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14-year diabetes incidence: the role of socio-economic status.

https://arctichealth.org/en/permalink/ahliterature139840
Source
Health Rep. 2010 Sep;21(3):19-28
Publication Type
Article
Date
Sep-2010
Author
Nancy A Ross
Heather Gilmour
Kaberi Dasgupta
Author Affiliation
Department of Geography, McGill University, Montreal, Quebec H3A 2K6, Canada. Nancy.Ross@mcgill.ca
Source
Health Rep. 2010 Sep;21(3):19-28
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Algorithms
Canada - epidemiology
Diabetes Mellitus, Type 2 - epidemiology
Family Characteristics
Female
Health Surveys
Humans
Incidence
Income
Interviews as Topic
Longitudinal Studies
Male
Pregnancy
Pregnancy in Diabetics - epidemiology
Proportional Hazards Models
Questionnaires
Socioeconomic Factors
Abstract
Diabetes prevalence is associated with low socioeconomic status (SES), but less is known about the relationship between SES and diabetes incidence.
Data from eight cycles of the National Population Health Survey (1994/1995 through 2008/2009) are used. A sample of 5,547 women and 6,786 men aged 18 or older who did not have diabetes in 1994/1995 was followed to determine if household income and educational attainment were associated with increased risk of diagnosis of or death from diabetes by 2008/2009. Three proportional hazards models were applied for income and for education--for men, for women and for both sexes combined. Independent variables were measured at baseline (1994/1995). Diabetes diagnosis was assessed by self-report of diagnosis by a health professional. Diabetes death was based on ICD-10 codes E10-E14.
Among people aged 18 or older in 1994/1995 who were free of diabetes, 7.2% of men and 6.3% of women had developed or died from the disease by 2008/2009. Lower-income women were more likely to develop type 2 diabetes than were those in high-income households. This association was attenuated, but not eliminated, by ethno-cultural background and obesity/overweight. Associations with lower educational attainment in unadjusted models were almost completely mediated by demographic and behavioural variables.
Social gradients in diabetes incidence cannot be explained entirely by demographic and behavioural variables.
PubMed ID
20973430 View in PubMed
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The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature115112
Source
Can J Cardiol. 2013 May;29(5):528-42
Publication Type
Article
Date
May-2013
Author
Daniel G Hackam
Robert R Quinn
Pietro Ravani
Doreen M Rabi
Kaberi Dasgupta
Stella S Daskalopoulou
Nadia A Khan
Robert J Herman
Simon L Bacon
Lyne Cloutier
Martin Dawes
Simon W Rabkin
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Ross D Feldman
Patrice Lindsay
Michael D Hill
Mark Gelfer
Kevin D Burns
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Luc Trudeau
Robert J Petrella
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Marshall Godwin
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Luc Poirier
Raj S Padwal
Author Affiliation
Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada. dhackam@uwo.ca
Source
Can J Cardiol. 2013 May;29(5):528-42
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Aging - physiology
Antihypertensive Agents - therapeutic use
Blood Pressure - physiology
Blood Pressure Determination
Canada
Cardiovascular Diseases - prevention & control
Exercise - physiology
Health education
Humans
Hypertension - diagnosis - drug therapy
Risk assessment
Abstract
We updated the evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in adults for 2013. This year's update includes 2 new recommendations. First, among nonhypertensive or stage 1 hypertensive individuals, the use of resistance or weight training exercise does not adversely influence blood pressure (BP) (Grade D). Thus, such patients need not avoid this type of exercise for fear of increasing BP. Second, and separately, for very elderly patients with isolated systolic hypertension (age 80 years or older), the target for systolic BP should be
PubMed ID
23541660 View in PubMed
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The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.

https://arctichealth.org/en/permalink/ahliterature104360
Source
Can J Cardiol. 2014 May;30(5):485-501
Publication Type
Article
Date
May-2014
Author
Kaberi Dasgupta
Robert R Quinn
Kelly B Zarnke
Doreen M Rabi
Pietro Ravani
Stella S Daskalopoulou
Simon W Rabkin
Luc Trudeau
Ross D Feldman
Lyne Cloutier
Ally Prebtani
Robert J Herman
Simon L Bacon
Richard E Gilbert
Marcel Ruzicka
Donald W McKay
Tavis S Campbell
Steven Grover
George Honos
Ernesto L Schiffrin
Peter Bolli
Thomas W Wilson
Patrice Lindsay
Michael D Hill
Shelagh B Coutts
Gord Gubitz
Mark Gelfer
Michel Vallée
G V Ramesh Prasad
Marcel Lebel
Donna McLean
J Malcolm O Arnold
Gordon W Moe
Jonathan G Howlett
Jean-Martin Boulanger
Pierre Larochelle
Lawrence A Leiter
Charlotte Jones
Richard I Ogilvie
Vincent Woo
Janusz Kaczorowski
Kevin D Burns
Robert J Petrella
Swapnil Hiremath
Alain Milot
James A Stone
Denis Drouin
Kim L Lavoie
Maxime Lamarre-Cliche
Guy Tremblay
Pavel Hamet
George Fodor
S George Carruthers
George B Pylypchuk
Ellen Burgess
Richard Lewanczuk
George K Dresser
S Brian Penner
Robert A Hegele
Philip A McFarlane
Milan Khara
Andrew Pipe
Paul Oh
Peter Selby
Mukul Sharma
Debra J Reid
Sheldon W Tobe
Raj S Padwal
Luc Poirier
Author Affiliation
Divisions of General Internal Medicine, Clinical Epidemiology and Endocrinology, Department of Medicine, McGill University, McGill University Health Centre, Montreal, Québec, Canada. Electronic address: kaberi.dasgupta@mcgill.ca.
Source
Can J Cardiol. 2014 May;30(5):485-501
Date
May-2014
Language
English
Publication Type
Article
Keywords
Antihypertensive Agents - therapeutic use
Blood pressure
Blood Pressure Determination - standards
Canada
Health Promotion - organization & administration
Humans
Hypertension - diagnosis - drug therapy - prevention & control
Life Style
Patient Education as Topic
Practice Guidelines as Topic
Prognosis
Program Evaluation
Abstract
Herein, updated evidence-based recommendations for the diagnosis, assessment, prevention, and treatment of hypertension in Canadian adults are detailed. For 2014, 3 existing recommendations were modified and 2 new recommendations were added. The following recommendations were modified: (1) the recommended sodium intake threshold was changed from = 1500 mg (3.75 g of salt) to approximately 2000 mg (5 g of salt) per day; (2) a pharmacotherapy treatment initiation systolic blood pressure threshold of = 160 mm Hg was added in very elderly (age = 80 years) patients who do not have diabetes or target organ damage (systolic blood pressure target in this population remains at
PubMed ID
24786438 View in PubMed
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An algorithm to differentiate diabetic respondents in the Canadian Community Health Survey.

https://arctichealth.org/en/permalink/ahliterature157393
Source
Health Rep. 2008 Mar;19(1):71-9
Publication Type
Article
Date
Mar-2008
Author
Edward Ng
Kaberi Dasgupta
Jeffrey A Johnson
Author Affiliation
Health Information and Research Division at Statistics Canada in Ottawa, Ontario K1A 0T6. Edward.Ng@statcan.ca
Source
Health Rep. 2008 Mar;19(1):71-9
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Algorithms
Canada
Decision Trees
Diabetes Mellitus - classification - diagnosis - drug therapy - physiopathology
Female
Health Surveys
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Pregnancy
Abstract
This article describes an algorithm to classify respondents to cycle 1.1 (2000/2001) of the Canadian Community Health Survey (CCHS) according to whether they have type 1, type 2 or gestational diabetes.
The data are from the chronic disease module and the drug module of cycle 1.1 of the CCHS.
A total of 6,361 respondents to cycle 1.1 of the CCHS reported that a health care professional had diagnosed them as having diabetes. The Ng-Dasgupta-Johnson algorithm classifies this group according to whether they have type 1, type 2 or gestational diabetes, based on their answers to CCHS questions about diabetes during pregnancy, use of oral medications to control diabetes, use of insulin, timing of initiation of insulin treatment, and age at diagnosis.
Application of an earlier algorithm to CCHS cycle 1.1 results in a 10%-90% split for type 1 and type 2 diabetes. By contrast, the Ng-Dasgupta-Johnson algorithm yields a 5%-95% split. This is not unreasonable, given the rapid rise in obesity, a major risk factor for type 2 diabetes, in Canada.
PubMed ID
18457213 View in PubMed
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Association between frequent use of nonsteroidal anti-inflammatory drugs and breast cancer.

https://arctichealth.org/en/permalink/ahliterature171565
Source
BMC Cancer. 2005;5:159
Publication Type
Article
Date
2005
Author
Elham Rahme
Joumana Ghosn
Kaberi Dasgupta
Raghu Rajan
Marie Hudson
Author Affiliation
Division of Clinical Epidemiology, McGill University Health Centre Research Institute, Montreal, Canada. elham.rahme@mcgill.ca
Source
BMC Cancer. 2005;5:159
Date
2005
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Anticarcinogenic Agents - therapeutic use
Aspirin - therapeutic use
Breast Neoplasms - epidemiology - etiology - prevention & control
Case-Control Studies
Cyclooxygenase 2 - biosynthesis
Databases, Factual
Female
Humans
Insurance, Health
Mammography
Models, Statistical
Odds Ratio
Postmenopause
Quebec
Regression Analysis
Risk
Risk factors
Time Factors
Abstract
Eighty percent of all breast cancers and almost 90% of breast cancer deaths occur among post-menopausal women. We used a nested case control design to examine the association between nonsteroidal anti-inflammatory drug (NSAID) use and breast cancer occurrence among women over 65 years of age. The cyclooxygenase (COX)-2 enzyme is expressed more in breast cancers than in normal breast tissue. COX-2 inhibition may have a role in breast cancer prevention.
In the Canadian province of Quebec, physician services are covered through a governmental insurance plan. Medication costs are covered for those > or = 65 years of age and a publicly funded screening program for breast cancer targets all women 50 years of age or older. We obtained encrypted data from these insurance databases on all women > or = 65 years of age who filled a prescription for COX-2 inhibitors, non-selective NSAIDs (ns-NSAIDs), aspirin, or acetaminophen between January 1998 and December 2002. Cases were defined as those women who have undergone mammography between April 2001 and June 2002 and had a diagnosis of breast cancer within six months following mammography. Controls included those who have undergone mammography between April 2001 and June 2002 without a diagnosis of any cancer during the six months following mammography. The exposure of interest, frequent NSAID use, was defined as use of ns-NSAIDs and/or COX-2 inhibitors for > or = 90 days during the year prior to mammography. Frequent use served as a convenient proxy for long term chronic use.
We identified 1,090 cases and 44,990 controls. Cases were older and more likely to have breast cancer risk factors. Logistic regression models adjusting for potential confounders showed that frequent use of ns-NSAIDs and/or COX-2 inhibitors was associated with a lower risk of breast cancer (OR: 0.75, 95% confidence interval 0.64-0.89). Results were similar for COX-2 inhibitors (0.81, 0.68-0.97) and ns-NSAIDs (0.65, 0.43-0.99), when assessed separately. Frequent use of aspirin at doses > 100 mg/day in the year prior to mammography was also associated with a lower risk of breast cancer (0.75, 0.64-0.89). However, use of aspirin at doses 100 mg frequently may have a lower risk of breast cancer.
Notes
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PubMed ID
16343343 View in PubMed
Less detail

Association between nonsteroidal anti-inflammatory drugs and prostate cancer occurrence.

https://arctichealth.org/en/permalink/ahliterature169647
Source
Cancer J. 2006 Mar-Apr;12(2):130-5
Publication Type
Article
Author
Kaberi Dasgupta
David Di Cesar
Joumana Ghosn
Raghu Rajan
Salaheddin Mahmud
Elham Rahme
Author Affiliation
Research Institute, Department of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, Canada.
Source
Cancer J. 2006 Mar-Apr;12(2):130-5
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Aspirin - therapeutic use
Case-Control Studies
Databases as Topic
Humans
Likelihood Functions
Logistic Models
Male
Prostatic Neoplasms - epidemiology
Quebec - epidemiology
Abstract
Prostate cancer is the most common malignancy among men in Western nations. Previous studies indicate that nonsteroidal anti-inflammatory drugs have an inhibitory effect on prostate cancer cells. We evaluated the association between frequent use of nonsteroidal anti-inflammatory drugs and prostate cancer occurrence.
We conducted a nested case-control study using medical administrative databases. All men older than 65 years of age who had filled at least one prescription for nonselective nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors (coxibs), aspirin, or acetaminophen between January 1999 and December 2002 were eligible. Among this group, we identified men who underwent prostate biopsy between January 2000 and June 2002 and did not have a diagnosis of any cancer in the preceding 2-year period. Cases were those with a diagnosis of prostate cancer. Controls were those who did not receive a diagnosis of any cancer. Logistic regression models were used to determine associations between prostate cancer occurrence and frequent exposure (more than 4 months) to nonsteroidal anti-inflammatory drugs/cyclooxygenase-2 inhibitors or aspirin during the prior 2 years in comparison with no exposure to any of these drugs, adjusting for age and prior finasteride use.
We identified 2025 cases and 2150 controls. Older men were at greater risk for developing prostate cancer. Exposure to nonsteroidal anti-inflammatory drugs/cyclooxygenase-2 inhibitors was associated with a reduced likelihood of prostate cancer (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.58-0.86) as was exposure to aspirin (OR, 0.84; 95% CI, 0.74-0.96).
Our results suggest that among men 65 years of age or older, frequent use of nonsteroidal anti-inflammatory drugs/cyclooxygenase-2 inhibitors and use of aspirin are associated with a reduced risk of prostate cancer.
Notes
Comment In: Cancer J. 2006 Mar-Apr;12(2):108-916630400
PubMed ID
16630404 View in PubMed
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A comprehensive view of sex-specific issues related to cardiovascular disease.

https://arctichealth.org/en/permalink/ahliterature164712
Source
CMAJ. 2007 Mar 13;176(6):S1-44
Publication Type
Article
Date
Mar-13-2007
Author
Louise Pilote
Kaberi Dasgupta
Veena Guru
Karin H Humphries
Jennifer McGrath
Colleen Norris
Doreen Rabi
Johanne Tremblay
Arsham Alamian
Tracie Barnett
Jafna Cox
William Amin Ghali
Sherry Grace
Pavel Hamet
Teresa Ho
Susan Kirkland
Marie Lambert
Danielle Libersan
Jennifer O'Loughlin
Gilles Paradis
Milan Petrovich
Vicky Tagalakis
Author Affiliation
Division of Internal Medicine, The McGill University Health Centre Research Institute, McGill University, Montréal, Que. louise.pilote@mcgill.ca
Source
CMAJ. 2007 Mar 13;176(6):S1-44
Date
Mar-13-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Atrial Fibrillation - diagnosis - epidemiology
Canada - epidemiology
Cardiovascular Diseases - diagnosis - epidemiology
Cause of Death
Child
Coronary Disease - diagnosis - epidemiology
Female
Heart Failure - diagnosis - epidemiology
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Prevalence
Quality of Life
Risk assessment
Severity of Illness Index
Sex Distribution
Sex Factors
Survival Analysis
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex-and gender-related factors and CVD outcomes in women remains largely unknown.
Notes
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Erratum In: CMAJ. 2007 Apr 24;176(9):1310
PubMed ID
17353516 View in PubMed
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Daily steps are low year-round and dip lower in fall/winter: findings from a longitudinal diabetes cohort.

https://arctichealth.org/en/permalink/ahliterature138968
Source
Cardiovasc Diabetol. 2010;9:81
Publication Type
Article
Date
2010
Author
Kaberi Dasgupta
Lawrence Joseph
Louise Pilote
Ian Strachan
Ron J Sigal
Cathy Chan
Author Affiliation
Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, Montreal, Canada. kaberi.dasgupta@mcgill.ca
Source
Cardiovasc Diabetol. 2010;9:81
Date
2010
Language
English
Publication Type
Article
Keywords
Actigraphy - instrumentation
Aged
Blood pressure
Body mass index
Diabetes Mellitus, Type 2 - blood - complications - physiopathology
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypertension - etiology - physiopathology - prevention & control
Longitudinal Studies
Male
Middle Aged
Quebec
Seasons
Waist-Hip Ratio
Walking
Abstract
Higher walking levels lead to lower mortality in type 2 diabetes, but inclement weather may reduce walking. In this patient population, we conducted a longitudinal cohort study to objectively quantify seasonal variations both in walking and in two vascular risk factors associated with activity levels, hemoglobin A1C and blood pressure.
Between June 2006 and July 2009, volunteer type 2 diabetes patients in Montreal, Quebec, Canada underwent two weeks of pedometer measurement up to four times over a one year follow-up period (i.e. once/season). Pedometer viewing windows were concealed (snap-on cover and tamper proof seal). A1C, blood pressure, and anthropometric parameters were also assessed. Given similarities in measures for spring/summer and fall/winter, and because not all participants completed four assessments, spring and summer values were collapsed as were fall and winter values. Mean within-individual differences (95% confidence intervals) were computed for daily steps, A1C, and systolic and diastolic blood pressure, by subtracting spring/summer values from fall/winter values.
Among 201 participants, 166 (82.6%) underwent at least one fall/winter and one spring/summer evaluation. Approximately half were women, the mean age was 62.4 years (SD 10.8), and the mean BMI was 30.1 kg/m2 (SD 5.7). Step counts averaged at a sedentary level in fall/winter (mean 4,901 steps/day, SD 2,464) and at a low active level in spring/summer (mean 5,659 steps/day, SD 2,611). There was a -758 (95% CI: -1,037 to -479) mean fall/winter to spring/summer within-individual difference. There were no significant differences in A1C or in anthropometric parameters. Systolic blood pressure was higher in fall/winter (mean 137 mm Hg, SD 16) than spring/summer (133 mm Hg, SD 14) with a mean difference of 4.0 mm Hg (95% CI: 2.3 to 5.7).
Daily step counts in type 2 diabetes patients are low, dipping lower during fall/winter. In this medication-treated cohort, A1C was stable year-round but a fall/winter systolic blood pressure increase was detected. Our findings signal a need to develop strategies to help patients increase step counts year-round and prevent both reductions in step counts and increases in blood pressure during the fall and winter.
Notes
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PubMed ID
21118567 View in PubMed
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Differences in food intake among obese and nonobese women and men with type 2 diabetes.

https://arctichealth.org/en/permalink/ahliterature131280
Source
J Am Coll Nutr. 2011 Aug;30(4):225-32
Publication Type
Article
Date
Aug-2011
Author
Soghra Jarvandi
Réjeanne Gougeon
Abeer Bader
Kaberi Dasgupta
Author Affiliation
Department of Medicine, McGill University, Montreal, Quebec, CANADA.
Source
J Am Coll Nutr. 2011 Aug;30(4):225-32
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged
Body mass index
Canada - epidemiology
Diabetes Mellitus, Type 2 - complications - epidemiology
Diet
Dietary Fats - administration & dosage
Dietary Fiber - administration & dosage
Dietary Supplements
Energy intake
Female
Food Habits
Fruit
Guideline Adherence
Guidelines as Topic
Humans
Longitudinal Studies
Male
Middle Aged
Obesity - complications - epidemiology
Sodium, Dietary
Vegetables
Vitamins - administration & dosage
Weight Loss
Abstract
Weight reduction is a key goal for the prevention of vascular complications in obese individuals with type 2 diabetes, but a nutritionally balanced intake is also important in this regard. We compared dietary intakes and vitamin supplement use between obese and nonobese women and men with type 2 diabetes to identify gaps in adherence to nutritional management guidelines.
We analyzed data from a longitudinal study of adults with type 2 diabetes, wherein participants were assessed once per season over 1 year. Dietary data were collected using a validated semiquantitative, self-administered food-frequency questionnaire. Given the absence of seasonal variations in anthropometric variables and dietary intake, data from multiple visits were averaged for each individual. Associations of both intake of fruit and vegetables and nutrients related to cardiovascular disease risk were compared between obese (body mass index = 30 kg/m²) and nonobese individuals through multivariable linear regression with adjustments for age, education, and energy intake.
Among the 200 participants (93 women and 107 men), 53% of women and 43% of men were obese. Compared with nonobese women, obese women consumed more saturated fat (mean difference, 1.2% of total energy intake; 95% confidence interval [CI], 3% to 2.2%) and sodium (mean difference, 0.3 g; 95% CI, 0.04 to 0.5 g), and they had a lower intake of fiber (mean difference, -2.7 g; 95% CI, -4.4 to -0.9 g) and magnesium (mean difference, -33.6 mg; 95% CI, -55.2 to -12.0 g). No differences in dietary intake were observed between obese and nonobese men, but the intakes of men overall were similar to those of obese women. Compared with nonobese participants, fewer obese individuals used vitamin/mineral supplements (women: 37% vs 48%, men: 26% vs 38%).
Obese women and both obese and nonobese men appeared to have poorer dietary quality compared with nonobese women. Our findings support the need to emphasize dietary composition in addition to weight control in diabetes.
PubMed ID
21917702 View in PubMed
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Estimating the population prevalence of diagnosed and undiagnosed diabetes.

https://arctichealth.org/en/permalink/ahliterature114051
Source
Diabetes Care. 2013 Oct;36(10):3002-8
Publication Type
Article
Date
Oct-2013
Author
Aaron Leong
Kaberi Dasgupta
Jean-Louis Chiasson
Elham Rahme
Author Affiliation
Corresponding author: Elham Rahme, elham.rahme@mcgill.ca.
Source
Diabetes Care. 2013 Oct;36(10):3002-8
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Diabetes Complications - diagnosis - epidemiology
Diabetes Mellitus - diagnosis - epidemiology
Female
Humans
Male
Middle Aged
Prevalence
Quebec - epidemiology
Abstract
Health administrative data are frequently used for diabetes surveillance, but validation studies are limited, and undiagnosed diabetes has not been considered in previous studies. We compared the test properties of an administrative definition with self-reported diabetes and estimated prevalence of undiagnosed diabetes by measuring glucose levels in mailed-in capillary blood samples.
A stratified random sample of 6,247 individuals (Quebec province) was surveyed by telephone and asked to mail in fasting blood samples on filter paper to a central laboratory. An administrative definition was applied (two physician claims or one hospitalization for diabetes within a 2-year period) and compared with self-reported diabetes alone and with self-reported diabetes or elevated blood glucose level (=7 mmol/L). Population-level prevalence was estimated with the use of the administrative definition corrected for its sensitivity and specificity.
Compared with self-reported diabetes, sensitivity and specificity were 84.3% (95% CI 79.3-88.5%) and 97.9% (97.4-98.4%), respectively. Compared with diabetes by self-report and/or glucose testing, sensitivity was lower at 58.2% (52.2-64.6%), whereas specificity was similar at 98.7% (98.0-99.3%). Adjusted for sampling weights, population-level prevalence of physician-diagnosed diabetes was 7.2% (6.3-8.0%). Prevalence of total diabetes (physician-diagnosed and undiagnosed) was 13.4% (11.7-15.0%), indicating that ~40% of diabetes cases are undiagnosed.
A substantial proportion of diabetes cases are missed by surveillance methods that use health administrative databases. This finding is concerning because individuals with undiagnosed diabetes are likely to have a delay in treatment and, thus, a higher risk for diabetes-related complications.
PubMed ID
23656982 View in PubMed
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