Journal of Preventive Medicine and Public Health

Original Articles

Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea: Haryeom Ghang, Juhyang Lee; J Prev Med Public Health. 2023;56(6):504-514. Published online October 5, 2023; DOI: https://doi.org/10.3961/jpmph.23.252

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Abstract Summary PDF Supplementary Material: Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.; Summary

Korean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).

Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).

Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia: Muhammad Husen Prabowo, Ratih Puspita Febrinasari, Eti Poncorini Pamungkasari, Yodi Mahendradhata, Anni-Maria Pulkki-Brännström, Ari Probandari; J Prev Med Public Health. 2023;56(5):467-474. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.229

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Abstract Summary PDF: Objectives
Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population’s health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia.
Methods
A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group’s validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL.
Results
Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score.
Conclusions
Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.; Summary

Key Message
This study examined Health-Related Quality of Life (HRQoL) in 260 type 2 diabetes patients in Indonesia. Most were male (60.6%), over 50 (91.5%), with low education (75%) and unemployed (85.6%). Pain/discomfort was the most common issue (64%), followed by anxiety (28.4%). The average HRQoL score was 0.86. Higher education positively impacted HRQoL. Diabetes patients face lower HRQoL compared to the general population, with notable issues in pain and anxiety. Education level significantly influences HRQoL. This highlights the importance of education in improving the well-being of diabetes patients in Indonesia.

Health-related Quality of Life Instrument With 8 Items for Use in Patients With Type 2 Diabetes Mellitus: A Validation Study in Korea: Juyoung Kim, Hyeon-Jeong Lee, Min-Woo Jo; J Prev Med Public Health. 2022;55(3):234-242. Published online May 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.020

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Abstract Summary PDF Supplementary Material

Objectives
This study assessed the validity and reliability of the Health-related Quality of Life Instrument with 8 Items (HINT-8) in patients with diabetes. HINT-8 is a newly-developed, generic health-related quality of life (HRQoL) instrument.
Methods
Three HRQoL instruments—HINT-8, EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Short Form Health Survey version 2.0 (SF-36v2)—were provided to 300 patients with diabetes visiting a tertiary hospital for follow-up visits in Korea. The HRQoL scores obtained using the HINT-8 were evaluated for subgroups with known differences based on demographics and diabetes-related characteristics (known-group validity). The mean scores of the instruments were compared between groups segmented by their responses to the HINT-8 (discriminatory ability). Correlation coefficients of the HINT-8 with other instruments were calculated (convergent and divergent validity). The Cohen kappa and intra-class correlation coefficient (ICC) were also evaluated (test-retest reliability).
Results
The average HINT-8 indexes were lower among women, older, and less-educated subjects. Subjects who did not list any problems on the HINT-8 had significantly higher HRQoL scores than those who did. The correlation coefficients of the HINT-8 with the EQ-5D-5L index and EuroQoL visual analogue scale were 0.715 (p<0.001) and 0.517 (p<0.001), respectively. The correlation coefficients between the HINT-8 index and the scores of 8 domains of the SF-36v2 ranged from 0.478 (p<0.001) to 0.669 (p<0.001). The Cohen kappa values for the HINT-8 ranged from 0.268 to 0.601, and the ICC of the HINT-8 index was 0.800 (95% confidence interval [CI], 0.720 to 0.860).
Conclusions
This study showed that the HINT-8 is a valid and reliable HRQoL instrument for patients with diabetes.

Summary

Korean summary
이 연구는 한국인의 사회문화적 특성을 반영하여 개발된 건강관련 삶의 질 도구인 HINT-8의 타당도 및 신뢰도를 대표적인 만성 질환인 제2형 당뇨 환자를 대상으로 검증하였다. 연구결과는 제2형 당뇨 환자에서 HINT-8의 활용 가능성을 보여주었을 뿐만 아니라 일반적 건강관련 삶의 질 도구 중 가장 널리 사용되고 있는 EQ-5D-5L보다 HINT-8이 삶의 질 상태를 더욱 정교하게 구분하고 있음을 보여주었다.

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Systematic Review

Low Social Support and Risk for Depression in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis: Akhmad Azmiardi, Bhisma Murti, Ratih Puspita Febrinasari, Didik Gunawan Tamtomo; J Prev Med Public Health. 2022;55(1):37-48. Published online January 10, 2022; DOI: https://doi.org/10.3961/jpmph.21.490

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Abstract PDF

Objectives
Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis.
Methods
PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I² statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias.
Results
Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I²= 87%).
Conclusions
Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

Summary

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Luisa De Risio, Mauro Pettorruso, Rebecca Collevecchio, Barbara Collacchi, Marta Boffa, Mario Santorelli, Massimo Clerici, Giovanni Martinotti, Francesca Zoratto, Marta Borgi
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The risk factors for mental health disorders in patients with type 2 diabetes: An umbrella review of systematic reviews with and without meta-analysis
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Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis
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Individuelle Behandlung bei Glaukompatienten mit einem Diabetes mellitus
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Original Articles

Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes: Narges Malih, Mohammad-Reza Sohrabi, Alireza Abadi, Shahnam Arshi; J Prev Med Public Health. 2021;54(3):190-198. Published online April 7, 2021; DOI: https://doi.org/10.3961/jpmph.20.496

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Abstract PDF Supplementary Material

Objectives
Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods
This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results
Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions
Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.

Summary

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Nahid Shahabi, Yadolah Fakhri, Teamur Aghamolaei, Zahra Hosseini, Atefeh Homayuni
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Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
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Thirst for Information and Needs Reflections of Type 2 Diabetes Patients Receiving Insulin Treatment in North-East Ethiopia: A Qualitative Exploration: Ewunetie Mekashaw Bayked, Birhanu Demeke Workneh, Mesfin Haile Kahissay; J Prev Med Public Health. 2021;54(2):119-128. Published online March 1, 2021; DOI: https://doi.org/10.3961/jpmph.20.510

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Objectives
Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia.
Methods
The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients’ registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies.
Results
Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants’ recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions.
Conclusions
Patients’ main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

Summary

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Quality of life and associated factors among patients with cancer receiving chemotherapy at Dessie Comprehensive Specialized Hospital, North-East Ethiopia: a cross-sectional study
Ewunetie Mekashaw Bayked, Mekdes Getachew Yimam, Zemen Mengesha Yalew, Husien Nurahmed Toleha, Segenet Zewdie
Frontiers in Oncology.2024;[Epub] CrossRef
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Dasom Im, Jeehye Pyo, Haneul Lee, Hyeran Jung, Minsu Ock
Journal of Preventive Medicine and Public Health.2023; 56(2): 100. CrossRef
Sufferings of its consequences; patients with Type 2 diabetes mellitus in North-East Ethiopia, A qualitative investigation
Ewunetie Mekashaw Bayked, Birhanu Demeke Workneh, Mesfin Haile Kahissay
Heliyon.2022; 8(2): e08871. CrossRef
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Ewunetie Mekashaw Bayked, Mesfin Haile Kahissay, Birhanu Demeke Workneh
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The “Life-World” trip of type 2 diabetes patients with allopathic treatment options: a triangulated qualitative investigation
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The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population: Hyungseon Yeom, Jung Hyun Lee, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2016;49(2):108-117. Published online March 23, 2016; DOI: https://doi.org/10.3961/jpmph.15.062

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Abstract PDF Supplementary Material

Objectives
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
Methods
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m²). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
Results
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
Conclusions
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Summary

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Kidney International Reports.2024; 9(4): 752. CrossRef
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Lili Guo, Yue Zhang, Jian Lu, Xiaoyang Li, Chao Zhang, Wenzhu Song, Yafang Dong, Xiangyang Zhou, Rongshan Li
Molecular and Cellular Endocrinology.2023; 576: 111989. CrossRef
Lifestyle factors associated with a rapid decline in the estimated glomerular filtration rate over two years in older adults with type 2 diabetes–Evidence from a large national database in Japan
Yaya Li, Makoto Fujii, Yuko Ohno, Asuka Ikeda, Kayo Godai, Yuko Nakamura, Yuya Akagi, Daisuke Yabe, Kazuyo Tsushita, Naoki Kashihara, Kei Kamide, Mai Kabayama, Patricia Khashayar
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Development of a Risk Model for Predicting Microalbuminuria in the Chinese Population Using Machine Learning Algorithms
Wei Lin, Songchang Shi, Huibin Huang, Nengying Wang, Junping Wen, Gang Chen
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Jianjun Bai, Fang Shi, Yudiyang Ma, Donghui Yang, Chuanhua Yu, Jinhong Cao
Frontiers in Endocrinology.2022;[Epub] CrossRef
ASIAN PACIFIC SOCIETY OF NEPHROLOGY CLINICAL PRACTICE GUIDELINE ON DIABETIC KIDNEY DISEASE
Adrian LIEW, Sunita BAVANANDAN, Narayan PRASAD, Muh Geot WONG, Jer Ming CHANG, Somchai EIAM‐ONG, Chuan‐Ming HAO, Chiao Yuen LIM, Soo Kun LIM, Kook‐Hwan OH, Hirokazu OKADA, Paweena SUSANTITAPHONG, Aida LYDIA, Huong Thi Bich TRAN, Russell VILLANUEVA, See Ch
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Xu Longming, Dai Shuiping, Zuo Yunxia
Chinese Medical Sciences Journal.2020; 35(2): 170. CrossRef
Interaction of MTHFR C677T polymorphism with smoking in susceptibility to diabetic nephropathy in Chinese men with type 2 diabetes
Liang Ma, Yongwei Jiang, Xiaomu Kong, Qian Liu, Hailing Zhao, Tingting Zhao, Yongtong Cao, Ping Li
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Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus: a systematic review and meta-analysis
Debasish Kar, Clare Gillies, Mintu Nath, Kamlesh Khunti, Melanie J. Davies, Samuel Seidu
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Peter Roderick, Victoria Turner, Anne Readshaw, Omara Dogar, Kamran Siddiqi
Diabetes Research and Clinical Practice.2019; 154: 52. CrossRef
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Haili Xu, Jinliu Suo, Jing Lian
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Association of single-nucleotide polymorphisms in the RAGE gene and its gene- environment interactions with diabetic nephropathy in Chinese patients with type 2 diabetes
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Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study: Hyeongtaek Woo, Jeeyoo Lee, Jeonghee Lee, Ji Won Park, Sungchan Park, Jeongseon Kim, Jae Hwan Oh, Aesun Shin; J Prev Med Public Health. 2016;49(1):45-52. Published online December 22, 2015; DOI: https://doi.org/10.3961/jpmph.15.029

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Abstract PDF

Objectives
Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women.
Methods
A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models.
Results
DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08).
Conclusions
Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

Summary

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Determinants of Poor Self-rated Health in Korean Adults With Diabetes: Hwi-Won Lee, Minkyo Song, Jae Jeong Yang, Daehee Kang; J Prev Med Public Health. 2015;48(6):287-300. Published online October 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.048

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Abstract PDF Supplementary Material

Objectives
Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes.
Methods
A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance.
Results
We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR]_{Frequent stress events}, 5.40; 95% confidence interval [CI], 4.63 to 6.29; OR_{Severe distress}, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants’ medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A_1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health.
Conclusions
Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.

Summary

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Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications: Young-Hoon Gong, Seok-Jun Yoon, Hyeyoung Seo, Dongwoo Kim; J Prev Med Public Health. 2015;48(4):188-194. Published online July 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.020

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Abstract PDF

Objectives
The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea.
Methods
This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited.
Results
Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance.
Conclusions
Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

Summary

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Chasms in Achievement of Recommended Diabetes Care among Geographic Regions in Korea
Sanghyun Cho, Ji-Yeon Shin, Hyun Joo Kim, Sang Jun Eun, Sungchan Kang, Won Mo Jang, Hyemin Jung, Yoon Kim, Jin Yong Lee
Journal of Korean Medical Science.2019;[Epub] CrossRef

Association of Selected Medical Conditions With Breast Cancer Risk in Korea: Sun Jae Jung, Minkyo Song, Ji-Yeob Choi, Nan Song, Sue Kyung Park, Keun-Young Yoo, Daehee Kang; J Prev Med Public Health. 2013;46(6):346-352. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.346

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Abstract PDF

Objectives

To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study.

Methods

The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer.

Results

Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer.

Conclusions

Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

Summary

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Diabetes and incidence of breast cancer and its molecular subtypes: A systematic review and meta‐analysis
Fanxiu Xiong, Qichen Dai, Sihan Zhang, Stephen Bent, Peggy Tahir, Erin L. Van Blarigan, Stacey A. Kenfield, June M. Chan, Gabriela Schmajuk, Rebecca E. Graff
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Reverse Onco-Cardiology: What Is the Evidence for Breast Cancer? A Systematic Review of the Literature
Ioannis Boutas, Adamantia Kontogeorgi, Sophia N. Kalantaridou, Constantine Dimitrakakis, Panagiotis Patsios, Maria Kalantzi, Theodoros Xanthos
International Journal of Molecular Sciences.2023; 24(22): 16500. CrossRef
Association of Hypertension and Organ-Specific Cancer: A Meta-Analysis
Morgan Connaughton, Mahsa Dabagh
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Aristeidis Seretis, Sofia Cividini, Georgios Markozannes, Xanthippi Tseretopoulou, David S. Lopez, Evangelia E. Ntzani, Konstantinos K. Tsilidis
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Mathilde Gottschau, Allan Jensen, Kristian Reinholdt, Sonia Guleria, Christian Munk, Lene Mellemkjær, Susanne K. Kjær
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Thierry Habyarimana, Mohammed Attaleb, Jean Baptiste Mazarati, Youssef Bakri, Mohammed El Mzibri
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Cancer du sein et diabète de type 2 : des interactions complexes
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Differences in Cigarette Use Behaviors by Age at the Time of Diagnosis With Diabetes From Young Adulthood to Adulthood: Results From the National Longitudinal Study of Adolescent Health: Jisuk Bae; J Prev Med Public Health. 2013;46(5):249-260. Published online September 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.5.249

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Abstract PDF

Objectives

Previous observations propose that risk-taking behaviors such as cigarette smoking are prevailing among young people with chronic conditions including diabetes. The purpose of this study was to examine whether cigarette smoking is more prevalent among diabetics than non-diabetics and whether it differs by age at the time of diagnosis with diabetes from young adulthood (YAH) to adulthood (AH).

Methods

We used US panel data from the National Longitudinal Study of Adolescent Health (Add Health Study) during the years 2001 to 2002 (Wave III, YAH) and 2007 to 2008 (Wave IV, AH). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of cigarette use behaviors according to age at the time of diagnosis with diabetes, after adjusting for demographic and selected behavioral factors.

Results

Of 12 175 study participants, 2.6% reported having been diagnosed with diabetes up to AH. Early-onset diabetics (age at diagnosis <13 years) were more likely than non-diabetics to report frequent cigarette smoking (smoking on ≥20 days during the previous 30 days) in YAH (OR, 3.34; 95% CI, 1.27 to 8.79). On the other hand, late-onset diabetics (age at diagnosis ≥13 years) were more likely than non-diabetics to report heavy cigarette smoking (smoking ≥10 cigarettes per day during the previous 30 days) in AH (OR, 1.54; 95% CI, 1.03 to 2.30).

Conclusions

The current study indicated that diabetics are more likely than non-diabetics to smoke cigarettes frequently and heavily in YAH and AH. Effective smoking prevention and cessation programs uniquely focused on diabetics need to be designed and implemented.

Summary

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Nuha A. ElSayed, Grazia Aleppo, Vanita R. Aroda, Raveendhara R. Bannuru, Florence M. Brown, Dennis Bruemmer, Billy S. Collins, Marisa E. Hilliard, Diana Isaacs, Eric L. Johnson, Scott Kahan, Kamlesh Khunti, Jose Leon, Sarah K. Lyons, Mary Lou Perry, Priya
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Interaction of Body Mass Index and Diabetes as Modifiers of Cardiovascular Mortality in a Cohort Study: Seung Hyun Ma, Bo-Young Park, Jae Jeong Yang, En-Joo Jung, Yohwan Yeo, Yungi Whang, Soung-Hoon Chang, Hai-Rim Shin, Daehee Kang, Keun-Young Yoo, Sue Kyung Park; J Prev Med Public Health. 2012;45(6):394-401. Published online November 29, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.6.394

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Abstract PDF

Objectives

Diabetes and obesity each increases mortality, but recent papers have shown that lean Asian persons were at greater risk for mortality than were obese persons. The objective of this study is to determine whether an interaction exists between body mass index (BMI) and diabetes, which can modify the risk of death by cardiovascular disease (CVD).

Methods

Subjects who were over 20 years of age, and who had information regarding BMI, past history of diabetes, and fasting blood glucose levels (n=16 048), were selected from the Korea Multi-center Cancer Cohort study participants. By 2008, a total of 1290 participants had died; 251 and 155 had died of CVD and stroke, respectively. The hazard for deaths was calculated with hazard ratio (HR) and 95% confidence interval (95% CI) by Cox proportional hazard model.

Results

Compared with the normal population, patients with diabetes were at higher risk for CVD and stroke deaths (HR, 1.84; 95% CI, 1.33 to 2.56; HR, 1.82; 95% CI, 1.20 to 2.76; respectively). Relative to subjects with no diabetes and normal BMI (21 to 22.9 kg/m²), lean subjects with diabetes (BMI <21 kg/m²) had a greater risk for CVD and stroke deaths (HR, 2.83; 95% CI, 1.57 to 5.09; HR, 3.27; 95% CI, 1.58 to 6.76; respectively), while obese subjects with diabetes (BMI ≥25 kg/m²) had no increased death risk (p-interaction <0.05). This pattern was consistent in sub-populations with no incidence of hypertension.

Conclusions

This study suggests that diabetes in lean people is more critical to CVD deaths than it is in obese people.

Summary

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Smoking Is Associated With Abdominal Obesity, Not Overall Obesity, in Men With Type 2 Diabetes: Ji Eun Yun, Heejin Kimm, Young Ju Choi, Sun Ha Jee, Kap Bum Huh; J Prev Med Public Health. 2012;45(5):316-322. Published online September 28, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.5.316

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Abstract PDF

Objectives

Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes.

Methods

Subjects consisted of 2197 type 2 diabetic patients who visited Huh's Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI).

Results

Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively.

Conclusions

Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.

Summary

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Arterial Stiffness is Associated With Diabetic Retinopathy in Korean Type 2 Diabetic Patients: Yong-Woon Yun, Min-Ho Shin, Young-Hoon Lee, Jung-Ae Rhee, Jin-Su Choi; J Prev Med Public Health. 2011;44(6):260-266. Published online November 14, 2011; DOI: https://doi.org/10.3961/jpmph.2011.44.6.260

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Abstract PDF

Objectives

We evaluated the association between common carotid artery intima-media thickness (CCA-IMT), brachial-ankle pulse wave velocity (baPWV), carotid plaque, and peripheral arterial disease (PAD) as indicators of macroangiopathy and diabetic retinopathy as an indicator of microangiopathy in type 2 diabetic patients.

Methods

We analyzed 605 type 2 diabetic patients registered at a public health center in Korea. Following overnight fasting, venous blood and urine samples were collected and analyzed. The CCA-IMT, levels of carotid plaque, baPWV, and ankle-brachial index (ABI) of the subjects were assessed. We used non-mydriatic fundus photography to diagnose diabetic retinopathy. Multiple logistic regression analyses were used to evaluate the association between macroangiopathy and diabetic retinopathy. CCA-IMT and baPWV were divided into tertiles: CCA-IMT, 0.39 to 0.65 mm, 0.66 to 0.78 mm, and 0.79 to 1.30 mm; baPWV, 9.9 to 15.8 m/s, 15.9 to 18.9 m/s, and 19.0 to 38.0 m/s.

Results

The association between baPWV and diabetic retinopathy remained significant after adjustment, with an increasing odds ratio (OR) in the second tertile (OR, 2.41; 95% confidence interval [CI], 1.27 to 4.55) and the third tertile (OR, 4.63; 95% CI, 2.33 to 9.21). No significant differences were observed in carotid plaque, PAD, and each tertile of CCA-IMT.

Conclusions

BaPWV was associated with diabetic retinopathy, while CCA-IMT, carotid plaque, and PAD were not. This study suggests that the association between macroangiopathy and microangiopathy may be attributable to functional processes rather than structural processes within the vascular system.

Summary

Citations

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