Postprandial Plasma Glucose between 4 and 7.9 h May Be a Potential Diagnostic Marker for Diabetes

Biomedicines, Год журнала: 2024, Номер 12(6), С. 1313 - 1313

Опубликована: Июнь 13, 2024

Postprandial glucose levels between 4 and 7.9 h (PPG4–7.9h) correlate with mortality from various diseases, including hypertension, diabetes, cardiovascular disease, cancer. This study aimed to assess if predicted PPG4–7.9h could diagnose diabetes. Two groups of participants were involved: Group 1 (4420 participants) had actual PPG4–7.9h, while 2 (8422 lacked this measure but all the diabetes diagnostic measures. underwent multiple linear regression predict using 30 predictors, achieving accuracy within 11.1 mg/dL in 80% participants. model. A receiver operating characteristic curve analysis showed that an 87.3% 2, a sensitivity 75.1% specificity 84.1% at optimal cutoff 102.5 mg/dL. simulation on 10,000 random samples revealed 175 may be needed investigate as marker power least 80%. In conclusion, appears promising indicator for Future studies seeking ascertain its definitive value might require minimum sample size

Язык: Английский

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Homeostasis Model Assessment for Insulin Resistance Mediates the Positive Association of Triglycerides with Diabetes

Опубликована: Март 5, 2024

Elevated circulating triglyceride levels have been linked to an increased risk of diabetes, although the precise mechanisms remain unclear. This study aimed investigate whether low-density lipoprotein (LDL) cholesterol, homeostatic model assessment (HOMA) for insulin resistance, and C-reactive protein served as mediators in this association across a sample 18,435 US adults. Mediation analysis was conducted using PROCESS Version 4.3 Macro SPSS. Simple medi-ation revealed that all three potential played role mediating associa-tion. However, parallel mediation analysis, where were simultaneously included, HOMA resistance remained significant mediator (indirect effect coefficient, 0.47; 95% confidence interval [CI], 0.43—0.52; p < 0.05) after adjusting tested confounding factors. Conversely, LDL cholesterol -0.13; CI, -0.31—0.05; > 0.01; -0.003—0.02; ceased be mediators. accounted 49% between triglycerides diabetes. In conclusion, dominant underlying Therefore, reducing may hold promise improving sensitivity diabetic patients.

Язык: Английский

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Fasting Triglycerides in the Upper Normal Range Are Independently Associated with an Increased Risk of Diabetes Mortality

Опубликована: Фев. 29, 2024

The association between normal-range triglycerides and diabetes mortality remains unclear. This cohort study aimed to elucidate this relationship by examining 19,010 US adult participants with fasting serum below 150 mg/dL. Cox proportional hazards models were employed estimate hazard ratios (HRs) 95% confidence intervals (CIs). Participants followed up for a mean of 15.3 years, during which 342 deaths recorded. A 1-natural-log-unit increase in was associated 57% higher risk (adjusted HR, 1.57; CI, 1.04–2.38). Comparable results obtained when analyzed quartiles. Receiver operating characteristic curve analysis identified an optimal triglyceride cutoff 94.5 mg/dL mortality; individuals levels above threshold faced greater 1.43; 1.12–1.83). Further investigation revealed positive normal all-cause mortality, though no observed from hypertension or cardiovascular disease. In conclusion, elevated within the range increased mortality. Individuals 95 may require vigilant monitoring its complications.

Язык: Английский

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Homeostasis Model Assessment for Insulin Resistance Mediates the Positive Association of Triglycerides with Diabetes

Diagnostics, Год журнала: 2024, Номер 14(7), С. 733 - 733

Опубликована: Март 29, 2024

Elevated circulating triglyceride levels have been linked to an increased risk of diabetes, although the precise mechanisms remain unclear. This study aimed investigate whether low-density lipoprotein (LDL) cholesterol, homeostatic model assessment (HOMA) for insulin resistance, and C-reactive protein (CRP) served as mediators in this association across a sample 18,435 US adults. Mediation analysis was conducted using PROCESS Version 4.3 Macro SPSS. Simple mediation revealed that all three potential played role mediating association. However, parallel analysis, where were simultaneously included, HOMA resistance remained significant mediator (indirect effect coefficient, 0.47; 95% confidence interval [CI], 0.43–0.52; p < 0.05) after adjusting tested confounding factors. Conversely, LDL cholesterol −0.13; CI, −0.31–0.05; > 0.01; −0.003–0.02; ceased be mediators. accounted 49% between triglycerides diabetes. In conclusion, dominant underlying Therefore, reducing may hold promise improving sensitivity diabetic patients.

Язык: Английский

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Fasting Triglycerides in the Upper Normal Range Are Independently Associated with an Increased Risk of Diabetes Mortality in a Large Representative US Population

Journal of Cardiovascular Development and Disease, Год журнала: 2024, Номер 11(4), С. 128 - 128

Опубликована: Апрель 21, 2024

The association between normal-range triglyceride levels and diabetes mortality remains unclear. This cohort study aimed to elucidate this relationship by examining 19,010 US adult participants with fasting serum triglycerides below 150 mg/dL. Cox proportional hazards models were employed estimate hazard ratios (HRs) 95% confidence intervals (CIs). Participants followed up for a mean of 15.3 years, during which 342 deaths recorded. A 1 natural log unit increase in was associated 57% higher risk (adjusted HR, 1.57; CI, 1.04-2.38). Comparable results obtained when analyzed quartiles. Receiver operating characteristic curve analysis identified an optimal cutoff 94.5 mg/dL mortality; individuals above threshold faced greater 1.43; 1.12-1.83). Further investigation revealed positive normal all-cause mortality, though no observed from hypertension or cardiovascular disease. In conclusion, elevated within the range increased mortality. Individuals 95 may require vigilant monitoring its complications.

Язык: Английский

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The 2-Hour Plasma Glucose Levels During OGTT, Conducted in the Postprandial Period Between 4 and 7.9 Hours, Are Associated With the Diagnosis of Diabetes, Diabetes Mortality, and Cardiovascular Mortality

Опубликована: Июль 5, 2024

Postprandial plasma glucose between 4 and 7.9 hours is associated with the diagnosis of diabetes, diabetes mortality, cardiovascular mortality. However, it unknown whether 2-hour during oral tolerance test conducted in this postprandial period (4–7.9 hours), termed as 2-h PGOGTT@4–7.9h, can accurately classify predict mortality risks. This study aimed to address these questions using 2,347 adult participants. Diabetes was defined HbA1c ≥6.5%, ability PGOGTT@4–7.9h analyzed receiver operating characteristic curves. Cox proportional hazards models were employed estimate hazard ratios (HRs) 95% confidence intervals (CIs). The results showed that could 92% accuracy. Participants followed up for a mean 21.4 years. A 1-natural-log higher an increased risk from (adjusted HR, 21.1; CI, 9.2–48.0) disease 1.47; 1.13–1.91). Simulation analysis indicated future studies may require at least 100 participants investigate diagnosis. In conclusion, be useful classification prediction risk.

Язык: Английский

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Understanding older patients’ willingness to have medications deprescribed in primary care: a protocol for a cross-sectional survey study in nine European countries

BMC Geriatrics, Год журнала: 2022, Номер 22(1)

Опубликована: Ноя. 30, 2022

To reduce inappropriate polypharmacy, deprescribing should be part of patients' regular care. Yet is difficult to implement, as shown in several studies. Understanding attitudes towards at the individual and country level may reveal effective ways involve older adults decisions about medications help implement primary care settings. In this study we aim investigate adults' perceptions views on different European countries. Specific objectives are willingness have deprescribed by medication type herbal or dietary supplements reduced stopped, role Patient Typology (on perspectives), impact patient-GP relationship these decisions.This cross-sectional survey has two parts: Part A B. Data collection for will take place nine countries, which per 10 GPs recruit patients (≥65 years old) each (n = 900). B conducted Switzerland only, an additional 35 five respond a questionnaire themselves, with questions medications, their deprescribe those, patient-provider relationship. For both B, used assess polypharmacy other relevant information. same use supplements.The international design allow comparisons patient perspectives from We collect information regarding supplements, adds important literature preferences. addition, also surveyed, allowing us compare GPs' preferences stopping reducing specific medications. Our findings understand deprescribing, contributing improvements implementation interventions that better tailored

Язык: Английский

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Optimizing Prescribing in Older Adults with Multimorbidity and Polypharmacy in Primary Care: A Cluster Randomized Clinical Trial (OPTICA Trial)

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2022, Номер unknown

Опубликована: Окт. 31, 2022

Abstract Importance Inappropriate prescribing and omissions are major drivers of healthcare-related harm. Medication review may help improve pharmacotherapy. Objective To study the effects a primary care medication intervention centered around an electronic clinical decision support system (eCDSS) on appropriateness number in older adults with multimorbidity polypharmacy compared to usual care. Design Setting The “Optimising PharmacoTherapy In multimorbid elderly Care” (OPTICA) trial is cluster randomized conducted general practitioners (GPs) patients Swiss settings, between January 2019 February 2020. 12-month follow-up was completed 2021. Participants Eligible had be ≥65 years age ≥3 chronic conditions ≥5 long-term medications. Intervention optimize pharmacotherapy eCDSS Main Outcomes Measures two outcomes were improvement Appropriateness Index (MAI) Assessment Underutilization (AOU) at 12 months. Secondary included medications, falls fractures quality life. Results 43 GP clusters, 323 recruited (median age: 77 (IQR: 73-83), 45% female). 21 GPs 160 assigned group 22 163 control group. On average, 1 recommendation stop or start reported implemented per patient. At months, there no differences (Odds ratio (OR): 1.05; 95% confidence interval (CI): 0.59 1.87) nor (OR: 0.90; CI: 0.41 1.96) intention-to-treat analysis. per-protocol analysis showed statistically significant difference secondary either. Conclusions Relevance this adults, reviews based reduced inappropriate prescriptions but did not lead higher patients’ could safely delivered without causing any detriment their health. Funding National Science Foundation (407440_167465) Key points Question What effect administered supported by polypharmacy? Findings This controlled patients. end period, differ who received those Meaning feasible safe implement overall reduce omissions.

Язык: Английский

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Swiss GPs’ preferences for antidepressant treatment in mild depression: vignette-based quantitative analysis

BMC Family Practice, Год журнала: 2021, Номер 22(1)

Опубликована: Дек. 30, 2021

GPs frequently prescribe antidepressants in mild depression. The aim of this study was to examine, how often Swiss recommend various clinical presentations depression and which factors contribute antidepressant treatment recommendations.We conducted an online survey among with within-subject effect analysis. Alternating case vignettes described a typical female according International Classification Diseases, 10th edition criteria, without anxiety symptoms sleep problems. indicated for each vignette their preferred treatments (several recommendations were possible). Additionally, we assessed GP characteristics, attitudes towards treatments, elements decision-making.Altogether 178 completed the survey. In initial description depression, 11% (95%-CI: 7%-17%) recommended antidepressants. If added same case, 29% (23%-36%) problems mentioned, 47% (40%-55%) antidepressants, if both 63% (56%-70%) Several independently associated increased odds recommending specifically more years practical experience, advanced training psychosomatic psychosocial medicine, self-dispensation, higher perceived effectiveness By contrast, influence patient characteristics use practice guidelines reduced antidepressants.Consistent guidelines, rarely no co-indications (i.e., symptoms) depicted. However, presence symptoms, many overestimation antidepressants' effectiveness, non-use may lead over-prescribing.

Язык: Английский

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Medikamentenoptimierung dank elektronischer Entscheidungshilfen

Primary and Hospital Care Allgemeine Innere Medizin, Год журнала: 2024, Номер unknown

Опубликована: Июль 3, 2024

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