To determine the prevalence and correlates of elevated blood pressure (BP) in youth with type 1 or type 2 diabetes mellitus by using data from the SEARCH Study.
The analysis included youth aged 3 to 17 years with type 1 (n = 3691) and type 2 diabetes mellitus (n = 410) who attended a research visit. Elevated BP was defined as systolic or diastolic values >or=95 percentile, regardless of drug use. In youth with elevated BP, awareness was defined as self-report of an earlier diagnosis. Control was defined as BP values <90th percentile and <120/90 mm Hg in youth with an earlier diagnosis who were taking BP medications.
The prevalence of elevated BP in youth with type 1 diabetes mellitus was 5.9%; minority ethnic groups, obese adolescents, and youth with poor glycemic control were disproportionately affected. In contrast, 23.7% of adolescents with type 2 diabetes mellitus had elevated BP (P < .0001), Similarly, 31.9% of youth with type 2 diabetes mellitus and elevated BP were aware, compared with only 7.4% of youth with type 1 diabetes mellitus (P < .0001). Once BP was diagnosed and treated, control was similar in type 1 (57.1%) and type 2 diabetes mellitus (40.6%).
Our findings identify high-risk groups of youth with diabetes mellitus at which screening and treatment efforts should be directed.
"All of the patients lived in large cities and were cared for by a specialist in a public health center; thus, patients who relied on primary care facilities and lived in rural areas may not have been considered. However, this group of patients with T1D is the minority of those who receive treatment in Brazil, i.e., fewer than 1%, according to the survey conducted in 1988 . Another limitation was the absence of psychosocial evaluation. "
[Show abstract][Hide abstract] ABSTRACT: Background:
To evaluate the determinants of intensive insulin regimens (ITs) in patients with type 1 diabetes (T1D).
This multicenter study was conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. Data were obtained from 3,591 patients (56.0% female, 57.1% Caucasian). Insulin regimens were classified as follows: group 1, conventional therapy (CT) (intermediate human insulin, one to two injections daily); group 2 (three or more insulin injections of intermediate plus regular human insulin); group 3 (three or more insulin injections of intermediate human insulin plus short-acting insulin analogues); group 4, basal-bolus (one or two insulin injections of long-acting plus short-acting insulin analogues or regular insulin); and group 5, basal-bolus with continuous subcutaneous insulin infusion (CSII). Groups 2 to 5 were considered IT groups.
We obtained complete data from 2,961 patients. Combined intermediate plus regular human insulin was the most used therapeutic regimen. CSII was used by 37 (1.2%) patients and IT by 2,669 (90.2%) patients. More patients on IT performed self-monitoring of blood glucose and were treated at the tertiary care level compared to CT patients (p < 0.001). The majority of patients from all groups had HbA1c levels above the target. Overweight or obesity was not associated with insulin regimen. Logistic regression analysis showed that economic status, age, ethnicity, and level of care were associated with IT (p < 0.001).
Given the prevalence of intensive treatment for T1D in Brazil, more effective therapeutic strategies are needed for long term-health benefits.
[Show abstract][Hide abstract] ABSTRACT: Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions). In 2009 alone, the various Statistical Updates were cited 1600 times (data from ISI Web of Science). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas. For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk. Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.