Journal of Preventive Medicine and Public Health

Original Articles

The Diabetogenic Effect of Statin Use May Interact With Polygenic Risk Scores for Type 2 Diabetes: Evidence From the UK Biobank: Jong Hyun Park, Kyu-Taek Lim, Jooyeon Lee, Yongjin Gil, Joohon Sung; J Prev Med Public Health. 2025;58(1):92-102. Published online December 11, 2024; DOI: https://doi.org/10.3961/jpmph.24.671

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Abstract Summary PDF Supplementary Material: Objectives
Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk.
Methods
This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders.
Results
In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19).
Conclusions
PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.; Summary

Korean summary
스타틴은 심혈관 질환 예방에 필수적이지만, 제2형 당뇨병 발생 위험을 높인다고 알려져 있습니다. 본 연구는 영국 바이오뱅크 데이터를 활용하여, 스타틴 사용과 제2형 당뇨병 다유전자 위험 점수(Polygenic Risk Score, PRS)의 상호작용이 당뇨병 발생 위험에 미치는 영향을 분석했습니다. 연구 결과, PRS가 높은 집단에서는 스타틴 사용이 제2형 당뇨병 발생 위험을 유의하게 증가시켰으나, PRS가 낮은 집단에서는 스타틴 사용이 오히려 당뇨병 위험을 낮추는 경향을 보였습니다. 이러한 결과는 유전적 요인을 고려한 맞춤형 심혈관 질환 예방 전략의 중요성을 시사합니다.

Key Message
This study highlights that the diabetogenic effect of statins interacts significantly with genetic predisposition, as quantified by polygenic risk scores (PRS) for type 2 diabetes mellitus (T2DM). Individuals with high PRS are at a significantly increased risk of developing T2DM with statin use, while those with low PRS may experience a reduced risk. These findings underscore the potential of integrating genetic risk stratification into clinical decision-making to optimize the balance between cardiovascular benefits and T2DM risk in statin therapy.

The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia: Putu Rika Veryanti, Rani Sauriasari, Ratu Ayu Dewi Sartika, Berna Elya, Muhammad Ikhsan Mokoagow; J Prev Med Public Health. 2025;58(1):31-43. Published online November 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.313

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Abstract Summary PDF Supplementary Material: Objectives
The purpose of this study was to develop a valid and reliable instrument for assessing patients’ behavior toward the risk of hypoglycemia through self-assessment. Insufficient education and supervision of type 2 diabetes mellitus (DM) outpatients by healthcare providers is a significant concern, affecting their behavior during the treatment process. Additionally, inappropriate behavior typically increases the risk of hypoglycemia. To mitigate this risk, several studies have recommended evaluating patients’ behavior, necessitating the development of a new instrument.
Methods
The study procedures were conducted in 3 stages: instrument development (face and content validity, stage I), construct validity and reliability test (stage II), and criterion validity (stage III). Stage I involved 5 healthcare practitioners, including internal medicine doctors, nurses, dietitians, and pharmacists in hospitals and community health centers. Stage II included 20 respondents using a 1-shot test method. Stage III involved 237 type 2 DM outpatients at Central General Hospital (RSUP) in Jakarta, employing a cross-sectional design and consecutive sampling.
Results
The results indicated that the developed instrument was valid and reliable, comprising 9 domains (29 questions). These domains included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Furthermore, poor behavior was found to increase the risk of hypoglycemia by 2.36 times.
Conclusions
Based on these results, the developed instrument could be effectively used to evaluate behavior toward hypoglycemia among type 2 DM outpatients, confirming its validity and reliability.; Summary

Key Message
The development of an assessment instrument for behavior toward hypoglycemia risk among type 2 diabetes mellitus outpatients in Jakarta, Indonesia have been carried out. The instrument contains 9 domains, included behavior toward blood glucose monitoring, diet, physical activity, medication, assistance from healthcare providers, hypoglycemia management, self-care, family support, and insulin use. Poor behavior was found to increase the risk of hypoglycemia by 2.36 times. The instrument developed is valid and reliable.

Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients With Type 2 Diabetes Mellitus in Bali, Indonesia: Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati; J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.424

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Abstract Summary PDF: Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients’ knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²=0.988). Additionally, the instrument was named “Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).”
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.; Summary

Key Message
- HYPOGLYRISK is an instrument that can be used to assess the risk of hypoglycemia requiring hospitalization in T2DM patients. This instrument met all the requirements for psychometric properties testing in this study. - Patients discharged on antidiabetic medications can be screened for risk of severe hypoglycemia using HYPOGLYRISK, specifically by pharmacists, during drug dispensing. - Patients with T2DM must be ensured to have knowledge related to the five dimensions of medication safety to avoid the risk of hypoglycemia requiring hospitalization.

Systematic Review

Effects of Physical and Mind-body Exercise on Sleep Quality in Individuals With Diabetes Mellitus: A Systematic Review and Meta‐analysis: Yohanes Andy Rias, Renny Wulan Apriliyasari, Made Satya Nugraha Gautama, Faizul Hasan, Margareta Teli, Hsiao-Yean Chiu, Ratsiri Thato; J Prev Med Public Health. 2025;58(1):1-10. Published online October 7, 2024; DOI: https://doi.org/10.3961/jpmph.24.354

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Abstract Summary PDF Supplementary Material

Objectives
Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus.
Methods
Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed.
Results
Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust.
Conclusions
Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.

Summary

Key Message
This systematic review and meta-analysis reviewed the impact of physical and mind-body exercise interventions on sleep quality in individuals with diabetes mellitus, examining six randomised, controlled trials. The results indicated a notable enhancement in sleep quality. A meta-analysis revealed a negative correlation between haemoglobin A1c levels and improvements in sleep quality. The findings suggest that physical and mind-body exercise are effective methods for improving sleep quality; however, additional rigorous research with larger sample sizes and standardised protocols is necessary.

Citations

Citations to this article as recorded by

Acute and chronic effects of inspiratory muscle training in patients with type 2 diabetes mellitus: a systematic review of randomized controlled trials
Zoé Breuil-Marsal, Clémence Godek, Amandine Lotti, Patrick Feiereisen, Isabela Roque Marçal, Patricia Rehder-Santos, Juliana Cristina Milan-Mattos, Raphael Martins de Abreu
Frontiers in Sports and Active Living.2024;[Epub] CrossRef

Original Articles

Healthcare Utilization and Discrepancies by Income Level Among Patients With Newly Diagnosed Type 2 Diabetes in Korea: An Analysis of National Health Insurance Sample Cohort Data: Eun Jee Park, Nam Ju Ji, Chang Hoon You, Weon Young Lee; J Prev Med Public Health. 2024;57(5):471-479. Published online August 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.165

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Abstract Summary PDF

Objectives
The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D.
Methods
A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care.
Results
From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99).
Conclusions
Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.

Summary

Korean summary
의료서비스 이용의 강도와 질을 측정하는 당뇨 관련 합병증 검진율은 저소득층에서 특히 낮았습니다. 보편적 건강 보장이 있는 국가에서도 신환환자 특히 낮은 경제적 계층의 치료 불균형을 해소 하기 위해서는 재정적 부담은 절감하고, 건강 문해력 증진시키고, 일차의료 기관의 기능을 최적화 하여 책임을 강화하는 것이 필요합니다.

Key Message
Diabetic-related complications screening rates that measure the intensity and quality of medical care service usage were statistically lower in low-income groups. Reducing financial burden, promoting health literacy and optimizing the function of primary care physician and reinforcing the health care provider’s accountability are necessary to address the discrepancy of care for those with low socioeconomic status people in early stage of disease, even in nations with universal health coverage.

Citations

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Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef

Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea: Haryeom Ghang, Juhyang Lee; J Prev Med Public Health. 2023;56(6):504-514. Published online October 5, 2023; DOI: https://doi.org/10.3961/jpmph.23.252

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.

Summary

Korean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).

Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).

Citations

Citations to this article as recorded by

The Diabetogenic Effect of Statin Use May Interact With Polygenic Risk Scores for Type 2 Diabetes: Evidence From the UK Biobank
Jong Hyun Park, Kyu-Taek Lim, Jooyeon Lee, Yongjin Gil, Joohon Sung
Journal of Preventive Medicine and Public Health.2025; 58(1): 92. CrossRef

Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia: Muhammad Husen Prabowo, Ratih Puspita Febrinasari, Eti Poncorini Pamungkasari, Yodi Mahendradhata, Anni-Maria Pulkki-Brännström, Ari Probandari; J Prev Med Public Health. 2023;56(5):467-474. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.229

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Abstract Summary PDF

Objectives
Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population’s health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia.
Methods
A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group’s validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL.
Results
Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score.
Conclusions
Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.

Summary

Key Message
This study examined Health-Related Quality of Life (HRQoL) in 260 type 2 diabetes patients in Indonesia. Most were male (60.6%), over 50 (91.5%), with low education (75%) and unemployed (85.6%). Pain/discomfort was the most common issue (64%), followed by anxiety (28.4%). The average HRQoL score was 0.86. Higher education positively impacted HRQoL. Diabetes patients face lower HRQoL compared to the general population, with notable issues in pain and anxiety. Education level significantly influences HRQoL. This highlights the importance of education in improving the well-being of diabetes patients in Indonesia.

Citations

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Socio-demographic disparities in health-related quality of life in hypertensive patients in Bangladesh: a comprehensive survey analysis
Md. Mizanur Rahman, Md. Nesar Uddin Sorkar, Ryota Nakamura, Md. Monirul Islam, Md. Ashraful Alam, Syed Khurram Azmat, Motohiro Sato
Quality of Life Research.2025;[Epub] CrossRef
Genetic CYP2A6 Polymorphism May Worsen Glycohemoglobin Levels: Study among Javanese Indonesian Smokers
Christine Patramurti, Dita Maria Virginia
Borneo Journal of Pharmacy.2024; 7(1): 29. CrossRef

Health-related Quality of Life Instrument With 8 Items for Use in Patients With Type 2 Diabetes Mellitus: A Validation Study in Korea: Juyoung Kim, Hyeon-Jeong Lee, Min-Woo Jo; J Prev Med Public Health. 2022;55(3):234-242. Published online May 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.020

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Abstract Summary PDF Supplementary Material

Objectives
This study assessed the validity and reliability of the Health-related Quality of Life Instrument with 8 Items (HINT-8) in patients with diabetes. HINT-8 is a newly-developed, generic health-related quality of life (HRQoL) instrument.
Methods
Three HRQoL instruments—HINT-8, EuroQoL 5-Dimension 5-Level (EQ-5D-5L), and Short Form Health Survey version 2.0 (SF-36v2)—were provided to 300 patients with diabetes visiting a tertiary hospital for follow-up visits in Korea. The HRQoL scores obtained using the HINT-8 were evaluated for subgroups with known differences based on demographics and diabetes-related characteristics (known-group validity). The mean scores of the instruments were compared between groups segmented by their responses to the HINT-8 (discriminatory ability). Correlation coefficients of the HINT-8 with other instruments were calculated (convergent and divergent validity). The Cohen kappa and intra-class correlation coefficient (ICC) were also evaluated (test-retest reliability).
Results
The average HINT-8 indexes were lower among women, older, and less-educated subjects. Subjects who did not list any problems on the HINT-8 had significantly higher HRQoL scores than those who did. The correlation coefficients of the HINT-8 with the EQ-5D-5L index and EuroQoL visual analogue scale were 0.715 (p<0.001) and 0.517 (p<0.001), respectively. The correlation coefficients between the HINT-8 index and the scores of 8 domains of the SF-36v2 ranged from 0.478 (p<0.001) to 0.669 (p<0.001). The Cohen kappa values for the HINT-8 ranged from 0.268 to 0.601, and the ICC of the HINT-8 index was 0.800 (95% confidence interval [CI], 0.720 to 0.860).
Conclusions
This study showed that the HINT-8 is a valid and reliable HRQoL instrument for patients with diabetes.

Summary

Korean summary
이 연구는 한국인의 사회문화적 특성을 반영하여 개발된 건강관련 삶의 질 도구인 HINT-8의 타당도 및 신뢰도를 대표적인 만성 질환인 제2형 당뇨 환자를 대상으로 검증하였다. 연구결과는 제2형 당뇨 환자에서 HINT-8의 활용 가능성을 보여주었을 뿐만 아니라 일반적 건강관련 삶의 질 도구 중 가장 널리 사용되고 있는 EQ-5D-5L보다 HINT-8이 삶의 질 상태를 더욱 정교하게 구분하고 있음을 보여주었다.

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Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases
Chiwook Chung, Ah-Ram Kim, Dongbum Kim, Hee Kwon, Seong Ho Lee, Il-Young Jang, Min-Woo Jo, Do-Yoon Kang, Sei Won Lee
Scientific Reports.2024;[Epub] CrossRef
Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
Mi-Sun Lee, Hooyeon Lee
JMIR Public Health and Surveillance.2024; 10: e49433. CrossRef
Health‐related quality of life instrument with 8 items to measure health‐related quality of life among family caregivers of people with dementia: A pilot validation study
Eunjeong Choi, Hyun‐Ju Seo, IL Han Choo, Seong Min Kim, Jeong Min Park, Yu Mi Choi
Public Health Nursing.2024; 41(5): 1210. CrossRef
Exploring Long-Term Determinants and Attitudes Toward Smartphone-Based Commercial Health Care Applications Among Patients With Cancer
Yae Won Tak, Ye-Eun Park, Seunghee Baek, Jong Won Lee, Seockhoon Chung, Yura Lee
JCO Clinical Cancer Informatics.2024;[Epub] CrossRef
Quality of life, physical symptoms, and psychological symptoms according to the status of chronic vestibulopathy
Sang-Yoon Han, Sang-Yeon Lee, Myung-Whan Suh, Jun Ho Lee, Moo Kyun Park, Renato S. Melo
PLOS ONE.2024; 19(11): e0312727. CrossRef
Willingness to pay for integrative healthcare services to treat sleep disturbances: Evidence from a nationwide survey
Min Kyung Hyun
European Journal of Integrative Medicine.2023; 58: 102223. CrossRef
Internal Structure of the Health-Related Quality of Life Instrument with 8-Items in a Nationally Representative Population
Eun-Hyun Lee
Journal of Korean Academy of Nursing.2023; 53(3): 359. CrossRef
Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea
Mee-Ri Lee, Sung Min Jung, Frances Chung
PLOS ONE.2023; 18(6): e0287182. CrossRef
Smartphone application-based rehabilitation in patients with chronic respiratory and cardiovascular diseases: a randomised controlled trial study protocol
Chiwook Chung, Ah-Ram Kim, Il-Young Jang, Min-Woo Jo, Seongho Lee, Dongbum Kim, Hee Kwon, Do-Yoon Kang, Sei Won Lee
BMJ Open.2023; 13(9): e072698. CrossRef

Systematic Review

Low Social Support and Risk for Depression in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis: Akhmad Azmiardi, Bhisma Murti, Ratih Puspita Febrinasari, Didik Gunawan Tamtomo; J Prev Med Public Health. 2022;55(1):37-48. Published online January 10, 2022; DOI: https://doi.org/10.3961/jpmph.21.490

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Abstract PDF

Objectives
Depression is a frequent complication of type 2 diabetes mellitus. This study aimed to investigate the relationship between low social support and risk for depression in people with type 2 diabetes through a meta-analysis.
Methods
PubMed, ProQuest, SpringerLink, ScienceDirect, Scopus, the Cochrane Library, Embase, and Google Scholar were searched for English-language articles published up to 2021. Pooled adjusted odds ratios (aORs) were calculated using a random-effect model with 95% confidence intervals (CIs). Heterogeneity was evaluated by using the Cochrane Q test and I² statistics. The risk of publication bias was estimated using a funnel plot, the Egger test, and the Begg test. The Joanna Briggs Institute Critical Appraisal Tools were used to assess the quality of evidence and the risk of bias.
Results
Eleven studies were included in this meta-analysis, containing a total of 3151 people with type 2 diabetes mellitus. The pooled analysis showed that people with type 2 diabetes mellitus who had low social support had twice as high a risk of depression as those with high social support (aOR, 2.02; 95% CI, 1.51 to 2.70; p<0.001). A random-effect model was used because the heterogeneity was high (I²= 87%).
Conclusions
Low social support was found to increase the risk of depression among people with type 2 diabetes mellitus. Further investigation into factors that may moderate this relationship is required.

Summary

Citations

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Depression prevalence, screening, and treatment in adult outpatients with type 1 and type 2 diabetes: A nationally representative cross-sectional study (National Ambulatory Medical Care Survey 2014–2019)
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Original Articles

Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes: Narges Malih, Mohammad-Reza Sohrabi, Alireza Abadi, Shahnam Arshi; J Prev Med Public Health. 2021;54(3):190-198. Published online April 7, 2021; DOI: https://doi.org/10.3961/jpmph.20.496

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Abstract PDF Supplementary Material

Objectives
Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods
This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results
Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions
Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.

Summary

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The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities
Yenifer Diaz Montes, Tania Acosta Vergara, Rafael Tuesca Molina, Gillian Martinez Guerrero, Luis A. Anillo Arrieta, Pablo Aschner, Jorge Acosta-Reyes, Victor Florez-Garcia, Edgar Navarro Lechuga, Noël C. Barengo
Primary Care Diabetes.2024; 18(4): 458. CrossRef
Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis
Nahid Shahabi, Yadolah Fakhri, Teamur Aghamolaei, Zahra Hosseini, Atefeh Homayuni
Primary Care Diabetes.2023; 17(3): 205. CrossRef
Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
Epidemiology and Health.2023; 45: e2023029. CrossRef
BİR ÜNİVERSİTE AKADEMİSYENLERİNİN SAĞLIK DAVRANIŞLARINA VE TARAMA PROGRAMLARINA UYUMU: KESİTSEL BİR ÇALIŞMA
Hatice İkiışık, Sibel Sakarya
Eskişehir Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi.2022; 7(1): 98. CrossRef
Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults
Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim
Epidemiology and Health.2021; 43: e2021049. CrossRef

Thirst for Information and Needs Reflections of Type 2 Diabetes Patients Receiving Insulin Treatment in North-East Ethiopia: A Qualitative Exploration: Ewunetie Mekashaw Bayked, Birhanu Demeke Workneh, Mesfin Haile Kahissay; J Prev Med Public Health. 2021;54(2):119-128. Published online March 1, 2021; DOI: https://doi.org/10.3961/jpmph.20.510

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Abstract PDF Supplementary Material

Objectives
Ongoing, proactive, planned, and patient-centered diabetes education is the cornerstone of care for all persons with diabetes. Thus, the aim of this study was to explore the information needs of type 2 diabetes mellitus patients receiving insulin treatment in North-East Ethiopia.
Methods
The study was conducted from July 2019 to January 2020 using a qualitative enquiry (phenomenological approach) with purposive sampling. Face-to-face in-depth interviews were used to collect data until reaching theoretical saturation. The participants were type 2 diabetes patients receiving insulin treatment. They were identified from the diabetes patients’ registration book at the diabetes clinic and interviewed at their appointment time, and were selected to include wide variations in terms of socio-demographic characteristics. Twenty-four participants (11 men and 13 women), with a median age of 57 years, were interviewed. The data were organized using QDA Miner Lite version 2.0.7 and analyzed thematically using narrative strategies.
Results
Most participants had not heard of diabetes before their diagnosis. They had limited knowledge of diabetes, but ascribed different connotations for it in the local language (Amharic). The needs reflections of patients were categorized into diabetes education and participants’ recommendations. Diabetes education was totally absent at hospitals, and patients received education primarily from the Ethiopian Diabetes Association and broadcast and digital media. Thus, the major concern of patients was the availability of diabetes education programs at health institutions.
Conclusions
Patients’ main concern was the absence of routine diabetes education, which necessitates urgent action to implement diabetes education programs, especially at health institutions.

Summary

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The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population: Hyungseon Yeom, Jung Hyun Lee, Hyeon Chang Kim, Il Suh; J Prev Med Public Health. 2016;49(2):108-117. Published online March 23, 2016; DOI: https://doi.org/10.3961/jpmph.15.062

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Abstract PDF Supplementary Material

Objectives
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
Methods
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m²). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
Results
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
Conclusions
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Summary

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Haihui Zhu, Liang Li, Songchun Liu, Jing Li
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Jianping Kong, Wenting Tao, Yuhong Sun, Yong Xu, Hailun Li, Jing Li
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Xiaona Wang, Shanshan Su
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Peter N. Lee, John S. Fry
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Nicotine promotes renal interstitial fibrosis via upregulation of XIAP in an alpha7-nAChR-dependent manner
Lili Guo, Yue Zhang, Jian Lu, Xiaoyang Li, Chao Zhang, Wenzhu Song, Yafang Dong, Xiangyang Zhou, Rongshan Li
Molecular and Cellular Endocrinology.2023; 576: 111989. CrossRef
Lifestyle factors associated with a rapid decline in the estimated glomerular filtration rate over two years in older adults with type 2 diabetes–Evidence from a large national database in Japan
Yaya Li, Makoto Fujii, Yuko Ohno, Asuka Ikeda, Kayo Godai, Yuko Nakamura, Yuya Akagi, Daisuke Yabe, Kazuyo Tsushita, Naoki Kashihara, Kei Kamide, Mai Kabayama, Patricia Khashayar
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Wei Lin, Songchang Shi, Huibin Huang, Nengying Wang, Junping Wen, Gang Chen
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Liang Ma, Yongwei Jiang, Xiaomu Kong, Qian Liu, Hailing Zhao, Tingting Zhao, Yongtong Cao, Ping Li
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Debasish Kar, Clare Gillies, Mintu Nath, Kamlesh Khunti, Melanie J. Davies, Samuel Seidu
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Peter Roderick, Victoria Turner, Anne Readshaw, Omara Dogar, Kamran Siddiqi
Diabetes Research and Clinical Practice.2019; 154: 52. CrossRef
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Haili Xu, Jinliu Suo, Jing Lian
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Jia Xia, Lin Wang, Zhiheng Ma, Liping Zhong, Ying Wang, Yachan Gao, Liqun He, Xiao Su
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Ying Zhang, Nan Jia, Feng Hu, Naijun Fan, Xiaohua Guo, Han Du, Changlin Mei, Chunfang Gao
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Diabetes Mellitus and Site-specific Colorectal Cancer Risk in Korea: A Case-control Study: Hyeongtaek Woo, Jeeyoo Lee, Jeonghee Lee, Ji Won Park, Sungchan Park, Jeongseon Kim, Jae Hwan Oh, Aesun Shin; J Prev Med Public Health. 2016;49(1):45-52. Published online December 22, 2015; DOI: https://doi.org/10.3961/jpmph.15.029

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Abstract PDF

Objectives
Previous large-scale cohort studies conducted in Korea have found a positive association between diabetes mellitus (DM) and colorectal cancer (CRC) in men only, in contrast to studies of other populations that have found significant associations in both men and women.
Methods
A total of 1070 CRC cases and 2775 controls were recruited from the National Cancer Center, Korea between August 2010 and June 2013. Self-reported DM history and the duration of DM were compared between cases and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by binary and polytomous logistic regression models.
Results
DM was associated with an elevated risk of CRC in both men (OR, 1.47; 95% CI, 1.13 to 1.90) and women (OR, 1.92; 95% CI, 1.24 to 2.98). This association remained when we controlled for age, body mass index, alcohol consumption, and physical activity level. In sub-site analyses, DM was associated with distal colon cancer risk in both men (multivariate OR, 2.04; 95% CI, 1.39 to 3.00) and women (multivariate ORs, 1.99; 95% CI, 1.05 to 3.79), while DM was only associated with rectal cancer risk in women (multivariate OR, 2.05; 95% CI, 1.10 to 3.82). No significant association was found between DM and proximal colon cancer risk in either men (multivariate OR, 1.45; 95% CI, 0.88 to 2.41) or women (multivariate OR, 1.79; 95% CI, 0.78 to 4.08).
Conclusions
Overall, DM was associated with an increased risk of CRC in Koreans. However, potential over-estimation of the ORs should be considered due to potential biases from the case-control design.

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Determinants of Poor Self-rated Health in Korean Adults With Diabetes: Hwi-Won Lee, Minkyo Song, Jae Jeong Yang, Daehee Kang; J Prev Med Public Health. 2015;48(6):287-300. Published online October 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.048

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Abstract PDF Supplementary Material

Objectives
Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes.
Methods
A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance.
Results
We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR]_{Frequent stress events}, 5.40; 95% confidence interval [CI], 4.63 to 6.29; OR_{Severe distress}, 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants’ medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A_1c levels of 6.5% or more, and comorbidities, were other correlates of poor reported health.
Conclusions
Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.

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Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications: Young-Hoon Gong, Seok-Jun Yoon, Hyeyoung Seo, Dongwoo Kim; J Prev Med Public Health. 2015;48(4):188-194. Published online July 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.020

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Abstract PDF

Objectives
The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea.
Methods
This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited.
Results
Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance.
Conclusions
Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

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Chasms in Achievement of Recommended Diabetes Care among Geographic Regions in Korea
Sanghyun Cho, Ji-Yeon Shin, Hyun Joo Kim, Sang Jun Eun, Sungchan Kang, Won Mo Jang, Hyemin Jung, Yoon Kim, Jin Yong Lee
Journal of Korean Medical Science.2019;[Epub] CrossRef

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