Publications
399 results found
NCD Risk Factor Collaboration NCD-RisC, 2020, Repositioning of the global epicentre of non-optimal cholesterol, Nature, Vol: 582, Pages: 73-77, ISSN: 0028-0836
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and per
Magliano DJ, Sacre JW, Harding JL, et al., 2020, Young-onset type 2 diabetes mellitus - implications for morbidity and mortality, NATURE REVIEWS ENDOCRINOLOGY, Vol: 16, Pages: 321-331, ISSN: 1759-5029
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- Citations: 153
Gregg EW, Duru OK, Shi L, et al., 2020, Filling the Public Health Science Gaps for Diabetes With Natural Experiments, MEDICAL CARE, Vol: 58, Pages: S1-S3, ISSN: 0025-7079
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- Citations: 1
Bracco PA, Gregg EW, Rolka DB, et al., 2020, A nationwide analysis of the excess death attributable to diabetes in Brazil, JOURNAL OF GLOBAL HEALTH, Vol: 10, ISSN: 2047-2978
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- Citations: 7
Chao AM, Wadden TA, Berkowitz RI, et al., 2020, Weight Change 2 Years After Termination of the Intensive Lifestyle Intervention in the Look AHEAD Study, OBESITY, Vol: 28, Pages: 893-901, ISSN: 1930-7381
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- Citations: 19
Benoit SR, Hora I, Pasquel FJ, et al., 2020, Trends in Emergency Department Visits and Inpatient Admissions for Hyperglycemic Crises in Adults With Diabetes in the US, 2006-2015, DIABETES CARE, Vol: 43, Pages: 1057-1064, ISSN: 0149-5992
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- Citations: 40
Saeedi P, Salpea P, Karuranga S, et al., 2020, Mortality attributable to diabetes in 20-79 years old adults, 2019 estimates: Results from the International Diabetes Federation Diabetes Atlas, 9th edition, DIABETES RESEARCH AND CLINICAL PRACTICE, Vol: 162, ISSN: 0168-8227
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- Citations: 283
Muhlenbruch K, Zhuo X, Bardenheier B, et al., 2020, Selecting the optimal risk threshold of diabetes risk scores to identify high-risk individuals for diabetes prevention: a cost-effectiveness analysis, ACTA DIABETOLOGICA, Vol: 57, Pages: 447-454, ISSN: 0940-5429
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- Citations: 7
Lewis CE, Bantle JP, Bertoni AG, et al., 2020, History of Cardiovascular Disease, Intensive Lifestyle Intervention, and Cardiovascular Outcomes in the Look AHEAD Trial, OBESITY, Vol: 28, Pages: 247-258, ISSN: 1930-7381
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- Citations: 5
Andes LJ, Cheng Y, Rolka DB, et al., 2020, Prevalence of Prediabetes Among Adolescents and Young Adults in the United States, 2005-2016, JAMA PEDIATRICS, Vol: 174, ISSN: 2168-6203
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- Citations: 162
Thornton PL, Kumanyika SK, Gregg EW, et al., 2020, New research directions on disparities in obesity and type 2 diabetes, ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, Vol: 1461, Pages: 5-24, ISSN: 0077-8923
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- Citations: 36
Carrillo Larco R, Pearson-Stuttard J, Bernabe-Ortiz A, et al., 2020, The Andean Latin-American burden of diabetes attributable to high body mass index: a comparative risk assessment, Diabetes Research and Clinical Practice, Vol: 160, Pages: 1-10, ISSN: 0168-8227
Background:Body mass index (BMI)has increased in Latin-America, but the implications for the diabetesburden havenot been quantified. We estimated the proportion and absolute number of diabetescasesattributable to high BMI in Bolivia, Ecuador and Peru(Andean Latin-America), with estimation of region-level indicators in Peru.Methods: Weestimated the population attributable fraction (PAF) of BMI ondiabetes(regardless of type 1 or 2)from 1980 to 2014, including the number of cases attributable to overweight (BMI 25-<30), class I (30-<35),class II (BMI 35-<40) and class III(BMI ≥40)obesity.We used age-and sex-specific prevalence estimates of diabetes and BMI categories(NCD-RisC and Peru’s DHS survey)combined with relative risks from population-based cohortsin Peru. Findings: Across Andean Latin-Americain 2014, there were 1,258,313diabetes cases attributable to high BMI: 209,855 in Bolivia, 367,440in Ecuadorand681,018in Peru. Between 1980-2010, the absolute proportion of diabetes cases attributable toclass I obesity increased the most (from 12.9% to 27.2%) across the region. The second greatest increase was for class II obesity (from 3.6% to 16.5%). There was heterogeneity in the fraction of diabetes cases attributable to high BMI by region in Peru, ascoastal regions hadthelargestfractions,andso did high-income regions. Interpretation: Over one milliondiabetes cases are attributable to high BMI in Andean Latin-America. Public health efforts should focus on implementing population-based interventions to reduce high BMI and to developfocused interventions targeted at those at highest risk of diabetes.
Ogilvie D, Adams J, Bauman A, et al., 2020, Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head, JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, Vol: 74, Pages: 203-208, ISSN: 0143-005X
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- Citations: 90
Bullock A, Sheff K, Hora I, et al., 2020, Prevalence of diagnosed diabetes in American Indian and Alaska Native adults, 2006-2017, BMJ OPEN DIABETES RESEARCH & CARE, Vol: 8
Claypool KT, Chung M-K, Deonarine A, et al., 2020, Characteristics of undiagnosed diabetes in men and women under the age of 50 years in the Indian subcontinent: the National Family Health Survey (NFHS-4)/Demographic Health Survey 2015-2016, BMJ OPEN DIABETES RESEARCH & CARE, Vol: 8
Harding JL, Andes LJ, Gregg EW, et al., 2020, Trends in cancer mortality among people with vs without diabetes in the USA, 1988-2015, DIABETOLOGIA, Vol: 63, Pages: 75-84, ISSN: 0012-186X
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- Citations: 36
Cheng YJ, Kanaya AM, Araneta MRG, et al., 2019, Prevalence of diabetes by race and ethnicity in the United States, 2011-2016, JAMA: Journal of the American Medical Association, Vol: 322, Pages: 2389-2398, ISSN: 0098-7484
Importance The prevalence of diabetes among Hispanic and Asian American subpopulations in the United States is unknown.Objective To estimate racial/ethnic differences in the prevalence of diabetes among US adults 20 years or older by major race/ethnicity groups and selected Hispanic and non-Hispanic Asian subpopulations.Design, Setting, and Participants National Health and Nutrition Examination Surveys, 2011-2016, cross-sectional samples representing the noninstitutionalized, civilian, US population. The sample included adults 20 years or older who had self-reported diagnosed diabetes during the interview or measurements of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2-hour plasma glucose (2hPG).Exposures Race/ethnicity groups: non-Hispanic white, non-Hispanic black, Hispanic and Hispanic subgroups (Mexican, Puerto Rican, Cuban/Dominican, Central American, and South American), non-Hispanic Asian and non-Hispanic Asian subgroups (East, South, and Southeast Asian), and non-Hispanic other.Main Outcomes and Measures Diagnosed diabetes was based on self-reported prior diagnosis. Undiagnosed diabetes was defined as HbA1c 6.5% or greater, FPG 126 mg/dL or greater, or 2hPG 200 mg/dL or greater in participants without diagnosed diabetes. Total diabetes was defined as diagnosed or undiagnosed diabetes.Results The study sample included 7575 US adults (mean age, 47.5 years; 52% women; 2866 [65%] non-Hispanic white, 1636 [11%] non-Hispanic black, 1952 [15%] Hispanic, 909 [6%] non-Hispanic Asian, and 212 [3%] non-Hispanic other). A total of 2266 individuals had diagnosed diabetes; 377 had undiagnosed diabetes. Weighted age- and sex-adjusted prevalence of total diabetes was 12.1% (95% CI, 11.0%-13.4%) for non-Hispanic white, 20.4% (95% CI, 18.8%-22.1%) for non-Hispanic black, 22.1% (95% CI, 19.6%-24.7%) for Hispanic, and 19.1% (95% CI, 16.0%-22.1%) for non-Hispanic Asian adults (overall P < .001). Among Hispanic adults, the prevalence of total
Pearson-Stuttard J, Ezzati M, Gregg E, 2019, Multimorbidity—a defining challenge for health systems, Lancet Public Health, Vol: 4, Pages: e599-e600, ISSN: 2468-2667
Bancks MP, Casanova R, Gregg EW, et al., 2019, Epidemiology of diabetes phenotypes and prevalent cardiovascular risk factors and diabetes complications in the National Health and Nutrition Examination Survey 2003-2014, DIABETES RESEARCH AND CLINICAL PRACTICE, Vol: 158, ISSN: 0168-8227
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- Citations: 22
Brinks R, Kaufmann S, Hoyer A, et al., 2019, Analysing detection of chronic diseases with prolonged sub-clinical periods: modelling and application to hypertension in the US, BMC MEDICAL RESEARCH METHODOLOGY, Vol: 19
Shao H, Lin J, Zhuo X, et al., 2019, Influence of diabetes complications on HbA(1c) treatment goals among older US adults: A cost-effectiveness analysis, Diabetes Care, Vol: 42, Pages: 2136-2142, ISSN: 0149-5992
OBJECTIVE Guidelines on the standard care of diabetes recommend that glycemic treatment goals for older adults consider the patient’s complications and life expectancy. In this study, we examined the influence of diabetes complications and associated life expectancies on the cost-effectiveness (CE) of HbA1c treatment goals.RESEARCH DESIGN AND METHODS We used data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) to generate nationally representative subgroups of older individuals with diabetes with various health states. We used the Centers for Disease Control and Prevention–RTI International diabetes CE model to estimate the long-term consequences of two treatment goals—a stringent control goal (HbA1c <7.5%) and a moderate control goal (HbA1c <8.5%)—on health and cost. Our simulation population represented typical patients, and all individuals in each health subgroup had average characteristics, which did not account for person-level variations. The CE study was conducted from a health system perspective and followed the study samples over a lifetime. We used $50,000 per quality-adjusted life year (QALY) as the incremental CE threshold.RESULTS A stringent goal was, on average, cost-effective for individuals with no complications ($10,007 per QALY) or only microvascular complications (excluding renal failure; $19,621 per QALY), but it was not cost-effective for individuals with one or more macrovascular complications (all >$82,413 per QALY). Further, a stringent goal was not cost-effective when an individual had less than 7 years of life remaining.CONCLUSIONS Our findings support the guideline recommendation that glycemic goals for older adults should consider the complexity of their complications and their life expectancy from a CE perspective.
Riddle MC, Cefalu WT, Gregg EW, 2019, Response to Comment on Riddle et al. Diabetes Care Editors' Expert Forum 2018: Managing Big Data for Diabetes Research and Care. Diabetes Care 2019;42:1136-1146, DIABETES CARE, Vol: 42, Pages: E184-E184, ISSN: 0149-5992
Andes LJ, Li Y, Srinivasan M, et al., 2019, Diabetes Prevalence and Incidence Among Medicare Beneficiaries - United States, 2001-2015, MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, Vol: 68, Pages: 961-966, ISSN: 0149-2195
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- Citations: 25
Saeedi P, Petersohn I, Salpea P, et al., 2019, Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition, DIABETES RESEARCH AND CLINICAL PRACTICE, Vol: 157, ISSN: 0168-8227
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- Citations: 3539
Gregg EW, Hora I, Benoit S, 2019, Reasons for increases in complications of diabetes-reply., JAMA: Journal of the American Medical Association, Vol: 322, Pages: 1519-1519, ISSN: 0098-7484
Harding JL, Benoit SR, Gregg EW, et al., 2019, Trends in rates of infections requiring hospitalization among adults with versus without diabetes in the U.S., 2000-2015, Diabetes Care, Vol: 43, Pages: 106-116, ISSN: 0149-5992
OBJECTIVE: Vascular complications of diabetes have declined substantially over the past 20 years. However, the impact of modern medical treatments on infectious diseases in people with diabetes remains unknown. RESEARCH DESIGN AND METHODS: We estimated rates of infections requiring hospitalizations in adults (≥18 years) with versus without diabetes, using the 2000-2015 National Inpatient Sample and the National Health Interview Surveys. Annual age-standardized and age-specific hospitalization rates in groups with and without diabetes were stratified by infection type. Trends were assessed using Joinpoint regression with the annual percentage change (Δ%/year) reported. RESULTS: In 2015, hospitalization rates remained almost four times as high in adults with versus without diabetes (rate ratio 3.8 [95% CI 3.8-3.8]) and as much as 15.7 times as high, depending on infection type. Overall, between 2000 and 2015, rates of hospitalizations increased from 63.1 to 68.7 per 1,000 persons in adults with diabetes and from 15.5 to 16.3 in adults without diabetes. However, from 2008, rates declined 7.9% in adults without diabetes (from 17.7 to 16.3 per 1,000 persons; Δ%/year -1.5, P < 0.01), while no significant decline was noted in adults with diabetes. The lack of decline in adults with diabetes in the later period was driven by significant increases in rates of foot infections and cellulitis as well as by lack of decline for pneumonia and postoperative wound infections in young adults with diabetes. CONCLUSIONS: Findings from this study highlight the need for greater infectious risk mitigation in adults with diabetes, especially young adults with diabetes.
Lee CMY, Colagiuri S, Woodward M, et al., 2019, Comparing different definitions of prediabetes with subsequent risk of diabetes: an individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes, BMJ OPEN DIABETES RESEARCH & CARE, Vol: 7
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- Citations: 31
Magliano DJ, Islam RM, Barr ELM, et al., 2019, Trends in incidence of total or type 2 diabetes: systematic review, BMJ: British Medical Journal, Vol: 366, ISSN: 0959-535X
Objective To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes.Design Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines.Data sources Medline, Embase, CINAHL, and reference lists of relevant publications.Eligibility criteria Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year.Results Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively.Conclusions The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different.Systematic review registration Prospero CRD42018092287.
Gruss S, Nhim K, Gregg E, et al., 2019, Public health approaches to type 2 diabetes prevention: the US National Diabetes Prevention Program and beyond, Current Diabetes Reports, Vol: 19, ISSN: 1534-4827
Purpose of review This article highlights foundational evidence, translation studies, and current research behind type 2 diabetes prevention efforts worldwide, with focus on high risk populations, and whole population approaches as catalysts to global prevention.Recent findings Continued focus on the goals of foundational lifestyle change program trials and their global translations, and the targeting of those at highest risk through both in-person and virtual modes of program delivery, is critical. Whole population approaches (e.g. socioeconomic policies, healthy food promotion, environmental/systems changes) and awareness raising are essential complements to efforts aimed at high-risk populations. Summary Successful type 2 diabetes prevention strategies are being realized in the U.S. through the National Diabetes Prevention Program and elsewhere in the world. A multi-tiered approach involving appropriate risk targeting and whole population efforts is essential to curb the global diabetes epidemic.
Zhou B, Danaei G, Stevens GA, et al., 2019, Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys, Lancet, Vol: 394, Pages: 639-651, ISSN: 0140-6736
Background: Antihypertensive medicines are effective in reducing adverse cardiovascular events. Our aim was to compare hypertension awareness, treatment and control, and how they have changed over time, in high-income countries. Methods: We used data on 526,336 participants aged 40-79 years in 123 national health examination surveys from 1976 to 2017 in twelve high-income countries: Australia, Canada, Finland, Germany, Ireland, Italy, Japan, New Zealand, South Korea, Spain, the UK, and the USA. We calculated the percent of participants with hypertension – defined as systolic blood pressure ≥140mmHg or diastolic blood pressure ≥90mmHg or being on pharmacological treatment for hypertension – who were aware of their condition, who were treated, and whose hypertension was controlled (i.e. lower than 140/90 mmHg). Findings: Canada, South Korea, Australia and the UK have the lowest prevalence of hypertension, and Finland the highest. In the 1980s and early 1990s, treatment rates were at most 40% and control rates were below 25% in most countries and age-sex groups. Over time, hypertension awareness and treatment increased and control rate improved in all twelve countries, with South Korea and Germany experiencing the largest improvements. Most of the increase occurred in the 1990s and early-mid 2000s, having plateaued since in most countries.Canada, Germany, South Korea and the USA have the highest rates of awareness, treatment and control, while Finland, Ireland, Japan and Spain the lowest. Even in the best performing countries, treatment coverage was at most 80% and control rates were below 70%. Interpretation: Hypertension awareness, treatment and control have improved substantially in high-income countries since the 1980s and 1990s. However, control rates have plateaued in the past decade, at levels lower than those in high-quality hypertension
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