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  • 1
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    Online Resource
    Mean age and body mass index at type 2 diabetes diagnosis: Pooled analysis of 56 health surveys across income groups and world regions
    Wiley ; 2024
    In:  Diabetic Medicine Vol. 41, No. 2 ( 2024-02)
    Details
    In: Diabetic Medicine, Wiley, Vol. 41, No. 2 ( 2024-02)
    Abstract: Screening for type 2 diabetes mellitus (T2DM) targets people aged 35+ years and those with overweight/obesity. With mounting evidence on young‐onset T2DM and T2DM patients with lean phenotypes, it is worth revising the screening criteria to include younger and leaner adults. We quantified the mean age and body mass index (BMI; kg/m 2 ) at T2DM diagnosis in 56 countries. Methods Descriptive cross‐sectional analysis of WHO STEPS surveys. We analysed adults (25–69 years) with new T2DM diagnosis (not necessarily T2DM onset) as per fasting plasma glucose ≥126 mg/dL measured during the survey. For people with new T2DM diagnosis, we summarized the mean age and the proportion of each five‐year age group; also, we summarized the mean BMI and the proportion of mutually exclusive BMI categories. Results There were 8695 new T2DM patients. Overall, the mean age at T2DM diagnosis was 45.1 years in men and 45.0 years in women; and the mean BMI at T2DM diagnosis was 25.2 in men and 26.9 in women. Overall, in men, 10.3% were 25–29 years and 8.5% were 30–34 years old; in women, 8.6% and 12.5% were 25–29 years and 30–34 years old, respectively. 48.5% of men and 37.3% of women were in the normal BMI category. Conclusions A non‐negligible proportion of new T2DM patients were younger than 35 years. Many new T2DM patients were in the normal weight range. Guidelines for T2DM screening may consider revising the age and BMI criteria to incorporate young and lean adults.
    Type of Medium: Online Resource
    ISSN: 0742-3071 , 1464-5491
    URL: Issue
    URL: Article
    DOI: 10.1111/dme.v41.2
    DOI: 10.1111/dme.15174
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2019647-7
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  • 2
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    Use of continuous glucose monitors in low‐ and middle‐income countries: A scoping review
    Wiley ; 2023
    In:  Diabetic Medicine Vol. 40, No. 6 ( 2023-06)
    Details
    In: Diabetic Medicine, Wiley, Vol. 40, No. 6 ( 2023-06)
    Abstract: The use of continuous glucose monitors (CGMs) has been shown to have positive impact on diabetes management for people with type 1 diabetes (T1DM), type 2 diabetes (T2DM) and gestational diabetes (GDM) in high‐income countries. However, as useful as CGMs are, the experience in low‐ and middle‐income countries (LMICs) is limited and has not been summarized. Methods A scoping review of the scientific literature was conducted. Medline, Embase, Global Health and Scopus were used to seek original research conducted in LMICs. The search results were screened by two reviewers independently. We included studies assessing health outcomes following the use of CGMs at the individual level (e.g. glycaemic control or complications) and at the health system level (e.g. barriers, facilitators and cost‐effectiveness) in English, Portuguese, Spanish and French. Results were summarized narratively. Results From 4772 records found in database search, 27 reports were included; most of them from China ( n  = 7), Colombia ( n  = 5) and India ( n  = 4). Thirteen reports studied T1DM, five T2DM, seven both T1DM and T2DM and two GDM. Seven reports presented results of experimental studies (five randomized trials and two quasi‐experimental); two on cost‐effective analysis and the remaining 18 were observational. Studies showed that CGMs improved surrogate glycaemic outcomes (HbA 1c reduction), hard endpoints (lower hospitalization rates and diabetes complications) and patient‐oriented outcomes (quality of life). However, several caveats were identified: mostly observational studies, few participants in trials, short follow‐up and focused on surrogate outcomes. Conclusions The scoping review identified that studies about CGMs in LMICs have several limitations. Stronger study designs, appropriate sample sizes and the inclusion of patient‐important outcomes should be considered to inform the evidence about CGMs for the management of people with diabetes in LMICs.
    Type of Medium: Online Resource
    ISSN: 0742-3071 , 1464-5491
    URL: Issue
    URL: Article
    DOI: 10.1111/dme.v40.6
    DOI: 10.1111/dme.15089
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2019647-7
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  • 3
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    Urbanization in Peru is inversely associated with double burden of malnutrition: Pooled analysis of 92,841 mother–child pairs
    Wiley ; 2021
    In:  Obesity Vol. 29, No. 8 ( 2021-08), p. 1363-1374
    Details
    In: Obesity, Wiley, Vol. 29, No. 8 ( 2021-08), p. 1363-1374
    Abstract: This study assessed the relationship between urbanization and the double burden of malnutrition (DBM) in Peru. Methods A cross‐sectional analysis of the Demographic and Health Survey (2009 to 2016) was conducted. A DBM “case” comprised a child with undernutrition and a mother with overweight/obesity. For urbanization, three indicators were used: an eight‐category variable based on district‐level population density (inhabitants/km 2 ), a dichotomous urban/rural variable, and place of residence (countryside, towns, small cities, or capital/large cities). Results The prevalence of DBM was lower in urban than in rural areas (prevalence ratio [PR] 0.70; 95% CI: 0.65‐0.75), and compared with the countryside, DBM was less prevalent in towns (PR 0.75; 95% CI: 0.69‐0.82), small cities (PR 0.73; 95% CI: 0.67‐0.79), and capital/large cities (PR 0.53; 95% CI: 0.46‐0.61). Using population density, the adjusted prevalence of DBM was 9.7% (95% CI: 9.4%‐10.1%) in low‐density settings (1 to 500 inhabitants/km 2 ), 5.9% (95% CI: 4.9%‐6.8%) in mid‐urbanized settings (1,001 to 2,500 inhabitants/km 2 ), 5.8% (95% CI: 4.5%‐7.1%) in more densely populated settings (7,501 to 10,000 inhabitants/km 2 ), and 5.5% (95% CI: 4.1%‐7.0%) in high‐density settings ( 〉 15,000 inhabitants/km 2 ). Conclusions The prevalence of DBM is higher in the least‐urbanized settings such as rural and peri‐urban areas, particularly those under 2,500 inhabitants/km 2 .
    Type of Medium: Online Resource
    ISSN: 1930-7381 , 1930-739X
    URL: Issue
    URL: Article
    DOI: 10.1002/oby.v29.8
    DOI: 10.1002/oby.23188
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2027211-X
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  • 4
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    The risk of mortality among people with type 2 diabetes in Latin America: A systematic review and meta‐analysis of population‐based cohort studies
    Wiley ; 2019
    In:  Diabetes/Metabolism Research and Reviews Vol. 35, No. 4 ( 2019-05)
    Details
    In: Diabetes/Metabolism Research and Reviews, Wiley, Vol. 35, No. 4 ( 2019-05)
    Abstract: Type 2 diabetes mellitus (T2DM) is associated with a high mortality risk, although the magnitude of this association remains unknown in Latin America (LA). We aimed to assess the strength of the association between T2DM and all‐cause and cause‐specific mortality in population‐based cohort studies in LA. Systematic review and meta‐analysis: inclusion criteria were (1) men and women 18 years old and above with T2DM; (2) study outcomes all‐cause and/or cause‐specific mortality; and (3) using people without T2DM as comparison group. Five databases (Scopus, Medline, Embase, Global Health, and LILACS) were searched. Risk of bias was evaluated with the ROBINS‐I criteria. Initially, there were 979 identified studies, of which 17 were selected for qualitative synthesis; 14 were included in the meta‐analysis ( N  = 416 821). Self‐reported T2DM showed a pooled relative risk (RR) of 2.49 for all‐causes mortality (I‐squared [I 2 ] = 85.7%, p   〈  0.001; 95% confidence interval [CI], 1.96‐3.15). T2DM based on a composite definition was associated with a 2.26‐fold higher all‐cause mortality (I 2  = 93.9%, p   〈  0.001; 95% CI, 1.36‐3.74). The pooled risk estimates were similar between men and women, although higher at younger ages. The pooled RR for cardiovascular mortality was 2.76 (I 2  = 59.2%; p   〈  0.061; 95% CI, 1.99‐3.82) and for renal mortality 15.85 (I 2  = 0.00%; p   〈  0.645; 95% CI, 9.82‐25.57). Using available population‐based cohort studies, this work has identified and estimated the strength of the association between T2DM and mortality in LA. The higher mortality risk compared with high‐income countries deserves close attention from health policies makers and clinicians to improve diabetes care and control hence preventing complications and delaying death.
    Type of Medium: Online Resource
    ISSN: 1520-7552 , 1520-7560
    URL: Issue
    URL: Article
    DOI: 10.1002/dmrr.v35.4
    DOI: 10.1002/dmrr.3139
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2001565-3
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  • 5
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    Skeletal muscle mass and all‐cause mortality: Findings from the CRONICAS cohort study
    Wiley ; 2023
    In:  Tropical Medicine & International Health Vol. 28, No. 2 ( 2023-02), p. 107-115
    Details
    In: Tropical Medicine & International Health, Wiley, Vol. 28, No. 2 ( 2023-02), p. 107-115
    Abstract: We aimed (1) to evaluate the agreement between two methods (equation and bio‐impedance analysis [BIA]) to estimate skeletal muscle mass (SMM), and (2) to assess if SMM was associated with all‐cause mortality risk in individuals across different geographical sites in Peru. Methods We used data from the CRONICAS Cohort Study (2010–2018), a population‐based longitudinal study in Peru to assess cardiopulmonary risk factors from different geographical settings. SMM was computed as a function of weight, height, sex and age (Lee equation) and by BIA. All‐cause mortality was retrieved from national vital records. Cox proportional‐hazard models were developed and results presented as hazard ratios (HRs) with 95% confidence intervals (95% CIs). Results At baseline, 3216 subjects, 51.5% women, mean age 55.7 years, were analysed. The mean SMM was 23.1 kg (standard deviation [SD]: 6.0) by Lee equation, and 22.7 (SD: 5.6) by BIA. Correlation between SMM estimations was strong (Pearson's ρ coefficient = 0.89, p  〈  0.001); whereas Bland–Altman analysis showed a small mean difference. Mean follow‐up was 7.0 (SD: 1.0) years, and there were 172 deaths. In the multivariable model, each additional kg in SMM was associated with a 19% reduction in mortality risk (HR = 0.81; 95% CI: 0.75–0.88) using the Lee equation, but such estimate was not significant when using BIA (HR = 0.98; 95% CI: 0.94–1.03). Compared to the lowest tertile, subjects at the highest SMM tertile had a 56% reduction in risk of mortality using the Lee equation, but there was no such association when using BIA estimations. Conclusion There is a strong correlation and agreement between SMM estimates obtained by the Lee equation and BIA. However, an association between SMM and all‐cause mortality exists only when the Lee equation is used. Our findings call for appropriate use of approaches to estimate SMM, and there should be a focus on muscle mass in promoting healthier ageing.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    URL: Article
    DOI: 10.1111/tmi.v28.2
    DOI: 10.1111/tmi.13844
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2018112-7
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  • 6
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    Parental body mass index and blood pressure are associated with higher body mass index and blood pressure in their adult offspring: a cross‐sectional study in a resource‐limited setting in northern Peru
    Wiley ; 2018
    In:  Tropical Medicine & International Health Vol. 23, No. 5 ( 2018-05), p. 533-540
    Details
    In: Tropical Medicine & International Health, Wiley, Vol. 23, No. 5 ( 2018-05), p. 533-540
    Abstract: L'indice de masse corporelle ( IMC ) et la tension artérielle ( TA ) élevés sont les principaux facteurs contribuant à la charge élevée des maladies non transmissibles à l’âge adulte. Les approches visant les individus à haut risque et les populations pour la prévention nécessitent de nouvelles stratégies pour cibler ces facteurs de risque et, se concentrer sur la famille pour introduire des initiatives de prévention apparaît comme un scénario prometteur. La caractérisation de la relation entre l’ IMC et la TA parmi les membres adultes d'une famille donnée mérite d’être évaluée. Nous avons effectué une analyse secondaire d'une étude d'implémentation à Tumbes, au Pérou, bénéficiant de données provenant de familles ayant au moins une progéniture adulte. Méthodes Les expositions d'intérêt étaient l’ IMC , la TA systolique ( TAS ) et diastolique ( TAD ) de la mère et du père. Les résultats ont été l’ IMC , TAS et TAD de la progéniture. Des modèles de régression linéaire à effets mixtes ont été effectuées. Résultats L’âge moyen de la progéniture, des mères et des pères était respectivement de 29 ans ( SD : 9,5), 54 ans ( SD : 11,8) et 59 ans ( SD : 11,6). L’ IMC du père était associé à une augmentation de l’ IMC de la progéniture d'un quart de point, quel que soit le sexe de la progéniture. L’ IMC de la mère avait un effet similaire sur l’ IMC de ses fils, mais pas d'effet significatif sur ses filles. La TAS de la mère était associée à une augmentation d'environ un dixième de mmHg de la TAS de la progéniture adulte. Il n'y avait aucune preuve d'association pour la TAD . Conclusions Dans les familles comptant des membres adultes, plus l’ IMC et la TAS des parents sont élevés, plus ils seront élevés chez leur descendance adulte.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    URL: Issue
    URL: Article
    DOI: 10.1111/tmi.2018.23.issue-5
    DOI: 10.1111/tmi.13052
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2018112-7
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