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International Journal of Public Health 2023We report results of a systematic review on the health effects of long-term traffic-related air pollution (TRAP) and diabetes in the adult population. An expert Panel... (Meta-Analysis)
Meta-Analysis Review
We report results of a systematic review on the health effects of long-term traffic-related air pollution (TRAP) and diabetes in the adult population. An expert Panel appointed by the Health Effects Institute conducted this systematic review. We searched the PubMed and LUDOK databases for epidemiological studies from 1980 to July 2019. TRAP was defined based on a comprehensive protocol. Random-effects meta-analyses were performed. Confidence assessments were based on a modified Office for Health Assessment and Translation (OHAT) approach, complemented with a broader narrative synthesis. We extended our interpretation to include evidence published up to May 2022. We considered 21 studies on diabetes. All meta-analytic estimates indicated higher diabetes risks with higher exposure. Exposure to NO was associated with higher diabetes prevalence (RR 1.09; 95% CI: 1.02; 1.17 per 10 μg/m), but less pronounced for diabetes incidence (RR 1.04; 95% CI: 0.96; 1.13 per 10 μg/m). The overall confidence in the evidence was rated moderate, strengthened by the addition of 5 recently published studies. There was moderate evidence for an association of long-term TRAP exposure with diabetes.
Topics: Adult; Humans; Air Pollutants; Air Pollution; Environmental Exposure; Diabetes Mellitus; Incidence; Particulate Matter
PubMed: 37325174
DOI: 10.3389/ijph.2023.1605718 -
Endocrine Mar 2022Type 1 diabetes (T1D) and asthma are both the top concurrent non-communicable diseases in the world, and the existence of a relationship between the two is an area of... (Meta-Analysis)
Meta-Analysis
PURPOSE
Type 1 diabetes (T1D) and asthma are both the top concurrent non-communicable diseases in the world, and the existence of a relationship between the two is an area of debate.
METHODS
All eligible observational studies in PubMed and EMBASE databases from inception to August 2021 were searched for data extraction and analysis. The pooled odds ratio (OR) with corresponding 95% confidence intervals (95% CI) was evaluated using fixed-effects or random-effects models in RevMan 5.3, and I and Cochran Q tests were used to assess the heterogeneity.
RESULTS
22 studies with 25,578 T1D and 3,330,901 non-T1D were included in this meta-analysis. After data analysis, there seems to be no apparent connectivity between asthma and T1D as the crude OR (cOR) was 1.07 (95%CI, 0.93-1.23). Nevertheless, after limiting the meta-analysis to 6 studies with adjusted OR (aOR) available, the results suggested a positive association between T1D and asthma (aOR, 1.15; 95%CI, 1.06-1.25). Corresponding with this, a meta-analysis of cohort studies also found a positive association between T1D and asthma with the pooled cOR of 1.27 (95% CI, 1.09-1.49) and aOR of 1.15 (95%CI, 1.05-1.26). Further analysis of 7 studies in which the diagnosis of asthma precedes T1D onset revealed that asthma patients are at increased risk of subsequent T1D with the pooled cOR of 1.23 (95%CI, 1.04-1.44) and aOR of 1.58 (95% CI, 1.11-2.24).
CONCLUSION
Our meta-analysis suggests a possible association between T1D and asthma, and patients who were previously diagnosed with asthma carried higher odds of developing T1D.
Topics: Asthma; Cohort Studies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans
PubMed: 35029744
DOI: 10.1007/s12020-021-02973-x -
Journal of Prevention (2022) Feb 2023Primary prevention of type 2 diabetes mellitus (T2DM) is possible in at-risk populations, and prevention programmes have been shown to be effective in real-world... (Review)
Review
BACKGROUND
Primary prevention of type 2 diabetes mellitus (T2DM) is possible in at-risk populations, and prevention programmes have been shown to be effective in real-world scenarios. Despite this evidence, diabetes prevalence has tripled in recent decades and is expected to reach 700 million patients by 2045, making it one of the leading causes of death globally. This review is aimed at identifying the issues and challenges in the primary prevention of T2DM.
METHODS
Scopus, Web of Science, PubMed and Ovid MEDLINE were systematically searched for published articles. Articles were screened based of inclusion and exclusion criteria. The inclusion criteria were: (1) published in 2010-2020, (2) full original article, (3) written in English, (4) qualitative, mixed-methods article, observational or interventional study. The exclusion criteria were: (1) animal study, (2) in vivo/in vitro study, (3) type 1 diabetes or gestational DM and (4) conference abstract, book chapter, report, and systematic review. Eligible articles were assessed using Mixed Methods Appraisal Tool (MMAT) by three assessors.
RESULTS
A total of 11 articles were selected for qualitative synthesis from the initial 620 articles. The issues and challenges seen in T2DM primary prevention followed three themes: healthcare program (sub-themes: lack of resources, community partnership, participation, health literacy), health provider (sub-themes: lack of implementation, health care staff, collaboration, availability), individual (sub-themes: awareness, communication, misbehaviour, family conflict).
CONCLUSION
Factors relating to healthcare programmes, health providers, and individual issues are the main challenges in T2DM primary prevention. By establishing sustainable preventative initiatives that address these issues and challenges in the primary prevention of T2DM, a reduction in T2DM prevalence could be achievable.
Topics: Humans; Diabetes Mellitus, Type 2; Risk Factors; Diabetes Mellitus, Type 1; Primary Prevention
PubMed: 36129587
DOI: 10.1007/s10935-022-00707-x -
Tropical Medicine & International... Nov 2022To investigate the current status of the availability and affordability of specific essential medicines and diagnostics for diabetes in Africa. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To investigate the current status of the availability and affordability of specific essential medicines and diagnostics for diabetes in Africa.
METHODS
Systematic review and meta-analysis. Studies conducted in Africa that reported any information on the availability and affordability of short-acting, intermediate-acting, and premixed insulin, glibenclamide, metformin, blood glucose, glycated haemoglobin or HbA1c, and lipid profile tests were included. Random-effect model meta-analysis and descriptive statistics were performed to determine the pooled availability and affordability, respectively.
RESULTS
A total of 21 studies were included. The pooled availability of each drug was as follows: short-acting insulin 33.5% (95% CI: 17.8%-49.2%, I = 95.02%), intermediate-acting insulin 23.1% (95% CI: 6.3%-39.9%, I = 91.6%), premixed insulin 49.4% (95% CI: 24.9%-73.9%, I = 90.57%), glibenclamide 55.9% (95% CI: 43.8%-68.0%, I = 96.7%), and metformin 47.0% (95% CI: 34.6%-59.4%, I = 97.54%). Regarding diagnostic tests, for glucometers the pooled availability was 49.5% (95% CI: 37.9%-61.1%, I = 97.43%), for HbA1c 24.6% (95% CI: 3.1%-46.1%, I = 91.64), and for lipid profile tests 35.7% (95% CI: 19.4%-51.9%, I = 83.77%). The median (IQR) affordability in days' wages was 7 (4.7-7.5) for short-acting insulin, 4.4 (3.9-4.9) for intermediate-acting insulin, 7.1 (5.8-16.7) for premixed insulin, 0.7 (0.7-0.7) for glibenclamide, and 2.1 (1.8-2.8) for metformin.
CONCLUSION
The availability of the five essential medicines and three diagnostic tests for diabetes in Africa is suboptimal. The relatively high cost of insulin, HbA1c, and lipid profile tests is a significant barrier to optimal diabetes care. Pragmatic country-specific strategies are urgently needed to address these inequities in access and cost.
Topics: Humans; Diagnostic Tests, Routine; Glyburide; Glycated Hemoglobin; Health Services Accessibility; Drugs, Essential; Diabetes Mellitus; Costs and Cost Analysis; Insulin; Metformin; Insulin, Short-Acting; Lipids
PubMed: 36121433
DOI: 10.1111/tmi.13819 -
VASA. Zeitschrift Fur Gefasskrankheiten Sep 2021This systematic review examined the interrelationship between concomitant diabetes mellitus (DM) and peripheral arterial disease (PAD). The objective was to determine...
This systematic review examined the interrelationship between concomitant diabetes mellitus (DM) and peripheral arterial disease (PAD). The objective was to determine differences in the prevalence as well as in the outcomes in diabetic vs. non-diabetic PAD patients. The current review followed a study protocol that was published online in German in 2017. The search included societal practice guidelines, consensus statements, systematic reviews, meta-analyses, and observational studies published from 2007 to 2020 reporting symptomatic PAD and concomitant DM in patients undergoing invasive open-surgical and endovascular revascularizations. German and English literature has been considered. Eligibility criteria were verified by three independent reviewers. Disagreement was resolved by discussion involving a fourth reviewer. 580 articles were identified. After exclusion of non-eligible studies, 61 papers from 30 countries remained, respectively 850,072 patients. The included studies showed that PAD prevalence differed between diabetic vs. non-diabetic populations (20-50% vs. 10-26%), and further by age, gender, ethnicity, duration of existing diabetes, and geographic region. The included studies revealed worse outcomes regarding perioperative complications, amputation rate, and mortality rate in diabetic patients when compared to non-diabetic patients. In both groups, the amputation rates decreased during the research period. This review emphasizes an interrelationship between PAD and DM. To improve the outcomes, early detection of PAD in diabetic patients, and vice versa, should be recommended. The results of this systematic review may help to update societal practice guidelines.
Topics: Amputation, Surgical; Diabetes Mellitus; Humans; Peripheral Arterial Disease; Vascular Surgical Procedures
PubMed: 33175668
DOI: 10.1024/0301-1526/a000925 -
Diabetes Research and Clinical Practice May 2022Patients with diabetes mellitus (DM) are at increased risk of developing several cancers; however, there is a lack of consensus on the relationship between gastric... (Meta-Analysis)
Meta-Analysis Review
Patients with diabetes mellitus (DM) are at increased risk of developing several cancers; however, there is a lack of consensus on the relationship between gastric cancer (GC) and DM. This study aimed to explore the association between GC and DM based on the type and duration of DM. We searched nine databases from inception to December 1, 2021, and 40 cohort studies that evaluated the relationship between DM and the incidence of GC were included in this review. The summary relative ratios for the relationship of GC incidence with type 1 DM (T1DM) and type 2 DM (T2DM) were estimated using the fixed-effect and random-effect models, respectively. The risk of GC was 46% and 14% higher in individuals with T1DM and T2DM, respectively, than in those without diabetes. The risk of GC development in patients with diabetes showed a U-shape curve of change with DM duration. Our meta-analysis suggested that both T1DM and T2DM present a higher risk of GC development. The risk of GC may be influenced by the different time windows following the onset of diabetes. Future studies are required to explore the mechanism by which the duration of DM, antidiabetic medication use, and sex affect this association.
Topics: Cohort Studies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Incidence; Risk Factors; Stomach Neoplasms
PubMed: 35398143
DOI: 10.1016/j.diabres.2022.109866 -
Endocrinology, Diabetes & Metabolism Jul 2021Anaemia is common but often overlooked in diabetes mellitus (DM) patients. There is also no official nationwide survey registry that estimated the prevalence of anaemia... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Anaemia is common but often overlooked in diabetes mellitus (DM) patients. There is also no official nationwide survey registry that estimated the prevalence of anaemia in DM patients in Ethiopia. Therefore, the main aim of this study is to determine the countrywide pooled prevalence and associated factors of anaemia in DM patients.
METHODS
This systematic review and meta-analysis were conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. STATA 11 software was used for all statistical analysis. Random effects model was used to estimate the pooled prevalence of anaemia and associated factors at a 95% confidence interval (CI) with its respective odds ratio (OR). Subgroup analysis and egger test were used to determine heterogeneity and publication bias, respectively.
RESULTS
Nine articles were included in this systematic review and meta-analysis with a total of 2889 DM patients. The pooled prevalence of anaemia among DM patients in Ethiopia was 22.11% (95% CI: 15.83-28.39) = 94.8%. The prevalence of anaemia in type I and type II DM patients was (16.78% [95% CI: 11.53-22.04]) and (31.12% [95% CI; 9.66-52.58]), respectively. The prevalence of anaemia was higher among male (36.72% [95% CI: 22.58-50.87] = 97.6%) than female (27.51% [95% CI: 16.12-38.90] = 96.3%). Moreover, the odds of anaemia were higher among patients with age ˃ 60 (OR = 2.98; 95% CI: 1.83, 4.87), low estimated glomerular filtration rate (eGFR) (OR = 8.59; 95% CI: 4.76, 15.57), and duration of illness ≥5 years (OR = 2.66; 95%: 1.38, 5.13).
CONCLUSIONS
The result of this review implies that anaemia is a moderate public health problem among DM patients in Ethiopia. Older age, poor glycemic control, low eGFR and longer duration of illness were found to be the contributing factors for the development of anaemia in DM patients. Therefore, by considering the negative impact of anaemia, it is important to include anaemia screening into routine assessment of DM-related complications targeting patients with older age, poor glycemic control, low eGFR, and longer duration of illness to reduce the magnitude of the problem.
Topics: Anemia; Diabetes Complications; Diabetes Mellitus, Type 2; Ethiopia; Female; Humans; Male; Prevalence
PubMed: 34277984
DOI: 10.1002/edm2.260 -
Diabetes & Vascular Disease Research 2022Certain sleep behaviours increase risk of type 2 diabetes mellitus (T2DM) in the general population, but whether they contribute to the progression from pre-diabetes to... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Certain sleep behaviours increase risk of type 2 diabetes mellitus (T2DM) in the general population, but whether they contribute to the progression from pre-diabetes to T2DM is uncertain. We conducted a systematic review to assess this.
METHODS
Structured searches were performed on bibliographic databases (MEDLINE, EMBASE and CINAHL) from inception to 26/04/2021 for longitudinal studies/trials consisting of adults⩾18 years with pre-diabetes and sleep behaviours (short or long sleep duration (SD), late chronotype, insomnia, obstructive sleep apnoea, daytime napping and/or night-shift employment) that reported on incident T2DM or glycaemic changes. The Newcastle-Ottawa Scale was used for quality assessment.
RESULTS
Six studies were included. Meta-analysis of three studies ( = 20,139) demonstrated that short SD was associated with greater risk of progression to T2DM, hazard ratio (HR) 1.59 (95% CI 1.29-1.97), I heterogeneity score 0%, < 0.0001, but not for long SD, HR 1.50 (0.86-2.62), I heterogeneity 77%, = 0.15. The systematic review showed insomnia and night-shift duty were associated with higher progression to T2DM. Studies were rated as moderate-to-high quality.
CONCLUSIONS
Progression from pre-diabetes to T2DM increases with short SD, but only limited data exists for insomnia and night-shift duty. Whether manipulating sleep could reduce progression from pre-diabetes to T2DM needs to be examined.
Topics: Adult; Diabetes Mellitus, Type 2; Habits; Humans; Prediabetic State; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35616501
DOI: 10.1177/14791641221088824 -
Current Diabetes Reviews 2023Diabetes mellitus affects almost 20% of the world's population between 65 and 99 years old. The care for this disease urges a complex, multidisciplinary, and stepwise...
BACKGROUND
Diabetes mellitus affects almost 20% of the world's population between 65 and 99 years old. The care for this disease urges a complex, multidisciplinary, and stepwise approach. Telemedicine has been evaluated, and clinical trials as well as systematic reviews have been performed, and most have shown the benefits of its use in DM management. However, as the prevalence of diabetes mellitus increases, as well as the population ages, considerations regarding access and compliance of older patients to such technologies arise.
OBJECTIVE
The study aimed to determine the efficacy of telemedicine medical consultations in comparison to standard face-to-face consultations.
METHODS
A systematic literature search to identify trials investigating the effect of telemedicine medical consultations in clinical-laboratory aspects of DM management was conducted. The search was carried out in electronic databases: Medline, EMBASE, LILACS, ClinicalTrials.gov, and the CENTRAL Cochrane. Two authors independently assessed the included studies using the proper bias assessment tool for each study design.
RESULTS
In agreement with the eligibility criteria, three studies were included. In terms of the main outcome, HbA1c, only one out of three articles showed a significant difference between the groups, favoring patients in the telemedicine group. With respect to blood pressure, Sood A reported that the usual care group exhibited a greater improvement in systolic blood pressure with statistical differences. All other results displayed no significant statistical difference between the groups. Also, no statistical difference was found in most of the lipid profile results.
CONCLUSION
Our review shows that teleconsultations do not provide a clear benefit to elderly people with diabetes, but they may be non-inferior.
Topics: Humans; Aged; Aged, 80 and over; Glycated Hemoglobin; Diabetes Mellitus; Telemedicine; Blood Pressure; Diabetes Mellitus, Type 2
PubMed: 35619303
DOI: 10.2174/1573399818666220519164605 -
Environmental Science and Pollution... Dec 2021To investigate the association between antibiotic exposure and risk of type 2 diabetes mellitus (T2DM). Four electronic databases, including PubMed, MEDLINE, EMBASE, and... (Meta-Analysis)
Meta-Analysis Review
To investigate the association between antibiotic exposure and risk of type 2 diabetes mellitus (T2DM). Four electronic databases, including PubMed, MEDLINE, EMBASE, and Cochrane Library, were searched for all relevant studies, from inception until May 2021, without restrictions. Pooled odds risk (OR) with 95% confidence intervals (CI) was applied to evaluate the effect value. Nine studies counting a total of 3,924,272 participants were assessed in the systematic review and meta-analyses. By meta-analysis using no antibiotic exposure as the reference, antibiotic exposure has a higher risk for T2DM (OR=1.16; 95% CI, 1.10-1.22). Subgroup analyses suggested that the antibiotic exposure could significantly enhance the risk of T2DM in those whose age were more than 50 (OR=1.17; 95% CI, 1.08-1.25). Further stratified analysis indicated that the association was likely attributed to the chemical structure of antibiotics, but not to antibacterial type and mechanism of action. Our results may further support the possibility that antibiotic use in recent years was associated with increased risk of T2DM. More attentions and cautions should be taken by the physicians when prescribing antibiotics.
Topics: Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Humans
PubMed: 34622400
DOI: 10.1007/s11356-021-16781-3