WorldWideScience

Sample records for diabetes benefits risks

  1. Hiking with DiabetesRisks and Benefits.

    Science.gov (United States)

    Jenkins, David W; Jenks, Alexander

    2017-09-01

    Exercise is highly beneficial for persons with diabetes. Similar to many other patients, those with diabetes may be reluctant to exercise given a lack of motivation and proper instruction regarding an exercise prescription. In general, medical providers are poorly equipped to develop an exercise prescription and furnish motivation. Attempts to find activities that not only provide effective aerobic challenges but also are enjoyable to participate in are fraught with difficulty. Hiking as a potential option for a safe and enjoyable activity is discussed, including the possible downsides. Multiple publications were reviewed using key words. A review of the literature uncovered limited publications or controlled trials that discussed the use of hiking per se as an activity for the management of diabetes. Newer studies reviewing weightbearing exercise and diabetic polyneuropathy and those discussing the advantages of trekking poles for balance and proprioception are cited in support of the recommendation for hiking as an activity for those with diabetes. Exercise has been shown to substantially benefit individuals with diabetes, but convincing patients with diabetes to exercise is daunting. Hiking, unlike other, more tedious exercise programs, may be an exercise option that persons with diabetes might find enjoyable. Hiking may encourage balance training and reduced ground reaction forces. These benefits may be augmented by trekking poles, which may likewise counter the concerns of the uneven surfaces that present challenges to the hiker with diabetes.

  2. Statin therapy and the risk for diabetes among adult women: do the benefits outweigh the risk?

    Science.gov (United States)

    Ma, Yunsheng; Culver, Annie; Rossouw, Jacques; Olendzki, Barbara; Merriam, Philip; Lian, Bill; Ockene, Ira

    2013-02-01

    The purpose of this review was to examine statin therapy and the risk for diabetes among adult women using a selective review. The literature contains reports of new-onset diabetes associated with statin use. While many studies do not report sex-specific results, there is evidence indicating the risk to benefit ratio may vary by gender. However, the absolute effects are not clear because women have historically been under-represented in clinical trials. A review of the literature indicates that the cardiovascular benefits of statins appear to outweigh the risk for statin-related diabetes. However, the effect may depend upon baseline diabetes risk, dose, and statin potency. Rigorous, long-term studies focused on the risks and benefits of statins in women are unavailable to sort for gender-specific differences. Until this changes, individualized attention to risk assessment, and strong prevention with lifestyle changes must prevail.

  3. Estimating the incremental net health benefit of requirements for cardiovascular risk evaluation for diabetes therapies.

    Science.gov (United States)

    Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P

    2014-03-01

    To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was -1.80 million LYs, attributable to delayed access to diabetes therapies (-0 .18 million LYs) and fewer drugs (-1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or for gone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. Copyright © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

  4. The use of low-carbohydrate diet in type 2 diabetesbenefits and risks

    Directory of Open Access Journals (Sweden)

    Łucja Czyżewska-Majchrzak

    2014-06-01

    Full Text Available The pharmacological treatment of type 2 diabetes is increasingly being supported by the recommendation of an appropriate diet. The purpose of this study is to identify the potential benefits and risks arising from the use of one of the modern models of low-carbohydrate diet in patients with type 2 diabetes. Research shows that diet can favourably affect the health of diabetic patients. It has been shown that diet affects positively the concentration of blood glucose, glycosylated haemoglobin, and also contributes to the reduction of insulin taken in the course of drug therapy. At the same time, short-term studies have demonstrated a positive relationship of nutrition with reduction in body weight, as well as favourable changes in lipid profile of HDL cholesterol and levels of triglyceride. Attention is also drawn to the negative health effects of a low-carbohydrate diet; these include an increased risk of mineral deficiency, hypovitaminosis and reduced intake of dietary fibres. This diet may be associated with very high levels of protein which, in turn, raises the risk of renal dysfunction and the appearance of irregularities in the water and electrolyte balance. The impact of changes in the skeletal system and the development of osteopenia and osteoporosis is also observed. Besides the positive impact of this model of diet on the lipid profile parameters, its use significantly increases the risk of adverse changes in other markers predisposing to atherosclerosis occurring in individuals with type 2 diabetes. In composing a nutrition model for diabetes patients, both the benefits and potential risks of a low-carbohydrate diet should therefore take into account. At the same time, it is important to individualize the diet used, based on the current state of health, used pharmacological treatments, as well as taking into account the individual characteristics of the patient.

  5. Benefits & risks of statin therapy for primary prevention of cardiovascular disease in Asian Indians – A population with the highest risk of premature coronary artery disease & diabetes

    Science.gov (United States)

    Enas, Enas A.; Kuruvila, Arun; Khanna, Pravien; Pitchumoni, C.S.; Mohan, Viswanathan

    2013-01-01

    Several reviews and meta-analyses have demonstrated the incontrovertible benefits of statin therapy in patients with cardiovascular disease (CVD). But the role for statins in primary prevention remained unclear. The updated 2013 Cochrane review has put to rest all lingering doubts about the overwhelming benefits of long-term statin therapy in primary prevention by conclusively demonstrating highly significant reductions in all-cause mortality, major adverse cardiovascular events (MACE) and the need for coronary artery revascularization procedures (CARPs). More importantly, these benefits of statin therapy are similar at all levels of CVD risk, including subjects at low (statins is also highly effective in delaying and avoiding expensive CARPs such as angioplasties, stents, and bypass surgeries. There is no evidence of any serious harm or threat to life caused by statin therapy, though several adverse effects that affect the quality of life, especially diabetes mellitus (DM) have been reported. Asian Indians have the highest risk of premature coronary artery disease (CAD) and diabetes. When compared with Whites, Asian Indians have double the risk of CAD and triple the risk of DM, when adjusted for traditional risk factors for these diseases. Available evidence supports the use of statin therapy for primary prevention in Asian Indians at a younger age and with lower targets for low-density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein (non-HDL-C), than those currently recommended for Americans and Europeans. Early and aggressive statin therapy offers the greatest potential for reducing the continuing epidemic of CAD among Indians. PMID:24434254

  6. Nanocosmetics: benefits and risks

    OpenAIRE

    Shokri, Javad

    2017-01-01

    Summary Various nanomaterials/nanoparticles (NPs) have been used for the development of cosmetic products - a field so-called nanocosmetic formulations. These advanced materials offer some benefits, while their utilization in the cosmetic formulations may be associated with some risks. The main aim of this editorial is to highlight the benefits and risks of the nanomaterials used in the cosmetic products.

  7. [Low-dose aspirin in patients with diabete melitus: risks and benefits regarding macro and microvascular complications].

    Science.gov (United States)

    Camargo, Eduardo G; Gross, Jorge Luiz; Weinert, Letícia S; Lavinsky, Joel; Silveiro, Sandra P

    2007-04-01

    Aspirin is recommended as cardiovascular disease prevention in patients with diabetes mellitus. Due to the increased risk of bleeding and because of the hypothesis that there could be a worsening of microvascular complications related to aspirin, there has been observed an important underutilization of the drug. However, it is now known that aspirin is not associated with a deleterious effect on diabetic retinopathy and there is evidence indicating that it also does not affect renal function with usual doses (150 mg/d). On the other hand, higher doses may prove necessary, since recent data suggest that diabetic patients present the so called "aspirin resistance". The mechanisms of this resistance are not yet fully understood, being probably related to an abnormal intrinsic platelet activity. The employment of alternative antiplatelet strategies or the administration of higher aspirin doses (150-300 mg/d) should be better evaluated regarding effective cardiovascular disease prevention in diabetes as well as the possible effects on microvascular complications.

  8. Benefits at risk

    DEFF Research Database (Denmark)

    Lassen, Jesper; Sandøe, Peter

    2007-01-01

    Herbicide resistant GM plants have been promoted as a tool in the development of more environment-friendly agriculture. The environmental benefits here, however, depend not only on farmer's acceptance of GM crops as such, but also on their willingness to use herbicides in accordance with altered ...... spraying plans. In this paper, we will argue that factors driving the spraying practices of Danish farmers may hamper efforts to secure the environmental benefits of the new crops....

  9. Nuclear benefits and risks

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, P

    1987-03-01

    The paper reviews the broader issues that affect nuclear power in a world energy context. The importance of nuclear power as an energy source is described, as well as the environmental effects of different energy sources. The risks associated with the nuclear industry are discussed with respect to: risks due to radiation exposure, risks to workers in the nuclear industry, and risks to the public due to discharges from nuclear installations. (U.K.).

  10. Diabetes benefit management: evolving strategies for payers.

    Science.gov (United States)

    Tzeel, Albert L

    2011-11-01

    Over the next quarter century, the burden of type 2 diabetes mellitus (T2DM) is expected to at least double. Currently, 1 in every 10 healthcare dollars is spent on diabetes management; by 2050, it has been projected that the annual costs of managing T2DM will rise to $336 billion. Without substantial, systemic changes, T2DM management costs will lead to a potentially untenable strain on the healthcare system. However, the appropriate management of diabetes can reduce associated mortality and delay comorbidities. In addition, adequate glycemic control can improve patient outcomes and significantly reduce diabetes-related complications. This article provides an overview of key concepts associated with a value-based insurance design (VBID) approach to T2DM coverage. By promoting the use of services or treatments that provide high benefits relative to cost, and by alternatively discouraging patients from utilizing services whose benefits do not justify their cost, VBID improves the quality of healthcare while simultaneously reining in spending. VBID initiatives tend to focus on chronic disease management and generally target prescription drug use. However, some programs have expanded their scope by incorporating services traditionally offered by wellness and disease management programs. The concept of VBID is growing, and it is increasingly being implemented by a diverse and growing number of public and private entities, including pharmacy benefit managers, health plans, and employers. This article provides key background on VBID strategies, with a focus on T2DM management. It also provides a road map for health plans seeking to implement VBID as part of their programs.

  11. Risk versus benefit in radiology

    International Nuclear Information System (INIS)

    Samuel, E.

    1985-01-01

    The risks of radiology may be grouped into a) those inherent in the use of ionizing radiation which today are well known and b) those associated with the use of any scientific method in medicine. Inherent risks of scientific methods like inadequate examination and the interpretation of results are discussed. Radiology brought major benefits in medical care and some of the newer methods are considered

  12. Ionizing radiation: benefits vs. risks

    International Nuclear Information System (INIS)

    Wagner, H.N. Jr.

    1986-01-01

    No one has been identifiably injured by radiation within the levels set by the NCRP and ICRP in 1934. This fact and the level of natural radiation (average dose 102 millirems/year) help provide standards against which the authors can view the relative increases in exposure from manmade sources of radiation. Because one person in five in the US will die of cancer from all causes, it is impossible to detect small increases in some types of cancer from radiation. A valid assumption is that any exposure to radiation carries some possibility of harm and should be kept below the level of the expected benefits. More is known about radiation toxicity than about any other potentially toxic substances. An obstacle to progress in the use of radioactive materials in biology and medicine is an exaggerated impression by the public of the risk of radiation. Several studies indicate that the public perceives the risk of radiation to be the greatest of all societal risks and at times does not distinguish peaceful from military uses of radiation. It behooves scientists and physicians to inform the public about the benefits as well as the risks of procedures involving radiation

  13. Mediterranean diet for type 2 diabetes: cardiometabolic benefits.

    Science.gov (United States)

    Esposito, Katherine; Maiorino, Maria Ida; Bellastella, Giuseppe; Panagiotakos, Demosthenes B; Giugliano, Dario

    2017-04-01

    Dietary patterns influence various cardiometabolic risk factors, including body weight, lipoprotein concentrations, and function, blood pressure, glucose-insulin homeostasis, oxidative stress, inflammation, and endothelial health. The Mediterranean diet can be described as a dietary pattern characterized by the high consumption of plant-based foods, olive oil as the main source of fat, low-to-moderate consumption of fish, dairy products and poultry, low consumption of red and processed meat, and low-to-moderate consumption of wine with meals. The American Diabetes Association and the American Heart Association recommend Mediterranean diet for improving glycemic control and cardiovascular risk factors in type 2 diabetes. Prospective studies show that higher adherence to the Mediterranean diet is associated with a 20-23 % reduced risk of developing type 2 diabetes, while the results of randomized controlled trials show that Mediterranean diet reduces glycosylated hemoglobin levels by 0.30-0.47 %, and is also associated with a 28-30 % reduced risk for cardiovascular events. The mechanisms by which Mediterranean diet produces its cardiometabolic benefits in type 2 diabetes are, for the most, anti-inflammatory and antioxidative: increased consumption of high-quality foods may cool down the activation of the innate immune system, by reducing the production of proinflammatory cytokines while increasing that of anti-inflammatory cytokines. This may favor the generation of an anti-inflammatory milieu, which in turn may improve insulin sensitivity in the peripheral tissues and endothelial function at the vascular level and ultimately act as a barrier to the metabolic syndrome, type 2 diabetes and development of atherosclerosis.

  14. Reducing the risks of diabetes complications through diabetes self-management education and support.

    Science.gov (United States)

    Kent, Dan; D'Eramo Melkus, Gail; Stuart, Patricia Mickey W; McKoy, June M; Urbanski, Patti; Boren, Suzanne Austin; Coke, Lola; Winters, Janis E; Horsley, Neil L; Sherr, Dawn; Lipman, Ruth

    2013-04-01

    People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion. This report summarizes the discussion and presents recommendations to incorporate into practice to improve outcomes. The objective of the symposium was to develop practical advice for diabetes educators and other members of the diabetes care team regarding the reduction of diabetes-related risks. Optimal diabetes management requires patients to actively participate in their care, which occurs most effectively with a multidisciplinary team. Diabetes education is an integral part of this team approach because it not only helps the patient understand diabetes, its progression, and possible complications, but also provides guidance and encouragement to the patient to engage in proactive risk-reduction decisions for optimal health. A variety of tools are available to help the diabetes educator develop an individualized, patient-centered plan for risk reduction. More research is needed regarding intervention efficacy, best practices to improve adherence, and quantification of benefits from ongoing diabetes support in risk reduction. Diabetes educators are urged to stay abreast of evolving models of care and to build relationships with health care providers both within and beyond the diabetes care team.

  15. Nuclear energy: benefits versus risks

    International Nuclear Information System (INIS)

    Jordan, W.H.

    1975-01-01

    Of the benefits of nuclear power three are described briefly. 1. It offers virtually an inexhaustible supply of cheap electricity, so the real reason for its installation in the U.S. (80 nuclear power plants on order and 15 in operation) is to save money. (2) Nuclear power would offer a chance to clean up the atmosphere; it has been observed that the carbon dioxide concentration in the atmosphere is increasing at about 2 percent per decade, a change that may have implications for long-term effects on climate. (3) Power reactors will undoubtedly be the major producers of radioisotopes in the future; estimates of the benefits of these isotopes are of the order of $1000 million a year from such applications as fluid flow measurements, thickness gages, leak detection, well logging, deformation determinations, agricultural application, biological applications, and in medicine. Risks of operating nuclear power plants can be classified as: thermal pollution of the rivers and lakes; low level release of radioactivity into the air and ground waters caused by the normal operation of nuclear power and reprocessing plants; and the accidental release of large amounts of radioactivity. These risks are put in perspective by comparing them with common risks that man accepts daily--transportation, cigarette smoking, mountain climbing, etc.-- after which nuclear power seems not so risky after all

  16. Diabetes, insulin and cancer risk

    OpenAIRE

    Yang, Xi-Lin; Chan, Juliana CN

    2012-01-01

    There is a consensus that both type 1 and type 2 diabetes are associated with a spectrum of cancers but the underlying mechanisms are largely unknown. On the other hand, there are ongoing debates about the risk association of insulin use with cancer. We have briefly reviewed recent related research on exploration of risk factors for cancer and pharmacoepidemiological investigations into drug use in diabetes on the risk of cancer, as well as the current understanding of metabolic pathways impl...

  17. Metabolite Profiles of Diabetes Risk

    OpenAIRE

    Gerszten, Robert E.

    2013-01-01

    Metabolic diseases present particular difficulty for clinicians because they are often present for years before becoming clinically apparent. We investigated whether metabolite profiles can predict the development of diabetes in the Framingham Heart Study. Five branched-chain and aromatic amino acids had highly-significant associations with future diabetes, while a combination of three amino acids strongly predicted future diabetes by up to 12 years (>5-fold increased risk for individuals in ...

  18. Nuclear energy risks and benefits

    International Nuclear Information System (INIS)

    Jansen, S.D.; Bailey, R.E.; Randolph, J.C.; Hartnett, J.P.; Mastanaiah, K.

    1981-09-01

    The report was prepared as part of the Ohio River Basin Energy Study (ORBES), a multidisciplinary policy research program. The study region consists of all of Kentucky, most of West Virginia, and substantial portions of Illinois, Indiana, Ohio, and Pennsylvania. By 1988, coal-fired electrical generating capacity in the region is expected to total over 100,000 MWe, versus about 11,000 MWe projected for nuclear-fueled capacity by that year. Thus, the ORBES emphasis was on coal-fired generation. This report attempts to fill in some of the gaps in the relative lack of emphasis on the risks and benefits of nuclear electricity production in the study region. It covers the following topics: (1) basic facts about radiation, (2) an overview of the current regulatory framework of the nuclear industry, (3) health risks associated with electricity production by LWRs, (4) the risks of nuclear proliferation, terrorism, and sabotage, (5) comparative economics and healthy risks of coal versus nuclear, and (6) the March 1979 accident at Three Mile Island

  19. Risks, benefits, health and the food economy

    NARCIS (Netherlands)

    Kornelis, M.; Fischer, A.R.H.

    2007-01-01

    This report examines consumer attitudes and purchase behaviour towards risks and benefits of food products. Experimental approaches are used to analyse determinants of consumer risk and benefit perceptions regarding food products. The results suggest that perceptions and behaviour of consumers

  20. Statins and risk of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Richard Tjan

    2015-12-01

    blood glucose of 3 mg/dL as a result of statin use.(3 Here is a verbatim quote from Shah and Goldfine: “For any prescription drug, the potential benefits to health must be balanced against potential risks. Understanding these potential risks can help physicians and patients make informed decisions on whether to use a medication.” Since the risk of statin-induced diabetes mellitus is important and unknown in the population of persons at lower risk of heart disease, it is considered prudent not to prescribe statins, except when diet and exercise cannot achieve LDL goals.(3 The mechanism by which statins induce diabetes in older persons has been recently uncovered. A Canadian research team has shown that statins increase macrophage IL-1 secretion, ndicating activation of the nucleotide-binding and oligomerization domain (NOD-like receptor pyrin domain 3 (NLRP3 inflammasome (caspase-1 inflammasome, which promotes insulin resistance, a precursor of type 2 diabetes. These investigators are of the opinion that the risk of statin-induced insulin Univ Med - Vol. 33 No.2 73 resistance may be reduced by inhibiting the NLRP3/caspase-1 inflammasome, particularly in obese, hyperlipidemic patients who are often at risk for developing diabetes, but have to use statins.(4 In conclusion, although the risk of new diabetes mellitus with statin therapy may be considered to be minimal, the use of statins should only be prescribed by physicians for patients at risk for cardiovascular disease. However, when these patients are also at risk for diabetes mellitus, their blood glucose level should be monitored.(3 On the other hand, since statins may trigger new onset diabetes, presumably in predisposed persons, and since diabetes carries a risk of cardiovascular disease, even statins with the least side effects should not be used routinely for primary prevention, least of all as over-the-counter drugs. Primum non nocere.

  1. Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

    Directory of Open Access Journals (Sweden)

    Romeu Mendes

    2017-09-01

    Full Text Available Background: The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Methods: Participants (n = 124; 63.25 ± 7.20 years old engaged in either a 9-month supervised exercise program (n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session or a control group (n = 85 who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. Results: A significant time * group interaction effect (p < 0.001 was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. Conclusions: A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

  2. Diabetic ketoacidosis: risk factors, mechanisms and management ...

    African Journals Online (AJOL)

    Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review. ... ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes.

  3. Benefits and Risks of Cochlear Implants

    Science.gov (United States)

    ... and Medical Procedures Implants and Prosthetics Cochlear Implants Benefits and Risks of Cochlear Implants Share Tweet Linkedin ... the Use of Cochlear Implants What are the Benefits of Cochlear Implants? For people with implants: Hearing ...

  4. Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

    Science.gov (United States)

    Mendes, Romeu; Sousa, Nelson; Reis, Victor Machado; Themudo-Barata, Jose Luis

    2017-09-13

    The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. Participants ( n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program ( n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group ( n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. A significant time * group interaction effect ( p exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

  5. Cost and benefits of a multidisciplinary intensive diabetes education programme

    NARCIS (Netherlands)

    Keers, J.C.; Groen, H.; Sluiter, W.J.; Bouma, J.; Links, T.P.

    OBJECTIVES: To determine the cost and benefits of an intensive diabetes education programme for patients with prolonged self-management problems and to determine the inclusion criteria for optimal outcomes. METHODS: Sixty-one participants of a multidisciplinary intensive diabetes education programme

  6. Potential benefits and risks of clinical xenotransplantation

    Directory of Open Access Journals (Sweden)

    Cooper DKC

    2012-07-01

    Full Text Available David KC Cooper,1 David Ayares21Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2Revivicor, Blacksburg, VA, USAAbstract: The transplantation of organs and cells from pigs into humans could overcome the critical and continuing problem of the lack of availability of deceased human organs and cells for clinical transplantation. Developments in the genetic engineering of pigs have enabled considerable progress to be made in the experimental laboratory in overcoming the immune barriers to successful xenotransplantation. With regard to pig organ xenotransplantation, antibody- and cell-mediated rejection have largely been overcome, and the current major barrier is the development of coagulation dysregulation. This is believed to be due to a combination of immune activation of the vascular endothelial cells of the graft and molecular incompatibilities between the pig and primate coagulation–anticoagulation systems. Pigs with new genetic modifications specifically directed to this problem are now becoming available. With regard to less complex tissues, such as islets (for the treatment of diabetes, neuronal cells (for the treatment of Parkinson's disease, and corneas, the remaining barriers are less problematic, and graft survival in nonhuman primate models extends for >1 year in all three cases. In planning the initial clinical trials, consideration will be concentrated on the risk–benefit ratio, based to a large extent on the results of preclinical studies in nonhuman primates. If the benefit to the patient is anticipated to be high, eg, insulin-independent control of glycemia, and the potential risks low, eg, minimal risk of transfer of a porcine infectious agent, then a clinical trial would be justified.Keywords: infection, pigs, genetically-engineered, xenotransplantation, islets, xenotransplantation, organs

  7. Cardiovascular risk-benefit profile of sibutramine.

    Science.gov (United States)

    Scheen, A J

    2010-01-01

    (Sibutramine Cardiovascular and Diabetes Outcome Study) was designed to prospectively evaluate the efficacy/safety ratio of sibutramine in a high-risk population. The efficacy/safety results of the first 6-week lead-in open period of treatment with sibutramine 10 mg/day were reassuring in 10 742 overweight/obese high-risk subjects (97% had cardiovascular disease, 88% had hypertension, and 84% had type 2 diabetes mellitus). However, the final results of SCOUT showed that long-term (5 years') treatment with sibutramine (10-15 mg/day) exposed subjects with pre-existing cardiovascular disease to a significantly increased risk for nonfatal myocardial infarction and nonfatal stroke, but not cardiovascular death or all-cause mortality. Because the benefit of sibutramine as a weight-loss aid seems not to outweigh the cardiovascular risks, the European Medicines Agency recommended the suspension of marketing authorizations for sibutramine across the EU. The US FDA stated that the drug should carry a 'black box' warning due to an increased risk of stroke and heart attack in patients with a history of cardiovascular disease. In conclusion, concern still persists about the safety profile of sibutramine regarding cardiovascular outcomes, and the drug should not be prescribed for overweight/obese patients with a high cardiovascular risk profile.

  8. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Reducing the risk, improving women's health Research has shown that ... diabetes from developing type 2 diabetes in the years after pregnancy. ... maternal and child health and nutrition together, rather than separately, as is currently done.

  9. Benefit/risk comparisons in diagnostic radiology

    International Nuclear Information System (INIS)

    Oosterkamp, W.J.

    1976-01-01

    Benefit and risks in radiodiagnostic examination, either with X-rays or with radioactive isotopes, can be expressed in restored health and health impaired by radiation or: lives saved and estimated lives lost as a result of genetic or somatic radiation damage. Published data on benefit-risk comparisons for mass stomach and chest surveys show a considerable benefit surplus. It is demonstrated that this is also true in the case of clinical examinations of the sick. Efforts should be concentrated on better ways and means to reduce the number of diagnostic errors. Risk estimates should be made as realistic as possible

  10. Risks and benefits of genetically modified foods

    African Journals Online (AJOL)

    Jane

    2011-09-30

    Sep 30, 2011 ... education on the subject to the public. Modern ... published were on the progress of GMF technology followed by attitude studies (such as perceptions ..... Genetically Modified Corn: Environmental Benefits and. Risks.

  11. Equilibrium in benefits and hazard risk

    International Nuclear Information System (INIS)

    1988-01-01

    The chapter briefly discussed the following subjects: benefits of nuclear activities, the concept of operation optimization, concept of risks, hazards index, comparison in production costs of nuclear power generation and others sources of power generation

  12. Am I at Risk for Gestational Diabetes?

    Science.gov (United States)

    ... they control their blood sugar levels. Babies whose mothers had gestational diabetes are at higher risk for certain health ... best way to improve outcomes for babies whose mothers have gestational diabetes. Later in Life Babies whose mothers had ...

  13. Bias in risk-benefit analysis

    International Nuclear Information System (INIS)

    Mazur, A.

    1985-01-01

    Risk-benefit analysis has become popular in the past decade as a means of improving decision making, especially in the area of technology policy. Here risk-benefit analysis is compared to other (equally defensible) approaches to decision making, showing how it favors some political interests more than others, and suggesting why it has recently come to the fore as a tool of political analysis. A considerable portion of the discussion concerns nuclear power. 6 references

  14. Benefits and risks of smart home technologies

    OpenAIRE

    Wilson, Charlie; Hargreaves, Tom; Hauxwell-Baldwin, Richard

    2017-01-01

    Smart homes are a priority area of strategic energy planning and national policy. The market adoption of smart home technologies (SHTs) relies on prospective users perceiving clear benefits with acceptable levels of risk. This paper characterises the perceived benefits and risks of SHTs from multiple perspectives. A representative national survey of UK homeowners (n=1025) finds prospective users have positive perceptions of the multiple functionality of SHTs including energy management. Cedin...

  15. X-ray diagnostics - benefits and risks

    International Nuclear Information System (INIS)

    Bartholomaeus, Melanie

    2016-01-01

    The brochure on benefits and risks of X-ray diagnostics discusses the following issues: X radiation - a pioneering discovery and medical sensation, fundamentals of X radiation, frequency of X-ray examinations in Germany in relation to CT imaging, radiation doses resulting from X-ray diagnostics, benefits of X-ray diagnostics - indication and examples, risks - measures for radiation exposure reductions, avoidance of unnecessary examinations.

  16. Financial risk management of pharmacy benefits.

    Science.gov (United States)

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  17. Conventional myelography - evaluation of risk and benefit

    International Nuclear Information System (INIS)

    Hentschel, F.

    1989-01-01

    While the benefit and methodic risk of conventional myelography (KMG) are known, a radiation risk of 0.04 to 0.9 annual radiation-induced cancers can be estimated for all inhabitants of the GDR, dependent on the investigated region and the technique used. An optimized technique can reduce the radiation burden to 50 or 25%. With comparable values of benefit and radiation risk spinal CT and KMG are not contradictory but complementary investigations. Alternative methods (MRT, US) must not be discussed from the standpoint of radiation burden, but according to their availability and their methodic limitations. (author)

  18. Menopause and risk of diabetes in the Diabetes Prevention Program.

    Science.gov (United States)

    Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

    2011-08-01

    The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

  19. PCSK9 genetic variants and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Schmidt, Amand F; Swerdlow, Daniel I; Holmes, Michael V

    2017-01-01

    used data from cohort studies, randomised controlled trials, case control studies, and genetic consortia to estimate associations of PCSK9 genetic variants with LDL cholesterol, fasting blood glucose, HbA1c, fasting insulin, bodyweight, waist-to-hip ratio, BMI, and risk of type 2 diabetes, using...... diabetes, which in no way offsets their substantial benefits. We sought to investigate the associations of LDL cholesterol-lowering PCSK9 variants with type 2 diabetes and related biomarkers to gauge the likely effects of PCSK9 inhibitors on diabetes risk. METHODS: In this mendelian randomisation study, we...... a standardised analysis plan, meta-analyses, and weighted gene-centric scores. FINDINGS: Data were available for more than 550 000 individuals and 51 623 cases of type 2 diabetes. Combined analyses of four independent PCSK9 variants (rs11583680, rs11591147, rs2479409, and rs11206510) scaled to 1 mmol/L lower LDL...

  20. Diabetic Foot Risk Factors in Patients with Diabetes at the

    Directory of Open Access Journals (Sweden)

    R. Hosseini

    2008-10-01

    Full Text Available Background and Objectives Diabetic foot problems are one of the major causes of mortality and disability in diabetic patients. It is considered one of the costliest conditions for health care systems. This study is designed to identify diabetic foot risk factors in patients with diabetes mellitus at Kamkar Hospital diabetes clinic in Qom, Iran during 2006.MethodsThis study was performed on 140 diabetes mellitus patients at the Kamkar Hospital diabetic clinic. International working Group on the Diabetic Foot (IWGDF guidelines were used for physical exam of diabetic foot in these patients. The physical exam consisted of inspection of foot appearance for deformity, skin keratosis and ulcer, and neurological and arterial pulse exam of the lower extremities of these patients. Patients in this study were divided into four risk groups based on the IWGDF guidelines. ANOVA method was used for analysis and comparison of the results with P<0.05 considered as significant. ResultsMean age of the participants in this study was 52.4±11.2 years old from which 67.1% were female, 37.1% of patients were illiterate, and 10% were active smokers. Mean duration of diabetes in these patients was 8.9 years. Mean body mass index (BMI was 29.4± 4.4 and HbA1C was 9.3 ± 1.9. Percentages of the patients with retinopathy and nephropathy were 33.6% and 17.7% respectively. 95% of the patients did not know the correct way of nail clipping, 95.5% were wearing uncomfortable shoes, and 14.3% of patients had history of foot ulcer. None of the them had any education about foot care. Physical examination with monofilament, ankle reflex and vibration perception were defected in 28.6%, 52.5%, and 32.1% of patients respectively. 37.7% of patients had a decreased lower extremity pulse that was not felt by touch. Based on the IWGDF classifications, 70% of the patients were in the higher-risk group for diabetic foot ulcer. In the high risk group, age, duration of diabetes, illiteracy was

  1. Benefits from reducing risk of death

    Energy Technology Data Exchange (ETDEWEB)

    Krupnick, A

    1994-07-01

    Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States.

  2. Benefits from reducing risk of death

    International Nuclear Information System (INIS)

    Krupnick, A.

    1994-01-01

    Of the categories of benefits to individuals, reductions in the risk of premature mortality are of central. concern to the public and environmental policy makers. These benefits can include those from reductions in own- risk, for example, an individual's valuation of reducing his or her own mortality risks; reductions in risk to an individual's family, friends, or co-workers (i.e., of people known to the individual); and reductions in risks to unknown individuals. The last type would be an example of altruistic value. The overall goal is to measure the welfare change from a change in the current and/or future probability of dying. The willingness to pay (WTP) reflects the amount of income taken from a person that would leave him or her indifferent to a decrease in risk, whenever it occurs. When this value is divided by the risk change, the resulting value is called the 'value of a statistical life'. Another relevant measure appearing in the literature is the value of life-years saved. A final issue concerns the type of premature mortality risks one is valuing when environmental pollution is at issue. While most effort has gone into estimating the welfare effects of a change in current probability of death of healthy workers on the job, this is more relevant for characterizing the benefits of reducing accidental death risks than death from environmental causes. Exposure to pollutants raises risks of developing cancer, chronic heart, respiratory, and other diseases that raise mortality risks in the future. Such exposure also may raise current death risks for the very old and the sick. But, surely the pollution effect that is analogous to occupational health risks-pollution exposures high enough to raise current risks of death for the healthy, prime-age person-is insignificant in the United States

  3. Risk perception for diabetes in Appalachian women.

    Science.gov (United States)

    Chopra, Ishveen; Chopra, Avijeet

    2017-01-01

    The social and economic burden of diabetes is large and growing. Diabetes is a significant public health issue in the Appalachian region; women constitute approximately 50% of those diagnosed with diabetes. This cross-sectional study examined the relationship among sociodemographic, anthropometric, lifestyle, and psychosocial factors (cognitive and affective representations) and perceived risk of diabetes in non-diabetic, non-elderly (21-50 years) Appalachian women residing in West Virginia (N = 202). Participants were recruited through social media, flyers, and a newsletter from the West Virginia University Extension. The final survey was conducted from March 2015 to June 2015. Bivariate analyses were used to examine unadjusted relations among sociodemographic, anthropometric, lifestyle, and psychosocial factors and comparative perceived risk of diabetes. In a multivariable logistic regression model, we found that younger age, higher body mass index, non-White race, greater diabetes knowledge, personal control, and moderate amounts of physical activity were significantly, positively associated with higher diabetes risk perception (p related to diabetes risk perception among Appalachian women. Understanding perceived diabetes-related risk may aid in the development of effective intervention strategies to reduce the burden of diabetes among Appalachian and other populations. These cross-sectional findings need further evaluation in longitudinal studies.

  4. Public attitudes toward nuclear risks and benefits

    International Nuclear Information System (INIS)

    Savellano, R.A.

    As the world progresses in technology, public awareness of risks and benefits have become more acute. This is more so towards nuclear risks and benefits. This comes about when people throughout the world, because of the energy crisis, have accepted the nuclear option. Hand in hand with the benefits that it brings are the risks of radiation and other calamities. ''The role of information, the methods of public participation, and the involvement of scientific expertise play an important part in risk assessment.'' Interest in nuclear power has gained momentum with the announcement of the construction of the first nuclear power plant. Different reactions, brought about by economic, social, moral and political factors were evident, but the economic benefits seem to prevail. Nuclear power accidents, citing particularly the recent TMI incident, have started the hornets nest of nuclear controversies and have widened the scope of concern on nuclear power. The newspapers and the media, public meetings and hearings have been used as arenas of these conflicts. These brought about varying opinions and growing disagreement among the public. Risk assessment is therefore dependent on effective communication not only with the public but between scientists and decision makers and also individuals. Risk assessment in nuclear power is a complex undertaking which is to consider a wide spectrum of factors to come up with reliable results. (author)

  5. Disclosing Risk Information: Assessing the Benefits

    International Nuclear Information System (INIS)

    Beierle, Thomas C.

    2003-01-01

    This paper describes a framework for examining the benefits of risk information disclosure and illustrates the framework through brief case studies of three information disclosure programs in the United States. I describe a general framework for analyzing the benefits of information disclosure and illustrate the framework by analyzing three disclosure programs in the United States: risk management planning (RMP), which provides detailed information on chemical accident risks and prevention; materials accounting, which provides information on how chemicals travel through processes at industrial facilities; and the Sector Facility Indexing Project (SFIP), which consolidates enforcement, compliance, and other data into a package of environmental performance indicators. This paper has outlined the types of benefits information disclosure programs ought to seek to achieve. Normative right-to-know benefits have been limited in some program because of intentionally circumscribed information sharing and apparent public disinterest. Substantive benefits have been more apparent, with many firms, agencies, NGOs, and others being able to point to the value of newly revealed information in better understanding environmental problems and the means to correct them. Instrumental benefits have been mixed, and firms appear to be responding to many motivations - not just public pressure - in deciding whether to improve environmental performance

  6. Risk-benefit assessment of cold-smoked salmon: microbial risk versus nutritional benefit

    DEFF Research Database (Denmark)

    Berjia, Firew Lemma; Hoekstra, Jeljer; Andersen, Rikke

    2012-01-01

    Heart Disease (CHD) mortality and stroke, as well as enhanced cognitive (IQ) development of unborns following maternal intake, are identified as the main health benefits of omega-3 fatty acid from CSS. Contrary, risk of meningitis, septicemia and abortion/stillborn are identified as a major health risk......The objective of the study is to perform an integrated analysis of microbiological risks and nutritional benefits in a fish product, Cold Smoked Salmon (CSS). Literature study identified the major health risks and benefits in connection with CSS consumption. The reduction of the risk of Coronary...

  7. Diet, intermediate risk markers and risk of type 2 diabetes

    NARCIS (Netherlands)

    Sluijs, I.

    2011-01-01

    This thesis aimed to study the relation of diet with risk of type 2 diabetes and intermediate risk markers of diabetes. We investigated the effect of cis9, trans11 conjugated linoleic acid (c9,t11 CLA) supplementation on pulse wave velocity and cardiovascular risk factors in a randomized, controlled

  8. Nuclear energy risks and benefits in perspective

    International Nuclear Information System (INIS)

    Gordelier, S.

    2007-01-01

    Energy demand, rising prices, security of supply, climate change... these are major issues facing today's energy policy makers. In response, the NEA has recently published a study on Risks and Benefits of Nuclear Energy in order to provide these policy makers with authoritative information in support of their decision making. The study has also provided much of the basis for this article. (author)

  9. Risk of atrial fibrillation in diabetes mellitus

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik L; Schjerning, Anne-Marie; Lindhardt, Tommi B

    2016-01-01

    AIM: Diabetes has been associated with atrial fibrillation but the current evidence is conflicting. In particular knowledge regarding young diabetes patients and the risk of developing atrial fibrillation is sparse. The aim of our study was to investigate the risk of atrial fibrillation in patients...... with diabetes compared to the background population in Denmark. METHODS AND RESULTS: Through Danish nationwide registries we included persons above 18 years of age and without prior atrial fibrillation and/or diabetes from 1996 to 2012. The study cohort was divided into a background population without diabetes...... and a diabetes group. The absolute risk of developing atrial fibrillation was calculated and Poisson regression models adjusted for sex, age and comorbidities were used to calculate incidence rate ratios of atrial fibrillation. The total study cohort included 5,081,087 persons, 4,827,713 (95%) in the background...

  10. Elevated transferrin saturation and risk of diabetes

    DEFF Research Database (Denmark)

    Ellervik, Christina; Mandrup-Poulsen, Thomas; Andersen, Henrik Ullits

    2011-01-01

    OBJECTIVE We tested the hypothesis that elevated transferrin saturation is associated with an increased risk of any form of diabetes, as well as type 1 or type 2 diabetes separately. RESEARCH DESIGN AND METHODS We used two general population studies, The Copenhagen City Heart Study (CCHS, N = 9......,121) and The Copenhagen General Population Study (CGPS, N = 24,195), as well as a 1:1 age- and sex-matched population-based case-control study with 6,129 patients with diabetes from the Steno Diabetes Centre and 6,129 control subjects, totaling 8,535 patients with diabetes and 37,039 control subjects. RESULTS...

  11. Benefits and risks of smart home technologies

    International Nuclear Information System (INIS)

    Wilson, Charlie; Hargreaves, Tom; Hauxwell-Baldwin, Richard

    2017-01-01

    Smart homes are a priority area of strategic energy planning and national policy. The market adoption of smart home technologies (SHTs) relies on prospective users perceiving clear benefits with acceptable levels of risk. This paper characterises the perceived benefits and risks of SHTs from multiple perspectives. A representative national survey of UK homeowners (n=1025) finds prospective users have positive perceptions of the multiple functionality of SHTs including energy management. Ceding autonomy and independence in the home for increased technological control are the main perceived risks. An additional survey of actual SHT users (n=42) participating in a smart home field trial identifies the key role of early adopters in lowering perceived SHT risks for the mass market. Content analysis of SHT marketing material (n=62) finds the SHT industry are insufficiently emphasising measures to build consumer confidence on data security and privacy. Policymakers can play an important role in mitigating perceived risks, and supporting the energy-management potential of a smart-home future. Policy measures to support SHT market development include design and operating standards, guidelines on data and privacy, quality control, and in situ research programmes. Policy experiences with domestic energy efficiency technologies and with national smart meter roll-outs offer useful precedents. - Highlights: • Representative national survey of prospective smart home users. • Comparative analysis of three datasets to analyse perceived benefits and risks of smart home technologies. • Distinctive characteristics identified of early adopters who seed market growth. • Comparison of user perceptions with industry marketing. • Detailed policy recommendations to support energy benefits of smart home technologies.

  12. Prediabetes: a high-risk state for diabetes development.

    Science.gov (United States)

    Tabák, Adam G; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J; Kivimäki, Mika

    2012-06-16

    Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Gestational Diabetes Mellitus: Risks and Management during and after Pregnancy

    Science.gov (United States)

    Buchanan, Thomas A.; Xiang, Anny H.; Page, Kathleen A.

    2015-01-01

    Gestational diabetes mellitus (GDM) represents glucose levels in the high end of the population distribution during pregnancy. GDM carries a small but potentially important risk of adverse perinatal outcomes and a longer-term risk of obesity and glucose intolerance in offspring. Mothers with GDM have an excess of hypertensive disorders during pregnancy and a high risk of diabetes mellitus thereafter. Diagnosing and treating GDM can reduce perinatal complications, but only a small fraction of pregnancies benefit. Nutritional management is the cornerstone of treatment; insulin, glyburide and metformin can be used to intensify treatment. Fetal measurements compliment maternal glucose measurements in identifying pregnancies that need such intensification. Glucose testing shortly after pregnancy can stratify the near-term diabetes risk in mothers, Thereafter, annual glucose and HbA1C testing can detect deteriorating glycaemic control, a harbinger of future diabetes, usually type 2. Interventions that mitigate obesity or its metabolic effects are most potent in preventing or delaying diabetes. Lifestyle modification is the primary approach; use of medications for diabetes prevention after GDM remains controversial. Family planning allows optimization of health in subsequent pregnancies. Breastfeeding may reduce obesity in children and is recommended. Families should be encouraged to help children adopt lifestyles that reduce the risk of obesity. PMID:22751341

  14. Comparing diagnostic tests on benefit-risk.

    Science.gov (United States)

    Pennello, Gene; Pantoja-Galicia, Norberto; Evans, Scott

    2016-01-01

    Comparing diagnostic tests on accuracy alone can be inconclusive. For example, a test may have better sensitivity than another test yet worse specificity. Comparing tests on benefit risk may be more conclusive because clinical consequences of diagnostic error are considered. For benefit-risk evaluation, we propose diagnostic yield, the expected distribution of subjects with true positive, false positive, true negative, and false negative test results in a hypothetical population. We construct a table of diagnostic yield that includes the number of false positive subjects experiencing adverse consequences from unnecessary work-up. We then develop a decision theory for evaluating tests. The theory provides additional interpretation to quantities in the diagnostic yield table. It also indicates that the expected utility of a test relative to a perfect test is a weighted accuracy measure, the average of sensitivity and specificity weighted for prevalence and relative importance of false positive and false negative testing errors, also interpretable as the cost-benefit ratio of treating non-diseased and diseased subjects. We propose plots of diagnostic yield, weighted accuracy, and relative net benefit of tests as functions of prevalence or cost-benefit ratio. Concepts are illustrated with hypothetical screening tests for colorectal cancer with test positive subjects being referred to colonoscopy.

  15. Global prevalence and major risk factors of diabetic retinopathy

    DEFF Research Database (Denmark)

    Yau, Joanne W Y; Rogers, Sophie L; Kawasaki, Ryo

    2012-01-01

    To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes.......To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes....

  16. Risks and Benefits of Bisphosphonate Therapies

    DEFF Research Database (Denmark)

    Reyes, Carlen; Hitz, Mette; Prieto-Alhambra, Daniel

    2016-01-01

    -term adverse effects. Some of the adverse effects identified include an increased risk of atypical femur fractures, osteonecrosis of the jaw, gastrointestinal side effects, or atrial fibrillation. The harm/benefit thinking and the constant update regarding these medications are vital in the day-to-day decision-making...... in clinical practices. The aims of this review are to compile the basic characteristics of these drugs and outline the most important benefits and side effects and provide a clinical context as well as a research agenda to fill the gaps in our knowledge....

  17. Lifestyle interventions to reduce risk of diabetes among women with prior gestational diabetes mellitus.

    Science.gov (United States)

    Chasan-Taber, Lisa

    2015-01-01

    While lifestyle interventions involving exercise and a healthy diet in high-risk adults have been found to reduce progression to type 2 diabetes by >50%, little attention has been given to the potential benefits of such strategies in women with a history of gestational diabetes mellitus (GDM). We conducted a literature search of PubMed for English language studies of randomized controlled trials of lifestyle interventions among women with a history of GDM. In total, nine studies were identified which fulfilled the eligibility criteria. The majority of randomized trials of lifestyle interventions in women with GDM have been limited to pilot or feasibility studies. However, preliminary findings suggest that such interventions can improve diabetes risk factors in women with a history of GDM. Larger, well-designed controlled randomized trials are needed to assess the effects of lifestyle interventions on preventing subsequent progression to type 2 diabetes among women with GDM. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. SGLT2 Inhibitors: Benefit/Risk Balance.

    Science.gov (United States)

    Scheen, André J

    2016-10-01

    Inhibitors of sodium-glucose cotransporters type 2 (SGLT2) reduce hyperglycemia by increasing urinary glucose excretion. They have been evaluated in patients with type 2 diabetes treated with diet/exercise, metformin, dual oral therapy or insulin. Three agents are available in Europe and the USA (canagliflozin, dapagliflozin, empagliflozin) and others are commercialized in Japan or in clinical development. SGLT2 inhibitors reduce glycated hemoglobin, with a minimal risk of hypoglycemia. They exert favorable effects beyond glucose control with consistent body weight, blood pressure, and serum uric acid reductions. Empagliflozin showed remarkable reductions in cardiovascular/all-cause mortality and in hospitalization for heart failure in patients with previous cardiovascular disease. Positive renal outcomes were also shown with empagliflozin. Mostly reported adverse events are genital mycotic infections, while urinary tract infections and events linked to volume depletion are rather rare. Concern about a risk of ketoacidosis and bone fractures has been recently raised, which deserves caution and further evaluation.

  19. The Risks and Benefits of Calcium Supplementation

    Directory of Open Access Journals (Sweden)

    Chan Soo Shin

    2015-03-01

    Full Text Available The association between calcium supplementation and adverse cardiovascular events has recently become a topic of debate due to the publication of two epidemiological studies and one meta-analysis of randomized controlled clinical trials. The reports indicate that there is a significant increase in adverse cardiovascular events following supplementation with calcium; however, a number of experts have raised several issues with these reports such as inconsistencies in attempts to reproduce the findings in other populations and questions concerning the validity of the data due to low compliance, biases in case ascertainment, and/or a lack of adjustment. Additionally, the Auckland Calcium Study, the Women's Health Initiative, and many other studies included in the meta-analysis obtained data from calcium-replete subjects and it is not clear whether the same risk profile would be observed in populations with low calcium intakes. Dietary calcium intake varies widely throughout the world and it is especially low in East Asia, although the risk of cardiovascular events is less prominent in this region. Therefore, clarification is necessary regarding the occurrence of adverse cardiovascular events following calcium supplementation and whether this relationship can be generalized to populations with low calcium intakes. Additionally, the skeletal benefits from calcium supplementation are greater in subjects with low calcium intakes and, therefore, the risk-benefit ratio of calcium supplementation is likely to differ based on the dietary calcium intake and risks of osteoporosis and cardiovascular diseases of various populations. Further studies investigating the risk-benefit profiles of calcium supplementation in various populations are required to develop population-specific guidelines for individuals of different genders, ages, ethnicities, and risk profiles around the world.

  20. [Air humidifier--benefit or risk?].

    Science.gov (United States)

    Fidler, A H

    1989-12-01

    Indoor air pollution has become an issue of growing importance for the scientific community. A recent publication of a report of the US Environmental Protection Agency (EPA) showed evidence that portable ultrasonic humidifiers may play a significant role as health hazards as far as indoor air pollution with heavy metal particles is concerned. Especially if the manufacturers' guidelines are not followed strictly and the device is operated with tap water, indoor particle concentrations may reach up to 50 times US outdoor standards for toxic particle concentration. This paper highlights potential risks and benefits of various types of humidifiers, both in private and hospital settings, emphasizing that risks of air humidification in certain situations might outweigh anticipated benefits. The health policy implication of these findings should lead to a more critical application of air humidification in the health care environment and in addition to that, promote better information of the customer about safe operation and useful indications of such devices.

  1. Benefits and Risks of Open Government Data

    Directory of Open Access Journals (Sweden)

    Jan Kucera

    2014-01-01

    Full Text Available Public sector bodies maintain a large amount of data from various domains. This data represents a potential resource that organizations and individuals can use to enhance their own datasets or which can be used to develop new and innovative products and services. In order to foster the reuse of the data held by the public sector bodies a number of countries around the world has started to publish its data according to the Open Data principles. In this paper we present a set of benefits that can be achieved by publishing Open Government Data (OGD and a set of risks that should be assessed when a dataset is considered for opening up. Benefits and risks presented in this paper were mostly identified during two of our OGD activities.

  2. Risk Perception for Developing Diabetes among Non-diabetic Individuals

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2016-06-01

    Full Text Available Background: the incidence and prevalence of type 2 diabetes mellitus have increased in recent decades and this trend is expected to continue. Objective: to determine the risk perception for developing type 2 diabetes among non-diabetic individuals. Methods: a cross-sectional study involving non-diabetic individuals in the catchment area of the doctor-and-nurse office No.15 of the Manuel Fajardo Polyclinic in Cienfuegos was conducted between May 2013 and June 2014. The universe consisted of 1145 people, and the sample included 323 individuals of different age groups selected by sex. The variables studied were: age, sex, body mass index, nutritional assessment, and having a perceived risk when they answered 70 % of questions correctly. The arithmetic mean, standard deviation, Chi-square test, and risk estimation were calculated with a 95 % confidence interval. Results: individuals aged 25 to 34 years and females predominated. Fifty nine point two percent of the study participants knew of their risk. Eighty one point one percent understood that diabetes is preventable and 93.5 % stated that it is their responsibility to prevent its development. Thirty five point two percent of women considered normal-weight/thin fully agreed on the importance of physical activity and diabetes prevention. Eighty point five percent of women and 78.5 % of men answered positively to the question about obesity and diabetes. Conclusions: study participants knew of their risk of developing type 2 diabetes, although a large number of them attributed all responsibility for prevention to the health personnel.

  3. Cannabis and neuropsychiatry, 1: benefits and risks.

    Science.gov (United States)

    Andrade, Chittaranjan

    2016-05-01

    Cannabis is popularly believed to be a relatively benign substance. Cannabis is also considered to have potential medical benefits, and medical marijuana has been legislated in many parts of the world. However, a recent meta-analysis found that cannabinoids were associated with only modest benefits for chemotherapy-related nausea and vomiting, small and inconsistent benefits for pain and spasticity, and inconclusive benefits for other indications such as improvement of appetite and weight, reduction in tic severity, and improvement of mood or sleep. On the flip side, cannabinoids and cannabis have acute and long-term adverse effects. In randomized controlled trials, cannabinoids increase the risk of total adverse events, serious adverse events, and dropout due to adverse events. Cannabis impairs cognition, and driving after cannabis use is associated with an increased risk of traffic accidents, including fatal accidents. Long-term cannabis use may lead to dependence, respiratory conditions, psychosis, and possibly cancer, as well. Cannabis use during pregnancy may compromise certain pregnancy outcomes such as fetal growth, and use during adolescence may compromise neurodevelopment, social adjustment, and vocational success. The composition and bioavailability of cannabis vary across preparations of the substance and routes of administration; this limits the ability to generalize the findings of studies. The findings of older research may no longer apply to current strains of cannabis that are higher in psychotogenic content. It is important for medical professionals and the lay public to understand the limitations of the efficacy data and the seriousness of the risks associated with cannabis use in medical and recreational contexts. © Copyright 2016 Physicians Postgraduate Press, Inc.

  4. Think It Through: Managing the Benefits and Risks of Medicines

    Science.gov (United States)

    ... Drugs) Think It Through: Managing the Benefits and Risks of Medicines Share Tweet Linkedin Pin it More ... make decisions about the medicines you use. Managing Risk When a medicine's benefits outweigh its known risks, ...

  5. SGLT2-I in the Hospital Setting: Diabetic Ketoacidosis and Other Benefits and Concerns.

    Science.gov (United States)

    Levine, Joshua A; Karam, Susan L; Aleppo, Grazia

    2017-07-01

    Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents. They are increasingly being prescribed in the outpatient diabetic population. In this review, we examine the risks and benefits of continuation and initiation of SGLT2 inhibitors in the inpatient setting. There are currently no published data regarding safety and efficacy of SGLT2 inhibitor use in the hospital. Outpatient data suggests that SGLT2 inhibitors have low hypoglycemic risk. They also decrease systolic blood pressure and can prevent cardiovascular death. The EMPA-REG study also showed a decrease in admissions for acute decompensated heart failure. There have been increasing cases of diabetic ketoacidosis, and specifically the euglycemic manifestation, associated with SGLT2 inhibitors use. We present two cases of inpatient SGLT2 inhibitor use, one of continuation of outpatient therapy and one of new initiation of therapy. We then discuss potential risks and methods to mitigate these as well as benefits of these medications in the inpatient setting. We cautiously suggest the use of SGLT2 inhibitors in the hospital. However, these must be used judiciously and the practitioner must be aware of euglycemic diabetic ketoacidosis and its risk factors in this population.

  6. Prediabetes: A high-risk state for developing diabetes

    Science.gov (United States)

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  7. Crowdfunding our health: Economic risks and benefits.

    Science.gov (United States)

    Renwick, Matthew J; Mossialos, Elias

    2017-10-01

    Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Evaluating the benefits of risk prevention initiatives

    Science.gov (United States)

    Di Baldassarre, G.

    2012-04-01

    The likelihood and adverse impacts of water-related disasters, such as floods and landslides, are increasing in many countries because of changes in climate and land-use. This presentation illustrates some preliminary results of a comprehensive demonstration of the benefits of risk prevention measures, carried out within the European FP7 KULTURisk project. The study is performed by using a variety of case studies characterised by diverse socio-economic contexts, different types of water-related hazards (floods, debris flows and landslides, storm surges) and space-time scales. In particular, the benefits of state-of-the-art prevention initiatives, such as early warning systems, non-structural options (e.g. mapping and planning), risk transfer strategies (e.g. insurance policy), and structural measures, are showed. Lastly, the importance of homogenising criteria to create hazard inventories and build memory, efficient risk communication and warning methods as well as active dialogue with and between public and private stakeholders, is highlighted.

  9. Safety in relation to risk and benefit

    International Nuclear Information System (INIS)

    Siddall, E.

    1985-01-01

    The proper definition and quantification of human safety is discussed and from this basis the historical development of our present very high standard of safety is traced. It is shown that increased safety is closely associated with increased wealth, and the quantitative relationship between then is derived from different sources of evidence. When this factor is applied to the production of wealth by industry, a safety benefit is indicated which exceeds the asserted risks by orders of magnitude. It is concluded that present policies and attitudes in respect to the safety of industry may be diametrically wrong. (orig.) [de

  10. Smart Transmission Grids - Benefits and Risks

    Directory of Open Access Journals (Sweden)

    Velasco-Ramírez E.

    2013-01-01

    Full Text Available Nowadays the Power Systems are working near their stability limits, for this reason it is necessary and essential a transition to new transmission systems that ensure efficient delivery of electrical energy, with the objective to prevent “blackouts” that causesignificant losses in the economy of any country in the world. This paper analyzes important elements to consider having a healthy and efficient transition from a power grid vertically integrated into a smart transmission grid. A comparative analysis in the model, development, benefits and risks of the implementation of these systems, between two of the main marc of references of smart grids, the EU and the USA is presented.

  11. Benefit and risk in breast screening

    International Nuclear Information System (INIS)

    Law, J.; Faulkner, K.; Neilson, F.

    2001-01-01

    Justification of breast screening in radiation protection terms both for the screened population and on an individual basis is necessary. In this paper the number of cancers detected, and the number of cancers potentially induced by radiation in the UK National Health Service Breast Screening Programme (NHS BSP) are compared. Detection rates reported up to 1998 are used, with x-ray doses for 1997 and 1998 and breast cancer induction risk factors, stratified by age, recommended by the National Radiological Protection Board in 1994. Cancers detected exceed those potentially induced at all ages from 50-64. The relationship between these cancer numbers and the associated benefit and risk, in terms of breast cancer deaths avoided and induced, is then investigated. Improved values of the Nottingham Prognostic Indicator (NPI) attributed to screening provide one means of doing this. Using this strict criterion the breast-screening programme is also justified in radiation protection terms. (author)

  12. Integrated Intervention for Diabetes Risk After Gestational Diabetes ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    They will work with at-risk women from poor communities who use the public health system in the cities of Cape Town and Johannesburg. The proposed intervention involves offering women a special test to see whether they have diabetes six weeks after delivery, along with counselling about healthy lifestyles from a ...

  13. Meat Consumption as a Risk Factor for Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Neal Barnard

    2014-02-01

    Full Text Available Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption, as a scalar variable (i.e., gradations of meat consumption, or as part of a broader dietary pattern.

  14. The affect heuristic in judgments of risks and benefits

    International Nuclear Information System (INIS)

    Finucane, M.; Slovic, P.; Johnson, S.M.; Alhakami, A.

    1998-01-01

    The role of affect in judgment of risks and benefits is examined in two studies. Despite using different methodologies the two studies suggest that risk and benefit are linked somehow in people's perception, consequently influencing their judgments. Short paper

  15. Risks and Benefits of Rapid Clozapine Titration.

    Science.gov (United States)

    Lochhead, Jeannie D; Nelson, Michele A; Schneider, Alan L

    2016-05-18

    Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid clozapine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS) during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

  16. Risks and benefits of rapid clozapine titration

    Directory of Open Access Journals (Sweden)

    Jeannie D. Lochhead

    2016-05-01

    Full Text Available Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid clozapine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

  17. Personalized Genetic Risk Counseling to Motivate Diabetes Prevention

    OpenAIRE

    Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.

    2012-01-01

    OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top an...

  18. Benefits and risks of fish consumption

    International Nuclear Information System (INIS)

    Domingo, Jose L.; Bocio, Ana; Falco, Gemma; Llobet, Juan M.

    2007-01-01

    In recent years, and based on the importance of fish as a part of a healthy diet, there has been a notable promotion of fish consumption. However, the balance between health benefits and risks, due to the intake of chemical contaminants, is not well characterized. In the present study, edible samples of 14 marine species were analyzed for the concentrations of omega-3 fatty acids, as well as a number of metals and organic pollutants. Daily intakes were specifically determined for a standard adult of 70 kg, and compared with the tolerable/admissible intakes of the pollutants, if available. Salmon, mackerel, and red mullet were the species showing the highest content of omega-3 fatty acids. The daily intakes of cadmium, lead, and mercury through fish consumption were 1.1, 2.0, and 9.9 μg, respectively. Dioxins and furans plus dioxin-like polychlorinated biphenyls (PCBs) intake was 38.0 pg WHO-TEQ/day, whereas those of polybrominated diphenyl ethers (PBDEs), polychlorinated diphenyl ethers (PCDEs), polychlorinated naphthalenes (PCNs) and hexachlorobenzene (HCB) were 20.8, 39.4, 1.53, and 1.50 ng/day, respectively. In turn, the total intake of 16 analyzed polycyclic aromatic hydrocarbons (PAHs) was 268 ng/day. The monthly fish consumption limits for human health endpoints based on the intake of these chemical contaminants were calculated for a 70 years exposure. In general terms, most marine species here analyzed should not mean adverse health effects for the consumers. However, the type of fish, the frequency of consumption, and the meal size are essential issues for the balance of the health benefits and risks of regular fish consumption

  19. Human milk pasteurization: benefits and risks.

    Science.gov (United States)

    O'Connor, Deborah L; Ewaschuk, Julia B; Unger, Sharon

    2015-05-01

    Recent findings substantiate that the optimal method of nourishing preterm, very low birth weight infants (VLBW, born pasteurized donor milk. The availability of donor milk for VLBW infants during initial hospitalization continues to increase with the launch of new milk banks in North America. The majority of North American neonatal ICUs now have written policies governing the provision of donor milk. The purpose of this review is to summarize recent evidence regarding the risks and benefits of pasteurization of human milk and outcomes associated with its provision to VLBW preterm infants. Studies investigating the impact of collection, storage and pasteurization on the bacteriostatic, immunologic and nutritional aspects of human milk continue to be published, generally revealing a partial, but not complete reduction in bioactivity. Risk of contamination of pasteurized donor human milk with pathogenic agents is mitigated through pasteurization. New pasteurization methods aiming to maintain the safety of pooled human milk while better preserving bioactivity are under investigation. Provision of a human milk-derived diet to preterm VLBW infants is associated with improved outcomes.

  20. Gestational Diabetes in Korea: Incidence and Risk Factors of Diabetes in Women with Previous Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Hak Chul Jang

    2011-02-01

    Full Text Available Korean women with a history of gestational diabetes mellitus (GDM have a 3.5 times greater risk of developing postpartum diabetes than the general population. The incidence of type 2 diabetes mellitus in early postpartum is reported as 10-15% in Korean women. A prospective follow-up study on Korean women with GDM showed that approximately 40% of women with previous GDM were expected to develop diabetes within 5 years postpartum. Independent risk factors for the development of diabetes in Korean women with previous GDM are pre-pregnancy body weight, gestational age at diagnosis, antepartum hyperglycemia on oral glucose tolerance test, low insulin response to oral glucose load, and family history of diabetes. Women with postpartum diabetes have greater body mass indexes, body weight, and waist circumferences than women with normal glucose tolerance. Multiple logistic regression analysis has revealed that waist circumference is the strongest obesity index along with systolic blood pressure and that triglyceride levels are a major independent risk factor for developing diabetes. These results in Korean women with previous GDM underline the importance of postpartum testing in Korean women diagnosed with GDM, and demonstrate that impaired B-cell function, obesity, and especially visceral obesity, are associated with the development of diabetes.

  1. Ketamine for chronic pain: risks and benefits

    Science.gov (United States)

    Niesters, Marieke; Martini, Christian; Dahan, Albert

    2014-01-01

    The anaesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibition of the N-methyl-D-aspartate receptor although other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short term infusions indicate that ketamine produces potent analgesia during administration only, while three studies on the effect of prolonged infusion (4–14 days) show long-term analgesic effects up to 3 months following infusion. The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and, in a minority of patients, hepatoxicity. The recreational use of ketamine is increasing and comes with a variety of additional risks ranging from bladder and renal complications to persistent psychotypical behaviour and memory defects. Blind extrapolation of these risks to clinical patients is difficult because of the variable, high and recurrent exposure to the drug in ketamine abusers and the high frequency of abuse of other illicit substances in this population. In clinical settings, ketamine is well tolerated, especially when benzodiazepines are used to tame the psychotropic side effects. Irrespective, close monitoring of patients receiving ketamine is mandatory, particularly aimed at CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Further research is required to assess whether the benefits outweigh the risks and costs. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain. PMID:23432384

  2. Ketamine for chronic pain: risks and benefits.

    Science.gov (United States)

    Niesters, Marieke; Martini, Christian; Dahan, Albert

    2014-02-01

    The anaesthetic ketamine is used to treat various chronic pain syndromes, especially those that have a neuropathic component. Low dose ketamine produces strong analgesia in neuropathic pain states, presumably by inhibition of the N-methyl-D-aspartate receptor although other mechanisms are possibly involved, including enhancement of descending inhibition and anti-inflammatory effects at central sites. Current data on short term infusions indicate that ketamine produces potent analgesia during administration only, while three studies on the effect of prolonged infusion (4-14 days) show long-term analgesic effects up to 3 months following infusion. The side effects of ketamine noted in clinical studies include psychedelic symptoms (hallucinations, memory defects, panic attacks), nausea/vomiting, somnolence, cardiovascular stimulation and, in a minority of patients, hepatoxicity. The recreational use of ketamine is increasing and comes with a variety of additional risks ranging from bladder and renal complications to persistent psychotypical behaviour and memory defects. Blind extrapolation of these risks to clinical patients is difficult because of the variable, high and recurrent exposure to the drug in ketamine abusers and the high frequency of abuse of other illicit substances in this population. In clinical settings, ketamine is well tolerated, especially when benzodiazepines are used to tame the psychotropic side effects. Irrespective, close monitoring of patients receiving ketamine is mandatory, particularly aimed at CNS, haemodynamic, renal and hepatic symptoms as well as abuse. Further research is required to assess whether the benefits outweigh the risks and costs. Until definite proof is obtained ketamine administration should be restricted to patients with therapy-resistant severe neuropathic pain. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

  3. Risk factors of diabetic retinopathy in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    CAI Xiao-ling; WANG Fang; JI Li-nong

    2006-01-01

    Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

  4. Alcohol drinking patterns and risk of diabetes

    DEFF Research Database (Denmark)

    Holst, Charlotte; Becker, Ulrik; Jørgensen, Marit E

    2017-01-01

    AIMS/HYPOTHESIS: Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population. METHODS: This cohort study...... was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4.9 years. Self-reported questionnaires were used to obtain information on alcohol drinking patterns......, i.e. frequency of alcohol drinking, frequency of binge drinking, and consumption of wine, beer and spirits, from which we calculated beverage-specific and overall average weekly alcohol intake. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox...

  5. Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes?

    Science.gov (United States)

    Sluik, Diewertje; Boeing, Heiner; Li, Kuanrong; Kaaks, Rudolf; Johnsen, Nina Føns; Tjønneland, Anne; Arriola, Larraitz; Barricarte, Aurelio; Masala, Giovanna; Grioni, Sara; Tumino, Rosario; Ricceri, Fulvio; Mattiello, Amalia; Spijkerman, Annemieke M W; van der A, Daphne L; Sluijs, Ivonne; Franks, Paul W; Nilsson, Peter M; Orho-Melander, Marju; Fhärm, Eva; Rolandsson, Olov; Riboli, Elio; Romaguera, Dora; Weiderpass, Elisabete; Sánchez-Cantalejo, Emilio; Nöthlings, Ute

    2014-01-01

    Thus far, it is unclear whether lifestyle recommendations for people with diabetes should be different from those for the general public. We investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Joint Cox proportional hazard regression models of people with and without diabetes were built for the following lifestyle factors in relation to overall mortality risk: BMI, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking. Likelihood ratio tests for heterogeneity assessed statistical differences in regression coefficients. Multivariable adjusted mortality risk among individuals with diabetes compared with those without was increased, with an HR of 1.62 (95% CI 1.51, 1.75). Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk. These associations were significantly different in magnitude from those in diabetes-free individuals, but directions were similar. No differences between people with and without diabetes were detected for the other lifestyle factors. Diabetes status did not substantially influence the associations between lifestyle and mortality risk. People with diabetes may benefit more from a healthy diet, but the directions of association were similar. Thus, our study suggests that lifestyle advice with respect to mortality for patients with diabetes should not differ from recommendations for the general population.

  6. Parental History of Diabetes, Positive Affect, and Diabetes Risk in Adults: Findings from MIDUS.

    Science.gov (United States)

    Tsenkova, Vera K; Karlamangla, Arun S; Ryff, Carol D

    2016-12-01

    Family history of diabetes is one of the major risk factors for diabetes, but significant variability in this association remains unexplained, suggesting the presence of important effect modifiers. To our knowledge, no previous work has examined whether psychological factors moderate the degree to which family history of diabetes increases diabetes risk. We investigated the relationships among parental history of diabetes, affective states (positive affect, negative affect, and depressed affect), and diabetes in 978 adults from the MIDUS 2 national sample. As expected, parental history of diabetes was associated with an almost threefold increase in diabetes risk. We found a significant interaction between positive affect and parental history of diabetes on diabetes (p = .009): higher positive affect was associated with a statistically significant lower relative risk for diabetes in participants who reported having a parental history of diabetes (RR = .66 per unit increase in positive affect; 95 % CI = .47; .93), but it did not influence diabetes risk for participants who reported no parental history of diabetes (p = .34). This pattern persisted after adjusting for an extensive set of health and sociodemographic covariates and was independent of negative and depressed affect. These results suggest that psychological well-being may protect individuals at increased risk from developing diabetes. Understanding such interactions between non-modifiable risk factors and modifiable psychological resources is important for delineating biopsychosocial pathways to diabetes and informing theory-based, patient-centered interventions to prevent the development of diabetes.

  7. Ionization radiations - basis, risks and benefits

    International Nuclear Information System (INIS)

    Bodart, F.

    1991-01-01

    An attempt is made to discuss the use of ionizing radiations in an impartial way. Ionizing radiation is potentially harmfull; excessive doses have a devastating effect on living cells. However, there is no direct, conclusive evidence of human disability, either in the form of cancer or genetic anomalies, arising as a consequence of low-level doses of x- or gamma-rays of about 0.01 Gray (1 rad) the entire dose range involved in medical radiography or in nuclear industry. Statements appearing in the press that a certain number of excess cancers will be produced are estimates, based maybe on plausible assumptions, but estimates nevertheless; they are not measured quantities or established facts. A balanced view of radiation must include appreciation of the substantial benefits which result from their use in both medicine and industry. The risks are small and hard to demonstrate, and it is instructive to make a comparison with the other hazards occuring continually in an industrialized society, such as driving a motorcar or smoking cigarettes. (Author)

  8. Job insecurity and risk of diabetes

    DEFF Research Database (Denmark)

    Ferrie, Jane E.; Virtanen, Marianna; Jokela, Markus

    2016-01-01

    participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary...... risk estimate. Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk...... of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09–1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking...

  9. Risk factors for feline diabetes mellitus

    NARCIS (Netherlands)

    Slingerland, L.I.|info:eu-repo/dai/nl/304830917

    2008-01-01

    The chapters of Part I of the thesis describe the development of techniques that can be used in the assessment of risk factors for the development of diabetes mellitus (DM) in cats. The hyperglycemic glucose clamp (HGC) was developed for use in conscious cats, equipped with arterial catheters for

  10. Diabetes propels the risk for cardiovascular disease

    NARCIS (Netherlands)

    Diepen, van Janna A.; Thiem, Kathrin; Stienstra, Rinke; Riksen, Niels P.; Tack, Cees J.; Netea, Mihai G.

    2016-01-01

    Diabetes strongly predisposes to cardiovascular disease (CVD), the leading cause of mortality in these patients, as well as in the entire population. Hyperglycemia is an important cardiovascular risk factor as shown by the observation that even transient periods of hyperglycemia, despite return

  11. The benefits of integrating cost-benefit analysis and risk assessment

    International Nuclear Information System (INIS)

    Fisher, K.; Clarke-Whistler, K.

    1995-01-01

    It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements in health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada's concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health

  12. Alcohol consumption and diabetes risk in the Diabetes Prevention Program1234

    OpenAIRE

    Crandall, Jill P; Polsky, Sarit; Howard, Andrea A; Perreault, Leigh; Bray, George A; Barrett-Connor, Elizabeth; Brown-Friday, Janet; Whittington, Tracy; Foo, Sandra; Ma, Yong; Edelstein, Sharon L

    2009-01-01

    Background: Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes.

  13. Pleiotropic effects of type 2 diabetes management strategies on renal risk factors.

    Science.gov (United States)

    Muskiet, Marcel H A; Tonneijck, Lennart; Smits, Mark M; Kramer, Mark H H; Heerspink, Hiddo J Lambers; van Raalte, Daniël H

    2015-05-01

    In parallel with the type 2 diabetes pandemic, diabetic kidney disease has become the leading cause of end-stage renal disease worldwide, and is associated with high cardiovascular morbidity and mortality. As established in landmark randomised trials and recommended in clinical guidelines, prevention and treatment of diabetic kidney disease focuses on control of the two main renal risk factors, hyperglycaemia and systemic hypertension. Treatment of systemic hypertension with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers is advocated because these drugs seem to exert specific renoprotective effects beyond blood pressure lowering. Emerging evidence shows that obesity, glomerular hyperfiltration, albuminuria, and dyslipidaemia might also adversely affect the kidney in diabetes. Control of these risk factors could have additional benefits on renal outcome in patients with type 2 diabetes. However, despite multifactorial treatment approaches, residual risk for the development and progression of diabetic kidney disease in patients with type 2 diabetes remains, and novel strategies or therapies to treat the disease are urgently needed. Several drugs used in the treatment of type 2 diabetes are associated with pleiotropic effects that could favourably or unfavourably change patients' renal risk profile. We review the risk factors and treatment of diabetic kidney disease, and describe the pleiotropic effects of widely used drugs in type 2 diabetes management on renal outcomes, with special emphasis on antihyperglycaemic drugs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Statin use before diabetes diagnosis and risk of microvascular disease

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Nordestgaard, Børge G

    2014-01-01

    BACKGROUND: The role of statins in the development of microvascular disease in patients with diabetes is unknown. We tested the hypothesis that statin use increases the risk of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and gangrene of the foot in individuals with diabetes...... the cumulative incidence of diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, or gangrene of the foot in statin users versus non-statin users. We analysed data with Cox regression models, adjusted for covariates including sex, age at diabetes diagnosis, and method of diabetes diagnosis. To address...... diabetic neuropathy, 1248 developed diabetic nephropathy, and 2392 developed gangrene of the foot. Compared with non-statin users, statin users had a lower cumulative incidence of diabetic retinopathy (hazard ratio 0·60, 95% CI 0·54-0·66; pdiabetic neuropathy (0·66, 0·57-0·75; p

  15. Communicating the risks, and the benefits, of nanotechnology

    Science.gov (United States)

    Schuler, Emmanuelle

    2009-01-01

    Issues surrounding the wide spectrum of (perceived) risks and possible benefits associated with the rapid advance of modern nanotechnology are deliberated. These include the current realities of nanotechnological hazards, their impact vis-à-vis perceived nanotech-risks and perceived nanotech-benefits, and the consequent repercussions on the public and society. It is argued that both the risks and the benefits of nanoscientific advances must be properly communicated if the public is to support this emerging technology. PMID:19823594

  16. Potential Effect of Opium Consumption on Controlling Diabetes and Some Cardiovascular Risk Factors in Diabetic Patients

    OpenAIRE

    Rahimi, Najmeh; Gozashti, Mohamad Hossain; Najafipour, Hamid; Shokoohi, Mostafa; Marefati, Hamid

    2014-01-01

    Background Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors, the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients. Methods This study enrolled 374 diabetic subjects from diabetes care centers in Kerman, Iran, including opium user group (n = 179) and a non-opium user group (n = 195). The data were collected through a questionnair...

  17. Benefits, risks, and costs of stratospheric geoengineering

    KAUST Repository

    Robock, Alan; Marquardt, Allison; Kravitz, Ben; Stenchikov, Georgiy L.

    2009-01-01

    Injecting sulfate aerosol precursors into the stratosphere has been suggested as a means of geoengineering to cool the planet and reduce global warming. The decision to implement such a scheme would require a comparison of its benefits, dangers

  18. Benefits and risks of nuclear power

    International Nuclear Information System (INIS)

    Faessler, A.

    1982-01-01

    This popular report tries to compare advantages and risks of nuclear energy to one another. In comparison with other risks the author considers the remaining risk of nuclear energy acceptable. The main condition of a further development is, however, a political decision borne by the majority of the population. (UA) [de

  19. Discussing Benefits and Risks of Tracheostomy: What Physicians Actually Say.

    Science.gov (United States)

    Hebert, Lauren M; Watson, Anne C; Madrigal, Vanessa; October, Tessie W

    2017-12-01

    When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children. A multicenter, multidisciplinary expert panel of clinicians was surveyed to generate a list of recommended benefits and risks for comparison. Primary analysis of statements by clinicians was qualitative. Single-center PICU of a tertiary medical center. Family members who participated in family-physician conferences regarding tracheostomy placement for a critically ill child from April 2012 to August 2014. We identified 300 physician statements describing benefits and risks of tracheostomy. Physicians were more likely to discuss benefits than risks (72% vs 28%). Three broad categories of benefits were identified: 1) tracheostomy would limit the impact of being in the PICU (46%); 2) perceived obstacles of tracheostomy can be overcome (34%); and 3) tracheostomy optimizes respiratory health (20%). Risks fell into two categories: tracheostomy involves a big commitment (71%), and it has complications (29%). The expert panel's recommendations were similar to risks and benefits discussed during family conferences; however, they suggested physicians present an equal balance of discussion of risks and benefits. When discussing tracheostomy placement, physicians emphasized benefits that are shared by physicians and families while minimizing the risks. The expert panel recommended a balanced approach by equally weighing risks and benefits. To facilitate educated decision making, physicians should present a more extensive range of risks and benefits to families making this critical

  20. Use of Medicare's Diabetes Self-Management Training Benefit

    Science.gov (United States)

    Strawbridge, Larisa M.; Lloyd, Jennifer T.; Meadow, Ann; Riley, Gerald F.; Howell, Benjamin L.

    2015-01-01

    Medicare began reimbursing for outpatient diabetes self-management training (DSMT) in 2000; however, little is known about program utilization. Individuals diagnosed with diabetes in 2010 were identified from a 20% random selection of the Medicare fee-for-service population (N = 110,064). Medicare administrative and claims files were used to…

  1. Adiponectin, type 2 diabetes and cardiovascular risk

    DEFF Research Database (Denmark)

    Lindberg, Søren; Jensen, Jan Skov; Bjerre, Mette

    2015-01-01

    participants experienced a CV event (myocardial infarction, ischaemic stroke, or CV death). RESULTS: Participants with increasing adiponectin had reduced risk of developing T2DM (p physical activity, alcohol......BACKGROUND: Adiponectin is viewed as an insulin-sensitizing hormone with anti-inflammatory effects. In accordance, plasma adiponectin is decreased in metabolic disorders including type 2 diabetes mellitus (T2DM). However, in spite of the apparently beneficially effects, recent data from large...

  2. Dietary Fibre and Cardiovascular Risk in Diabetes Mellitus

    NARCIS (Netherlands)

    Slurink, Isabel A.L.; Soedamah-Muthu, S.S.

    2016-01-01

    Patients with type 1 and 2 diabetes have a higher risk of cardiovascular disease
    compared to non-diabetic populations. Improved dietary quality is essential to
    control risk factors and can prevent or delay cardiovascular disease in diabetic
    patients. Higher dietary fibre intake was

  3. Risk Factors for Cardiovascular Diseases among Diabetic Patients ...

    African Journals Online (AJOL)

    BACKGROUND: Studies on cardiovascular risk factors among diabetic persons in Ethiopia are lacking. The objective of this study was to determine the prevalence of the cardiovascular risk factors (hypertension, obesity, physical inactivity, dyslipidemia and smoking) among diabetic patients at the diabetic clinic of Jimma ...

  4. Consumer responses to risk-benefit information about food

    NARCIS (Netherlands)

    Dijk, van H.

    2010-01-01

    Communication about the healthiness of consuming different food products has typically involved either health messages about the associated risks or benefits. In reality, consumption decisions often involve consumers “trading-off” the risks and benefits associated with the consumption of a

  5. Values, Perceived Risks and Benefits, and Acceptability of Nuclear Energy

    NARCIS (Netherlands)

    de Groot, Judith I. M.; Steg, Linda; Poortinga, Wouter

    We examined how personal values and perceptions of risks and benefits are associated with the acceptability of nuclear energy (NE). A theoretical model is tested in which beliefs about the risks and benefits of NE mediate the relationship between values and acceptability. The results showed that

  6. The affect heuristic in judgments of risks and benefits

    Energy Technology Data Exchange (ETDEWEB)

    Finucane, M.; Slovic, P.; Johnson, S.M. [Decision Research, 1201 Oak St, Eugene, Oregon (United States); Alhakami, A. [Imam Muhammad Ibn Saud Islamic University Psychology Dept. (Saudi Arabia)

    1998-07-01

    The role of affect in judgment of risks and benefits is examined in two studies. Despite using different methodologies the two studies suggest that risk and benefit are linked somehow in people's perception, consequently influencing their judgments. Short paper.

  7. Assessment of ulceration risk in diabetic individuals

    Directory of Open Access Journals (Sweden)

    Luz Marina Alfonso Dutra

    Full Text Available ABSTRACT Objective: To identify the risk factors for foot ulceration through the tracing of diabetic peripheral neuropathy and peripheral arterial disease in individuals with type I and II diabetes, who were assisted in reference centers of the Federal District, Brazil. Method: a cross-sectional and analytical study, with the assessment of 117 individuals in outpatient clinics of the Federal District. Continuous variables were compared through Mann-Whitney test, and categorized variables, through Chi-square test for univariate analysis and Logistics regression test for multivariate analysis. Results: painful diabetic peripheral neuropathy was present in 37 (75.5% of the individuals with neuropathy. Deformities and loss of protective plant sensibility were related to neuropathy (p=0.014 and p=0.001, respectively. Of the 40 (34.2% individuals in the sample who presented peripheral arterial disease, 26 (65% presented calcification risk. Conclusion: signs of painful peripheral polyneuropathy, peripheral arterial disease, deformities, loss of protective plantar sensibility, and dry skin were identified as risk factors for ulceration.

  8. Cardiovascular benefits and safety of non-insulin medications used in the treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Yandrapalli, Srikanth; Jolly, George; Horblitt, Adam; Sanaani, Abdallah; Aronow, Wilbert S

    2017-11-01

    Diabetes mellitus is a growing in exponential proportions. If the current growth trend continues, it may result in every third adult in the United States having diabetes mellitus by 2050, and every 10 th adult worldwide. Type 2 diabetes mellitus (T2DM) confers a 2- to 3-fold increased risk of cardiovascular (CV) events compared with non-diabetic patients, and CV mortality is responsible for around 80% mortality in this population. Patients with T2DM can have other features of insulin resistance-metabolic syndrome like hypertension, lipid abnormalities, and obesity which are all associated with increased CV disease and stroke risk even in the absence of T2DM. The management of a T2DM calls for employing a holistic risk factor control approach. Metformin is the first line therapy for T2DM and has been shown to have cardiovascular beneficial effects. Intense debate regarding the risk of myocardial infarction with rosiglitazone led to regulatory agencies necessitating cardiovascular outcome trials with upcoming anti-diabetic medications. Glucagon like peptide-1 agonists and sodium glucose co-transporter-2 inhibitors have shown promising CV safety and additional CV benefit in recent clinical trials. These drugs have favorable effects on traditional CV risk factors. The findings from these studies further support that fact that CV risk factor control plays an important role in reducing morbidity and mortality in T2DM patients. This review article will discuss briefly the cardiovascular safety and benefits of the oral medications which are currently being used for T2DM and will then discuss in detail about the newer medications being investigated for the treatment of T2DM.

  9. Risks and benefits of energy systems in Czechoslovakia

    International Nuclear Information System (INIS)

    Bohal, L.; Erban, P.; Kadlec, J.; Kraus, V.; Trcka, V.

    1984-01-01

    The paper describes the fundamental philosophy of an approach to risk and benefit assessment in the fuel and energy complex in Czechoslovakia. The first part analyses the need to solve the risk and benefit problems stemming from structural changes occurring in the Czechoslovakian fuel and energy complex. The second part describes main features of risk and benefit research with special respect to the fuel and energy complex defined within the framework of the national economy with interfaces to the relevant environment. Furthermore, a glimpse is given of how to assess, using the general philosophy, the risks and benefits of various developing variants of the fuel and energy complex. The third part deals with methodological aspects of such risk and benefit evaluation research with special consideration of the methods of long-term prediction in structural analysis and multi-measure assessment. Finally, further progress in solving these problems in VUPEK and some other Czechoslovakian scientific institutions is briefly noted. (author)

  10. Future risk of diabetes in mother and child after gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Damm, Peter; Damm, Peter

    2009-01-01

    diabetes, later in life. Moreover, the risk of the metabolic syndrome is increased 3-fold in these women. Their offspring have an 8-fold risk of diabetes/prediabetes at 19-27 years of age. Thus, GDM is part of a vicious circle which increases the development of diabetes in the coming generations....

  11. State of the art in benefit-risk analysis: introduction.

    Science.gov (United States)

    Verhagen, H; Tijhuis, M J; Gunnlaugsdóttir, H; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken, G; Pohjola, M V; Tuomisto, J T; Ueland, Ø; White, B C; Holm, F

    2012-01-01

    Risk-taking is normal in everyday life if there are associated (perceived) benefits. Benefit-Risk Analysis (BRA) compares the risk of a situation to its related benefits and addresses the acceptability of the risk. Over the past years BRA in relation to food and food ingredients has gained attention. Food, and even the same food ingredient, may confer both beneficial and adverse effects. Measures directed at food safety may lead to suboptimal or insufficient levels of ingredients from a benefit perspective. In BRA, benefits and risks of food (ingredients) are assessed in one go and may conditionally be expressed into one currency. This allows the comparison of adverse and beneficial effects to be qualitative and quantitative. A BRA should help policy-makers to make more informed and balanced benefit-risk management decisions. Not allowing food benefits to occur in order to guarantee food safety is a risk management decision much the same as accepting some risk in order to achieve more benefits. BRA in food and nutrition is making progress, but difficulties remain. The field may benefit from looking across its borders to learn from other research areas. The BEPRARIBEAN project (Best Practices for Risk-Benefit Analysis: experience from out of food into food; http://en.opasnet.org/w/Bepraribean) aims to do so, by working together with Medicines, Food Microbiology, Environmental Health, Economics & Marketing-Finance and Consumer Perception. All perspectives are reviewed and subsequently integrated to identify opportunities for further development of BRA for food and food ingredients. Interesting issues that emerge are the varying degrees of risk that are deemed acceptable within the areas and the trend towards more open and participatory BRA processes. A set of 6 'state of the art' papers covering the above areas and a paper integrating the separate (re)views are published in this volume. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. "There Are No Known Benefits . . .": Considering the Risk/Benefit Ratio of Qualitative Research.

    Science.gov (United States)

    Opsal, Tara; Wolgemuth, Jennifer; Cross, Jennifer; Kaanta, Tanya; Dickmann, Ellyn; Colomer, Soria; Erdil-Moody, Zeynep

    2016-07-01

    Institutional review boards (IRBs) are responsible for weighing the risks and benefits of research participation. Qualitative researchers note numerous instances where IRB ethical frameworks fail to align with the ethics of their research projects and point out that IRB understandings of the benefits and risks of research often differ from those of the participants they seek to protect. This qualitative cross-case research investigates participants' interview experiences in six qualitative studies that differed in their methods, subject of focus, and populations. Our findings indicate that contemporary IRBs' use of population "vulnerability" and topic "sensitivity" to assess project risk does not adequately determine the benefits, risks, or ethicality of research. We recommend that IRBs treat as real the evidence for benefits in qualitative research, recognize that sensitivity and vulnerability do not predict risk, and encourage researchers to attend to relationships in their projects. © The Author(s) 2015.

  13. Balancing the risks and the benefits.

    Science.gov (United States)

    Klopack

    2000-04-01

    Pharmaceutical research organizations can benefit from outsourcing discovery activities that are not core competencies of the organization. The core competencies for a discovery operation are the expertise and systems that give the organization an advantage over its competition. Successful outsourcing ventures result in cost reduction, increased operation efficiency and optimization of resource allocation. While there are pitfalls to outsourcing, including poor partner selection and inadequate implementation, outsourcing can be a powerful tool for enhancing drug discovery operations.

  14. Insulin resistance in type 1 diabetes: what is ?double diabetes? and what are the risks?

    OpenAIRE

    Cleland, S. J.; Fisher, B. M.; Colhoun, H. M.; Sattar, N.; Petrie, J. R.

    2013-01-01

    In this review, we explore the concept of ‘double diabetes’, a combination of type 1 diabetes with features of insulin resistance and type 2 diabetes. After considering whether double diabetes is a useful concept, we discuss potential mechanisms of increased insulin resistance in type 1 diabetes before examining the extent to which double diabetes might increase the risk of cardiovascular disease (CVD). We then go on to consider the proposal that weight gain from intensive insulin regimens ma...

  15. Medication Adherence and Health Insurance/Health Benefit in Adult Diabetics in Kingston, Jamaica.

    Science.gov (United States)

    Bridgelal-Nagassar, R J; James, K; Nagassar, R P; Maharaj, S

    2015-05-15

    To determine the association between health insurance/health benefit and medication adherence amongst adult diabetic patients in Kingston, Jamaica. This was a cross-sectional study. The target population was diabetics who attended the diabetic outpatient clinics in health centres in Kingston. Two health centres were selectively chosen in Kingston. All diabetic patients attending the diabetic clinics and over the age of 18 years were conveniently sampled. The sample size was 260. An interviewer-administered questionnaire was utilized which assessed health insurance/health benefit. Adherence was measured by patients' self-reports of medication usage in the previous week. The Chi-squared test was used to determine the significance of associations. Sample population was 76% female and 24% male. Type 2 diabetics comprised 93.8%. More than 95% of patients were over the age of 40 years. Approximately 32% of participants were employed. Approximately 75% of patients had health insurance/health benefit. Among those who had health insurance or health benefit, 71.5% were adherent and 28.5% were non-adherent. This difference was statistically significant (χ2 = 6.553, p = 0.01). Prevalence of medication non-adherence was 33%. AIn Kingston, diabetic patients who are adherent are more likely to have health insurance/health benefit ( p = 0.01).

  16. Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees.

    Science.gov (United States)

    Lenz, Thomas L; Gillespie, Nicole D; Skrabal, Maryann Z; Faulkner, Michele A; Skradski, Jessica J; Ferguson, Liz A; Pagenkemper, Joni J; Moore, Geri A; Jorgensen, Diane

    2013-03-01

    A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

  17. Exercise in the management of type 2 diabetes mellitus: what are the benefits and how does it work?

    Science.gov (United States)

    Duclos, Martine; Virally, Marie-Laure; Dejager, Sylvie

    2011-05-01

    In this article, we examine the results from meta-analyses of studies that have focused on the effects of supervised exercise in patients with established type 2 diabetes mellitus. Exercise has been clearly demonstrated to have benefits on blood glucose control (average reduction of glycated hemoglobin, 0.6%) and cardiovascular risk factors. These benefits are observed independently of any change in body mass index and fat mass, and are also seen in older populations. Multiple mechanisms are involved, and the improved insulin-sensitizing effect of exercise training is not restricted to muscle but extends to hepatic and adipose tissue. However, while the benefits of exercise in type 2 diabetes management are undisputable, it is not as easy to draw correlations between clinical benefit and the amount of physical activity included in daily life. Recent studies have shown encouraging results with moderate increases in physical activity, which are feasible for most patients and are sufficient to induce sustained positive changes for 2 years. Thus, the benefits of structured and supervised exercise in patients with type 2 diabetes have been consistently demonstrated. Currently, the primary challenge is to determine how long-term increased physical activity can be durably implemented in a patient's daily life.

  18. Radiation risks and benefits: politics and morality

    International Nuclear Information System (INIS)

    Maxey, M.N.

    1983-01-01

    The bioethical framework from which moral reasoning concerning nuclear technology has been derived is both seriously flawed and conceptually inadequate. The reasons are examined and are arranged in response to three questions. First, what is the status of alleged scientific evidence from which moral conclusions about the unacceptability of man-made radiation exposures are derived. Secondly, what criticisms of risk assessment reasoning are pertinent to ethical reflection. Finally, what revisions in an ethical framework are necessary if risk estimates of low-dose radiation exposure are to be conducted properly

  19. Benefits and risks of nuclear power

    International Nuclear Information System (INIS)

    Barnert, H.; Borsch, P.; Feldmann, A.; Merz, E.; Muench, E.; Oesterwind, D.; Voss, A.

    1977-03-01

    Discussion, in a popular form, of issues of interest for an unemotional information of the public on problems of nuclear power: 1) Energy consumption, its assumed growth, and possible ways of supply; 2) the physical fundamental and technical realisation of power generation by nuclear fission; 3) problems of the fuel cycle and possible solutions; 4) the effects of radioactive radiation; 5) the safety of nuclear power plants and the risks of nuclear power as compared to other technical and natural risks. (orig./HP) [de

  20. Interbirth interval is associated with childhood type 1 diabetes risk

    DEFF Research Database (Denmark)

    Cardwell, Chris R; Svensson, Jannet; Waldhoer, Thomas

    2012-01-01

    to calculate pooled odds ratios (ORs) and investigate heterogeneity between studies. Overall, 2,787 children with type 1 diabetes were included. There was a reduction in the risk of childhood type 1 diabetes in children born to mothers after interbirth intervals...... of childhood type 1 diabetes has not been investigated. A secondary analysis of 14 published observational studies of perinatal risk factors for type 1 diabetes was conducted. Risk estimates of diabetes by category of interbirth interval were calculated for each study. Random effects models were used...

  1. Risk-benefit evaluation for large technological systems

    International Nuclear Information System (INIS)

    Okrent, D.

    1979-01-01

    The related topics of risk-benefit analysis, risk analysis, and risk-acceptance criteria (How safe is safe enough) are of growing importance. An interdisciplinary study on various aspects of these topics, including applications to nuclear power, was recently completed at the University of California, Los Angeles (UCLA), with the support of the National Science Foundation. In addition to more than 30 topical reports and various open-literature publications, a final report (UCLA-ENG-7777) to the study, titled ''A Generalized Evaluation Approach to Risk--Benefit for Large Technological Systems and Its Application to Nuclear Power'', was issued in early 1978. This article briefly summarizes portions of the final report dealing with general aspects of risk-benefit methodology, societal knowledge and perception of risk, and risk-acceptance criteria

  2. Risk and benefits in ionizing radiation uses

    International Nuclear Information System (INIS)

    2010-08-01

    This meeting include: A tribute to Szeinfeld, presentation software for population dose, impact on radiation protection, radiation protection hospital and population exposed workers, regulation and licensing. radiological emergencies, risk, inspection, external radiotherapy and radiation protection with photons, brachytherapy, industrial, environmental monitoring, food irradiation, nuclear power, nuclear medicine.

  3. Benefits, risks, and costs of mammography

    International Nuclear Information System (INIS)

    Richter, B.; Rausch, L.

    1977-01-01

    The risk seems to be acceptable if the age-dependency of the frequency of breast cancer is disregarded, i.e. if calculation is done with average values, as is being done frequently (15, 25, 32, 48). This procedure however veils the real circumstances in the examination of young women thus also veiling a risk which could otherwise be made precise and avoidable. The risk of radiation-induced cancerogenesis in the female breast was verified by similar statements made by several empiric investigations on man. The course of the dose-effect-relation in the region of few rad is still unexplained however, although the results do not contradict to the assumption of a linear dose-effect-relation. Thus it seems not advisable to ignore the induction of carcinomas by x-radiation for the sphere of mammography with the doses usually applied today. A reduction of radiation exposition by dose-saving measures to one tenth of the present value (or less) however would make the risk highly unimportant. Advantage/risk/cost-analyses should encourage the responsible persons to make reasonable proposals for the application of methods, in this case mammography. The discouraging of patients whom mammography is indicated for would be a side-effect which is not desired. Just as wrong would be the stimulation of an unjustified feeling of being sure and the demand for costly medical measures by uncritical reports of success. The indication of the considerably high costs of mammography should, together with the advantage expected, be a quantitative criterion for the optimal distribution of limited means the necessity of which cannot be denied. (orig.) [de

  4. Benefit and adherence of the disease management program "diabetes 2": a comparison of Turkish immigrants and German natives with diabetes.

    Science.gov (United States)

    Makowski, Anna Christin; Kofahl, Christopher

    2014-09-17

    There is an ongoing debate about equity and equality in health care, and whether immigrants benefit equally from services as the non-immigrant population. The study focuses on benefits from and adherence to the diabetes mellitus type 2 (DM 2) disease management program (DMP) among Turkish immigrants in Germany. So far, it has not been researched whether this group benefits from enrollment in the DMP as well as diabetics from the non-immigrant population. Data on the non-immigrant sample (N = 702) stem from a survey among members of a German health insurance, the Turkish immigrant sample (N = 102) was recruited in the area of Hamburg. Identical questions in both surveys enable comparing major components. Regarding process quality, Turkish diabetics do not differ from the non-immigrant sample; moreover, they have significantly more often received documentation and diabetes training. In terms of outcome quality however, results display a greater benefit on behalf of the non-immigrant sample (e.g., blood parameters and body mass index), and they also met more of the DMP criteria. This underlines the need of diabetics with Turkish background for further education and information in order to become the empowered patient as is intended by the DMP as well as to prevent comorbidities.

  5. Recommendations for benefit-risk assessment methodologies and visual representations

    DEFF Research Database (Denmark)

    Hughes, Diana; Waddingham, Ed; Mt-Isa, Shahrul

    2016-01-01

    PURPOSE: The purpose of this study is to draw on the practical experience from the PROTECT BR case studies and make recommendations regarding the application of a number of methodologies and visual representations for benefit-risk assessment. METHODS: Eight case studies based on the benefit......-risk balance of real medicines were used to test various methodologies that had been identified from the literature as having potential applications in benefit-risk assessment. Recommendations were drawn up based on the results of the case studies. RESULTS: A general pathway through the case studies...

  6. Understanding the real risks of changing employee benefit plans.

    Science.gov (United States)

    Kane, Jon; St Amour, Jeffrey

    2005-01-01

    In an environment of constant change, corporations are looking to alter employee benefits programs to make them more responsive to employee and business needs. A complete risk assessment process is the key to preparing for changes to employee benefits programs by providing employers with an analysis of cost savings against the potential negative ramifications of change. This article outlines the steps involved in a complete review of risk assessment. It then discusses how employers can develop successful change management communication strategies if, after conducting a risk assessment, employers decide to move forward with alterations to their employee benefits programs.

  7. Moonshot Science—Risks and Benefits

    Directory of Open Access Journals (Sweden)

    Arturo Casadevall

    2016-08-01

    Full Text Available Ever since the successful Apollo 11 Moon landing in 1969, a “moonshot” has come to signify a bold effort to achieve a seemingly impossible task. The Obama administration recently called for a moonshot to cure cancer, an initiative that has elicited mixed responses from researchers who welcome additional funding but worry about raising expectations. We suggest that a successful moonshot requires a sufficient understanding of the basic science underlying a problem in question so that efforts can be focused on engineering a solution. Current gaps in our basic knowledge of cancer biology make the cancer moonshot a uniquely challenging endeavor. Nevertheless, history has shown that intensive research efforts have frequently yielded conceptual and technological breakthroughs with unanticipated benefits for society. We expect that this effort will be no different.

  8. Noncontraceptive use of oral combined hormonal contraceptives in polycystic ovary syndrome-risks versus benefits.

    Science.gov (United States)

    Dokras, Anuja

    2016-12-01

    The use of steroid sex hormones for noncontraceptive benefits has been endorsed by several medical societies. In women with polycystic ovary syndrome (PCOS), hormonal contraceptives are first-line therapy for concurrent treatment of menstrual irregularity, acne, and hirsutism. The association of PCOS with obesity, diabetes, and dyslipidemia frequently brings up the debate regarding risks versus benefits of hormonal contraceptives in this population. In women with PCOS, the lack of large-scale studies evaluating the risks with varying doses of ethinyl estradiol, types of progestins, and presence of confounding factors such as obesity, smoking, and other cardiometabolic comorbidities is a significant limitation in these deliberations. Although it is important to assess the absolute risk for major morbidities including cardiovascular events, currently, there are a paucity of long-term data for these outcomes in PCOS. Most of the current studies do not suggest an increase in risk of prediabetes/diabetes, clinically significant dyslipidemia, inflammatory changes, or depressive/anxiety symptoms with oral contraceptive pill use. Screening of women with PCOS for cardiometabolic and psychiatric comorbidities is routinely recommended. This information should be used by health care providers to individualize the choice of hormonal contraceptive treatment, adequately counsel patients regarding risks and benefits, and formulate an appropriate follow-up plan. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Risk factors for type 2 diabetes mellitus in adolescents secondary ...

    African Journals Online (AJOL)

    Background: The prevalence of Type 2 diabetes mellitus (T2 DM) in children and ... had none of the risk factors while 272(30.9%) had at least one risk factor. Using the American Diabetes Association criteria for identification of those at risk for ...

  10. Risk factors for developing diabetic foot

    Directory of Open Access Journals (Sweden)

    Julia Estela Willrich Boell

    2014-06-01

    Full Text Available The goal of the present study is to identify the risk factors for developing diabetic foot. A cross-sectional study, with a convenience sample, developed with 70 individuals with diabetes mellitus (DM, registered in three basic health units in the municipality of Florianópolis/SC, Brazil, in the period from November 2010 to May 2011. Biometric data was collected regarding their sociodemographic, health and illness conditions. An assessment of the feet was also carried out. The average participant age was 66.17 years and time with diagnosed disease was under ten years (61.42%. The following risk factors were identified: advanced age; time of DM diagnosis; few years of schooling; overweight/obesity; inadequate diet; physical inactivity; inadequate metabolic control; lack of proper and specific foot care; and arterial hypertension. We conclude that the majority of the population presented one or more risk factors that favor the appearance of foot-related complications. doi: 10.5216/ree.v16i2.20460.

  11. Risk-benefit analysis and public policy: a bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E.M.; Van Horn, A.J.

    1976-11-01

    Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis, and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk.

  12. Risk-benefit analysis and public policy: a bibliography

    International Nuclear Information System (INIS)

    Clark, E.M.; Van Horn, A.J.

    1976-11-01

    Risk-benefit analysis has been implicitly practiced whenever decision-makers are confronted with decisions involving risks to life, health, or to the environment. Various methodologies have been developed to evaluate relevant criteria and to aid in assessing the impacts of alternative projects. Among these have been cost-benefit analysis, which has been widely used for project evaluation. However, in many cases it has been difficult to assign dollar costs to those criteria involving risks and benefits which are not now assigned explicit monetary values in our economic system. Hence, risk-benefit analysis has evolved to become more than merely an extension of cost-benefit analysis, and many methods have been applied to examine the trade-offs between risks and benefits. In addition, new scientific and statistical techniques have been developed for assessing current and future risks. The 950 references included in this bibliography are meant to suggest the breadth of those methodologies which have been applied to decisions involving risk

  13. Benefits, risks, and costs of stratospheric geoengineering

    KAUST Repository

    Robock, Alan

    2009-10-02

    Injecting sulfate aerosol precursors into the stratosphere has been suggested as a means of geoengineering to cool the planet and reduce global warming. The decision to implement such a scheme would require a comparison of its benefits, dangers, and costs to those of other responses to global warming, including doing nothing. Here we evaluate those factors for stratospheric geoengineering with sulfate aerosols. Using existing U.S. military fighter and tanker planes, the annual costs of injecting aerosol precursors into the lower stratosphere would be several billion dollars. Using artillery or balloons to loft the gas would be much more expensive. We do not have enough information to evaluate more exotic techniques, such as pumping the gas up through a hose attached to a tower or balloon system. Anthropogenic stratospheric aerosol injection would cool the planet, stop the melting of sea ice and land-based glaciers, slow sea level rise, and increase the terrestrial carbon sink, but produce regional drought, ozone depletion, less sunlight for solar power, and make skies less blue. Furthermore it would hamper Earth-based optical astronomy, do nothing to stop ocean acidification, and present many ethical and moral issues. Further work is needed to quantify many of these factors to allow informed decision-making.

  14. Common type 2 diabetes risk gene variants associate with gestational diabetes

    DEFF Research Database (Denmark)

    Lauenborg, Jeannet; Grarup, Niels; Damm, Peter

    2009-01-01

    Objective: We aimed to examine the association between gestational diabetes (GDM) and eleven recently identified type 2 diabetes susceptibility loci. Research Design and Methods: Type 2 diabetes risk variants in TCF7L2, CDKAL1, SLC30A8, HHEX/IDE, CDKN2A/2B, IGF2BP2, FTO, TCF2, PPARG, KCNJ11 and WFS......1 loci were genotyped in a cohort of women with a history of GDM (n=283) and in glucose tolerant women of the population-based Inter99 cohort (n=2,446). Results: All the risk alleles in the 11 examined type 2 diabetes risk variants showed an odds ratio greater than 1 for the GDM group compared...... previously proven type 2 diabetes risk alleles equals the findings from association studies on type 2 diabetes. This supports the hypothesis that GDM and type 2 diabetes are two of the same entity....

  15. Statin Side Effects: Weigh the Benefits and Risks

    Science.gov (United States)

    ... may also reduce some of the cholesterol-lowering benefits your medication has. Another option is to take the medication every other day. Take it easy when exercising. Unaccustomed vigorous exercise might increase the risk of ...

  16. Medical marijuana use for chronic pain: risks and benefits.

    Science.gov (United States)

    Greenwell, Garth T

    2012-01-01

    Questions from patients about medical marijuana use for chronic pain are becoming more common. The information in this report will help patients understand the potential risks and benefits of using this substance for painful conditions.

  17. Daily Aspirin Therapy: Understand the Benefits and Risks

    Science.gov (United States)

    Daily aspirin therapy: Understand the benefits and risks Daily aspirin therapy can be a lifesaving option, but it's not ... everyone. Get the facts before considering a daily aspirin. By Mayo Clinic Staff Daily aspirin therapy may ...

  18. Pre-Diabetes Non-Modifiable Risk Factors

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pre-diabetes Non-modifiable Risk Factors Updated:Nov 9,2015 ... This content was last reviewed August 2015. Pre-diabetes • Introduction • About Pre-diabetes • What's the Problem? Intro ...

  19. Statins and Risk of New-Onset Diabetes Mellitus

    Science.gov (United States)

    ... if you have or are at risk for diabetes mellitus. What Does This US Food and Drug Administration Advisory Mean to Me? ... Cause Diabetes Mellitus? What If I Already Have Diabetes? Will Statin Therapy Make It Worse? What Does This US Food and Drug Administration Advisory Mean to Me? ...

  20. Global prevalence and major risk factors of diabetic retinopathy

    NARCIS (Netherlands)

    J.W.Y. Yau (Joanne W.); S.L. Rogers (Sophie); Y. Kawasaki; E.L. Lamoureux (Ecosse); J.W. Kowalski (Jonathan); T. Bek (Toke); S.-J. Chen (Shih-Jen); J.M. Dekker (Jacqueline); A.E. Fletcher (Astrid E.); J. Grauslund (Jakob); R.C.G. Haffner; U. Hamman (Ute); M.K. Ikram (Kamran); T. Kayama (Takamasa); B.E.K. Klein (Barbara); B.E.K. Klein (Barbara); S. Krishnaiah (Sannapaneni); K. Mayurasakorn (Korapat); J.P. O'Hare (Joseph); T. Orchard; M. Porta; M. Rema (Mohan); M.S. Roy (Monique); T. Sharma (Tarun); S-M. Saw (Seang-Mei); H. Taylor (Hugh); J.M. Tielsch (James); D. Varma (Dhiraj); J.J. Wang (Jie Jin); N. Wang (Ningli); S. West (Sheila); L. Zu (Liang); M. Yasuda (Maya); X. Zhang (Xinzhi); P. Mitchell (Paul); T.Y. Wong (Tien Yin)

    2012-01-01

    textabstractOBJECTIVE - To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. RESEARCH DESIGN AND METHODS - A pooled analysis using individual participant data from population-based studies

  1. Benefits of Risk Based Inspection Planning for Offshore Structures

    DEFF Research Database (Denmark)

    Straub, D.M.; Goyet, J.; Sørensen, John Dalsgaard

    2006-01-01

    The economical benefits of applying risk-based inspection planning (RBI) for offshore structures subject to fatigue are evaluated based on experiences from past industrial projects. To this end, the factors influencing the cost of inspection, repair and failure of structures are discussed......, the financial benefit of RBI is assessed....

  2. Risk-benefit analysis of 18FDG PET cancer screening

    International Nuclear Information System (INIS)

    Murano, Takeshi; Daisaki, Hiromitsu; Terauchi, Takashi; Iinuma, Takeshi; Tateno, Yukio; Tateishi, Ukihide; Kato, Kazuaki; Inoue, Tomio

    2008-01-01

    The benefits of 18 F-fluorodeoxyglucose ( 18 FDG) positron emission tomography (PET) cancer screening are expected to include a large population of examinees and are intended for a healthy group. Therefore, we attempted to determine the benefit/risk ratio, estimated risk of radiation exposure, and benefit of cancer detection. We used software that embodied the method of the International Commission on Radiological Protection (ICRP) to calculate the average duration of life of radiation exposure. We calculated the lifesaving person years of benefit to be obtained by 18 FDG PET cancer screening detection. We also calculated the benefit/risk ratio using life-shortening and lifesaving person years. According to age, the benefit/risk ratio was more than 1 at 35-39 years old for males and 30-34 years old for females. 18 FDG PET cancer screening also is effective for examinees older than this. A risk-benefit analysis of 18 FDG-PET/computed tomography (CT) cancer screening will be necessary in the future. (author)

  3. Assessment of Diabetes Risk in an Adult Population Using Indian Diabetes Risk Score in an Urban Resettlement Colony of Delhi.

    Science.gov (United States)

    Acharya, Anita Shankar; Singh, Anshu; Dhiman, Balraj

    2017-03-01

    Diabetes mellitus is one of the non-communicable diseases which has become a major global health problem whose prevalence is increasing worldwide and is expected to reach 4.4% by 2030. The risk of diabetes escalates with increase in the number of risk factors and their duration as well. The Indian Diabetic Risk Score (IDRS) is a simple, low cost, feasible tool for mass screening programme at the community level. To assess the risk score of diabetes among the study subjects using IDRS. A cross sectional survey was conducted on adults >30 years (n=580) on both gender in an urban resettlement colony of Delhi during December 2013 to March 2015. A Semi-structured interview schedule consisting of Socio-demographic characteristics, risk factor profile and Indian Diabetes Risk Score was used. Data was entered and analyzed in SPSS. Out of 580 subjects, 31 (5.3%) study subjects were not at risk of having diabetes, rest 94.5% were at moderate or high risk of diabetes.A statistically significant association of diabetes risk with marital status(p=0.0001), education(0.005),body mass index(0.049) and systolic blood pressure was seen.(p=0.006). More than 90% of the study subjects were at risk of having diabetes, hence screening is of utmost importance so that interventions can be initiated at an early stage.

  4. Integration of risk and benefit analysis - The window of benefit as a new tool?

    NARCIS (Netherlands)

    Palou, A.; Pico, C.; Keijer, J.

    2009-01-01

    Foods and food components can have positive and/or negative effects on our health, resulting in benefits and risks. At present these are evaluated in largely separated trajectories. In view of assessment, management, and communication, we here propose and argue for an integrated evaluation of risk

  5. Bayesian joint modelling of benefit and risk in drug development.

    Science.gov (United States)

    Costa, Maria J; Drury, Thomas

    2018-05-01

    To gain regulatory approval, a new medicine must demonstrate that its benefits outweigh any potential risks, ie, that the benefit-risk balance is favourable towards the new medicine. For transparency and clarity of the decision, a structured and consistent approach to benefit-risk assessment that quantifies uncertainties and accounts for underlying dependencies is desirable. This paper proposes two approaches to benefit-risk evaluation, both based on the idea of joint modelling of mixed outcomes that are potentially dependent at the subject level. Using Bayesian inference, the two approaches offer interpretability and efficiency to enhance qualitative frameworks. Simulation studies show that accounting for correlation leads to a more accurate assessment of the strength of evidence to support benefit-risk profiles of interest. Several graphical approaches are proposed that can be used to communicate the benefit-risk balance to project teams. Finally, the two approaches are illustrated in a case study using real clinical trial data. Copyright © 2018 John Wiley & Sons, Ltd.

  6. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    OpenAIRE

    Burlina, S.; Dalfr?, M. G.; Chilelli, N. C.; Lapolla, A.

    2016-01-01

    The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of contai...

  7. Risk/benefit comparisons are still too vague

    International Nuclear Information System (INIS)

    Kroeger, W.

    1984-01-01

    190 experts from 36 countries and 11 international organisations took part in the International Symposium on the Risks and Benefits of Energy Systems, sponsored jointly by the IAEA, UNEP and WHO. The 31 papers presented there discussed a variety of problems under headlines such as: Energy (strategies, risk-benefit analyses), the economy and the society; Environmental impacts and risks emanating from energy systems, and methods to avert them; National energy strategies in view of global restraints. Three panel sessions were concerned with defined goals and objectives of social and energy policies and resulting problems, with relations for defined risks and the future value of risk-benefit assessments, and with the search for improved means and instruments of communication between decision-taking authorities. (orig./UA) [de

  8. Perceived Benefits and Barriers of a Community-Based Diabetes Prevention and Management Program.

    Science.gov (United States)

    Shawley-Brzoska, Samantha; Misra, Ranjita

    2018-03-13

    This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants' perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% females; 62% diabetic; 77% had adequate health literacy); 79% of participants completed the benefits and barriers survey. Principal component analysis indicated two components representing benefits (Cronbach's α = 0.83) and barriers (α = 0.65). The majority perceived high benefits and low barriers to program participation; benefits included helpful interaction with health coach or program leader (73%), improved lifestyle modification (65%) due to the program, and satisfaction with the program (75%). Open-ended questions confirmed themes related to benefits of program participation, suggestion for programmatic improvements as well as barriers to participation. Participant feedback could be used to guide interventions and tailor future program implementation.

  9. Brazilian daycares: weighing the risks and benefits.

    Science.gov (United States)

    Marchand, D

    1994-10-01

    The number of day care centers in Brazil has doubled over the last few years; with this increase has come a rise in the numbers of cases of communicable disease, particularly pneumonia (the main cause of child mortality in Brazil). A study by Dr. Walter V.C. da Fonseca states that a day care child is 5 times more likely to contact pneumonia. However, since the income earned by women in Brazil today is necessary to meet basic needs, children must be left at home with relatives or sent to day care. Most of the centers taking in children under 6 years of age are urban; they care for, on average, 125-200 children. These children are usually from low income families who live on the outskirts of cities; free day care is only provided to working mothers. There are 3 social factors involved: the greater number of single-parent families, more households supported solely by the mother, and an economic crisis that has hit the poor particularly hard. Financial and administrative responsibility for these centers varies. The centers provide meals, baths, rest, education (including some special education services), and health care (doctors, dentists, and nurses). Some accept abandoned children, who are cared for until they are adopted. However, new studies indicate that the centers represent the primary risk factor for respiratory illnesses and were, until recently, the principal causes of diarrhea and child mortality. An ongoing comparative study by da Fonseca is analyzing the incidence rates of respiratory and infectious diseases among 400 children attending a nursery in Fortaleza in comparison to those for 400 cared for at home by family. Doctor Aluiso Barros, in another study, is observing 1000 children in 40 nurseries in Campinas. For 8 weeks, data was collected on the health, socioeconomic situation, medical history, and family medical history of each child. The nurseries were examined and information was collected regarding the number of diseases reported each month, their

  10. Lung Cancer Screening May Benefit Those at Highest Risk

    Science.gov (United States)

    People at the highest risk for lung cancer, based on a risk model, may be more likely to benefit from screening with low-dose CT, a new analysis suggests. The study authors believe the findings may better define who should undergo lung cancer screening, as this Cancer Currents blog post explains.

  11. Influence of diabetes mellitus on heart failure risk and outcome

    Directory of Open Access Journals (Sweden)

    Van Belle Eric

    2003-01-01

    Full Text Available Abstract Our aim is to summarize and discuss the recent literature linking diabetes mellitus with heart failure, and to address the issue of the optimal treatment for diabetic patients with heart failure. The studies linking diabetes mellitus (DM with heart failure (HF The prevalence of diabetes mellitus in heart failure populations is close to 20% compared with 4 to 6% in control populations. Epidemiological studies have demonstrated an increased risk of heart failure in diabetics; moreover, in diabetic populations, poor glycemic control has been associated with an increased risk of heart failure. Various mechanisms may link diabetes mellitus to heart failure: firstly, associated comorbidities such as hypertension may play a role; secondly, diabetes accelerates the development of coronary atherosclerosis; thirdly, experimental and clinical studies support the existence of a specific diabetic cardiomyopathy related to microangiopathy, metabolic factors or myocardial fibrosis. Subgroup analyses of randomized trials demonstrate that diabetes is also an important prognostic factor in heart failure. In addition, it has been suggested that the deleterious impact of diabetes may be especially marked in patients with ischemic cardiomyopathy. Treatment of heart failure in diabetic patients The knowledge of the diabetic status may help to define the optimal therapeutic strategy for heart failure patients. Cornerstone treatments such as ACE inhibitors or beta-blockers appear to be uniformly beneficial in diabetic and non diabetic populations. However, in ischemic cardiomyopathy, the choice of the revascularization technique may differ according to diabetic status. Finally, clinical studies are needed to determine whether improved metabolic control might favorably influence the outcome of diabetic heart failure patients.

  12. Public perceptions about nanotechnology: Risks, benefits and trust

    International Nuclear Information System (INIS)

    Cobb, Michael D.; Macoubrie, Jane

    2004-01-01

    We report data from the first representative national phone survey of Americans' perceptions about nanotechnology (N =1536). Public opinion about nanotechnology is in its infancy, and knowledge about it is quite limited. Yet, Americans' initial reaction to nanotechnology is thus far generally positive, probably rooted in a generally positive view of science overall. Survey respondents expected benefits of nanotechnology to be more prevalent than risks, and they reported feeling hopeful about nanotechnology rather than worried. Their most preferred potential benefit of nanotechnology is 'new and better ways to detect and treat human diseases,' and they identified 'losing personal privacy to tiny new surveillance devices' as the most important potential risk to avoid. The most discouraging aspect to the data is respondents' lack of trust in business leaders to minimize nanotechnology risks to human health. Overall, these data indicate that while Americans do not necessarily presume benefits and the absence of risks, their outlook is much more positive than not

  13. Dietary intake of carotenoids and risk of type 2 diabetes

    NARCIS (Netherlands)

    Sluijs, I.; Cadier, E.; Beulens, J. W J; van der A, D. L.; Spijkerman, A. M W; van der Schouw, Y. T.

    Background and aims: Carotenoids may reduce diabetes risk, due to their antioxidant properties. However, the association between dietary carotenoids intake and type 2 diabetes risk is still unclear. Therefore, the objective of this study was to examine whether higher dietary carotenoid intakes

  14. Prevalence of diabetes mellitus and the associated behavioral risks ...

    African Journals Online (AJOL)

    Objective: The prevalence of type 2 Diabetes is associated with significant morbidity and mortality, hence the need for early identification of risk factors. This study, therefore, aimed to determine the prevalence of diabetes mellitus and the associated behavioral risks among secondary school staff in Owo, Ondo State, Nigeria.

  15. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    McRoy

    Key words: Diabetes mellitus, gestation, risk factors, Sudan. INTRODUCTION. Gestational diabetes mellitus (GDM) is a universal risk factor for maternal and neonatal morbidity and mortality.[1] Low gestational age, neonatal macrosomia, hypoglycemia, respiratory distress syndrome are frequent complications of GDM and ...

  16. Vitamin D concentration, obesity, and risk of diabetes

    DEFF Research Database (Denmark)

    Afzal, Shoaib; Brøndum-Jacobsen, Peter; Bojesen, Stig E

    2014-01-01

    of variation in FTO, MCR4, and TMEM18 on BMI. We then assessed the effect of genetic variation in these genes on risk of type 2 diabetes, and the association of measured plasma 25(OH)D concentration and BMI with risk of type 2 diabetes. We did a mediation analysis to assess how much of the effect of BMI...

  17. HDL Cholesterol and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Haase, Christiane L; Tybjærg-Hansen, Anne; Nordestgaard, Børge G

    2015-01-01

    Observationally, low levels of HDL cholesterol are consistently associated with increased risk of type 2 diabetes. Therefore, plasma HDL cholesterol increasing has been suggested as a novel therapeutic option to reduce the risk of type 2 diabetes. Whether levels of HDL cholesterol are causally as...

  18. Pricing Externalities to Balance Public Risks and Benefits of Research.

    Science.gov (United States)

    Farquhar, Sebastian; Cotton-Barratt, Owen; Snyder-Beattie, Andrew

    How should scientific funders evaluate research with public health risks? Some risky work is valuable, but accepting too much risk may be ethically neglectful. Recent controversy over H5N1 influenza experiments has highlighted the difficulty of this problem. Advocates of the research claim the work is needed to understand pandemics, while opponents claim that accidents or misuse could release the very pandemic the work is meant to prevent. In an attempt to resolve the debate, the US government sponsored an independent evaluation that successfully produced a quantitative estimate of the risks involved, but only a qualitative estimate of the benefits. Given the difficulties of this "apples-to-oranges" risk-benefit analysis, what is the best way forward? Here we outline a general approach for balancing risks and benefits of research with public risks. Instead of directly comparing risks and benefits, our approach requires only an estimate of risk, which is then translated into a financial price. This estimate can be obtained either through a centrally commissioned risk assessment or by mandating liability insurance, which allows private markets to estimate the financial burden of risky research. The resulting price can then be included in the cost of the research, enabling funders to evaluate grants as usual-comparing the scientific merits of a project against its full cost to society. This approach has the advantage of aligning incentives by assigning costs to those responsible for risks. It also keeps scientific funding decisions in the hands of scientists, while involving the public on questions of values and risk experts on risk evaluation.

  19. Does vital exhaustion increase the risk of type 2 diabetes?

    DEFF Research Database (Denmark)

    Volden, Sasia; Wimmelmann, Cathrine Lawaetz; Flensborg-Madsen, Trine

    2017-01-01

    Hospital Discharge Register to detect registrations with type 2 diabetes until 2014. Results: A high degree of VE was associated with an increased risk of developing type 2 diabetes in both substudies. In the first substudy, the OR for developing type 2 diabetes was 2.56 (95% CI, 1.53; 4,29, P ...Background: There is evidence that both stress and depression have a causal relationship with type 2 diabetes suggesting that vital exhaustion (VE) too could be a risk factor. The association between VE and type 2 diabeteshas, however, not been investigated prospectively. Aim: To prospectively...... investigate whether VE is associated with an increased risk of type 2 diabetes in a Danish population. Methods: A prospective cohort study based on the Copenhagen City Heart Study (1991–1993). The degree of VE was measured among 9075 participants without type 1 or 2 diabetes at baseline. To detect type 2...

  20. Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

    Science.gov (United States)

    Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

    2018-01-31

    Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Gestational Diabetes Mellitus and Future Cardiovascular Risk: An Update

    Directory of Open Access Journals (Sweden)

    S. Burlina

    2016-01-01

    Full Text Available The prevalence of gestational diabetes mellitus is increasing in parallel with the rising prevalence of type 2 diabetes and obesity around the world. Current evidence strongly suggests that women who have had gestational diabetes mellitus are at greater risk of cardiovascular disease later in life. Given the growing prevalence of gestational diabetes mellitus, it is important to identify appropriate reliable markers of cardiovascular disease and specific treatment strategies capable of containing obesity, diabetes, and metabolic syndrome in order to reduce the burden of cardiovascular disease in the women affected.

  2. Predictors of low diabetes risk perception in a multi-ethnic cohort of women with gestational diabetes mellitus.

    Science.gov (United States)

    Mukerji, G; Kainth, S; Pendrith, C; Lowe, J; Feig, D S; Banerjee, A T; Wu, W; Lipscombe, L L

    2016-10-01

    To determine what proportion of women with gestational diabetes underestimate their diabetes risk and identify factors associated with low diabetes risk perception. Participants included pregnant adult women with gestational diabetes between 2009 and 2012 across seven diabetes clinics in Ontario, Canada. Data were collected through chart review and a survey that included a diabetes risk perception question. Of the 614 of 902 women (68% response rate) with gestational diabetes, 89% correctly responded that gestational diabetes increases the risk for developing diabetes. However, 47.1% of women perceived themselves to be at low risk for developing diabetes within 10 years. On multivariable analysis, BMI gestational diabetes history, absent diabetes family history and absent insulin use were appropriately associated with low diabetes risk perception. However, compared with Caucasian ethnicity, high-risk ethnicity (Aboriginal, Latin American, West Indian, South Asian, Middle Eastern, Filipino, Black, Pacific Islander) [odds ratio (OR) 2.07; 95% CI 1.30-3.31] and East and South East Asian ethnicity (OR 2.01; 1.10-3.67) were associated with low diabetes risk perception. After further adjustment for immigration, only high-risk ethnicity remained a predictor of low diabetes risk perception (OR 1.86; 1.09-3.19), whereas East and South East Asian ethnicity did not (OR 1.67; 0.86-3.22). Although the majority of women recognized gestational diabetes as a risk factor for diabetes, almost half underestimated their personal high diabetes risk despite prenatal care. Furthermore, women from high-risk ethnic groups were more likely to underestimate their risk, even after adjusting for immigration. Interventions tailored to these groups are necessary to enhance perceived diabetes risk. © 2015 Diabetes UK.

  3. Communicating risks and benefits of medical exposures to patients

    International Nuclear Information System (INIS)

    Wall, B.F.

    2001-01-01

    An information leaflet for concerned patients is in preparation, which attempts to explain the risks and benefits of diagnostic medical exposures in terms suitable for the layman. In view of the wide variability in patient doses for the same examination and the considerable uncertainties in radiation risk coefficients, x-ray examinations have been divided into just four broad categories each spanning a factor of 10 in risk. The doses are put into perspective by comparison with those from natural background radiation. Sufficient quantitative information on the approximate level of the risks for some common diagnostic procedures is provided to allow patients to make an informed decision on whether the benefits, as described by the referring clinician, outweigh the radiation risks. (author)

  4. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence

    Directory of Open Access Journals (Sweden)

    Patricia Feliciano Pereira

    2014-01-01

    Full Text Available OBJECTIVE: The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. SOURCES: Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes. DATA SYNTHESIS: The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. CONCLUSION: Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

  5. Benefit-Risk Analysis for Decision-Making: An Approach.

    Science.gov (United States)

    Raju, G K; Gurumurthi, K; Domike, R

    2016-12-01

    The analysis of benefit and risk is an important aspect of decision-making throughout the drug lifecycle. In this work, the use of a benefit-risk analysis approach to support decision-making was explored. The proposed approach builds on the qualitative US Food and Drug Administration (FDA) approach to include a more explicit analysis based on international standards and guidance that enables aggregation and comparison of benefit and risk on a common basis and a lifecycle focus. The approach is demonstrated on six decisions over the lifecycle (e.g., accelerated approval, withdrawal, and traditional approval) using two case studies: natalizumab for multiple sclerosis (MS) and bedaquiline for multidrug-resistant tuberculosis (MDR-TB). © 2016 American Society for Clinical Pharmacology and Therapeutics.

  6. Comparing Risks and Benefits for Value Enhancement of Online Purchase

    Directory of Open Access Journals (Sweden)

    Priyanka Sinha

    2018-12-01

    Full Text Available In a developing economy, the acceptability of e–retailing is not very new, but the potential of online marketing in market research and analysis is still largely unexplored. This article is an attempt to understand the psyche of Indian online consumers. As consumers have their own preconceived notions toward this growing purchasing environment, it becomes important for e-retailers to understand the consumers’ perceptions and attitudes toward online purchases. This paper integrates the dimensions of the risks and benefits with the Theory of Planned Behavior (TPB to understand how consumers adopt their online purchase processes. Four hundred and sixty-eight valid responses were analyzed using structural equation modeling on AMOS 21 to identify the relationship between the different factors and the intention to purchase online. The paper concludes that consumers’ purchase intentions are jointly determined by their attitude towards online purchases and the subjective norm. Furthermore, their attitude is determined by the sub-dimensions of perceived benefits (hedonic benefit, convenience benefit, economic benefit and variety and the sub-dimensions of perceived risk (product risk and financial risk.

  7. Women at High Risk for Diabetes

    Science.gov (United States)

    ... Report Card 2012: National and State Profile of Diabetes and its Complications. Atlanta, GA: US Department of Health and Human Services; 2012. 8 American Diabetes Association. Standards of medical care in diabetes—2012. ...

  8. Diabetes and risk of hospitalized fall injury among older adults.

    Science.gov (United States)

    Yau, Rebecca K; Strotmeyer, Elsa S; Resnick, Helaine E; Sellmeyer, Deborah E; Feingold, Kenneth R; Cauley, Jane A; Vittinghoff, Eric; De Rekeneire, Nathalie; Harris, Tamara B; Nevitt, Michael C; Cummings, Steven R; Shorr, Ronald I; Schwartz, Ann V

    2013-12-01

    To determine whether older adults with diabetes are at increased risk of an injurious fall requiring hospitalization. The longitudinal Health, Aging, and Body Composition Study included 3,075 adults aged 70-79 years at baseline. Hospitalizations that included ICD-9-Clinical Modification codes for a fall and an injury were identified. The effect of diabetes with and without insulin use on the rate of first fall-related injury hospitalization was assessed using proportional hazards models. At baseline, 719 participants had diabetes, and 117 of them were using insulin. Of the 293 participants who were hospitalized for a fall-related injury, 71 had diabetes, and 16 were using insulin. Diabetes was associated with a higher rate of injurious fall requiring hospitalization (hazard ratio [HR] 1.48 [95% CI 1.12-1.95]) in models adjusted for age, race, sex, BMI, and education. In those participants using insulin, compared with participants without diabetes, the HR was 3.00 (1.78-5.07). Additional adjustment for potential intermediaries, such as fainting in the past year, standing balance score, cystatin C level, and number of prescription medications, accounted for some of the increased risk associated with diabetes (1.41 [1.05-1.88]) and insulin-treated diabetes (2.24 [1.24-4.03]). Among participants with diabetes, a history of falling, poor standing balance score, and A1C level ≥8% were risk factors for an injurious fall requiring hospitalization. Older adults with diabetes, in particular those using insulin, are at greater risk of an injurious fall requiring hospitalization than those without diabetes. Among those with diabetes, poor glycemic control may increase the risk of an injurious fall.

  9. [Risks factors for the development of diabetes in women with history of gestational diabetes mellitus].

    Science.gov (United States)

    Cypryk, Katarzyna; Szymczak, Wiesław; Pertyńska-Marczewska, Magdalena; Zawodniak-Szałapska, Małgorzata; Lewiński, Andrzej

    2005-01-01

    Women who suffered from impaired carbohydrate metabolism during pregnancy are more likely to develop different types of diabetes later in their lives. The aim of this paper was to study the risk factors for the development of diabetes in group of women with gestational diabetes mellitus (GDM) in anamnesis. 200 women took part in this study, who had gestational diabetes diagnosed between 1980-1998. All women were divided into 4 groups depending on the type of disorders occurring at the moment of examination: DM1 - women diagnosed with type I diabetes, DM2 - women diagnosed with type 2 diabetes, IGT-women with glucose levels in OGTT, which applied to impaired glucose tolerance (acc. to WHO criteria), NDM - women with no clinical signs of diabetes, with normal result of OGTT. The risk of diabetes development is significantly higher (independently of the clinical type) in women who had had GDM include: high glucose levels at the time of GDM diagnosis, early onset of symptoms - related to weeks of gestation, and the insulin treatment during pregnancy. However multifactor analysis indicates that the only significant risk factors for DM 1 are early onset of diabetes during pregnancy and high glucose levels 2 hours after OGTT during pregnancy (p women who suffered from diabetes during pregnancy.

  10. Association between type 2 diabetes mellitus and disability: What is the contribution of diabetes risk factors and diabetes complications?

    Science.gov (United States)

    Tabesh, Maryam; Shaw, Jonathan E; Zimmet, Paul Z; Söderberg, Stefan; Koye, Digsu N; Kowlessur, Sudhir; Timol, Maryam; Joonas, Noorjehan; Sorefan, Ameena; Gayan, Praneel; Alberti, K George M M; Tuomilehto, Jaakko; Magliano, Dianna J

    2018-03-06

    The aim of this study was to evaluate the association between type 2 diabetes and disability in Mauritius and to assess the extent to which the effect of diabetes is explained by diabetes risk factors and concomitant complications. Data from a national survey in the multiethnic nation of Mauritius, which comprises South Asians and African Creoles, were analyzed. Disability was measured using the Katz activities of daily living questionnaire in participants aged >50 years. Among 3692 participants, 487 (13.2%) had some level of disability. Diabetes was associated with significantly higher risk of disability (odds ratio [OR] 1.67; 95% confidence interval [CI] 1.34-2.08). After adjusting for demographic, behavioral, and metabolic factors, as well as comorbidities, disability was significantly associated with diabetes among African Creoles (OR 2.03; 95% CI 1.16-3.56), but not South Asians (OR 1.27; 95% CI 0.98-1.66). Obesity explained much of the association between diabetes and disability (excess percentage of risk: 26.3% in South Asians and 12.1% in African Creoles). Obesity, history of cardiovascular disease (CVD), asthma-like symptoms, and depression together explained 46.5% and 29.0% of the excess risk in South Asians and African Creoles, respectively. Diabetes is associated with a 67% increased risk of disability. Diabetes risk factors and comorbidities explain more of the association between diabetes and disability among South Asians than Africans. Obesity and history of CVD explained the largest percentage of the relationship between diabetes and disability, indicating that weight and CVD management may be helpful in controlling disability related to diabetes. © 2018 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  11. Metabolite profiles and the risk of developing diabetes.

    Science.gov (United States)

    Wang, Thomas J; Larson, Martin G; Vasan, Ramachandran S; Cheng, Susan; Rhee, Eugene P; McCabe, Elizabeth; Lewis, Gregory D; Fox, Caroline S; Jacques, Paul F; Fernandez, Céline; O'Donnell, Christopher J; Carr, Stephen A; Mootha, Vamsi K; Florez, Jose C; Souza, Amanda; Melander, Olle; Clish, Clary B; Gerszten, Robert E

    2011-04-01

    Emerging technologies allow the high-throughput profiling of metabolic status from a blood specimen (metabolomics). We investigated whether metabolite profiles could predict the development of diabetes. Among 2,422 normoglycemic individuals followed for 12 years, 201 developed diabetes. Amino acids, amines and other polar metabolites were profiled in baseline specimens by liquid chromatography-tandem mass spectrometry (LC-MS). Cases and controls were matched for age, body mass index and fasting glucose. Five branched-chain and aromatic amino acids had highly significant associations with future diabetes: isoleucine, leucine, valine, tyrosine and phenylalanine. A combination of three amino acids predicted future diabetes (with a more than fivefold higher risk for individuals in top quartile). The results were replicated in an independent, prospective cohort. These findings underscore the potential key role of amino acid metabolism early in the pathogenesis of diabetes and suggest that amino acid profiles could aid in diabetes risk assessment.

  12. Persistent Organic Pollutants as Risk Factors for Obesity and Diabetes.

    Science.gov (United States)

    Yang, Chunxue; Kong, Alice Pik Shan; Cai, Zongwei; Chung, Arthur C K

    2017-11-02

    The rising prevalence of obesity and diabetes cannot be fully explained by known risk factors, such as unhealthy diet, a sedentary lifestyle, and family history. This review summarizes the available studies linking persistent organic pollutants (POPs) to obesity and diabetes and discusses plausible underlying mechanisms. Increasing evidence suggest that POPs may act as obesogens and diabetogens to promote the development of obesity and diabetes and induce metabolic dysfunction. POPs are synthesized chemicals and are used widely in our daily life. These chemicals are resistant to degradation in chemical or biological processes, which enable them to exist in the environment persistently and to be bio-accumulated in animal and human tissue through the food chain. Increasingly, epidemiologic studies suggest a positive association between POPs and risk of developing diabetes. Understanding the relationship of POPs with obesity and diabetes may shed light on preventive strategies for obesity and diabetes.

  13. Anticardiolipin antibodies in proliferative diabetic retinopathy: An additional risk factor

    International Nuclear Information System (INIS)

    Shahin, Maha; ElDiasty, Amany M; Mabed, Mohamed

    2009-01-01

    To report the prevalence of anticardiolipin antibodies in patients with proliferative diabetic retinopathy (PDR) having high-risk criteria (HRC). Diabetic patients having PDR with HRC and diabetics free of retinopathy were compared for the presence of anticardiolipin antibodies. Among the 34 patients, 6 (17.7%) of diabetics having PDR with HRC were positive for anticardiolipin antibodies. There was no significant association of aCL antibodies with sex or type of diabetes. Using Pearson's correlation test, no significant associations of aCL antibodies with duration of diabetes or age of patients were found. All patients who were positive for anticardiolipin antibodies had PDR with HRC. The difference was statistically significant. Presence of anticardiolipin antibodies may represent an additional risk factor for PDR. (author)

  14. Potential benefit of (--epigallocatechin-3-gallate for macrovascular complications in diabetes

    Directory of Open Access Journals (Sweden)

    L. Tang

    2017-08-01

    Full Text Available Vascular problems are the most common complications in diabetes. Substantial evidence from epidemiological and pathophysiological studies show that hyperglycemia is a major risk factor for macrovascular complications in patients with diabetes. (--Epigallocatechin-3-gallate (EGCG, the major catechin derived from green tea, is known to exert a variety of cardiovascular beneficial effects. The protective effects of EGCG in diabetes are also evident. However, whether EGCG is beneficial against macrovascular complications that occur in diabetes remains unknown. Our previous studies demonstrated that treatment of EGCG inhibits high glucose-induced vascular smooth muscle cell proliferation and suppresses high glucose-mediated vascular inflammation in human umbilical vein endothelial cells. Therefore, we hypothesize that EGCG might be an effective potential candidate to reduce the macrovascular complications in diabetes.

  15. Risk Factors of Diabetes Mellitus in Rural Puducherry

    Directory of Open Access Journals (Sweden)

    Sumanth Mallikarjuna Majgi

    2012-04-01

    Full Text Available Purpose: Prevalence of type 2 diabetes is increasing in India. Rural area constitutes 80% of India. Hence it is essential to understand the epidemiology for appropriate interventions. Objectives: to identify risk factors of type 2 diabetes mellitus in rural Puducherry. Methodology: Cross sectional study in two villages of Puducherry, India. 1403 subjects above 25 years from 2 villages. Study measured demographic variables, Body Mass Index (BMI, physical activity, family history of Diabetes Mellitus, smoking and alcohol consumption. Fasting blood glucose was measured for study subjects. Further, those with >126 mg/dl were subjected for Oral Glucose Tolerance Test. Univariate and multivariate analysis was done. Receiver Operating characteristic Curve was plotted to find out cut off for Diabetic Risk Score. Findings: The prevalence of type 2 Diabetes Mellitus (DM was 5.8%. The response rate was (88%. In univariate analysis age, occupation, Socio Economic Status, BMI, physical activity, family history were significant for DM. In multivariate analysis age, BMI, family history of diabetes and occupation were significant for type 2 DM. The ‘diabetes risk score’ generated by the study using age, BMI and family history of DM, had specificity, sensitivity and accuracy of 54%, 77% and 76.2% respectively. The area under curve for scoring system was 0.784 (<0.05. Conclusions: Identified risk factors are useful for early diagnosis by using ‘diabetes risk score’ – thus uncovering the iceberg of disease.

  16. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk

    OpenAIRE

    Aryangat, Ajikumar V; Gerich, John E

    2010-01-01

    Ajikumar V Aryangat, John E GerichUniversity of Rochester, Rochester, New York, USAAbstract: Hyperglycemia is a major risk factor for both the microvascular and macrovascular complications in  patients with type 2 diabetes. This review summarizes the cardiovascular results of large outcomes trials in diabetes and presents new evidence on the role of hyperglycemia, with particular emphasis on postprandial hyperglycemia, in adverse cardiovascular outcomes in patients with type 2 diabet...

  17. Promise assessment: A corollary to risk assessment for characterizing benefits

    International Nuclear Information System (INIS)

    Sholtis, J.A. Jr.

    1993-01-01

    Decisions involving the use of hazardous technologies are often made based on risk-benefit considerations. This is the case for U.S. space mission use of nuclear power and propulsion systems, where launch decisions are made within the office of the President. A great deal of time and effort is spent characterizing the risk for each nuclear-powered space mission. However, this is not so for benefits, even though they are no less important. To correct this situation, a new technical term--promise--is defined, and a new methodology--promise assessment--is proposed. This paper introduces and advances this concept, addresses its future application, as a tool, can be developed sufficiently and applied to methodically identify and characterized benefits. Further, it can introduce a degree of balance when judgments concerning the use of hazardous technologies are involved

  18. Benefit-risk evaluation of mammographic mass screening

    International Nuclear Information System (INIS)

    Sato, Nobuo; Ogura, Toshihiro

    1990-01-01

    This study evaluated the benefit-risk balance of mammography in mass screening by using survival rates from 3000 breast cancer patients at the Japanese Foundation for Cancer Research Institute Hospital. Because the number of participants in mammographic mass screening was small, asymptomatic patients with pathologically proven early breast cancer were categorized as the screenee group. Symptomatic patients were categorized as the patient group. Survival rates were compared in both the screenee and the patient groups. Based on the difference in areas of survival curves between screenees and patients, the ratio of person-year gain (PYG) to person-year lost (PYL) was obtained. The ratio of PYG to PYL was multiplied by the detection rate resulting from a particular screening program to obtain the benefit/risk ratio. The detection rate of nonpalpable breast cancer was 15 times higher in the screenee group than the patient group. Breast cancer was detected in 7 (0.85%) of 824 patients in the screenee group. Even when mammographic mass screening was started at the age of 30, the benefit of mammography was far superior to the risk. The number of participants in mass screening stratified by age may be required for the conclusion of the benefit-risk balance of mammography in mass screening. (N.K.)

  19. Prelabor Cesarean Section and Risk of Childhood Type 1 Diabetes

    DEFF Research Database (Denmark)

    Clausen, Tine Dalsgaard; Bergholt, Thomas; Eriksson, Frank

    2016-01-01

    BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish...... nationwide cohort study followed all singletons born during 1982-2010. Five national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons...... contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental...

  20. Transition from pre-diabetes to diabetes and predictors of risk in Mexican-Americans

    Directory of Open Access Journals (Sweden)

    Wu SH

    2017-12-01

    Full Text Available Shenghui Wu,1 Joseph B McCormick,2 Joanne E Curran,3 Susan P Fisher-Hoch2 1Department of Epidemiology and Biostatistics, University of Texas Health at San Antonio-Laredo Campus, Laredo, 2Division of Epidemiology, University of Texas Health Science Center-Houston, School of Public Health, Brownsville Campus, Brownsville, 3South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville Campus, Brownsville, TX, USA Background: No studies have examined risk factors for the transition from pre-diabetes to diabetes in populations with widespread obesity and diabetes. We determined proximal changes and factors affecting the transition among Mexican-Americans with pre-diabetes.Methods: Participants with pre-diabetes (n=285 were recruited from our randomly sampled population-based Cameron County Hispanic Cohort. These participants were followed for an average of 27 months with repeat examination every 3 to 4 months. Metabolic health was defined as having less than 2 metabolic abnormalities (e.g., hypertension, elevated low-density lipoprotein, etc. Diabetes was identified as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% and/or on hypoglycemic medication.Results: Ninety-six of 285 (33.7% participants transitioned to overt diabetes. The increased risk of diabetes in the metabolically unhealthy varying with follow-up time was 81% (adjusted odds ratio [OR]: 1.81; 95% CI: 1.09–3.02. The risk of diabetes increased 8% for each kg/m2 of increase in body mass index (BMI, OR: 1.08; 95% CI: 1.05–1.11 independent of covariates. Transition to diabetes was accompanied by a mean increase in BMI of 0.28 kg/m2, and deterioration in metabolic health of 9% (OR: 1.09; 95% CI: 1.003–1.18 compared with those who did not transition.Conclusions: Deteriorating metabolic health and/or increasing BMI significantly raises the risk of transitioning from pre-diabetes to diabetes. Transition itself was

  1. Risk assessment for invasive species produces net bioeconomic benefits.

    Science.gov (United States)

    Keller, Reuben P; Lodge, David M; Finnoff, David C

    2007-01-02

    International commerce in live organisms presents a policy challenge for trade globalization; sales of live organisms create wealth, but some nonindigenous species cause harm. To reduce damage, some countries have implemented species screening to limit the introduction of damaging species. Adoption of new risk assessment (RA) technologies has been slowed, however, by concerns that RA accuracy remains insufficient to produce positive net economic benefits. This concern arises because only a small proportion of all introduced species escape, spread, and cause harm (i.e., become invasive), so a RA will exclude many noninvasive species (which provide a net economic benefit) for every invasive species correctly identified. Here, we develop a simple cost:benefit bioeconomic framework to quantify the net benefits from applying species prescreening. Because invasive species are rarely eradicated, and their damages must therefore be borne for long periods, we have projected the value of RA over a suitable range of policy time horizons (10-500 years). We apply the model to the Australian plant quarantine program and show that this RA program produces positive net economic benefits over the range of reasonable assumptions. Because we use low estimates of the financial damage caused by invasive species and high estimates of the value of species in the ornamental trade, our results underestimate the net benefit of the Australian plant quarantine program. In addition, because plants have relatively low rates of invasion, applying screening protocols to animals would likely demonstrate even greater benefits.

  2. Potential risk factors for diabetic neuropathy: a case control study

    Directory of Open Access Journals (Sweden)

    Nooraei Mahdi

    2005-12-01

    Full Text Available Abstract Background Diabetes mellitus type II afflicts at least 2 million people in Iran. Neuropathy is one of the most common complications of diabetes and lowers the patient's quality of life. Since neuropathy often leads to ulceration and amputation, we have tried to elucidate the factors that can affect its progression. Methods In this case-control study, 110 diabetic patients were selected from the Shariati Hospital diabetes clinic. Michigan Neuropathic Diabetic Scoring (MNDS was used to differentiate cases from controls. The diagnosis of neuropathy was confirmed by nerve conduction studies (nerve conduction velocity and electromyography. The multiple factors compared between the two groups included consumption of angiotensin converting enzyme inhibitors (ACEI, blood pressure, serum lipid level, sex, smoking, method of diabetes control and its quality. Results Statistically significant relationships were found between neuropathy and age, gender, quality of diabetes control and duration of disease (P values in the order: 0.04, 0.04, Conclusion In this study, hyperglycemia was the only modifiable risk factor for diabetic neuropathy. Glycemic control reduces the incidence of neuropathy, slows its progression and improves the diabetic patient's quality of life. More attention must be paid to elderly male diabetic patients with poor diabetes control with regard to regular foot examinations and more practical education.

  3. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.

    Science.gov (United States)

    Jobe, Alan H; Goldenberg, Robert L

    2018-04-07

    Antenatal corticosteroids are standard of care for pregnancies at risk of preterm delivery between 24-34 weeks' gestational age. Recent trials demonstrate modest benefits from antenatal corticosteroids for late preterm and elective cesarean deliveries, and antenatal corticosteroids for periviable deliveries should be considered with family discussion. However, many women with threatened preterm deliveries receive antenatal corticosteroids but do not deliver until >34 weeks or at term. The net effect is that a substantial fraction of the delivery population will be exposed to antenatal corticosteroids. There are gaps in accurate assessments of benefits of antenatal corticosteroids because the randomized controlled trials were performed prior to about 1990 in pregnancies generally >28 weeks. The care practices for the mother and infant survival were different than today. The randomized controlled trial data also do not strongly support the optimal interval from antenatal corticosteroid treatment to delivery of 1-7 days. Epidemiology-based studies using large cohorts with >85% of at-risk pregnancies treated with antenatal corticosteroids probably overestimate the benefits of antenatal corticosteroids. Although most of the prematurity-associated mortality is in low-resource environments, the efficacy and safety of antenatal corticosteroids in those environments remain to be evaluated. The short-term benefits of antenatal corticosteroids for high-risk pregnancies in high-resource environments certainly justify antenatal corticosteroids as few risks have been identified over many years. However, cardiovascular and metabolic abnormalities have been identified in large animal models and cohorts of children exposed to antenatal corticosteroids that are consistent with fetal programming for adult diseases. These late effects of antenatal corticosteroids suggest caution for the expanded use of antenatal corticosteroids beyond at-risk pregnancies at 24-34 weeks. A way forward

  4. Risk factors for diabetic retinopathy in Kuwaiti type 2 diabetic patients

    International Nuclear Information System (INIS)

    Al-Adsani, Afaf M.S.

    2007-01-01

    To determine the risk factors associated with diabetic retinopathy in Kuwaiti subjects with type 2 diabetes. Kuwaiti subjects with type 2 diabetes (n=165) attending the Diabetic Clinic at Al-sabah Hospital, Kuwait between October 2000 and March 2005 were screened for diabetic retinopathy. Any diabetic retinopathy was found in 40% while 20.6% had sight threatening retinopathy. Mild NPDR was present in 21.2%, moderate to severe non-proliferative diabetic retinopathy (NPDR) in 7.9%, and proliferative diabetic retinopathy in 3.0%. Maculopathy was present in 10.3% and 7.9 % pf patients were photocoagulated. Compared to those without retinopathy, diabetic patients with any retinopathy were significantly older (51.7+-10.3 versus 47.2+-9.5 years; p<0.005), had longer duration of diabetes (13.1+-6.3 versus 4.7 +-5.4 years; p<0.0001), higher systolic blood pressure (142.9+-23.0 versus 130.3+-20.2; p<0.0001) and poor glycemic control (Hemoglobin A1c=10.1+-2.4 versus 8.9+-2.3; p<0.005). The prevalence of hypertension and nephropathy was significantly higher in patients with any retinopathy than those without retinopathy (70.8% versus 49.5%; p<0.01 and 64.4% versus 30.8%; p<0.0001) respectively. Longer duration of diabetes and presence of nephropathy was the most significant independent factors associated with any retinopathy and sight-threatening retinopathy. Treatment with sulphonylurea or insulin, and poor glycemic control were other significant independent factors associated with any retinopathy. Longer duration of diabetes, presence of nephropathy, glycemic control and mode of treatment were the most significant independent factors of diabetic retinopathy. However, population-based study is warranted to identify the risk factors, as well as the prevalence of diabetic retinopathy. (author)

  5. The 24-month metabolic benefits of the healthy living partnerships to prevent diabetes: A community-based translational study.

    Science.gov (United States)

    Pedley, Carolyn F; Case, L Douglas; Blackwell, Caroline S; Katula, Jeffrey A; Vitolins, Mara Z

    2018-05-01

    Large-scale clinical trials and translational studies have demonstrated that weight loss achieved through diet and physical activity reduced the development of diabetes in overweight individuals with prediabetes. These interventions also reduced the occurrence of metabolic syndrome and risk factors linked to other chronic conditions including obesity-driven cancers and cardiovascular disease. The Healthy Living Partnerships to Prevent Diabetes (HELP PD) was a clinical trial in which participants were randomized to receive a community-based lifestyle intervention translated from the Diabetes Prevention Program (DPP) or an enhanced usual care condition. The objective of this study is to compare the 12 and 24 month prevalence of metabolic syndrome in the two treatment arms of HELP PD. The intervention involved a group-based, behavioral weight-loss program led by community health workers monitored by personnel from a local diabetes education program. The enhanced usual care condition included dietary counseling and written materials. HELP PD included 301 overweight or obese participants (BMI 25-39.9kg/m 2 ) with elevated fasting glucose levels (95-125mg/dl). At 12 and 24 months of follow-up there were significant improvements in individual components of the metabolic syndrome: fasting blood glucose, waist circumference, HDL, triglycerides and blood pressure and the occurrence of the metabolic syndrome in the intervention group compared to the usual care group. This study demonstrates that a community diabetes prevention program in participants with prediabetes results in metabolic benefits and a reduction in the occurrence of the metabolic syndrome in the intervention group compared to the enhanced usual care group. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  6. The prevalence and risk factors for gestational diabetes and ...

    African Journals Online (AJOL)

    Objectives: To determine the common diabetes risk factors (or OGTT; the prevalence of GDM; and the maternal and perinatal outcomes of GDM pregnancies in a Nigerian urban antenatal population. Patients and Methods: A retrospective study of pregnant women, who attended antenatal clinic, screened for diabetes ...

  7. Prevalence and risk factors of diabetes mellitus foot syndrome ...

    African Journals Online (AJOL)

    Background: Diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and thesociety. Diabetic foot ulcers are largely preventable by identifying people at risk of ulceration throughexamination of the feet, education and frequent follow-up of these ...

  8. Low 25-hydroxyvitamin d and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Afzal, Shoaib; Bojesen, Stig E; Nordestgaard, Børge G

    2013-01-01

    Vitamin D deficiency has been implicated in decreased insulin secretion and increased insulin resistance, hallmarks of type 2 diabetes mellitus. We tested the hypothesis that low plasma 25-hydroxyvitamin D [25(OH)D] is associated with increased risk of type 2 diabetes in the general population....

  9. Risk Factors Associated with Hypercoagulability in Type 2 Diabetes ...

    African Journals Online (AJOL)

    Background: Thrombosis, attributed to atherosclerosis, is the leading cause of morbidity and mortality in patients with diabetes mellitus. Pathogenesis of atherosclerosis in diabetes mellitus is not entirely clear and conventional risk factors such as smoking, obesity, blood pressure and serum lipids fail to explain fully this ...

  10. The epidemiology of lifestyle and risk for type 2 diabetes.

    NARCIS (Netherlands)

    van Dam, R.M.

    2003-01-01

    Results from ecological and migration studies indicate that a western lifestyle is associated with a higher prevalence of type 2 diabetes. In recent years, there has been a rapid accumulation of data on lifestyle and risk for type 2 diabetes from studies on an individual level. This article gives an

  11. The benefits and risks of testosterone replacement therapy: a review

    Directory of Open Access Journals (Sweden)

    Nazem Bassil

    2009-06-01

    Full Text Available Nazem Bassil1, Saad Alkaade2, John E Morley1,31Division of Geriatric Medicine; 2Internal Medicine, Saint Louis University Health Sciences Center, St. Louis, Missouri, USA; 3GRECC, VA Medical Center, St. Louis, Missouri, USAAbstract: Increased longevity and population aging will increase the number of men with late onset hypogonadism. It is a common condition, but often underdiagnosed and undertreated. The indication of testosterone-replacement therapy (TRT treatment requires the presence of low testosterone level, and symptoms and signs of hypogonadism. Although controversy remains regarding indications for testosterone supplementation in aging men due to lack of large-scale, long-term studies assessing the benefits and risks of testosterone-replacement therapy in men, reports indicate that TRT may produce a wide range of benefits for men with hypogonadism that include improvement in libido and sexual function, bone density, muscle mass, body composition, mood, erythropoiesis, cognition, quality of life and cardiovascular disease. Perhaps the most controversial area is the issue of risk, especially possible stimulation of prostate cancer by testosterone, even though no evidence to support this risk exists. Other possible risks include worsening symptoms of benign prostatic hypertrophy, liver toxicity, hyperviscosity, erythrocytosis, worsening untreated sleep apnea or severe heart failure. Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years. The physician should discuss with the patient the potential benefits and risks of TRT. The purpose of this review is to discuss what is known and not known regarding the benefits and risks of TRT.Keywords: hypogonadism, testosterone replacement therapy, erectile dysfunction, osteoporosis, cardiovascular disease

  12. Biotechnology risks and benefits: Science instructor perspectives and practices

    Science.gov (United States)

    Gardner, Grant Ean

    Developing scientifically literate students who understand the socially contextualized nature of science and technology is a national focus of science education reform. Understanding teachers' views on this topic is of equal importance. This document focuses on the topic of risks and benefits posed by science and technology as an important topic for which the socially contextualized nature of science and technology readily emerges. Following introduction of a theoretical model and a review of the literature, two research studies are described that examined teachers' perceptions of the risks posed by biotechnology and the role of risk topics in an undergraduate science course. The first research study examines four groups of science educators; pre-service science teachers, in-service science teachers, science graduate teaching assistants, and science professors (n = 91). The participants completed a survey and card sort task to determine their perceptions of the risks of biotechnology. The results show that teacher perceptions were shaped by the risk severity, regulation processes, public acceptance, fear, reciprocal benefits, and whether the applications would impact humans or the environment. Factors determining risk perception included personal worldviews, trust in communicating institutions, and personal experiences with biotechnology. The different types of science teachers were compared and contrasted in light of these factors and the implications of instructor perceptions on science pedagogy are discussed. The second research manuscript describes a case study in which six biology graduate teaching assistants (GTAs) were observed teaching as lesson on the potential risks and benefits of biotechnology. The data sources included classroom observations and semi-structured interviews. Qualitative analysis reveals that GTAs framed the instruction of risk in one of three ways: analytical, focus on perspectives and biases, and promotion of individual reflection

  13. The role of risk and cost benefit in program budgeting

    International Nuclear Information System (INIS)

    Henry, C.J.; Alchowiak, J.

    1995-01-01

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground open-quote The First Step,close-quote provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget

  14. The role of risk and cost benefit in program budgeting

    Energy Technology Data Exchange (ETDEWEB)

    Henry, C.J.; Alchowiak, J. [Dept. of Energy, Washington, DC (United States)

    1995-12-31

    The primary Environmental Management (EM) program mission is protecting human health and the environment. EM is currently facing a decreasing budget while still having to deal with competing requirements and risks to workers, public, and environment. There has been no consistent framework for considering in an integrated fashion the multiple types of risks and hazards present in the nuclear weapons complex. Therefore, to allocate resources during the budget process, EM is using risk, long term costs, mortgage reduction, compliance issues, and stakeholders concerns to prioritize the funding of activities. Risk and cost-benefit analysis are valuable tools to help make decisions to reduce risks to health, safety, and the environment in a sensible and cost-effective manner. Principles for priority setting using risk analysis are to seek to compare risks by grouping them into broad categories of concern (e.g., high, medium, and low); to set priorities in managing risks to account for relevant management and social considerations; to inform priorities by as broad a range of views as possible, ideally with consensus; and, to try to coordinate risk reduction efforts among programs. The Draft Risk Report to Congress, Risks and the Risk Debate: Searching for Common Ground {open_quote}The First Step,{close_quote} provides the first link between budget, compliance requirements, and risk reduction/pollution prevention activities. The process used for the report provides an initial framework to capture the spectrum of risks associated with environmental management activities and to link these risks in a qualitative fashion to compliance and the budget.

  15. Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

    Science.gov (United States)

    Al-Delaimy, W K; Webb, M

    2017-06-01

    The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

  16. Diabetes: Rethinking risk and the Dx that fits.

    Science.gov (United States)

    Kirk, Julienne K; Namak, Shahla

    2009-05-01

    Routinely screen adult patients with a sustained blood pressure >135/80 mm Hg for type 2 diabetes. Closely monitor pregnant women with 1 or more elevated glucose test results; although a diagnosis of gestational diabetes mellitus requires 2 or more abnormal values, even 1 may be associated with a higher risk of adverse outcomes. Include latent autoimmune diabetes in adults (LADA), a progressive form of type 1 with a slower onset, in the differential diagnosis for symptomatic patients who do not fit the classic patterns for type 1 or type 2 diabetes.

  17. Expert opinion on nanotechnology: risks, benefits, and regulation

    Energy Technology Data Exchange (ETDEWEB)

    Besley, John C., E-mail: jbesley@sc.edu; Kramer, Victoria L. [University of South Carolina, School of Journalism and Mass Communications (United States); Priest, Susanna H. [University of Nevada, Hank Greenspun School of Journalism and Media Studies (United States)

    2008-04-15

    A survey of American (US) nanotechnology researchers (N = 177) suggests a diversity of views about what areas are most important to the burgeoning field, as well as perceptions about the overall benefits and risks of such research. On average, respondents saw a range of technologies as key and viewed public health and environmental issues as areas where both risks and the need for regulation are greatest. These areas were also where respondents said current regulations were least adequate. Factor analyses of the survey questions suggest that, when considering both risks and regulations, respondents make a distinction between health and environmental risks, and what might be termed 'social risks' (e.g., invasion of privacy, use of nanotechnology in weapons, and economic impacts)

  18. Expert opinion on nanotechnology: risks, benefits, and regulation

    International Nuclear Information System (INIS)

    Besley, John C.; Kramer, Victoria L.; Priest, Susanna H.

    2008-01-01

    A survey of American (US) nanotechnology researchers (N = 177) suggests a diversity of views about what areas are most important to the burgeoning field, as well as perceptions about the overall benefits and risks of such research. On average, respondents saw a range of technologies as key and viewed public health and environmental issues as areas where both risks and the need for regulation are greatest. These areas were also where respondents said current regulations were least adequate. Factor analyses of the survey questions suggest that, when considering both risks and regulations, respondents make a distinction between health and environmental risks, and what might be termed 'social risks' (e.g., invasion of privacy, use of nanotechnology in weapons, and economic impacts)

  19. The Comparison of Matching Methods Using Different Measures of Balance: Benefits and Risks Exemplified within a Study to Evaluate the Effects of German Disease Management Programs on Long-Term Outcomes of Patients with Type 2 Diabetes.

    Science.gov (United States)

    Fullerton, Birgit; Pöhlmann, Boris; Krohn, Robert; Adams, John L; Gerlach, Ferdinand M; Erler, Antje

    2016-10-01

    To present a case study on how to compare various matching methods applying different measures of balance and to point out some pitfalls involved in relying on such measures. Administrative claims data from a German statutory health insurance fund covering the years 2004-2008. We applied three different covariance balance diagnostics to a choice of 12 different matching methods used to evaluate the effectiveness of the German disease management program for type 2 diabetes (DMPDM2). We further compared the effect estimates resulting from applying these different matching techniques in the evaluation of the DMPDM2. The choice of balance measure leads to different results on the performance of the applied matching methods. Exact matching methods performed well across all measures of balance, but resulted in the exclusion of many observations, leading to a change of the baseline characteristics of the study sample and also the effect estimate of the DMPDM2. All PS-based methods showed similar effect estimates. Applying a higher matching ratio and using a larger variable set generally resulted in better balance. Using a generalized boosted instead of a logistic regression model showed slightly better performance for balance diagnostics taking into account imbalances at higher moments. Best practice should include the application of several matching methods and thorough balance diagnostics. Applying matching techniques can provide a useful preprocessing step to reveal areas of the data that lack common support. The use of different balance diagnostics can be helpful for the interpretation of different effect estimates found with different matching methods. © Health Research and Educational Trust.

  20. Unintended benefits: the potential economic impact of addressing risk factors to prevent Alzheimer's disease.

    Science.gov (United States)

    Lin, Pei-Jung; Yang, Zhou; Fillit, Howard M; Cohen, Joshua T; Neumann, Peter J

    2014-04-01

    Certain chronic conditions appear to be modifiable risk factors of Alzheimer's disease and related dementias. To understand the potential health and economic impacts of addressing those risk factors, we used data on a Medicare cohort to simulate four scenarios: a 10 percent reduction in the prevalence of diabetes, hypertension, cardiovascular diseases, respectively, and a 10 percent reduction in body mass index among beneficiaries who were overweight or obese. Our simulation demonstrated that reducing the prevalence of these conditions may yield "unintended benefits" by lowering the risk, delaying the onset, reducing the duration, and lowering the costs of dementia. More research is needed to clarify the exact relationship between various other chronic diseases and dementia. However, our findings highlight potential health gains and savings opportunities stemming from the better management of other conditions associated with dementia.

  1. Cardiovascular risk markers in type II diabetes and hypertension at ...

    African Journals Online (AJOL)

    Cardiovascular risk markers in type II diabetes and hypertension at the Battor Catholic ... either precedes or is a consequence of the development of these diseases. ... The control group consisted of 62 age-matched healthy individuals.

  2. Cancer risks, risk-cost-benefit analyses, and the scientific method

    International Nuclear Information System (INIS)

    Seiler, F.A.; Alvarez, J.L.

    1995-01-01

    Two main changes in risk analysis are increasingly beginning to influence the manner in which, in the perception of scientists, low-dose modeling of radiation carcinogenesis is supposed to be done. In the past, efforts to model radiation risks have been carried out under the banner of scientific endeavors. On closer inspection, however, it has become obvious that these efforts were not guided by the scientific method and that a change in approach is needed. We realize increasingly that risk analysis is not done in a vacuum and that any action taken due to the result of the analysis not only has a benefit in the form of a risk reduction but leads inevitably to an increase in cost and an increase in the risks of persons effecting the benefit. Thus, a risk-cost-benefit analysis should be done and show a clear-cut net benefit before a remedial action is taken

  3. Cost-benefit and risk-benefit assessment for nuclear power plants

    International Nuclear Information System (INIS)

    Eichholz, G.G.

    1976-01-01

    A cost benefit assessment is an essential part of the Environmental Impact Statement submitted as part of the licensing considerations for a nuclear facility. Such an assessment forms part of the initial decision to build a nuclear facility, enters critically into the selection of a suitable site, and ultimately forms part of the design procedures to optimize engineering solutions to deal with waste-heat dissipation, treatment methods for radioactive effluent control, and land and site use. Whereas the initial decision usually can be made in purely economic terms, the latter stages involve environmental and social issues that are not readily quantified and involve a qualitative judgment of what constitutes the least, readily achievable impact. The radiological impact of the plant on the surrounding population from the release of low-level effluents can be quantified and treated as a financial ''cost.'' Alternatively it can be treated as a ''risk'' and related to other risks modern man is subjected to and can be used as a means to establish site boundaries. Both cost-benefit and risk-benefit analyses represent essentially optimization approaches to the problem of making nuclear power plants economically competitive, socially and politically acceptable, and as safe or innocuous as one can reasonably make them

  4. Public perceptions about nanotechnology: Risks, benefits and trust

    Energy Technology Data Exchange (ETDEWEB)

    Cobb, Michael D.; Macoubrie, Jane [North Carolina State University, Department of Political Science (United States)

    2004-08-15

    We report data from the first representative national phone survey of Americans' perceptions about nanotechnology (N =1536). Public opinion about nanotechnology is in its infancy, and knowledge about it is quite limited. Yet, Americans' initial reaction to nanotechnology is thus far generally positive, probably rooted in a generally positive view of science overall. Survey respondents expected benefits of nanotechnology to be more prevalent than risks, and they reported feeling hopeful about nanotechnology rather than worried. Their most preferred potential benefit of nanotechnology is 'new and better ways to detect and treat human diseases,' and they identified 'losing personal privacy to tiny new surveillance devices' as the most important potential risk to avoid. The most discouraging aspect to the data is respondents' lack of trust in business leaders to minimize nanotechnology risks to human health. Overall, these data indicate that while Americans do not necessarily presume benefits and the absence of risks, their outlook is much more positive than not.

  5. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C. [Brower & Company, Andover, MA (United States); Bell, K. [Convergence Research, Seattle, WA (United States); Bernow, S.; Duckworth, M. [Tellus Inst., Boston, MA (United States); Spinney P. [Charles River Associates, Boston, MA (United States)

    1996-12-31

    This paper presents preliminary results of a study to evaluate the risk-reduction benefits of wind power for a case study utility system using decision analysis techniques. The costs and risks of two alternative decisions-whether to build a 400 MW gas-fired combined cycle plant or a 1600 MW wind plant in 2003-were compared through computer simulations as fuel prices, environmental regulatory costs, wind and conventional power plant availability, and load growth were allowed to vary. Three different market scenarios were examined: traditional regulation, a short-term power pool, and fixed-price contracts of varying duration. The study concludes that, from the perspective of ratepayers, wind energy provides a net levelized risk-reduction benefit of $3.4 to $7.8/MWh under traditional regulation, and less in the other scenarios. From the perspective of the utility plant owners, wind provides a significant risk benefit in the unregulated market scenarios but none in a regulated market. The methodology and findings should help inform utility resource planning and industry restructuring efforts. 2 figs., 3 tabs.

  6. Risk factors associated with diabetic retinopathy among type 2 diabetes patients at teaching hospital in Malaysia.

    Science.gov (United States)

    Abougalambou, Salwa Selim Ibrahim; Abougalambou, Ayman S

    2015-01-01

    Diabetic retinopathy (DR) is the leading cause of blindness in the United States and it is the leading cause of new cases of blindness in adults aged 20-74. It is estimated that about 20% of patients with type 2 DM have evidence of diabetic retinopathy at diagnosis with diabetes. To evaluate the prevalence of DR and to determine risk factors related to diabetic retinopathy among type 2 diabetes patients attending endocrinology clinics at Hospital Universiti Sains Malaysia (HUSM). The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at HUSM. Diagnosis of retinopathy is based on finding the diagnostic signs of retinopathy on eye exams by fundoscopy. Logistic regression analysis was used to assess the independent variables that affect the development of retinopathy. The prevalence of retinopathy was 39.3%. It has been noticed from this study findings, that the progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is highly prevalent among type 2 DM. The progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is a serious diabetic complication and public health strategies are required in order to reduce its risk factors and decrease its prevalence. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  7. Risk-benefit evaluation of nuclear power plant siting

    International Nuclear Information System (INIS)

    Miettinen, J.; Savolainen, I.; Silvennoinen, P.

    1976-01-01

    An assessment scheme is described for the risk-benefit analyses of nuclear power versus conventional alternatives. Given the siting parameters for the proposed nuclear plant an economic comparison is made with the most advantageous competitive conventional production scenario. The economic benefit is determined from the differential discounted annual energy procurement cost as a function of the real interest rate and amortization time. The risk analysis encompasses the following factors: radiation risks in normal operation, reactor accident hazards and economic risks, atmospheric pollutants from the conventional power plants, and fuel transportation. The hazards are first considered in terms of probabilistic dose distributions. In the second stage risk components are converted to a compatible form where excess mortality is used as the risk indicator. Practical calculations are performed for the power production alternatives of Helsinki where district heat would be extracted from the nuclear power plant. At the real interest rate of 10% and amortization time of 20 yr the 1000 MW(e) nuclear option is found to be Pound9.1 m per yr more economic than the optimal conventional scenario. Simultaneously the nuclear alternative is estimated to reduce excess mortality by 2 to 5 fatal injuries annually. (author)

  8. White blood cell subtypes and risk of type 2 diabetes.

    Science.gov (United States)

    Zhang, Hongmei; Yang, Zhen; Zhang, Weiwei; Niu, Yixin; Li, Xiaoyong; Qin, Li; Su, Qing

    2017-01-01

    It is reported that total white blood cell is associated with risk of diabetes mellitus. The present study is to investigate the relationship of white blood cell subsets with incidence of type 2 diabetes at baseline and 3year follow-up. We chose individuals without diabetes history as our study population; 8991 individuals were included at baseline. All of the participants underwent a 75-g OGTT at baseline. White blood cell count including all the subsets were measured along with all the other laboratory indices. The participants who were not diagnosed with type 2 diabetes according to the WHO 1999 diagnostic criteria underwent another 75-g OGTT at 3year follow-up. The total WBC count, neutrophil count, and lymphocyte count were significantly increased in subjects newly diagnosed with diabetes mellitus compared to non-DM subjects at baseline (all ptype 2 diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Neonatal delivery weight and risk of future maternal diabetes.

    Science.gov (United States)

    Stuart, Andrea E; Amer-Wåhlin, Isis; Källen, Karin B M

    2018-01-01

    To investigate associations between neonatal delivery weight and future risk of maternal type 1 or type 2 diabetes. Data included in the Swedish Medical Birth Registry and Swedish National Diabetes Registry were merged to include all women born during 1930-1989; patients with pre-existing diabetes or gestational diabetes were excluded. Cox regression analyses were performed to identify associations between the neonatal delivery weight from the most recent pregnancy and later occurrence of diabetes. There were 1 873 440 patients included in the analyses. An increased risk of type 1 (hazard ratio 3.60, 95% confidence interval [CI] 3.23-4.01) or type 2 diabetes (hazard ratio 2.77, 95% CI 2.68-2.87) was observed among patients who had a large for gestational age neonate compared with patients who had neonates within one standard definition of the mean weight for gestational age; the odds of developing type 1 (odds ratio 10.27, 95% CI 7.37-14.31) or type 2 diabetes (odds ratio 8.50, 95% CI 6.01-12.02) within 1 year of delivery was also increased compared with patients who had a neonate within one standard deviation of the mean weight for gestational age. Delivering a large for gestational age neonate was a potent risk factor for the later development of maternal type 1 or type 2 diabetes. © 2017 International Federation of Gynecology and Obstetrics.

  10. Benefits of flu vaccination for persons with diabetes mellitus: A review.

    Science.gov (United States)

    Goeijenbier, M; van Sloten, T T; Slobbe, L; Mathieu, C; van Genderen, P; Beyer, Walter E P; Osterhaus, Albert D M E

    2017-09-12

    Diabetes mellitus imposes a significant and increasing burden on society, with major consequences for human health, welfare and the economy worldwide. Persons with diabetes mellitus are at increased risk of developing severe complications after influenza virus infection and guidelines advise vaccination. The present evidence for influenza vaccine effectiveness in persons with diabetes mellitus is mainly based on observational studies with clinical endpoints like hospitalization and death, indicating a beneficial reduction of morbidity and mortality. Further supportive evidence comes from serological studies, in which persons with diabetes mellitus usually develop similar antibody levels after vaccination as healthy people. Observational studies may be prone to selection bias, and serological studies may not completely mirror vaccine effectiveness in the field. Although more controlled trials in persons with diabetes mellitus with laboratory-confirmed, influenza-specific outcomes would be desirable to better estimate the effect of vaccination, the currently available data justify routine influenza vaccination in persons with diabetes mellitus. As in this risk group, the use of influenza vaccine is far below target worldwide, efforts should be made to increase vaccination coverage. Copyright © 2017. Published by Elsevier Ltd.

  11. Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans.

    Science.gov (United States)

    Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Talegawkar, Sameera A; Effoe, Valery S; Okhomina, Victoria; Carnethon, Mercedes R; Hsueh, Willa A; Golden, Sherita H

    2017-11-01

    The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) with incident diabetes among AAs. Modifiable lifestyle risk factors were characterized among 3,252 AAs in the Jackson Heart Study who were free of diabetes at baseline (2000-2004) using baseline questionnaires and combined into risk factor categories: poor (0-3 points), average (4-7 points), and optimal (8-11 points). Incidence rate ratios (IRR) for diabetes (fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or glycosylated hemoglobin A1c ≥6.5%) were estimated using Poisson regression modeling adjusting for age, sex, education, occupation, systolic blood pressure, and BMI. Outcomes were collected 2005-2012 and data analyzed in 2016. Over 7.6 years, there were 560 incident diabetes cases (mean age=53.3 years, 64% female). An average or optimal compared to poor risk factor categorization was associated with a 21% (IRR=0.79, 95% CI=0.62, 0.99) and 31% (IRR=0.69, 95% CI=0.48, 1.01) lower risk of diabetes. Among participants with BMI <30, IRRs for average or optimal compared to poor categorization were 0.60 (95% CI=0.40, 0.91) and 0.53 (95% CI=0.29, 0.97) versus 0.90 (95% CI=0.67, 1.21) and 0.83 (95% CI=0.51, 1.34) among participants with BMI ≥30. A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Benefits and risks of danazol in hereditary angioedema

    DEFF Research Database (Denmark)

    Bork, Konrad; Bygum, Anette; Hardt, Jochen

    2008-01-01

    the benefits and risks of long-term treatment with danazol. METHODS: Data were generated retrospectively from 118 German and Danish patients who had HAE due to C1 inhibitor deficiency and were treated with danazol from 2 months to 30 years. The frequency and severity of acute attacks were registered before......, headache, depression, and/or liver adenomas) occurred in 93 of the 118 patients and led to discontinuation of danazol therapy in 30 patients. CONCLUSIONS: Danazol is highly beneficial in patients with frequent and severe attacks of HAE. Because the risk of adverse effects is high, close monitoring...

  13. A benefit-risk assessment of class III antiarrhythmic agents

    DEFF Research Database (Denmark)

    Elming, Hanne; Brendorp, Bente; Pehrson, Steen

    2004-01-01

    The prevalence of arrhythmia in the population is increasing as more people survive for longer with cardiovascular disease. It was once thought that antiarrhythmic therapy could save life, however, it is now evident that antiarrhythmic therapy should be administrated with the purpose of symptomat......, and reducing the need for implantable cardioverter defibrillator shock/antitachycardia therapy, since no class III antiarrhythmic agents have proven survival benefit. The risks discussed mainly focus on pro-arrhythmia as torsade de pointes ventricular tachycardia....

  14. Social media in food risk and benefit communication

    OpenAIRE

    Rutsaert, Pieter

    2013-01-01

    The overall objective of this doctoral thesis was to contribute to a better understanding of the role social media can fulfil for the communication of food-related risks and benefits. Social media is the collective name for a number of online applications, including social networks, video- and picture-sharing websites, blogs, and microblogs, that allow users to generate and share information online. As a consequence users now control how information is found and used instead of the producers....

  15. Do the health benefits of cycling outweigh the risks?

    OpenAIRE

    Hartog,Jeroen Johan de; Boogaard,Hanna; Nijland,Hans; Hoek,Gerard

    2011-01-01

    BACKGROUND: Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail.Objective: We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outw...

  16. Do the health benefits of cycling outweigh the risks?

    Science.gov (United States)

    Johan de Hartog, Jeroen; Boogaard, Hanna; Nijland, Hans; Hoek, Gerard

    2010-08-01

    Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks. We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies. We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3-14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8-40 days lost) and the increase in traffic accidents (5-9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents. On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport.

  17. Wind farm investment risks under uncertain CDM benefit in China

    International Nuclear Information System (INIS)

    Yang, Ming; Nguyen, Francois; T'Serclaes, Philippine de; Buchner, Barbara

    2010-01-01

    China has set an ambitious target to increase its wind power capacity by 35 GW from 2007 to 2020. The country's hunger for clean power provides great opportunities for wind energy investors. However, risks from China's uncertain electricity market regulation and an uncertain energy policy framework, mainly due to uncertain Clean Development Mechanism (CDM) benefits, prevent foreign investors from investing in China's wind energy. The objectives of this paper are to: (1) quantify wind energy investment risk premiums in an uncertain international energy policy context and (2) evaluate the impact of uncertain CDM benefits on the net present values of wind power projects. With four scenarios, this study simulates possible prices of certified emissions reductions (CERs) from wind power projects. Project net present values (NPVs) have been calculated. The project risk premiums are drawn from different and uncertain CER prices. Our key findings show that uncertain CDM benefits will significantly affect the project NPVs. This paper concludes that the Chinese government needs revising its tariff incentives, most likely by introducing fixed feed-in tariffs (FITs), and re-examining its CDM-granting policy and its wind project tax rates, to facilitate wind power development and enable China to achieve its wind energy target. (author)

  18. [Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit].

    Science.gov (United States)

    Márquez-Godínez, S A; Zonana-Nacach, A; Anzaldo-Campos, M C; Muñoz-Martínez, J A

    2014-01-01

    To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95%CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95%CI: 2.8-9.4), female gender (OR 2.0; 95%CI: 1.1-3.6), monthly familiar income diabetic neuropathy, since they have a high risk of diabetic foot. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  19. Cognition in type 2 diabetes: Association with vascular risk factors, complications of diabetes and depression

    Directory of Open Access Journals (Sweden)

    Iype Thomas

    2009-01-01

    Full Text Available Background : The role of variables like duration of diabetes, diabetic control and microvascular complications in the causation of cognitive decline in patients with type 2 diabetes is not well studied. The contribution of hypertension to the cognitive decline in nondemented diabetic patients is unclear. Aims: We wanted to see if cognition in patients with type 2 diabetes is associated with the duration of diabetes, control of diabetes, complications of diabetes, vascular risk factors, or depression. We also looked at association of noncompliance with cognition, and depression. Settings and Design: We recruited ambulant patients with type 2 diabetes who are 55 years or more in age from the weekly diabetic clinic. We excluded patients with past history of stroke. Methods and Material: We selected the time taken for the Trial A test, delayed recall on ten-word list from Consortium to Establish a Registry for Alzheimer′s Disease (CERAD, Rowland Universal Dementia Assessment Scale (RUDAS and Centre for Epidemiologic Studies Depression scale (CES-D screening instrument to assess these patients. Statistical Analysis Used: We utilized mean, standard deviation, Chi-square test and Pearson′s correlation for statistical analysis. We considered P < 0.05 to be significant. Results: RUDAS scores inversely correlated ( r = -0.360 with CES-D scores ( P = 0.002. Scores of the screening instrument for depression, the CES-D was associated with the duration of diabetes mellitus ( P = 0.018, fasting blood glucose ( P = 0.029 as well as with 2-hour post prandial blood glucose ( P = 0.017. Conclusions: There is correlation between depression and global cognitive score. Depression seems to be associated with duration of diabetes and control of diabetes.

  20. Thyroid cancer risk is not increased in diabetic patients.

    Directory of Open Access Journals (Sweden)

    Chin-Hsiao Tseng

    Full Text Available OBJECTIVE: This study evaluated thyroid cancer risk with regards to diabetes status and diabetes duration, and with the use of anti-diabetic drugs including sulfonylurea, metformin, insulin, acarbose, pioglitazone and rosiglitazone, by using a population-based reimbursement database in Taiwan. METHODS: A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. After excluding patients with type 1 diabetes, 999730 subjects (495673 men and 504057 women were recruited into the analyses. Logistic regression estimated the odds ratios (OR and their 95% confidence intervals (CI for independent variables including age, sex, diabetes status/duration, anti-diabetic drugs, other medications, comorbidities, living regions, occupation and examinations that might potentially lead to the diagnosis of thyroid cancer in various models. RESULTS: The diabetic patients had a significantly higher probability of receiving potential detection examinations (6.38% vs. 5.83%, P<0.0001. After multivariable-adjustment, the OR (95% CI for diabetes status was 0.816 (0.652-1.021; and for diabetes duration <1 year, 1-3 years, 3-5 years and ≥ 5 years vs. non-diabetes was 0.071 (0.010-0.507, 0.450 (0.250-0.813, 0.374 (0.203-0.689 and 1.159 (0.914-1.470, respectively. Among the anti-diabetic agents, only sulfonylurea was significantly associated with thyroid cancer, OR (95% CI: 1.882 (1.202-2.947. The OR (95% CI for insulin, metformin, acarbose, pioglitazone and rosiglitazone was 1.701 (0.860-3.364, 0.696 (0.419-1.155, 0.581 (0.202-1.674, 0.522 (0.069-3.926 and 0.669 (0.230-1.948, respectively. Furthermore, patients with benign thyroid disease or other cancer, living in Kao-Ping/Eastern regions, or receiving potential detection examinations might have a significantly higher risk; and male sex, hypertension, dyslipidemia, chronic obstructive pulmonary disease, vascular complications or use of statin, aspirin or non-steroidal anti

  1. Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan.

    Science.gov (United States)

    Al-Agha, Abdulmoein E; Kafi, Shahd E; Zain Aldeen, Abdullah M; Khadwardi, Raghdah H

    2017-04-01

    To assess the benefit of using the flash glucose monitoring system (FGMS) in children and adolescents with type 1 diabetes mellitus (T1DM) during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA) was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute's protocol. Results: Participants were able to fast for 67.0% of the total days eligible for fasting, whereas they did not fast on 33% of the days due to either hypoglycemia (15.4%) or non-diabetes-related reasons (17.6 %). None of the participants developed severe hypoglycemia. The mean number of hyperglycemic episodes during fasting hours was 1.29, per day, which was higher than that of hypoglycemic episodes (0.7). None of the participants developed diabetic ketoacidosis (DKA). Glycemic control with mean of estimated hemoglobin A1C reading during Ramadan (8.16 ± 1.64% [pre study]) to 8.2 ± 1.63% [post study] p=0.932. Conclusions: Children and adolescents with T1DM who use the FGMS could fast without the risk of life-threatening episodes of severe hypoglycemia (namely seizure, coma), or DKA during Ramadan. Adequate education and good glycemic control prior to Ramadan are important strategies in combination with the use of an FGMS to achieve better outcome.

  2. Flash glucose monitoring system may benefit children and adolescents with type 1 diabetes during fasting at Ramadan

    Directory of Open Access Journals (Sweden)

    Abdulmoein E. Al-Agha

    2017-04-01

    Full Text Available Objectives: To assess the benefit of using the flash glucose monitoring system (FGMS in children and adolescents with type 1 diabetes mellitus (T1DM during Ramadan fasting. Methods: A prospective pilot study of 51 participants visited the pediatric diabetes clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from between June until and July 2016. The FreeStyle® Libre™ FGMS (Abbott Diabetes Care, Alameda, CA, USA was used. Hypoglycemia was defined as glucose values of less than 70 mg/dL, while hyperglycemia as glucose values of more than 150 mg/dL for all participants based on our institute’s protocol. Results: Participants were able to fast for 67.0% of the total days eligible for fasting, whereas they did not fast on 33% of the days due to either hypoglycemia (15.4% or non-diabetes-related reasons (17.6 %. None of the participants developed severe hypoglycemia. The mean number of hyperglycemic episodes during fasting hours was 1.29, per day, which was higher than that of hypoglycemic episodes (0.7. None of the participants developed diabetic ketoacidosis (DKA. Glycemic control with mean of estimated hemoglobin A1C reading during Ramadan (8.16 ± 1.64% [pre study] to 8.2 ± 1.63% [post study] p=0.932. Conclusions: Children and adolescents with T1DM who use the FGMS could fast without the risk of life-threatening episodes of severe hypoglycemia (namely seizure, coma, or DKA during Ramadan. Adequate education and good glycemic control prior to Ramadan are important strategies in combination with the use of an FGMS to achieve better outcome.

  3. SMA statement the benefits and risks of exercise during pregnancy. Sport Medicine Australia.

    Science.gov (United States)

    2002-03-01

    There are numerous benefits to pregnant women of remaining active during pregnancy. These include improved weight control and maintenance of fitness. There may also be benefits in terms of reduced risk of development of gestational diabetes meilitus and improved psychological functioning. Moderate intensity aerobic exercise has been shown to be safe in pregnancy, with a number of studies now indicating that for trained athletes it may be possible to exercise at a higher level than is currently recommended by the American College of Obstetricians and Gynecologists. Studies of resistance training, incorporating moderate weights and avoiding maximal isometnc contractions, have shown no adverse outcomes. There may be benefits of increased strength and flexibility. The risk of neural tube defects due to exercise-induced hyperthermia that is suggested by animal studies is less likely in women, because of more effective mechanisms of heat dissipation in humans. There is accumulating evidence to suggest that participation in moderate intensity exercise throughout pregnancy may enhance birth weight, while more severe or frequent exercise, maintained for longer into the pregnancy: may result in lighter babies. There have been no reports of foetal injury or death in relation to trauma or contact during sporting activities. Despite this, a risk of severe blunt trauma is present in some sporting situations as pregnancy progresses. Exercise and lactation are compatible in the post-partum period, providing adequate calories are consumed. Considerations of pelvic floor function and type of delivery are relevant in planning a return to certain types of exercise at this time.

  4. Does diabetes increase the risk of periodontitis?

    DEFF Research Database (Denmark)

    Nascimento, Gustavo G; Leite, Fábio R M; Vestergaard, Peter

    2018-01-01

    AIM: Even though the association between diabetes and periodontitis is taken for granted, results on this association are conflicting within the literature. This systematic review assessed whether poorly controlled diabetes was associated with periodontitis onset or progression. METHODS: Electronic...... searches were performed in PubMed, Scopus and Embase databases. Hand search was carried out in the reference list of all articles included. Gray literature was investigated with a Google Scholar search. Prospective longitudinal studies on the association between diabetes and periodontitis were considered...... for this review. Studies should have presented at least two measurements of periodontal conditions over time. Data on study design, crude and adjusted estimates were collected. We used meta-analysis to estimate the pooled effect of hyperglycemia in people with diabetes on periodontitis onset or progression. Meta...

  5. Preliminary risk benefit assessment for nuclear waste disposal in space

    Science.gov (United States)

    Rice, E. E.; Denning, R. S.; Friedlander, A. L.; Priest, C. C.

    1982-01-01

    This paper describes the recent work of the authors on the evaluation of health risk benefits of space disposal of nuclear waste. The paper describes a risk model approach that has been developed to estimate the non-recoverable, cumulative, expected radionuclide release to the earth's biosphere for different options of nuclear waste disposal in space. Risk estimates for the disposal of nuclear waste in a mined geologic repository and the short- and long-term risk estimates for space disposal were developed. The results showed that the preliminary estimates of space disposal risks are low, even with the estimated uncertainty bounds. If calculated release risks for mined geologic repositories remain as low as given by the U.S. DOE, and U.S. EPA requirements continue to be met, then no additional space disposal study effort in the U.S. is warranted at this time. If risks perceived by the public are significant in the acceptance of mined geologic repositories, then consideration of space disposal as a complement to the mined geologic repository is warranted.

  6. Cooperation under Predation Risk: Experiments on Costs and Benefits

    Science.gov (United States)

    Milinski, Manfred; Luthi, Jean H.; Eggler, Rolf; Parker, Geoffrey A.

    1997-06-01

    Two fish that cooperatively inspect a predator may have negotiated the share of the risk that each takes. A test of both the costs of predator inspection dependent on the distance from which the predator is approached and the potential benefits of cooperation was carried out strictly experimentally. We made either singletons or pairs of dead sticklebacks, Gasterosteus aculeatus, approach hungry pike, Esox lucius, by remote control according to an algorithm that mimicked natural inspection. The predation risk of both single inspectors and parallel inspecting pairs increased with closer inspection distances. A member of an inspecting pair had only about half the risk of that of a single inspector. In pairs, a companion diluted the lead fish's risk of being caught, depending on its distance behind the leader. The absolute risk difference between leader and follower was greatest for close inspection distances and decreased further away from the predator. The leader's relative risk increased with its distance ahead of the laggard. However, for a given distance between leader and laggard, the relative risks to the two fish remained similar with distance from the predator. The cost side of the inequalities that define a 'Prisoner's Dilemma' has thus been measured for this system. In a second experiment the 'attack deterrence hypothesis' of predator inspection (i.e. inspection decreases attack probability) was tested. The pike was offered a choice between two sticklebacks, one of which had carried out a predator inspection visit. There was no indication of attack deterrence through predator inspection.

  7. Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study.

    Science.gov (United States)

    Bond, R; Pace, R; Rahme, E; Dasgupta, K

    2017-12-01

    To investigate whether polycystic ovary syndrome further increases postpartum diabetes risk in women with gestational diabetes mellitus and to explore relationships between polycystic ovary syndrome and incident diabetes in women who do not develop gestational diabetes. This retrospective cohort study (Quebec Physician Services Claims; Hospitalization Discharge Databases; Birth and Death registries) included 34 686 women with gestational diabetes during pregnancy (live birth), matched 1:1 to women without gestational diabetes by age group, year of delivery and health region. Diagnostic codes were used to define polycystic ovary syndrome and incident diabetes. Cox regression models were used to examine associations between polycystic ovary syndrome and incident diabetes. Polycystic ovary syndrome was present in 1.5% of women with gestational diabetes and 1.2% of women without gestational diabetes. There were more younger mothers and mothers who were not of white European ancestry among those with polycystic ovary syndrome. Those with polycystic ovary syndrome more often had a comorbidity and a lower proportion had a previous pregnancy. Polycystic ovary syndrome was associated with incident diabetes (hazard ratio 1.52; 95% CI 1.27, 1.82) among women with gestational diabetes. No conclusive associations between polycystic ovary syndrome and diabetes were identified (hazard ratio 0.94; 95% CI 0.39, 2.27) in women without gestational diabetes. In women with gestational diabetes, polycystic ovary syndrome confers additional risk for incident diabetes postpartum. In women without gestational diabetes, an association between PCOS and incident diabetes was not observed. Given the already elevated risk of diabetes in women with a history of gestational diabetes, a history of both polycystic ovary syndrome and gestational diabetes signal a critical need for diabetes surveillance and prevention. © 2017 Diabetes UK.

  8. Multi-targeted and aggressive treatment of patients with type 2 diabetes at high risk

    DEFF Research Database (Denmark)

    Gaede, P; Pedersen, O

    2005-01-01

    Results from many single risk factor intervention trials and the multi-targeted Steno-2 trial in the last few years have provided a strong case that management of type 2 diabetes in all age groups requires a structured and intensified approach that is far more than just glucocentric, an approach...... addressing additional cardiovascular risk factors including hypertension, dyslipidaemia, sedentary behaviour, smoking and dietary habits causing insulin resistance and pro-inflammation. This type of integrated therapy applied for almost 8 years to high-risk type 2 diabetic patients has cut the relative risk......-driven polypharmacy and simple but focused behaviour modelling with continuous education, motivation and trouble-shooting for treatment barriers identified for the patient and the care giver. It is high time we transfer these experiences and major health benefits gained in the 'green house' of controlled clinical...

  9. Health care professionals from developing countries report educational benefits after an online diabetes course

    DEFF Research Database (Denmark)

    Wewer Albrechtsen, Nicolai J; Poulsen, Kristina W; Svensson, Lærke Ø

    2017-01-01

    , millions of people have participated in evidence-based MOOCs, however educational and professional benefit(s) for course participants of such initiatives have not been addressed sufficiently. We therefore investigated if participation in a 6 week open online course in the prevention and treatment...... educational benefits, improved knowledge about the prevention and treatment therapies of diabetes and furthermore improved professional life and practice. Over 40% reported that their professional network expanded after course participation. Study participants who did not complete all modules of the course......-reports from course participants, MOOC based medical education seems promising with respect to providing accessible and free research-based education to health professionals in both developing and developed countries. Course participants from developing countries report more benefits from course participation...

  10. Sports activity and risk of type 2 diabetes in Chinese.

    Science.gov (United States)

    Chien, Kuo-Liong; Chen, Ming-Fong; Hsu, Hsiu-Ching; Su, Ta-Chen; Lee, Yuan-Teh

    2009-06-01

    An association between physical inactivity and obesity risk has been established. However, the relationship between sports activity and the risk of diabetes among Chinese populations is still unclear. We prospectively investigated the association between sports activity and incidence of type 2 diabetes in a Chinese population. Habitual physical activity in the presumed last year was obtained from a questionnaire developed by Baecke and colleagues. During a median 9.02-year follow-up period among the 1936 participants with complete questionnaire data, 312 participants developed diabetes. After adjusting for age, gender and body mass index, the relative risk (RR) of diabetes according to quartiles of sports activity were 0.86, 0.71 and 0.72 (95% Confidence Interval [CI], 0.52-0.99, P for trend, 0.048). Participants with the highest quartiles of sports activity had a significantly lower risk than the participants with the lowest quartiles among the obese group (multivariate RR, 0.61, 95% CI, 0.41-0.92, P for trend=0.018). Furthermore, the RRs of diabetes were 2.24 (95% CI, 1.58-3.19) for participants who were obese and sedentary, compared with those who were of a healthy weight and participated actively in sports. The findings suggest a significant inverse association between sports activity and incidence of type 2 diabetes in middle to older-aged Chinese individuals.

  11. Uric acid and diabetes risk among Chinese women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Leng, Junhong; Wang, Leishen; Wang, Jing; Li, Weiqin; Liu, Huikun; Zhang, Shuang; Li, Lili; Tian, Huiguang; Xun, Pengcheng; Yang, Xilin; Yu, Zhijie; Hu, Gang

    2017-12-01

    To assess the association of uric acid (UA) with the risks of postpartum type 2 diabetes and prediabetes among women with prior gestational diabetes mellitus (GDM). We performed a cross-sectional study of 1262 GDM women at 1-5 years after delivery using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Program. Logistic regression models were used to estimate the association of different levels of serum UA with the risks of type 2 diabetes and prediabetes. The multivariable-adjusted odds ratios (ORs) across quartiles of serum UA were 1.00, 1.23 (95% confidence interval [CI] 0.55-2.78), 2.05 (95% CI 0.96-4.39), and 3.17 (95% CI 1.54-6.55) (P trend  diabetes, and 1.00, 1.50 (95% CI 1.03-2.19), 2.28 (95% CI 1.58-3.30), and 2.88 (95% CI 1.99-4.17) (P trend  diabetes and prediabetes. This positive association was significant when stratified by healthy weight and overweight participants. Serum UA levels have a graded positive association with the risks of type 2 diabetes and prediabetes among Chinese with a history of GDM. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Potential effect of opium consumption on controlling diabetes and some cardiovascular risk factors in diabetic patients.

    Science.gov (United States)

    Rahimi, Najmeh; Gozashti, Mohamad Hossain; Najafipour, Hamid; Shokoohi, Mostafa; Marefati, Hamid

    2014-01-01

    Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors, the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients. This study enrolled 374 diabetic subjects from diabetes care centers in Kerman, Iran, including opium user group (n = 179) and a non-opium user group (n = 195). The data were collected through a questionnaire completed by interviewing, physical examination and laboratory assessment. Opium did not show any statistically significant effect on blood glucose, glycated hemoglobin (HbA1C), fasting blood sugar (FBS), low-density lipoprotein (LDL) and diastolic blood pressure. However, systolic blood pressure (SBP) and prevalence of high SBP were significantly higher in opium user group (P opium user group (P opium does not seem to have beneficial effects on diabetes control or cardiovascular risk factors. Therefore, it would not be advisable to consume opium as an anti-diabetes or cardioprotective agent.

  13. Benefits and Harms of Sodium-Glucose Co-Transporter 2 Inhibitors in Patients with Type 2 Diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Gluud, Lise L; Bennett, Cathy

    2016-01-01

    OBJECTIVE: Sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are a novel drug class for the treatment of diabetes. We aimed at describing the maximal benefits and risks associated with SGLT2-i for patients with type 2 diabetes. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND STUDY......, ketoacidosis and CVD. Secondary outcomes were fasting plasma glucose, body weight, blood pressure, heart rate, lipids, liver function tests, creatinine and adverse events including infections. The quality of the evidence was assessed using GRADE. RESULTS: Meta-analysis of 34 RCTs with 9,154 patients showed...... to low quality evidence). Analysis of 12 RCTs found a beneficial effect of SGLT2-i on HbA1c compared with OAD (-0.20%, -0.28 to -0.13%; moderate quality evidence). CONCLUSION: This review includes a large number of patients with type 2 diabetes and found that SGLT2-i reduces HbA1c with a notable...

  14. Maternal fertility problems and risk for transient neonatal diabetes mellitus

    DEFF Research Database (Denmark)

    Hargreave, Marie; Kjaer, Susanne Krüger; Jørgensen, Marit Eika

    2017-01-01

    AIMS: The study of imprinting disorders in the context of infertility and its treatment is important, as studies have indicated an increased risk. In this study, we evaluated the risk of transient neonatal diabetes mellitus (TNDM), defined here as diabetes mellitus presenting within the first six...... for TNDM, after adjustment for birth year, maternal age at birth and parental history of diabetes, although this was not statistically significant (HR = 1.49; 95% CI 0.73-3.03). The risk of children born in the period 1994-2010 (a period with more comprehensive information on maternal fertility problems...... and with more invasive fertility treatment procedures) was increased almost twofold (HR = 1.92; 95% CI 0.92-4.00) but was still not statistically significant. CONCLUSIONS: Our results indicate that children born to women with fertility problems, particularly after 1993, may be at an elevated risk for TNDM...

  15. Association of heart failure severity with risk of diabetes

    DEFF Research Database (Denmark)

    Demant, Malene N; Gislason, Gunnar H; Køber, Lars

    2014-01-01

    AIMS/HYPOTHESIS: Heart failure has been suggested to increase the risk of developing diabetes. We investigated the relation between heart failure severity, defined by loop-diuretic dosage, and the risk of developing diabetes in a nationwide cohort of patients with heart failure. METHODS: We...... followed all Danish patients discharged from hospitalisation for first-time heart failure in 1997-2010, without prior use of hypoglycaemic agents, until a claimed prescription for hypoglycaemic agents, death or 31 December 2010. The association of loop-diuretic dosage (furosemide equivalents) 90 days after.......32), 2.28 (2.01, 2.59), 2.88 (2.52, 3.30) and 3.02 (2.66, 3.43) without RASi treatment. CONCLUSIONS/INTERPRETATION: In a nationwide cohort of patients with heart failure, severity of heart failure was associated with a stepwise increased risk of developing diabetes. Increased awareness of risk...

  16. Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial

    OpenAIRE

    Grant, Richard W.; O’Brien, Kelsey E.; Waxler, Jessica L.; Vassy, Jason L.; Delahanty, Linda M.; Bissett, Laurie G.; Green, Robert C.; Stember, Katherine G.; Guiducci, Candace; Park, Elyse R.; Florez, Jose C.; Meigs, James B.

    2013-01-01

    OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top an...

  17. Mild gestational diabetes as a risk factor for congenital cryptorchidism

    DEFF Research Database (Denmark)

    Virtanen, Helena E; Tapanainen, Anna E; Kaleva, Marko M

    2006-01-01

    of cryptorchidism, e.g. prematurity and weight for gestational age, abnormal maternal glucose metabolism was significantly more common in the group of cryptorchid boys [diet-treated gestational diabetes, P = 0.0001; odds ratio, 3.98 (95% confidence interval, 1.97-8.05); diet-treated gestational diabetes or only......CONTEXT: Cryptorchidism is the most common malformation in newborn boys. Maternal diabetes has previously been suggested to be a risk factor for this disorder in one epidemiological study. OBJECTIVE: Evaluation of the prevalence of maternal glucose metabolism disorders during pregnancy in newborn...... diabetes diagnosis and abnormality of the result of a 2-h 75-g oral glucose tolerance test during pregnancy were obtained from the hospital records after delivery. RESULTS: After adjustment for possible confounding factors, i.e. maternal smoking during pregnancy, maternal age at delivery, and risk factors...

  18. Risk factors, ulcer grade and management outcome of diabetic foot ...

    African Journals Online (AJOL)

    Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital. ... Data documented included age, gender, type of DM, duration of DM, risk factors of DFU, duration of DFU ... 85.2% had type 2 DM.

  19. Lifestyle factors and mortality risk in individuals with diabetes mellitus

    DEFF Research Database (Denmark)

    Sluik, Diewertje; Boeing, Heiner; Li, Kuanrong

    2014-01-01

    among individuals with diabetes compared with those without was increased, with an HR of 1.62 (95% CI 1.51, 1.75). Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk...

  20. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    Background: The prevalence of gestational diabetes mellitus (GDM) in Sudan is less compared with international reports. Whether there is concomitant difference in the risk factors for GDM among Sudanese women is uncertain. Aim: This study investigated the common risk factors for GDM among Sudanese pregnant ...

  1. Estimating the risk of cardio vascular diseases among pakistani diabetics using uk pds risk engine

    International Nuclear Information System (INIS)

    Moazzam, A.; Amer, J.

    2015-01-01

    The concept of risk estimation of Coronary Heart Disease (CHD) is helpful for clinician to identifying high risk populations for their effective treatment. Latest studies recommended only initiating cardio-protective treatment in diabetic patients based on personalized CHD risk estimates so as to reduce undue harm from overly aggressive risk factor modification. The United Kingdom Prospective Diabetes Study (UK PDS) Risk Engine is a widely used tool to assess the risk of Cardio Vascular diseases (CVD) in diabetics. The literature search so far did not reveal any study of risk assessment among Pakistani Diabetics. Methods: This descriptive study is based on the data of 470 type-2 diabetics seen in Department of Endocrinology and Metabolism, Services Institute of Medical Sciences, Lahore during 2011. The data of these 470 patients was analyzed through UKPDS Risk Engine. CHD risk was calculated. Results: The 10 years risk of CHD, fatal CHD, stroke and fatal stroke was 9.4%, 4.4%, 1.7% and 0.2% respectively. Conclusions: The present study show a lower risk of CVD occurring among Pakistani diabetics as compared to studies from western countries. (author)

  2. Benefits and risks of shared services in healthcare.

    Science.gov (United States)

    Kennewell, Suzanne; Baker, Laura

    2016-05-16

    Purpose - The purpose of this paper is to explore the experiences of staff in a large, public health service involved in transitioning support services to a shared services model. It aims to understand their perceptions of the benefits and risks arising from this change. Design/methodology/approach - Thematic analysis of qualitative data from semi-structured interviews with both service provider and customer agency staff was used to identify, analyze and report patterns of benefits and risks within data. Findings - Staff expressed the need for relevant subject-matter-experts to work within customer agencies to facilitate effective communication between the customer agency and shared services provider, reflecting observations found in out-sourcing literature. Research limitations/implications - Results point to significant challenges continuing to occur for shared services in healthcare. Risks identified suggest a more intimate relationship between clinical and support services than previously discussed. Originality/value - Previous discussion of the shared services model has not considered the skills, knowledge and ability required by staff in the customer agency. This research indicates that in the absence of such consideration, the concepts of the shared services model are weakened.

  3. Genetic risk factors for type 1 diabetes

    DEFF Research Database (Denmark)

    Pociot, Flemming; Lernmark, Åke

    2016-01-01

    Type 1 diabetes is diagnosed at the end of a prodrome of β-cell autoimmunity. The disease is most likely triggered at an early age by autoantibodies primarily directed against insulin or glutamic acid decarboxylase, or both, but rarely against islet antigen-2. After the initial appearance of one...... is generally needed. The pathogenesis can be divided into three stages: 1, appearance of β-cell autoimmunity, normoglycaemia, and no symptoms; 2, β-cell autoimmunity, dysglycaemia, and no symptoms; and 3, β-cell autoimmunity, dysglycaemia, and symptoms of diabetes. The genetic association with each one...... of the three stages can differ. Type 1 diabetes could serve as a disease model for organ-specific autoimmune disorders such as coeliac disease, thyroiditis, and Addison's disease, which show similar early markers of a prolonged disease process before clinical diagnosis....

  4. Increased risk of type 2 diabetes in elderly twins

    DEFF Research Database (Denmark)

    Poulsen, Pernille; Grunnet, Louise G; Pilgaard, Kasper

    2009-01-01

    OBJECTIVE: Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes...... in twins on a lifetime perspective are lacking. RESEARCH DESIGN AND METHODS: A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance...

  5. Irregular menses: an independent risk factor for gestational diabetes mellitus.

    Science.gov (United States)

    Haver, Mary Claire; Locksmith, Gregory J; Emmet, Emily

    2003-05-01

    Our purpose was to determine whether a history of irregular menses predicts gestational diabetes mellitus independently of traditional risk factors. We analyzed demographic characteristics, body mass index, and menstrual history of 85 pregnant women with gestational diabetes mellitus and compared them with 85 systematically selected control subjects who were matched for age, race, and delivery year. Subjects with pregestational diabetes mellitus, previous gestational diabetes mellitus, family history of diabetes mellitus, weight >200 pounds, previous macrosomic infants, or previous stillbirth were excluded. Demographic characteristics between case and control groups were similar. Mean body mass index was higher among cases (26.5 kg/m(2)) versus control subjects (24.5 kg/m(2), P =.004). Irregular cycles were more prevalent in the cases (24% vs 7%, P =.006). With the use of body mass index as a stratification factor, menstrual irregularity maintained a strong association with gestational diabetes mellitus (P =.014). A history of irregular menstrual cycles was a significant independent predictor of gestational diabetes mellitus. If selective screening is implemented for gestational diabetes mellitus, such history should be considered in the decision of whom to test.

  6. Diabetes and Prediabetes and Risk of Hospitalization: The Atherosclerosis Risk in Communities (ARIC) Study.

    Science.gov (United States)

    Schneider, Andrea L C; Kalyani, Rita R; Golden, Sherita; Stearns, Sally C; Wruck, Lisa; Yeh, Hsin Chieh; Coresh, Josef; Selvin, Elizabeth

    2016-05-01

    To examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes. This study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with prediabetes, 4% with undiagnosed diabetes, 9% with diagnosed diabetes) with follow-up in 1990-2011 for hospitalizations. Participants were categorized by diabetes/HbA1c status: without diagnosed diabetes, HbA1c prediabetes, 5.7 to prediabetes had 1.3 times higher rates of hospitalization than those without diabetes and HbA1c prediabetes are at a significantly elevated risk of hospitalization compared with those without diabetes. Substantial excess rates of hospitalizations in persons with diagnosed diabetes were for endocrine, infection, and iatrogenic/injury causes, which may be preventable with improved diabetes care. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  7. The accuracy of polyuria, polydipsia, polyphagia, and Indian Diabetes Risk Score in adults screened for diabetes mellitus type-II

    OpenAIRE

    Shivshakti D Pawar; Poonam Thakur; B K Radhe; Harshal Jadhav; Vivek Behere; Vikrant Pagar

    2017-01-01

    Context: The World Health Organization report suggests that over 19% of the world's diabetic population currently resides in India. Unfortunately, >50% of the diabetics in India are unaware about their diabetic status. In the poor income country like India, it is essential to use cost-effective methods for screening for diabetes, and traditionally using three classical symptoms and Indian Diabetes Risk Score (IDRS) tool is helpful but, data regarding their diagnostic accuracy is very less. Ob...

  8. Risks and benefits in health care: the view from economics.

    Science.gov (United States)

    Pauly, Mark V

    2007-01-01

    This paper discusses the meaning of the term risk from the economic perspective. It argues that some consumer decisions about insurance and the use of medical care are consistent with the economic model, but many are not. When decisions are inconsistent, real-world democratic governments' ability to intervene is limited by politicians' desire to please voters. The choice of incomplete insurance coverage in private markets is often said to present a case for governmental intervention, but the choice of insurance design in the Medicare drug benefit shows that the political process also may fail to select insurance that is optimal from an economic viewpoint.

  9. Mental models of the benefits and risks of novel foods

    DEFF Research Database (Denmark)

    Hagemann, Kit; Scholderer, Joachim

    issues outside the scope of current legislation. Often, these concerned system-wide impacts on eco-systems which are notoriously difficult to identify and assess, but also impacts on the broader consumption patterns of consumers in the industrialised world. Moreover, expert participants tended to define...... risk and benefit in terms of detailed chains of cause-effect relationships between variables for which clear definitions and measurement rules exist. Such level of detail could not be found in the consumer data. The concepts consumers used when reasoning about biological processes tended to be very...

  10. Risk perception and benefits perception. Survey results and discussion

    International Nuclear Information System (INIS)

    Touzet, R.; Remedi, J.; Baron, J.; Caspani, C.

    2000-01-01

    The fact that the risks deriving from different activities involving the same radiation exposure are seen very differently by a single population is a highly significant one. Exactly identical risks are considered oppositely, depending on the origin of radiation (whether produced by medical applications or by nuclear power plants, resulting from natural radiation or from artificial radiation). It appears as if there was good radiation and bad radiation..! One of the purposes of the paper is the discussion of causes. The acceptance of a given risk by a certain section of the population is closely related to the benefits that the group expects to receive-either consciously or unconsciously-from the activity producing the risk. Consequently, an analysis of the factors influencing the eventual rejection of a practice should explore not only fears, but also hopes...! On the basis of a risk-perception survey carried out in a population sector attending hospitals-including both patients and physicians-, a prior objective analysis of the results obtained was performed and, later on, the various statements by those surveyed were studied. The design of the survey allowed for a comparative assessment of the perception of different risks depending on the people's educational and social level. An epistemological study was made on the validity involved in the use of the data resulting from the survey, so as to reach different conclusions. The population's opinion about the capacity for response, the qualification and the mitigation means available to the State authorities in order to face an eventual radiological emergency plays a leading role in risk perception. In an analysis of the relevant factors involved in risk and benefits perception by the population (in the real world), attention must be paid to the existence of organized opinion groups representing the interest of a given sector. Of course, the population's confidence in the experts providing the information is a key

  11. The cardiometabolic benefits of flavonoids and dark chocolate intake in patients at risk

    Directory of Open Access Journals (Sweden)

    Andra-Iulia Suceveanu

    2014-02-01

    Full Text Available Scientific research proves that the cardiac and the metabolic functions are improved by the consumption of flavonoids, natural elements found in cocoa. The dark chocolate is the main alimentary compound rich in flavonoids, and for this reason it can be used to prevent some cardiometabolic disorders. This study aims to demonstrate the relationship between chocolate consumption and the cardiometabolic disorders risk in 85 patients hospitalized in Internal Medicine Unit of Emergency Hospital “St. Apostle Andrew” of Constanta. Patients were split according to the quantity of the dark chocolate consumption into 2 groups. The study groups were matched by the demographic parameters, the BMI, the physical activity and other risk factors (fats, saturated lipids, etc. We found that the daily consumption of dark chocolate, with content of cocoa > 35% according to European recommendations, had cardiometabolic benefits. The risk of coronary heart disease was reduced with 23% by the daily dark chocolate intake. The cardiovascular disease mortality and the risk of any cardiovascular disease were decreased with 19%, respectively with 38%. The risk of incident diabetes decreased with 28% after daily dark chocolate consumption, regardless the gender of patients. The number of ischemic cerebral events was reduced with 32%. In summary, the daily consumption of dark chocolate rich in flavonoids decreases the cardiometabolic disorders in patients at risk [1].

  12. Androgens, Irregular Menses, and Risk of Diabetes and Coronary Artery Calcification in the Diabetes Prevention Program.

    Science.gov (United States)

    Kim, Catherine; Aroda, Vanita R; Goldberg, Ronald B; Younes, Naji; Edelstein, Sharon L; Carrion-Petersen, MaryLou; Ehrmann, David A

    2018-02-01

    It is unclear whether relative elevations in androgens or irregular menses (IM) are associated with greater cardiometabolic risk among women who are already overweight and glucose intolerant. We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS). Participants included women with sex hormone measurements who did not use exogenous estrogen (n = 1422). We examined whether free androgen index (FAI) or IM was associated with diabetes risk during the DPP/DPPOS or with coronary artery calcification (CAC) at DPPOS year 10. Models were adjusted for menopausal status, age, race or ethnicity, randomization arm, body mass index (BMI), and hemoglobin A1c. Women had an average age of 48.2 ± 9.9 years. Elevations in FAI and IM were associated with greater BMI, waist circumference, and blood pressure and lower adiponectin. FAI was not associated with diabetes risk during the DPP/DPPOS [hazard ratio (HR) 0.97; 95% confidence interval (CI), 0.93 to 1.02] or increased odds of CAC [odds ratio (OR) 1.06; 95% CI, 0.92 to 1.23]. IM was also not associated with diabetes risk during the DPP/DPPOS (HR 1.07; 95% CI, 0.87 to 1.31) or increased odds of CAC (OR 0.89; 95% CI, 0.53 to 1.49). Women who had both relative elevations in FAI and IM had similar diabetes risk and odds of CAC as women without these conditions. Differences by treatment arm and menopausal status were not observed. Among midlife women who were already glucose intolerant and overweight, androgen concentrations and IM did not additionally contribute to increased risk for diabetes or CAC. Copyright © 2017 Endocrine Society

  13. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence.

    Science.gov (United States)

    Pereira, Patrícia Feliciano; Alfenas, Rita de Cássia G; Araújo, Raquel Maria A

    2014-01-01

    The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes). The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  14. Estimation of Cardiovascular Risk in Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Belkis Vicente Sánchez

    2015-09-01

    Full Text Available Background: diabetes mellitus accelerates atherosclerotic changes throughout the vascular tree and consequently increases the risk of developing fatal acute events. Objective: to estimate the global cardiovascular risk in patients with type 2 diabetes mellitus. Method: a cross-sectional study of a series of type 2 diabetic patients from the People's Council of Constancia, Abreus municipality, Cienfuegos province was conducted from July to December 2012. The universe comprised the 180 people with diabetes in the area. Variables studied were: age, sex, body mass index, nutritional assessment, blood pressure, toxic habits, associated chronic diseases, blood levels of glucose, lipids (total cholesterol and triglycerides and microalbuminuria. World Health Organization/International Society of Hypertension prediction charts specific to the region of the Americas, in which Cuba is included, were used to estimate the cardiovascular risk. Results: mean age was 61.63 years and females predominated. Relevant risk factors were hypertension followed by obesity, smoking and dyslipidemia. Mean body mass index was 27.66kg/m2; waist circumference was 94.45 cm in women and 96.86 cm in men. Thirty point six percent had more than two uncontrolled risk factors and 28.3 % of the total presented a high to very high cardiovascular risk. Conclusions: cardiovascular risk prediction charts are helpful tools for making clinical decisions, but their interpretation must be flexible and allow the intervention of clinical reasoning.

  15. Treatment Modality-Dependent Risk of Diabetic Ketoacidosis in Patients with Type 1 Diabetes

    DEFF Research Database (Denmark)

    Hoshina, Sari; Andersen, Gregers S; Jørgensen, Marit E

    2018-01-01

    BACKGROUND AND AIMS: The aim of this study was to evaluate the incidence rates of diabetic ketoacidosis (DKA) according to treatment modality in patients with type 1 diabetes (T1D) in Denmark, either multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). MATERIALS AND...... events were lower among CSII users, while the opposite was true for the smaller clinics (P = 0.016). CONCLUSIONS: Delivery of CSII in large diabetes clinics with sufficient support and patient education may ensure that CSII treatment does not lead to an increased risk of DKA....

  16. Increase in overall mortality risk in patients with type 2 diabetes receiving different oral diabetes drugs

    Directory of Open Access Journals (Sweden)

    E A Pigarova

    2012-12-01

    Full Text Available Реферат по статье: Pantalone KM, Kattan MW, Yu C, Wells BJ, Arrigain S, Jain A, Atreja A, Zimmerman RS. Increase in overall mortality risk in patients with type 2 diabetes receiving glipizide, glyburide or glimepiride monotherapy versus metformin: a retrospective analysis. Diabetes Obes Metab. 2012 Sep;14(9:803-809.

  17. A benefit-risk assessment of class III antiarrhythmic agents

    DEFF Research Database (Denmark)

    Brendorp, Bente; Pedersen, Oledyg; Torp-Pedersen, Christian

    2002-01-01

    , which differentiates them from the others. However, all have potential serious adverse events. Proarrhythmia, especially torsade de pointes, is a common problem making the benefit-risk ratio of these drugs a key question. Class III drugs have been evaluated in different settings: primary and secondary...... prevention of ventricular arrhythmias and in treatment of atrial fibrillation or flutter. Based on existing evidence there is no routine indication for antiarrhythmic drug therapy other than beta-blockers in patients at high risk of sudden death. Subgroup analyses of trials with amiodarone and dofetilide......-intervals or - in the future - from genetic testing. Class III drugs are effective in converting atrial fibrillation to sinus rhythm and for the maintenance of sinus rhythm after conversion. This is currently by far the most important indication for this class of drugs. As defined by recent guidelines, amiodarone...

  18. The ethics, the risks and the benefits of screening

    International Nuclear Information System (INIS)

    Miller, A.B.

    1989-01-01

    The ethical principles underlying screening are reviewed. It is concluded that the ethical requirements for the introduction of screening are stringent, and that screening should not be offered in the absence of unequivocal evidence of effectiveness except in a carefully conducted research study. Part of the reasons for this are the risks associated with screening, which extend beyond the risk of the test itself, to those associated with invitations for screening, false reassurance for false negatives, the diagnostic process and the problem of false positives, and the overtreatment of those with borderline abnormalities. Finally, the benefits expected from screening are considered, especially reduction in mortality from the disease, but also reduction in incidence if a precursor is detected by the test, less radical treatment for cases detected, reassurance for those who test true negative, and resource savings, though it has to be demonstrated that these exceed resource costs

  19. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction.

    Science.gov (United States)

    Williams, Paul T; Thompson, Paul D

    2013-05-01

    To test whether equivalent energy expenditure by moderate-intensity (eg, walking) and vigorous-intensity exercise (eg, running) provides equivalent health benefits. We used the National Runners' (n=33 060) and Walkers' (n=15 945) Health Study cohorts to examine the effect of differences in exercise mode and thereby exercise intensity on coronary heart disease (CHD) risk factors. Baseline expenditure (metabolic equivant hours per day [METh/d]) was compared with self-reported, physician-diagnosed incident hypertension, hypercholesterolemia, diabetes mellitus, and CHD during 6.2 years follow-up. Running significantly decreased the risks for incident hypertension by 4.2% (Pdiabetes mellitus by 12.1% (Phypertension; and (3) 43.5%, 44.1%, 47.7%, and 68.2% from running, and 34.1%, 44.2% and 23.6% from walking for diabetes mellitus (walking >5.4 METh/d excluded for too few cases). The risk reductions were not significantly different for running than walking for diabetes mellitus (P=0.94), hypertension (P=0.06), or CHD (P=0.26), and only marginally greater for walking than running for hypercholesterolemia (P=0.04). Equivalent energy expenditures by moderate (walking) and vigorous (running) exercise produced similar risk reductions for hypertension, hypercholesterolemia, diabetes mellitus, and possibly CHD.

  20. The Impact of Personalized Risk Feedback on Mexican Americans' Perceived Risk for Heart Disease and Diabetes

    Science.gov (United States)

    Hovick, Shelly R.; Wilkinson, Anna V.; Ashida, Sato; de Heer, Hendrik D.; Koehly, Laura M.

    2014-01-01

    Little is known about the effect of personalized risk information on risk perceptions over time, particularly among ethnically diverse subpopulations. The present study examines Mexican American's (MAs) risk perceptions for heart disease and diabetes at baseline and following receipt of risk feedback based on family health history. Participants…

  1. Diabetes risk among overweight and obese metabolically healthy young adults.

    Science.gov (United States)

    Twig, Gilad; Afek, Arnon; Derazne, Estela; Tzur, Dorit; Cukierman-Yaffe, Tali; Gerstein, Hertzel C; Tirosh, Amir

    2014-11-01

    To determine diabetes incidence over time among obese young adults without metabolic risk factors. Incident diabetes during a median follow-up of 6.1 years was assessed among 33,939 young men (mean age 30.9 ± 5.2 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults cohort who were stratified for BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥30 kg/m2 in the presence of normoglycemia, normal blood pressure, and normal levels of fasting triglyceride and HDL-cholesterol levels (n = 631). A total of 734 new cases of diabetes were diagnosed during 210,282 person-years of follow-up. The incidence rate of diabetes among participants with no metabolic risk factors was 1.15, 2.10, and 4.34 cases per 1,000 person-years among lean, overweight, and obese participants, respectively. In a multivariable model adjusted for age, region of origin, family history of diabetes, physical activity, fasting plasma glucose, triglyceride level, HDL-cholesterol, systolic blood pressure, and white blood cell count, a higher diabetes risk was observed among MH-overweight (hazard ratio [HR] 1.89 [95% CI 1.25-2.86]; P young adults from incident diabetes associated with overweight and obesity. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  2. Circulating Fetuin-A and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Kröger, Janine; Meidtner, Karina; Stefan, Norbert

    2018-01-01

    with those from the Diabetes Genetics Replication And Meta-analysis (DIAGRAM) consortium (12,171 cases) also did not suggest a clear significant relation of fetuin-A with diabetes risk. In conclusion, although there is mechanistical evidence for an effect of fetuin-A on insulin sensitivity and secretion......Fetuin-A, a hepatic-origin protein, is strongly positively associated with risk of type 2 diabetes in human observational studies, but it is unknown whether this association is causal. We aimed to study the potential causal relation of circulating fetuin-A to risk of type 2 diabetes in a Mendelian...... score of theAHSGSNPs was strongly associated with fetuin-A (28% explained variation). Using the genetic score as instrumental variable of fetuin-A, we observed no significant association of a 50 µg/ml higher fetuin-A concentration with diabetes risk (HR 1.02 [95%-CI 0.97, 1.07]). Combining our results...

  3. Do the health benefits of cycling outweigh the risks?

    Directory of Open Access Journals (Sweden)

    Jeroen Johan de Hartog

    Full Text Available Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies. We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We estimate that beneficial effects of increased physical activity are substantially larger (3-14 months gained than the potential mortality effect of increased inhaled air pollution doses (0.8-40 days lost and the increase in traffic accidents (5-9 days lost. Societal benefits are even larger because of a modest reduction in air pollution and traffic accidents. On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport.

  4. Disaster risk reduction in developing countries: costs, benefits and institutions.

    Science.gov (United States)

    Kenny, Charles

    2012-10-01

    Some 60,000 people worldwide die annually in natural disasters, mostly due to the collapse of buildings in earthquakes, and primarily in the developing world. This is despite the fact that engineering solutions exist that can eliminate almost completely the risk of such deaths. Why is this? The solutions are expensive and technically demanding, so their cost-benefit ratio often is unfavourable as compared to other interventions. Nonetheless, there are various public disaster risk reduction interventions that are highly cost-effective. That such interventions frequently remain unimplemented or ineffectively executed points to a role for issues of political economy. Building regulations in developing countries appear to have limited impact in many cases, perhaps because of inadequate capacity and corruption. Public construction often is of low quality, perhaps for similar reasons. This suggests the need for approaches that emphasise simple and limited disaster risk regulation covering only the most at-risk structures-and that, preferably, non-experts can monitor-as well as numerous transparency and oversight mechanisms for public construction projects. © 2012 The Author(s). Journal compilation © Overseas Development Institute, 2012.

  5. ''Risk versus benefit'' for diagnostic X-rays and radionuclides

    International Nuclear Information System (INIS)

    Uzunov, I.

    1975-01-01

    In the fifties, when a radiation protection program in medicine was initiated in the country, permissible population exposure standards were based solely on genetic risk, and medical irradiations were excluded from these standards. It is currently thought, however, that somatic-stochastic consequences of the carcinogenic effect of ionizing radiations are commensurable with genetic lesions. Since carcinogenic risk is determined by organ dose, it is much higher than the genetic risk in most X-ray and radionuclide examinations. Furthermore, the majority of authors feel that medical radiation should be included in total maximum permissible population dose (5 rem up to 30 years of age). Taking into consideration that over 95% of population exposure in the following decades is expected to result from medical radiation, and that the risk of induction of malignancies cannot be taken to be ''negligible'' even at an exposure level of the order of natural background, it is evident that in any specific case where radiation is to be applied, ''risk vs. benefit'' should be appraised with adequate precision. This will necessitate a thorough revision of problems involving patient protection, particularly so since shortcomings in this respect have lately been brought to light (for instance, cardiac catheterization or roentgenoscopic examination for expertise purposes), unmotivated mass screening tests, etc.), such cases occurring mostly because of unsatisfactory regulatory activities, especially as regards use of X-rays by non-radiologists. The paper discusses carcinogenic risk for a number of specific procedure types and stresses the need for a symposium on radiation protection in medical practice, with participation of physicians employed in areas of medicine relevant to X-ray and radionuclide diagnostics, in order to arrive at reasonable decisions enabling the achievement of a drastic reduction in population exposure. (author)

  6. Evaluating the risk-reduction benefits of wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Brower, M.C.; Bell, K.; Spinney, P. [and others

    1997-05-01

    The question of uncertainty and risk in electric utility resource planning has received considerable attention in recent years. During the 1980s, many utilities suffered financial losses because of unexpectedly high plant construction costs and low growth in electricity demand. In addition, the introduction of competition to the electric industry is creating new risks for power companies. No longer will utilities be able to count on regulatory protections and a base of captive consumers to provide a stable market and adequate return on their investments. Alternative risk management strategies will have to be considered instead. One approach to managing risk is for a utility company to invest in diverse power sources such as wind power plants. Since wind plants consume no fuel, can be built in relatively small increments with short construction lead times, and generate no pollutants, it is often said that they offer significant protection from risks associated with conventional fossil-fuel power plants. So far there have been few efforts to quantify these benefits, however. The study compares the costs and risks of two competing resource options, a gas-fired combined cycle plant and a wind plant, both utility-owned, through decision analysis. The case study utility is Texas Utilities Electric, a very large investor-owned company serving an area with substantial, high-quality wind resources. The authors chose a specific moment in the future - the year 2003 - when the utility currently plans to build a large fossil-fueled power plant, and examined the implications for the utility`s expected revenues, costs, and profits if a wind plant were to be built instead.

  7. Beta-glucans in the treatment of diabetes and associated cardiovascular risks

    Directory of Open Access Journals (Sweden)

    Jiezhong Chen

    2008-12-01

    Full Text Available Jiezhong Chen1,3, Kenneth Raymond21John Curtin School of Medical Research, Australian National University, Acton, ACT, Australia; 2School of Pharmacy and Applied Science, Faculty of Science, Technology and Engineering, LaTrobe University, Bendigo, Vic, Australia; 3Adjunct Senior Research Fellow, University of Canberra, ACT, AustraliaAbstract: Diabetes mellitus is characterized by high blood glucose level with typical manifestations of thirst, polyuria, polydipsia, and weight loss. It is caused by defects in insulin-mediated signal pathways, resulting in decreased glucose transportation from blood into muscle and fat cells. The major risk is vascular injury leading to heart disease, which is accelerated by increased lipid levels and hypertension. Management of diabetes includes: control of blood glucose level and lipids; and reduction of hypertension. Dietary intake of beta-glucans has been shown to reduce all these risk factors to benefit the treatment of diabetes and associated complications. In addition, beta-glucans also promote wound healing and alleviate ischemic heart injury. However, the mechanisms behind the effect of beta-glucans on diabetes and associated complications need to be further studied using pure beta-glucan.Keywords: diabetes mellitus, hyperglycemia, prevalence, pathogenesis

  8. Fertility problems and risk of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Holst, Signe; Kjær, Susanne K; Jørgensen, M. E.

    2016-01-01

    Objective To determine whether women with a history of fertility problems have a higher risk of gestational diabetes mellitus (GDM) than women without a history of fertility problems after adjustment for maternal factors. Design Nationwide population-based cohort study. Setting Not applicable...... of diabetes, level of education, and smoking during pregnancy. Result(s) In total, 7,433 (2%) pregnant women received a diagnosis of GDM. Multivariate analysis showed that pregnant women with a history of fertility problems had a statistically significantly higher risk of GDM than pregnant women without...

  9. Healthcare Encounters for Pokémon Go: Risks and Benefits of Playing.

    Science.gov (United States)

    Barbero, Erika M; Carpenter, Diane M; Maier, Joetta; Tseng, Daniel S

    2018-04-30

    Our aim was to quantify the health risks and benefits of Pokémon Go, an augmented reality game played on the mobile phone utilizing real-world locations. Healthcare encounters containing references to Pokémon Go in Kaiser Permanente Northern California (KPNC) from July 5, 2016 to November 5, 2016 were reviewed. Subjects were classified according to the nature of the healthcare encounter subsequent to playing Pokémon Go: adverse event/injury, self-reported benefit, or incidental mention. Comparisons were made using the Wilcoxon-Mann-Whitney nonparametric test where variables were continuous and the chi-squared or Fisher's exact test where variables were binomial. Of 222 Pokémon Go players reporting an adverse event or benefit, 75 (33.8%) experienced adverse events and 147 (66.2%) reported benefits. Among our cohort, 114 subjects (54.0%) were obese, and 62 (27.9%) were diabetic or prediabetic. More subjects reporting benefits had an endocrine-related comorbidity than those reporting injuries (40.1% vs. 16.0%, P benefit group than in the adverse event group ($83,846 vs. $70,378, P = 0.027). Of 75 subjects having adverse events, 8 (10.7%) had severe injuries, including fractures and head trauma, with 4 (5.3%) having inpatient stays. Most adverse events were musculoskeletal or skin injuries (n = 51, 68.0%). Injuries were similar to those seen with other light-to-moderate outdoor physical activities. Given KPNC's membership of 3.85 million, the number of severe injuries reported was low; this suggests that the game is safe to play. Pokémon Go may be reaching a population that requires increased physical activity.

  10. Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB prospective complications study

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Simon, D.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S.

    2014-01-01

    Context: Glycemic targets and the benefit of intensive glucose control are currently under debate because intensive glycemic control has been suggested to have negative effects on mortality risk in type 2 diabetes patients. Objective: We examined the association between glycated hemoglobin (HbA1c)

  11. A benefit-risk analysis of rotavirus vaccination, France, 2015.

    Science.gov (United States)

    Lamrani, Adnane; Tubert-Bitter, Pascale; Hill, Catherine; Escolano, Sylvie

    2017-12-01

    IntroductionTwo vaccines available for protection against rotavirus gastroenteritis (RVGE), Rotarix and RotaTeq, have contributed to a large decrease in the incidence of paediatric diarrhoea in countries where they have been used. However, they have also led to a small increase in the risk of intussusception. Methods: We compare the number of prevented hospitalisations for RVGE to the number of vaccine-induced hospitalised intussusceptions in France. Results: With 9.5% coverage (French 2015 estimation), vaccination was estimated to prevent, annually, a median of 1,074 hospitalisations (2.5th and 97.5th percentiles (2.5th-97.5th): 810-1,378) and 1.4 deaths (2.5th-97.5th: 1.2-1.6) from RVGE. It was also estimated to cause, annually, 5.0 hospitalisations (2.5th-97.5th: 3.2-7.7) and 0.005 deaths (2.5th-97.5th: 0.001-0.015) from intussusception. The benefit-risk ratio is therefore 214 (2.5th-97.5th: 128-362) for hospitalisations and 273 (2.5th-97.5th: 89-1,228) for deaths. Under a hypothetical 92% coverage, rotavirus vaccination with Rotarix would avoid 10,459 (2.5th-97.5th: 7,702-13,498) hospitalisations for RVGE and induce 47.0 (2.5th-97.5th: 25.1-81.4) hospitalisations for intussusception annually, thereby preventing 13.7 (2.5th-97.5th: 11.1-15.2) deaths and inducing 0.05 (2.5th-97.5th: 0.01-0.15) deaths. Conclusion: The benefit-risk ratio in France is similar to that of other European countries.

  12. Use of Antibiotics and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mikkelsen, Kristian; Knop, Filip; Nielsen, Morten Frost Munk

    2015-01-01

    conducted a population-based case-control study of incident type 2 diabetes cases in Denmark (population 5.6 million) between January 1, 2000, and December 31, 2012. Data from the Danish National Registry of Patients, the Danish National Prescription Registry, and the Danish Person Registry were combined......CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics. METHODS: We....... RESULTS: The odds ratio (OR) associating type 2 diabetes with exposure to antibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) with redemption of more than or equal to 5 versus 0-1 prescriptions. Although no individual group of antibiotics was specifically associated with type 2 diabetes...

  13. Job Strain as a Risk Factor for Type 2 Diabetes

    DEFF Research Database (Denmark)

    Nyberg, Solja T; Fransson, Eleonor I; Heikkilä, Katriina

    2014-01-01

    with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. RESULTS: There were 3,703 cases......OBJECTIVE: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress...... at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain...

  14. Can modeling of health outcomes facilitate regulatory decision making? The benefit-risk tradeoff for rosiglitazone in 1999 vs. 2007.

    Science.gov (United States)

    Cross, J T; Veenstra, D L; Gardner, J S; Garrison, L P

    2011-03-01

    Rosiglitazone was initially approved for type 2 diabetes monotherapy. We tested health-outcomes modeling as an aid to regulatory decision making by quantifying the incremental net benefit (INB) value of rosiglitazone (relative to a comparator), both at the time of first approval (1999) and at the FDA advisory committee review (2007). Using 1999 data, rosiglitazone was projected to provide an additional 0.639 years of life (0.373 quality-adjusted life years (QALYs)) relative to placebo but a loss of 0.312 years (0.173 QALYs) relative to glyburide, with uncertainty in reduction of hemoglobin A(1c) (HbA(1c)) level having the greatest impact on the benefit-risk profile. By 2007, rosiglitazone was projected to provide an additional 0.222 years (0.091 QALYs) vs. glyburide and 0.026 years vs. metformin (0.009 QALYs). Modeling suggested that the use of rosiglitazone as monotherapy was not initially warranted, given the uncertainty with regard to benefit. Despite similar net benefit (NB) as metformin shown in postmarketing data, residual cardiovascular (CV) concerns did not support the use of rosiglitazone as first-line therapy. We adapted a mathematical diabetes model to estimate NB and uncertainty of diabetes monotherapy.

  15. Benefits and risks of hormonal contraception for women

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2007-08-01

    Full Text Available Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception, among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings, progestogen-only contraceptives (pills, injections, implants, hormone spirals and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and risks of hormonal contraceptives, their economic effects as well as their ethical-social and legal implications.MethodsA systematic literature search was conducted in April 2006 starting from 2000. The evaluation is primarily based on systematic reviews. Results: In perfect use, all hormonal contraceptives excluding emergency contraceptives proved to be the most effective reversible contraceptive methods (rate of unintended pregnancies 0.05% to 0.3%. However, the typical use of oral contraceptives, injections, skin patches, and vaginal rings, which also considers possible application errors, showed a lower contraceptive efficacy (rate of unintended pregnancies 3% to 8%. It was lower than that of copper spirals. The risk of venous thromboembolism increased three to six times in users of hormonal contraceptives, the risks of stroke and myocardial infarction two to three times. The risk declined after discontinuation of use. The effects were estrogen-dose and progestogen-type dependent. The use of hormonal contraceptives showed a relative risk of ovarian and endometrial carcinomas of approximately 0.5 or 0.7, of breast and cervical cancer of approximately 1.2 or 1.6. The effect remained several years after discontinuation of use. The results concerning hepatocellular carcinoma suggested a carcinogenic effect. In women with acne, an improvement due to use of hormonal contraceptives was proven. Cervical chlamydial infections were more frequent in users of hormonal

  16. Chocolate intake and diabetes risk in postmenopausal American women.

    Science.gov (United States)

    Greenberg, J A; Manson, J E; Tinker, L; Neuhouser, M L; Garcia, L; Vitolins, M Z; Phillips, L S

    2017-09-01

    Recent long-term prospective cohort studies found inverse associations between chocolate consumption and the risk of type 2 diabetes, but provided conflicting evidence on the nature of the association among women. To assess this association in a large cohort of American women. Multivariable Cox regression was used with the data from 92 678 postmenopausal women in the prospective Women's Health Initiative study. Chocolate intake was assessed by food frequency questionnaire. Incidence of type 2 diabetes was determined by self-report of the first treatment with oral medication or insulin. Among women free of diabetes at baseline, there were 10 804 cases, representing an incidence rate of 11.7% during 13.1 years and 1 164 498 person-years of follow-up. There was no significant linear association between long-term chocolate intake and type 2 diabetes risk, but there was significantly reduced risk at moderate levels of intake. Compared to women who ate 1 oz. of chocolate chocolate consumption and type 2 diabetes at moderate levels of consumption in two subgroups of postmenopausal women in the Women's Health initiative cohort.

  17. Patients' Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA).

    Science.gov (United States)

    Paton, Joanne S; Roberts, Anne; Bruce, Graham K; Marsden, Jonathan

    2014-02-22

    Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear therapeutic footwear is driven by the

  18. Patients’ Experience of therapeutic footwear whilst living at risk of neuropathic diabetic foot ulceration: an interpretative phenomenological analysis (IPA)

    Science.gov (United States)

    2014-01-01

    Background Previous work has found that people with diabetes do not wear their therapeutic footwear as directed, but the thinking behind this behaviour is unclear. Adherence to therapeutic footwear advice must improve in order to reduce foot ulceration and amputation risk in people with diabetes and neuropathy. Therefore this study aimed to explore the psychological influences and personal experiences behind the daily footwear selection of individuals with diabetes and neuropathy. Methods An interpretative phenomenological analysis (IPA) approach was used to explore the understanding and experience of therapeutic footwear use in people living at risk of diabetic neuropathic foot ulceration. This study benefited from the purposive selection of a small sample of four people and used in-depth semi structured interviews because it facilitated the deep and detailed examination of personal thoughts and feelings behind footwear selection. Findings Four overlapping themes that interact to regulate footwear choice emerged from the analyses: a) Self-perception dilemma; resolving the balance of risk experienced by people with diabetes and neuropathy day to day, between choosing to wear footwear to look and feel normal and choosing footwear to protect their feet from foot ulceration; b) Reflective adaption; The modification and individualisation of a set of values about footwear usage created in the minds of people with diabetes and neuropathy; c) Adherence response; The realignment of footwear choice with personal values, to reinforce the decision not to change behaviour or bring about increased footwear adherence, with or without appearance management; d) Reality appraisal; A here and now appraisal of the personal benefit of footwear choice on emotional and physical wellbeing, with additional consideration to the preservation of therapeutic footwear. Conclusion For some people living at risk of diabetic neuropathic foot ulceration, the decision whether or not to wear

  19. Balancing risks and benefits fairly across generations: cost/benefit considerations

    International Nuclear Information System (INIS)

    Catron, B.L.

    1994-01-01

    This paper has been prepared by the OECD Nuclear Energy Agency Workshop on the environmental and ethical aspects of long-lived radioactive waste disposal. The workshop is intended as a step toward preparation of a collective opinion on deep geological storage of nuclear waste. As requested, this paper answers to the following specific questions : 1) Discounting of costs with time is a widely applied technique in the evaluation of the impact of economic and industrial decisions. Could or should discounting of long-term health risks due to radioactive waste disposal be envisaged? 2) Is it possible to assess what is passed on to future generations in terms of health risks, other detriments and possible benefits of all sorts, directly or indirectly? Should such an assessment be applied generically to human activities in a broad sense or should it concern only waste disposal issues? 3) How can the immediate needs of the current generations for example for energy generation or public health protection be balanced with inter generational equity requirements in the very long term? 4) Are resources devoted to assuring safety of radioactive waste disposal appropriately balanced with risks given that these resources could be applied to other societal goals? 5) Is it preferable to take all physical actions today to minimize any bequest of liabilities for waste management actions to future generations. If not how should financial assets be set aside to meet the liabilities? 6) What guidelines and principles should we follow to balance these risks? Does the proposition that we should not expose future generations to a risk that is not acceptable today appropriately address this issue? 7) Should measures of risk acceptability be considered in the context of individual rights or local rights or the collective rights of the population? 8) What measures are necessary in the siting of repositories to assure that disadvantaged populations do not bear disproportionate burdens? 9) Is

  20. Cost-benefit analysis of internet therapeutic intervention on patients with diabetes.

    Science.gov (United States)

    Deng, Lan; White, Adam S; Pawlowska, Monika; Pottinger, Betty; Aydin, Jessica; Chow, Nelson; Tildesley, Hugh D

    2015-04-01

    With the emergence of IBGMS for allowing for patients to communicate their self-monitored blood glucose (SMBG) readings with their health care providers, their impact on the management of diabetes is becoming well-supported with regards to clinical benefits. Their impact on healthcare costs, however, has yet to be investigated. This study aims to determine the cost-benefits of such interventions in comparison to routine care. To analyze the cost-benefit of an Internet Blood Glucose Monitoring Service (IBGMS) in comparison to routine diabetes care. 200 patients were surveyed to assess the cost associated with doctor appointments in the past 12 months. Annual number of visits to medical services for diabetes and costs of transportation, parking, and time taken off work for visits were surveyed. Self-reported frequency of SMBG and most recent A1C were also surveyed. We compared 100 patients who used the IBGMS with 100 patients who only used routine care. There is a trend of lowered total cost in the intervention group compared to the control group. The control group spent $210.89 per year on visits to physicians; the intervention group spent $131.26 (P = 0.128). Patients in control group visited their endocrinologist 1.76 times per year, those in intervention group visited their endocrinologist 1.36 times per year, significantly less frequently than the control group (P = 0.014). Number of visits to other medical services is similar between the groups. Average A1C in intervention group is 7.57%, in control group is 7.69% (P = 0.309). We have demonstrated that IBGMS, while not reaching statistical significance, may be associated with slightly reduced A1C and cost due to visiting physicians.

  1. SCREENING FOR UNDIAGNOSED DIABETIC SUBJECTS USING A SIMPLIFIED INDIAN DIABETES RISK SCORE [IDRS] IN KHAMMAM URBAN

    Directory of Open Access Journals (Sweden)

    Pothukuchi Madhavi

    2016-07-01

    Full Text Available BACKGROUND The rising prevalence of diabetes in developing countries is closely associated with industrialisation and socioeconomic development. The major determinants of diabetics in these countries are population growth, age structure, and urbanisation, prevalence of obesity because of increased intake of junk food, lack of physical activity, and stress among urban dwellers. Diabetes is increasingly concentrated in the urban areas. Hence, the present study was undertaken. METHODOLOGY A community based cross-sectional study was carried out in Raghunadhapalem, an urban area of Khammam with a total population of 1552. List of areas under Khammam (urban was obtained from Municipal Corporation and the present study area Raghunadhapalem, was chosen by simple random sampling technique. Duration of the study was 4 months. RESULTS Majority 232 (74.3% of study participants are at risk of developing Diabetes in future. Majority 291 (93.3% of the study participants do not have family history of diabetes. CONCLUSIONS IDRS is a simple, useful and cost-effective screening tool for diabetes in resource limited settings. By identifying the high & medium risk individuals using IDRS, we could make screening programs more cost effective.

  2. Diabetes

    Science.gov (United States)

    ... you, discussing your symptoms, and going over your health history, your doctor may test for diabetes if he or she suspects you are at risk. To check for diabetes, your doctor may request the following tests: Fasting blood sugar test. This test is usually done ...

  3. X-ray examination for breast cancer: Benefit versus risk

    International Nuclear Information System (INIS)

    Dalrymple, G.V.; Baker, M.L.

    1984-01-01

    Cancer of the breast is the most common malignancy afflicting American women. According to the American Cancer Society, one of 11 women (9 percent) born in the United States today, will develop breast cancer in her lifetime. Twenty-seven percent of all cancers in women and 19 percent of all cancer deaths in women are attributable to breast cancer. In 1982, 112,000 women were found to have cancer of the breast, and 37,000 women died from breast cancer. X-ray examinations of the breast are of considerable value in the diagnosis of breast cancer. This may be especially true in the asymptomatic patient who does not have a palpable mass. These x-ray examinations, however, are associated with both a finite though small risk of induction of cancer of the breasts and even smaller risk of death from cancer of the breast. This chapter presents a brief review of cancer of the breast and discusses the value of diagnostic studies, including x-ray mammography; the benefits and risks associated with x-ray examinations; and the future potential of computed tomography (CT) and ultrasound as imaging modalities in the detection of breast cancer

  4. Health care professionals from developing countries report educational benefits after an online diabetes course.

    Science.gov (United States)

    Wewer Albrechtsen, Nicolai J; Poulsen, Kristina W; Svensson, Lærke Ø; Jensen, Lasse; Holst, Jens J; Torekov, Signe S

    2017-05-31

    Medical education is a cornerstone in the global combat against diseases such as diabetes and obesity which together affect more than 500 million humans. Massive Open Online Courses (MOOCs) are educational tools for institutions to teach and share their research worldwide. Currently, millions of people have participated in evidence-based MOOCs, however educational and professional benefit(s) for course participants of such initiatives have not been addressed sufficiently. We therefore investigated if participation in a 6 week open online course in the prevention and treatment of diabetes and obesity had any impact on the knowledge, skills, and career of health care professionals contrasting participants from developing countries versus developed countries. 52.006 participants signed up and 29.469 participants were active in one of the three sessions (2014-2015) of Diabetes - a Global Challenge. Using an online based questionnaire (nine sections) software (Survey Monkey), email invitations were send out using a Coursera based database to the 29.469 course participants. Responses were analyzed and stratified, according to the United Nations stratification method, by developing and developed countries. 1.303 (4.4%) of the 29.469 completed the questionnaire. 845 of the 1303 were defined as health care professionals, including medical doctors (34%), researchers (15%), nurses (11%) and medical students (8%). Over 80% of the health care participants report educational benefits, improved knowledge about the prevention and treatment therapies of diabetes and furthermore improved professional life and practice. Over 40% reported that their professional network expanded after course participation. Study participants who did not complete all modules of the course reported similar impact as the ones that completed the entire course(P = 0.9). Participants from developing countries gained more impact on their clinical practice (94%) compared to health care professionals from

  5. Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom

    Directory of Open Access Journals (Sweden)

    Dimy Fluyau

    2017-04-01

    Full Text Available BackgroundKratom (Mitragyna speciosa is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules. Some case reports have associated kratom exposure with psychosis, seizures, intrahepatic cholestasis, other medical conditions, and deaths. The clinical manifestations of kratom effects are not well defined and the clinical studies are limited. Data research suggest that both stimulant and sedative dose-dependent effects do exist, in addition to antinociceptive, antidepressant activity, anxiolytic-like effects, and anorectic effects, but a growing concern for the drug’s effects and safety of use has resulted in national and international attention primarily due to an increase in hospital visits and deaths in several countries that are believed to have been caused by extracts of the plant. There is a dearth of double blind controlled studies. In this study, we aim to use existing literature to clarify both benefits and risks of kratom as well as its diagnosis evaluation as kratom misuse is an emerging trend in the Western world.MethodsLiterature review using databases such as Embase, Medline, PubMed, Cochrane Library, and Mendeley from 2007 to 2017 were evaluated by all authors to analyze current state on benefits, risks, and diagnosis evaluation of kratom (M. speciosa.ResultsData analysis suggested that kratom possesses some benefits such as stimulant and sedative effects as wells as antinociceptive effects. It seems to inhibit pro-inflammatory mediator release and vascular permeability and can enhance immunity. In addition, it may be an antidepressant and

  6. Gm crops: between biological risk and environmental and economic benefits

    International Nuclear Information System (INIS)

    Chaparro Giraldo, Alejandro

    2011-01-01

    The transgenic crops were the result of the application of recombinant DNA technology in agriculture. These crops were developed by transfer of foreign genes (transgenes) from any biological origin (animal, plant, microbial, viral) to the genome of cultivated species of plants. The crops genetically modified (GM) have been used in the world since 1996; up to December 2010 they counted to a billion hectares planted throughout the period. In just the past year 2010 148 million hectares were planted, grown by 15.4 million farmers in 29 countries. GM crops that are used in global agriculture are mainly soybean, cotton, corn and canola, which express transgenes derived from bacteria, and confer resistance to lepidopteron insects (ILR) or herbicide tolerance (HT; glyphosate and glufosinate ammonium). the first transgenic varieties containing only a single transgene, or simple event, while the current varieties express several transgenes, or stacked, conferring resistance to different species of Lepidoptera and coleopteran insects and tolerance to two different herbicides. In 2010 were planted in Colombia, 18.874 hectares of GM cotton, 16.793 hectares of GM corn, and 4 hectares of GM carnations and GM roses. GM corn and GM cotton were planted in Sucre, Cesar, Cordoba, Huila and Tolima. GM corn was planted in Antioquia, Valle del Cauca, Meta, Cundinamarca and Santander. Carnations and roses were planted in Cundinamarca. GM maize and GM cotton expressing ILR and HT features, as simple events or stacked. In the case of GM carnation and GM roses, these genotypes that express the color blue. Academia has tried to organize the debate on the adoption of GM crops around the analysis of biological risks and environmental vs environmental and economic benefits. Biological hazards are defined by the possible negative effects on human consumers or negative effects on the environment. The environmental benefits are related to reduce use of agrochemicals (insecticides and herbicides

  7. 77 FR 43601 - Risks and Benefits of Hydroxyethyl Starch Solutions; Public Workshop

    Science.gov (United States)

    2012-07-25

    ...] Risks and Benefits of Hydroxyethyl Starch Solutions; Public Workshop AGENCY: Food and Drug... public workshop entitled: ``Risks and Benefits of Hydroxyethyl Starch Solutions.'' The purpose of this public workshop is to discuss new information on the risks and benefits of FDA-approved hydroxyethyl...

  8. Risk/Benefit Communication about Food—A Systematic Review of the Literature

    NARCIS (Netherlands)

    Frewer, L.J.; Fischer, A.R.H.; Brennan, M.; Bánáti, D.; Lion, R.; Meertens, R.M.; Rowe, G.; Siegrist, M.; Verbeke, W.; Vereijken, C.M.J.L.

    2016-01-01

    A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit

  9. SGLT2 inhibitors with cardiovascular benefits: Transforming clinical care in Type 2 diabetes mellitus.

    Science.gov (United States)

    d'Emden, Michael; Amerena, John; Deed, Gary; Pollock, Carol; Cooper, Mark E

    2018-02-01

    Cardiovascular risk reduction in individuals with Type 2 diabetes mellitus (T2DM) is a key part of clinical management. Sodium-glucose co-transporter (SGLT2) inhibitors improve glycaemic control, reduce body weight and decrease blood pressure. In addition, the SGLT2 inhibitors empagliflozin and canagliflozin reduced the risk of composite cardiovascular events in high-risk individuals with T2DM in the EMPA-REG OUTCOME trial and the CANVAS Program, respectively. Empagliflozin also reduced cardiovascular deaths and improved renal outcomes. This class of agents should be considered in people with established cardiovascular disease, usually in combination with other glucose lowering medications, when satisfactory glycaemic control has not been achieved. The dose of insulin or sulfonylureas may need to be lowered when used with SGLT2 inhibitors, to reduce the risk of hypoglycaemia. Genitourinary infections can occur with SGLT2 inhibitors in a small proportion of people. In people with osteoporosis or prior amputation, it may be prudent to use empagliflozin rather than canagliflozin, based on the increased risk for bone fractures and amputations observed with canagliflozin in the CANVAS Program. SGLT2 inhibitors have the potential to transform the clinical care of persons with T2DM by not only improving glycaemic control but also reducing blood pressure, body weight and diabetes-related end-organ complications. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

    Centers for Disease Control (CDC) Podcasts

    This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.

  11. Risk factors for gestational diabetes mellitus in Sudanese pregnant ...

    African Journals Online (AJOL)

    McRoy

    Int J Med Biomed Res 2012;1(1):79-84. 79. Risk factors for gestational diabetes mellitus in Sudanese pregnant women. Mardi T.G1, Lutfi M.F2*. 1Department of Physiology, Faculty of Medicine and Health Sciences, Omdurman Islamic University,. Sudan. 2Department of Physiology, Faculty of Medicine and Health Sciences, ...

  12. Assessing diabetic foot ulcer development risk with hyperspectral tissue oximetry

    Science.gov (United States)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2011-02-01

    Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment. Early detection and preventive care, such as offloading or improved hygiene, can greatly reduce the risk of further complications. We aim to assess the use of hyperspectral tissue oximetry in predicting the risk of diabetic foot ulcer formation. Tissue oximetry measurements are performed during several visits with hyperspectral imaging of the feet in type 1 and 2 diabetes mellitus subjects that are at risk for foot ulceration. The data are retrospectively analyzed at 21 sites that ulcerated during the course of our study and an ulceration prediction index is developed. Then, an image processing algorithm based on this index is implemented. This algorithm is able to predict tissue at risk of ulceration with a sensitivity and specificity of 95 and 80%, respectively, for images taken, on average, 58 days before tissue damage is apparent to the naked eye. Receiver operating characteristic analysis is also performed to give a range of sensitivity/specificity values resulting in a Q-value of 89%.

  13. Comparison of Some Risk Factors for Diabetes Across Different ...

    African Journals Online (AJOL)

    the adoption of lifestyles, which enhance risk of NCDs such as diabetes, by ... was done to assess the effect of socioeconomic status on the prevalence of type 2 ..... smoking including ban on advertisements and restriction of smoking in public ...

  14. Prepregnancy Diabetes and Offspring Risk of Congenital Heart Disease

    DEFF Research Database (Denmark)

    Øyen, Nina; Diaz, Lars Jorge; Leirgul, Elisabeth

    2016-01-01

    BACKGROUND: Maternal diabetes mellitus is associated with an increased risk of offspring congenital heart defects (CHD); however, the causal mechanism is poorly understood. We further investigated this association in a Danish nationwide cohort. METHODS AND RESULTS: In a national cohort study, we...

  15. Comparison of frequency of obesity in high risk non diabetic young individuals with low risk non diabetic young individuals

    International Nuclear Information System (INIS)

    Shaikh, M.A.; Kumar, R.; Ghori, R.A.

    2011-01-01

    Objective: To assess the body mass index and waist circumferences of high risk non diabetic young individuals and compare them with low risk non diabetic young individuals. Method: A cross sectional, case control comparative study was conducted in the department of medicine, LUMHS from January 2008 to March 2009. Five hundred individuals 20-40 years of age were selected and divided into two groups i.e. Group A: high risk (250 individuals) and Group B: low risk (250 individuals) on the basis of same age and gender. Group A included those who had positive family history of type 2 DM in first degree relatives while group B had no family history of type 2 DM in first degree relatives. The blood pressure, BMI and Waist Circumference was measured and Fasting Blood Sugar was estimated in each individual. In each group 125 (50%) were males and 125 (50%) were females. Results: In group A 58% and in group B 28.8% individuals represented raised BMI whereas 42% in group A and 36% in group B individuals showed an increased waist circumference. Mean fasting blood glucose was significantly higher in Group A than in Group B (P=0.001). Conclusion: Impaired Fasting Glucose is strongly associated with family history of type 2 diabetes mellitus. Presence of obesity specially in high risk non-diabetic young individuals emphasize the need for routine health screening for early institution of preventive measures. (author)

  16. Diabetic retinopathy: A predictor of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Fawzia El Demerdash

    2012-06-01

    Conclusion: Diabetic retinopathy is a good predictor of coronary artery disease that exceeds the conventional risk factors. Diabetics with retinopathy would benefit from early coronary angiography and diabetic retinocoronary clinics are warranted.

  17. Risk perception and unrecognized type 2 diabetes in women with previous gestational diabetes mellitus.

    Science.gov (United States)

    Malcolm, Janine; Lawson, Margaret L; Gaboury, Isabelle; Keely, Erin

    2009-09-01

    Women with a history of gestational diabetes mellitus (GDM) have a high chance of developing type 2 diabetes mellitus (T2DM) following the index pregnancy, however, little is known of women's perception of this risk. The objectives were to (1) determine women's perception of risk of future development of T2DM following a GDM pregnancy and (2) describe the prevalence of undetected dysglycaemia in a Canadian population. The study was designed as a 9-11 year follow-up study of women previously enrolled in a randomized controlled trial of tight versus minimal intervention for GDM. Women's perception of future risk of diabetes was determined by questionnaire. Fasting lipid profile, height and weight were performed on all participants. Oral glucose tolerance tests were performed on all women without prior history of diabetes mellitus type 2 (DM2). The study was conducted at Ottawa Hospital General Campus and Children's Hospital of Eastern Ontario, in Ottawa, Canada. Eighty-nine of 299 (30%) of the original cohort were recruited. Eighty-eight women completed the questionnaire and 77 women without known diabetes underwent two hour glucose tolerance testing. Twenty-three (30%) felt their risk was no different than other women or did not know, 27 (35%) felt risk was increased a little and 27 (35%) felt risk was increased a lot. Only 52% (40/77) had normal glucose tolerance. Of all, 25/88 (28%) patients had diabetes (11 previously diagnosed and 14 diagnosed within the study). Of those newly diagnosed with DM2, four (29%) were diagnosed by fasting glucose, six (42%) by two hour glucose tolerance test (GTT) alone and four (29%) by both. Twenty-four of the women (27%) had impaired glucose tolerance (IGT). Of those with IGT, 12 (57%) had a fasting food glucose DM2, and all had a waist circumference >88 cm. In conclusion the perception of being at high risk for T2DM did not prevent women from having undetected T2DM. Many factors are likely to contribute to this, including the

  18. Risk of bladder cancer in patients with diabetes

    DEFF Research Database (Denmark)

    Goossens, Maria E; Zeegers, Maurice P; Bazelier, Marloes T

    2015-01-01

    Statistics (ONS). Patients diagnosed with diabetes mellitus type 1 or 2, or using antidiabetic drugs (ADDs), were compared to matched non-diabetic controls. Cox proportional hazards models were used to estimate the risk and mortality of UBC. We adjusted for age, sex, smoking status and body mass index....... RESULTS: The cohort included 329,168 patients using ADD, and 307,315 controls with 1295 and 1071 patients, respectively, diagnosed as having UBC during follow-up. The adjusted HRs of UBC were 0.77 (95% CI 0.57 to 1.05) and 1.04 (95% CI 0.96 to 1.14) for type 1 and 2 diabetes, respectively. These results...... haemoglobin. Mortality of UBC was not increased for patients with either type 1 (HR=0.95 (95% CI 0.39 to 2.34)) or type 2 diabetes (HR=1.16 (95% CI 0.91 to 1.46)). CONCLUSIONS: Neither the risk of UBC nor the mortality from UBC was increased in patients with type 1 and patients with type 2 diabetes...

  19. Association of GSTs polymorphisms with risk of gestational diabetes mellitus.

    Science.gov (United States)

    Li, Yan; Li, Shaoru; Zhai, Qianqian; Hai, Jie; Wang, Di; Cao, Meng; Zhang, Qinggui

    2015-01-01

    We conducted a case-control study to investigate the association between GSTM1, GSTT1 and GSTP1 IIe105Val polymorphisms and development of gestational diabetes mellitus in a Chinese population. A total of 320 patients with gestational diabetes mellitus and 358 pregnancy subjects were consecutively collected between January 2013 and December 2014. Genotyping for detection of GSTM1, GSTT1 and GSTP1 IIe105Val was conducted by using PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphisms) method. By Fisher's exact test, we found that the genotype distributions of GSTP1 IIe105Val were in line with the Hardy-Weinberg equilibrium in control subjects (P=0.57). By Chi-square test, we found significant differences in the genotype distributions of GSTM1 (χ(2)=11.49, P=0.001) and GSTT1 (χ(2)=18.50, Pgestational diabetes mellitus when compared with the present genotype, and the adjusted Ors (95% CI) were 1.71 (1.24-2.36) and 2.00 (1.44-2.79), respectively. However, the GSTP1 IIe105Val polymorphism was not associated with an elevated risk of gestational diabetes mellitus. In conclusion, we suggest that the GSTM1 null genotype and GSTT1 null genotype are correlated with an increased risk of gestational diabetes mellitus in a Chinese population.

  20. Analysis of risk factors of pulmonary embolism in diabetic patients

    International Nuclear Information System (INIS)

    Xie Changhui; Ma Zhihai; Zhu Lin; Chi Lianxiang

    2012-01-01

    Objective: To study the related risk factors in diabetic patients with pulmonary embolism (PE). Methods: 58 diabetic cases underwent lower limbs 99m Tc-MAA veins imaging (and/or ultrasonography) and pulmonary perfusion imaging. The related laboratory data [fasting blood glucose (FBG), blood cholesterol, blood long chain triglycerides (LCT)] and clinic information [age, disease courses, chest symptoms (chest pain and short of breathe), lower limbs symptoms (swelling, varicose veins and diabetic foot) and acute complication (diabetic ketoacidosis and hyperosmolar non ketotic diabetic coma)] were collected simultaneously. SPSS was used for χ 2 -test and Logistic regression analysis. Results: (1) 28 patients (48.3%) were showed to be with lower limbs deep vein thrombosis (DVT) and by 99m Tc-MAA imaging, 10 cases (17.2%) with PE. The PE ratios (32.1%) of the patients with DVT was more higher than no DVT (3.3%) (χ 2 =6.53, P 2 ≥4.23, P 2 ≤2.76, P>0.05), respectively. (3) Multiplicity analysis indicated: the related risk factors for PE included chest symptoms (Score=13.316, P=0.000) and lower limbs symptoms (Score=7.780, P=0.005). No significant difference to other factors (Score≤2.494, P>0.114), respectively. Conclusion: The serious DM with chest symptoms, lower limbs symptoms and/or DVT must be controlled as early as possible by all kinds of treatment. It will decrease the PE complication. (authors)

  1. Oral contraceptives in polycystic ovary syndrome: risk-benefit assessment.

    Science.gov (United States)

    Yildiz, Bulent O

    2008-01-01

    Combined oral contraceptive pills (OCPs) have been a key component of the chronic treatment of polycystic ovary syndrome (PCOS) by improving androgen excess and regulating menstrual cycles. Earlier epidemiologic studies with second- and third-generation OCPs in the general population have raised important questions regarding long-term cardiometabolic effects of these agents. In PCOS, there are only a few short-term studies with contradictory results evaluating potential adverse effects of OCPs on cardiovascular risk factors and glucose homeostasis. These studies included a small number of participants and did not take into account several confounding factors that might influence the outcome. Nevertheless, limited available data support the benefits of long-term OCP use in PCOS. By contrast, solid evidence for cardiometabolic adverse outcome with the use of these agents, especially with newer OCPs containing antiandrogenic progestins, is lacking. More studies are needed to resolve controversies regarding the safety of long-term OCP use in PCOS. Meanwhile, assessment of each PCOS patient's personal cardiometabolic risk profile should be an essential component of the evaluation before prescribing OCPs and also during follow-up.

  2. Medical Care Expenditures for Individuals with Prediabetes: The Potential Cost Savings in Reducing the Risk of Developing Diabetes.

    Science.gov (United States)

    Khan, Tamkeen; Tsipas, Stavros; Wozniak, Gregory

    2017-10-01

    The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with diabetes. A cohort analysis of a commercially insured population was conducted using individual-level claims data from Truven Health MarketScan ® Lab Database to identify adults with prediabetes, track whether they develop diabetes, and compare medical expenditures for those who are newly diagnosed with diabetes to those who are not. This study then illustrates how reducing the risk of developing diabetes by participation in an evidence-based lifestyle change program could yield both positive net savings on medical care expenditures and return on investment (ROI). Annual expenditures are found to be nearly one third higher for those who develop diabetes in subsequent years relative to those who do not transition from prediabetes to diabetes, with an average difference of $2671 per year. At that cost differential, the 3-year ROI for a National DPP is estimated to be as high as 42%. The results show the importance and economic benefits of participation in lifestyle intervention programs to prevent or delay the onset of type 2 diabetes.

  3. Incidence of diabetic macular edema and associated risk factors in a cohort of patients with type 1 diabetes in Denmark

    DEFF Research Database (Denmark)

    Rasmussen, Malin Lundberg

    Incidence of diabetic macular edema and associated risk factors in a cohort of patients with type 1 diabetes in Denmark. Rasmussen M.L.1, Pedersen R.B. 1, Sjølie A.K. 1, Grauslund J1 1University of Southern Denmark, Department of ophthalmology, Odense University Hospital, Denmark Purpose: To eval......Incidence of diabetic macular edema and associated risk factors in a cohort of patients with type 1 diabetes in Denmark. Rasmussen M.L.1, Pedersen R.B. 1, Sjølie A.K. 1, Grauslund J1 1University of Southern Denmark, Department of ophthalmology, Odense University Hospital, Denmark Purpose......: To evaluate the 16-year incidence of diabetic macular edema (DME) in a cohort of type 1 diabetic patients and to investigate possible risk factors of developing DME. Methods: This was a prospective cohort study of Danish type 1 diabetic patients. A total of 131 patients were examined at baseline in 1995...

  4. [Incidence and clinical risk factors for the development of diabetes mellitus in women with previous gestational diabetes].

    Science.gov (United States)

    Domínguez-Vigo, P; Álvarez-Silvares, E; Alves-Pérez M T; Domínguez-Sánchez, J; González-González, A

    2016-04-01

    Gestational diabetes is considered a variant of diabetes mellitus as they share a common pathophysiological basis: insulin resistance in target and insufficient secretion of it by pancreatic p-cell bodies. Pregnancy is a unique physiological situation provides an opportunity to identify future risk of diabetes mellitus. To determine the long-term incidence of diabetes mellitus in women who have previously been diagnosed with gestational diabetes and identifying clinical risk factors for developing the same. nested case-control cohort study. 671 patients between 1996 and 2009 were diagnosed with gestational diabetes were selected. The incidence of diabetes mellitus was estimated and 2 subgroups were formed: Group A or cases: women who develop diabetes mellitus after diagnosis of gestational diabetes. Group B or control: random sample of 71 women with a history of gestational diabetes in the follow-up period remained normoglycemic. Both groups were studied up to 18 years postpartum. By studying Kaplan Meier survival of the influence of different gestational variables it was obtained in the later development of diabetes mellitus with time parameter and COX models for categorical variables were applied. Significant variables were studied by multivariate Cox analysis. In all analyzes the Hazard ratio was calculated with confidence intervals at 95%. The incidence of diabetes mellitus was 10.3% in patients with a history of gestational diabetes. They were identified as risk factors in the index pregnancy to later development of diabetes mellitus: greater than 35 and younger than 27 years maternal age, BMI greater than 30 kg/m2, hypertensive disorders of pregnancy, insulin therapy, poor metabolic control and more than a complicated pregnancy with gestational diabetes. Clinical factors have been identified in the pregnancy complicated by gestational diabetes that determine a higher probability of progression to diabetes mellitus in the medium and long term.

  5. Clinical imaging guidelines part 2: Risks, benefits, barriers, and solutions.

    Science.gov (United States)

    Malone, James; del Rosario-Perez, Maria; Van Bladel, Lodewijk; Jung, Seung Eun; Holmberg, Ola; Bettmann, Michael A

    2015-02-01

    A recent international meeting was convened by two United Nations bodies to focus on international collaboration on clinical appropriateness/referral guidelines for use in medical imaging. This paper, the second of 4 from this technical meeting, addresses barriers to the successful development/deployment of clinical imaging guidelines and means of overcoming them. It reflects the discussions of the attendees, and the issues identified are treated under 7 headings: ■ Practical Strategy for Development and Deployment of Guidelines; ■ Governance Arrangements and Concerns with Deployment of Guidelines; ■ Finance, Sustainability, Reimbursement, and Related Issues; ■ Identifying Benefits and Radiation Risks from Radiological Examinations; ■ Information Given to Patients and the Public, and Consent Issues; ■ Special Concerns Related to Pregnancy; and ■ The Research Agenda. Examples of topics identified include the observation that guideline development is a global task and there is no case for continuing it as the project of the few professional organizations that have been brave enough to make the long-term commitment required. Advocacy for guidelines should include the expectations that they will facilitate: (1) better health care delivery; (2) lower cost of that delivery; with (3) reduced radiation dose and associated health risks. Radiation protection issues should not be isolated; rather, they should be integrated with the overall health care picture. The type of dose/radiation risk information to be provided with guidelines should include the uncertainty involved and advice on application of the precautionary principle with patients. This principle may be taken as an extension of the well-established medical principle of "first do no harm." Copyright © 2015. Published by Elsevier Inc.

  6. Increased mortality risk in women with depression and diabetes mellitus

    Science.gov (United States)

    Pan, An; Lucas, Michel; Sun, Qi; van Dam, Rob M.; Franco, Oscar H.; Willett, Walter C.; Manson, JoAnn E.; Rexrode, Kathryn M.; Ascherio, Alberto; Hu, Frank B.

    2011-01-01

    Context Both depression and diabetes have been associated with an increased risk of all-cause and cardiovascular diseases (CVD) mortality. However, data evaluating the joint effects of these two conditions on mortality are sparse. Objectives To evaluate the individual and joint effects of depression and diabetes on all-cause and CVD mortality in a prospective cohort study. Design, Settings and Participants A total of 78282 female participants in the Nurses' Health Study aged 54-79 years at baseline in 2000 were followed until 2006. Depression was defined as having self-reported diagnosed depression, treatment with antidepressant medications, or a score indicating severe depressive symptomatology, i.e., a five-item Mental Health Index score ≤52. Self-reported type 2 diabetes was confirmed using a supplementary questionnaire. Main outcome measures All-cause and CVD-specific mortality. Results During 6 years of follow-up (433066 person-years), 4654 deaths were documented, including 979 deaths from CVD. Compared to participants without either condition, the age-adjusted relative risks (95% confidence interval, CI) for all-cause mortality were 1.76 (1.64-1.89) for women with depression only, 1.71 (1.54-1.89) for individuals with diabetes only, and 3.11 (2.70-3.58) for those with both conditions. The corresponding age-adjusted relative risks of CVD mortality were 1.81 (1.54-2.13), 2.67 (2.20-3.23), and 5.38 (4.19-6.91), respectively. These associations were attenuated after multivariate adjustment for other demographic variables, body mass index, smoking status, alcohol intake, physical activity, and major comorbidities (including hypertension, hypercholesterolemia, heart diseases, stroke and cancer) but remained significant, with the highest relative risks for all-cause and CVD mortality found in those with both conditions (2.07 [95% CI, 1.79-2.40] and 2.72 [95% CI, 2.09-3.54], respectively). Furthermore, the combination of depression with a long duration of diabetes

  7. Confirmation of novel type 1 diabetes risk loci in families

    DEFF Research Database (Denmark)

    Cooper, J D; Howson, J M M; Smyth, D

    2012-01-01

    Over 50 regions of the genome have been associated with type 1 diabetes risk, mainly using large case/control collections. In a recent genome-wide association (GWA) study, 18 novel susceptibility loci were identified and replicated, including replication evidence from 2,319 families. Here, we......, the Type 1 Diabetes Genetics Consortium (T1DGC), aimed to exclude the possibility that any of the 18 loci were false-positives due to population stratification by significantly increasing the statistical power of our family study....

  8. CARDIOVASCULAR RISK FACTORS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Z ABDEYASDAN

    2003-12-01

    Full Text Available Introduction: Diabetes melliuts is a chronic, metabolic disease that involves the macro and micro vascular complications and one of its maer ascular cowplications is the cardio vascular disease, as ,the risk of cardiovascular disease is 2-4 folds in diabetic patients in comparison with non diabetic individuals. The researches have demonstrated that the risk factors of the cardio vascular disease are formed at childhood. Therefore the preventive measures must begin from early childhood. So the present study was planned with the goals to determine and compare the cardia-vascular risk factors in the diabetic children with type 1 of diabetes mellitus. Method: This was an analytic, cross sectional study that has been done in two groups (case-control. In this research, 148 children, suffering from the typel diabetes mellitus being supported by the metabolism and endocrine research center, were chosen in the continues case manner and for the control group, 148 children, matched with the study group (according to the age and the sex, at 6-18 years old from the schools in Isfahan city randomly and at 2-6 years from the neiborhoods of the case group. The data-gathering tool was the questionnaires includes lipid profile, blood pressure, weight and height. To analyze the data we used the analytic (t student and logistic regression and descriptive (mean and standard deviation statistic methods and SPSS. Results: Findings revealed that the means of Lipid profile, systolic blood pressure and body mass index had not statistically significant differences in the two groups. But the mean of diastolic blood pressure and the mean arterial blood pressure in the control group were more than the case group and this difference was significant. The mean, 75 and 95 percentiles for cholesterol and LDL in all the age groups, mean, 75 and 95 percentile for triglyceride in all the age groups except the age group of 1-4 years in the diabetic and non diabetic groups were

  9. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study.

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    Full Text Available The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors.A total of 54,670 patients with type 2 diabetes aged ≥ 25 years were selected from the Saudi National Diabetes Registry (SNDR and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD for prevalence estimation and risk factor assessment.The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25-44 years and a duration of >5 years, to 21.8% in patients ≥ 65 years with a diabetes duration of ≥ 15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy.The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population.

  10. Diabetic Nephropathy and Its Risk Factors in a Society with a Type 2 Diabetes Epidemic: A Saudi National Diabetes Registry-Based Study

    Science.gov (United States)

    Al-Rubeaan, Khalid; Youssef, Amira M.; Subhani, Shazia N.; Ahmad, Najlaa A.; Al-Sharqawi, Ahmad H.; Al-Mutlaq, Hind M.; David, Satish K.; AlNaqeb, Dhekra

    2014-01-01

    Aims The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors. Methodology A total of 54,670 patients with type 2 diabetes aged ≥25 years were selected from the Saudi National Diabetes Registry (SNDR) and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA) criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD) for prevalence estimation and risk factor assessment. Results The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25–44 years and a duration of >5 years, to 21.8% in patients ≥65 years with a diabetes duration of ≥15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy. Conclusion The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population. PMID:24586457

  11. Brain function and structure and risk for incident diabetes: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Bancks, Michael P; Alonso, Alvaro; Gottesman, Rebecca F; Mosley, Thomas H; Selvin, Elizabeth; Pankow, James S

    2017-12-01

    Diabetes is prospectively associated with cognitive decline. Whether lower cognitive function and worse brain structure are prospectively associated with incident diabetes is unclear. We analyzed data for 10,133 individuals with cognitive function testing (1990-1992) and 1212 individuals with brain magnetic resonance imaging (1993-1994) from the Atherosclerosis Risk in Communities cohort. We estimated hazard ratios for incident diabetes through 2014 after adjustment for traditional diabetes risk factors and cohort attrition. Higher level of baseline cognitive function was associated with lower risk for diabetes (per 1 standard deviation, hazard ratio = 0.94; 95% confidence interval = 0.90, 0.98). This association did not persist after accounting for baseline glucose level, case ascertainment methods, and cohort attrition. No association was observed between any brain magnetic resonance imaging measure and incident diabetes. This is one of the first studies to prospectively evaluate the association between both cognitive function and brain structure and the incidence of diabetes. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  12. Effect of Mediterranean Diet in Diabetes Control and Cardiovascular Risk Modification: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Dana eSleiman

    2015-04-01

    Full Text Available Background: Over the past few years, there has been a worldwide significant increase in the incidence of type II diabetes (T2DM with both increase in morbidity and mortality. Controlling diabetes through life style modifications, including diet and exercise has always been the cornerstone in diabetes management. As a matter of fact, a number of studies addressed the potential protective role of Mediterranean diet in diabetic patients. Increasing evidence suggests that the Mediterranean diet could be of benefit in diseases associated with chronic inflammation, including metabolic syndrome, diabetes, obesity as well as atherosclerosis, cancer, pulmonary diseases, and cognition disorders. Methods: A systematic review was conducted on the effect of Mediterranean diet in diabetes control and cardiovascular risk modification as well as the possible mechanism through which this diet might exhibit its beneficial role. We did a comprehensive search of multiple electronic databases such as Medline, Google Scholars, PubMed, and the Cochrane central register data until May 2014. We included cross-sectional, prospective and controlled clinical trials that looked at the associations between Mediterranean diet and indices of diabetes control such HbA1c, fasting glucose, and HOMA, in addition to cardiovascular and peripheral vascular outcomes.Outcome/Conclusion: Most of the studies showed favorable effects of Mediterranean diet on glycemic control and CVD, although a certain degree of controversy remains regarding some issues, such as obesity. Important methodological differences and limitations in the studies make it difficult to compare results, thus further longer term studies are needed to evaluate the long-term efficacy of the Mediterranean diet along with the possibility of explaining its mechanism.

  13. Tool Weighs Benefits, Risks of Raloxifene or Tamoxifen to Prevent Breast Cancer

    Science.gov (United States)

    Researchers have developed a benefit-risk index to help guide decisions on whether postmenopausal women at increased risk of developing breast cancer should take raloxifene or tamoxifen to reduce that risk.

  14. Common familial risk factors for schizophrenia and diabetes mellitus.

    Science.gov (United States)

    Foley, Debra L; Mackinnon, Andrew; Morgan, Vera A; Watts, Gerald F; Castle, David J; Waterreus, Anna; Galletly, Cherrie A

    2016-05-01

    The co-occurrence of type 2 diabetes and psychosis is an important form of medical comorbidity within individuals, but no large-scale study has evaluated comorbidity within families. The aim of this study was to determine whether there is evidence for familial comorbidity between type 2 diabetes and psychosis. Data were analysed from an observational study of a nationally representative sample of 1642 people with psychosis who were in contact with psychiatric services at the time of survey (The 2010 Australian National Survey of Psychosis). Participants were aged 18-64 years and met World Health Organization's International Classification of Diseases, 10th Revision diagnostic criteria for a psychotic disorder (857 with schizophrenia, 319 with bipolar disorder with psychotic features, 293 with schizoaffective disorder, 81 with depressive psychosis and 92 with delusional disorder or other non-organic psychoses). Logistic regression was used to estimate the association between a family history of diabetes and a family history of schizophrenia. A positive family history of diabetes was associated with a positive family history of schizophrenia in those with a psychotic disorder (odds ratio = 1.35, p = 0.01, adjusted for age and gender). The association was different in those with an affective versus non-affective psychosis (odds ratio = 0.613, p = 0.019, adjusted for age and gender) and was significant only in those with a non-affective psychosis, specifically schizophrenia (odds ratio = 1.58, p = 0.005, adjusted for age and sex). Adjustment for demographic factors in those with schizophrenia slightly strengthened the association (odds ratio = 1.74, p = 0.001, adjusted for age, gender, diagnosis, ethnicity, education, employment, income and marital status). Elevated risk for type 2 diabetes in people with schizophrenia is not simply a consequence of antipsychotic medication; type 2 diabetes and schizophrenia share familial risk factors. © The Royal Australian and New

  15. Development of a Coronary Heart Disease Risk Prediction Model for Type 1 Diabetes: The Pittsburgh CHD in Type 1 Diabetes Risk Mode

    NARCIS (Netherlands)

    Zgibor, J.C.; Ruppert, K.; Orchard, T.J.; Soedamah-Muthu, S.S.; Fuller, J.H.; Chaturvedi, N.; Roberts, M.S.

    2010-01-01

    Aim - To create a coronary heart disease (CHD) risk prediction model specific to type 1 diabetes. Methods - Development of the model used data from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC). EDC subjects had type 1 diabetes diagnosed between 1950 and 1980, received their

  16. Instrumentation and control balancing the risks and benefits of modernization

    International Nuclear Information System (INIS)

    Doshi, P.K.; Rawlins, D.H.; Falascino, J.A.

    1996-01-01

    This paper examines the benefits and risks of modernization of instrumentation and control (I and C) systems for nuclear power plants. It will draw conclusions on how to proceed with such modernization across the spectrum from operating reactors to new plant designs. Lessons learned from Westinghouse's application of digital systems to the Temelin Nuclear Power Plant in the Czech Republic, and other nuclear plant upgrades will be used to support principles and conclusions drawn in the paper. A long term view of the modernization program is essential, even if piecemeal or individual upgrades are envisioned. A framework for considering these risks and goals into a long range strategic plan will be presented. The framework will be presented in the form of I and C architectures which permit long term growth, planning ahead for technological obsolescence, selectron of suppliers for term relationships, and effective integration of individual upgrades. Potential upgrade areas will be summarized for functional improvements, I and C hardware upgrades, and man-machine interface improvements. Examples from Westinghouse's I and C experience will be presented to clarify the principles and framework described in the paper. Lessons learned from the application of the Eagle product line to operating reactors and the emergence of distributed computer information systems as an integration vehicle for I and C upgrades will be discussed. Westinghouse is currently modernizing the Temelin Nuclear Power Plant I and C system in the Czech Republic. An overview of this program will be included as it relates to the modernization framework presented in the paper. (authors)

  17. Diabetes prevention among American Indians: the role of self-efficacy, risk perception, numeracy and cultural identity.

    Science.gov (United States)

    Simonds, Vanessa W; Omidpanah, Adam; Buchwald, Dedra

    2017-10-02

    According to the Risk Perception Attitude (RPA) framework, classifying people according to their perceptions of disease risk and their self-efficacy beliefs allows us to predict their likelihood for engaging in preventive behaviors. Health interventions can then be targeted according to RPA group. We applied the framework to type 2 diabetes prevention behaviors among American Indians and expanded it to include culture and numeracy. Using a cross-sectional study design, we surveyed a sample of Northern Plains American Indians in a reservation community setting on self-reported perceptions of diabetes risk, objective diabetes risk, self-efficacy, engagement in healthy behaviors, knowledge of diabetes risk factors, and covariates including demographics, numeracy, and cultural identity. We used the RPA framework to classify participants into four groups based on their perceptions of risk and self-efficacy. Analyses of variance and covariance estimated inter-group differences in behaviors associated with type 2 diabetes prevention. Among 128 participants, our only finding consistent with the RPA framework was that self-efficacy and risk perception predicted knowledge about diabetes risk factors. We found limited evidence for the influence of cultural identity within the RPA framework. Overall, participants had lower numeracy skills which tended to be associated with inaccurate perceptions of higher levels of risk. The theoretical framework may benefit from inclusion of further contextual factors that influence these behaviors. Attention to numeracy skills stands out in our study as an important influence on the RPA framework, highlighting the importance of attending to numeracy when targeting and tailoring risk information to participants segmented by the RPA framework.

  18. Balance Training Reduces Falls Risk in Older Individuals With Type 2 Diabetes

    OpenAIRE

    Morrison, Steven; Colberg, Sheri R.; Mariano, Mira; Parson, Henri K.; Vinik, Arthur I.

    2010-01-01

    OBJECTIVE This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50–75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. RESULTS Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also e...

  19. Risks and benefits of commonly used herbal medicines in Mexico.

    Science.gov (United States)

    Rodriguez-Fragoso, Lourdes; Reyes-Esparza, Jorge; Burchiel, Scott W; Herrera-Ruiz, Dea; Torres, Eliseo

    2008-02-15

    In Mexico, local empirical knowledge about medicinal properties of plants is the basis for their use as home remedies. It is generally accepted by many people in Mexico and elsewhere in the world that beneficial medicinal effects can be obtained by ingesting plant products. In this review, we focus on the potential pharmacologic bases for herbal plant efficacy, but we also raise concerns about the safety of these agents, which have not been fully assessed. Although numerous randomized clinical trials of herbal medicines have been published and systematic reviews and meta-analyses of these studies are available, generalizations about the efficacy and safety of herbal medicines are clearly not possible. Recent publications have also highlighted the unintended consequences of herbal product use, including morbidity and mortality. It has been found that many phytochemicals have pharmacokinetic or pharmacodynamic interactions with drugs. The present review is limited to some herbal medicines that are native or cultivated in Mexico and that have significant use. We discuss the cultural uses, phytochemistry, pharmacological, and toxicological properties of the following plant species: nopal (Opuntia ficus), peppermint (Mentha piperita), chaparral (Larrea divaricata), dandlion (Taraxacum officinale), mullein (Verbascum densiflorum), chamomile (Matricaria recutita), nettle or stinging nettle (Urtica dioica), passionflower (Passiflora incarnata), linden flower (Tilia europea), and aloe (Aloe vera). We conclude that our knowledge of the therapeutic benefits and risks of some herbal medicines used in Mexico is still limited and efforts to elucidate them should be intensified.

  20. Risks and benefits of commonly used herbal medicines in Mexico

    International Nuclear Information System (INIS)

    Rodriguez-Fragoso, Lourdes; Reyes-Esparza, Jorge; Burchiel, Scott W.; Herrera-Ruiz, Dea; Torres, Eliseo

    2008-01-01

    In Mexico, local empirical knowledge about medicinal properties of plants is the basis for their use as home remedies. It is generally accepted by many people in Mexico and elsewhere in the world that beneficial medicinal effects can be obtained by ingesting plant products. In this review, we focus on the potential pharmacologic bases for herbal plant efficacy, but we also raise concerns about the safety of these agents, which have not been fully assessed. Although numerous randomized clinical trials of herbal medicines have been published and systematic reviews and meta-analyses of these studies are available, generalizations about the efficacy and safety of herbal medicines are clearly not possible. Recent publications have also highlighted the unintended consequences of herbal product use, including morbidity and mortality. It has been found that many phytochemicals have pharmacokinetic or pharmacodynamic interactions with drugs. The present review is limited to some herbal medicines that are native or cultivated in Mexico and that have significant use. We discuss the cultural uses, phytochemistry, pharmacological, and toxicological properties of the following plant species: nopal (Opuntia ficus), peppermint (Mentha piperita), chaparral (Larrea divaricata), dandlion (Taraxacum officinale), mullein (Verbascum densiflorum), chamomile (Matricaria recutita), nettle or stinging nettle (Urtica dioica), passionflower (Passiflora incarnata), linden flower (Tilia europea), and aloe (Aloe vera). We conclude that our knowledge of the therapeutic benefits and risks of some herbal medicines used in Mexico is still limited and efforts to elucidate them should be intensified

  1. Benefits and risks associated with genetically modified food products.

    Science.gov (United States)

    Kramkowska, Marta; Grzelak, Teresa; Czyżewska, Krystyna

    2013-01-01

    Scientists employing methods of genetic engineering have developed a new group of living organisms, termed 'modified organisms', which found application in, among others, medicine, the pharmaceutical industry and food distribution. The introduction of transgenic products to the food market resulted in them becoming a controversial topic, with their proponents and contestants. The presented study aims to systematize objective data on the potential benefits and risks resulting from the consumption of transgenic food. Genetic modifications of plants and animals are justified by the potential for improvement of the food situation worldwide, an increase in yield crops, an increase in the nutritional value of food, and the development of pharmaceutical preparations of proven clinical significance. In the opinions of critics, however, transgenic food may unfavourably affect the health of consumers. Therefore, particular attention was devoted to the short- and long-lasting undesirable effects, such as alimentary allergies, synthesis of toxic agents or resistance to antibiotics. Examples arguing for the justified character of genetic modifications and cases proving that their use can be dangerous are innumerable. In view of the presented facts, however, complex studies are indispensable which, in a reliable way, evaluate effects linked to the consumption of food produced with the application of genetic engineering techniques. Whether one backs up or negates transgenic products, the choice between traditional and non-conventional food remains to be decided exclusively by the consumers.

  2. Benefits and risks associated with genetically modified food products

    Directory of Open Access Journals (Sweden)

    Marta Kramkowska

    2013-09-01

    Full Text Available Scientists employing methods of genetic engineering have developed a new group of living organisms, termed ‘modified organisms’, which found application in, among others, medicine, the pharmaceutical industry and food distribution. The introduction of transgenic products to the food market resulted in them becoming a controversial topic, with their proponents and contestants. The presented study aims to systematize objective data on the potential benefits and risks resulting from the consumption of transgenic food. Genetic modifications of plants and animals are justified by the potential for improvement of the food situation worldwide, an increase in yield crops, an increase in the nutritional value of food, and the development of pharmaceutical preparations of proven clinical significance. In the opinions of critics, however, transgenic food may unfavourably affect the health of consumers. Therefore, particular attention was devoted to the short- and long-lasting undesirable effects, such as alimentary allergies, synthesis of toxic agents or resistance to antibiotics. Examples arguing for the justified character of genetic modifications and cases proving that their use can be dangerous are innumerable. In view of the presented facts, however, complex studies are indispensable which, in a reliable way, evaluate effects linked to the consumption of food produced with the application of genetic engineering techniques. Whether one backs up or negates transgenic products, the choice between traditional and non-conventional food remains to be decided exclusively by the consumers.

  3. Genetically modified organisms: do the benefits outweigh the risks?

    Science.gov (United States)

    Hug, Kristina

    2008-01-01

    The objective of this literature review is to analyze the implications of using genetically modified organisms (GMOs) as well as international and European position regarding such organisms. Review of international and European legal requirements and ethical guidelines and relevant publications, found and accessed with the help of PubMed and Lund University Library databases. The article discusses the main application areas of GMOs, the expansion of using GMOs in the world as well as the advantages and disadvantages of the implications of their usage. It further provides an overview of the suggested ways to tackle or avoid the GMO-related risks. The international and European positions regarding the application of GMOs are discussed and European Directives, Regulations, and ethical guidelines are overviewed. The article further presents the public attitudes towards GMOs in Europe as well as overviews surveys conducted at the national level. Suggested steps to tackle the challenge of developing and managing biotechnology for the benefit of public health and the environment are presented.

  4. How to Decide on Modeling Details: Risk and Benefit Assessment.

    Science.gov (United States)

    Özilgen, Mustafa

    Mathematical models based on thermodynamic, kinetic, heat, and mass transfer analysis are central to this chapter. Microbial growth, death, enzyme inactivation models, and the modeling of material properties, including those pertinent to conduction and convection heating, mass transfer, such as diffusion and convective mass transfer, and thermodynamic properties, such as specific heat, enthalpy, and Gibbs free energy of formation and specific chemical exergy are also needed in this task. The origins, simplifying assumptions, and uses of model equations are discussed in this chapter, together with their benefits. The simplified forms of these models are sometimes referred to as "laws," such as "the first law of thermodynamics" or "Fick's second law." Starting to modeling a study with such "laws" without considering the conditions under which they are valid runs the risk of ending up with erronous conclusions. On the other hand, models started with fundamental concepts and simplified with appropriate considerations may offer explanations for the phenomena which may not be obtained just with measurements or unprocessed experimental data. The discussion presented here is strengthened with case studies and references to the literature.

  5. EXTERNAL VALIDATION OF THE DIABETES EARLY READMISSION RISK INDICATOR (DERRI™).

    Science.gov (United States)

    Rubin, Daniel J; Recco, Dominic; Turchin, Alexander; Zhao, Huaqing; Golden, Sherita Hill

    2018-04-06

    The Diabetes Early Readmission Risk Indicator (DERRI ™ ) was previously developed and internally validated as a tool to predict the risk of all-cause readmission within 30 days of discharge (30-d readmission) of hospitalized patients with diabetes. In this study, the predictive performance of the DERRI ™ with and without additional predictors was assessed in an external sample. We conducted a retrospective cohort study of adult patients with diabetes discharged from 2 academic medical centers between 1/1/2000 and 12/31/2014. We applied the previously developed DERRI ™ , which includes admission laboratory results, sociodemographics, a diagnosis of certain comorbidities, and recent discharge information, and evaluated the effect of adding metabolic indicators on predictive performance using multivariable logistic regression. Total cholesterol and A1c were selected based on clinical relevance and univariate association with 30-d readmission. Among 105,974 discharges, 19,032 (18.0%) were followed by 30-d readmission for any cause. The DERRI ™ had a C-statistic of 0.634 for 30-d readmission. Total cholesterol (TC) was the lipid parameter most strongly associated with 30-d readmission. The DERRI ™ predictors, A1c, and TC were significantly associated with 30-d readmission; however, their addition to the DERRI ™ did not significantly change model performance (C-statistic 0.643 [95% CI, 0.638-0.647], p=0.92). Performance of the DERRI ™ in this external cohort was modest but comparable to other readmission prediction models. Addition of A1c and TC to the DERRI ™ did not significantly improve performance. Although the DERRI ™ may be useful to direct resources toward diabetes patients at higher risk, better prediction is needed. DERRI = Diabetes Early Readmission Risk Indicator; TC = Total cholesterol; A1c = hemoglobin A1c; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; DKA = diabetic ketoacidosis; HHS

  6. Association of clopidogrel treatment with risk of mortality and cardiovascular events following myocardial infarction in patients with and without diabetes

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Lyngbæk, Stig; Nguyen, Cu Dinh

    2012-01-01

    Pharmacodynamic studies have shown that persistently high platelet reactivity is common in patients with diabetes in spite of clopidogrel treatment. Clinical trials have not convincingly demonstrated that clopidogrel benefits patients with diabetes as much patients without diabetes....

  7. Risk predictive modelling for diabetes and cardiovascular disease.

    Science.gov (United States)

    Kengne, Andre Pascal; Masconi, Katya; Mbanya, Vivian Nchanchou; Lekoubou, Alain; Echouffo-Tcheugui, Justin Basile; Matsha, Tandi E

    2014-02-01

    Absolute risk models or clinical prediction models have been incorporated in guidelines, and are increasingly advocated as tools to assist risk stratification and guide prevention and treatments decisions relating to common health conditions such as cardiovascular disease (CVD) and diabetes mellitus. We have reviewed the historical development and principles of prediction research, including their statistical underpinning, as well as implications for routine practice, with a focus on predictive modelling for CVD and diabetes. Predictive modelling for CVD risk, which has developed over the last five decades, has been largely influenced by the Framingham Heart Study investigators, while it is only ∼20 years ago that similar efforts were started in the field of diabetes. Identification of predictive factors is an important preliminary step which provides the knowledge base on potential predictors to be tested for inclusion during the statistical derivation of the final model. The derived models must then be tested both on the development sample (internal validation) and on other populations in different settings (external validation). Updating procedures (e.g. recalibration) should be used to improve the performance of models that fail the tests of external validation. Ultimately, the effect of introducing validated models in routine practice on the process and outcomes of care as well as its cost-effectiveness should be tested in impact studies before wide dissemination of models beyond the research context. Several predictions models have been developed for CVD or diabetes, but very few have been externally validated or tested in impact studies, and their comparative performance has yet to be fully assessed. A shift of focus from developing new CVD or diabetes prediction models to validating the existing ones will improve their adoption in routine practice.

  8. Lipoprotein(a) and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Mora, Samia; Kamstrup, Pia R; Rifai, Nader

    2010-01-01

    BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp......(a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass...... index, hemoglobin A(1c) (Hb A(1c)), C-reactive protein, and lipids. RESULTS: Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01), 0.80 (0.68-0.93), 0.88 (0.76-1.02), and 0.78 (0.67-0.91); P...

  9. Lipoprotein(a) and risk of type 2 diabetes

    DEFF Research Database (Denmark)

    Mora, S.; Kamstrup, Pia R; Rifai, N.

    2010-01-01

    (a) concentrations and incident type 2 diabetes (n = 1670) for a follow-up period of 13 years. We confirmed our findings in 9652 Danish men and women with prevalent diabetes (n = 419). Analyses were adjusted for risk factors that included age, race, smoking, hormone use, family history, blood pressure, body mass......BACKGROUND: Previous studies have demonstrated that cardiovascular risk is higher with increased lipoprotein (a) [Lp(a)]. Whether Lp(a) concentration is related to type 2 diabetes is unclear. METHODS: In 26 746 healthy US women (mean age 54.6 years), we prospectively examined baseline Lp...... index, hemoglobin A(1c) (Hb A(1c)), C-reactive protein, and lipids. RESULTS: Lp(a) was inversely associated with incident diabetes, with fully adjusted hazard ratios (HRs) and 95% CIs for quintiles 2-5 vs quintile 1 of 0.87 (0.75-1.01), 0.80 (0.68-0.93), 0.88 (0.76-1.02), and 0.78 (0.67-0.91); P...

  10. Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women's Health Initiative.

    Science.gov (United States)

    LeBlanc, Erin S; Kapphahn, Kristopher; Hedlin, Haley; Desai, Manisha; Parikh, Nisha I; Liu, Simin; Parker, Donna R; Anderson, Matthew; Aroda, Vanita; Sullivan, Shannon; Woods, Nancy F; Waring, Molly E; Lewis, Cora E; Stefanick, Marcia

    2017-01-01

    The aim of the study was to understand the association between women's reproductive history and their risk of developing type 2 diabetes. We hypothesized that characteristics signifying lower cumulative endogenous estrogen exposure would be associated with increased risk. Prospective cohort analysis of 124,379 postmenopausal women aged 50 to 79 years from the Women's Health Initiative (WHI). We determined age of menarche and final menstrual period, and history of irregular menses from questionnaires at baseline, and calculated reproductive length from age of menarche and final menstrual period. Presence of new onset type 2 diabetes was from self-report. Using multivariable Cox proportional hazards models, we assessed associations between reproductive variables and incidence of type 2 diabetes. In age-adjusted models, women with the shortest (<30 y) reproductive periods had a 37% (95% CI, 30-45) greater risk of developing type 2 diabetes than women with medium-length reproductive periods (36-40 y). Women with the longest (45+ y) reproductive periods had a 23% (95% CI, 12-37) higher risk than women with medium-length periods. These associations were attenuated after full adjustment (HR 1.07 [1.01, 1.14] for shortest and HR 1.09 [0.99, 1.22] for longest, compared with medium duration). Those with a final menstrual period before age 45 and after age 55 had an increased risk of diabetes (HR 1.04; 95% CI, 0.99-1.09 and HR 1.08; 95% CI, 1.01-1.14, respectively) compared to those with age of final menstrual period between 46 and 55 years. Timing of menarche and cycle regularity was not associated with risk after full adjustment. Reproductive history may be associated with type 2 diabetes risk. Women with shorter and longer reproductive periods may benefit from lifestyle counseling to prevent type 2 diabetes.

  11. Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit?

    Science.gov (United States)

    Crosby, David A; Ryan, Kevin; McEniff, Niall; Dicker, Patrick; Regan, Carmen; Lynch, Caoimhe; Byrne, Bridgette

    2018-03-01

    Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother. The objective of this study was to determine the efficacy and safety of these devices in pregnancy and to compare these with rates reported in the general population. The aim of this study was report three recent cases of retrievable IVC filter use in pregnant women in our department and to perform a systematic review of the literature to identify published cases of filters in pregnancy. The efficacy and complication rates of these devices in pregnancy were estimated and compared to rates reported in the general population in a recent review [2]. Fisher's exact test was used for statistical analysis. In addition to our three cases, 16 publications were identified with retrievable IVC filter use in 40 pregnant women resulting in a total of 43 cases. There was no pulmonary embolus in the pregnant group (0/43) compared to 57/6291 (0.9%) in the general population. Thrombosis of the filter (2.3% vs. 0.9%, p = 0.33) and perforation of the IVC (7.0% vs 4.4%, p = 0.44) were more common in pregnancy compared to the general population but the difference was not statistically significant. Failure to retrieve the filter is more likely to occur in pregnancy (26% vs. 11%, p = 0.006) but this did not correlate with the type of device (p = 0.61), duration of insertion (p = 0.58) or mode of delivery (p = 0.37). Data for retrievable IVC filters in pregnancy is limited and there may be a publication bias towards complicated cases. This study

  12. Outcomes of combined cardiovascular risk factor management strategies in type 2 diabetes: the ACCORD randomized trial.

    Science.gov (United States)

    Margolis, Karen L; O'Connor, Patrick J; Morgan, Timothy M; Buse, John B; Cohen, Robert M; Cushman, William C; Cutler, Jeffrey A; Evans, Gregory W; Gerstein, Hertzel C; Grimm, Richard H; Lipkin, Edward W; Narayan, K M Venkat; Riddle, Matthew C; Sood, Ajay; Goff, David C

    2014-06-01

    To compare effects of combinations of standard and intensive treatment of glycemia and either blood pressure (BP) or lipids in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. ACCORD enrolled 10,251 type 2 diabetes patients aged 40-79 years at high risk for cardiovascular disease (CVD) events. Participants were randomly assigned to hemoglobin A1c goals of risk of the primary outcome was lower in the groups intensively treated for glycemia (hazard ratio [HR] 0.67; 95% CI 0.50-0.91), BP (HR 0.74; 95% CI 0.55-1.00), or both (HR 0.71; 95% CI 0.52-0.96) compared with combined standard BP and glycemia treatment. For secondary outcomes, MI was significantly reduced by intensive glycemia treatment and stroke by intensive BP treatment; most other HRs were neutral or favored intensive treatment groups. In the lipid trial, the general pattern of results showed no evidence of benefit of intensive regimens (whether single or combined) compared with combined standard lipid and glycemia treatment. The mortality HR was 1.33 (95% CI 1.02-1.74) in the standard lipid/intensive glycemia group compared with the standard lipid/standard glycemia group. In the ACCORD BP trial, compared with combined standard treatment, intensive BP or intensive glycemia treatment alone improved major CVD outcomes, without additional benefit from combining the two. In the ACCORD lipid trial, neither intensive lipid nor glycemia treatment produced an overall benefit, but intensive glycemia treatment increased mortality. © 2014 by the American Diabetes Association.

  13. Benefits of statin therapy and compliance in high risk cardiovascular patients

    Directory of Open Access Journals (Sweden)

    Joel A Lardizabal

    2010-09-01

    Full Text Available Joel A Lardizabal1, Prakash C Deedwania21Division of Cardiology, Department of Medicine, University of California in San Francisco (Fresno-MEP, Fresno, CA, USA; 2University of California in San Francisco, Chief of Cardiology, Veterans Affairs Central California System, Fresno, CA, USAAbstract: Cardiovascular disease (CVD remains the top cause of global mortality. There is considerable evidence that supports the mortality and morbidity benefit of statin therapy in coronary heart disease (CHD and stroke, both in primary and secondary prevention settings. Data also exist pointing to the advantage of statin treatment in other high-risk CVD conditions, such as diabetes, CKD, CHF, and PVD. National and international clinical guidelines in the management of these CVD conditions all advocate for the utilization of statin therapy in appropriate patients. However, overall compliance to statin therapy remains suboptimal. Patient-, physician-, and economic-related factors all play a role. These factors need to be considered in devising approaches to enhance adherence to guideline-based therapies. To fully reap the benefits of statin therapy, interventions which improve long-term treatment compliance in real-world settings should be encouraged.Keywords: cardiovascular disease, statin therapy, coronary heart disease, long-term treatment compliance

  14. Mitochondrial Haplogroups Modify the Effect of Diabetes Duration and HbA1c on Proliferative Diabetic Retinopathy Risk in Patients With Type 2 Diabetes.

    Science.gov (United States)

    Mitchell, Sabrina L; Neininger, Abigail C; Bruce, Carleigh N; Chocron, Isaac M; Bregman, Jana A; Estopinal, Christopher B; Muhammad, Ayesha; Umfress, Allison C; Jarrell, Kelli L; Warden, Cassandra; Harlow, Paula A; Wellons, Melissa; Samuels, David C; Brantley, Milam A

    2017-12-01

    We previously demonstrated an association between European mitochondrial haplogroups and proliferative diabetic retinopathy (PDR). The purpose of this study was to determine how the relationship between these haplogroups and both diabetes duration and hyperglycemia, two major risk factors for diabetic retinopathy (DR), affect PDR prevalence. Our population consisted of patients with type 2 diabetes with (n = 377) and without (n = 480) DR. A Kruskal-Wallis test was used to compare diabetes duration and hemoglobin A1c (HbA1c) among mitochondrial haplogroups. Logistic regressions were performed to investigate diabetes duration and HbA1c as risk factors for PDR in the context of European mitochondrial haplogroups. Neither diabetes duration nor HbA1c differed among mitochondrial haplogroups. Among DR patients from haplogroup H, longer diabetes duration and increasing HbA1c were significant risk factors for PDR (P = 0.0001 and P = 0.011, respectively). Neither diabetes duration nor HbA1c was a significant risk factor for PDR in DR patients from haplogroup UK. European mitochondrial haplogroups modify the effects of diabetes duration and HbA1c on PDR risk in patients with type 2 diabetes. In our patient population, longer diabetes duration and higher HbA1c increased PDR risk in patients from haplogroup H, but did not affect PDR risk in patients from haplogroup UK. This relationship has not been previously demonstrated and may explain, in part, why some patients with nonproliferative DR develop PDR and others do not, despite similar diabetes duration and glycemic control.

  15. Beverage-consumption patterns and associations with metabolic risk factors among low-income Latinos with uncontrolled type 2 diabetes.

    Science.gov (United States)

    Wang, Monica L; Lemon, Stephenie C; Olendzki, Barbara; Rosal, Milagros C

    2013-12-01

    In the United States, Latinos experience disproportionately higher rates of type 2 diabetes and diabetes-related complications than non-Latino whites. Sugar-sweetened beverage (SSB) consumption is strongly associated with increased risk of developing type 2 diabetes. Reducing caloric intake, particularly from energy-dense, low-nutrient foods or beverages, can be an effective and key strategy for metabolic and weight control. However, little is known about the contribution of various types of beverages, including but not limited to SSBs, to total caloric intake among Latinos with type 2 diabetes. Low-income Latinos (87.7% Puerto Rican) participating in a diabetes self-management intervention trial (N=238) provided cross-sectional, descriptive data on beverage-consumption patterns, anthropometric outcomes, and metabolic characteristics. Beverages accounted for one fifth of the total daily caloric intake. SSBs and milk beverages, respectively, contributed 9.6% of calories to overall daily caloric intake. Interventions directed at diabetes risk factors among low-income Latinos with diabetes can benefit from consideration of beverage-consumption behaviors as an important strategy to reduce caloric and sugar intake. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  16. Perceived Versus Actual Risk of Type 2 Diabetes by Race and Ethnicity.

    Science.gov (United States)

    Yang, Kyeongra; Baniak, Lynn M; Imes, Christopher C; Choi, JiYeon; Chasens, Eileen R

    2018-04-01

    Purpose The purpose of this study was to examine associations between perceived risk and actual risk of type 2 diabetes by race and/or ethnicity. Methods The study sample included 10 999 adults from the 2011 to 2014 National Health and Nutrition Examination Survey. Sociodemographic, clinical, and behavioral data were collected using interviews and physical examinations. Participants were asked if they felt at risk for diabetes or prediabetes and then asked the reasons why. Data analyses were conducted with SAS to properly analyze complex survey data. Results About 86% of the sample (n = 9496) answered the risk perception question for diabetes, and among those, 28.4% indicated having a high perceived risk. Among this subsample, 38.3% were identified as having an actual risk for prediabetes or diabetes according to the American Diabetes Association guidelines. Across all race groups, the most frequently reported risk factors participants believed to contribute to their risk for diabetes were family history of diabetes, obesity, and poor diet habits. When the percentage of participants with an actual risk factor who correctly perceived it as a risk factor was examined, fewer Asians correctly perceived weight status and physical activity level as a risk for diabetes in contrast to the other racial/ethnic groups. Conclusions Our study showed that when perception was compared to actual risks, associations differed statistically by race. It will be essential to discuss their risk perception to proper screening for diabetes and relevant lifestyle modifications to prevent and delay the onset of diabetes.

  17. Prevalence of Diabetes and Pre-Diabetes and Associated Risk Factors among Tuberculosis Patients in India

    Science.gov (United States)

    Viswanathan, Vijay; Kumpatla, Satyavani; Aravindalochanan, Vigneswari; Rajan, Rajeswari; Chinnasamy, C.; Srinivasan, Rajan; Selvam, Jerard Maria; Kapur, Anil

    2012-01-01

    Background Diabetes mellitus (DM) is recognised as an important risk factor to tuberculosis (TB). India has high TB burden, along with rising DM prevalence. There are inadequate data on prevalence of DM and pre-diabetes among TB cases in India. Aim was to determine diabetes prevalence among a cohort of TB cases registered under Revised National Tuberculosis Control Program in selected TB units in Tamil Nadu, India, and assess pattern of diabetes management amongst known cases. Methods 827 among the eligible patients (n = 904) underwent HbA1c and anthropometric measurements. OGTT was done for patients without previous history of DM and diagnosis was based on WHO criteria. Details of current treatment regimen of TB and DM and DM complications, if any, were recorded. A pretested questionnaire was used to collect information on sociodemographics, habitual risk factors, and type of TB. Findings DM prevalence was 25.3% (95% CI 22.6–28.5) and that of pre-diabetes 24.5% (95% CI 20.4–27.6). Risk factors associated with DM among TB patients were age (31–35, 36–40, 41–45, 46–50, >50 years vs 50 years vs <30 years) [2.24 (1.1–4.55) (p = 0.026); 6.96 (3.3–14.7); 3.44 (1.83–6.48); 4.3 (2.25–8.2) (p<0.001)], waist circumference [<90 vs. ≥90 cm (men), <80 vs. ≥80 cm (women)] [3.05 (1.35–6.9) (p = 0.007)], smoking [1.92 (1.12–3.28) (p = 0.017)] and monthly income (5000–10,000 INR vs <5000 INR) [0.59 (0.37–0.94) (p = 0.026)]. DM risk was higher among pulmonary TB [3.06 (1.69–5.52) (p<0.001)], especially sputum positive, than non-pulmonary TB. Interpretation Nearly 50% of TB patients had either diabetes or pre-diabetes. PMID:22848473

  18. Evaluation of Risk Versus Benefit Information in Direct-To-Consumer (DTC) Prescription Drug Television Advertisements.

    Science.gov (United States)

    Fahim, Germin; Toscani, Michael; Barone, Joseph A; Wang, Chris; Gandhi, Shivani

    2018-01-01

    The FDA's Presenting Risk Information draft guidance from May 2009 states that the time of risk versus benefit is a factor taken into consideration when evaluating audio and video direct-to-consumer (DTC) broadcasts. The objective of the study is to evaluate the proportion of risk narration on television (TV) advertisements in comparison to the actual proportion of serious adverse effects findings across select therapeutic areas. The study reviews prescription drug TV advertisements between the years 2010 and 2015 separated by therapeutic class. Indicators to assess risk versus benefit are as follows: total benefit time, total risk time, total ad time, percentage proportion of risk, and number of serious adverse effects (SAEs) listed in the package insert. The objective is establishing proportion of risk-to-benefit narration across therapeutic areas and the proportion of risk narration compared to the number of SAEs in the package insert. These outcomes will reflect whether TV advertisements abide by the "fair balance" rule and if the time spent on risk narrations is proportional to the number of SAEs across therapeutic areas. An analysis of risk versus benefit showed that there was a vast range of percentage differences in risk versus benefit narration across the products selected. The majority of the products narrated showed a 40% to 60% risk-to-benefit ratio. Six out of the 10 products evaluated communicated applicable black box warnings. There was variability among the SAE percentages presented between products. Lack of consistency exists between risks versus benefit proportions among different drug products.

  19. Comparative performance of diabetes-specific and general population-based cardiovascular risk assessment models in people with diabetes mellitus.

    Science.gov (United States)

    Echouffo-Tcheugui, J-B; Kengne, A P

    2013-10-01

    Multivariable models for estimating cardiovascular disease (CVD) risk in people with diabetes comprise general population-based models and those from diabetic cohorts. Whether one set of models should receive preference is unclear. We evaluated the evidence on direct comparisons of the performance of general population vs diabetes-specific CVD risk models in people with diabetes. MEDLINE and EMBASE databases were searched up to March 2013. Two reviewers independently identified studies that compared the performance of general CVD models vs diabetes-specific ones in the same group of people with diabetes. Independent, dual data extraction on study design, risk models, outcomes; and measures of performance was conducted. Eleven articles reporting on 22 pair wise comparisons of a diabetes-specific model (UKPDS, ADVANCE and DCS risk models) to a general population model (three variants of the Framingham model, Prospective Cardiovascular Münster [PROCAM] score, CardioRisk Manager [CRM], Joint British Societies Coronary Risk Chart [JBSRC], Progetto Cuore algorithm and the CHD-Riskard algorithm) were eligible. Absolute differences in C-statistic of diabetes-specific vs general population-based models varied from -0.13 to 0.09. Comparisons for other performance measures were unusual. Outcomes definitions were congruent with those applied during model development. In 14 comparisons, the UKPDS, ADVANCE or DCS diabetes-specific models were superior to the general population CVD risk models. Authors reported better C-statistic for models they developed. The limited existing evidence suggests a possible discriminatory advantage of diabetes-specific over general population-based models for CVD risk stratification in diabetes. More robust head-to-head comparisons are needed to confirm this trend and strengthen recommendations. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

    Directory of Open Access Journals (Sweden)

    Ashraf Soliman

    2014-01-01

    Full Text Available Continuous glucose monitoring (CGM systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT and measurement of glycated hemoglobin (HbA1C in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO, gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS, and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

  1. HEART FAILURE, DIABETES, BETA-BLOCKERS AND RISK OF HYPOGLYCEMIA

    Directory of Open Access Journals (Sweden)

    A. A. Aleksandrov

    2008-01-01

    Full Text Available Aim. To evaluate an influence of carvedilol on risk of hypoglycemia in patients with diabetes type 2 (D2 and chronic heart failure (CHF treated with angiotensin converting enzyme (ACE inhibitors.Material and methods. 13 patients (10 men, 3 women; aged 59,8±6,7 y.o. with D2 and CHF caused by ischemic heart disease were included in the study. Before inclusion all patients were treated with ACE inhibitors and various beta-blockers (atenolol, metoprolol, bisoprolol. These beta-blockers were changed for carvedilol. Heart ultrasonography, blood pressure control, glycemia monitoring, HbA1c level determination were performed before, during and after carvedilol therapy.Results. Carvedilol reduces frequency and duration of hypoglycaemia episodes. There were not episodes of severe hypoglycaemia during carvedilol therapy.Conclusion. Carvedilol reduces risk of hypoglycemia when it is used in combination with ACE inhiditors in diabetic patients with CHF.

  2. H. pylori seroprevalence and risk of diabetes: An ancillary case-control study nested in the diabetes prevention program.

    Science.gov (United States)

    Alzahrani, Saud; Nelson, Jason; Moss, Steven F; Paulus, Jessica K; Knowler, William C; Pittas, Anastassios G

    2017-10-01

    To determine the association between H. pylori infection and risk of incident diabetes in adults at high risk for diabetes who participated in the Diabetes Prevention Program (DPP) study. In a nested case-control study conducted among 421 adults with newly diagnosed diabetes and 421 matched controls, we examined the association between serological status of H. pylori at baseline and risk of incident diabetes over a mean follow-up period of 2.6years. Using data from the baseline visit of the DPP, we also examined the cross-sectional association between presence of H. pylori antibodies and insulin sensitivity, insulin secretion and the disposition index-like measure after a 75-g oral glucose tolerance test (OGTT). At baseline, H. pylori antibodies were present in 40% of participants who developed diabetes and 39% of controls. After adjusting for matching factors, there was no association between exposure to H. pylori and incident diabetes (odds ratio [OR] of 1.04 (95% CI, 0.77 to 1.40). In cross-sectional analyses, H. pylori status was not significantly associated with insulin sensitivity and disposition index-like measure from OGTT. In adults at high risk for diabetes, H. pylori seropositivity was not associated with risk of developing diabetes. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective.

    Science.gov (United States)

    Zhu, Yeyi; Zhang, Cuilin

    2016-01-01

    Despite the increasing epidemic of diabetes mellitus affecting populations at different life stages, the global burden of gestational diabetes mellitus (GDM) is not well assessed. Systematically synthesized data on global prevalence estimates of GDM are lacking, particularly among developing countries. The hyperglycemic intrauterine environment as exemplified in pregnancies complicated by GDM might not only reflect but also fuel the epidemic of type 2 diabetes mellitus (T2DM). We comprehensively reviewed available data in the past decade in an attempt to estimate the contemporary global prevalence of GDM by country and region. We reviewed the risk of progression from GDM to T2DM as well. Synthesized data demonstrate wide variations in both prevalence estimates of GDM and the risk of progression from GDM to T2DM. Direct comparisons of GDM burden across countries or regions are challenging given the great heterogeneity in screening approaches, diagnostic criteria, and underlying population characteristics. In this regard, collaborative efforts to estimate global GDM prevalence would be a large but important leap forward. Such efforts may have substantial public health implications in terms of informing health policy makers and healthcare providers for disease burden and for developing more targeted and effective diabetes prevention and management strategies globally.

  4. Prevalence and Risk Factors of Diabetic Nephropathy in Omani Type 2 Diabetics in Al-Dakhiliyah Region

    Directory of Open Access Journals (Sweden)

    Abdulhakeem Hamood Alrawahi

    2012-05-01

    Full Text Available Objective: To assess the prevalence and risk factors of diabetic nephropathy among Omani type 2 diabetics in Al-Dakhiliyah region of the Sultanate of Oman.Methods: A cross-sectional and a case control study designs were used to assess the prevalence and risk factors respectively. For the prevalence study a sample of 699 diabetic subjects were selected randomly from two polyclinics in Al-Dakhiliyah region; Sumail and Nizwa polyclinics. For the case control study, a sample consisting of 215 cases and 358 controls were randomly selected from those who were included in the cross-sectional study. A well designed questionnaire has been used to collect data regarding the disease and risk factors. Data was analyzed using SPSS19 statistical program.Results: Total prevalence of diabetic nephropathy was calculated as 42.5% (95% C.I: 38.83% - 46.15%. The difference in the prevalence in the two polyclinic catchment area was not significant. The prevalence was significantly higher among males (51.6% compared to females (36.5%. Crude analysis of the risk factors showed significant association between diabetic nephropathy and the following factors; male gender, decreased literacy, long duration of diabetes mellitus, hypertension, retinopathy, neuropathy, family history of diabetic nephropathy, poor glycemic control (high HbA1c, and hypertriglyceridemia. Multivariate analysis showed the following factors to be independent risk factors; male gender, decreased literacy, long duration of diabetes, family history of diabetic nephropathy and poor glycaemic control (high HbA1c.Conclusion: The prevalence of diabetic nephropathy in this study was 42.5% and the significant risk factors associated with it included male gender, decreased literacy, long duration of diabetes, family history of diabetic nephropathy and poor glycemic control (high HbA1c.

  5. Why Weight? An Analytic Review of Obesity Management, Diabetes Prevention, and Cardiovascular Risk Reduction.

    Science.gov (United States)

    Igel, L I; Saunders, K H; Fins, J J

    2018-05-21

    In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management. This includes broader coverage of anti-diabetic medications with evidence of cardiovascular risk reduction and mortality benefit, anti-obesity pharmacotherapy, bariatric surgery, weight loss devices, endoscopic bariatric therapies, and lifestyle interventions for the treatment of obesity. The fundamental question to ask is why weight? Why wait to go after obesity until its end-stage sequelae cause intractable conditions? Instead of managing the complications of T2DM, consider preventing them by tackling obesity.

  6. Type 2 Diabetes Mellitus and Increased Risk for Malaria Infection

    Centers for Disease Control (CDC) Podcasts

    2010-09-23

    This podcast describes research done in Ghana examining a correlation between type 2 diabetes and a possible increased risk for malaria infection in adults. Dr. Manoj Menon, a medical officer in the Division of Parasitic Diseases and Malaria in the Center for Global Health, discusses questions the study raises.  Created: 9/23/2010 by National Center for Emerging and Zoonotic Infectious Diseases; Center for Global Health.   Date Released: 9/23/2010.

  7. Intensive glucose control and risk of cancer in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Stefansdottir, G; Zoungas, S; Chalmers, J

    2011-01-01

    AIMS/HYPOTHESIS: Type 2 diabetes has been associated with an increased risk of cancer. This study examines the effect of more vs less intensive glucose control on the risk of cancer in patients with type 2 diabetes. METHODS: All 11,140 participants from the Action in Diabetes and Vascular Disease...

  8. Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals

    NARCIS (Netherlands)

    Bauer, Florianne; Beulens, Joline W. J.; van der A, Daphne L.; Wijmenga, Cisca; Grobbee, Diederick E.; Spijkerman, Annemieke M. W.; van der Schouw, Yvonne T.; Onland-Moret, N. Charlotte

    Although overweight is an important determinant of diabetes risk, it remains unclear whether food choices can still influence the risk for type 2 diabetes in overweight persons. In this paper, we aim to clarify the role of dietary patterns in the development of type 2 diabetes in overweight and

  9. Diabetes, fasting glucose levels, and risk of ischemic stroke and vascular events: findings from the Northern Manhattan Study (NOMAS).

    Science.gov (United States)

    Boden-Albala, Bernadette; Cammack, Sam; Chong, Ji; Wang, Culing; Wright, Clinton; Rundek, Tatjana; Elkind, Mitchell S V; Paik, Myunghee C; Sacco, Ralph L

    2008-06-01

    There is insufficient randomized trial data to support evidence-based recommendations for tight control of fasting blood glucose (FBG) among diabetic subjects in primary stroke prevention. We explored the relationship between FBG among diabetic subjects and risk of ischemic stroke in a multiethnic prospective cohort. Medical and social data and FBG values were collected for 3,298 stroke-free community residents: mean age +/- SD was 69 +/-10 years; 63% were women, 21% were white, 24% were black, and 53% were Hispanic; and follow-up was 6.5 years. Baseline FBG levels were categorized: 1) elevated FBG: history of diabetes and FBG >or=126 mg/dl (7.0 mmol/l); 2) target FBG: history of diabetes and FBG benefits of tighter glucose control for primary stroke prevention.

  10. Comparative risk perception: how the public perceives the risks and benefits of energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, K [Open Univ., Milton Keynes (UK)

    1981-04-30

    The view of risk perception adopted in this paper focuses on how individuals define, and hence feel about, the outcomes of a risk issue. Perception of risk is seen as encompassing a variety of attributes of a risk issue including wider beliefs that permit a risk benefit trade-off. A survey of beliefs and attitudes of the general public toward the use of various energy systems (coal, oil, hydro, solar and nuclear energy) was carried out in Austria at a time of increasing concern with energy strategies and the controversy surrounding Austria's first nuclear energy plant. The results are analysed. In general, energy systems were found to be associated with only environmental risk; however, nuclear energy was an exception in that the public, whether in favour of nuclear energy or against, believed that it is also associated with psychological and physical risk. It was also found that the policy makers underestimated the public's negative feelings about the psychological risk dimension and their belief in its association with nuclear energy.

  11. Comparative risk perception: how the public perceives the risks and benefits of energy systems

    International Nuclear Information System (INIS)

    Thomas, K.

    1981-01-01

    The view of risk perception adopted in this paper focuses on how individuals define, and hence feel about, the outcomes of a risk issue. Perception of risk is seen as encompassing a variety of attributes of a risk issue including wider beliefs that permit a risk benefit trade-off. A survey of beliefs and attitudes of the general public toward the use of various energy systems (coal, oil, hydro, solar and nuclear energy) was carried out in Austria at a time of increasing concern with energy strategies and the controversy surrounding Austria's first nuclear energy plant. The results are analysed. In general, energy systems were found to be associated with only environmental risk; however, nuclear energy was an exception in that the public, whether in favour of nuclear energy or against, believed that it is also associated with psychological and physical risk. It was also found that the policy makers underestimated the public's negative feelings about the psychological risk dimension and their belief in its association with nuclear energy. (author)

  12. Nanotechnology: Scientific challenges and societal benefits and risks

    Science.gov (United States)

    Romig, A. D.

    2004-12-01

    The field of nanotechnology is developing rapidly, as are its practical application in society. In this article, we give examples that demonstrate the enormous potential that exists for this new class of materials, and for devices with critical dimensions of less than 100 nm. We also identify some of the challenges that need to be faced in order to fully realize the practical benefits of nanotechnology, and discuss possible risks that may come with this new technology. In all cases, the unique advantage of nanotechnology can be traced back to nanoscale physical and chemical properties that are quite different from those encountered in more traditional microscopic (micro) or macroscopic (macro) materials and devices. Unique nanoscale properties and behaviors are already being used to increase energy efficiency, improve healthcare, and strengthen national security. However, while progress is rapid, many challenges remain. These include manufacturing at the nanoscale, integration of nanoscale materials and devices with more conventional technology, and predictive modeling that will allow nanotechnology to be engineered reliably into useful applications and products. Nanotechnology can be expected to have an increasing impact on human lives and society at large. As we strive to use nanotechnology to improve human life through better healthcare, cleaner environment, and improved national security, we must also work to detect and assess the negative impacts that nanotechnology science (or any new technology) might bring. We suggest that the conduct of should be allowed to proceed unimpeded, so that we can fully understand and appreciate the rules of nature at the nanometer scale. That said, scientific pursuits that involve self-replication in synthetic systems, encryption, defense technology, or the enhancement of human intelligence should be reviewed. The development of new technology from fundamental science and the process of deciding what new technology is to be

  13. Risk Factors of Treatment Failure in Diabetic Foot Ulcer Patients

    Directory of Open Access Journals (Sweden)

    Kyung Mook Lee

    2013-03-01

    Full Text Available BackgroundSome diabetic feet heal without complication, but others undergo amputation due to progressive wounds. This study investigates the risk factors for amputation of diabetic feet.MethodsA total of 55 patients who visited our institution from 2008 to 2012 were included in the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, and poor nutrition were excluded from the study group, and the wound states were unified. The patients were categorized into a treatment success group (n=47 and a treatment failure group (n=8, and their hemoglobin A1C (HgA1C, C-reactive protein (CRP, white blood cell count (WBC, and serum creatinine levels were analyzed.ResultsThe initial CRP, WBC, and serum creatinine levels in the treatment failure group were significantly higher than that of the treatment success group, and the initial HgA1C level was significantly higher in the treatment success group. The CRP and WBC levels of both groups changed significantly as time passed, but their serum creatinine levels did not.ConclusionsThe initial CRP, WBC, and serum creatinine levels were considered to be risk factors for amputation. Among them, the serum creatinine level was found to be the most important predictive risk factor. Because serum creatinine represents the renal function, thorough care is needed for the feet of diabetic patients with renal impairment.

  14. [Identification of risk factors in relatives of type-2 diabetics].

    Science.gov (United States)

    Cuevas-Alvarez, Norma Angélica; Vela-Otero, Yolanda; Carrada-Brav, Teodoro

    2006-01-01

    To identify risk factors and warning signs in a sample of first-degree relatives of type-2 diabetics at the Family Medicine Unit 2 of the General Hospital in Irapuato, Guanajuato, Mexico. In a non-probabilistic sample of 360 relatives, a 14-item questionnaire was applied to measure abdominal perimeter and body mass index (obesity and overweight), eating habits, addictions and sedentarism. The questionnaire was made by general consent of experts, by applying Cronbach's alpha reliability coefficient. Specific rates of prevalence by sex and age groups were estimated. 233 (65%) relatives were females. As part of their family history background, arterial hypertension was recorded in 263 (73%) and acute myocardial infarction in 97 (27%). Among the dangerous food for health consumed by the relatives of diabetics are cola drinks in 94.7%, red meat in 83%, candies in 74.7% and chips in 65.8%; only half of them consumed fresh fruits and vegetables; a quarter of them ate prickly pears or whole wheat bread. There were 163 (45.3%) persons with high-risk abdominal perimeter, and sedentarism was present in 267 (74.2%). However, obesity was 3 times more frequent in females, but excessive drinking or smoking habits were 7 times more prevailing in males. A high-risk behavior was demonstrated among relativies of diabetic patients. Therefore, a public-health educational program is required to modify risky habits. A change towards prevention rather than cure is much needed in health staff.

  15. [A brief of gestational diabetes mellitus, risk factors and current criteria of diagnosis].

    Science.gov (United States)

    Al-Aissa, Zahra; Hadarits, Orsolya; Rosta, Klára; Zóka, András; Rigó, János; Firneisz, Gábor; Somogyi, Anikó

    2017-02-01

    Diabetes is one of the most common metabolic disorders that may cause pathological pregnancy. Treating diabetes recognized during pregnancy results in lowering maternal and fetal complications. These patients present higher risk for excessive weight gain, preeclampsia, delivery with cesarean sections, high risk of developing type 2 diabetes and cardiovascular disease in the future. Fetuses of mothers with gestational diabetes are at higher risk for macrosomia and birth trauma, after delivery they present higher risk of developing neonatal hypoglycemia, hyperbilirubinemia, and respiratory distress syndrome. There is still no consensus in the recommendations for the diagnosis of gestational diabetes mellitus by expert committees. Orv. Hetil., 2017, 158(8), 283-290.

  16. The affect heuristic, mortality salience, and risk: domain-specific effects of a natural disaster on risk-benefit perception.

    Science.gov (United States)

    Västfjäll, Daniel; Peters, Ellen; Slovic, Paul

    2014-12-01

    We examine how affect and accessible thoughts following a major natural disaster influence everyday risk perception. A survey was conducted in the months following the 2004 south Asian Tsunami in a representative sample of the Swedish population (N = 733). Respondents rated their experienced affect as well as the perceived risk and benefits of various everyday decision domains. Affect influenced risk and benefit perception in a way that could be predicted from both the affect-congruency and affect heuristic literatures (increased risk perception and stronger risk-benefit correlations). However, in some decision domains, self-regulation goals primed by the natural disaster predicted risk and benefit ratings. Together, these results show that affect, accessible thoughts and motivational states influence perceptions of risks and benefits. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  17. Place and health in diabetes: the neighbourhood environment and risk of depression in adults with type 2 diabetes.

    Science.gov (United States)

    Gariepy, G; Kaufman, J S; Blair, A; Kestens, Y; Schmitz, N

    2015-07-01

    Depression is a common co-illness in people with diabetes. Evidence suggests that the neighbourhood environment impacts the risk of depression, but few studies have investigated this effect in those with diabetes. We examined the effect of a range of neighbourhood characteristics on depression in people with Type 2 diabetes. This cohort study used five waves of data from 1298 participants with Type 2 diabetes from the Diabetes Health Study (2008-2013). We assessed depression using the Patient Health Questionnaire. We measured neighbourhood deprivation using census data; density of services using geospatial data; level of greenness using satellite imagery; and perceived neighbourhood characteristics using survey data. The effect of neighbourhood factors on risk of depression was estimated using survival analysis, adjusting for sociodemographic variables. We tested effect modification by age, sex and socio-economic characteristics using interaction terms. More physical activity facilities, cultural services and a greater level of greenness in the neighbourhood were associated with a lower risk of depression in our sample, even after adjusting for confounders. Material deprivation was associated with increased risk of depression, particularly in participants who were older or retired. Characteristics of neighbourhoods were associated with the risk of depression in people with Type 2 diabetes and there were vulnerable subgroups within this association. Clinicians are encouraged to consider the neighbourhood environment of their patients when assessing the risk of depression. Future intervention research is need for health policy recommendations. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  18. Type 2 diabetes after gestational diabetes: greater than fourfold risk among Indigenous compared with non-Indigenous Australian women.

    Science.gov (United States)

    Chamberlain, Catherine R; Oldenburg, Brian; Wilson, Alyce N; Eades, Sandra J; O'Dea, Kerin; Oats, Jeremy J N; Wolfe, Rory

    2016-02-01

    Gestational diabetes is associated with a high risk of type 2 diabetes. However, progression rates among Indigenous women in Australia who experience high prevalence of gestational diabetes are unknown. This retrospective cohort study includes all births to women at a regional hospital in Far North Queensland, Australia, coded as having 'gestational diabetes' from 1 January 2004 to 31 December 2010 (1098 births) and receiving laboratory postpartum screening from 1 January 2004 to 31 December 2011 (n = 483 births). Women who did not receive postpartum screening were excluded from the denominator. Data were linked between hospital electronic records, routinely collected birth data and laboratories, with sample validation by reviews of medical records. Analysis was conducted using Cox-proportional regression models. Indigenous women had a greater than fourfold risk of developing type 2 diabetes within 8 years of having gestational diabetes, compared with non-Indigenous women (hazards ratio 4.55, 95% confidence interval 2.63-7.88, p Australian women have a greater than fourfold risk of developing type 2 diabetes after gestational diabetes. Strategies are urgently needed to reduce rates of type 2 diabetes by supporting a healthy weight and breastfeeding and to improve postpartum screening among Indigenous women with gestational diabetes. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  19. A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.

    Science.gov (United States)

    Raju, G K; Gurumurthi, Karthik; Domike, Reuben; Kazandjian, Dickran; Landgren, Ola; Blumenthal, Gideon M; Farrell, Ann; Pazdur, Richard; Woodcock, Janet

    2018-01-01

    Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  20. The nutraceutical benefits of subfractions of Abelmoschus esculentus in treating type 2 diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Chien-Ning Huang

    Full Text Available Abelmoschus esculentus (AE, a commonly consumed vegetable, is well-known for its anti-hyperglycemic effects. However, few scientific reports have identified its targets because mucilage increases the difficulty of manipulation. We recently reported extraction steps to obtain subfractions of AE, which were found to attenuate the adverse effects of high glucose and fatty acid in vitro. In this study, we used modified extraction steps and type 2 diabetic rats to explore whether AE subfractions can improve the metabolic disturbances caused by insulin resistance in vivo. AE subfractions (F1, F2, and FR were prepared. The type 2 diabetes model was induced by feeding male Sprague-Dawley rats with a high-fat diet and injecting them with 35 mg/kgbw streptozotocin when their body weight reached 475 ± 15 g. After a hyperglycemic status had been confirmed, the rats were tube-fed with or without different doses of AE subfractions. Serum glucose, lipid markers, insulin, HbA1c and HOMA-IR were measured in the following 12 weeks. Serum glucose promptly increased and insulin resistance was noted in the diabetic rats (glucose: 360-500 mg/dl, HOMA-IR 9.8-13.8. F2, rich in polysaccharides and carbohydrates, was most effective in attenuating hyperglycemia and insulin resistance (glucose: 200 mg/dl; HOMA-IR: 5.3 and especially HbA1C (from 8.0% to 6.5%. All of the AE subfractions lowered the level of triglycerides and free fatty acid, but not the level of total cholesterol. FR significantly increased the high-density lipoprotein/low-density lipoprotein ratio, indicating its benefits for lipoprotein profiles. While F2 and FR were associated with weight gain, F1 possessed an anti-obese effect. In conclusion, whether it is consumed as a vegetable or as a nutraceutical, AE has the potential to be an adjuvant therapy for diabetes. AE subfractions could be developed individually and deserve further investigation.

  1. Community-Based Diabetes Screening and Risk Assessment in Rural West Virginia

    Directory of Open Access Journals (Sweden)

    Ranjita Misra

    2016-01-01

    Full Text Available This project utilized a cross-sectional study design to assess diabetes risk among 540 individuals from 12 counties using trained extension agents and community organizations in West Virginia. Individuals were screened for diabetes using (1 the validated 7-item diabetes risk assessment survey and (2 hemoglobin A1c tests. Demographic and lifestyle behaviors were also collected. The average age, body mass index, and A1c were 51.2±16.4, 31.1±7.5, and 5.8±0.74, respectively. The majority were females, Non-Hispanic Whites with no prior diagnosis of diabetes. Screenings showed that 61.8% of participants were at high risk for diabetes. Family history of diabetes (siblings or parents, overweight or obese status, sedentary lifestyle, and older age were commonly prevalent risk factors. Higher risk scores computed from the 7-item questions correlated positively with higher A1c (r=0.221, P<0.001. In multivariate logistic regression analyses, higher diabetes risk was predicted by obesity, older age, family history of hypertension, and gestational diabetes. Females were 4 times at higher risk than males. The findings indicated that community-based screenings were an effective way to assess diabetes risk in rural West Virginia. Linking diabetes screenings with referrals to lifestyle programs for high risk individuals can help reduce the burden of diabetes in the state.

  2. Association between parental history of diabetes and type 2 diabetes genetic risk scores in the PPP-Botnia and Framingham Offspring Studies

    DEFF Research Database (Denmark)

    Vassy, Jason L; Shrader, Peter; Jonsson, Anna Elisabet

    2011-01-01

    Parental history of diabetes and specific gene variants are risk factors for type 2 diabetes, but the extent to which these factors are associated is unknown.......Parental history of diabetes and specific gene variants are risk factors for type 2 diabetes, but the extent to which these factors are associated is unknown....

  3. Danish GPs' perception of disease risk and benefit of prevention

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Gyrd-Hansen, Dorte; Kragstrup, Jakob

    2002-01-01

    risk reduction. RESULTS: The GPs' attitude towards recommending medical treatment was dependent on the phrasing of risk reductions. Seventy-two per cent of doctors who received all information on risk reductions would definitely or probably recommend medication, while 91% would recommend medication...... to take into account all available measures of risk reductions....

  4. Quantifying the benefits of achieving or maintaining long-term low risk profile for cardiovascular disease: The Doetinchem Cohort Study.

    Science.gov (United States)

    Hulsegge, Gerben; Smit, Henriëtte A; van der Schouw, Yvonne T; Daviglus, Martha L; Verschuren, W M Monique

    2015-10-01

    Studies investigating the relation between risk profiles and cardiovascular disease have measured risk at baseline only. We investigated maintenance and changes of risk profiles over time and their potential impact on incident cardiovascular disease. Population-based cohort study. Risk factors were measured at baseline (1987-1991) among 5574 cardiovascular disease-free adults aged 20-59 years. They were classified into four risk categories according to smoking status, presence of diabetes and widely accepted cut-off values for blood pressure, total cholesterol/HDL-ratio and body mass index. Categories were subdivided (maintenance, deterioration, improvement) based on risk factor levels at six and 11 years of follow-up. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for cardiovascular disease incidence 5-10 years following the risk-change period were fitted using Cox proportional hazards models. Only 12% of participants were low risk at baseline, and only 7% maintained it. Participants who maintained a low risk profile over 11 years had seven times lower risk of cardiovascular disease (HR: 0.14, 95% CI: 0.05-0.41) than participants with long-term high risk profile, whereas those low risk at baseline whose profile deteriorated had three times lower risk (HR: 0.36, 95% CI: 0.18-0.71). Our results suggest that, within each baseline risk profile group, compared with a stable profile, improving profiles may be associated with up to two-fold lower HRs, and deteriorating profiles with about two-fold higher HRs. Our study, using long-term risk profiles, demonstrates the full benefits of low risk profile. These findings underscore the importance of achieving and maintaining low risk from young adulthood onwards. © The European Society of Cardiology 2014.

  5. Effects of contraceptive steroids on cardiovascular risk factors in women with insulin-dependent diabetes mellitus

    DEFF Research Database (Denmark)

    Petersen, K R; Skouby, S O; Sidelmann, Johannes Jakobsen

    1994-01-01

    OBJECTIVE: We evaluated established cardiovascular risk factors within lipoprotein metabolism, hemostasis, and endothelial function in women with insulin-dependent diabetes mellitus who were using oral contraceptives. STUDY DESIGN: Twenty-five women with uncomplicated insulin-dependent diabetes m...

  6. All about Your Risk for Prediabetes, Type 2 Diabetes, and Heart Disease

    Science.gov (United States)

    Toolkit No. 1 All About Your Risk for Prediabetes, Type 2 Diabetes, and Heart Disease What does prediabetes have to do with type 2 diabetes and heart disease? When you have prediabetes, your blood glucose (sugar) levels are higher than ...

  7. Frequency of Atherogenic Risk in Type 2 Diabetes Mellitus and Non ...

    African Journals Online (AJOL)

    ... diabetes, hypertension, contraceptive use and certain genetic predisposing factors. ... Objectives: Was to assess the degree of atherogenic risk in type 2 DM and ... hundred (100) type 2 diabetes mellitus patients and ninety-two (92) healthy ...

  8. Understanding public perceptions of benefits and risks of childhood vaccinations in the United States.

    Science.gov (United States)

    Song, Geoboo

    2014-03-01

    In the face of a growing public health concern accompanying the reemerging threat of preventable diseases, this research seeks mainly to explain variations in the perceived benefits and risks of vaccinations among the general public in the United States. As Mary Douglas and Aaron Wildavsky's grid-group cultural theory of risk perception claims, the analytical results based upon original data from a nationwide Internet survey of 1,213 American adults conducted in 2010 suggest that individuals' cultural predispositions contribute to the formation of their perceptions pertaining to vaccine benefits and risks at both societal and individual levels, in conjunction with other factors suggested by previous risk perception literature, such as perceived prevalence of diseases, trust, knowledge level, and demographic characteristics. Those with a strong hierarch orientation tend to envision greater benefits and lesser risks and conceive of a relatively high ratio of benefit to risk when compared to other cultural types. By contrast, those with a strong fatalist tendency are inclined to emphasize risks and downplay benefits while conceiving of a low vaccination benefit-risk ratio. Situated between hierarchs and fatalists, strong egalitarians are prone to perceive greater benefits, smaller risks, and a more positive benefit-risk ratio than strong individualists. © 2013 Society for Risk Analysis.

  9. Statin use and risk for type 2 diabetes: what clinicians should know.

    Science.gov (United States)

    Maki, Kevin C; Diwadkar-Navsariwala, Veda; Kramer, Melvyn W

    2018-03-01

    Statins are the first line of pharmacologic treatment for the management of hypercholesterolemia in patients at risk for atherosclerotic cardiovascular (CV) disease. In recent years, several randomized, controlled trials (RCTs) and observational studies have reported increased risk for new-onset type 2 diabetes mellitus (T2D) with statin treatment, particularly with use of high-intensity statins that reduce low-density lipoprotein cholesterol (LDL-C) by 50% or more. This paper summarizes the data from RCTs and observational studies for statin-associated T2D risk, and puts into perspective this evidence, weighed against the established benefits of statin therapy for CV risk reduction. In RCTs, the increase in T2D risk with statin therapy appears to be attributable mainly to those with major T2D risk factors. The increase in incidence of T2D in those with major risk is approximately 25% for statin use, compared to placebo, and for intensive statin therapy compared to moderate-intensity statin therapy. However, in those with major T2D risk factors, the number of CV disease events prevented for each excess case of T2D is close to or greater than one, indicating that the risk-benefit ratio still strongly favors use of statin therapy, or intensive statin therapy, for patients with sufficient CV disease risk to warrant cholesterol-lowering drug therapy. Recommendations are summarized for evaluation of the T2D risk factor profile before initiation of and during statin therapy. In addition, the importance of lifestyle management and other preventive measures is emphasized for management of risks for both T2D and CV disease events in patients receiving statin therapy.

  10. Type 2 diabetes in children: Clinical aspects and risk factors

    Directory of Open Access Journals (Sweden)

    P V Rao

    2015-01-01

    Full Text Available A strong link between obesity, insulin resistance, and metabolic syndrome has been reported with development of a new paradigm to type 2 diabetes mellitus (T2DM, with some evidence suggesting that beta-cell dysfunction is present before the onset of impaired glucose tolerance. Differentiating type 1 diabetes mellitus (T1DM from T2DM is actually not very easy and there exists a number of overlapping characteristics. The autoantibody frequencies of seven antigens in T1DM patients may turn out to be actually having T2DM patients (pre-T2DM. T2DM patients generally have increased C-peptide levels (may be normal at time of diagnosis, usually no auto-antibodies, strong family history of diabetes, obese and show signs of insulin resistance (hypertension, acanthosis, PCOS. The American Academy of Paediatrics recommends lifestyle modifications ± metformin when blood glucose is 126-200 mg/dL and hemoglobin A1c (HbA1c 200 mg/dL and HbA1c >8.5, with or without ketosis. Metformin is not recommended if the patient is ketotic, because this increases the risk of lactic acidosis. Metformin is currently the only oral hypoglycemic that has been approved for use in children. Knowing these subtle differences in mechanism, and knowing how to test patients for which mechanism (s are causing their diabetes mellitus, may help us eventually tailor treatment programs on an individual basis.

  11. The risk factors for diabetes mellitus after kidney transplantation

    International Nuclear Information System (INIS)

    Effat Razeghi; Monireh Amerian; Peimaneh Heydarian

    2010-01-01

    Post-transplant diabetes mellitus (PTDM) is an adverse complication of kidney transplantation, associated with decreased graft and patient survival. We investigated the risk factors for PTDM and their relation to graft rejection in our kidney transplant recipients. We prospectively included 109 consecutive first kidney transplant recipients transplanted at the Sina Hospital in Tehran from June 2003 to May 2004. Patients were excluded if they had diabetes at the time of transplantation either as the cause of kidney failure or as a comorbidity. PTDM was defined by fasting blood sugar =126 mg/dL or random blood sugar =200 mg/dL on two occasions and the need for insulin therapy and/or oral hypoglycemic drugs for at least two weeks. Thirty non-diabetic transplant recipients were diagnosed as having PTDM during the six month followup period after transplantation. Sixty non-PTDM controls, matched for age, sex and immun suppressive regimen, and transplanted as closely as possible to the PTDM cases, were randomly selected. The risk factors for PTDM were investigated in these 90 transplant recipients. Age older than 50 years (P = 0.04), history of hypertension (P = 0.02), polycystic kidney disease (P = 0.015), duration on dialysis more than one year (P < 0.0001), family history of diabetes mellitus (P < 0.0001), mean daily dose of prednisolone =15 mg/day (P < 0.0001) and cyclosporine =240 mg/day (P < 0.0001) were all more in the PTDM group. Also, the mean serum triglycerides was higher (P = 0.019) and there was an increased risk of graft rejection (P < 0.0001) in the PTDM group (Author).

  12. State of the art in benefit-risk analysis: economics and marketing-finance.

    Science.gov (United States)

    Kalogeras, N; Odekerken-Schröder, G; Pennings, J M E; Gunnlaugsdóttir, H; Holm, F; Leino, O; Luteijn, J M; Magnússon, S H; Pohjola, M V; Tijhuis, M J; Tuomisto, J T; Ueland, Ø; White, B C; Verhagen, H

    2012-01-01

    All market participants (e.g., investors, producers, consumers) accept a certain level of risk as necessary to achieve certain benefits. There are many types of risk including price, production, financial, institutional, and individual human risks. All these risks should be effectively managed in order to derive the utmost of benefits and avoid disruption and/or catastrophic economic consequences for the food industry. The identification, analysis, determination, and understanding of the benefit-risk trade-offs of market participants in the food markets may help policy makers, financial analysts and marketers to make well-informed and effective corporate investment strategies in order to deal with highly uncertain and risky situations. In this paper, we discuss the role that benefits and risks play in the formation of the decision-making process of market-participants, who are engaged in the upstream and downstream stages of the food supply chain. In addition, we review the most common approaches (expected utility model and psychometrics) for measuring benefit-risk trade-offs in the economics and marketing-finance literature, and different factors that may affect the economic behaviour in the light of benefit-risk analyses. Building on the findings of our review, we introduce a conceptual framework to study the benefit-risk behaviour of market participants. Specifically, we suggest the decoupling of benefits and risks into the separate components of utilitarian benefits, hedonic benefits, and risk attitude and risk perception, respectively. Predicting and explaining how market participants in the food industry form their overall attitude in light of benefit-risk trade-offs may be critical for policy-makers and managers who need to understand the drivers of the economic behaviour of market participants with respect to production, marketing and consumption of food products. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. [Increased risk of type II diabetes mellitus and cardiovascular disease after gestational diabetes mellitus: a systematic review].

    Science.gov (United States)

    Hopmans, Tara-Eileen J P; van Houten, Chantal B; Kasius, Annemieke; Kouznetsova, Ouliana I; Nguyen, Ly A; Rooijmans, Sanne V; Voormolen, Daphne N; van Vliet, Elvira O G; Franx, Arie; Koster, M P H Wendy

    2015-01-01

    To determine the long-term risk of developing type II diabetes (T2D) and cardiovascular disease (CVD) for women with a history of gestational diabetes mellitus. Systematic review and meta-analysis. Two search strategies were used in PubMed and Embase to determine the long-term risks of developing T2D and CVD after a pregnancy complicated by gestational diabetes mellitus. After critical appraisal of the papers found, 11 papers were included, involving a total of 328,423 patients. Absolute and relative risks (RRs) were calculated. Eight studies (n=276,829) reported on the long-term risk of T2D and 4 (n=141,048) on the long-term risk of CVD. Follow-up ranged from 3.5 to 11.5 years for T2D and from 1.2 to 74.0 years for CVD. Women with gestational diabetes had a risk of T2D varying between 9.5% and 37.0% and a risk of CVD of between 0.28% and 15.5%. Women with gestational diabetes were at increased risk of T2D (weighted RR: 13.2; 95% CI: 8.5-20.7) and CVD (weighted RR: 2.0; 95% CI: 1.1-3.7) compared to women without gestational diabetes. Women with prior gestational diabetes mellitus have a significantly increased risk of developing T2D and CVD. It is very important that gestational diabetes is recognised as a cardiovascular risk factor in daily practice. It would be desirable to screen this group of women for the presence of hyperglycaemia and other cardiovascular risk factors. Further research is required to be able to specify the long-term risk of T2D and CVD and to demonstrate whether such screening is cost-effective.

  14. Is low birth weight a risk factor for the development of diabetic nephropathy in patients with type 1 diabetes?

    DEFF Research Database (Denmark)

    Eshoj, O; Vaag, A; Borch-Johnsen, K

    2002-01-01

    OBJECTIVES: To investigate if low birth weight as a consequence of intrauterine malnutrition is a risk factor for the later development of diabetic nephropathy. DESIGN AND SUBJECTS: In a case-control set-up a group of type 1 diabetic subjects with diabetic nephropathy (n = 51) and a matched control...... group with normal kidney function (n = 51) were compared. Diabetic nephropathy and normal kidney function were defined as urinary albumin excretion rate above 200 microg min-1 and below 20 microg min-1, respectively. The birth weights were all obtained from the midwives' original records. SETTING......: The patients were identified from a population-based study of chronic diabetic complications in the Funen County, Denmark. MAIN OUTCOMES: Birth weights according to the presence of diabetic nephropathy. RESULTS: The median (10-90 percentile) birth weights were 3,600 g (2,960-4,274) in the group with diabetic...

  15. Performance of Comorbidity, Risk Adjustment, and Functional Status Measures in Expenditure Prediction for Patients With Diabetes

    OpenAIRE

    Maciejewski, Matthew L.; Liu, Chuan-Fen; Fihn, Stephan D.

    2009-01-01

    OBJECTIVE?To compare the ability of generic comorbidity and risk adjustment measures, a diabetes-specific measure, and a self-reported functional status measure to explain variation in health care expenditures for individuals with diabetes. RESEARCH DESIGN AND METHODS?This study included a retrospective cohort of 3,092 diabetic veterans participating in a multisite trial. Two comorbidity measures, four risk adjusters, a functional status measure, a diabetes complication count, and baseline ex...

  16. The influence of baseline risk on the relation between HbA1c and risk for new cardiovascular events and mortality in patients with type 2 diabetes and symptomatic cardiovascular disease

    NARCIS (Netherlands)

    Bots, Sophie H; van der Graaf, Yolanda; Nathoe, Hendrik M W; de Borst, Gert Jan; Kappelle, Jaap L; Visseren, Frank L J; Westerink, Jan

    2016-01-01

    BACKGROUND: Strict glycaemic control in patients with type 2 diabetes has proven to have microvascular benefits while the effects on CVD and mortality are less clear, especially in high risk patients. Whether strict glycaemic control would reduce the risk of future CVD or mortality in patients with

  17. Academic Skills in Children with Early-Onset Type 1 Diabetes: The Effects of Diabetes-Related Risk Factors

    Science.gov (United States)

    Hannonen, Riitta; Komulainen, Jorma; Riikonen, Raili; Ahonen, Timo; Eklund, Kenneth; Tolvanen, Asko; Keskinen, Paivi; Nuuja, Anja

    2012-01-01

    Aim: The study aimed to assess the effects of diabetes-related risk factors, especially severe hypoglycaemia, on the academic skills of children with early-onset type 1 diabetes mellitus (T1DM). Method: The study comprised 63 children with T1DM (31 females, 32 males; mean age 9y 11mo, SD 4mo) and 92 comparison children without diabetes (40…

  18. State of the art in benefit-risk analysis: consumer perception.

    Science.gov (United States)

    Ueland, Ø; Gunnlaugsdottir, H; Holm, F; Kalogeras, N; Leino, O; Luteijn, J M; Magnússon, S H; Odekerken, G; Pohjola, M V; Tijhuis, M J; Tuomisto, J T; White, B C; Verhagen, H

    2012-01-01

    Benefit and risk perception with respect to food consumption, have been a part of human daily life from beginning of time. In today's society the food chain is long with many different types of actors and low degree of transparency. Making informed food choices where knowledge of benefits and risks is part of the decision making process are therefore complicated for consumers. Thus, to understand how consumers perceive benefits and risks of foods, their importance in relation to quality evaluations are aspects that need to be addressed. The objective of this paper is to discuss state of the art in understanding consumer perceptions of benefits and risks of foods in order to improve understanding of consumer behaviour in the food domain. Risks may be associated with both acute and long term consequences, some of which may have serious effects. Perceived risks are connected to morbidity and mortality along two dimensions relating to unknown risk, and to which extent the risk is dreaded by the consumer. Unfamiliar, uncertain, unknown, uncontrollable, and severe consequences are some factors associated with risk perception. Novel food processing techniques, for instance, score high on several of these parameters and are consequently regarded with suspicion and perceived as risky by consumers. On a daily basis, benefits of foods and food consumption are more important in most consumers' minds than risks. Benefits are often associated with food's ability to assuage hunger, and to provide pleasure through eating and socialising. In addition, two main categories of benefits that are important for acceptance of product innovations are health and environmental benefits. Benefit and risk perception of foods seem to be inversely correlated, so when something is perceived as being highly beneficial, it is correspondingly perceived as having low risk. However, slightly different paths are used in the formation of these perceptions; benefit perception is based on heuristics and

  19. Diabetes mellitus: an important risk factor for reactivation of tuberculosis

    Directory of Open Access Journals (Sweden)

    Ernesto Solá

    2016-07-01

    Full Text Available Diabetes mellitus was identified as a risk factor for developing tuberculosis (TB infection, and relapse after therapy. The risk of acquiring TB is described as comparable to that of HIV population. The fact that diabetics are 3× times more prone to develop pulmonary TB than nondiabetics cannot be overlooked. With DM recognized as global epidemic, and TB affecting one-third of the world population, physicians must remain vigilant. We present a 45-year-old woman born in Dominican Republic (DR, with 10-year history of T2DM treated with metformin, arrived to our Urgency Room complaining of dry cough for the past 3months. Interview unveiled unintentional 15lbs weight loss, night sweats, occasional unquantified fever, and general malaise but denied bloody sputum. She traveled to DR 2years before, with no known ill exposure. Physical examination showed a thin body habitus, otherwise well appearing woman with stable vital signs, presenting solely right middle lung field ronchi. LDH, ESR, hsCRP and Hg A1C were elevated. Imaging revealed a right middle lobe cavitation. Sputum for AFB disclosed active pulmonary TB. Our case portrays that the consideration of TB as differential diagnosis in diabetics should be exercised with the same strength, as it is undertaken during the evaluation of HIV patients with lung cavitation. Inability to recognize TB will endanger the patient, hospital dwellers and staff, and perpetuate this global public health menace.

  20. Risk factors and complications in type 2 diabetes outpatients

    Directory of Open Access Journals (Sweden)

    Ellen Fernandes Flávio Silva

    Full Text Available Summary Objective: Our study investigated type 2 diabetes mellitus (T2DM outpatients attending a university hospital in Montes Claros, MG, to estimate the prevalence of risk factors and their association with diabetes complications. Method: This was a quantitative, documental, retrospective and analytical study. Medical records of 95 outpatients with T2DM treated in this hospital from 2011 to 2015 were analyzed. Data were collected according to a structured questionnaire surveying sociodemographic, anthropometric and biochemical data and clinical and lifestyle aspects. Regression analysis was used to evaluate the association between risk factor variables and complications. Results: With a mean age of 54 years, the study population showed irregular blood glucose control, despite the use of hypoglycemic medication, and did not have a healthy lifestyle. The main complication reported was high blood pressure (HBP, occurring in 70.9% of patients. The prevalence of complications was positively associated with patients receiving insulin treatment (p=0.042 and multidisciplinary monitoring (p=0.050. Conclusion: The associations identified reflect the condition of patients that were already treating diabetes and its complications, especially HBP. The characteristics of the study population indicate the need to improve clinical follow-up and increase motivation for healthy behaviors.

  1. Balance training reduces falls risk in older individuals with type 2 diabetes.

    Science.gov (United States)

    Morrison, Steven; Colberg, Sheri R; Mariano, Mira; Parson, Henri K; Vinik, Arthur I

    2010-04-01

    This study assessed the effects of balance/strength training on falls risk and posture in older individuals with type 2 diabetes. Sixteen individuals with type 2 diabetes and 21 age-matched control subjects (aged 50-75 years) participated. Postural stability and falls risk was assessed before and after a 6-week exercise program. Diabetic individuals had significantly higher falls risk score compared with control subjects. The diabetic group also exhibited evidence of mild-to-moderate neuropathy, slower reaction times, and increased postural sway. Following exercise, the diabetic group showed significant improvements in leg strength, faster reaction times, decreased sway, and, consequently, reduced falls risk. Older individuals with diabetes had impaired balance, slower reactions, and consequently a higher falls risk than age-matched control subjects. However, all these variables improved after resistance/balance training. Together these results demonstrate that structured exercise has wide-spread positive effects on physiological function for older individuals with type 2 diabetes.

  2. Risk perception is not associated with attendance at a preventive intervention for type 2 diabetes mellitus among South Asians at risk of diabetes.

    Science.gov (United States)

    Vlaar, Everlina M A; Nierkens, Vera; Nicolaou, Mary; Middelkoop, Barend J C; Stronks, Karien; van Valkengoed, Irene G M

    2015-04-01

    To evaluate the association between risk perception and attendance in a diabetes prevention programme among South Asians with a high risk for diabetes. An observational study. We measured risk perception during the baseline interview with causal beliefs, perceived susceptibility and perceived controllability. We used logistic regression to examine the relationship between risk perception and attendance. We adjusted for relevant sociodemographic factors, screening results and psychosocial factors. The Hague, the Netherlands. Five hundred and thirty-five Hindustani Surinamese (South Asians) aged 18-60 years from a lifestyle-versus-control intervention for the prevention of diabetes. In total, 68·2% attended the lifestyle or control intervention. Participants perceived lifestyle and heredity to increase the risk of diabetes and perceived increasing physical activity to decrease it. Only 44·2% of the participants perceived themselves as susceptible to diabetes and only those who perceived a family history of diabetes as a cause of diabetes appeared to be more inclined to attend. However, after adjustment for confounding, the association was not statistically significant. Risk perception was not significantly associated with attendance. The results suggest that increasing the risk perception alone in this South Asian population is unlikely to increase the attendance at a diabetes prevention programme.

  3. Comparison of Accuracy of Diabetes Risk Score and Components of the Metabolic Syndrome in Assessing Risk of Incident Type 2 Diabetes in Inter99 Cohort

    DEFF Research Database (Denmark)

    Shafizadeh, Tracy B; Moler, Edward J; Kolberg, Janice A

    2011-01-01

    developed diabetes risk score, PreDxH Diabetes Risk Score (DRS). DRS assesses 5 yr risk of incident T2DM based on the measurement of 7 biomarkers in fasting blood. Methodology/Principal Findings: DRS was evaluated in baseline serum samples from 4,128 non-diabetic subjects in the Inter99 cohort (Danes aged......Background: Given the increasing worldwide incidence of diabetes, methods to assess diabetes risk which would identify those at highest risk are needed. We compared two risk-stratification approaches for incident type 2 diabetes mellitus (T2DM); factors of metabolic syndrome (MetS) and a previously...... 30–60) for whom diabetes outcomes at 5 years were known. Subjects were classified as having MetS based on the presence of at least 3 MetS risk factors in baseline clinical data. The sensitivity and false positive rate for predicting diabetes using MetS was compared to DRS. When the sensitivity...

  4. Benefits and Risks of Antiretroviral Therapy for Perinatal HIV Prevention.

    Science.gov (United States)

    Fowler, Mary G; Qin, Min; Fiscus, Susan A; Currier, Judith S; Flynn, Patricia M; Chipato, Tsungai; McIntyre, James; Gnanashanmugam, Devasena; Siberry, George K; Coletti, Anne S; Taha, Taha E; Klingman, Karin L; Martinson, Francis E; Owor, Maxensia; Violari, Avy; Moodley, Dhayendre; Theron, Gerhard B; Bhosale, Ramesh; Bobat, Raziya; Chi, Benjamin H; Strehlau, Renate; Mlay, Pendo; Loftis, Amy J; Browning, Renee; Fenton, Terence; Purdue, Lynette; Basar, Michael; Shapiro, David E; Mofenson, Lynne M

    2016-11-03

    Randomized-trial data on the risks and benefits of antiretroviral therapy (ART) as compared with zidovudine and single-dose nevirapine to prevent transmission of the human immunodeficiency virus (HIV) in HIV-infected pregnant women with high CD4 counts are lacking. We randomly assigned HIV-infected women at 14 or more weeks of gestation with CD4 counts of at least 350 cells per cubic millimeter to zidovudine and single-dose nevirapine plus a 1-to-2-week postpartum "tail" of tenofovir and emtricitabine (zidovudine alone); zidovudine, lamivudine, and lopinavir-ritonavir (zidovudine-based ART); or tenofovir, emtricitabine, and lopinavir-ritonavir (tenofovir-based ART). The primary outcomes were HIV transmission at 1 week of age in the infant and maternal and infant safety. The median CD4 count was 530 cells per cubic millimeter among 3490 primarily black African HIV-infected women enrolled at a median of 26 weeks of gestation (interquartile range, 21 to 30). The rate of transmission was significantly lower with ART than with zidovudine alone (0.5% in the combined ART groups vs. 1.8%; difference, -1.3 percentage points; repeated confidence interval, -2.1 to -0.4). However, the rate of maternal grade 2 to 4 adverse events was significantly higher with zidovudine-based ART than with zidovudine alone (21.1% vs. 17.3%, P=0.008), and the rate of grade 2 to 4 abnormal blood chemical values was higher with tenofovir-based ART than with zidovudine alone (2.9% vs. 0.8%, P=0.03). Adverse events did not differ significantly between the ART groups (P>0.99). A birth weight of less than 2500 g was more frequent with zidovudine-based ART than with zidovudine alone (23.0% vs. 12.0%, P<0.001) and was more frequent with tenofovir-based ART than with zidovudine alone (16.9% vs. 8.9%, P=0.004); preterm delivery before 37 weeks was more frequent with zidovudine-based ART than with zidovudine alone (20.5% vs. 13.1%, P<0.001). Tenofovir-based ART was associated with higher rates than

  5. The illusion of certainty: health benefits and risks

    National Research Council Canada - National Science Library

    Rifkin, Erik; Bouwer, Edward

    2007-01-01

    ... as it reaches the reading public. This would be an excellent and welcome outcome, as it is the unexamined conclusion that holds the greatest threat to well-being. By forcing the discussion of risk appraisal and the ways risk is presented to the public, Rifkin and Bouwer provide the discussion of risk with the counterpoint that is necessary to it...

  6. Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years

    DEFF Research Database (Denmark)

    Andersen, Signe T; Witte, Daniel R; Dalsgaard, Else-Marie

    2018-01-01

    OBJECTIVE: To study incident diabetic polyneuropathy (DPN) prospectively during the first 13 years after a screening-based diagnosis of type 2 diabetes and determine the associated risk factors for the development of DPN. RESEARCH DESIGN AND METHODS: We assessed DPN longitudinally in the Danish arm...... of the Anglo-Danish-Dutch study of Intensive Treatment of Diabetes in Primary Care (ADDITION) using the Michigan Neuropathy Screening Instrument questionnaire (MNSIQ), defining DPN with scores ≥4. Risk factors present at the diabetes diagnosis associated with the risk of incident DPN were estimated using Cox...... DPN. CONCLUSIONS: This study provides further epidemiological evidence for obesity as a risk factor for DPN. Moreover, low HDL cholesterol levels and higher levels of methylglyoxal, a marker of dicarbonyl stress, are identified as risk factors for the development of DPN....

  7. Menopausal Estrogen Therapy Benefits and Risks Vary by Age, WHI Analysis Suggests

    Science.gov (United States)

    Long-term follow-up data from the Women’s Health Initiative (WHI) provide new information about the potential risks and benefits of hormone therapy to treat symptoms related to menopause, including its effect on breast cancer risk,

  8. Cardiovascular risk prediction: the old has given way to the new but at what risk-benefit ratio?

    Directory of Open Access Journals (Sweden)

    Yeboah J

    2014-10-01

    Full Text Available Joseph Yeboah Heart and Vascular Center of Excellence, Wake Forest University School of Medicine, Winston-Salem, NC, USA Abstract: The ultimate goal of cardiovascular risk prediction is to identify individuals in the population to whom the application or administration of current proven lifestyle modifications and medicinal therapies will result in reduction in cardiovascular disease events and minimal adverse effects (net benefit to society. The use of cardiovascular risk prediction tools dates back to 1976 when the Framingham coronary heart disease risk score was published. Since then a lot of novel risk markers have been identified and other cardiovascular risk prediction tools have been developed to either improve or replace the Framingham Risk Score (FRS. In 2013, the new atherosclerotic cardiovascular disease risk estimator was published by the American College of Cardiology and the American Heart Association to replace the FRS for cardiovascular risk prediction. It is too soon to know the performance of the new atherosclerotic cardiovascular disease risk estimator. The risk-benefit ratio for preventive therapy (lifestyle modifications, statin +/− aspirin based on cardiovascular disease risk assessed using the FRS is unknown but it was assumed to be a net benefit. Should we also assume the risk-benefit ratio for the new atherosclerotic cardiovascular disease risk estimator is also a net benefit? Keywords: risk prediction, prevention, cardiovascular disease

  9. Risk Factors for Thyroid Dysfunction among Type 2 Diabetic Patients in a Highly Diabetes Mellitus Prevalent Society

    Directory of Open Access Journals (Sweden)

    Metab Al-Geffari

    2013-01-01

    Full Text Available Diabetes and thyroid dysfunction found to exist simultaneously. In this regard, the present study looked into the prevalence of different forms of thyroid dysfunction and their risk factors among Type 2 diabetic Saudi patients. Methodology. A cross-sectional retrospective randomized hospital-based study of 411 Type 2 diabetic Saudi patients of >25 years of age was conducted to test the prevalence of different types of thyroid dysfunction and their risk factors. Results. The prevalence of different types of thyroid dysfunction is 28.5%, of which 25.3% had hypothyroidism, where 15.3%, 9.5%, and 0.5% are clinical, subclinical, and overt hypothyroidism, respectively. The prevalence of hyperthyroidism is 3.2%, of which subclinical cases accounted for 2.7% and overt hyperthyroidism accounted for 0.5%. Risk factors for thyroid dysfunction among Saudi Type 2 diabetic patients are family history of thyroid disease, female gender, and duration of diabetes of >10 years, while the risk was not significant in patients with history of goiter and patients aged >60 years. Smoking and parity show a nonsignificant reduced risk. Conclusion. Thyroid dysfunction is highly prevalent among Saudi Type 2 diabetic patients, and the most significant risk factors are family history of thyroid disease, female gender, and >10 years duration of diabetes.

  10. [Cardiac risk profile in diabetes mellitus and impaired fasting glucose].

    Science.gov (United States)

    Schaan, Beatriz D'Agord; Harzheim, Erno; Gus, Iseu

    2004-08-01

    Mortality of diabetic patients is higher than that of the population at large, and mainly results from cardiovascular diseases. The purpose of the present study was to identify the prevalence of cardiovascular risk factors in subjects with diabetes mellitus (DM) or abnormal fasting glucose (FG) in order to guide health actions. A population-based cross-sectional study was carried out in a representative random cluster sampling of 1,066 adult urban population (> or =20 years) in the state of Rio Grande do Sul between 1999 and 2000. A structured questionnaire on coronary risk factors was applied and sociodemographic characteristics of all adults older than 20 years living in the same dwelling were collected. Subjects were clinically evaluated and blood samples were obtained for measuring total cholesterol and fasting glycemia. Statistical analysis was performed using Stata 7 and a 5% significance level was set. Categorical variables were compared by Pearson's chi-square and continuous variables were compared using Student's t-test or Anova and multivariate analysis, all controlled for the cluster effect. Of 992 subjects, 12.4% were diabetic and 7.4% had impaired fasting glucose. Among the risk factors evaluated, subjects who presented any kind of glucose homeostasis abnormality were at a higher prevalence of obesity (17.8, 29.2 and 35.3% in healthy subjects, impaired fasting glucose and DM respectively, pfasting glucose and DM, respectively, pfasting glucose and DM respectively, p=0.01). Subjects with any kind of glucose homeostasis abnormality represent a group, which preventive individual and population health policies should target since they have higher prevalence of coronary artery disease risk factors.

  11. A comparative study of risk factors for corneal infection in diabetic and non-diabetic patients

    Directory of Open Access Journals (Sweden)

    Bin Wang

    2018-01-01

    Full Text Available AIM: To compare the clinical characteristics of infectious keratopathy in type 2 diabetes mellitus (T2DM and non-diabetes mellitus (NDM and to investigate risk factors for infectious keratopathy in T2DM patients. METHODS: Totally 230 patients with T2DM and 168 with NDM diagnosed as infectious keratopathy were hospitalized at Qingdao Eye Hospital from 2001 to 2015. Data including sex, age, occupation, season, smoking and alcohol consumption habits, duration between onset and treatments, duration of hospitalization were collected. Initially identified indicators were analyzed with a multivariate logistic regression. Glycosylated hemoglobin A1c (HbA1c in patients with T2DM was analyzed. The infectious keratopathies in the two groups were categorized and compared. RESULTS: The diabetic group consisted of 146 (63.5% males and 84 (36.5% females. The NDM group consisted of 111 (66.1% males and 57 (33.9% females. There was no signigicantly difference in sex distribution between the two groups (P>0.05. There were significant differences in age, occupation of patients, season of the onset of diseases, duration between onset and treatment, and durations of hospitalization between the two groups (P0.05. CONCLUSION: Advanced age and the summer and winter seasons are identified as risk factors for infectious keratopathy in T2DM patients, and T2DM patients are more prone to bacterial keratitis.

  12. Development of a simple tool to predict the risk of postpartum diabetes in women with gestational diabetes mellitus.

    Science.gov (United States)

    Köhler, M; Ziegler, A G; Beyerlein, A

    2016-06-01

    Women with gestational diabetes mellitus (GDM) have an increased risk of diabetes postpartum. We developed a score to predict the long-term risk of postpartum diabetes using clinical and anamnestic variables recorded during or shortly after delivery. Data from 257 GDM women who were prospectively followed for diabetes outcome over 20 years of follow-up were used to develop and validate the risk score. Participants were divided into training and test sets. The risk score was calculated using Lasso Cox regression and divided into four risk categories, and its prediction performance was assessed in the test set. Postpartum diabetes developed in 110 women. The computed training set risk score of 5 × body mass index in early pregnancy (per kg/m(2)) + 132 if GDM was treated with insulin (otherwise 0) + 44 if the woman had a family history of diabetes (otherwise 0) - 35 if the woman lactated (otherwise 0) had R (2) values of 0.23, 0.25, and 0.33 at 5, 10, and 15 years postpartum, respectively, and a C-Index of 0.75. Application of the risk score in the test set resulted in observed risk of postpartum diabetes at 5 years of 11 % for low risk scores ≤140, 29 % for scores 141-220, 64 % for scores 221-300, and 80 % for scores >300. The derived risk score is easy to calculate, allows accurate prediction of GDM-related postpartum diabetes, and may thus be a useful prediction tool for clinicians and general practitioners.

  13. Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy

    DEFF Research Database (Denmark)

    Joergensen, C; Tarnow, L; Goetze, J P

    2015-01-01

    AIM: To evaluate the effects of therapy with the vitamin D analogue paricalcitol on markers of cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy. METHODS: In a double-blind, randomized placebo-controlled, crossover trial, 48 participants on s...

  14. Diabetes prevalence and its risk factors in rural area of Tamil Nadu

    Directory of Open Access Journals (Sweden)

    Gupta Sanjay

    2010-01-01

    Full Text Available Objectives: To estimate the usefulness of the Indian diabetes risk score for detecting undiagnosed diabetes in the rural area of Tamil Nadu. Materials and Methods: The present study was conducted in the field practice area of rural health centers (Chunampett and Annechikuppam, Tamil Nadu, covering a population of 35000 from February to March 2008 by using a predesigned and pretested protocol to find out the prevalence and the risk of diabetes mellitus in general population by using Indian diabetes risk score. Results: 1936 respondents comprising 1167 (60.27% females and 769 (39.73% males were studied. Majority 1203 (62.50% were Hindus. 1220 (63.% had studied up to higher secondary. 1200 (62% belonged to lower and lower-middle socio-economic class. A large number of the subjects 948 (50% were below 35 years of age. Most of the respondents 1411 (73% indulged in mild to moderate physical activity. 1715 (87.91% had no family history of diabetes mellitus. 750 (39.64% individuals were in the overweight category (>25 BMI. Out of these overweight persons, 64% had high diabetic risk score. It is observed that chances of high diabetic score increase with the increase in BMI. Prevalence of diabetes in studied population was 5.99%; out of these, 56% known cases of diabetes mellitus had high (>60 IDRS. Co-relation between BMI and IDRS shows that, if BMI increases from less than 18.50 to more than 30, chances of high risk for developing diabetes mellitus also significantly increase. Conclusion: This study estimates the usefulness of simplified Indian diabetes risk score for identifying undiagnosed high risk diabetic subjects in India. This simplified diabetes risk score has categorized the risk factors based on their severity. Use of the IDRS can make mass screening for undiagnosed diabetes in India more cost effective.

  15. Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Joan C. Lo

    2017-01-01

    Full Text Available Background. This study examines gestational diabetes mellitus (GDM in women with polycystic ovary syndrome (PCOS and the risk of type 2 diabetes mellitus (DM following GDM pregnancy. Methods. A cohort of 988 pregnant women with PCOS who delivered during 2002–2005 was examined to determine the prevalence and predictors of GDM, with follow-up through 2010 among those with GDM to estimate the risk of DM. Results. Of the 988 pregnant women with PCOS, 192 (19% developed GDM. Multivariable predictors of GDM included older age, Asian race, prepregnancy obesity, family history of DM, preconception metformin use, and multiple gestation. Among women with PCOS and GDM pregnancy, the incidence of DM was 2.8 (95% confidence interval (CI 1.9–4.2 per 100 person-years and substantially higher for those who received pharmacologic treatment for GDM (6.6 versus 1.5 per 100 person-years, p<0.01. The multivariable adjusted risk of DM was fourfold higher in women who received pharmacologic treatment for GDM (adjusted hazard ratio 4.1, 95% CI 1.8–9.6. The five-year incidence of DM was 13.1% overall and also higher in the pharmacologic treatment subgroup (27.0% versus 7.1%, p<0.01. Conclusions. The strongest predictors of GDM among women with PCOS included Asian race and prepregnancy obesity. Pharmacologic treatment of GDM is associated with fourfold higher risk of subsequent DM.

  16. Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

    DEFF Research Database (Denmark)

    Thomsen, Reimar W.; Mor, Anil

    2013-01-01

    This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...... increase for hospitalization with pneumonia associated with diabetes. The increase of risk for tuberculosis is of similar magnitude in highly developed countries, and possibly higher in low-income countries. Poor glycemic control and long diabetes duration predict higher risk for both pneumonia...... and tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk...

  17. Cost/benefit and risk/benefit analyses in LMFBR program planning

    International Nuclear Information System (INIS)

    Brewer, S.T.; Benson, R.A.; Palmer, R.S.

    1978-01-01

    The subject is discussed under the following headings: incentives analyses, uranium availability, electrical demand, the present value of future savings, alternatives to the breeder, environmental considerations, development program risks, results and conclusions. (U.K.)

  18. Policy Reform with Marijuana Use: Weighing Risks and Benefits.

    Science.gov (United States)

    Nkemdirim Okere, Arinze

    2018-03-01

    With the current legalization of medical marijuana and the possibility of recreational use being permitted in some states, the health care benefits associated with the use of marijuana is questionable. States that are on the path of legalizing marijuana, should recognize that as there are perceived positive benefits, there are also many evidence-based negative health consequences which may result in negative economic and societal consequences. As more data on health outcomes regarding the use of marijuana continue to emerge, policies directed toward legalizing marijuana, whether medical or recreational, should consider protecting the society from both harm and societal cost.

  19. The bisphosphonates: risks and benefits of long term use

    DEFF Research Database (Denmark)

    Hermann, Anne Pernille; Abrahamsen, Bo

    2013-01-01

    Bisphosphonates are widely used globally as the main treatment for osteoporosis. Both safety and efficacy have only been rigorously evaluated in studies of relatively short duration (3-5 years), with smaller extension studies. The evidence for benefit beyond five years in intervention studies...... is limited and does not include proven efficacy against nonvertebral fractures. Observational studies suggest a sustained benefit against hip fractures. Bisphosphonates are stored in the skeleton for months to years, depending on the degree of bone turnover and the binding properties of the bisphosphonate...

  20. Presence of diabetic microvascular complications does not incrementally increase risk of ischemic stroke in diabetic patients with atrial fibrillation

    Science.gov (United States)

    Chou, Annie Y.; Liu, Chia-Jen; Chao, Tze-Fan; Wang, Kang-Ling; Tuan, Ta-Chuan; Chen, Tzeng-Ji; Chen, Shih-Ann

    2016-01-01

    Abstract Conventional stroke risk prediction tools used in atrial fibrillation (AF) incorporate the presence of diabetes mellitus (DM) as a risk factor. However, it is unknown whether this risk is homogenous or dependent on the presence of diabetic microvascular complications, such as diabetic retinopathy, nephropathy, and neuropathy. The present study examined the risk of ischemic stroke in diabetic patients with and without microvascular complications. The present study used the National Health Insurance Research Database in Taiwan with detailed healthcare data on all-comers to the Taiwanese medical system from January 1, 1996 to December 31, 2011. AF and DM were identified when listed as discharge diagnoses or confirmed more than twice in the outpatient department. Patients on antithrombotic agents were excluded. The clinical endpoint was ischemic stroke. Among the 50,180 AF patients with DM, the majority had no microvascular complications (72.7%), while 2.6% had diabetic retinopathy, 8.4% had diabetic nephropathy, and 16.1% had diabetic neuropathy. Ischemic stroke occurred in 6003 patients, with a 4.74% annual risk of ischemic stroke. When compared with DM patients without microvascular complications, those with diabetic retinopathy, nephropathy, or neuropathy had higher incidences of ischemic stroke (4.65 vs 5.07, 4.77, or 5.20 per 100 person-years, respectively). However, after adjusting for confounding factors, the differences were no longer significant. In a large nationwide AF cohort with DM, risk of ischemic stroke was similar between patients with and without microvascular complications, suggesting that risk stratification of these patients does not require inclusion of diabetic retinopathy, nephropathy, and neuropathy. PMID:27399075

  1. Comparing the mortality risks of nursing professionals with diabetes and general patients with diabetes: a nationwide matched cohort study

    Directory of Open Access Journals (Sweden)

    Hsiu-Ling Huang

    2016-10-01

    Full Text Available Abstract Background Nursing professionals have received comprehensive medical education and training. However, whether these medical professionals exhibit positive patient care attitudes and behaviors and thus reduce mortality risks when they themselves are diagnosed with chronic diseases is worth exploring. This study compared the mortality risks of female nurses and general patients with diabetes and elucidated factors that caused this difference. Methods A total of 510,058 female patients newly diagnosed with diabetes between 1998 and 2006 as recorded in the National Health Insurance Research Database were the participants in this study. Nurses with diabetes and general population with diabetes were matched with propensity score method in a 1:10 ratio. The participants were tracked from the date of diagnosis to 2009. The Cox proportional hazards model was utilized to compare the mortality risks in the two groups. Results Nurses were newly diagnosed with diabetes at a younger age compared with the general public (42.01 ± 12.03 y vs. 59.29 ± 13.11 y. Nevertheless, the matching results showed that nurses had lower mortality risks (HR: 0.53, 95 % CI: 0.38–0.74 and nurses with diabetes in the < 35 and 35–44 age groups exhibited significantly lower mortality risks compared with general patients (HR: 0.23 and 0.36. A further analysis indicated that the factors that influenced the mortality risks of nurses with diabetes included age, catastrophic illnesses, and the severity of diabetes complications. Conclusion Nurses with diabetes exhibited lower mortality risks possibly because they had received comprehensive medical education and training, may had more knowledge regarding chronic disease control and change their lifestyles. The results can serve as a reference for developing heath education, and for preventing occupational hazards in nurses.

  2. Excess BMI in Childhood: A Modifiable Risk Factor for Type 1 Diabetes Development?

    Science.gov (United States)

    Ferrara, Christine Therese; Geyer, Susan Michelle; Liu, Yuk-Fun; Evans-Molina, Carmella; Libman, Ingrid M; Besser, Rachel; Becker, Dorothy J; Rodriguez, Henry; Moran, Antoinette; Gitelman, Stephen E; Redondo, Maria J

    2017-05-01

    We aimed to determine the effect of elevated BMI over time on the progression to type 1 diabetes in youth. We studied 1,117 children in the TrialNet Pathway to Prevention cohort (autoantibody-positive relatives of patients with type 1 diabetes). Longitudinally accumulated BMI above the 85th age- and sex-adjusted percentile generated a cumulative excess BMI (ceBMI) index. Recursive partitioning and multivariate analyses yielded sex- and age-specific ceBMI thresholds for greatest type 1 diabetes risk. Higher ceBMI conferred significantly greater risk of progressing to type 1 diabetes. The increased diabetes risk occurred at lower ceBMI values in children <12 years of age compared with older subjects and in females versus males. Elevated BMI is associated with increased risk of diabetes progression in pediatric autoantibody-positive relatives, but the effect varies by sex and age. © 2017 by the American Diabetes Association.

  3. Methods for cost-benefit-risk analysis of material-accounting upgrades

    International Nuclear Information System (INIS)

    Fishbone, L.G.; Gordon, D.M.; Higinbotham, W.; Keisch, B.

    1988-01-01

    The authors have developed a cost-benefit-risk methodology for evaluating material-accounting upgrades at key measurement points in nuclear facilities. The focus of this methodology is on nuclear-material measurements and their effects on inventory differences and shipper/receiver differences. The methodology has three main components: cost, benefits, and risk factors. The fundamental outcome of the methodology is therefore cost-benefit ratios characterizing the proposed upgrades, with the risk factors applied as necessary to the benefits. Examples illustrate the methodology's use

  4. Radiographic screening of edentulous patients: sense or nonsense? A risk-benefit analysis

    International Nuclear Information System (INIS)

    Keur, J.J.

    1986-01-01

    The benefits of radiographic examination of symptomless edentulous patients are presented. Based on data from the literature, an estimate of the risk of fatal malignancy from such a procedure is provided. Because the benefits are considerable and the risks low, a recommendation for selective screening of edentulous patients is made

  5. Fentanyl Utility Function: A Risk-Benefit Composite of Pain Relief and Breathing Responses

    NARCIS (Netherlands)

    van der Boom, M.; Olofsen, E.; Neukirchen, M.; Fussen, R.; Hay, J.; Groeneveld, G.J.; Aarts, L.; Sarton, E.; Dahan, A.

    2013-01-01

    INTRODUCTION:: Integrating opioid risk and benefit into a single function may give a useful single measure of the opioid's positive and negative effects. An explorative study on the effects of fentanyl on antinociception and respiratory depression was performed to construct fentanyl risk-benefit

  6. Analysis of benefits, opportunities, costs, and risks (BOCR) with the AHP+ANP : A critical validation

    NARCIS (Netherlands)

    Wijnmalen, D.J.D.

    2007-01-01

    This paper shows that the usual multiplicative synthesis of alternative priorities for benefits, opportunities, costs and risks, obtained from separate Analytic Hierarchy or Network models, can be ambiguous. The ratio of benefit and opportunity priorities to cost and risk priorities can be

  7. Risks versus benefits of medication use during pregnancy : What do women perceive?

    NARCIS (Netherlands)

    Mulder, Bianca; Bijlsma, Maarten J; Schuiling-Veninga, Catharina Cm; Morssink, Leonard P; van Puijenbroek, Eugene; Aarnoudse, Jan G; Hak, Eelko; de Vries, Tjalling W

    2018-01-01

    Background: Understanding perception of risks and benefits is essential for informed patient choices regarding medical care. The primary aim of this study was to evaluate the perception of risks and benefits of 9 drug classes during pregnancy and associations with women's characteristics. Methods:

  8. Estimating mortality risk reduction and economic benefits from controlling ozone air pollution

    National Research Council Canada - National Science Library

    Committee on Estimating Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure

    2008-01-01

    ... in life expectancy, and to assess methods for estimating the monetary value of the reduced risk of premature death and increased life expectancy in the context of health-benefits analysis. Estimating Mortality Risk Reduction and Economic Benefits from Controlling Ozone Air Pollution details the committee's findings and posits several recommendations to address these issues.

  9. A practical approach to communicating benefit-risk decisions of medicines to stakeholders

    Directory of Open Access Journals (Sweden)

    James eLeong

    2015-06-01

    Full Text Available AbstractPurposeThe importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication in a manner that would uphold transparency, consistency and standards. MethodsA retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA. ResultsThe BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders.ConclusionsThe use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  10. A practical approach to communicating benefit-risk decisions of medicines to stakeholders.

    Science.gov (United States)

    Leong, James; Walker, Stuart; Salek, Sam

    2015-01-01

    The importance of a framework for a systematic structured assessment of the benefits and risks has been established, but in addition, it is necessary that the benefit-risk decisions and the processes to derive those decisions are documented and communicated to various stakeholders for accountability. Hence there is now a need to find appropriate tools to enhance communication between regulators and other stakeholders, in a manner that would uphold transparency, consistency and standards. A retrospective, non-comparative study was conducted to determine the applicability and practicality of a summary template in documenting benefit-risk assessment and communicating benefit-risk balance and conclusions for reviewers to other stakeholders. The benefit-risk (BR) Summary Template and its User Manual was evaluated by 12 reviewers within a regulatory agency in Singapore, the Health Sciences Authority (HSA). The BR Summary Template was found to be adequate in documenting benefits, risks, relevant summaries and conclusions, while the User Manual was useful in guiding the reviewer in completing the template. The BR Summary Template was also considered a useful tool for communicating benefit-risk decisions to a variety of stakeholders. The use of a template may be of value for the communicating benefit-risk assessment of medicines to stakeholders.

  11. Risk/Benefit Communication about Food-A Systematic Review of the Literature.

    Science.gov (United States)

    Frewer, L J; Fischer, A R H; Brennan, M; Bánáti, D; Lion, R; Meertens, R M; Rowe, G; Siegrist, M; Verbeke, W; Vereijken, C M J L

    2016-07-26

    A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit attitudes and behaviors. Fifty four papers were identified. The analysis revealed that (primarily European or US) research interest has been relatively recent. Certain food issues were of greater interest to researchers than others, perhaps reflecting the occurrence of a crisis, or policy concern. Three broad themes relevant to the development of best practice in risk (benefit) communication were identified: the characteristics of the target population; the contents of the information; and the characteristics of the information sources. Within these themes, independent and dependent variables differed considerably. Overall, acute risk (benefit) communication will require advances in communication process whereas chronic communication needs to identify audience requirements. Both citizen's risk/benefit perceptions and (if relevant) related behaviors need to be taken into account, and recommendations for behavioral change need to be concrete and actionable. The application of theoretical frameworks to the study of risk (benefit) communication was infrequent, and developing predictive models of effective risk (benefit) communication may be contingent on improved theoretical perspectives.

  12. Risk scores for diabetes and impaired glycaemia in the Middle East and North Africa

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Witte, Daniel Rinse; Almdal, Thomas Peter

    2013-01-01

    AIMS: To develop risk scores for diabetes and diabetes or impaired glycaemia for individuals living in the Middle East and North Africa region. In addition, to derive national risk scores for Algeria, Saudi Arabia and the United Arab Emirates and to compare the performance of the regional risk...

  13. Selected risk factors of diabetes mellitus among road transport drivers.

    Science.gov (United States)

    Marcinkiewicz, Andrzej; Szosland, Dorota

    2010-01-01

    Road transport drivers are one of the professional groups whose activities have a strong impact on public safety. In view of the nature of their professional activity, the drivers are at a higher risk of obesity and hypertension, and thus, indirectly, of carbohydrate metabolism disorders such as diabetes mellitus. Medical documentation was a source of data for the reported study. It derived from medical examinations of truck and bus drivers applying for the new category II driving licence or for prolongation of the one they already had. Excessive body weight was recorded in 62.6% of the study population; 45.3% had overweight and 17.4% were diagnosed with obesity. Hypertension was noted in the medical records of 36.7% drivers. The prevalence of abnormal BP values was increasing with age. Overweight was found to be a risk factor for hypertension. Hyperglycaemia was found in 47.5% of the drivers and was also increasing with age. In road transport drivers, the high prevalence of excessive body weight and elevated arterial blood pressure as the risk factors for diabetes indicates a need to undertake multidimensional actions targeted on this particular profession and involving various health care sectors. Prophylactic and detailed pre-placement examinations should be considered, depending on the rate and intensity of the disorders diagnosed. This should be coupled with an introduction of primary and secondary prophylactic activities and monitoring of relevant treatment. A close collaboration with the patient's GP is necessary.

  14. TCF7L2 variant genotypes and type 2 diabetes risk in Brazil: significant association, but not a significant tool for risk stratification in the general population

    Directory of Open Access Journals (Sweden)

    Mill JG

    2008-12-01

    Full Text Available Abstract Background Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population. Methods We genotyped the single nucleotide polymorphisms (SNP rs7903146 of the TCF7L2 gene in 560 patients with known coronary disease enrolled in the MASS II (Medicine, Angioplasty, or Surgery Study Trial and in 1,449 residents of Vitoria, in Southeast Brazil. The associations of this gene variant to diabetes risk and metabolic characteristics in these two different populations were analyzed. To access the potential benefit of using this marker for diabetes risk prediction in the general population we analyzed the impact of this genetic variant on a validated diabetes risk prediction tool based on clinical characteristics developed for the Brazilian general population. Results SNP rs7903146 of the TCF7L2 gene was significantly associated with type 2 diabetes in the MASS-II population (OR = 1.57 per T allele, p = 0.0032, confirming, in the Brazilian population, previous reports of the literature. Addition of this polymorphism to an established clinical risk prediction score did not increased model accuracy (both area under ROC curve equal to 0.776. Conclusion TCF7L2 rs7903146 T allele is associated with a 1.57 increased risk for type 2 diabetes in a Brazilian cohort of patients with known coronary heart disease. However, the inclusion of this polymorphism in a risk prediction tool developed for the general population resulted in no improvement of performance. This is the first study, to our knowledge, that has confirmed this recent association in a South American population and adds to the great consistency of this finding in studies around the world

  15. Maximize Benefits, Minimize Risk: Selecting the Right HVAC Firm.

    Science.gov (United States)

    Golden, James T.

    1993-01-01

    An informal survey of 20 major urban school districts found that 40% were currently operating in a "break down" maintenance mode. A majority, 57.9%, also indicated they saw considerable benefits in contracting for heating, ventilating, and air conditioning (HVAC) maintenance services with outside firms. Offers guidelines in selecting…

  16. Portuguese consumers’ Interest in seafood production and consumption : insights considering benefits, risks and their environmental Impact

    OpenAIRE

    Moura, Ana Pinto de; Cunha, Luís Miguel

    2015-01-01

    Considering food choice, individuals base their decisions on assessments of risks and benefits. For seafood products, consumers may balance between perceived benefits and risks from consuming fish in order to get the health benefits without exceeding tolerable intakes of chemical contaminants. Moreover, consumers may balance between the potential environmental impacts of farmed fish and the thought of fish farming as a way to help save the wild fish stocks from over exploration. The aim of th...

  17. House price risk and the hedging benefits of home Ownership

    NARCIS (Netherlands)

    Dröes, M.I.; Hassink, W.H.J.

    2013-01-01

    Using a repeat-sales methodology, this paper finds that estimates of house price risk based on aggregate house price indices substantially underestimate the true size of house price risk. This is the result of the fact that aggregate house price indices average away the idiosyncratic volatility in

  18. Diet and breast cancer: understanding risks and benefits.

    Science.gov (United States)

    Thomson, Cynthia A

    2012-10-01

    Breast cancer is the most commonly diagnosed cancer among women in the United States. Extensive research has been completed to evaluate the relationship between dietary factors and breast cancer risk and survival after breast cancer; however, a summary report with clinical inference is needed. Materials and This review summarizes the current epidemiological and clinical trial evidence relating diet to breast cancer incidence, recurrence, survival, and mortality. The review includes emerging epidemiological studies that assess risk within breast cancer subtypes as well as a summary of previous and ongoing dietary intervention trials designed to modify breast cancer risk. The available literature suggests that both low-fat and high-fiber diets may be weakly protective against breast cancer, whereas total energy intake and alcohol appear to be positively associated. Fiber may be weakly protective possibly through modulation of estrogen, whereas fruit and vegetable intake is not clearly associated with risk. Obesity is a risk factor for postmenopausal disease, and adult weight gain should be avoided to reduce risk. In survivors, diet has the greatest potential influence on overall mortality rather than breast cancer-specific events. Diet is modestly associated with breast cancer risk; associations appear more pronounced for postmenopausal disease, and healthy choices after diagnosis and treatment likely support longevity more so than reduced risk for recurrent disease.

  19. Risk factors influencing the treatment outcome in diabetic macular oedema

    Directory of Open Access Journals (Sweden)

    Gupta Amod

    1996-01-01

    Full Text Available A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p<0.05. The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively. Wavelength of the laser (argon or krypton used for treatment did not significantly influence the outcome.

  20. Early feeding and risk of type 1 diabetes

    DEFF Research Database (Denmark)

    Knip, Mikael; Virtanen, Suvi M; Becker, Dorothy

    2011-01-01

    recruited 5606 newborn infants with a family member affected by type 1 diabetes and enrolled 2159 eligible subjects who carried a risk-conferring HLA genotype. All recruited mothers were encouraged to breastfeed. The intervention lasted for 6-8 mo with a minimum study formula exposure time of 2 mo......, and hydrolyzed casein and standard cow milk-based weaning formulas were compared. Eighty percent of the participants were exposed to the study formula. The overall retention rate over the first 5 y was 87%, and protocol compliance was 94%. The randomization code will be opened when the last recruited child turns...

  1. Incident Type 2 Diabetes Risk is Influenced by Obesity and Diabetes in Social Contacts: a Social Network Analysis.

    Science.gov (United States)

    Raghavan, Sridharan; Pachucki, Mark C; Chang, Yuchiao; Porneala, Bianca; Fox, Caroline S; Dupuis, Josée; Meigs, James B

    2016-10-01

    Obesity and diabetes family history are the two strongest risk factors for type 2 diabetes (T2D). Prior work shows that an individual's obesity risk is associated with obesity in social contacts, but whether T2D risk follows similar patterns is unknown. We aimed to estimate the relationship between obesity or diabetes in an individual's social contacts and his/her T2D risk. We hypothesized that obesity and diabetes in social contacts would increase an individual's T2D risk. This was a retrospective analysis of the community-based Framingham Offspring Study (FOS). FOS participants with T2D status, height and weight, and at least one social contact were eligible for this study (n = 4797 at Exam 1). Participants' interpersonal ties, cardiometabolic and demographic variables were available at eight exams from 1971 to 2008, and a T2D additive polygenic risk score was measured at the fifth exam. Primary exposures were T2D (fasting glucose ≥ 7 mmol/L or taking diabetes medications) and obesity status (BMI ≥ 30 kg/m(2)) of social contacts at a prior exam. Primary outcome was incident T2D in participants. Incident T2D was associated with having a social contact with diabetes (OR 1.32, p = 0.004) or with obesity (OR 1.21, p = 0.004). In stratified analyses, incident T2D was associated with diabetes in siblings (OR 1.64, p = 0.001) and obesity in spouses (OR 1.54, p = 0.0004). The associations between diabetes and obesity in social contacts and an individual's incident diabetes risk were stronger in individuals with a high diabetes genetic risk score. T2D and obesity in social contacts, particularly siblings and spouses, were associated with an individual's risk of incident diabetes even after accounting for parental T2D history. Assessing risk factors in an individual's siblings and spouses can inform T2D risk; furthermore, social network based lifestyle interventions involving spouses and siblings might be a novel T2D prevention approach.

  2. Albuminuria and associated risk factors in type II diabetics

    International Nuclear Information System (INIS)

    Hashim, R.; Ahmed, T.A.; Mushtaq, S.; Zafar, L.; Attique, M.; Khalil-ur-Rehman

    2004-01-01

    Objective: To determine the frequency of microalbuminuria (MA) and its associated medical risk factors in type II diabetic patients. Materials and Methods: Study population included 150 type II diabetic patients (70 women, 80 men) attending outpatient department of the hospital. Patients having clinical albuminuria and with other causes of proteinuria were excluded. Results: Women and men were of comparable ages. Women (26.4 kg/m/sup 2/) had higher body mass index (BMI) than men 24.3 kg/m/sup 2/). The frequency of MA was 46.7%, higher in males (50.6%) than females (41.5%). Fasting plasma glucose HbA/sub 1c/ levels were significantly higher in patients with MA compared to those with normo albuminuria (p < 0.001). The microalbuminuria patients had significantly decreased HDL-c levels compared to normoalbuminuric subjects (p< 0.001). However, no relation of MA with age, gender, known duration of diabetes, BMI, history of smoking, hypertension and serum: total cholesterol, LDL-c, triglyceride, urea and creatinine was found. Conclusion: There is a strong association of poor glycaemic control and decreased HDL-c levels with the presence of micro albuminuria. (author)

  3. Diabetes and Cardiovascular Disease Risk in Cambodian Refugees.

    Science.gov (United States)

    Marshall, Grant N; Schell, Terry L; Wong, Eunice C; Berthold, S Megan; Hambarsoomian, Katrin; Elliott, Marc N; Bardenheier, Barbara H; Gregg, Edward W

    2016-02-01

    To determine rates of diabetes, hypertension, and hyperlipidemia in Cambodian refugees, and to assess the proportion whose conditions are satisfactorily managed in comparison to the general population. Self-report and laboratory/physical health assessment data obtained from a household probability sample of U.S.-residing Cambodian refugees (N = 331) in 2010-2011 were compared to a probability sample of the adult U.S. population (N = 6,360) from the 2009-2010 National Health and Nutrition Examination Survey. Prevalence of diabetes, hypertension and hyperlipidemia in Cambodian refugees greatly exceeded rates found in the age- and gender-adjusted U.S. Cambodian refugees with diagnosed hypertension or hyperlipidemia were less likely than their counterparts in the general U.S. population to have blood pressure and total cholesterol within recommended levels. Increased attention should be paid to prevention and management of diabetes and cardiovascular disease risk factors in the Cambodian refugee community. Research is needed to determine whether this pattern extends to other refugee groups.

  4. Cardiovascular disease risk profile and microvascular complications of diabetes: comparison of Indigenous cohorts with diabetes in Australia and Canada

    Directory of Open Access Journals (Sweden)

    Maple-Brown Louise J

    2012-03-01

    Full Text Available Abstract Background Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada. Methods We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes, urban Indigenous Australians (2003-2005, n = 99 known diabetes, and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes. Results The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p Conclusions Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.

  5. Diabetes risk score in the United Arab Emirates: a screening tool for the early detection of type 2 diabetes mellitus

    Science.gov (United States)

    Sulaiman, Nabil; Hussein, Amal; Elbadawi, Salah; Abusnana, Salah; Zimmet, Paul

    2018-01-01

    Objective The objective of this study was to develop a simple non-invasive risk score, specific to the United Arab Emirates (UAE) citizens, to identify individuals at increased risk of having undiagnosed type 2 diabetes mellitus. Research design and methods A retrospective analysis of the UAE National Diabetes and Lifestyle data was conducted. The data included demographic and anthropometric measurements, and fasting blood glucose. Univariate analyses were used to identify the risk factors for diabetes. The risk score was developed for UAE citizens using a stepwise forward regression model. Results A total of 872 UAE citizens were studied. The overall prevalence of diabetes in the UAE adult citizens in the Northern Emirates was 25.1%. The significant risk factors identified for diabetes were age (≥35 years), a family history of diabetes mellitus, hypertension, body mass index ≥30.0 and waist-to-hip ratio ≥0.90 for males and ≥0.85 for females. The performance of the model was moderate in terms of sensitivity (75.4%, 95% CI 68.3 to 81.7) and specificity (70%, 95% CI 65.8 to 73.9). The area under the receiver-operator characteristic curve was 0.82 (95% CI 0.78 to 0.86). Conclusions A simple, non-invasive risk score model was developed to help to identify those at high risk of having diabetes among UAE citizens. This score could contribute to the efficient and less expensive earlier detection of diabetes in this high-risk population. PMID:29629178

  6. Depression as a risk for the onset of type 2 diabetes mellitus. A meta-analysis

    NARCIS (Netherlands)

    Twisk, J.W.; Beekman, A.T.F.; Heine, R.J.; Snoek, F.J.; Pouwer, F.

    2006-01-01

    Aims/hypothesis: Evidence strongly suggests that depression and type 2 diabetes are associated, but the direction of the association is still unclear. Depression may occur as a consequence of having diabetes, but may also be a risk factor for the onset of type 2 diabetes. This study examined the

  7. Decrease Your Risk for Diabetes (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    Nearly 30 million people in the U.S. have diabetes. Almost three times that many may have prediabetes, which puts them at increased risk for developing type 2 diabetes, heart disease, and stroke. In this podcast, Dr. Pamela Allweiss discusses ways to prevent or control diabetes.

  8. Relationship between limited joint mobility of the hand and diabetic foot risk in patients with type 2 diabetes.

    Science.gov (United States)

    Mineoka, Yusuke; Ishii, Michiyo; Tsuji, Akiko; Komatsu, Yoriko; Katayama, Yuko; Yamauchi, Mitsuko; Yamashita, Aki; Hashimoto, Yoshitaka; Nakamura, Naoto; Katsumi, Yasukazu; Isono, Motohide; Fukui, Michiaki

    2017-06-01

    Foot ulceration is a serious problem for patients with type 2 diabetes (T2D), and the early detection of risks for this condition is important to prevent complications. The present cross-sectional study in T2D patients determined the relationship between limited joint mobility (LJM) of the hand and diabetic foot risk classified using the criteria of the International Working Group on the Diabetic Foot (IWGDF). Relationships between LJM of the hand and foot risk according to IWGDF category, HbA1c, age, body mass index, blood pressure, estimated glomerular filtration (eGFR), and diabetic complications (including diabetic peripheral neuropathy [DPN] and peripheral arterial disease [PAD]) were evaluated in 528 consecutive T2D patients. Poor glycemic control was defined as HbA1c ≥ 7%. Patients with LJM of the hand were older and had a longer duration of diabetes, a higher prevalence of diabetic complications, including DPN and PAD, and a higher IWDGF category (all P foot risk assessed with IWDGF category was correlated with age (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.06; P = 0.001), poor glycemic control (OR 1.66; 95% CI 1.00-2.77; P = 0.04), eGFR (OR 0.98; 95% CI 0.97-0.99; P = 0.02), and the presence of LJM of the hand (OR 3.86; 95% CI 2.21-6.86; P foot risk. Diagnosis of diabetic hand is simple and non-invasive, and is thus a useful method for assessing the risk of diabetic foot in T2D patients. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  9. Correlation between atherogenic risk and adiponectin in gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Beata Matyjaszek-Matuszek

    2014-03-01

    Full Text Available Introduction and objective. Gestational diabetes mellitus (GDM is a pregnancy complication which increases the risk for maternal and foetal complications during pregnancy, and also significantly increases the cardiovascular risk for women’s health in the postpartum. Current literature provides contradictory information on the role of adiponectin (AdipoQ in the course of GDM. The aim of the study was to measure AdipoQ concentration in blood of women with GDM and to find correlations between this adipokine and clinical and biochemical parameters of the atherogenic risk. Material and methods. The GDM group included 50 women diagnosed with GDM between 24 – 28 weeks of gestation who underwent routine prenatal tests for GDM in compliance with the guidelines of the Polish Diabetes Association. All patients underwent clinical and laboratory evaluation at GDM diagnosis. Laboratory tests included serum AdipoQ concentration, fasting glucose and insulin, OGTT, lipid parameters, C-reactive protein and fibrinogen in serum. Results. The GDM group showed significantly elevated fasting glucose, insulin, HOMA-IR values, total cholesterol, LDLcholesterol and triglicerydes as compared with the control group (p<0.05. The atherogenic index, CRP, fibrinogen in women with GDM were significantly higher than in the control group (p<0.05. AdipoQ concentrations did not differ significantly between the groups during gestation (p=0.7054. No correlations, except with the neonatal weight (r= – 0.29, p<0.05, were found between AdipoQ and the studied parameters. Conclusions. Based on the conducted studies, it may be conclude that women with early diagnosed and promptly treated GDM have a normal adiponectin level, although insulin resistant changes and increased cardiovascular risk in basic metabolic parameters are observed. Moreover, adiponectin does not reflect the atherogenic risk in pregnant women with GDM.

  10. Diabetes and Cirrhosis Are Risk Factors for Hepatocellular Carcinoma After Successful Treatment of Chronic Hepatitis C.

    Science.gov (United States)

    Hedenstierna, Magnus; Nangarhari, Ali; Weiland, Ola; Aleman, Soo

    2016-09-15

    Successful treatment of hepatitis C virus (HCV) infection reduces the risk for hepatocellular carcinoma (HCC), but a risk remains. Current guidelines recommend continued HCC surveillance after sustained virologic response (SVR) has been achieved. This study aimed to investigate risk factors and incidence rates for HCC after SVR in HCV patients with pretreatment advanced liver disease (Metavir stage F3/F4). All patients with advanced liver disease successfully treated for HCV at Karolinska University Hospital during 1992-2013 (n = 399) were followed up for a median of 7.8 years. Data from national registries were used to minimize loss to follow-up. Incidence rates and hazard ratios (HRs) for development of HCC were calculated by Cox regression analysis. Seventeen patients developed HCC during 3366 person-years (PY) of follow-up. The HCC incidence rate was 0.95 (95% confidence interval [CI], .57-1.6) and 0.15 (95% CI, .05-.49) per 100 PY for patients with pretreatment F4 and F3, respectively. Patients with pretreatment cirrhosis and diabetes had a HR to develop HCC of 6.3, and an incidence rate of 7.9 per 100 PY (95% CI, 3.3-19) during the first 2 years of follow-up. The risk for HCC decreased significantly 2 years after SVR had been achieved. Diabetes mellitus and cirrhosis are strong risk factors for HCC development after SVR has been achieved. The risk to develop HCC diminishes significantly 2 years after SVR. Patients without cirrhosis have a low risk to develop HCC after SVR, and the benefit of HCC surveillance for this group is questionable. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  11. Should risk from medical imaging be assessed in the absence of benefit and vice versa?

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Louis K. [The University of Texas - Houston Medical School, Department of Diagnostic and Interventional Imaging, Houston, TX (United States)

    2014-10-15

    Diagnostic radiology has an image problem. In its effort to develop a better understanding of benefit-risk in medical radiology, data on potential risks associated with medical imaging have been welcomed into the medical community. As such, risk perspectives and mantras from the occupational health profession have been adopted and applied to patients. These perspectives often focus on risk with only casual, incidental, or no reference to the benefits experienced by patients. These occupational health viewpoints have accumulated over decades, have overshadowed a very limited perspective about the benefits of medical X-rays, and have become an integrated part of our profession. This review argues that the medical profession should abandon perspectives on risk that are adopted from occupational health professions and focus on perspectives that realistically focus on the medical benefit-risk for patients. (orig.)

  12. Benefits and risks of hormonal contraception for women

    OpenAIRE

    Gorenoi, Vitali; Schönermark, Matthias P.; Hagen, Anja

    2007-01-01

    Scientific background: A large proportion of women of reproductive age in Germany use various methods of pregnancy prevention (contraception), among them various hormone-based methods. Hormonal contraceptives may be divided into combined estrogen-progestogen contraceptives (pills, skin patches, vaginal rings), progestogen-only contraceptives (pills, injections, implants, hormone spirals) and emergency contraceptives. Research questions: The evaluation addressed the question of benefits and ri...

  13. Design of a randomized trial of diabetes genetic risk testing to motivate behavior change: the Genetic Counseling/lifestyle Change (GC/LC) Study for Diabetes Prevention.

    Science.gov (United States)

    Grant, Richard W; Meigs, James B; Florez, Jose C; Park, Elyse R; Green, Robert C; Waxler, Jessica L; Delahanty, Linda M; O'Brien, Kelsey E

    2011-10-01

    The efficacy of diabetes genetic risk testing to motivate behavior change for diabetes prevention is currently unknown. This paper presents key issues in the design and implementation of one of the first randomized trials (The Genetic Counseling/Lifestyle Change (GC/LC) Study for Diabetes Prevention) to test whether knowledge of diabetes genetic risk can motivate patients to adopt healthier behaviors. Because individuals may react differently to receiving 'higher' vs 'lower' genetic risk results, we designed a 3-arm parallel group study to separately test the hypotheses that: (1) patients receiving 'higher' diabetes genetic risk results will increase healthy behaviors compared to untested controls, and (2) patients receiving 'lower' diabetes genetic risk results will decrease healthy behaviors compared to untested controls. In this paper we describe several challenges to implementing this study, including: (1) the application of a novel diabetes risk score derived from genetic epidemiology studies to a clinical population, (2) the use of the principle of Mendelian randomization to efficiently exclude 'average' diabetes genetic risk patients from the intervention, and (3) the development of a diabetes genetic risk counseling intervention that maintained the ethical need to motivate behavior change in both 'higher' and 'lower' diabetes genetic risk result recipients. Diabetes genetic risk scores were developed by aggregating the results of 36 diabetes-associated single nucleotide polymorphisms. Relative risk for type 2 diabetes was calculated using Framingham Offspring Study outcomes, grouped by quartiles into 'higher', 'average' (middle two quartiles) and 'lower' genetic risk. From these relative risks, revised absolute risks were estimated using the overall absolute risk for the study group. For study efficiency, we excluded all patients receiving 'average' diabetes risk results from the subsequent intervention. This post-randomization allocation strategy was

  14. The use of drugs in food animals: benefits and risks

    National Research Council Canada - National Science Library

    .... The volume discusses the prevalence of human pathogens in foods of animal origin. It also addresses the transfer of resistance in animal microbes to human pathogens and the resulting risk of human disease...

  15. Benefits and risks of P & T of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    Abrahams, K. [Netherlands Energy Research Foundation, Petten (Netherlands)

    1995-10-01

    Efforts on waste transmutation are coordinated in a research programme called RAS. One of the aims of this RAS program is to inform the public and advise the authorities on methods for transmutation/conditioning of nuclear waste, and on techniques which are being developed. Such new procedures for the treatment of waste should of course not lead to significant risks for the present population. Small risks might be accepted, but these should sufficiently be compensated for by favours to future generations.

  16. Perceived risk and benefit of nuclear waste repositories: four opinion clusters.

    Science.gov (United States)

    Seidl, Roman; Moser, Corinne; Stauffacher, Michael; Krütli, Pius

    2013-06-01

    Local public resistance can block the site-selection process, construction, and operation of nuclear waste repositories. Social science has established that the perception of risks and benefits, trust in authorities, and opinion on nuclear energy play important roles in acceptance. In particular, risk and benefit evaluations seem critical for opinion formation. However, risks and benefits have rarely been studied independently and, most often, the focus has been on the two most salient groups of proponents and opponents. The aim of this exploratory study is to examine the often-neglected majority of people holding ambivalent or indifferent opinions. We used cluster analysis to examine the sample (N = 500, mailed survey in German-speaking Switzerland) in terms of patterns of risk and benefit perception. We reveal four significantly different and plausible clusters: one cluster with high-benefit ratings in favor of a repository and one cluster with high-risk ratings opposing it; a third cluster shows ambivalence, with high ratings on both risk and benefit scales and moderate opposition, whereas a fourth cluster seems indifferent, rating risks and benefits only moderately compared to the ambivalent cluster. We conclude that a closer look at the often neglected but considerable number of people with ambivalent or indifferent opinions is necessary. Although the extreme factions of the public will most probably not change their opinion, we do not yet know how the opinion of the ambivalent and indifferent clusters might develop over time. © 2012 Society for Risk Analysis.

  17. Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile

    DEFF Research Database (Denmark)

    Jensen, Dorte Møller; Sørensen, B; Feilberg-Jørgensen, N

    2000-01-01

    To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes.......To assess maternal and fetal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM) compared to non-diabetic pregnancies with an otherwise similar risk profile and to study the association between different anti-diabetic treatments and fetal outcomes....

  18. Social media as a useful tool in food risk and benefit communication? A strategic orientation approach

    OpenAIRE

    Verbeke, W.; Santare, D.; Guzzon, A.; Lozano, N.; Lores, M.; Kuttschreuter, M.; McConnon, Á.; Regan, Á.; Pieniak, Z.; Rutsaert, P.

    2014-01-01

    10.1016/j.foodpol.2014.02.003 Although considerable progress has been made in understanding the determinants of risk perception and in identifying the necessary components of effective food risk and benefit communication, this has not been matched with the development of efficient and appropriate communication tools. Little work has been done examining the implications of the explosion of new media and web technologies, which may offer potential for improving food risk and benefit communi...

  19. Implications of supermarket access, neighbourhood walkability and poverty rates for diabetes risk in an employee population.

    Science.gov (United States)

    Herrick, Cynthia J; Yount, Byron W; Eyler, Amy A

    2016-08-01

    Diabetes is a growing public health problem, and the environment in which people live and work may affect diabetes risk. The goal of the present study was to examine the association between multiple aspects of environment and diabetes risk in an employee population. This was a retrospective cross-sectional analysis. Home environment variables were derived using employees' zip code. Descriptive statistics were run on all individual- and zip-code-level variables, stratified by diabetes risk and worksite. A multivariable logistic regression analysis was then conducted to determine the strongest associations with diabetes risk. Data were collected from employee health fairs in a Midwestern health system, 2009-2012. The data set contains 25 227 unique individuals across four years of data. From this group, using an individual's first entry into the database, 15 522 individuals had complete data for analysis. The prevalence of high diabetes risk in this population was 2·3 %. There was significant variability in individual- and zip-code-level variables across worksites. From the multivariable analysis, living in a zip code with higher percentage of poverty and higher walk score was positively associated with high diabetes risk, while living in a zip code with higher supermarket density was associated with a reduction in high diabetes risk. Our study underscores the important relationship between poverty, home neighbourhood environment and diabetes risk, even in a relatively healthy employed population, and suggests a role for the employer in promoting health.

  20. Risk Factors for Type 2 Diabetes in Bangladesh: A Systematic Review

    Directory of Open Access Journals (Sweden)

    T Sal-sabil

    2016-01-01

    Full Text Available Diabetes is one of the most significant public health challenge in developing countries. The risk factors for diabetes are poorly understood among the Bangladeshi population. This study aimed to explore the potential risk factors for type 2 diabetes in Bangladesh. A systematic review was performed. Studies describing the risk factors for type 2 diabetes in Bangladesh published between 1994 to 2014 were included and summarized. Of the 35 studies identified, we included 14 studies that met the inclusion criteria. The prevalence of diabetes was higher among females compared to males. Fourteen common risk factors for diabetes in Bangladesh were identified, namely increased age, obesity, waist- hip ratio, social class, hypertension, family history, sedentary life style among others. The p otential risk factors differed by urban-rural areas and by gender. Several risk factors contribute to the increasing prevalence of type 2 diabetes. Our reviews suggest "metabolically-disadvantageous" body composition of more abdominal and visceral fat in Bangladeshi adults might cause higher diabetes risk at a lower BMI compared to Western population. Preventive strategies targeting to control risk factors for diabetes is a priority public health issue and should be considered for early intervention by clinicians and policy makers.

  1. Interpersonal amplification of risk? Citizen discussions and their impact on perceptions of risks and benefits of a biological research facility.

    Science.gov (United States)

    Binder, Andrew R; Scheufele, Dietram A; Brossard, Dominique; Gunther, Albert C

    2011-02-01

    Much risk communication research has demonstrated how mass media can influence individual risk perceptions, but lacks a comprehensive conceptual understanding of another key channel of communication: interpersonal discussion. Using the social amplification of risk as a theoretical framework, we consider the potential for discussions to function as amplification stations. We explore this possibility using data from a public opinion survey of residents living in potential locations for a new biological research facility in the United States. Controlling for a variety of key information variables, our results show that two dimensions of discussion-frequency and valence-have impacts on residents' perceptions of the facility's benefits and its risks. We also explore the possibility that an individual's overall attitude moderates the effect of discussion on their perceptions of risks and benefits. Our results demonstrate the potential for discussions to operate as amplifiers or attenuators of perceptions of both risks and benefits. © 2010 Society for Risk Analysis.

  2. Utility of Childhood Glucose Homeostasis Variables in Predicting Adult Diabetes and Related Cardiometabolic Risk Factors

    OpenAIRE

    Nguyen, Quoc Manh; Srinivasan, Sathanur R.; Xu, Ji-Hua; Chen, Wei; Kieltyka, Lyn; Berenson, Gerald S.

    2009-01-01

    OBJECTIVE This study examines the usefulness of childhood glucose homeostasis variables (glucose, insulin, and insulin resistance index [homeostasis model assessment of insulin resistance {HOMA-IR}]) in predicting pre-diabetes and type 2 diabetes and related cardiometabolic risk factors in adulthood. RESEARCH DESIGN AND METHODS This retrospective cohort study consisted of normoglycemic (n = 1,058), pre-diabetic (n = 37), and type 2 diabetic (n = 25) adults aged 19–39 years who were followed o...

  3. Impact of Lifestyle and Metformin Interventions on the Risk of Progression to Diabetes and Regression to Normal Glucose Regulation in Overweight or Obese People With Impaired Glucose Regulation.

    Science.gov (United States)

    Herman, William H; Pan, Qing; Edelstein, Sharon L; Mather, Kieren J; Perreault, Leigh; Barrett-Connor, Elizabeth; Dabelea, Dana M; Horton, Edward; Kahn, Steven E; Knowler, William C; Lorenzo, Carlos; Pi-Sunyer, Xavier; Venditti, Elizabeth; Ye, Wen

    2017-12-01

    Both lifestyle and metformin interventions can delay or prevent progression to type 2 diabetes mellitus (DM) in people with impaired glucose regulation, but there is considerable interindividual variation in the likelihood of receiving benefit. Understanding an individual's 3-year risk of progressing to DM and regressing to normal glucose regulation (NGR) might facilitate benefit-based tailored treatment. We used the values of 19 clinical variables measured at the Diabetes Prevention Program (DPP) baseline evaluation and Cox proportional hazards models to assess the 3-year risk of progression to DM and regression to NGR separately for DPP lifestyle, metformin, and placebo participants who were adherent to the interventions. Lifestyle participants who lost ≥5% of their initial body weight at 6 months and metformin and placebo participants who reported taking ≥80% of their prescribed medication at the 6-month follow-up were defined as adherent. Eleven of 19 clinical variables measured at baseline predicted progression to DM, and 6 of 19 predicted regression to NGR. Compared with adherent placebo participants at lowest risk of developing diabetes, participants at lowest risk of developing diabetes who adhered to a lifestyle intervention had an 8% absolute risk reduction (ARR) of developing diabetes and a 35% greater absolute likelihood of reverting to NGR. Participants at lowest risk of developing diabetes who adhered to a metformin intervention had no reduction in their risk of developing diabetes and a 17% greater absolute likelihood of reverting to NGR. Participants at highest risk of developing DM who adhered to a lifestyle intervention had a 39% ARR of developing diabetes and a 24% greater absolute likelihood of reverting to NGR, whereas those who adhered to the metformin intervention had a 25% ARR of developing diabetes and an 11% greater absolute likelihood of reverting to NGR. Unlike our previous analyses that sought to explain population risk, these

  4. Impact of gestational diabetes on the risk of diabetes following pregnancy among Chinese and South Asian women.

    Science.gov (United States)

    Mukerji, G; Chiu, M; Shah, B R

    2012-08-01

    Ethnicity and gestational diabetes mellitus (GDM) are both risk factors for the development of type 2 diabetes. However, it is uncertain whether ethnicity modifies the effect of GDM on diabetes risk. We aimed to determine the risk of diabetes following pregnancy with and without GDM for Chinese and South Asian women compared with white women. Using healthcare databases, all 1,050,108 women aged 20-49 with live births between January 1995 and June 2008 in Ontario were identified. They were followed for up to 15 years for the diagnosis of diabetes. The age-standardised prevalences of GDM were 4.1%, 7.1% and 2.9% for Chinese, South Asian and white women, respectively. The cumulative incidence of diagnosed diabetes at the median follow-up time of 7.6 years was 16.5% and 1.8% for Chinese women with and without GDM, 31.8% and 3.6% for South Asian women with and without GDM, and 25.7% and 1.8% for white women with and without GDM. The presence of GDM conferred an increase in the risk for diabetes after pregnancy of more than 13-fold in white women, but only a nine- to tenfold increase among Chinese and South Asian women. Although one-third of South Asian women with GDM were diagnosed with diabetes within 8 years postpartum, the incremental impact of GDM on diabetes risk was not as strong among Chinese and South Asian women as it was among white women.

  5. Perception of Risk for Developing Diabetes Among Foreign-Born Spanish-Speaking US Latinos.

    Science.gov (United States)

    Joiner, Kevin L; Sternberg, Rosa Maria; Kennedy, Christine M; Fukuoka, Yoshimi; Chen, Jyu-Lin; Janson, Susan L

    2016-08-01

    The purpose of the study was to describe perception of risk for developing diabetes among foreign-born Spanish-speaking US Latinos. Participants (N = 146), recruited at food-pantry distribution events and free clinics, were surveyed using the Risk Perception Survey for Developing Diabetes in Spanish. Type 2 diabetes risk factors measured included body mass index, physical activity, and A1C. Sample characteristics were mean (SD) age of 39.5 (9.9) years, 58% with less than a high school graduate-level education, and 65% with a family income less than $15,000/year. Prevalence of risk factors was 81% overweight or obese, 47% less than 150 minutes/week moderate/vigorous-intensity physical activity, and 12% A1C consistent with prediabetes. Of the 135 participants with complete data, 31% perceived a high/moderate risk for developing diabetes. In univariate logistic regression analyses, 9 of 18 potential variables were significant (P perception of risk. When these 9 variables were entered into a multiple logistic regression model, 5 were significant predictors of perception of risk: history of gestational diabetes, high school graduate or above, optimistic bias, worry, and perceived personal disease risk. Use of the Spanish-language translation of the Risk Perception Survey for Developing Diabetes revealed factors influencing perception of risk for developing diabetes. Results can be used to promote culturally acceptable type 2 diabetes primary prevention strategies and provide a useful comparison to other populations. © 2016 The Author(s).

  6. Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes.

    Science.gov (United States)

    Kanikarla-Marie, Preeti; Jain, Sushil K

    2016-06-01

    Diets that boost ketone production are increasingly used for treating several neurological disorders. Elevation in ketones in most cases is considered favorable, as they provide energy and are efficient in fueling the body's energy needs. Despite all the benefits from ketones, the above normal elevation in the concentration of ketones in the circulation tend to illicit various pathological complications by activating injurious pathways leading to cellular damage. Recent literature demonstrates a plausible link between elevated levels of circulating ketones and oxidative stress, linking hyperketonemia to innumerable morbid conditions. Ketone bodies are produced by the oxidation of fatty acids in the liver as a source of alternative energy that generally occurs in glucose limiting conditions. Regulation of ketogenesis and ketolysis plays an important role in dictating ketone concentrations in the blood. Hyperketonemia is a condition with elevated blood levels of acetoacetate, 3-β-hydroxybutyrate, and acetone. Several physiological and pathological triggers, such as fasting, ketogenic diet, and diabetes cause an accumulation and elevation of circulating ketones. Complications of the brain, kidney, liver, and microvasculature were found to be elevated in diabetic patients who had elevated ketones compared to those diabetics with normal ketone levels. This review summarizes the mechanisms by which hyperketonemia and ketoacidosis cause an increase in redox imbalance and thereby increase the risk of morbidity and mortality in patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Are obesity and anthropometry risk factors for diabetic retinopathy? The diabetes management project.

    Science.gov (United States)

    Dirani, Mohamed; Xie, Jing; Fenwick, Eva; Benarous, Rehab; Rees, Gwyneth; Wong, Tien Yin; Lamoureux, Ecosse L

    2011-06-22

    To investigate the relationship between anthropometric parameters and diabetic retinopathy (DR) in adults with diabetes. Five hundred participants with diabetes were recruited prospectively from ophthalmology clinics in Melbourne, Australia. Each underwent an eye examination, anthropometric measurements, and standardized interview-administered questionnaires, and fasting blood glucose and serum lipids were analyzed. Two-field fundus photographs were taken and graded for DR. Height; weight; body mass index (BMI); waist, hip, neck, and head circumferences; and skinfold measurements were recorded. A total of 492 patients (325 men, 66.1%) aged between 26 and 90 years (median, 65) were included in the analysis: 171 (34.8%), 187 (38.0%), and 134 (27.2%) with no DR, nonproliferative DR (NPDR), and proliferative DR (PDR), respectively. After multiple adjustments, higher BMI (odds ratio [OR], 1.06; 95% confidence interval [CI],1.01-1.11; P = 0.02) was significantly associated with any DR. Obese people were 6.5 times more likely to have PDR than were those with normal weight (OR, 6.52; 95% CI, 1.49-28.6; P = 0.013). Neck circumference (OR, 1.05; 95% CI, 1.00-1.10; P = 0.03) and waist circumference (OR, 1.12; 95% CI, 1.03-1.22; P = 0.01) were significantly associated with any DR. BMI (OR, 1.04; 95% CI, 1.00-1.08; P = 0.04) and neck circumference (OR, 1.04 95% CI, 1.01-1.08; P = 0.04) were also positively associated with increasing severity levels of DR. Persons with diabetes with higher BMI and larger neck circumference are more likely to have DR and more severe stages of DR. These data suggest that obesity is an independent risk factor for DR.

  8. Periodontal Microorganisms and Cardiovascular Risk Markers in Youth With Type 1 Diabetes and Without Diabetes.

    Science.gov (United States)

    Merchant, Anwar T; Nahhas, Georges J; Wadwa, R Paul; Zhang, Jiajia; Tang, Yifan; Johnson, Lonnie R; Maahs, David M; Bishop, Franziska; Teles, Ricardo; Morrato, Elaine H

    2016-04-01

    A subset of periodontal microorganisms has been associated with cardiovascular disease (CVD), which is the leading complication of type 1 diabetes (t1DM). The authors therefore evaluated the association between periodontal microorganism groups and early markers of CVD in youth with t1DM. A cross-sectional analysis was conducted among youth aged 12 to 19 years at enrollment; 105 had t1DM for ≥5 years and were seeking care at the Barbara Davis Center, University of Colorado, from 2009 to 2011, and 71 did not have diabetes. Subgingival plaque samples were assessed for counts of 41 periodontal microorganisms using DNA-DNA hybridization. Microorganisms were classified using cluster analysis into four groups named red-orange, orange-green, blue/other, and yellow/other, modified from Socransky's color scheme for periodontal microorganisms. Subsamples (54 with t1DM and 48 without diabetes) also received a periodontal examination at the University of Colorado School of Dental Medicine. Participants were ≈15 years old on average, and 74% were white. Mean periodontal probing depth was 2 mm (SE 0.02), and 17% had bleeding on probing. In multivariable analyses, glycated hemoglobin (HbA1c) was inversely associated with the yellow/other cluster (microorganisms that are not associated with periodontal disease) among youth with t1DM. Blood pressure, triglycerides, low-density lipoprotein, high-density lipoprotein, and total cholesterol were not associated with microorganism clusters in this group. HbA1c was not associated with periodontal microorganism clusters among youth without diabetes. Among youth with t1DM who had good oral health, periodontal microorganisms were not associated with CVD risk factors.

  9. Health benefits of reducing sugar-sweetened beverage intake in high risk populations of California: results from the cardiovascular disease (CVD policy model.

    Directory of Open Access Journals (Sweden)

    Tekeshe A Mekonnen

    Full Text Available Consumption of sugar-sweetened beverage (SSB has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and coronary heart disease (CHD. Reduction of SSB intake and the potential impact on health outcomes in California and among racial, ethnic, and low-income sub-groups has not been quantified.We projected the impact of reduced SSB consumption on health outcomes among all Californians and California subpopulations from 2013 to 2022. We used the CVD Policy Model - CA, an established computer simulation of diabetes and heart disease adapted to California. We modeled a reduction in SSB intake by 10-20% as has been projected to result from proposed penny-per-ounce excise tax on SSB and modeled varying effects of this reduction on health parameters including body mass index, blood pressure, and diabetes risk. We projected avoided cases of diabetes and CHD, and associated health care cost savings in 2012 US dollars.Over the next decade, a 10-20% SSB consumption reduction is projected to result in a 1.8-3.4% decline in the new cases of diabetes and an additional drop of 0.5-1% in incident CHD cases and 0.5-0.9% in total myocardial infarctions. The greatest reductions are expected in African Americans, Mexican Americans, and those with limited income regardless of race and ethnicity. This reduction in SSB consumption is projected to yield $320-620 million in medical cost savings associated with diabetes cases averted and an additional savings of $14-27 million in diabetes-related CHD costs avoided.A reduction of SSB consumption could yield substantial population health benefits and cost savings for California. In particular, racial, ethnic, and low-income subgroups of California could reap the greatest health benefits.

  10. Patients with type 2 diabetes benefit from primary care-based disease management: a propensity score matched survival time analysis.

    Science.gov (United States)

    Drabik, Anna; Büscher, Guido; Thomas, Karsten; Graf, Christian; Müller, Dirk; Stock, Stephanie

    2012-08-01

    This study aimed to assess the impact of a nationwide German diabetes mellitus disease management program (DMP) on survival time and costs in comparison to routine care. The authors conducted a retrospective observational cohort study using routine administration data from Germany's largest sickness fund to identify insured suffering from diabetes in 2002. A total of 95,443 insured with type 2 diabetes mellitus who were born before January 1, 1962 met the defined inclusion criteria, resulting in 19,888 pairs of DMP participants and nonparticipants matched for socioeconomic and health status using propensity score matching methods. This is the first time propensity score matching has been used to evaluate a survival benefit of DMPs. In the time frame analyzed (3 years), mean survival time for the DMP group was 1045 days vs. 985 days for the routine care group (Ptime. They also incurred lower costs compared to propensity score matched insured in routine care.

  11. Correlation of hs-CRP with environmental risk factors of nephropathy in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Jay Prakash Sah

    2015-06-01

    Full Text Available The objective of the present study was to investigate the association of hs-CRP levels with environmental risk factors of diabetic nephropathy like smoking, drinking alcohol, diet, age of diabetic patient, duration of diabetes, medication of diabetes, and blood pressure medication. A hospital-based quantitative study was conducted at the Department of Clinical Biochemistry of Manipal Teaching Hospital (MTH Pokhara, Nepal, with 89 patients suffering from type 2 diabetes. Blood samples (n=89 from the patients were collected and the serums were separated. On the other hand, data on environmental risk factors of nephropathy were collected by using standard questionnaire. In this study, serum hs-CRP level was not found to be correlated with smoking (p=0.111, alcohol consumption (p=0.722, diet (p=0.496, duration of diabetes (p=0.519, age of diabetic patient (p=0.369, medication of diabetes (p=0.734, and blood pressure medication (p=0.625. Hence, our study concludes that serum hs-CRP value in type 2 diabetic patients is insignificantly correlated with the risk factors especially smoking, drinking alcohol, diet, duration of diabetes, age of diabetic patient, medication of diabetes, and medication of blood pressure.

  12. Risk and benefit associated with preventive mammography examinations

    International Nuclear Information System (INIS)

    Vladar, M.; Nikodemova, D.

    1998-01-01

    The risk of mammographic examination was estimated. It is concluded that a mean glandular dose (MGD) of 1 mGy per exposure can be associated with a risk of 1 radiation-induced carcinoma per less than 100 positive detected by the preventive examination. The variability of actual MGD at various hospitals can be quite large. Although the majority of measurements were made on phantoms it is assumed that the national MGD average will exceed 3 mGy for the average breast size of 55 mm

  13. Nuclear power: accident probabilities, risks, and benefits. A bibliography

    International Nuclear Information System (INIS)

    1976-02-01

    This report is a selected listing of 396 documents pertaining to nuclear accident probability and nuclear risk. Because of the attention focused on these concepts by the recent (August 1974) publication of the draft of WASH-1400, ''Reactor Safety Study,'' it is intended that this bibliography make conveniently available the existence of relevant literature on these concepts. Such an awareness will enhance an understanding of probability and risk as applied to nuclear power plants and is essential to their further development and/or application. This bibliography includes first a listing of the selected documents with abstracts and keywords, followed by three indexes: (1) keyword, (2) author, and (3) permuted title

  14. Public opinion about biofuels: The interplay between party identification and risk/benefit perception

    International Nuclear Information System (INIS)

    Fung, Timothy K.F.; Choi, Doo Hun; Scheufele, Dietram A.; Shaw, Bret R.

    2014-01-01

    Using an experiment embedded within a representative survey, this study examined the interactive effect of party identification and risk/benefit perception on public opinion about biofuels. Democrats tended to be more supportive of biofuels than Republicans. However, the effect of party identification on opinion about biofuels varied when individuals considered the risk/benefit of biofuels in different domains. Individuals who reported greater affiliation with the Democratic Party were likely to support funding biofuels research when primed with the economic risks or the social/ethical benefits of biofuels. For those who considered the social/ethical benefits of biofuels, more self-identified Democrats were likely to support biofuels production and use. However, more self-identified Democrats were less supportive of biofuels production and use when they considered the political risks of biofuels. Implications are discussed. - Highlights: • We examined public opinion about biofuels policies. • Effect of risk/benefit perception varied across respondents' party identification. • Democrats favored more research when considering economic risks or social benefits. • Democrats favored biofuels more when considering social benefits. • Democrats favored biofuels less when considering political risks

  15. A counterfactual p-value approach for benefit-risk assessment in clinical trials.

    Science.gov (United States)

    Zeng, Donglin; Chen, Ming-Hui; Ibrahim, Joseph G; Wei, Rachel; Ding, Beiying; Ke, Chunlei; Jiang, Qi

    2015-01-01

    Clinical trials generally allow various efficacy and safety outcomes to be collected for health interventions. Benefit-risk assessment is an important issue when evaluating a new drug. Currently, there is a lack of standardized and validated benefit-risk assessment approaches in drug development due to various challenges. To quantify benefits and risks, we propose a counterfactual p-value (CP) approach. Our approach considers a spectrum of weights for weighting benefit-risk values and computes the extreme probabilities of observing the weighted benefit-risk value in one treatment group as if patients were treated in the other treatment group. The proposed approach is applicable to single benefit and single risk outcome as well as multiple benefit and risk outcomes assessment. In addition, the prior information in the weight schemes relevant to the importance of outcomes can be incorporated in the approach. The proposed CPs plot is intuitive with a visualized weight pattern. The average area under CP and preferred probability over time are used for overall treatment comparison and a bootstrap approach is applied for statistical inference. We assess the proposed approach using simulated data with multiple efficacy and safety endpoints and compare its performance with a stochastic multi-criteria acceptability analysis approach.

  16. Benefits of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise on albuminuria in diabetic and non-diabetic Japanese populations.

    Science.gov (United States)

    Yamamoto-Kabasawa, Keiko; Hosojima, Michihiro; Yata, Yusuke; Saito, Mariko; Tanaka, Noriko; Tanaka, Junta; Tanabe, Naohito; Narita, Ichiei; Arakawa, Masaaki; Saito, Akihiko

    2015-12-01

    Albuminuria is a biomarker for chronic kidney disease and an independent predictor of cardiovascular and all-cause mortality. A recent meta-analysis concluded that these risks increase with urinary albumin concentration, even when below the microalbuminuria threshold. Thus, minimizing urinary albumin may be a valuable therapeutic goal regardless of disease status. We investigated the benefits and safety of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise for reducing albuminuria in 295 normoalbuminuric or microalbuminuric Japanese adults, including 30 with type 2 diabetes mellitus (T2DM), 104 with metabolic syndrome (MS), and 145 with hypertension (HT). In the study population, the urinary albumin:creatinine ratio (UACR) was reduced significantly (ΔUACR -3.8 ± 16.8 mg/g, P < 0.001) with no change in estimated glomerular filtration rate (eGFR) (ΔeGFR -0.4 ± 7.4 mL/min/1.73 m(2), P = 0.343). The reduction in UACR was associated with decreased fasting plasma glucose (P < 0.05). The UACR was also reduced in the T2DM, MS, and HT groups with no change in eGFR. Reduced UACR was associated with decreased fasting plasma glucose in the MS group and decreased systolic blood pressure in the HT group. The UACR was also reduced in 46 subjects using renin-angiotensin system inhibitors with no change in eGFR. Our 12-week lifestyle modification program reduced UACR, maintained eGFR, and improved multiple fitness findings in Japanese subjects including T2DM, MS, and HT patients.

  17. Risk Perceptions in Diabetic Patients Who Have Experienced Adverse Events

    DEFF Research Database (Denmark)

    Sachs, Mikkel Lindskov; Sporrong, Sofia Kälvemark; Colding-Jørgensen, Morten

    2017-01-01

    as part of a benefit-risk assessment. However, the degree of heterogeneity of the patient population is critical for how accurately they can be represented by individuals. OBJECTIVES: This study aims to explore patients' risk perception of rare, serious adverse effects of medicines with regard to blood......, perceptions of the terms rare and serious, and overall levels of risk aversion. A thematic analysis of the interviews, including a consensus discussion, was carried out. RESULTS: Interestingly, respondents rarely made a clear distinction between medicines-induced AEs and complications related to disease...... focused on common and less serious AEs, thus disregarding rare and more serious events. CONCLUSION: The study suggests that experience of AEs, related to either medicines or disease, constitutes an important factor of patient risk perception. We therefore propose that serious adverse experiences should...

  18. Do the health benefits of cycling outweigh the risks?

    NARCIS (Netherlands)

    de Hartog, J.J.; Boogaard, H.; Nijland, H.; Hoek, G.

    2012-01-01

    Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic

  19. Young Children and Sports--Weighing the Risks and Benefits.

    Science.gov (United States)

    Elkind, David

    2000-01-01

    Examines the contemporary rationales of parents placing their preschool children in organized sports, including: (1) earlier is better; (2) parent peer pressure; (3) contemporary dangers; and (4) learning of self confidence, self esteem, cooperation and competition. Finds little value and much risk in engaging children at an early age in organized…

  20. Pregnancy after bariatric surgery - a review of benefits and risks

    DEFF Research Database (Denmark)

    Kjær, Mette Karie Mandrup; Nilas, Lisbeth

    2013-01-01

    in restriction of food intake and/or malabsorption leading to weight loss, but may induce a risk for malnutrition and pregnancy complications. Method. Systematically conducted review addressing pregnancy after bariatric surgery using the PubMed and Cochrane databases. Main Outcome Measures. Birthweight...

  1. Cardiovascular benefits and risks across the physical activity continuum.

    NARCIS (Netherlands)

    Eijsvogels, T.M.H.; George, K.P.; Thompson, P.D.

    2016-01-01

    PURPOSE OF REVIEW: Habitual physical activity can reduce the risk of future cardiovascular morbidity and mortality. This review evaluates recent publications that have assessed the impact of the dose of physical (in)activity on cardiovascular outcomes. RECENT FINDINGS: Sedentary behavior,

  2. Decision theory and the evaluation of risks and benefits of clinical trials.

    Science.gov (United States)

    Bernabe, Rosemarie D C; van Thiel, Ghislaine J M W; Raaijmakers, Jan A M; van Delden, Johannes J M

    2012-12-01

    Research ethics committees (RECs) are tasked to assess the risks and the benefits of a clinical trial. In previous studies, it was shown that RECs find this task difficult, if not impossible, to do. The current approaches to benefit-risk assessment (i.e. Component Analysis and the Net Risk Test) confound the various risk-benefit tasks, and as such, make balancing impossible. In this article, we show that decision theory, specifically through the expected utility theory and multiattribute utility theory, enable for an explicit and ethically weighted risk-benefit evaluation. This makes a balanced ethical justification possible, and thus a more rationally defensible decision making. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Meeting the challenges in the development of risk-benefit assessment of foods

    DEFF Research Database (Denmark)

    Nauta, Maarten; Andersen, Rikke; Pilegaard, Kirsten

    2018-01-01

    challenges are identified and discussed. They include the variety of different definitions and terminologies used in the underlying research disciplines, the differences between the “bottom-up” and the “top-down” approaches and the need for clear risk-benefit questions. The frequent lack of data......Background Risk-benefit assessment (RBA) of foods aims to assess the combined negative and positive health effects associated with food intake. RBAs integrate chemical and microbiological risk assessment with risk and benefit assessment in nutrition. Scope and Approach Based on the past experiences...... interdisciplinary consensus, reconsideration of methodological approaches and health metrics based on a categorisation of risk-benefit questions, and the performance of case studies to experience the feasibility of the proposed approaches....

  4. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study.

    Science.gov (United States)

    Zhang, Cuilin; Tobias, Deirdre K; Chavarro, Jorge E; Bao, Wei; Wang, Dong; Ley, Sylvia H; Hu, Frank B

    2014-09-30

    To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Prospective cohort study. Nurses' Health Study II, United States. 20,136 singleton live births in 14,437 women without chronic disease. Self reported incident gestational diabetes diagnosed by a physician, validated by medical records in a previous study. Incident first time gestational diabetes was reported in 823 pregnancies. Each lifestyle factor measured was independently and significantly associated with risk of gestational diabetes. The combination of three low risk factors (non-smoker, ≥ 150 minutes a week of moderate to vigorous physical activity, and healthy eating (top two fifths of Alternate Healthy Eating Index-2010 adherence score)) was associated with a 41% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.59, 95% confidence interval 0.48 to 0.71). Addition of body mass index (BMI) diabetes compared with all other pregnancies (relative risk 0.48, 0.38 to 0.61). Compared with pregnancies in women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of gestational diabetes (relative risk 0.17, 0.12 to 0.25). The population attributable risk percentage of the four risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar population attributable risk percentage (49.2%) was observed when the distributions of the four low risk factors from the US National Health and Nutrition Examination Survey (2007-10) data were applied to the calculation. Adherence to a low risk lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective strategy for the prevention of gestational diabetes. © Zhang et al 2014.

  5. Risks versus benefits of medication use during pregnancy : What do women perceive?

    NARCIS (Netherlands)

    Mulder, Bianca; Schuiling-Veninga, Nynke C.M.; Morssink, Leonard P.; Bijlsma, Maarten J.; Van Puijenbroek, Eugene; Aarnoudse, Jan G.; Hak, Eelko; De Vries, Tjalling W.

    2014-01-01

    Background: Understanding risk perception is essential in designing good risk communication strategies. It has been reported that women overestimate the teratogenic risk of medication use, but these studies didn't include perceived benefits and major concerns of pregnant women regarding medication

  6. Metabolic Effects of Mulberry Leaves: Exploring Potential Benefits in Type 2 Diabetes and Hyperuricemia

    Directory of Open Access Journals (Sweden)

    A. Hunyadi

    2013-01-01

    Full Text Available The leaves of Morus alba L. have a long history in Traditional Chinese Medicine and also became valued by the ethnopharmacology of many other cultures. The worldwide known antidiabetic use of the drug has been suggested to arise from a complex combination effect of various constituents. Moreover, the drug is also a potential antihyperuricemic agent. Considering that type 2 diabetes and hyperuricemia are vice-versa in each other’s important risk factors, the use of mulberry originated phytotherapeutics might provide an excellent option for the prevention and/or treatment of both conditions. Here we report a series of relevant in vitro and in vivo studies on the bioactivity of an extract of mulberry leaves and its fractions obtained by a stepwise gradient on silica gel. In vivo antihyperglycemic and antihyperuricemic activity, plasma antioxidant status, as well as in vitro glucose consumption by adipocytes in the presence or absence of insulin, xanthine oxidase inhibition, free radical scavenging activity, and inhibition of lipid peroxidation were tested. Known bioactive constituents of M. alba (chlorogenic acid, rutin, isoquercitrin, and loliolide were identified and quantified from the HPLC-DAD fingerprint chromatograms. Iminosugar contents were investigated by MS/MS, 1-deoxynojirimycin was quantified, and amounts of 2-O-alpha-D-galactopyranosyl-1-deoxynojirimicin and fagomine were additionally estimated.

  7. The risk of postpartum maternal hyperglycaemia in women with gestational diabetes is reduced by breastfeeding

    LENUS (Irish Health Repository)

    O'Reilly, MW

    2011-09-01

    Background and aims: Gestational diabetes (GDM) is associated with adverse fetal and maternal outcomes. It identifies women at risk of pre-diabetes, type 2 diabetes (T2DM) and cardiovascular risk in later life. Recent studies have suggested that breastfeeding may confer a beneficial effect on postpartum maternal glucose tolerance in both women with GDM and normal glucose tolerance (NGT) in pregnancy.\\r\

  8. Is exposure to chronic stressors a risk factor for Type 2 diabetes?

    OpenAIRE

    Kelly, Shona; Ismail, Mubarak

    2014-01-01

    Background - Current policy around Type 2 diabetes (T2D) interventions to reduce rates largely invokes a bio-behavioural model. This approach is also reflected in the research literature where most research that attempts to predict the development of diabetes is restricted to conventional clinical risk factors. However, a few researchers are now suggesting that psychosocial factors (PSF), acting via the physiologic stress response (PSR) systems, increases the risk of developing diabetes. Card...

  9. Risks and Benefits of Helicobacter pylori Eradication: Current Status

    Directory of Open Access Journals (Sweden)

    Richard H Hunt

    2002-01-01

    Full Text Available In patients with diseases known to be associated with Helicobacter pylori infection, such as peptic ulcer, treatment of the underlying infection is the standard of care. However, in most major consensus management guidelines, including those published in Canada, widespread testing for H pylori infection is not recommended. This practice is not encouraged because of insufficient evidence of cost-benefit in gastric cancer prevention, the potential for increases in antibiotic resistance and the controversial hypothesis of potential negative effects of eradication in certain clinical entities. For example, there is insufficient evidence to recommend against eradicating H pylori discovered in a patient with symptoms of gastroesophageal reflux disease. The management guidelines designed specifically in Canada should, therefore, continue to be applied, with H pylori diagnosed and treated in appropriately selected patients.

  10. Radiation Dose Risk and Diagnostic Benefit in Imaging Investigations

    OpenAIRE

    Dobrescu, Lidia; Rădulescu, Gheorghe-Cristian

    2015-01-01

    The paper presents many facets of medical imaging investigations radiological risks. The total volume of prescribed medical investigations proves a serious lack in monitoring and tracking of the cumulative radiation doses in many health services. Modern radiological investigations equipment is continuously reducing the total dose of radiation due to improved technologies, so a decrease in per caput dose can be noticed, but the increasing number of investigations has determined a net increase ...

  11. Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease : The Atherosclerosis Risk in Communities Study

    NARCIS (Netherlands)

    Alexander, Nadine; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana; Mahmoodi, Bakhtawar K.; Astor, Brad C.; Coresh, Josef

    2015-01-01

    Background: Whether the association of chronic kidney disease (CKD) with cardiovascular risk differs based on diabetes mellitus (DM) and hypertension (HTN) status remains unanswered. Methods: We investigated 11,050 participants from the Atherosclerosis Risk in Communities Study (fourth examination

  12. Accounting for risk aversion, income distribution, and social welfare in cost-benefit analysis for flood risk management

    NARCIS (Netherlands)

    Kind, Jarl; Botzen, W.J.W.|info:eu-repo/dai/nl/297620584; Aerts, Jeroen

    2017-01-01

    Most cost-benefit analysis (CBA) textbooks and guidelines recognize the objective of CBAs to improve social welfare—a function of well-being of all individuals, conceptualized by utility. However, today's common practice to value flood risk management benefits as the reduction of the expected annual

  13. Diabetes mellitus, fasting glucose, and risk of cause-specific death

    DEFF Research Database (Denmark)

    Seshasai, Sreenivasa Rao Kondapally; Kaptoge, Stephen; Thompson, Alexander

    2011-01-01

    The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain.......The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain....

  14. Coffee consumption and risk of type 2 diabetes: a systematic review

    NARCIS (Netherlands)

    van Dam, R.M.; Hu, F.B.

    2005-01-01

    Context: Emerging epidemiological evidence suggests that higher coffee consumption may reduce the risk of type 2 diabetes. Objective: To examine the association between habitual coffee consumption and risk of type 2 diabetes and related outcomes. Data Sources and Study Selection: We searched MEDLINE

  15. Comparison of accuracy of diabetes risk score and components of the metabolic syndrome in assessing risk of incident type 2 diabetes in Inter99 cohort.

    Directory of Open Access Journals (Sweden)

    Tracy B Shafizadeh

    Full Text Available BACKGROUND: Given the increasing worldwide incidence of diabetes, methods to assess diabetes risk which would identify those at highest risk are needed. We compared two risk-stratification approaches for incident type 2 diabetes mellitus (T2DM; factors of metabolic syndrome (MetS and a previously developed diabetes risk score, PreDx® Diabetes Risk Score (DRS. DRS assesses 5 yr risk of incident T2DM based on the measurement of 7 biomarkers in fasting blood. METHODOLOGY/PRINCIPAL FINDINGS: DRS was evaluated in baseline serum samples from 4,128 non-diabetic subjects in the Inter99 cohort (Danes aged 30-60 for whom diabetes outcomes at 5 years were known. Subjects were classified as having MetS based on the presence of at least 3 MetS risk factors in baseline clinical data. The sensitivity and false positive rate for predicting diabetes using MetS was compared to DRS. When the sensitivity was fixed to match MetS, DRS had a significantly lower false positive rate. Similarly, when the false positive rate was fixed to match MetS, DRS had a significantly higher specificity. In further analyses, subjects were classified by presence of 0-2, 3 or 4-5 risk factors with matching proportions of subjects distributed among three DRS groups. Comparison between the two risk stratification schemes, MetS risk factors and DRS, were evaluated using Net Reclassification Improvement (NRI. Comparing risk stratification by DRS to MetS factors in the total population, the NRI was 0.146 (p = 0.008 demonstrating DRS provides significantly improved stratification. Additionally, the relative risk of T2DM differed by 15 fold between the low and high DRS risk groups, but only 8-fold between the low and high risk MetS groups. CONCLUSIONS/SIGNIFICANCE: DRS provides a more accurate assessment of risk for diabetes than MetS. This improved performance may allow clinicians to focus preventive strategies on those most in need of urgent intervention.

  16. Egg consumption and the risk of type 2 diabetes mellitus: a case-control study.

    Science.gov (United States)

    Radzevičienė, Lina; Ostrauskas, Rytas

    2012-08-01

    Type 2 diabetes mellitus appears to involve an interaction between susceptible genetic backgrounds and environmental factors including highly calorific diets. As it is important to identify modifiable risk factors that may help reduce the risk of type 2 diabetes mellitus, the aim of the present study was to determine the association between egg consumption and the risk of type 2 diabetes mellitus. A specifically designed questionnaire was used to collect information on possible risk factors of type 2 diabetes mellitus. The odds ratios and 95 % confidence intervals for type 2 diabetes mellitus were calculated by conditional logistic regression. A case-control study in a Lithuanian out-patient clinic was performed in 2001. A total of 234 cases with a newly confirmed diagnosis of type 2 diabetes mellitus and 468 controls free of the disease. Variables such as BMI, family history of diabetes, cigarette smoking, education, morning exercise and plasma TAG level were retained in multivariate logistic regression models as confounders because their inclusion changed the value of the odds ratio by more than 10 % in any exposure category. After adjustment for possible confounders more than twofold increased risk of type 2 diabetes mellitus was determined for individuals consuming 3-4·9 eggs/week (OR = 2·60; 95 % CI 1·34, 5·08) and threefold increased risk of the disease was determined for individuals consuming ≥5 eggs/week (OR = 3·02; 95 % CI 1·14, 7·98) compared with those eating diabetes mellitus.

  17. Does Mindfulness-Based Cognitive Therapy benefit all people with diabetes and comorbid emotional complaints equally?

    DEFF Research Database (Denmark)

    Nyklíček, Ivan; VAN Son, Jenny; Pop, Victor J M

    2016-01-01

    , and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT)? METHODS: Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized...

  18. Hypoxic training: Clinical benefits on cardiometabolic risk factors.

    Science.gov (United States)

    Wee, Justin; Climstein, Mike

    2015-01-01

    The main aim of this review was to evaluate the effectiveness of hypoxic training on the modulation of cardiometabolic risk factors. Literature review. An electronic search encompassing five databases (PUBMED, EMBASE, MEDLINE, CINAHL, and SPORTDiscus) was conducted. A total of 2138 articles were retrieved. After excluding non-relevant articles, duplications and outcomes not related to cardiometabolic risk factors, 25 articles were chosen for review. Body weight and body composition were reported to be significantly improved when hypoxic training (≥1700 m) was used in conjunction with exercise regimes, at least three times a week, however extreme altitudes (>5000 m) resulted in a loss of fat-free muscle mass. Fasting blood glucose levels generally improved over time (≥21 days) at moderate levels of altitude (1500 m-3000 m), although reductions in blood glucose tolerance were observed when subjects were exposed to extreme hypoxia (>4000 m). Resting systolic and diastolic blood pressure levels improved as much as 26 mmHg and 13 mmHg respectively, with hypoxic training (1285 m-2650 m) in medicated, stable hypertensive subjects. Effects of hypoxic training when used in combination with exercise training on cholesterol levels were mixed. While there were improvements in total cholesterol (-4.2% to -30%) and low-density lipoprotein (-2.6% to -14.3%) reported as a result of hypoxic training, available evidence does not substantiate hypoxic training for the improvement of high-density lipoprotein and triglycerides. In conclusion, hypoxic training may be used as an adjunct treatment to modify some cardiometabolic risk factors. Measurement of hypoxic load may be used to individualize and ascertain appropriate levels of hypoxic training. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  19. Waist circumference threshold values for type 2 diabetes risk.

    Science.gov (United States)

    Friedl, Karl E

    2009-07-01

    Adult gains in body weight, excess adiposity, and intra-abdominal fat have each been associated with risk for type 2 diabetes mellitus (T2DM), forming the basis for preventive medicine guidelines and actuarial predictions using practical indices of weight (e.g., body mass index [BMI]) and waist circumference (WC). As obesity-related disease spreads beyond affluent western countries, application of WC thresholds to other populations has highlighted issues of their generalizability. For example, U.S. national health goals based on BMI technology has provided many great insights into disease, including modern imaging technologies that have differentiated fat depots that have the greatest influence on T2DM, but ultimately, an inexpensive measuring tape provides the most useful and cost-effective preventive measure for T2DM today. At some point in the future, a Star Trek-like abdominal body fat "tricorder" noninvasive assessment of tissue composition may provide an advantage over abdominal girth. Copyright 2009 Diabetes Technology Society.

  20. Rare neonatal diabetes insipidus and associated late risks: Case report

    Directory of Open Access Journals (Sweden)

    Rivas-Crespo Maximiliano

    2012-05-01

    Full Text Available Abstract Background Most cases of neonatal central diabetes insipidus are caused by an injury, which often results in other handicaps in the patient. The infant’s prognosis will be determined by his or her own early age and disability as well as by the physician’s skill. However, the rarity of this condition prevents the acquisition of personal experience dealing with it. Case Presentation A neonatal hemorrhagic stroke, caused by an aortic coarctation, caused right lower limb paresis, swallowing disability, and central diabetes insipidus in a term infant. The scant oral intake, as a consequence of his disability, caused progressive undernutrition which closed a vicious circle, delaying his development and his ability to overcome the swallowing handicap. On the other hand, nasal desmopressin absorption was blocked by several common colds, resulting in brain bleeding because of severe dehydration. This even greater brain damage hampered the improvement of swallowing, closing a second harmful circle. Moreover, a devastating central myelinolysis with quadriplegia, caused by an uncontrolled intravenous infusion, consummated a pernicious sequence, possibly unreported. Conclusions The child’s overall development advanced rapidly when his nutrition was improved by gastrostomy: This was a key effect of nutrition on his highly sensitive neurodevelopment. Besides, this case shows potential risks related to intranasal desmopressin treatment in young children.

  1. Risk benefits of climate-friendly energy supply options

    International Nuclear Information System (INIS)

    Hirschberg, S.; Burgherr, P.

    2003-01-01

    One of the central goals of sustainable development is the reduction of Greenhouse Gas (GHG) emissions. This is needed in order to prevent the anticipated climate change, and the potentially serious consequences for human beings and the environment. Energy supply systems constitute the dominant contributors to GHG emissions. This paper examines three illustrative emission scenarios for world-wide energy supply in the 21 st Century. These scenarios, including the associated GHG and major pollutant emissions, were chosen from a set established by the Intergovernmental Panel on Climate Change (IPCC). Using the emissions as a starting point, and based on recent findings concerning the impact on the environment and the financial costs resulting from global climate change on the one hand, and regional air pollution on the other hand, the present work provides estimates of the scenario-dependent, world-wide cumulative damage. The fossil-intensive reference scenario leads to overall damages which correspond to very substantial losses in Gross Domestic Product (GDP), and which widely exceed the damages caused by the scenarios reflecting climate-friendly policies. Generally, the somewhat speculative estimates of the GHG-specific damages are much less significant than damages to human health and the environment caused by the major air pollutants. This means that the secondary benefits of climate-friendly, energy-supply options, i.e. those which avoid the impacts due to air pollution, alone justify strategies protecting the climate. (author)

  2. Benefits and risks of bronchopulmonary lavage: a review

    International Nuclear Information System (INIS)

    Nolibe, D.; Metivier, H.; Masse, R.; Chretien, J.

    1989-01-01

    Studies were conducted in beagle dogs and baboons over a period of 20 years to determine the efficiency of treatment by lung lavage after inhalation of insoluble radioactive particles. The radionuclides tested were 144 Ce in fused clay, 238 Pu, 239 Pu, 241 Am, Pu-TBP, Pu0 2 , UO 2 , and (Pu,U)0 2 . After inhalation of any of these radionuclides, a single lavage of the two lungs removed almost a quarter of the intitial lung burden (ILB) in the two species. When lavage was repeated five times, it removed up to half of the ILB. However, the individual variation was large. For the same radionuclide, lavage efficiency was independent of the ILB. Particle removal was better and continued longer for particles with a long retention half-time. The use of lavage can be combined with that of chelating agents like DTPA. The removal of radioactive particles lenghtened survival time and reduced the severity of pathology. The lavage in itself is safe, and does not induce permanent or progressive pathology. The biomedical risk of the lavage mainly depends on the risks inherent in anaesthesia and the health status of the patient. (author)

  3. BVDV vaccination in North America: risks versus benefits.

    Science.gov (United States)

    Griebel, Philip J

    2015-06-01

    The control and prevention of bovine viral diarrhea virus (BVDV) infections has provided substantial challenges. Viral genetic variation, persistent infections, and viral tropism for immune cells have complicated disease control strategies. Vaccination has, however, provided an effective tool to prevent acute systemic infections and increase reproductive efficiency through fetal protection. There has been substantial controversy about the safety and efficacy of BVDV vaccines, especially when comparing killed versus modified-live viral (MLV) vaccines. Furthermore, numerous vaccination protocols have been proposed to protect the fetus and ensure maternal antibody transfer to the calf. These issues have been further complicated by reports of immune suppression during natural infections and following vaccination. While killed BVDV vaccines provide the greatest safety, their limited immunogenicity makes multiple vaccinations necessary. In contrast, MLV BVDV vaccines induce a broader range of immune responses with a longer duration of immunity, but require strategic vaccination to minimize potential risks. Vaccination strategies for breeding females and young calves, in the face of maternal antibody, are discussed. With intranasal vaccination of young calves it is possible to avoid maternal antibody interference and induce immune memory that persists for 6-8 months. Thus, with an integrated vaccination protocol for both breeding cows and calves it is possible to maximize disease protection while minimizing vaccine risks.

  4. Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

    The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting ...

  5. Predicting the Risk of Preeclampsia in Pregnant Women with Type 1 Diabetes Mellitus and Concomitant Diabetic Nephropathy: the Role of Genetic Markers

    Directory of Open Access Journals (Sweden)

    T.V. Avramenko

    2015-11-01

    Conclusions. In patients with diabetes mellitus type 1 and concomitant diabetic nephropathy without hypertension, we can recommend to study these polymorphic variants of genes to determine the risk of preeclampsia.

  6. 76 FR 77543 - Quantitative Summary of the Benefits and Risks of Prescription Drugs: A Literature Review

    Science.gov (United States)

    2011-12-13

    ... psychology'' (section 3507(b), Pub. L. 111-148, 124 Stat. 530), and to consult manufacturers and consumers... communication of quantitative benefit and risk information. FDA is making available the literature review report...

  7. Equilibrium in benefits and hazard risk; Keseimbangan manfaat dan risiko kemudaratan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-12-31

    The chapter briefly discussed the following subjects: benefits of nuclear activities, the concept of operation optimization, concept of risks, hazards index, comparison in production costs of nuclear power generation and others sources of power generation.

  8. A comprehensive approach to benefit-risk assessment in drug development

    DEFF Research Database (Denmark)

    Sarac, Sinan B; Rasmussen, Christian H; Rasmussen, Morten A.

    2012-01-01

    Major regulatory agencies, for example, FDA and EMA, have started to request comprehensive benefit-risk analyses of pharmaceutical products prior to approval or labelling expansion. The purpose of this study is to develop a generally applicable and reliable data-driven benefit-risk assessment......) discussion and formulation of an overall conclusion. To reduce the impact of subjective judgements, scores are assigned to each criterion on the basis of objective information (data) wherever possible. The proposed benefit-risk evaluation approach offers comprehensive, data-driven assessments that can...... method, where two or more drugs/doses can be compared. Our aim is to formulate an approach that is simple to apply, allows direct comparison of different types of risks and benefits, and is tailored for application in different disease areas both during clinical development and in the marketing approval...

  9. A Bayesian approach to probabilistic sensitivity analysis in structured benefit-risk assessment.

    Science.gov (United States)

    Waddingham, Ed; Mt-Isa, Shahrul; Nixon, Richard; Ashby, Deborah

    2016-01-01

    Quantitative decision models such as multiple criteria decision analysis (MCDA) can be used in benefit-risk assessment to formalize trade-offs between benefits and risks, providing transparency to the assessment process. There is however no well-established method for propagating uncertainty of treatment effects data through such models to provide a sense of the variability of the benefit-risk balance. Here, we present a Bayesian statistical method that directly models the outcomes observed in randomized placebo-controlled trials and uses this to infer indirect comparisons between competing active treatments. The resulting treatment effects estimates are suitable for use within the MCDA setting, and it is possible to derive the distribution of the overall benefit-risk balance through Markov Chain Monte Carlo simulation. The method is illustrated using a case study of natalizumab for relapsing-remitting multiple sclerosis. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Communicating Risks and Benefits in Informed Consent for Research: A Qualitative Study

    Science.gov (United States)

    Nusbaum, Lika; Douglas, Brenda; Damus, Karla; Paasche-Orlow, Michael; Estrella-Luna, Neenah

    2017-01-01

    Multiple studies have documented major limitations in the informed consent process for the recruitment of clinical research participants. One challenging aspect of this process is successful communication of risks and benefits to potential research participants. This study explored the opinions and attitudes of informed consent experts about conveying risks and benefits to inform the development of a survey about the perspectives of research nurses who are responsible for obtaining informed consent for clinical trials. The major themes identified were strategies for risks and benefits communication, ensuring comprehension, and preparation for the role of the consent administrator. From the experts’ perspective, inadequate education and training of the research staff responsible for informed consent process contribute to deficiencies in the informed consent process and risks and benefits communication. Inconsistencies in experts’ opinions and critique of certain widely used communication practices require further consideration and additional research. PMID:28975139

  11. A risk score to predict type 2 diabetes mellitus in an elderly Spanish Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Marta Guasch-Ferré

    Full Text Available INTRODUCTION: To develop and test a diabetes risk score to predict incident diabetes in an elderly Spanish Mediterranean population at high cardiovascular risk. MATERIALS AND METHODS: A diabetes risk score was derived from a subset of 1381 nondiabetic individuals from three centres of the PREDIMED study (derivation sample. Multivariate Cox regression model ß-coefficients were used to weigh each risk factor. PREDIMED-personal Score included body-mass-index, smoking status, family history of type 2 diabetes, alcohol consumption and hypertension as categorical variables; PREDIMED-clinical Score included also high blood glucose. We tested the predictive capability of these scores in the DE-PLAN-CAT cohort (validation sample. The discrimination of Finnish Diabetes Risk Score (FINDRISC, German Diabetes Risk Score (GDRS and our scores was assessed with the area under curve (AUC. RESULTS: The PREDIMED-clinical Score varied from 0 to 14 points. In the subset of the PREDIMED study, 155 individuals developed diabetes during the 4.75-years follow-up. The PREDIMED-clinical score at a cutoff of ≥6 had sensitivity of 72.2%, and specificity of 72.5%, whereas AUC was 0.78. The AUC of the PREDIMED-clinical Score was 0.66 in the validation sample (sensitivity = 85.4%; specificity = 26.6%, and was significantly higher than the FINDRISC and the GDRS in both the derivation and validation samples. DISCUSSION: We identified classical risk factors for diabetes and developed the PREDIMED-clinical Score to determine those individuals at high risk of developing diabetes in elderly individuals at high cardiovascular risk. The predictive capability of the PREDIMED-clinical Score was significantly higher than the FINDRISC and GDRS, and also used fewer items in the questionnaire.

  12. Gestational Age, Infant Birth Weight, and Subsequent Risk of Type 2 Diabetes in Mothers: Nurses' Health Study II

    Science.gov (United States)

    ... Subsequent Risk of Type 2 Diabetes in Mothers: Nurses’ Health Study II Navigate This Article Abstract Introduction ... Table 1. Pregnancy Complications and Diabetes Risk Factors, Nurses’ Health Study II, 1989–2005 Characteristic All Births ...

  13. The risk of colorectal cancer in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Peeters, Paul J H L; Bazelier, Marloes T; Leufkens, Hubert G M

    2015-01-01

    , 2,759 cases of colorectal cancer were observed among the diabetic study population. Type 2 diabetes was associated with a 1.3-fold increased risk of colorectal cancer (HR 1.26 [95% CI 1.18-1.33]). Among diabetic patients, no association was found with treatment stages. A trend of increased......OBJECTIVE: To assess the risk of colorectal cancer associated with type 2 diabetes, as compared with a nondiabetic reference population, and to study additional associations between treatment stage and duration of obesity and colorectal cancer risk. RESEARCH DESIGN AND METHODS: We conducted...... hazards models were used to derive adjusted hazard ratios (HRs) for colorectal cancer associated with type 2 diabetes. Within the diabetic cohort, associations of colorectal cancer with treatment stages and duration of obesity (BMI ≥30 kg/m(2)) were studied. RESULTS: After a median follow-up of 4.5 years...

  14. Diabetes as a risk factor for hepatic encephalopathy in cirrhosis patients

    DEFF Research Database (Denmark)

    Jepsen, Peter; Watson, Hugh; Andersen, Per Kragh

    2015-01-01

    BACKGROUND & AIMS: It remains unclear whether diabetes increases the risk for hepatic encephalopathy (HE) in cirrhotic patients. We examined this question using data from three randomized trials of satavaptan, a vasopressin receptor antagonist that does not affect HE risk, in cirrhotic patients...... with ascites. METHODS: The trials included 1198 patients, and we excluded those with HE before or at randomization and followed the remaining patients for the one year duration of the trials. They were examined for HE regularly, and we compared rates of first-time overt HE between diabetics and non-diabetic......Com comorbidity score. RESULTS: We included 862 patients of whom 193 (22%) had diabetes. In total, they experienced 115 first-time episodes of overt HE during the follow-up. Fewer diabetics than non-diabetic patients were in Child-Pugh class C at baseline (13% vs. 23%), yet they had higher cumulative risk...

  15. Predictive Risk Factors in the Treatment of Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Lebriz Hale Aktun

    2015-01-01

    Full Text Available Objective This study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM. Patients and Methods A total of 256 pregnant women who underwent 75 g oral glucose tolerance test (OGTT during 24–28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin A1c (HbA1c values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n = 89 and those receiving diet therapy (diet group, n = 167 during pregnancy according to the American Diabetes Association recommendations. Results A total of 34.76% of the pregnant women with GDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 ± 0.6 years vs. 31.9 ± 0.6 years; P = 0.004. Body mass index before pregnancy was also significantly higher in the insulin group than that in the diet group (32 ± 0.9 kg/m 2 vs. 29 ± 0.7 kg/m 2 ; P = 0.004. Fasting blood glucose (FBG during OGTT was 105.6 ± 2.1 mg/dL and 96.7 ± 1.1 mg/dL in the insulin group and diet group, respectively ( P < 0.001. There was no significant difference in fasting plasma glucose during OGTT between the groups ( P = 0.069, while plasma glucose at two hours was 161.1 ± 6.8 mg/dL in the insulin group and 145.1 ± 3.7 mg/dL in the diet group ( P = 0.027. At the time of diagnosis, HbA1c values were significantly higher in the insulin group compared to the diet group (5.3 ± 0.1 vs. 4.9 ± 0.1; P = 0.001. There was no significant difference in FBG and homeostasis model assessment-insulin resistance values between the groups ( P = 0.908, P = 0.073. Conclusion Our study results suggest that age, family history of diabetes, body

  16. Family history of diabetes and the risk of gestational diabetes mellitus in Iran: A systematic review and meta-analysis.

    Science.gov (United States)

    Moosazadeh, Mahmood; Asemi, Zatollah; Lankarani, Kamran B; Tabrizi, Reza; Maharlouei, Najmeh; Naghibzadeh-Tahami, Ahmad; Yousefzadeh, Gholamreza; Sadeghi, Reza; Khatibi, Seyed Reza; Afshari, Mahdi; Khodadost, Mahmoud; Akbari, Maryam

    2017-11-01

    Gestational diabetes is the most prevalent metabolic disorder being firstly diagnosed during pregnancy. The relationship between the family history of diabetes and the gestational diabetes mellitus (GDM) has been investigated in several primary studies with a number of contradictions in the results. Hence, the purpose of the present study is to determine the relationship between the GDM and the family history of diabetes using the meta-analysis method. All published papers in main national and international databases were systematically searched with some specific keywords to find the related studies between 2000 and 2016. We calculated the odds ratio (OR) with 95% confidence interval (CI) in analysis for each study using a random-effect and Mantel-Haenzel method. We also determined heterogeneity among these 33 articles and their publication bias. We entered 33 relevant studies of 2516 articles into the meta-analysis process including 2697 women with family history of diabetes mellitus as well as 29134 women without. Of them, 954 and 4372 subjects developed GDM respectively. Combining the results of the primary studies using the meta-analysis method, the overall odds ratio of family history for developing GDM was estimated as of 3.46 (95% CI: 2.80-4.27). This meta-analysis study revealed that the family history of diabetes is an important risk factor for the gestational diabetes mellitus. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  17. The Risks and Benefits of Running Barefoot or in Minimalist Shoes

    OpenAIRE

    Perkins, Kyle P.; Hanney, William J.; Rothschild, Carey E.

    2014-01-01

    Context: The popularity of running barefoot or in minimalist shoes has recently increased because of claims of injury prevention, enhanced running efficiency, and improved performance compared with running in shoes. Potential risks and benefits of running barefoot or in minimalist shoes have yet to be clearly defined. Objective: To determine the methodological quality and level of evidence pertaining to the risks and benefits of running barefoot or in minimalist shoes. Data Sources: In Septem...

  18. X-ray diagnostics - benefits and risks; Roentgendiagnostik - Nutzen und Risiken

    Energy Technology Data Exchange (ETDEWEB)

    Bartholomaeus, Melanie (comp.)

    2016-10-15

    The brochure on benefits and risks of X-ray diagnostics discusses the following issues: X radiation - a pioneering discovery and medical sensation, fundamentals of X radiation, frequency of X-ray examinations in Germany in relation to CT imaging, radiation doses resulting from X-ray diagnostics, benefits of X-ray diagnostics - indication and examples, risks - measures for radiation exposure reductions, avoidance of unnecessary examinations.

  19. Engaging with residents' perceived risks and benefits about technologies as a way of resolving remediation dilemmas.

    Science.gov (United States)

    Prior, Jason; Rai, Tapan

    2017-12-01

    In recent decades the diversity of remediation technologies has increased significantly, with the breadth of technologies ranging from dig and dump to emergent technologies like phytoremediation and nanoremediation. The benefits of these technologies to the environment and human health are believed to be substantial. However, they also potentially constitute risks. Whilst there is a growing body of knowledge about the risks and benefits of these technologies from the perspective of experts, little is known about how residents perceive the risks and benefits of the application of these technologies to address contaminants in their local environment. This absence of knowledge poses a challenge to remediation practitioners and policy makers who are increasingly seeking to engage these affected local residents in choosing technology applications. Building on broader research into the perceived benefits and risks of technologies, and data from a telephone survey of 2009 residents living near 13 contaminated sites in Australia, regression analysis of closed-ended survey questions and coding of open-ended questions are combined to identify the main predictors of resident's perceived levels of risk and benefit to resident's health and to their local environment from remediation technologies. This research identifies a range of factors associated with the residents' physical context, their engagement with institutions during remediation processes, and the technologies which are associated with residents' level of perceived risk and benefit for human health and the local environment. The analysis found that bioremediation technologies were perceived as less risky and more beneficial than chemical, thermal and physical technologies. The paper also supports broader technology research that reports an inverse correlation between levels of perceived risks and benefits. In addition, the paper reveals the types of risks and benefits to human health and the local environment that

  20. Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, Ida; Brendorp, Bente; Seibaek, Marie

    2004-01-01

    : The study is an analysis of survival data comprising 5,491 patients consecutively hospitalized with new or worsening HF and screened for entry into the Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND). Screening, which included obtaining an echocardiogram in 95% of the patients......-diabetic patients, resulting in a risk ratio (RR) of death in diabetic patients of 1.5 (95% confidence interval [CI] 1.4 to 1.6, p gender was found...