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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Beginning in 1988, a question added to the Washington State death certificate asked whether the decedent had smoked during the last 15 years of life. We analyzed death certificate data to evaluate the effectiveness of this question in identifying groups with high smoking rates and occupations with high rates of respiratory disease death among nonsmokers. We obtained statistical death certificate data from the Washington State Department of Health for resident deaths occurring between 1988 and 1991. Analyses included information on age, sex, race/ethnicity, marital status, underlying cause of death, high school graduation, smoking during the last 15 years of life, and occupation. Based on logistic regression analysis, we found that male sex, youth, divorced status, or death from lung cancer, chronic obstructive lung disease, or ischemic heart disease predicted a higher risk of smoking during the last 15 years of life. Hispanic ethnicity, single or widowed status, high school graduation, or death from breast cancer, diabetes, motor vehicle accidents, other accidents, or homicide predicted a lower risk of smoking. In farming occupations, there was an excess number of chronic obstructive lung disease deaths among nonsmokers. Findings from this study suggest that patterns of smoking during the last 15 years of life among decedents can provide useful public health surveillance information. The collection of risk factor information, such as smoking, should be recommended for the U.S. standard death certificate. Questions on smoking should be both simple and answerable by informants who may not have known the decedent for a lifetime. Additional studies on the accuracy of smoking history from the death certificate should be conducted.
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PMID:History of smoking from the Washington State death certificate. 788 May 52

Current levels of influenza vaccine uptake in patients considered to be at high risk have been determined by means of a questionnaire survey. During March-April 1992, information was sought from 624 patients in Leicestershire, UK with either chronic cardiovascular or respiratory disease, or diabetes; questions related to current health status and the request, offer and receipt of influenza vaccine in the current and three previous seasons. Ninety-eight percent of all offers of immunization were made in the primary care setting, and vaccine was well tolerated as judged by the fact that 86% of vaccinees between 1988/9-1990/1 returned for immunization in the following year. However in the 1991/2 season the overall level of vaccine uptake was only about 41% which is at variance with the stated policies and practices of general practitioners. Opportunities were missed, in both hospitals and general practices, to publicise and offer immunization to individuals with vaccine indications. Future attempts to improve vaccine uptake should focus on increasing the role of hospital staff in influenza prevention, in addition to promoting better vaccine delivery through primary care.
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PMID:Influenza immunization; vaccine offer, request and uptake in high-risk patients during the 1991/2 season. 840 61

Bronchial provocation tests (histamine and acetylcholine) were performed in 40 subjects (30 of them with type 1 diabetes, and 10 healthy volunteers) without any history of respiratory disease, not smoking and not taking any bronchodilating drugs. Bronchial reactivity was assessed using PC20 estimated spirographically by measuring FEV1. The patients were classified into three groups according to the duration of the disease: group I (0-7 yrs), group II (8-15), and group III (> 15). In all the three groups diabetes was at a similar degree of compensation, as evaluated by the mean circadian glycaemia, serum fructosamine and the Schlichtkrull Mw index. Bronchial reactivity to acetylcholine and histamine decreased with diabetes duration. Reaction to acetylcholine was statistically lower after 7 years of diabetes. An autonomic neuropathy was detected within the respiratory system, parallel to tachycardia at rest, alteration of the Valsalva test and orthostatic hypotension.
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PMID:[Impairment of bronchial reactivity in patients with diabetes mellitus type I]. 841 10

The causes of admission to hospital over a 5-year period of 3539 persons aged 60 years and above in Riyadh, Saudi Arabia have been analysed; 54.2% were males and 45.8% females and 68.5% were aged 65 years and above. The causes of morbidity were chronic degenerative disorders of which cardiovascular diseases were the most frequent followed by acute respiratory problems, diabetes, and digestive and neoplastic diseases. The pattern of disease was very similar to that in the industrialized countries. The median stay in hospital was 10.7 days. Respiratory diseases and diabetes mellitus were significantly higher in females than males (P < 0.02), while cardiovascular diseases, particularly ischaemic heart disease and heart failure, as well as malignant neoplastic diseases mainly of the digestive system, were more prevalent in males.
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PMID:Causes of morbidity among a sample of elderly hospital patients in Riyadh, Saudi Arabia. 850 69

To examine how functional, medical and psychosocial factors influence the differences in use of community and residential services by Australian-born and ethnic aged persons, all persons (n = 31,737) assessed by aged care assessment teams in Queensland in 1992 and 1993 were surveyed. Subjects were classified as Australian-born, overseas-born in countries where English is the primary language, or overseas-born in countries where English is not the primary language. Factors compared included use of services and residential care both prior to assessment and following assessment, and functional, medical and psychosocial factors. The group with non-English-speaking background were more likely to be both younger and underreferred compared to their proportion in the community. They were more likely to be referred for, and more likely to be recommended for, nursing home placement than the English-speaking groups. They were more commonly referred for assessment because of mental deficit problems, carer stress and/or social isolation, more likely to be diagnosed with dementia and diabetes, and less likely to be diagnosed with respiratory disease and vision disorders. That clients of non-English-speaking background are more likely to be recommended for nursing home placement is probably largely because of more advanced disease at the time of referral and therefore more functional dependence. Aged care assessment teams should increase ethnic communities' awareness of their services, particularly of the benefits of earlier referral.
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PMID:Ethnicity and aged care assessment teams in Queensland. 879 64

The causes of death and associated risk factors are compared in young and old diabetic patients attending a retinopathy clinic. Mortality in those diagnosed under and over the age of 30 years is also examined in order to compare insulin-dependent with non-insulin-dependent patients. A defined cohort attending the Hammersmith Hospital Retinopathy Clinic was followed for an average of 11 years. Main outcome measures were standardized mortality ratios (SMRs) in different age/sex groups and relative hazard rates (RHRs) for possible risk factors related to mortality. The patients were divided into those aged under and over the age of 60 years at attendance at the clinic. The RHRs were smaller in the elderly for plasma urea [1.015 versus 1.107 (p < 0.01)]. Attenuation of risk was also suggested for systolic blood pressure (RHR of 1.005 in the elderly versus 1.015 in the younger patients) and for the effects of smoking [RHR of 1.17 (elderly patients) and 1.35 (younger patients)]. In those diagnosed under the age of 30 years, there were very high SMRs for renal disease, cerebrovascular disease (men only), ischemic heart disease, other heart disease, and respiratory disease (men only), but increased SMRs were also demonstrated in those diagnosed over the age of 30 years. The risk factors associated with poor survival were similar for those diagnosed over and under the age of 30 years: poor diabetic control, high systolic and diastolic blood pressure, and increased plasma urea. In conclusion, there was no evidence that blood sugar control or diastolic blood pressure were less important in older age groups. Plasma urea, systolic pressure, and being on insulin were less useful as predictors of mortality in the elderly, but were still important in patients diagnosed over the age of 30 years.
J Diabetes Complications
PMID:Causes of death and risk factors in young and old diabetic patients referred to a retinopathy clinic. 880 66

An understanding of changes in pulmonology disease patterns observed at a general hospital before and after implantation of a population-based model of health care not only provides useful insight into the diseases treated but also aids adjustment of health care service organization. The aim of this study was to compare data collected after 1992 (when the new system was established) with records kept by the same pulmonology group in earlier years (1974-1986). Data after 1992 described patients attended in Health District 11 by the newly organized pneumologists. For the two periods the most common pneumological diagnoses were chronic air flow obstruction and chronic hypersecretory bronchitis. The most common non pneumological diagnoses were systemic arterial hypertension, obesity, diabetes, liver disease and hiatus hernia/gastroesophageal reflux. The prospective study covered a larger population and was closer to primary care, including as it did patients at clinics unattached to hospitals. In the earlier hospital-based experience the most common diagnoses were acute respiratory infection, chronic air flow obstruction and asthma, apart from those patients referred in whom no respiratory disease was found. With the organizational integration of hospital and health district pulmonology service, contact between patients and specialists has increased. Record systems have been established for a well-defined population to permit better forecasting at less cost and facilitate contact with primary care givers and epidemiological studies.
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PMID:[Diseases diagnosed at a pneumology unit integrated with its health area. Comparison with historical controls]. 894 84

The cause-specific mortality experience of a cohort inclusive of all subjects compensated for asbestosis in Italy (altogether 3417 persons--2776 men and 641 women), was studied from 31.12.1979 through 30.6.1990. Forty-eight subjects, corresponding to 1.4% of the cohort, were lost to follow-up, while it was not possible to ascertain the cause of death of 78 subjects, corresponding to 6.9% of the deceased. Observed mortality was compared with expected figures, derived from the Italian population mortality rates. The study showed significant increases in mortality from all causes (SMR 153, 1134 obs), respiratory disease (SMR 388, 218 obs), all neoplasms (SMR 192, 438 obs), namely lung (SMR 289, 190 obs), pleura (SMR 2745, 34 obs), peritoneum (SMR 1372, 14 obs), intestine and rectum (SMR 186, 36 obs) and ovary (SMR 545, 6 obs). A significantly decreased mortality was observed for cardiovascular disease (SMR 85, 266 obs), diabetes (SMR 37, 8 obs) and disease of the nervous system (SMR 29, 3 obs). The increase in neoplasms of lung, pleura and peritoneum was significant in both genders, while the increase in intestinal neoplasms was significant among women but not among men. Exposure in the manufacture of asbestos-cement products, the shipbuilding and textile industries accounted for most of the observed mortality excess.
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PMID:[A mortality study of recipients of compensation for asbestosis in Italy (1980-1990)]. 931 67

Overweight and obese adults are at increased risk for morbidity and mortality associated with many acute and chronic medical conditions, including hypertension, dyslipidemia, coronary heart disease, diabetes mellitus, gallbladder disease, respiratory disease, some types of cancer, gout, and arthritis. In addition, overweight during childhood and adolescence is associated with overweight during adulthood, and previous reports have documented an increase in the prevalence of overweight among children, adolescents, and adults from 1976-1980 to 1988-1991. This report presents data from CDC's Third National Health and Nutrition Examination Survey (NHANES III) (1988-1994) to provide the most recent national estimates of overweight among children (ages 6-11 years), adolescents (aged 12-17 years), and adults (aged > or = 20 years) in the United States. The findings indicate that the prevalence of overweight in the United States has continued to increase.
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PMID:Update: prevalence of overweight among children, adolescents, and adults--United States, 1988-1994. 907 80

Using a population-based cohort from 10 general practices in East Dorset, the mortality rate of diabetic patients compared to non-diabetic controls was investigated during 8 years follow-up. From a total population of 90660, 917 diabetic patients were identified; 693 (75%) with non-insulin-dependent (Type 2) diabetes and 224 (25%) with insulin-dependent (Type 1) diabetes. A control group of 917 non-diabetic subjects were selected, matched by age and sex. After 8 years, significantly more diabetic patients (334 or 36.4%) had died than controls (219 or 24%), (odds ratio (OR) 1.99, 95% CI 1.60-2.47). Compared with the controls, the odds ratio of all causes of mortality for diabetic men was 1.89 (CI 1.4-2.54) and for diabetic women 2.16 (CI 1.57-2.96). Compared with controls, the odds ratio for mortality from circulatory disease was significantly increased for diabetic patients 2.0 (CI 1.5-2.6) but mortality for respiratory disease or neoplasms was not significantly different (OR 0.7, CI 0.4-1.2 and OR 0.7, CI 0.6-1.0, respectively). Control data were lower than would be expected from national database data. The diabetic population had a significantly higher mortality than controls, both from all causes and circulatory diseases. Our data incidentally show the importance of appropriate controls for estimating the impact of a chronic disease.
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PMID:Mortality rates in diabetic patients from a community-based population compared to local age/sex matched controls. 937 87


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