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Aim: Hypertension increases complication risk in type 1 diabetes (T1D). We examined blood pressure (BP) in adolescents and young adults with T1D from the Australasian Diabetes Data Network, a prospective clinical diabetes registry in Australia and New Zealand.
Methods: This was a longitudinal study of prospectively collected registry data.
Inclusion Criteria: T1D (duration ≥ 1 year) and age 16-25 years at last visit (2011-2020). Hypertension was defined as (on ≥ 3 occasions) systolic BP and/or diastolic BP > 95 percentile for age < 18 years, and systolic BP > 130 and/or diastolic BP > 80 mmHg for age ≥ 18 years. Multivariable Generalised Estimating Equations were used to examine demographic and clinical factors associated with BP in the hypertensive range across all visits.
Results: Data from 6338 young people (male 52.6%) attending 24 participating centres across 36,655 T1D healthcare visits were included; 2812 (44.4%) had BP recorded at last visit. Across all visits, 19.4% of youth aged < 18 years and 21.7% of those aged ≥ 18 years met criteria for hypertension. In both age groups, BP in the hypertensive range was associated with male sex, injection (vs. pump) therapy, higher HbA1c, and higher body mass index.
Conclusions: There is a high proportion of adolescents and young adults reported with BP persistently in hypertensive ranges. Findings flag the additive contribution of hypertension to the well-established body of evidence indicating a need to review healthcare models for adolescents and young adults with T1D.
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http://dx.doi.org/10.1007/s00592-023-02057-4 | DOI Listing |
Implement Sci
December 2024
Center for Global Health, Weill Cornell Medicine, New York, NY, USA.
Background: A central goal of implementation science is to generate insights that allow evidence-based practices to be successfully applied across diverse settings. However, challenges often arise in preserving programs' effectiveness outside the context of their intervention development. We propose that qualitative data can inform generalizability via elucidating mechanisms of an intervention.
View Article and Find Full Text PDFJ Transl Med
December 2024
Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, 253 Industrial Avenue, Guangzhou, 510282, China.
Background: Diabetic retinopathy (DR) is the most important complication of Type 2 Diabetes (T2D) in eyes. Despite its prevalence, the early detection and management of DR continue to pose considerable challenges. Our research aims to elucidate potent drug targets that could facilitate the identification of DR and propel advancements in its therapeutic strategies.
View Article and Find Full Text PDFBMC Ophthalmol
December 2024
Juarez Hospital, Public Assistance Institution (Nonprofit Organization), Av. Politecnico Nacional 5160, Colonia Magdalena de las Salinas, Mexico City, 07760, Mexico.
This meta-analysis aims to evaluate the efficacy and safety of diabetic vitrectomy for treating tractional retinal detachment (TRD) by assessing visual acuity improvements, retinal reattachment success rates, and the frequency of postoperative complications. A comprehensive literature search identified 1,211 studies, 30 of which met the inclusion criteria and were analyzed. The meta-analyses were conducted via random effects models to account for heterogeneity.
View Article and Find Full Text PDFBMJ Open Diabetes Res Care
December 2024
Deparment of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia, USA
Introduction: There are limited data regarding the associations between public transportation reliance, availability, and diabetic foot ulcer (DFU)-related amputations.
Research Design And Methods: We used visit-level data from the Georgia 2016-2019 Healthcare Cost and Utilization Project database and obtained transportation variables from open sources. Using Bayesian spatial-temporal models, we assessed the associations between transportation and DFU-related amputations within each quartile of poverty status indicators at the ZIP code tabulation area (ZCTA) level.
Muscle Nerve
December 2024
Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, US.
Introduction/aims: Skeletal muscle magnetic resonance imaging (MRI) is a validated noninvasive tool to assess Duchenne muscular dystrophy (DMD) progression. There is interest in finding DMD biomarkers that decrease the burden of clinical trial participation, such as wearable devices. Our aim was to evaluate the relationship between activity, via accelerometry, and skeletal muscle MRI, particularly T mapping.
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