Evidence-based screening, clinical care and health education recommendations for Alaska Native peoples with prediabetes living in southcentral Alaska: findings from the Alaska EARTH follow-up study.

IF 1.3 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Kathryn R Koller, Sarah H Nash, Julie A Beans, Gretchen M Day, Vanessa Y Hiratsuka, Ai-Ling Lin, Meera Narayanan, Christi A Patten, Sherry A Hammock, Barbara V Howard, Jason G Umans
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Abstract

Pre-diabetes (pre-DM) is a strong predictor of diabetes (DM) over time. This study investigated how much of the recent increase in pre-DM identified among Alaska Native (AN) peoples living in urban southcentral Alaska may be due to changes in diagnostic methods. We used clinical and demographic data collected at baseline between 2004 and 2006 and at follow-up collected between 2015 and 2017 from the urban southcentral Alaska Education and Research Towards Health (EARTH) cohort. We used descriptive statistics and logistic regression to explore differences in demographic and clinical variables among the identified pre-DM groups. Of 388 participants in the follow-up study, 243 had A1c levels indicating pre-DM with only 20 demonstrating pre-DM also by fasting blood glucose (FBG). Current smoking was the sole predictor for pre-DM by A1c alone while abdominal obesity and elevated FBG-predicted pre-DM by A1c+FBG. No participants had an elevated FBG without an A1c elevation. A substantial portion of the rise in pre-DM found among urban southcentral AN peoples in the EARTH follow-up study was due to the addition of A1c testing. Pre-DM by A1c alone should be used to motivate behavioural changes that address modifiable risk factors, including smoking cessation, physical activity and weight management.

为居住在阿拉斯加中南部的阿拉斯加原住民糖尿病前期患者提供循证筛查、临床护理和健康教育建议:阿拉斯加 EARTH 跟踪研究的结果。
随着时间的推移,糖尿病前期(pre-DM)是糖尿病(DM)的有力预测因素。本研究调查了生活在阿拉斯加中南部城市的阿拉斯加原住民(AN)中发现的糖尿病前期病例最近有所增加,其中有多少可能是由于诊断方法的改变造成的。我们使用了 2004 年至 2006 年期间基线收集的临床和人口统计数据,以及 2015 年至 2017 年期间从阿拉斯加中南部城市健康教育与研究 (EARTH) 队列中收集的随访数据。我们使用描述性统计和逻辑回归来探讨已确定的DM前群体之间人口统计学和临床变量的差异。在后续研究的 388 名参与者中,有 243 人的 A1c 水平显示为糖尿病前期,只有 20 人的空腹血糖 (FBG) 也显示为糖尿病前期。仅从 A1c 角度看,当前吸烟是预测糖尿病前期的唯一因素,而从 A1c+FBG 角度看,腹部肥胖和 FBG 升高则是预测糖尿病前期的因素。没有人在 A1c 未升高的情况下出现 FBG 升高。在 EARTH 跟踪研究中发现,城市中南部 AN 族人的 DM 前值上升很大一部分是由于增加了 A1c 检测。仅通过 A1c 预测血糖值应能促使人们改变行为,以应对可改变的风险因素,包括戒烟、体育锻炼和体重管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Circumpolar Health
International Journal of Circumpolar Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.10
自引率
15.40%
发文量
51
审稿时长
6-12 weeks
期刊介绍: The International Journal of Circumpolar Health is published by Taylor & Francis on behalf of the Circumpolar Health Research Network [CircHNet]. The journal follows the tradition initiated by its predecessor, Arctic Medical Research. The journal specializes in circumpolar health. It provides a forum for many disciplines, including the biomedical sciences, social sciences, and humanities as they relate to human health in high latitude environments. The journal has a particular interest in the health of indigenous peoples. It is a vehicle for dissemination and exchange of knowledge among researchers, policy makers, practitioners, and those they serve. International Journal of Circumpolar Health welcomes Original Research Articles, Review Articles, Short Communications, Book Reviews, Dissertation Summaries, History and Biography, Clinical Case Reports, Public Health Practice, Conference and Workshop Reports, and Letters to the Editor.
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