[ Herbal Remedies ]

Dr Nita Forouhi – MRC Epidemiology Unit

Methods  An epidemiological model was constructed by applying age–sex–ethnic-specific reference prevalence rates from epidemiological studies to resident populations (2001 census) of England at national, regional, and local authority/Primary Care Trust levels. The researchers also found that the number of people receiving prescriptions for insulin for type 2 diabetes during the nearly 20-year period, overtook the number of people with type 1 diabetes. This study aimed to determine the prevalence of Type 2 diabetes and ‘pre-diabetes’, defined as impaired fasting glucose and impaired glucose tolerance, in the Portuguese population aged between 20 and 79 years. The prevalence of self-reported diabetes diagnosed by a doctor was analysed in relation to household income, occupational social class and educational qualifications. The prevalence of abnormal liver enzymes was significantly higher in men (odds ratio 1.40, 95% CI 1.07-1.83), in the youngest 5-year age band (odds ratio 2.02, 95% CI 1.44-2.84), in patients with diabetes duration < 5 years (odds ratio 1.38, 95% CI 1.01-1.90), plasma HbA(1c) ≥ 58 mmol/mol (7.5%) (odds ratio 1.43, 95% CI 1.09-1.88), obese BMI (odds ratio 2.84, 95% CI 1.59-3.06) and secondary care management for their diabetes (odds ratio 1.40, 95% CI 1.05-1.87). The metabolic syndrome was diagnosed according to the WHO criteria 1999 and to the working definition suggested by the NCEP 2001. IGT was detected in 8.2% of men and 14.3% of women. Nailfold videocapillaroscopy score also showed a positive correlation with retinopathy, detected by both ophthalmoscopy (P = 0.0001) and fluorangiography (P = 0.02), independently from sex, age, type of diabetes and all potential confounders. It is not directly related to diabetic control at other times of the day, and is independent of insulin species and insulin antibody levels. Of participants, 58.5% (n = 113) had dyslipidaemia, 28.0% (n = 54) had hypertension, 31.1% (n = 60) were vitamin D deficient and 7.3% (n = 14) had abnormal liver function. In addition, a common approach including psychiatric treatment in diabetes care may be necessary to achieve improved glycaemic control in this population. Increased urine albumin/creatinine ratio and macroalbuminuria were the only independent predictors of haematuria in patients with Type 2 diabetes, raising questions on the justifications of excluding haematuria in interpreting urinary albumin excretion in patients with Type 2 diabetes and including haematuria as an indication for renal biopsy in those with macroalbuminuria.

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