The prevalence of type 2 diabetes is increasing rapidly, particularly among younger age groups. Estimates suggest that people with diabetes die, on average, 6 years earlier than people without ...diabetes. We aimed to provide reliable estimates of the associations between age at diagnosis of diabetes and all-cause mortality, cause-specific mortality, and reductions in life expectancy.
For this observational study, we conducted a combined analysis of individual-participant data from 19 high-income countries using two large-scale data sources: the Emerging Risk Factors Collaboration (96 cohorts, median baseline years 1961–2007, median latest follow-up years 1980–2013) and the UK Biobank (median baseline year 2006, median latest follow-up year 2020). We calculated age-adjusted and sex-adjusted hazard ratios (HRs) for all-cause mortality according to age at diagnosis of diabetes using data from 1 515 718 participants, in whom deaths were recorded during 23·1 million person-years of follow-up. We estimated cumulative survival by applying age-specific HRs to age-specific death rates from 2015 for the USA and the EU.
For participants with diabetes, we observed a linear dose–response association between earlier age at diagnosis and higher risk of all-cause mortality compared with participants without diabetes. HRs were 2·69 (95% CI 2·43–2·97) when diagnosed at 30–39 years, 2·26 (2·08–2·45) at 40–49 years, 1·84 (1·72–1·97) at 50–59 years, 1·57 (1·47–1·67) at 60–69 years, and 1·39 (1·29–1·51) at 70 years and older. HRs per decade of earlier diagnosis were similar for men and women. Using death rates from the USA, a 50-year-old individual with diabetes died on average 14 years earlier when diagnosed aged 30 years, 10 years earlier when diagnosed aged 40 years, or 6 years earlier when diagnosed aged 50 years than an individual without diabetes. Using EU death rates, the corresponding estimates were 13, 9, or 5 years earlier.
Every decade of earlier diagnosis of diabetes was associated with about 3–4 years of lower life expectancy, highlighting the need to develop and implement interventions that prevent or delay the onset of diabetes and to intensify the treatment of risk factors among young adults diagnosed with diabetes.
British Heart Foundation, Medical Research Council, National Institute for Health and Care Research, and Health Data Research UK.
Diabetes-related distress (DD) is defined as the emotional and regimen-specific burdens of managing diabetes and affects 38%-45% of patients. It is associated with poorer medical outcomes. Health ...care providers (HCPs) are on the frontline of diabetes care, but no known research has assessed DD in HCPs. This study developed a measure of DD from the perspective of HCPs.
Items (N=69) were based on interviews and focus groups with HCPs who treat people with diabetes and rated on a 5-point Likert scale. The DREAD scale was completed by 135 HCPs. Mean age was 48.9 years, 90.8% female, 79.6% white, and 67.6% married. 49.3% were nurses/nurse practitioners, 16.9% endocrinologists and 16.2% dieticians. 56.3% identified as Certified Diabetes Educators.
Evaluation of item distribution characteristics, Cronbach’s α, factor analysis and scree plot analysis indicated a 1-factor solution with 43 items. Cronbach’s α item to total was 0.92. A principal axis factor analysis was conducted; the Kaiser-Meyer-Olkin test supported sampling adequacy (KMO = .80, p < .001). The eigenvalue for the single factor was 9.11. Factor loadings ranged from 0.63 to 0.31.
To test convergent validity, the DREAD total score was correlated with the Maslach Burnout Inventory Human Services Survey for Medical Personnel (r = 0.56, p< .001 for emotional exhaustion; r = 0.39, p < .001 for depersonalization; and r = 0.40, p < .001 for personal accomplishment) and the Marlow-Crowne Social Desirability Scale (r = 0.32, p < .001). Test-retest reliability (n = 93) was conducted >2-4 weeks after the first survey: coefficient r = 0.78 (p < .001).
Diabetes-related distress is part of the caregiving experience among HCPs who treat diabetes. The DREAD scale demonstrated acceptable levels of validity and reliability in a diverse sample of HCPs. These results suggest that the DREAD scale measures a related, yet distinct, construct from general physician burnout. This measure may be used to evaluate the psychological impact of treating diabetes among HCPs in future samples.
Disclosure
M. de Groot: Consultant; Self; Eli Lilly and Company, Johnson & Johnson Diabetes Institute. M. Craven: None. E.A. Vrany: None. Z. Simons: None.
Se presenta un modelo matemático de la dinámica del nitrógeno (NH.sub.4.sup.+, NO.sub.2.sup.-, NO.sub.3.sup.- y nitrógeno orgánico en fitoplancton) en estanques de camarón blanco (Litopenaeus ...vannamei) en condiciones de baja salinidad y sin recambio de agua. El modelo predice los resultados de producción comercial en tres estanques comerciales. Se demuestra que este sistema de cultivo, sin reemplazo, retiene el nitrógeno y los camarones producidos tienen una baja conversión de alimento en comparación con sistemas con recambio. El modelo se utiliza para evaluar mejores estrategias de manejo de estos ambientes.
Las bacteriocinas representan un sustituto potencial de conservantes químicos, debido a que son producidas por bacterias ácido lácticas (BAL), las cuales son consideradas GRAS (generalmente ...reconocidas como seguras, por sus siglas en inglés), que tienen un papel importante en la preservación y fermentación de alimentos. El uso de las bacteriocinas como bioconservantes se atribuye a sus características como inhibir numerosos microorganismos patógenos, su acción en amplios rangos de pHs y termoestabilidad, proponiéndose diferentes aplicaciones de las bacteriocinas en alimentos, ya sea en forma concentrada, en algún sustrato de grado alimentario o agregando la bacteriocina a un soporte, actuando éste como reservorio y difusor del péptido antimicrobiano concentrado a la comida. El propósito de este trabajo es el conocimiento general sobre bacteriocinas, y resaltar su uso potencial como bioconservante en alimentos.
En este trabajo se optimizó la extracción de una bebida de banano por métodos enzimáticos en tres cultivares. Se emplearon dos enzimas comerciales: una amilasa (Glucozyme-400) y una combinación de ...celulasa, hemicelulasa y pectinasa (Macerex PM). Se optimizó el estado de madurez de la fruta, la variedad, el tipo de enzima y la dilución, usando como variables de respuesta la concentración de sólidos solubles (gradosBrix) y el rendimiento de la extracción. La enzima amilasa no mostró un efecto positivo en la extracción en ninguna etapa de madurez. El complejo Macerex PM presentó un efecto positivo en el rendimiento; sin embargo, al aumentar el factor de dilución disminuye el rendimiento y la concentración de sólidos solubles (gradosBrix).
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