Hormones and Aging: An Endocrine Society Scientific Statement

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2023, Volume and Issue: 108(8), P. 1835 - 1874

Published: June 16, 2023

Multiple changes occur across various endocrine systems as an individual ages. The understanding of the factors that cause age-related and how they should be managed clinically is evolving. This statement reviews current state research in growth hormone, adrenal, ovarian, testicular, thyroid axes, well osteoporosis, vitamin D deficiency, type 2 diabetes, water metabolism, with a specific focus on older individuals. Each section describes natural history observational data individuals, available therapies, clinical trial efficacy safety key points, scientific gaps. goal this to inform future refines prevention treatment strategies age-associated conditions, improving health

Language: Английский

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Global burden of type 1 diabetes in adults aged 65 years and older, 1990-2019: population based study

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e078432 - e078432

Published: June 12, 2024

Abstract Objectives To estimate the burden, trends, and inequalities of type 1 diabetes mellitus (T1DM) among older adults at global, regional, national level from 1990 to 2019. Design Population based study. Adults aged ≥65 years 21 regions 204 countries territories (Global Burden Disease Risk Factors Study 2019) Main outcome measures Primary outcomes were T1DM related age standardised prevalence, mortality, disability adjusted life (DALYs), average annual percentage change. Results The global prevalence increased 400 (95% uncertainty interval (UI) 332 476) per 100 000 population in 514 (417 624) 2019, with an trend 0.86% confidence (CI) 0.79% 0.93%); while mortality decreased 4.74 UI 3.44 5.9) 3.54 (2.91 4.59) population, −1.00% CI −1.09% −0.91%), DALYs 113 89 137) 103 (85 127) −0.33% −0.41% −0.25%). most significant decrease was observed those <79 years: 65-69 (−0.44% year −0.53% −0.34%)), 70-74 (−0.34% (−0.41% −0.27%)), 75-79 (−0.42% (−0.58% −0.26%)). Mortality fell 13 times faster a high sociodemographic index versus low-middle (−2.17% −2.31% −2.02%) v −0.16% (−0.45% 0.12%)). While highest remained income North America, Australasia, western Europe, DALY rates found southern sub-Saharan Africa, Oceania, Caribbean. A fasting plasma glucose risk factor for during 1990-2019. Conclusions expectancy people has since 1990s along considerable associated DALYs. lower women years, living index, years. Management remains major challenge T1DM, targeted clinical guidelines are needed.

Language: Английский

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Diabetes Fact Sheets in Korea 2024

Diabetes & Metabolism Journal, Journal Year: 2025, Volume and Issue: 49(1), P. 24 - 33

Published: Jan. 1, 2025

This study aimed to investigate the prevalence, management, and comorbidities of diabetes mellitus among Korean adults. Data from Korea National Health Nutrition Examination Survey (2019-2022) were analyzed assess treatment, risk factors, diabetes. Comparisons between young older adults with emphasized. Among aged ≥30 years, prevalence is 15.5% during 2021-2022. Of these, 74.7% aware their condition, 70.9% received antidiabetic only 32.4% achieved glycosylated hemoglobin (HbA1c) <6.5%. Moreover, 15.9% met integrated management targets, which included HbA1c <6.5%, blood pressure <140/85 mm Hg, low-density lipoprotein cholesterol <100 mg/dL. In 19 39 was 2.2%. them, 43.3% 34.6% 29.6% Obesity affected 87.1%, 26.9% had both hypertension hypercholesterolemia. ≥65 29.3%, awareness, control rates 78.8%, 75.7%, 31.2%, respectively. Integrated targets (HbA1c <7.5%, hypertension, lipids) by 40.1%. Diabetes remains highly prevalent adults, significant gaps in glycemic, pressure, lipid control. Older show higher awareness treatment but limited outcomes. Young bear a burden obesity comorbidities, alongside low rates. Therefore, early intervention programs, education, strategies tailored younger populations are urgently required.

Language: Английский

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Reducing Nontraumatic Lower-Extremity Amputations by 20% by 2030: Time to Get to Our Feet: A Policy Statement From the American Heart Association

Circulation, Journal Year: 2021, Volume and Issue: 143(17)

Published: March 25, 2021

Nontraumatic lower-extremity amputation is a devastating complication of peripheral artery disease (PAD) with high mortality and medical expenditure. There are ≈150 000 nontraumatic leg amputations every year in the United States, most cases occur patients diabetes. Among diabetes, after an ≈40% decline between 2000 2009, rate increased by 50% from 2009 to 2015. A number evidence-based diagnostic therapeutic approaches for PAD can reduce risk. However, their implementation adherence suboptimal. Some racial/ethnic groups have elevated risk but less access high-quality vascular care, leading rates amputation. To stop, indeed reverse, increasing trends amputation, actionable policies that will incidence critical limb ischemia enhance delivery optimal care needed. This statement describes impact on society, summarizes identify prevent its progression, proposes policy solutions actions recommended improving public awareness greater use effective management strategies (eg, smoking cessation, statins, foot monitoring/care diabetes). facilitate these recommendations, we propose several regulatory/legislative organizational/institutional such as adoption quality measures care; affordable prevention, diagnosis, management; regulation tobacco products; clinical decision support professional education; dedicated funding opportunities research. If recommendations proposed implemented, should be able achieve goal reducing 20% 2030.

Language: Английский

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A PEDOT:PSS conductive hydrogel incorporated with Prussian blue nanoparticles for wearable and noninvasive monitoring of glucose

Chemical Engineering Journal, Journal Year: 2021, Volume and Issue: 431, P. 134109 - 134109

Published: Dec. 13, 2021

Language: Английский

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Prevalence of Diabetes Mellitus and Its Associated Factors in Bangladesh: Application of Two-level Logistic Regression Model

Scientific Reports, Journal Year: 2020, Volume and Issue: 10(1)

Published: June 24, 2020

Abstract This study intends to explore the prevalence of diabetes mellitus (DM) and its associated factors in Bangladesh. The necessary information was extracted from Bangladesh Demographic Health Survey (BDHS) 2011. In bivariate analysis, Chi-square test performed assess association between selected covariates status. A two-level logistic regression model with a random intercept at each individual regional level considered identify risk DM. total 7,535 individuals were included this study. From univariate DM found be 33.3% 50–54 age group for instance. setup, all except sex participants significant ( p < 0.05). According model, chance occurring increases as participants’ increases. It observed that female more likely have occurrence 62% higher educated participants, 42% who came rich family 63% having hypertension. developing among overweighed people almost double. However, engaged physical work had less calls greater attention government other concerned entities come up appropriate policy interventions lower

Language: Английский

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Cellular Senescence as the Pathogenic Hub of Diabetes-Related Wound Chronicity

Frontiers in Endocrinology, Journal Year: 2020, Volume and Issue: 11

Published: Sept. 16, 2020

Diabetes is the only non-communicable disease with pandemic magnitude. Essentially defined as an endocrine-metabolic condition, its entangled pathophysiology and broad spectrum of ever progressing complications has turned this intense investigational target that bridges to cancer, neurodegenerative processes, ultimately aging. Diabetic environment contains major stressors for onset premature cellular senescence precocious organismal Thus, diabetic subjects exhibit reduced tissue resilience limited biological reserves safeguarding mechanisms injury counteraction. The impaired wound healing response illustrative example accounting majority lower limbs amputations life expectancy. Classic studies seeded notion a founding pillar orchestration chronic phenotype wounds. Tracking diabetes molecular drivers teach glucose derivative glucooxidative products act chain reaction within progressive vicious circle in which classic "aging hallmarks" are pathogenically instrumental. Mitochondrial dysfunction interconnected dysmetabolism, pro-oxidative milieu, inflammatory activation program, conspire against DNA integrity, triggers switches program. Fibroblasts, endothelial cells keratinocytes chronically exposed catalyze their These in-wound senescent create society via secretome that, paracrine manner, contributes perpetuation chronicity. memory turns these refractory migrate, proliferate, secrete granulation ingredients under vivo vitro scenarios. Mesenchymal stem also impacted by diabetes-related pro-senescence forces, may translate reduction natural reservoir competent repair, turnover, conservation.

Language: Английский

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Diabetes in ageing: pathways for developing the evidence base for clinical guidance

The Lancet Diabetes & Endocrinology, Journal Year: 2020, Volume and Issue: 8(10), P. 855 - 867

Published: Sept. 15, 2020

Language: Английский

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Common pathways in dementia and diabetic retinopathy: understanding the mechanisms of diabetes-related cognitive decline

Trends in Endocrinology and Metabolism, Journal Year: 2021, Volume and Issue: 33(1), P. 50 - 71

Published: Nov. 15, 2021

Language: Английский

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Comparison of Diabetes Medications Used by Adults With Commercial Insurance vs Medicare Advantage, 2016 to 2019

JAMA Network Open, Journal Year: 2021, Volume and Issue: 4(2), P. e2035792 - e2035792

Published: Feb. 1, 2021

Importance

Glucagonlike peptide-1 receptor agonists (GLP-1RA), sodium-glucose cotransporter-2 inhibitors (SGLT2i), and dipeptidyl peptidase-4 (DPP-4i) are associated with low rates of hypoglycemia, postmarketing trials GLP-1RA SGLT2i demonstrated that these medications improved cardiovascular kidney outcomes.

Objective

To compare trends in initiation treatment GLP-1RA, SGLT2i, DPP-4i by older adults type 2 diabetes insured Medicare Advantage vs commercial health plans.

Design, Setting, Participants

This retrospective cohort study used administrative claims data from a deidentified database commercially beneficiaries. Adults aged 58 to 66 years who filled any medication prescription lower glucose levels January 1, 2016, December 31, 2019, were compared between groups.

Exposure

Enrollment or insurance plan.

Main Outcomes Measures

The odds initiating examined for beneficiaries using 3 separate logistic regression models adjusted year demographic clinical factors. These calculate annual

Results

A total 382 574 pharmacologically treated (52.9% men; mean [SD] age, 62.4 [2.7] years) identified, including 172 180 210 394 From 2016 increased among all beneficiaries, 2.14% 20.02% 1.50% 11.44% beneficiaries; 2.74% 18.15% 1.57% 8.51% 3.30% 11.71% 2.44% 7.68% Initiation drug classes consistently than Within each calendar year, the ranged 0.28 (95% CI, 0.26-0.29) 0.70 0.65-0.75) respectively; 0.21 0.20-0.22) 0.57 0.53-0.61), DPP-4i, 0.37 0.34-0.39) 0.73 0.69-0.78), respectively (P < .001 all). starting income; an income $200 000 higher less $40 000, ratio was 1.23 1.15-1.32) 1.16 1.09-1.24).

Conclusions Relevance

findings suggest may be likely newer levels, greater disparities lower-income patients. Better understanding nonclinical factors contributing decisions efforts promote equity management appear needed.

Language: Английский

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