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Aim: To investigate the appropriate fasting plasma glucose threshold by which to define prediabetes in children and adolescents, based on its ability to predict incident paediatric diabetes. Methods: In a nationwide survey of diabetes and renal disease conducted between 1992 and 2000 in all school‐aged children in Taiwan, those with abnormal results in repeated urine tests received further physical examination and blood tests. Students who had blood tests for at least two time points were selected for the present study (N = 12 119). The incidence of paediatric diabetes, adjusted hazard ratio and predictive power of fasting plasma glucose were analysed. Results: The incidence of paediatric diabetes increased with increasing fasting plasma glucose levels. Groups with fasting plasma glucose >5.6 mmol/l had a higher adjusted hazard ratio. The adjusted hazard ratio of incident diabetes for participants with higher fasting plasma glucose rose continuously when using a higher threshold for fasting plasma glucose. The area under the receiver‐operating characteristic curve for fasting plasma glucose was 0.628 for predicting paediatric diabetes. The association between fasting plasma glucose and incident paediatric diabetes and the area under the receiver‐operating characteristic curve were similar in boys and girls and were higher in the age group 12–18 years. According to receiver‐operating characteristic curve analysis, the optimal thresholds, sensitivity and specificity were 4.75 mmol/l, 65% and 51%, respectively, for those aged 6–11 years and 5.19 mmol/l, 60% and 73%, respectively, for those aged 12–18 years. Conclusion: Fasting plasma glucose is associated with the incidence of paediatric diabetes. The results of the present study can be used as reference data to suggest a cut‐off value to define paediatric prediabetes. What's new?: This is one of the few studies to investigate the plasma glucose threshold to predict incident paediatric diabetes.Using a nationwide dataset, we found that fasting plasma glucose (FPG) level was associated with the incidence of paediatric diabetes.The predictive power of FPG is better in the age group 12–18 years than in the age group 6–11 years.The results of the present study can be used as reference data to suggest a cut‐off value of FPG for paediatric prediabetes. [ABSTRACT FROM AUTHOR]

In the infant formula industry, products must rely on the prescription or recommendation from healthcare physicians (HCPs). Therefore, it is the most important activity in sales promotion to call on the identified HCPs in the prospected hospitals by the territory promotional sales representatives (PSRs). The PSRs have to establish their monthly hospital call schedule according to several constraints. In this paper, we investigate the hospital call scheduling of PSRs, a real-world case provided by an international infant formula company operating in Taiwan. The objective is minimising the total travel time. First, we present a four-phase heuristic to quickly generate a feasible schedule. We then apply a variable neighbourhood search incorporated with memory and revolver schemes to improve the solution quality. Through extensive computational experiments, it is shown that the proposed solution approaches are quite effective in terms of solution quality and computation time. [ABSTRACT FROM AUTHOR]

Diabet. Med. 27, 636–643 (2010) Aim To evaluate annual prevalence and incidence of Type 2 diabetes and to examine possible trends among adults in Taiwan. Methods A retrospective nationwide longitudinal study using the Taiwan National Health Insurance Research Database collected during 1999–2004. Adult patients aged ≥ 20 years old with prevalent and incident Type 2 diabetes were identified using ICD-9-CM diagnostic codes. Age-specific and age-direct-standardized annual incidence and prevalence were calculated to describe their trends in different gender and age group and compared using Poisson regression. Results During the study years, the age-standardized prevalence of Type 2 diabetes increased from 4.7 to 6.5% for men and from 5.3 to 6.6% for women. The increasing trends in prevalence were significant and higher among people aged < 40 and ≥ 80 years. The age-standardized incidence rates of Type 2 diabetes per 1000 person-years were approximately 7.6 and remain stable for men, but decreasing from 7.7 to 6.9 for women. However, the incidence increased significantly in younger adults aged < 40 years whose relative incidence (RI with 95% confidence interval) was 1.31 (1.20–1.42) for men and 1.04 (1.01–1.08) for women. The incidence trends for people aged ≥ 40 years were decreased for men and women. The differences in incidence trends between age groups and between genders were all statistically significant (all P < 0.001). Conclusions This study demonstrated a substantial increasing trend in Type 2 diabetes prevalence during 1999–2004 among adults in Taiwan. Despite the incidence decreased in older people, young men aged 20–40 years were most susceptible to higher incidence of Type 2 diabetes. [ABSTRACT FROM AUTHOR]

Lagophthalmos may be the most common potentially blinding ocular condition in leprosy. The magnitude of the problem among multibacillary patients has not been determined. We sought to ascertain the magnitude of lagophthalmos in a multibacillary leprosy patient population under multidrug therapy (MDT) (both newly diagnosed and with a prior history of dapsone monotherapy) in China and assess factors associated with its presence. In a survey of 640 multibacillary patients 3.8% of the newly diagnosed patients and 10.2% of the patients with prior dapsone monotherapy had lagophthalmos. Corneal disease and vision loss were common in both groups. Poor compliance with MDT, duration between onset and diagnosis, and duration on dapsone monotherapy were associated with the presence of lagophthalmos. Our findings suggest that there may be a threshold at which MDT must be maintained to prevent lagophthalmos. Early leprosy diagnosis and treatment would also lessen the incidence of lagophthalmos in these patients. The high proportion of lagophthalmos patients with corneal disease suggests that there has been inadequate eye care for these patients.