Relationship between social isolation and glycaemic control of people previously diagnosed with diabetes: secondary analysis from the CHARLS
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SUBMITTER: Lu Q
PROVIDER: S-EPMC10953297 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:AimTo investigate the relationship between Type D personality and adverse health outcomes [glycated haemoglobin (HbA1c) and health-related quality of life (HRQOL)] directly, and indirectly via diabetes distress and social isolation in people with type 2 diabetes.DesignA secondary analysis of 524 participant's data derived from a cross-sectional, correlational study with people with type 2 diabetes.MethodsData were analysed using the PROCESS macro of SPSS.ResultsType D personality was present in 31.3% of the participants, and exerted a direct effect on HRQOL but not on HbA1c. Type D personality indirectly affected both HbA1c and HRQOL via the mediators of diabetes distress and social isolation. Nurses need to monitor people with type 2 diabetes to determine whether Type D personality is present. Those with Type D personality should be provided with interventions to reduce diabetes distress and alleviate social isolation in order to improve HbA1c and HRQOL.
| S-EPMC10077398 | biostudies-literature
Project description:Epigenetic changes in red blood cells during the life of chickens exposed to social isolation stress or an enrich environment
| PRJEB91027 | ENA
Project description:AimsTo examine the relationships between glycated haemoglobin (HbA1c) and cardiovascular (CV) events in people beginning insulin in routine clinical practice in Europe, North America and Asia in a non-interventional study, the Cardiovascular Risk Evaluation in people with Type 2 Diabetes on Insulin Therapy (CREDIT) study.MethodsData on 2999 people were collected prospectively over 4 years from physician reports. The primary outcome was the composite of stroke or myocardial infarction (MI) or CV-specific death. Events were blindly adjudicated. The relative hazards of CV events were described from Cox proportional hazards models incorporating patient risk factors, with updated average HbA1c as a time-dependent covariate. The relationship of severe and symptomatic hypoglycaemia (collected during the 6 months before yearly ascertainment) with CV and all-cause mortality was examined.ResultsA total of 147 primary events were accrued during up to 54 months of follow-up. In all, 60 CV-specific deaths, 44 non-fatal MIs and 57 non-fatal strokes occurred, totalling 161 events. There was a significant positive relationship between updated mean HbA1c and primary outcome: hazard ratio (HR) 1.25 [95% confidence interval (CI) 1.12-1.40; p < 0.0001]. CV death [HR 1.31 (95% CI 1.10-1.57); p = 0.0027] and stroke [HR 1.36 (95% CI 1.17-1.59); p < 0.0001] were both strongly associated with HbA1c, while MI was not [HR 1.05 (95% CI 0.83-1.32)]. One or more severe hypoglycaemic episodes affected 175 participants, while 1508 participants experienced one or more symptomatic hypoglycaemic events. We found no relationship between severe/symptomatic hypoglycaemic events and CV-specific/all-cause death.ConclusionsOngoing poorer glucose control was associated with CV events; hypoglycaemia was not associated with CV-specific/all-cause death.
| S-EPMC4738470 | biostudies-literature
Project description: Not available
| S-EPMC9009294 | biostudies-literature
Project description:BackgroundIt is unclear whether diet affects glycaemic control in type 2 diabetes (T2D), over and above its effects on bodyweight. We aimed to assess whether changes in dietary patterns altered glycaemic control independently of effects on bodyweight in newly diagnosed T2D.MethodsWe used data from 4-day food diaries, HbA1c and potential confounders in participants of the Early-ACTivity-In-Diabetes trial measured at 0, 6 and 12 months. At baseline, a 'carb/fat balance' dietary pattern and an 'obesogenic' dietary pattern were derived using reduced-rank regression, based on hypothesised nutrient-mediated mechanisms linking dietary intake to glycaemia directly or via obesity. Relationships between 0 and 6 month change in dietary pattern scores and baseline-adjusted HbA1c at 6 months (n = 242; primary outcome) were assessed using multivariable linear regression. Models were repeated for periods 6-12 months and 0-12 months (n = 194 and n = 214 respectively; secondary outcomes).ResultsReductions over 0-6 months were observed in mean bodyweight (- 2.3 (95% CI: - 2.7, - 1.8) kg), body mass index (- 0.8 (- 0.9, - 0.6) kg/m2), energy intake (- 788 (- 953, - 624) kJ/day), and HbA1c (- 1.6 (- 2.6, -0.6) mmol/mol). Weight loss strongly associated with lower HbA1c at 0-6 months (β = - 0.70 [95% CI - 0.95, - 0.45] mmol/mol/kg lost). Average fat and carbohydrate intakes changed to be more in-line with UK healthy eating guidelines between 0 and 6 months. Dietary patterns shifting carbohydrate intakes higher and fat intakes lower were characterised by greater consumption of fresh fruit, low-fat milk and boiled/baked potatoes and eating less of higher-fat processed meats, butter/animal fats and red meat. Increases in standardised 'carb/fat balance' dietary pattern score associated with improvements in HbA1c at 6 months independent of weight loss (β = - 1.54 [- 2.96, - 0.13] mmol/mol/SD). No evidence of association with HbA1c was found for this dietary pattern at other time-periods. Decreases in 'obesogenic' dietary pattern score were associated with weight loss (β = - 0.77 [- 1.31, - 0.23] kg/SD) but not independently with HbA1c during any period.ConclusionsPromoting weight loss should remain the primary nutritional strategy for improving glycaemic control in early T2D. However, improving dietary patterns to bring carbohydrate and fat intakes closer to UK guidelines may provide small, additional improvements in glycaemic control.Trial registrationISRCTN92162869 . Retrospectively registered on 25 July 2005.
| S-EPMC9014614 | biostudies-literature
Project description: Not available
| S-EPMC6486035 | biostudies-literature
Project description:AimTo evaluate the economic and clinical burden associated with poor glycaemic control in Sweden, in people with type 2 diabetes (T2D) initiating first-line glucose-lowering therapy.Materials and methodsPopulation data were obtained from Swedish national registers. Immediate glycaemic control was compared with delays in achieving control of 1 and 3 years, with outcomes projected over 3, 10 and 50 years in the validated IQVIA CORE Diabetes Model. Glycaemic control was defined as glycated haemoglobin (HbA1c) targets of 52, 48 and 42 mmol/mol, as recommended in Swedish guidelines, according to age and disease duration. Costs (expressed in 2019 Swedish krona [SEK]) were accounted from a Swedish societal perspective.ResultsImmediate glycaemic control was associated with population-level cost savings of up to SEK 279 million and SEK 673 million versus delays of 1 and 3 years, respectively, as well as small population-level life expectancy benefits of up to 1305 and 2590 life years gained. Reduced levels of burden were a result of lower incidence and delayed time to onset of diabetes-related complications.ConclusionsEven in people with T2D initiating first-line glucose-lowering therapy, the economic burden of poor glycaemic control in Sweden is substantial, but could be reduced by early and effective treatment to achieve glycaemic targets.
| S-EPMC8360155 | biostudies-literature
Project description:We aimed to conduct a scoping review of social isolation in elderly patients with diabetes and to clarify current knowledge and gaps and future challenges. A literature search was conducted using Medline, Web of Science, CINAHL, CiNii, and Ichushi, and included studies with an eligibility criterion of a survey of social isolation in elderly patients with diabetes and aged ≥60 years. Social isolation was defined as limited or non-face-to-face contact with family and community. A data extraction form describing characteristics of studies incorporated in the present review was prepared. A total of six studies met eligibility criterion (sample size, 451-3,500). Subjects' age averaged 67 years, and 42% were female. Social isolation ranged from 9% to 49%. Factors related to social isolation included vascular complications,decreased activities of daily living, death, dementia, glycemic fluctuation, disturbance of lifestyle habits, and poor self-management and -rated health. However, research on the cause and mechanism of the relationship and impact of sex-based differences was lacking. In conclusion, additional research is needed on the definition of social isolation in elderly patients with diabetes, the causal relationship with related factors and their mechanisms, and the relationship with other outcomes.
| S-EPMC9350511 | biostudies-literature
Project description:Objective: The aim of the study was to compare uni- and multidimensional models of social isolation to improve the specificity of determining associations between social isolation and frailty. Methods: The study included participants aged ≥60 years from the English Longitudinal Study of Ageing assessed for social isolation and frailty (frailty index and Fried phenotype) over a 4-year period. Factor analysis assessed whether social isolation was multidimensional. Multiple regression analysis was used to assess specificity in associations between social isolation and frailty over time. Results: Social isolation comprises social isolation from nuclear family, other immediate family, and wider social networks. Over time, social isolation from a wider social network predicted higher frailty index levels, and higher frailty index and Fried phenotype levels predicted greater social isolation from a wider social network. Discussion: Social isolation is multidimensional. The reciprocal relationship between social isolation from wider social networks and accumulating frailty deficits, and frailty as a clinical syndrome influencing social isolation from social networks is discussed.
| S-EPMC8689424 | biostudies-literature
Project description:Aims/hypothesisThe aim of this work was to examine whether glycaemic control has improved in those with type 1 diabetes in Scotland between 2004 and 2016, and whether any trends differed by sociodemographic factors.MethodsWe analysed records from 30,717 people with type 1 diabetes, registered anytime between 2004 and 2016 in the national diabetes database, which contained repeated measures of HbA1c. An additive mixed regression model was used to estimate calendar time and other effects on HbA1c.ResultsOverall, median (IQR) HbA1c decreased from 72 (21) mmol/mol [8.7 (4.1)%] in 2004 to 68 (21) mmol/mol (8.4 [4.1]%) in 2016. However, all of the improvement across the period occurred in the latter 4 years: the regression model showed that the only period of significant change in HbA1c was 2012-2016 where there was a fall of 3 (95% CI 1.82, 3.43) mmol/mol. The largest reductions in HbA1c in this period were seen in children, from 69 (16) mmol/mol (8.5 [3.6]%) to 63 (14) mmol/mol (7.9 [3.4]%), and adolescents, from 75 (25) mmol/mol (9.0 [4.4]%) to 70 (23) mmol/mol (8.6 [4.3]%). Socioeconomic status (according to Scottish Index of Multiple Deprivation) affected the HbA1c values: from the regression model, the 20% of people living in the most-deprived areas had HbA1c levels on average 8.0 (95% CI 7.4, 8.9) mmol/mol higher than those of the 20% of people living in the least-deprived areas. However this difference did not change significantly over time. From the regression model HbA1c was on average 1.7 (95% CI 1.6, 1.8) mmol/mol higher in women than in men. This sex difference did not narrow over time.Conclusions/interpretationIn this high-income country, we identified a modest but important improvement in HbA1c since 2012 that was most marked in children and adolescents. These changes coincided with national initiatives to reduce HbA1c including an expansion of pump therapy. However, in most people, overall glycaemic control remains far from target levels and further improvement is badly needed, particularly in those from more-deprived areas.
| S-EPMC6647722 | biostudies-literature