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Available from: Jenny E. Gunton, Aug 12, 2014
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    ABSTRACT: Cigarette smoking during pregnancy may increase the risk of gestational diabetes mellitus (GDM) or pregestational diabetes mellitus (PDM). Smoking has been associated positively with hyperinsulinemia and insulin resistance in experimental studies, although the association with diabetes remains unclear. To further explore this issue, we examined the association with smoking in the largest prospective cohort study of GDM and PDM to date. The study population comprised 212190 women in the population-based Swedish Birth Registry who had their first and second deliveries between January 1987 and December 1995. Maternal characteristics were recorded in a standardized manner at the first prenatal visit, followed by a clinical examination and a standardized in-person interview to assess lifestyle habits. Women were categorized as nonsmokers, light smokers (one to nine cigarettes per day), or moderate-to-heavy smokers (at least 10 cigarettes per day). Women with GDM in their first pregnancy experienced an eight- to ninefold increased risk of GDM or PDM in their second pregnancy. Cigarette smoking was not associated with increased risk of these conditions. Neither women who smoked during their first and second pregnancies nor those who commenced smoking between pregnancies had a higher risk of GDM or PDM than nonsmokers. Our findings do not support an association between cigarette smoking and risk of GDM or PDM in young women of childbearing age.
    Diabetes Care 11/2003; 26(11):2994-8. DOI:10.2337/diacare.26.11.2994 · 8.57 Impact Factor
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    ABSTRACT: OBJECTIVE: The aim of this study was to explore the associations between inadequate glycemic control of diabetes and psychological, anthropometric and life style variables in a population based cohort of type 1 diabetes patients. DESIGN: Cross-sectional study. METHODS: In this study 292 patients with type 1 diabetes participated, age 18-59 years. Psychological data were assessed by self-report instruments, Hospital Anxiety and Depression Scale and Toronto Alexithymia Scale-20. Anthropometrics, blood analyses, data from medical records and data from the Swedish National Diabetes Registry were collected. RESULTS: Self-reported depression (Adjusted Odds Ratio (AOR) 4.8), obesity (AOR 4.3) and smoking (AOR 3.0) were independently associated with inadequate glycemic control of diabetes (HbA1c >8.6%). Gender stratified analyses showed that self-reported depression (AOR 19.8) and obesity (AOR 7.0) in women; and smoking in men (AOR 4.2) were associated with HbA1c >8.6%. Alexithymia, antidepressant medication and physical inactivity were associated with HbA1c >8.6% only in bivariate analyses. Alexithymia, self-rated anxiety, physical inactivity and absence of abdominal obesity were associated with self-reported depression. CONCLUSIONS: Depression was the only psychological factor independently associated with HbA1c >8.6%. The association was of comparable importance as obesity and smoking, well known risk factors for inadequate glycemic control and diabetes complications. The association between depression and HbA1c >8.6% was particularly strong for women. Alexithymia, which is a relatively stable personality trait, was associated with depression. In the future care of patients with diabetes, psychological aspects should be considered alongside anthropometrics and life style factors in order to achieve the goals for HbA1c.
    European Journal of Endocrinology 03/2013; DOI:10.1530/EJE-13-0137 · 3.69 Impact Factor
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    ABSTRACT: Background and Objectives: Saudi Arabia has one of the highest prevalence of diabetes. This study was conducted with the following objectives: (1) To study the socio-demographic profile of diabetic patients in Abha. (2) To find the socio-demographic determinants of compliance among diabetic patients in Abha. Material and Methods: A self administered questionnaire which had detailed the socio-demographic features and various aspects of compliance was used on a random sample of registered diabetics at two primary health care centres of Abha. Results: Most of the patients (70.4 percent) were between 40-60 years age. Most of the patients were men (about 60 percent) and Saudis. Majority of patients did not have a university education. Young patients (age<40) were more compliant with all aspects of management, except medication (23.8 percent). Women were significantly more compliant with exercise (49.7 percent), while men were significantly more compliant with follow up (81.1 percent). Saudi patients were significantly compliant with medication (79.2 percent), while non Saudis were compliant with exercise (62.9 percent). All single patients were diet compliant. Smokers were significantly less compliant with exercise. Patients with normal BMI were significantly more compliant with diet and exercise. Conclusion: Patients were found to be generally less compliant towards the regimen. Socio-demographic factors which were significantly associated with non compliance were age, gender, nationality, educational status, marital status, smoking status and BMI.
    12/2013; 7(12):2810-3. DOI:10.7860/JCDR/2013/6986.3708