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  • 1
    Online Resource
    Online Resource
    Hindawi Limited ; 2016
    In:  Journal of Diabetes Research Vol. 2016 ( 2016), p. 1-7
    In: Journal of Diabetes Research, Hindawi Limited, Vol. 2016 ( 2016), p. 1-7
    Abstract: Objective . To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D. Methods . Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals. Results . 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55, p 〈 0.001 ), stroke (HR = 7.05, p = 0.003 ), and acute renal failure (HR = 16.9, p = 0.001 ) increased the risk of death. In addition, having 2+ (HR = 7.75, p 〈 0.001 ) and 3+ (HR = 21.1, p 〈 0.001 ) conditions increased the risk of dying. Conclusion . Respiratory infections, stroke, and acute renal disease increased the risk of inhospital mortality among hospitalized patients with T2D. Infections are not the only cause of inhospital mortality. Certain causes of hospitalization require standardized and aggressive management to decrease mortality.
    Type of Medium: Online Resource
    ISSN: 2314-6745 , 2314-6753
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2016
    detail.hit.zdb_id: 2711897-6
    Location Call Number Limitation Availability
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  • 2
    In: Journal of Diabetes Research, Hindawi Limited, Vol. 2016 ( 2016), p. 1-9
    Abstract: Objective . To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country. Methods . Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey ( n = 2,472 ) and the CRONICAS Cohort Study ( n = 2,945 ). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study. Results . The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62–0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61–0.71), with a sensitivity of 69% and specificity of 59%. Conclusions . A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru.
    Type of Medium: Online Resource
    ISSN: 2314-6745 , 2314-6753
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2016
    detail.hit.zdb_id: 2711897-6
    Location Call Number Limitation Availability
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  • 3
    In: Journal of Diabetes Research, Hindawi Limited, Vol. 2018 ( 2018-12-16), p. 1-8
    Abstract: Aims . Prognostic thresholds to identify new type 2 diabetes mellitus (T2DM) cases using the HOMA-IR have not been defined. We studied the HOMA-IR performance to identify incident T2DM cases and to assess if the thresholds varied according to urbanization and altitude in Peru. Methods . Longitudinal analysis. The outcome was incident T2DM cases: self-report diagnosis and fasting glucose. The exposure was the HOMA-IR. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was estimated with 95% confidence intervals (95% CIs). Results are presented overall and stratified by study site (Lima, Tumbes, urban Puno, and rural Puno), rurality (urban, semiurban, and rural), and altitude (low and high). Results . A total of 3120 participants (mean age: 55.6 years, 51.2% females) contributed data to this analysis. The median baseline HOMA-IR was 1.7 (IQR 1.0–2.9), with median values ranging from 1.1 in rural Puno to 2.0 in Lima and Tumbes ( p 〈 0.001 ). Overall for incident T2DM, the AUC was 0.69 (95% CI: 0.64–0.74) with an empirical threshold of 2.8 yielding a positive likelihood ratio of 2.30 and a negative one of 0.61; the positive and negative predictive values were 14.6% and 95.7%, respectively. The empirical thresholds varied within the variables of interest, for example, from 0.9 in urban Puno to 2.9 in Lima. Conclusions . Using the HOMA-IR to identify incident T2DM cases seems to yield moderate accuracy. The HOMA-IR could help improve identifying people at high risk of T2DM.
    Type of Medium: Online Resource
    ISSN: 2314-6745 , 2314-6753
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2018
    detail.hit.zdb_id: 2711897-6
    Location Call Number Limitation Availability
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