Background: This study investigates the association between socioeconomic status (SES) and glycemic control in individuals with type 1 diabetes (T1D) using flash glucose monitoring (FGM) devices within a public health system where these technologies are freely available and utilized according to recommended guidelines.
Methods: A follow-up study of 1060 adults (mean age 47.4 ± 15.0 years, 49.0% women) with T1D, receiving care at three Spanish university hospitals that regularly employ the FGM system. SES was assessed using the Spanish Deprivation Index and the average annual net income per person. Glycemic data were collected over a 14-day follow-up period, including baseline glycated hemoglobin (HbA1c) levels prior to sensor placement, the last available HbA1c levels, and FGM-derived glucose metrics. Individuals with sensor usage time < 70% were excluded. Chronic micro and macrovascular complications related to diabetes were documented. Regression models, adjusted for clinical variables, were employed to determine the impact of SES on optimal sensor control (defined as time in range (TIR) ≥ 70% with time below range < 4%) and disease complications.
Results: The average follow-up was of 2 years. The mean TIR and the percentage of individuals with optimal control were higher in individuals in the highest SES quartile (64.9% ± 17.8% and 27.9%, respectively) compared to those in the lowest SES quartile (57.8 ± 17.4% and 12.1%) (p < 0.001). Regression models showed a higher risk of suboptimal control (OR 2.27, p < 0.001) and ischemic heart disease and/or stroke (OR 3.59, p = 0.005) in the lowest SES quartile. No association was observed between SES and the risk of diabetic nephropathy and retinopathy. FGM system improved HbA1c levels across all SES quartiles. Although individuals in the highest SES quartile still achieved a significantly lower value at the end of the follow-up 55 mmol/mol (7.2%) compared to those in the lowest SES quartile 60 mmol/mol (7.6%) (p < 0.001), the significant disparities in this parameter between the various SES groups were significantly reduced after FGM technology use.
Conclusions: Socioeconomic status plays a significant role in glycemic control and complications in individuals with T1D, extending beyond access to technology and its proper utilization. The free utilization of FGM technology helps alleviate the impact of social inequalities on glycemic control.
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http://dx.doi.org/10.1186/s12916-024-03254-w | DOI Listing |
: Cholera remains a major (and increasing) global public health problem. Goma, in the eastern Democratic Republic of Congo (DRC), has been a major cholera hotspot in Africa since 1994 and is currently experiencing one of the largest outbreaks in the world. This article contributes to the existing scholarship on cholera risk by utilizing a variety of qualitative research methods.
View Article and Find Full Text PDFJ Endovasc Ther
December 2024
Institute for Vascular Research, St. Franziskus Hospital, Münster, Germany.
Background: To compare the performance of a new-generation cobalt-chromium balloon-expandable bare metal stent with a stainless steel platform for the treatment of iliac occlusive disease.
Methods: Consecutive patients treated for symptomatic iliac occlusive disease between 2014 and 2021 with the cobalt-chromium Dynetic-35 or the stainless steel Dynamic platform were retrospectively evaluated. Outcome measures included technical success, device- or procedure-related death, clinically-driven target lesion revascularization (CD-TLR), primary patency, and major index limb amputation up to 12 months.
Alzheimers Dement
December 2024
Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, Nevada, USA.
Introduction: Understanding how contextual socioeconomic factors are associated with psychosocial distress among different ethnoracial groups is important for addressing health disparities in individuals at risk for Alzheimer's disease.
Methods: Using Health and Aging Brain Study-Health Disparities (HABS-HD) data collected between 2017 and 2023, we examined the association of neighborhood disadvantage with psychosocial distress using demographically adjusted linear regression models, stratified by ethnoracial group and cognitive status.
Results: We included 630 non-Hispanic Black, 1109 Hispanic, and 1068 non-Hispanic White older adults deemed cognitively normal (CN) or diagnosed with mild cognitive impairment (MCI).
Acute encephalitis syndrome (AES) is a significant public health issue in India, attributed to various etiologies. In eastern Uttar Pradesh, Japanese encephalitis (JE) was the leading cause of AES (10-14% of total AES) until scrub typhus (ST), caused by , was identified in cerebrospinal fluid and blood samples of AES patients contributing more than 60% of AES cases. This study investigates the prevalence of JE-ST coinfection and compares clinical outcomes among JE mono-infection, ST mono-infection, and JE-ST coinfection.
View Article and Find Full Text PDFBrain Behav
December 2024
Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, Guizhou, China.
Objective: This study aimed to synthesize and encapsulate findings from recent research (May 1, 2018 to August 1, 2023) on neurofeedback interventions for children diagnosed with attention deficit hyperactivity disorder (ADHD).
Methods: A comprehensive search was conducted across major databases and platforms, including randomized controlled trials s focusing on children aged 5-11 years with ADHD. The inclusion was broad, not restricted by ADHD subtype, gender, IQ, socioeconomic status, or coexisting conditions.
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