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Research Perspectives

scholarly journals Approach to the Patient with Diabetes during Pregnancy

2010 ◽  
Vol 95 (8) ◽  
pp. 3578-3585 ◽  
Author(s):  
Jennifer Hone ◽  
Lois Jovanovič
Keyword(s):  
Public Health ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Weight Gain ◽  
Preconception Care ◽  
Fetal Outcomes ◽  
Optimal Outcomes

The epidemics of obesity and type 2 diabetes mellitus (T2DM) globally are paralleling an increase in the number of women with T2DM becoming pregnant. Because T2DM is frequently undiagnosed before pregnancy, the risk of major malformations in the developing fetus is increased due to uncontrolled hyperglycemia. The lack of preconception care and the increase in complications of pregnancy due to the coexistence of obesity and T2DM are of concern from both an individual and a public health standpoint. Rapid achievement of normoglycemia with limited weight gain is critical to optimize maternal and fetal outcomes in all women with diabetes during pregnancy, regardless of the type of diabetes. This article will focus on T2DM preceding pregnancy due to its increasing prevalence and potentially dire fetal and maternal consequences. Euglycemia before, during, and after all pregnancies complicated by diabetes results in the best opportunity for optimal outcomes for mother and infant.

scholarly journals Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers

2016 ◽  
Vol 4 ◽  
pp. 283-288 ◽  
Author(s):  
Polly H. Noël ◽  
Michael L. Parchman ◽  
Erin P. Finley ◽  
Chen-Pin Wang ◽  
Mary Bollinger ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Community Based ◽  
Senior Centers ◽  
Primary Care Patients

scholarly journals High-intensity exercise to promote accelerated improvements in cardiorespiratory fitness (HI-PACE): Study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Joshua E. McGee ◽  
Savanna G. Barefoot ◽  
Nicole R. Gniewek ◽  
Patricia M. Brophy ◽  
Angela Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
African Americans ◽  
Aerobic Exercise ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Controlled Trial ◽  
High Intensity Exercise ◽  
Moderate Intensity

Abstract Background African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared to Caucasians. Recent evidence indicates low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g. reduction of glucose/insulin levels, pulse wave velocity, body fat, etc.) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness (HI-PACE) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans. Methods/Design­ A randomized controlled trial will be performed on overweight and obese (body mass index: 25-45 kg/m2) African Americans (35-65 years) (n=60). Participants will be randomized to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training, or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45-55% and 70-80% of VO2 max in the MOD-INT and the HIGH-INT groups, respectively, for an exercise dose of 600 MET-minutes/week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near infrared spectroscopy), skeletal muscle measurements (i.e. citrate synthase, COX IV, GLUT-4, CPT-1, PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment). Discussion The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity. Trial Registration ClinicalTrials.gov ID: NCT02892331. Registered on 8 September 2016, https://clinicaltrials.gov/ct2/show/NCT02892331

scholarly journals Understanding the complexity of socioeconomic disparities in type 2 diabetes risk: a study of 4.3 million people in Sweden

2019 ◽  
Vol 7 (1) ◽  
pp. e000749 ◽  
Author(s):  
Maria Wemrell ◽  
Louise Bennet ◽  
Juan Merlo
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Low Income ◽  
Educational Achievement ◽  
Absolute Risk ◽  
Diabetes Risk ◽  
Socioeconomic Disparities ◽  
Heterogeneous Distribution ◽  
Discriminatory Accuracy

ObjectiveInvestigating demographic and socioeconomic factors as intersecting rather than as separate dimensions may improve our understanding of the heterogeneous distribution of type 2 diabetes in the population. However, this complexity has scarcely been investigated and we still do not know the accuracy of these factors for predicting type 2 diabetes. Improved understanding of the demographic and socioeconomic disparities predicting type 2 diabetes risk in the population would contribute to more precise and effective public health interventions.Research design and methodsWe analyzed the risk of type 2 diabetes among 4 334 030 individuals aged 40–84 years who by 2010 had resided in Sweden for at least 5 years. We stratified the study population into 120 strata defined by categories of age, gender, income, education, and immigration status. We calculated measures of absolute risk (prevalence) and relative risk (prevalence ratio), and quantified the discriminatory accuracy of the information for predicting type 2 diabetes in the population.ResultsThe distribution of type 2 diabetes risk in the population was highly heterogeneous. For instance, immigrated men aged 70–79 years with low educational achievement and low income had a risk around 32 times higher than native women aged 40–49 years with high income and high educational achievement (ie, 17.6% vs 0.5%). The discriminatory accuracy of the information was acceptable.ConclusionA more detailed, intersectional mapping of socioeconomic and demographic distribution of type 2 diabetes can assist in public health management aiming to reduce the prevalence of the disease.

scholarly journals Direct healthcare costs of sedentary behaviour in the UK

2019 ◽  
Vol 73 (7) ◽  
pp. 625-629 ◽  
Author(s):  
Leonie Heron ◽  
Ciaran O'Neill ◽  
Helen McAneney ◽  
Frank Kee ◽  
Mark A Tully
Keyword(s):  
Public Health ◽  
Lung Cancer ◽  
Type 2 Diabetes ◽  
Sedentary Behaviour ◽  
Healthcare Costs ◽  
Double Counting ◽  
All Cause Mortality ◽  
Direct Healthcare Costs ◽  
The Uk

BackgroundGrowing evidence indicates that prolonged sedentary behaviour increases the risk of several chronic health conditions and all-cause mortality. Sedentary behaviour is prevalent among adults in the UK. Quantifying the costs associated with sedentary behaviour is an important step in the development of public health policy.MethodsNational Health Service (NHS) costs associated with prolonged sedentary behaviour (≥6 hours/day) were estimated over a 1-year period in 2016–2017 costs. We calculated a population attributable fraction (PAF) for five health outcomes (type 2 diabetes, cardiovascular disease [CVD], colon cancer, endometrial cancer and lung cancer). Adjustments were made for potential double-counting due to comorbidities. We also calculated the avoidable deaths due to prolonged sedentary behaviour using the PAF for all-cause mortality.ResultsThe total NHS costs attributable to prolonged sedentary behaviour in the UK in 2016–2017 were £0.8 billion, which included expenditure on CVD (£424 million), type 2 diabetes (£281 million), colon cancer (£30 million), lung cancer (£19 million) and endometrial cancer (£7 million). After adjustment for potential double-counting, the estimated total was £0.7 billion. If prolonged sedentary behaviour was eliminated, 69 276 UK deaths might have been avoided in 2016.ConclusionsIn this conservative estimate of direct healthcare costs, prolonged sedentary behaviour causes a considerable burden to the NHS in the UK. This estimate may be used by decision makers when prioritising healthcare resources and investing in preventative public health programmes.

scholarly journals Passive smoking and type 2 diabetes among never‐smoking women: The Japan Public Health Center‐based Prospective Study

2020 ◽  
Vol 11 (5) ◽  
pp. 1352-1358 ◽  
Author(s):  
Shino Oba ◽  
Atsushi Goto ◽  
Tetsuya Mizoue ◽  
Manami Inoue ◽  
Norie Sawada ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Prospective Study ◽  
Health Center ◽  
Passive Smoking ◽  
Public Health Center
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