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15 pages, 354 KiB

Open AccessArticle

Sex Differences in Hospital-Acquired Pneumonia among Patients with Type 2 Diabetes Mellitus Patients: Retrospective Cohort Study using Hospital Discharge Data in Spain (2016–2019)

by Ana Lopez-de-Andres, Marta Lopez-Herranz, Valentin Hernandez-Barrera, Javier de-Miguel-Diez, Jose M. de-Miguel-Yanes, David Carabantes-Alarcon, Romana Albaladejo-Vicente, Rosa Villanueva-Orbaiz and Rodrigo Jimenez-Garcia

Int. J. Environ. Res. Public Health 2021, 18(23), 12645; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312645 - 30 Nov 2021

Cited by 3 | Viewed by 1671

Abstract

(1) Background: To analyze the incidence, clinical characteristics, use of procedures, and in-hospital outcomes in patients who developed pneumonia during their hospital admission according to sex and to the presence of type 2 diabetes mellitus (T2DM). (2) Methods: Retrospective cohort study using data [...] Read more.

(1) Background: To analyze the incidence, clinical characteristics, use of procedures, and in-hospital outcomes in patients who developed pneumonia during their hospital admission according to sex and to the presence of type 2 diabetes mellitus (T2DM). (2) Methods: Retrospective cohort study using data from the Spanish National Hospital Discharge Database. Hospital-acquired pneumonia (HAP) was classed as non-ventilator HAP and ventilator-associated pneumonia (VAP). Separate analyses were performed for men and women with and without T2DM. Population subgroups were compared using propensity score matching. (3) Results: HAP was identified in 38,814 patients (24.07% with T2DM). The adjusted incidence of HAP was higher in patients with T2DM (both sexes) (IRR 1.28; 95% CI 1.25–1.31). The incidence of HAP was higher in men with T2DM than in women with T2DM (adjusted-IR 1.47; 95% CI 1.41–1.53). The incidence of HAP among T2DM patients increased over time. In-hospital mortality (IHM) was around 28% irrespective of T2DM status and sex. After adjusting for confounders and sex, VAP was associated to higher IHM among patients with T2DM (OR 2.09; 95% CI 1.7–2.57). (4) Conclusions: T2DM is associated with a higher risk of HAP, whose incidence increased over time. Men with T2DM have an almost 50% higher risk of HAP than women with T2DM. The probability of dying in the hospital was not associated with sex or T2DM. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

15 pages, 842 KiB

Open AccessArticle

Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

by Marta Lopez-Herranz, Rodrigo Jiménez-García, Zichen Ji, Javier de Miguel-Diez, David Carabantes-Alarcon, Clara Maestre-Miquel, José J. Zamorano-León and Ana López-de-Andrés

Int. J. Environ. Res. Public Health 2021, 18(11), 6088; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18116088 - 04 Jun 2021

Cited by 4 | Viewed by 1959

Abstract

Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National [...] Read more.

Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. Results: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. Conclusions: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

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14 pages, 383 KiB

Open AccessArticle

by Ana López-de-Andrés, Rodrigo Jimenez-Garcia, Valentin Hernández-Barrera, Isabel Jiménez-Trujillo, José J. Zamorano-León, David Carabantes-Alarcon, Marta Lopez-Herranz, José M. de Miguel-Yanes and Javier de Miguel-Diez

Int. J. Environ. Res. Public Health 2021, 18(7), 3659; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073659 - 01 Apr 2021

Cited by 5 | Viewed by 2036

Abstract

Background: To analyze the incidence, use of therapeutic procedures, and in-hospital outcomes among patients suffering an ischemic stroke (IS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the existence of sex differences. Methods: Matched-pair analysis [...] Read more.

Background: To analyze the incidence, use of therapeutic procedures, and in-hospital outcomes among patients suffering an ischemic stroke (IS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016–2018) and to assess the existence of sex differences. Methods: Matched-pair analysis using the Spanish National Hospital discharge. Results: IS was coded in 92,524 men and 79,731 women (29.53% with T2DM). The adjusted incidence of IS (IRR 2.02; 95% CI 1.99–2.04) was higher in T2DM than non-T2DM subjects, with higher IRRs in both sexes. Men with T2DM had a higher incidence of IS than T2DM women (IRR 1.54; 95% CI 1.51–1.57). After matching patients with T2DM, those with other comorbid conditions, however, significantly less frequently received endovascular thrombectomy and thrombolytic therapy. In-hospital mortality (IHM) was lower among T2DM men than matched non-T2DM men (8.23% vs. 8.71%; p < 0.001). Women with T2DM had a higher IHM rate than T2DM men (11.5% vs. 10.20%; p = 0.004). After adjusting for confounders, women with T2DM had a 12% higher mortality risk than T2DM men (OR 1.12; 95% CI 1.04–1.21). Conclusions: T2DM is associated with higher incidence of IS in both sexes. Men with T2DM have a higher incidence rates of IS than T2DM women. Women with T2DM have a higher risk of dying in the hospital. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

10 pages, 896 KiB

Open AccessArticle

Reversal of the Upward Trend of Obesity in Boys, but Not in Girls, in Spain

by Romana Albaladejo-Vicente, Rosa Villanueva-Orbaiz, David Carabantes-Alarcon, Juana Santos-Sancho, Rodrigo Jiménez-García and Enrique Regidor

Int. J. Environ. Res. Public Health 2021, 18(4), 1842; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041842 - 14 Feb 2021

Cited by 4 | Viewed by 2208

Abstract

(1) Background: To compare the prevalence of overweight and obesity in boys and girls and to estimate socioeconomic differences associated with obesity in Spain in 1997, 2007, and 2017. (2) Methods: Data were drawn from national health interview surveys. For each year of [...] Read more.

(1) Background: To compare the prevalence of overweight and obesity in boys and girls and to estimate socioeconomic differences associated with obesity in Spain in 1997, 2007, and 2017. (2) Methods: Data were drawn from national health interview surveys. For each year of study, the prevalence of overweight and obesity was measured, and these results were compared by gender (boy/girl) and socioeconomic status (low/high education). (3) Results: The prevalence of overweight and obesity rose from 1997 to 2007 but then fell in 2017 in all subgroups except in girls aged 10 to 15 years. In this group, there was a steady increase in the prevalence of both overweight (1997, 14.6%; 2007, 17.7%; 2017, 19.6%) and obesity (1.1, 3.2, and 3.7%, respectively). The decrease in prevalence of overweight in both sexes and of obesity in boys, along with the increase in prevalence of obesity in girls, was of a higher magnitude in children whose parents had a lower educational level. (4) Conclusions: The apparent turnaround in the obesity epidemic in Spain should be interpreted with caution. Children’s body weight is influenced by both gender and socioeconomic status—considerations that should be kept in mind when designing health promotion interventions. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

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8 pages, 536 KiB

Open AccessArticle

Do Diabetes Mellitus Differences Exist within Generations? Three Generations of Moluccans in The Netherlands

by Adee Bodewes, Charles Agyemang and Anton E. Kunst

Int. J. Environ. Res. Public Health 2021, 18(2), 493; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020493 - 09 Jan 2021

Cited by 2 | Viewed by 1803

Abstract

Background: Diabetes mellitus (DM) is known to be more prevalent among migrants compared to their host populations. It is unclear whether DM prevalence differs between generations among migrants. We investigated the differences in DM prevalence among three generations of Moluccans, who have been [...] Read more.

Background: Diabetes mellitus (DM) is known to be more prevalent among migrants compared to their host populations. It is unclear whether DM prevalence differs between generations among migrants. We investigated the differences in DM prevalence among three generations of Moluccans, who have been living for over 65 years in the Netherlands, compared to the Dutch population. Methods: In this cross-sectional study, data of a healthcare insurance database on hospital and medication use (Achmea Health Database) were used. The dataset contained 5394 Moluccans and 52,880 Dutch persons of all ages. DM differences were assessed by means of logistic regression, adjusting for age, sex, urbanization, and area socio-economic status. Results: The prevalence of DM was higher in all generations of Moluccans compared to the Dutch. The adjusted odds ratios (AORs) for DM were significantly higher in total group of Moluccans compared to the Dutch (AOR 1.60, 95% CI 1.42–1.80) and across the first and second generation of Moluccans compared to the Dutch (first generation (1.73, 1.47–2.04) and second generation (1.44, 1.19–1.75). Higher AOR were found for first generation men (1.55, 1.22–1.97) and first (1.90, 1.52–2.37) and second (1.63, 1.24–2.13) generation Moluccan women compared to the Dutch. AOR for the third generation Moluccans was increased to a similar extent (1.51, 0.97–2.34), although not statistical significant. Conclusions: Our findings show higher odds of DM across generations of Moluccans compared to the Dutch. DM prevention strategies for minorities should be targeted at all migrant generations in host countries. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

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15 pages, 371 KiB

Open AccessArticle

Time Trends in Spain from 2001 to 2018 in the Incidence and Outcomes of Hospitalization for Urinary Tract Infections in Patients with Type 2 Diabetes Mellitus

by Ana López-de-Andrés, Romana Albaladejo-Vicente, Domingo Palacios-Ceña, David Carabantes-Alarcon, José Javier Zamorano-Leon, Javier de Miguel-Diez, Marta Lopez-Herranz and Rodrigo Jiménez-García

Int. J. Environ. Res. Public Health 2020, 17(24), 9427; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249427 - 16 Dec 2020

Cited by 5 | Viewed by 1952

Abstract

We aim to examine the incidences, clinical characteristics, and in-hospital outcomes of type 2 diabetes (T2DM) patients hospitalized with urinary tract infections (UTIs) in Spain and to identify the factors associated with in-hospital mortality (IHM). A retrospective observational study was carried out with [...] Read more.

We aim to examine the incidences, clinical characteristics, and in-hospital outcomes of type 2 diabetes (T2DM) patients hospitalized with urinary tract infections (UTIs) in Spain and to identify the factors associated with in-hospital mortality (IHM). A retrospective observational study was carried out with a sample that included all adult patients who were hospitalized for UTIs between 2001 and 2018 and collected in the Spanish National Health System Hospital Discharge Database. We identified 850,276 patients with UTIs (25.49% with T2DM). The incidence of UTIs increased in patients with and without diabetes from 290.76 and 74.79 cases per 100,000 inhabitants in the period from year 2001 to year 2003 to 568.45 and 144.0 in the period from 2016 to 2018, respectively (p < 0.001). Adjusted incidence of UTIs was higher in T2DM patients (incidence rate ratio (IRR) 4.36; 95% CI 4.35–4.39). The multivariable analysis showed a significant reduction in the IHM over time for men and women with T2DM. In T2DM, patients’ higher IHM was associated with older age, comorbidities, and Staphylococcus aureus isolation. Women with T2DM had a higher risk of dying than men. The risk of IHM with an episode of UTIs was independent of the presence of T2DM (odds ratio (OR) 0.97; 95% CI 0.91–1.01). We conclude that the incidence of UTIs was over four times higher in T2DM than nondiabetic patients and has increased over time. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

15 pages, 382 KiB

Open AccessArticle

Type 2 Diabetes Is a Risk Factor for Suffering and for in-Hospital Mortality with Pulmonary Embolism. A Population-Based Study in Spain (2016–2018)

by Rodrigo Jiménez-García, Romana Albaladejo-Vicente, Valentin Hernandez-Barrera, Rosa Villanueva-Orbaiz, David Carabantes-Alarcon, Javier de-Miguel-Diez, José Javier Zamorano-Leon and Ana Lopez-de-Andres

Int. J. Environ. Res. Public Health 2020, 17(22), 8347; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228347 - 11 Nov 2020

Cited by 9 | Viewed by 2027

Abstract

(1) Background: The relationship between type 2 diabetes (T2DM) and pulmonary embolism (PE) has not been well stablished so far. We aim to analyze incidence, clinical conditions and in-hospital mortality (IHM) according to the presence of T2DM among patients hospitalized for suffering from [...] Read more.

(1) Background: The relationship between type 2 diabetes (T2DM) and pulmonary embolism (PE) has not been well stablished so far. We aim to analyze incidence, clinical conditions and in-hospital mortality (IHM) according to the presence of T2DM among patients hospitalized for suffering from PE. The factors associated with IHM were identified. (2) Methods: Patients aged ≥40 years hospitalized for PE from 2016 to 2018 included in the Spanish National Health System Hospital Discharge Database were analyzed. Dependent variables included incidence, IHM and length of hospital stay. Independent variables were age, sex, diagnosed comorbidities, thrombolytic therapy and inferior vena cava filter placement. Poisson and logistic regression models were constructed for multivariable analysis. (3) Results: Of the 47,190 hospitalizations for PE recorded, 16.52% had T2DM. Adjusted incidence of PE was higher among T2DM women (IRR 1.83; 95% CI: 1.58–1.96) and men (IRR 1.22; 95% CI: 1.18–1.27) than among non-diabetic subjects. Crude IHM in T2DM patients with PE was similar in both sexes but higher than in non-diabetic patients. Among T2DM patients with PE, risk factors for IHM included older age, comorbidity, atrial fibrillation and massive PE. Obesity was associated with lower IHM. Suffering T2DM was a risk of IHM (OR 1.15; 95% CI 1.05–1.26) after PE. (4) Conclusions: The incidence of PE is higher in T2DM men and women than in non-diabetic patients. T2DM was a risk factor for IHM after PE. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

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12 pages, 960 KiB

Open AccessSystematic Review

Psychotherapeutic Interventions to Improve Psychological Adjustment in Type 1 Diabetes: A Systematic Review

by Davinia M. Resurrección, Desirée Navas-Campaña, Mencía R. Gutiérrez-Colosía, Joaquín A. Ibáñez-Alfonso and Desireé Ruiz-Aranda

Int. J. Environ. Res. Public Health 2021, 18(20), 10940; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010940 - 18 Oct 2021

Cited by 8 | Viewed by 3158

Abstract

Background: International clinical practice guidelines highlight the importance of improving the psychological and mental health care of patients with Type 1 diabetes mellitus (T1DM). Psychological interventions can promote adherence to the demands of diabetes self-care, promoting high quality of life and wellbeing. [...] Read more.

Background: International clinical practice guidelines highlight the importance of improving the psychological and mental health care of patients with Type 1 diabetes mellitus (T1DM). Psychological interventions can promote adherence to the demands of diabetes self-care, promoting high quality of life and wellbeing. Methods: A systematic review was carried out to determine whether psychological treatments with a specific focus on emotional management have an impact on glycemic control and variables related to psychological adjustment. Comprehensive literature searches of PubMed Medline, Psycinfo, Cochrane Database, Web of Science, and Open Grey Repository databases were conducted, from inception to November 2019 and were last updated in December 2020. Finally, eight articles met inclusion criteria. Results: Results showed that the management of emotions was effective in improving the psychological adjustment of patients with T1DM when carried out by psychologists. However, the evidence regarding the improvement of glycemic control was not entirely clear. When comparing adolescent and adult populations, findings yielded slightly better results in adolescents. Conclusions: More rigorous studies are needed to establish what emotional interventions might increase glycemic control in this population. Full article

(This article belongs to the Special Issue Epidemiology and Prevention of Diabetes)

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