Diabetic medicine : a journal of the British Diabetic Association最新文献

{"title":"The effects of patient characteristics and geographical region on hospitalization in patients with type 2 diabetes.","authors":"M J Zaman,&nbsp;A Patel,&nbsp;J Chalmers,&nbsp;M Woodward,&nbsp;P Clarke,&nbsp;Q Li,&nbsp;S Zoungas","doi":"10.1111/dme.12181","DOIUrl":"https://doi.org/10.1111/dme.12181","url":null,"abstract":"<p><strong>Aims: </strong>The ADVANCE trial recruited participants from 20 countries worldwide. We analyse here regional variations and causes of hospitalization for people with Type 2 diabetes from Asia, Established Market Economies and Eastern Europe.</p><p><strong>Methods: </strong>A cohort analysis examining the effects of region on causes of first hospitalization, and the association of participant characteristics on all-cause first hospitalization across regions, using multivariable (adjusted for clinical, physiological, behavioural and socio-demographic factors) Cox models.</p><p><strong>Results: </strong>Of 11 140 individuals (6407 men), all-cause hospitalization rates were highest in Established Market Economies, followed by Eastern Europe then Asia. Eastern Europe had rates of hospitalization for diabetic causes four times greater than Established Market Economies [multivariable-adjusted hazard ratio 4.02 (95% CI 2.86-5.63)]. There were no significant regional variations in hospitalization rates for cardiovascular disease (P = 0.534), but much lower rates for musculoskeletal and non-specific causes in Eastern Europe [multivariable-adjusted hazard ratio 0.44 (95% CI 0.32-0.60) and 0.19 (95% CI 0.12-0.29)] and Asia [hazard ratio 0.21 (95% CI 0.16-0.29) and 0.09 (95% CI 0.06-0.14)] compared with Established Market Economies. In all regions, participants hospitalized for any cause were more likely to be older, male, hypertensive, smokers, have higher glycated haemoglobin and a history of macrovascular or macrovascular disease.</p><p><strong>Conclusions: </strong>Across three markedly different regions of the world, regional rates and causes of hospitalization varied widely in patients with Type 2 diabetes. Adjustment for a range of patient characteristics did not explain these regional differences in hospitalization, which appear to be attributable to health system factors.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"918-25"},"PeriodicalIF":3.5,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/dme.12181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40230319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 1 diabetes education and care: time for a rethink?","authors":"S Cradock,&nbsp;I C Cranston","doi":"10.1111/j.1464-5491.2011.03518.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2011.03518.x","url":null,"abstract":"Over the last century, the focus of healthcare professionals managing Type 1 diabetes has evolved, from improving shortterm survival to improving long-term survival to reducing complications risk (both macroand microvascular) to improving quality of life whilst achieving all of the above. The tools that assist in these goals are insulin, blood glucose monitoring, medications for vascular risk reduction, professional and patient education and psychological support. Thesetoolshavecomplementaryrolesinachievingthetherapeutic goals, although at given times in our history, ‘fashion’ in healthcare delivery has tended to favour some over others. For example, following the publication of the Diabetes Control and Complications Trial, we concentrated on insulin and insulin regimens, often forgetting the intensive processes that were required to support people. Many programmes have been designed to reduce the anxiety and depression associated with living with Type 1 diabetes [1]. Due-Christensen and colleagues [2], in this edition of Diabetic Medicine, continue the academic search for the programme that will help the struggles that many still face with Type 1 diabetes despite ‘good control’. Their study searches for the elements that we could add to our current care delivery system to reduce the burden of living with Type 1 diabetes. Following diagnosis, many receive ‘intensive’ 1:1 care that helps them develop the skills to administer insulin and monitor blood glucose; this is then followed with ‘regular’ reviews of complication status. Healthcare professionals who have worked with people with Type 1 diabetes know that insulin action is often far from predictable and does not respond exactly as expected, and many of our patients blame themselves for being unable to ‘control’ their blood glucose. We need to use all available advances together if weare to improve theoutcomes for all (rather than some) of our patients, recognizing that, for each individual, one or more of the developments in diabetes care may take priority. Since the initial discovery of insulin, endocrinology-based physicians treating diabetes and pharmacological scientists have tried to produce the ‘best’ insulin possible. Whilst the formulation purity and pharmacological properties of synthetic insulin and insulin analogues, and the means by which these are delivered, have made progressive step changes, it remains true for the majority of patients with Type 1 diabetes that the insulin should be matched to the desired goal. The early attempts to understand insulin action by the use of ‘periodic’ (‘three times a day’; ‘test occasionally before and after meals’) blood glucose monitoring have been recognized as unplanned and unfocused. There is now a more focused strategic approach to self testing. People with Type 1 diabetes are nowexpected to be supported to master the use of self-testing ‘tools’ (meters and strips ⁄ continuous glucose monitoring system) to adjust their insulin in a more info","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"159-60"},"PeriodicalIF":3.5,"publicationDate":"2012-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2011.03518.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40133926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?","authors":"M Due-Christensen,&nbsp;V Zoffmann,&nbsp;E Hommel,&nbsp;M Lau","doi":"10.1111/j.1464-5491.2011.03521.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2011.03521.x","url":null,"abstract":"<p><strong>Aims: </strong>To test whether patients with Type 1 diabetes would join support groups and benefit by improving psychosocial functioning, regardless of their HbA1c levels.</p><p><strong>Methods: </strong>A pre-post test with follow-up after 6 and 12 months was conducted as a concurrent mixed-method study. The convenience sample included patients with Type 1 diabetes aged ≥21 years, having been diagnosed ≥1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index and depression subscale), well-being (World Health Organization 5) and HbA1c .</p><p><strong>Results: </strong>Equal numbers of patients with HbA1c above and below 64 mmol/mol (8%) joined the support groups (n = 54). Focus group interviews revealed that major benefits were feeling less alone and being intuitively understood among peers. The patients perceived the support groups as a safe environment for sharing experiences. Problem Areas in Diabetes, Global Severity Index and depression subscale scores were significantly reduced post-intervention and maintained at 1-year follow-up. Well-being increased insignificantly. HbA1c was unchanged.</p><p><strong>Conclusions: </strong>Support groups are able to reduce diabetes-related and psychological distress 1 year after the intervention for patients with both good and poor glycaemic control displaying high levels of distress. Although patients with severely high levels of diabetes-related distress might need more extensive therapeutic interventions to further reduce their level of distress. Further, interventions that target specific self-management problems are needed for patients with poor glycaemic control to help them accomplish lower levels of HbA1c. Moreover, healthcare providers must be aware that patients with good glycaemic control might have an unacknowledged psychosocial burden of living with the illness.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"251-6"},"PeriodicalIF":3.5,"publicationDate":"2012-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2011.03521.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40135300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoglycaemia in Type 2 diabetes.","authors":"S A Amiel,&nbsp;T Dixon,&nbsp;R Mann,&nbsp;K Jameson","doi":"10.1111/j.1464-5491.2007.02341.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02341.x","url":null,"abstract":"<p><p>The primary cause of hypoglycaemia in Type 2 diabetes is diabetes medication-in particular, those which raise insulin levels independently of blood glucose, such as sulphonylureas (SUs) and exogenous insulin. The risk of hypoglycaemia is increased in older patients, those with longer diabetes duration, lesser insulin reserve and perhaps in the drive for strict glycaemic control. Differing definitions, data collection methods, drug type/regimen and patient populations make comparing rates of hypoglycaemia difficult. It is clear that patients taking insulin have the highest rates of self-reported severe hypoglycaemia (25% in patients who have been taking insulin for > 5 years). SUs are associated with significantly lower rates of severe hypoglycaemia. However, large numbers of patients take SUs in the UK, and it is estimated that each year > 5000 patients will experience a severe event caused by their SU therapy which will require emergency intervention. Hypoglycaemia has substantial clinical impact, in terms of mortality, morbidity and quality of life. The cost implications of severe episodes-both direct hospital costs and indirect costs-are considerable: it is estimated that each hospital admission for severe hypoglycaemia costs around pound1000. Hypoglycaemia and fear of hypoglycaemia limit the ability of current diabetes medications to achieve and maintain optimal levels of glycaemic control. Newer therapies, which focus on the incretin axis, may carry a lower risk of hypoglycaemia. Their use, and more prudent use of older therapies with low risk of hypoglycaemia, may help patients achieve improved glucose control for longer, and reduce the risk of diabetic complications.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"245-54"},"PeriodicalIF":3.5,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02341.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40414293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired glucose regulation, elevated glycated haemoglobin and cardiac ischaemic events in vascular surgery patients.","authors":"H H H Feringa,&nbsp;R Vidakovic,&nbsp;S E Karagiannis,&nbsp;M Dunkelgrun,&nbsp;A Elhendy,&nbsp;E Boersma,&nbsp;M R H M van Sambeek,&nbsp;P G Noordzij,&nbsp;J J Bax,&nbsp;D Poldermans","doi":"10.1111/j.1464-5491.2007.02352.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02352.x","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac morbidity and mortality is high in patients undergoing high-risk surgery. This study investigated whether impaired glucose regulation and elevated glycated haemoglobin (HbA(1c)) levels are associated with increased cardiac ischaemic events in vascular surgery patients.</p><p><strong>Methods: </strong>Baseline glucose and HbA(1c) were measured in 401 vascular surgery patients. Glucose < 5.6 mmol/l was defined as normal. Fasting glucose 5.6-7.0 mmol/l or random glucose 5.6-11.1 mmol/l was defined as impaired glucose regulation. Fasting glucose > or = 7.0 or random glucose > or = 11.1 mmol/l was defined as diabetes. Perioperative ischaemia was identified by 72-h Holter monitoring. Troponin T was measured on days 1, 3 and 7 and before discharge. Cardiac death or Q-wave myocardial infarction was noted at 30-day and longer-term follow-up (mean 2.5 years).</p><p><strong>Results: </strong>Mean (+/- sd) level for glucose was 6.3 +/- 2.3 mmol/l and for HbA(1c) 6.2 +/- 1.3%. Ischaemia, troponin release, 30-day and long-term cardiac events occurred in 27, 22, 6 and 17%, respectively. Using subjects with normal glucose levels as the reference category, multivariate analysis revealed that patients with impaired glucose regulation and diabetes were at 2.2- and 2.6-fold increased risk of ischaemia, 3.8- and 3.9-fold for troponin release, 4.3- and 4.8-fold for 30-day cardiac events and 1.9- and 3.1-fold for long-term cardiac events. Patients with HbA(1c) > 7.0% (n = 63, 16%) were at 2.8-fold, 2.1-fold, 5.3-fold and 5.6-fold increased risk for ischaemia, troponin release, 30-day and long-term cardiac events, respectively.</p><p><strong>Conclusions: </strong>Impaired glucose regulation and elevated HbA(1c) are risk factors for cardiac ischaemic events in vascular surgery patients.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"314-9"},"PeriodicalIF":3.5,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02352.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41068397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No association between routinely recorded infections in early life and subsequent risk of childhood-onset Type 1 diabetes: a matched case-control study using the UK General Practice Research Database.","authors":"C R Cardwell,&nbsp;D J Carson,&nbsp;C C Patterson","doi":"10.1111/j.1464-5491.2007.02351.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02351.x","url":null,"abstract":"<p><strong>Aims: </strong>To determine whether children with infections in early life (recorded routinely in general practice) have a reduced risk of Type 1 diabetes, as would be expected from the hygiene hypothesis.</p><p><strong>Methods: </strong>Children with Type 1 diabetes and up to 20 matched (on year of birth, sex and region) control subjects were selected from a cohort of children born in the UK at General Practice Research Database practices. For each child, the frequency of general practitioner consultations for infections and prescriptions for antibiotics in the first year of life were determined. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using conditional logistic regression.</p><p><strong>Results: </strong>The main analysis included 367 case and 4579 matched control subjects. There was no evidence of any reduction in the subsequent risk of Type 1 diabetes in children with at least one infection in the first year of life (OR = 1.03, 95%CI 0.79, 1.34) or in children prescribed antibiotics in the first year of life (OR = 1.03, 95%CI 0.82, 1.29). Further analyses also revealed little evidence of a difference in subsequent risk of Type 1 diabetes after different types of infection in the first year of life (including gastrointestinal, conjunctivitis, otitis media and upper and lower respiratory tract). Analyses of infections in the first 2 years of life reached similar conclusions.</p><p><strong>Conclusions: </strong>This study provides no evidence of an association between infections in early life and subsequent risk of childhood-onset Type 1 diabetes and therefore does not support the hygiene hypothesis.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"261-7"},"PeriodicalIF":3.5,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02351.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41068398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A low incidence of Type 1 diabetes between 1977 and 2001 in south-eastern Sweden in areas with high population density and which are more deprived.","authors":"B-M Holmqvist,&nbsp;O Lofman,&nbsp;U Samuelsson","doi":"10.1111/j.1464-5491.2007.02342.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02342.x","url":null,"abstract":"<p><strong>Aims: </strong>To explore how socioeconomic factors and population density may contribute to the geographical variation of incidence of Type 1 diabetes in children in south-eastern Sweden.</p><p><strong>Method: </strong>All children diagnosed with Type 1 diabetes in south-eastern Sweden during 1977-2001 were defined geographically to their place of residence and were allocated x and y coordinates in the national grid. The population at risk and socioeconomic data were aggregated in 82,000 200-m squares and geocoded likewise. A socioeconomic index was calculated using a signed chi(2) method. Rural-urban gradients were defined by overlay analysis in a geographic information system.</p><p><strong>Results: </strong>The incidence during the past 25 years has been rising steadily, particularly in the last 6 years. The incidence was highest in areas with a high proportion of small families, of families with a high family income and better education, and this was found both at the time of diagnosis and at the time of birth. In the rural-urban analysis, the lowest incidence was found in the urban area with > 20,000 inhabitants, where there was also a higher frequency of deprivation.</p><p><strong>Conclusions: </strong>Our findings indicate that geographical variations in incidence rates of Type 1 diabetes in children are associated with socioeconomic factors and population density, although other contributing factors remain to be explained.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"255-60"},"PeriodicalIF":3.5,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02342.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41068400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure means rather than nocturnal dipping pattern are related to complications in Type 2 diabetic patients.","authors":"C B Leitão,&nbsp;L H Canani,&nbsp;C K Kramer,&nbsp;M Moehlecke,&nbsp;L C Pinto,&nbsp;E D Ricardo,&nbsp;A F Pinotti,&nbsp;J L Gross","doi":"10.1111/j.1464-5491.2007.02354.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02354.x","url":null,"abstract":"<p><strong>Aim: </strong>To determine whether systolic and diastolic blood pressure (BP) means, during ambulatory BP monitoring (ABPM), are more strongly correlated with microvascular complications and echocardiographic structural alterations than night-time/daytime (N/D) BP ratio.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 270 Type 2 diabetes mellitus (DM) outpatients who underwent clinical and laboratory investigations, urinary albumin excretion rate (UAER) determination, echocardiography, office and 24-h ABPM (Spacelabs 90207).</p><p><strong>Results: </strong>UAER, after multivariate adjustments, was associated with office BP (systolic: R(2)(a) 0.162, P < 0.001; diastolic: R(2)(a) 0.124, P < 0.001) and ABPM (24-h systolic: R(2)(a) 0.195, P < 0.001; 24-h diastolic: R(2)(a) 0.197, P < 0.001) but not with N/D BP ratios (systolic: R(2)(a) 0.062, P = 0.080; diastolic: R(2)(a) 0.063, P = 0.069). Similar results were observed for echocardiographic parameters. The presence of retinopathy was associated only with night-time BP values [systolic means: odds ratio (OR) 1.13, 95% confidence interval (CI) 1.03-1.24 and diastolic means: OR 1.21, CI 1.04-1.40 and N/D diastolic BP ratio > 0.90, OR 3.21, CI 1.65-6.25].</p><p><strong>Conclusions: </strong>UAER and echocardiographic structural alterations had more consistent correlations of a greater magnitude with systolic BP means than with N/D BP ratios. The nocturnal BP values appear to be more relevant for diabetic retinopathy. BP measurement in patients with Type 2 DM should take into account the 24-h period rather than focusing on a specific time span of BP homeostasis.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"308-13"},"PeriodicalIF":3.5,"publicationDate":"2008-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02354.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41068396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of genetic variants in Krüppel-like factor 11 and Type 2 diabetes in the Japanese population.","authors":"T Tanahashi,&nbsp;K Shinohara,&nbsp;P Keshavarz,&nbsp;Y Yamaguchi,&nbsp;K Miyawaki,&nbsp;K Kunika,&nbsp;M Moritani,&nbsp;N Nakamura,&nbsp;T Yoshikawa,&nbsp;H Shiota,&nbsp;H Inoue,&nbsp;M Itakura","doi":"10.1111/j.1464-5491.2007.02315.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02315.x","url":null,"abstract":"<p><strong>Aims: </strong>Krüppel-like factor 11 (KLF11) is a transcriptional factor of the zinc finger domain family that regulates the expression of insulin. In North European populations, its common functional variant Q62R (rs35927125) is a strong genetic factor for Type 2 diabetes (P = 0.00033, odds ratio for G allele = 1.29, 95% CI 1.12-1.49). We examined the contribution of KLF11 variants to the susceptibility to Type 2 diabetes in a Japanese population.</p><p><strong>Methods: </strong>By re-sequencing Japanese individuals (n = 24, partly 96), we screened all four exons, exon/intron boundaries and flanking regions of KLF11. Verified single nucleotide polymorphisms (SNPs) were genotyped in 731 initial samples (369 control and 362 case subjects). Subsequently, we tested for association in 1087 samples (524 control and 563 case subjects), which were collected in different districts of Japan from the initial samples.</p><p><strong>Results: </strong>We identified eight variants, including a novel A/C variant on intron 3, but no mis-sense mutations. In an association study, we failed to find any significant result of SNPs (minor allele frequency 8.2-46.2%) after correcting for multiple testing. Similarly, no haplotypes were associated with Type 2 diabetes. It is notable that the G allele in rs35927125 was completely absent in 1818 Japanese individuals.</p><p><strong>Conclusions: </strong>Genetic variants in KLF11 are unlikely to have a major effect of Type 2 diabetes in the Japanese population, although they were significantly associated in North European populations. These observations might help to determine the role of KLF11 variants in Type 2 diabetes in different populations.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"19-26"},"PeriodicalIF":3.5,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02315.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40842347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic retinopathy is associated with an increased incidence of cardiovascular events in Type 2 diabetic patients.","authors":"G Targher,&nbsp;L Bertolini,&nbsp;L Zenari,&nbsp;G Lippi,&nbsp;I Pichiri,&nbsp;G Zoppini,&nbsp;M Muggeo,&nbsp;G Arcaro","doi":"10.1111/j.1464-5491.2007.02327.x","DOIUrl":"https://doi.org/10.1111/j.1464-5491.2007.02327.x","url":null,"abstract":"<p><strong>Aims: </strong>We investigated the association of diabetic retinopathy with the risk of incident cardiovascular disease (CVD) events in a large cohort of Type 2 diabetic adults.</p><p><strong>Methods: </strong>Our study cohort comprised 2103 Type 2 diabetic outpatients who were free of diagnosed CVD at baseline. Retinal findings were classified based on fundoscopy (by a single ophthalmologist) to categories of no retinopathy, non-proliferative retinopathy and proliferative/laser-treated retinopathy. Outcomes measures were incident CVD events (i.e. non-fatal myocardial infarction, non-fatal ischaemic stroke, coronary revascularization procedures or cardiovascular death).</p><p><strong>Results: </strong>During approximately 7 years of follow-up, 406 participants subsequently developed incident CVD events, whereas 1697 participants remained free of diagnosed CVD. After adjustment for age, body mass index, waist circumference, smoking, lipids, glycated haemoglobin, diabetes duration and medications use, patients with non-proliferative or proliferative/laser-treated retinopathy had a greater risk (P < 0.001 for all) of incident CVD events than those without retinopathy [hazard ratio 1.61 (95% confidence interval 1.2-2.6) and 3.75 (2.0-7.4) for men, and 1.67 (1.3-2.8) and 3.81 (2.2-7.3) for women, respectively]. After additional adjustment for hypertension and advanced nephropathy (defined as overt proteinuria and/or estimated glomerular filtration rate < or = 60 ml/min/1.73 m(2)), the risk of incident CVD remained markedly increased in those with proliferative/laser-treated retinopathy [hazard ratio 2.08 (1.02-3.7) for men and 2.41 (1.05-3.9) for women], but not in those with non-proliferative retinopathy.</p><p><strong>Conclusions: </strong>Diabetic retinopathy (especially in its more advanced stages) is associated with an increased CVD incidence independent of other known cardiovascular risk factors.</p>","PeriodicalId":520603,"journal":{"name":"Diabetic medicine : a journal of the British Diabetic Association","volume":" ","pages":"45-50"},"PeriodicalIF":3.5,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1464-5491.2007.02327.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41068080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}