Objective To estimate the relative risk forfatal coronary heart disease associated with diabetesin men and women·Design Meta-analysis of prospective cohortstudies·Data sources Studies published between 1966and March 2005, identified through Embase andMedline, using a combined text word and MESHheading search strategy, in addition to studies fromthe Asia Pacific Cohort Studies Collaboration·Review methods Studies were eligible if theyhad reported estimates of the relative risk for fatalcoronary heart disease comparing men and womenwith and without diabetes·Studies were excluded ifthe estimates were not adjusted at least for age·Results 37 studies of type 2 diabetes and fatalcoronary heart disease among a total of 447 064patients were identified·The rate of fatal coronaryheart disease was higher in patients with diabetesthan in those without (5·4v1·6%)·The overallsummary relative risk for fatal coronary heart diseasein patients with diabetes compared with no diabeteswas significantly greater among women than it wasamong men: 3.50, 95% confidence interval 2.70 to4·53v2.06, 1·81 to 2.34·After exclusion of theeight studies that had adjusted only for age, thedifference in risk between the sexes was substantiallyreduced but still highly significant·The pooled ratioof the relative risks ( women: men) from the 29studies with multiple adjusted estimates was 1·46(1·14 to 1·88)·Conclusions The relative risk for fatalcoronary heart disease associated with diabetes is50% higher in women than it is in men·This greaterexcess coronary risk may be explained by more adverse cardiovascular risk profiles among women with diabetes,combined with possible disparities in treatment that favour men·

Excess risk of fatal coronary heart disease associated with diabetes in men and women:meta-analysis of 37 prospective cohort studies

Cancer survivors are now living longer giving rise to a new concept—chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. Physical health (CES = − 0.894; CI, − 1.472, − 0.316), role-physical health (CES = − 2.039; CI, − 2.643, − 1.435), and mental health (CES = − 0.870; CI, − 1.447, − 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.

Quality of life in "chronic" cancer survivors: a meta-analysis

Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys

Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery.

Introduction: Age-related medical conditions are increasing worldwide. Type 2 Diabetes mellitus (T2DM) represents a chronic disease, which affects a large amount of general population, accounting for over 90% of DM cases. Purpose: As psychopathological symptoms frequently occur in medical conditions, our study aimed at exploring whether psychological factors and metabolic control may affect health related quality of life (HRQoL). Methods: 45 patients with T2DM were consecutively recruited and assessed with a psychodiagnostic battery: Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory II edition (BDI-II) and the 36-Item Short Form Health Survey (SF-36), including indexes Physical and Mental Component Summary (PCS, MCS). Moreover, time since DM diagnosis and glycated hemoglobin (HbA1c) values were detected. Results: Participants (mean age 65.3±5.9 yrs) had a mean time since diagnosis of 11.6±6.7 yrs, and showed a good metabolic control as highlighted by mean HbA1c values 7.1±0.9 %. Median HAM-A score [25(20.7-30.6)], represented high prevalence of anxious symptoms. A moderate expression of depressive symptoms was observed [BDI-II score: 13(8.3-21.4)]. A multiple regression analysis, after correcting for age, BMI, HbA1c value and BDI-II score, showed the perceived quality of life relative to PCS was significantly related to both disease duration (β=-0.55, p=0.03, SE=0.25) and HAM-A scores (β=-0.52, p=0.04, SE=0.24). Moreover, both HAM-A (β=-0.67, p=0.01, SE=0.26) and BDI-II (β=-0.48, p=0.02, SE=0.20) scores were independently predictive of MCS. Metabolic control, instead, was not a significant predictor. Conclusions: Our study suggests a predictive role of both anxiety levels and time since diagnosis in perceived HRQoL in T2DM patients. PCS was associated with anxiety and time since diagnosis and MCS was associated with anxiety and depressive symptoms but not with diabetes duration or metabolic control. These data could be useful to plan T2DM training programs focused on psychological health concerns, possibly leading to a healthy self-management and a better perceived HRQoL, even assisting patients in reducing the negative effect due to the chronicization of T2DM.

/pdf/as-time-goes-by-anxiety-negatively-affects-the-perceived-1gtt5s4yl5.pdf

As Time Goes by: Anxiety Negatively Affects the Perceived Quality of Life in Patients With Type 2 Diabetes of Long Duration

Diabetes is a chronic disease, and it could affect both health and quality of life (QOL). A lot of studies have reported some predictors of QOL of type 2 diabetes patients. While their results were not completely consistent. So the aim of our study was finding out the related factors (including characteristics related to the disease, life styles and mental health factors) of QOL of type 2 diabetes patients. We searched Cochrane library, EmBase, PubMed and CNKI databases for published studies that evaluated the related factors of QOL of type 2 diabetes patients by using a proper statistic method and had effect sizes (OR or β) and 95% confidence intervals from January 1st 2000 to May 31st 2016. Any study types were acceptable, and we excluded the reviews, letters, editorials and pooled analyses. The data were analyzed using STATA software (Version 12.0; Stata Corporation). Effect sizes and 95% confidence intervals were calculated to evaluate the relationship between these factors and QOL. Eighteen studies were included into our systematic review and meta-analysis, totaling 57,109 type 2 diabetes patients. Do more physical exercises (The pooled ORs ranged from 0.635 to 0.825 for different scales, less than 1.00), glucose check more frequently [pooled OR (95%CI): 0.175 (0.041, 0.756)] were associated with a better QOL. Presence of complications (The pooled ORs ranged from 1.462 to 3.038 for different scales, more than 1.00), presence of hypertension [pooled OR (95%CI): 1.389 (1.173, 1644)], longer duration of diabetes [pooled OR (95%CI): 1.865 (1.088, 3.197)], diet with more red meat [pooled OR (95%CI): 2.085 (1.063, 4.089)] and depression (The pooled ORs ranged from 3.003 to 11.473 for different scales, higher than 1.00) were associated with a worse QOL. The results of this study show that physical exercise, glucose check frequently, complications, hypertension, duration of diabetes, diet with more red meat, and depression were associated with the QOL of type 2 diabetes patients.

/pdf/related-factors-of-quality-of-life-of-type-2-diabetes-1b5isumxig.pdf

Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis

Lifestyle behaviors are essential elements of diabetes care. The aims of this study were to identify distinct subgroups of people with type 2 diabetes based on personal levels of lifestyle behaviors and explore the different characteristics across these subgroups. In 2015 and 2016, 1504 outpatients with a diagnosis of type 2 diabetes were selected via two-stage simple random sampling from 10 municipal district hospitals in Tianjin. Participants accepted an invitation by experienced physicians to complete a questionnaire containing demographic and lifestyle content. Clinical data were collected by reviewing medical records. Latent class analysis was applied to identify patterns of lifestyle behaviors. Multinomial logistic regression was used to investigate the characteristics of the subgroups. The final model yielded a four-class solution: the healthy behavioral group, unhealthy diet and less activity group, smoking and drinking group, and sedentary and extremely inactive group. Further analysis found that variables, including age, sex, general/central obesity, treatment modalities, glycemic control, diabetes duration, and diabetes-related complications and comorbidities, were disproportionately distributed across the four latent classes (P < 0.05). Participants in the unhealthy diet and less activity group were more likely to have a longer duration of diabetes, poor glycemic control and more diabetes-related diseases relative to the other three latent classes. Identification and characterization of subgroups based on lifestyle behaviors in individuals with type 2 diabetes can help health care providers to shift to targeted intervention strategies.

/pdf/identifying-patterns-of-lifestyle-behaviors-among-people-29p1f6ouf3.pdf

Identifying Patterns of Lifestyle Behaviors among People with Type 2 Diabetes in Tianjin, China: A Latent Class Analysis

The aim of this study was to explore a new classification way in persons with type 2 diabetes mellitus based on complications and comorbidities using Latent Class Analysis, moreover, finding out the factors associated with different latent classes and making specific suggestions. In this study, 5,500 patients with type 2 diabetes mellitus from ten hospitals in Tianjin, China were selected, and the response rate was 96.2%. Latent Class Analysis was used to cluster patients. After compared the baseline characteristics, multinomial logistic regression was applied. Patients with type 2 diabetes mellitus were classified into four classes. In the univariate analysis, all variables were significant (p<0.05). According to multinomial logistic regression, we found longer duration of type 2 diabetes mellitus, family history of diabetes, older age, obesity and central obesity, female menopause, living in a suburb, having a higher 2hPG at diagnosis, smoking and drinking were associated with the prevalence of complications and comorbidities. In conclusion, LCA was shown to be an effective method for grouping patients with T2DM, which presented a nuanced approach to data reduction. Further research using LCA may be especially useful to investigate causal relationships between complications and the significant factors identified in our study.

/pdf/latent-class-analysis-suggests-four-classes-of-persons-with-4dx22kmcr9.pdf

Latent class analysis suggests four classes of persons with type 2 diabetes mellitus based on complications and comorbidities in Tianjin, China: a cross-sectional analysis.

Objective 
This study aimed to identify the local levels of vulnerability among patients with Type-II diabetes (T2DM) in Tianjin. The study was aimed at curbing the rise of T2DM in cities.


Methods 
229 participants living with T2DM were purposively sampled from hospitals in Tianjin. Collected data were coded and analysed following well-established thematic analysis principles.


Results 
Twelve themes involving 29 factors were associated with diabetes patients’ vulnerability: 1. Financial constraints (Low Income, Unemployment, No Medical Insurance/Low ratio reimbursement); 2. Severity of disease (Appearance of symptoms, complications, co-morbidities, high BMI, poor disease control); 3. Health literacy (No/Low/Wrong knowledge of health literacy); 4. Health beliefs (Perceived diabetes indifferently, Passively Acquire Health Knowledge, Distrust of primary health services); 5. Medical environment (Needs not met by Medical Services); 6. Life restrictions (Daily Life, Occupational Restriction); 7. Lifestyle change (Adhering to traditional or unhealthy diet, Lack of exercise, Low-quality sleep); 8. Time poverty (Healthcare-seeking behaviours were limited by work, Healthcare-seeking behaviours were limited by family issues); 9. Mental Condition (Negative emotions towards diabetes, Negative emotions towards life); 10. Levels of Support (Lack of community support, Lack of support from Friends and Family, Lack of Social Support); 11. Social integration (Low Degree of Integration, Belief in Suffering Alone); 12. Experience of transitions (Diet, Dwelling Environment).


Conclusion 
Based on our findings, specific interventions targeting individual patients, family, community and society are needed to improve diabetes control, as well as patients’ mental health care and general living conditions.

/pdf/assessment-of-factors-affecting-diabetes-management-in-the-2syt9q2zen.pdf

Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin.

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Papers

Related factors of quality of life of type 2 diabetes patients: a systematic review and meta-analysis

Identifying Patterns of Lifestyle Behaviors among People with Type 2 Diabetes in Tianjin, China: A Latent Class Analysis

Latent class analysis suggests four classes of persons with type 2 diabetes mellitus based on complications and comorbidities in Tianjin, China: a cross-sectional analysis.

Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin.