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154. Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Author

Falguera, Mireia, primary, Vilanova, Maria Belén, additional, Alcubierre, Nuria, additional, Granado-Casas, Minerva, additional, Marsal, Josep Ramón, additional, Miró, Neus, additional, Cebrian, Cristina, additional, Molló, Àngels, additional, Franch-Nadal, Josep, additional, Mata-Cases, Manel, additional, Castelblanco, Esmeralda, additional, and Mauricio, Didac, additional

Published
2020
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156. SEMERGEN Estudio EnREDa2

Author

Fortúnez, Patricia Rodríguez, Franch-Nadal, Josep, F Martinez Martinez, Paz, Hector D De, Peña, María Luisa Orera, and J.A. Fornos Pérez

Published
2019
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157. Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes : Prescription According to Reimbursement Constraints and Guideline Recommendations in Catalonia

Author

Franch-Nadal, Josep, Mata-Cases, Manel, Ortega, Emilio, Real, Jordi, Gratacòs, Mònica, Vlacho, Bogdan, Vallés, Joan Antoni, Mauricio Puente, Dídac, Universitat Autònoma de Barcelona, Franch-Nadal, Josep, Mata-Cases, Manel, Ortega, Emilio, Real, Jordi, Gratacòs, Mònica, Vlacho, Bogdan, Vallés, Joan Antoni, Mauricio Puente, Dídac, and Universitat Autònoma de Barcelona

Abstract

To assess the clinical characteristics, the prescription pattern of GLP-1 receptor agonists (GLP-1RA) users, and HbA1c and weight change, we retrospectively assessed patients with type 2 diabetes by initiating GLP-1RA as an add-on to the standard of care in Catalonia. The mean change from the baseline in glycated hemoglobin (HbA1c) and weight at 6 and 12 months of therapy was calculated, and we assessed the predictors of the HbA1c reduction of ≥1% and/or the weight reduction of ≥3% as recommended by the Catalan Health Service. In 2854 patients who initiated a GLP-1RA during 2014 and 2015, the overall mean HbA1c values were reduced from the baseline by −0.84% (SD = 1.66) (−9.2 mmol/mol) and lost on average 2.73 kg (SD = 6.2). About 44% percent of patients decreased their HbA1c by ≥1%; 44% decreased their weight by ≥3%; and only 22% met both of them together. The odds of achieving a reduction of ≥1% in initial HbA1c were two-fold higher for patients with higher baseline levels, and the likelihood of a reduction of ≥3% in the initial weight was associated with a higher BMI at the baseline, but they were independent of each other. The composite outcome (target 1% HbA1c reduction and 3% weight loss) to evaluate both the GLP-1RA clinical benefit and treatment withdrawal should be judged from a patient-centered approach.

Published
2019

158. Ultrasound Tissue Characterization of Carotid Plaques Differs Between Patients with Type 1 Diabetes and Subjects without Diabetes

Author

Castelblanco, Esmeralda, Betriu, Àngels, Hernández, Marta, Granado-Casas, Minerva, Ortega, Emilio, Soldevila, Berta, Ramírez-Morros, Anna, Franch-Nadal, Josep, Puig Domingo, Manuel, Fernández, Elvira, Avogaro, Angelo, Alonso, Núria, Mauricio Puente, Dídac, Castelblanco, Esmeralda, Betriu, Àngels, Hernández, Marta, Granado-Casas, Minerva, Ortega, Emilio, Soldevila, Berta, Ramírez-Morros, Anna, Franch-Nadal, Josep, Puig Domingo, Manuel, Fernández, Elvira, Avogaro, Angelo, Alonso, Núria, and Mauricio Puente, Dídac

Abstract

The aim of the study was to investigate ultrasound tissue characterization of carotid plaques in subjects with and without diabetes type 1 (T1D). B-mode carotid ultrasound was performed to assess the presence and type of plaque in a group of 340 subjects with and 304 without T1D, all of them without cardiovascular disease. One hundred and seven patients with T1D (49.5% women; age 54 ± 9.8 years) and 67 control subjects without diabetes who had at least one carotid plaque were included in the study. The proportion of subjects who had only echolucent plaques was reduced in the group of patients with T1D (48.6% vs. 73.1%). In contrast, the proportion with only echogenic (25.2% vs. 7.5%) and calcified plaques (9.4% vs. 1.5%) was increased compared with subjects without diabetes. Moreover, having at least one echogenic plaque was more frequent in T1D patients compared with subjects without diabetes (49.5% vs. 26.9% p = 0.005). In addition to diabetes (OR 2.28; p = 0.026), age (OR 1.06, p = 0.002) was the other variable associated with echogenic plaque existence in multiple regression analysis. Patients with T1D exhibit a differential pattern of carotid plaque type compared with subjects without diabetes, with an increased frequency of echogenic and extensively calcified plaques.

Published
2019

159. Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area

Author

Coll-de-Tuero Gabriel, Mata-Cases Manel, Rodriguez-Poncelas Antonio, Pepió Josep MA, Roura Pilar, Benito Belen, Franch-Nadal Josep, and Saez Marc

Subjects
Kidney disease, Renal impairment, Albuminuria, Diabetic nephropathy, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Abstract Background Kidney disease is associated with an increased total mortality and cardiovascular morbimortality in the general population and in patients with Type 2 diabetes. The aim of this study is to determine the prevalence of kidney disease and different types of renal disease in patients with type 2 diabetes (T2DM). Methods Cross-sectional study in a random sample of 2,642 T2DM patients cared for in primary care during 2007. Studied variables: demographic and clinical characteristics, pharmacological treatments and T2DM complications (diabetic foot, retinopathy, coronary heart disease and stroke). Variables of renal function were defined as follows: 1) Microalbuminuria: albumin excretion rate & 30 mg/g or 3.5 mg/mmol, 2) Macroalbuminuria: albumin excretion rate & 300 mg/g or 35 mg/mmol, 3) Kidney disease (KD): glomerular filtration rate according to Modification of Diet in Renal Disease < 60 ml/min/1.73 m2 and/or the presence of albuminuria, 4) Renal impairment (RI): glomerular filtration rate < 60 ml/min/1.73 m2, 5) Nonalbuminuric RI: glomerular filtration rate < 60 ml/min/1.73 m2 without albuminuria and, 5) Diabetic nephropathy (DN): macroalbuminuria or microalbuminuria plus diabetic retinopathy. Results The prevalence of different types of renal disease in patients was: 34.1% KD, 22.9% RI, 19.5% albuminuria and 16.4% diabetic nephropathy (DN). The prevalence of albuminuria without RI (13.5%) and nonalbuminuric RI (14.7%) was similar. After adjusting per age, BMI, cholesterol, blood pressure and macrovascular disease, RI was significantly associated with the female gender (OR 2.20; CI 95% 1.86–2.59), microvascular disease (OR 2.14; CI 95% 1.8–2.54) and insulin treatment (OR 1.82; CI 95% 1.39–2.38), and inversely associated with HbA1c (OR 0.85 for every 1% increase; CI 95% 0.80–0.91). Albuminuria without RI was inversely associated with the female gender (OR 0.27; CI 95% 0.21–0.35), duration of diabetes (OR 0.94 per year; CI 95% 0.91–0.97) and directly associated with HbA1c (OR 1.19 for every 1% increase; CI 95% 1.09–1.3). Conclusions One-third of the sample population in this study has KD. The presence or absence of albuminuria identifies two subgroups with different characteristics related to gender, the duration of diabetes and metabolic status of the patient. It is important to determine both albuminuria and GFR estimation to diagnose KD.

Published
2012
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160. Fatty liver index is a predictor of incident diabetes in patients with prediabetes : The PREDAPS study

Author

Franch Nadal, Josep, Caballería Rovira, Llorenç, Mata Cases, Manel, Mauricio Puente, Dídac, Giraldez García, Carolina, Mancera, José, Goday Arnó, Albert, Mundet Tudurí, Xavier, Regidor, Enrique, PREDAPS Study Group, and Universitat de Barcelona

Subjects
Male, Steatosis, Physiology, Trastorns del metabolisme, lcsh:Medicine, Type 2 diabetes, Fetge -- Malalties, Pathology and Laboratory Medicine, Severity of Illness Index, Biochemistry, Cohort Studies, Cytopathology, 0302 clinical medicine, Endocrinology, Non-alcoholic Fatty Liver Disease, Risk Factors, Medicine and Health Sciences, Prediabetes, lcsh:Science, Primary health care, Aged, 80 and over, Multidisciplinary, Alcohol Consumption, Diabetis, Incidence, Liver Diseases, Hazard ratio, Fatty liver, Diabetes, Middle Aged, Prognosis, Lipids, Type 2 Diabetes, Cholesterol, Disorders of metabolism, Atenció primària, Disease Progression, 030211 gastroenterology & hepatology, Female, Research Article, Adult, medicine.medical_specialty, Pronòstic mèdic, Endocrine Disorders, 030209 endocrinology & metabolism, Gastroenterology and Hepatology, Prediabetic State, 03 medical and health sciences, Diabetes mellitus, Internal medicine, medicine, Diabetes Mellitus, Humans, Aged, Nutrition, Endocrine Physiology, Proportional hazards model, business.industry, lcsh:R, fungi, Biology and Life Sciences, medicine.disease, Diet, Fatty Liver, Diabetes Mellitus, Type 2, Anatomical Pathology, Metabolic Disorders, lcsh:Q, Metabolic syndrome, Insulin Resistance, business, Biomarkers
Abstract

OBJECTIVES: We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS: FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI 60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS: FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease. OBJECTIVES: We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS: FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI 60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS: FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease. OBJECTIVES: We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS: FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI 60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS: FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease. OBJECTIVES: We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). METHODS: FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI 60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. CONCLUSIONS: FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease.

Published
2018

161. MOESM1 of Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

Author

Carbonell, Marc, Castelblanco, Esmeralda, Valldeperas, Xavier, Betriu, Àngels, Traveset, Alícia, Granado-Casas, Minerva, Hernández, Marta, Vázquez, Federico, Mariona Martín, Rubinat, Esther, Lecube, Albert, Franch-Nadal, Josep, Fernández, Elvira, Puig-Domingo, Manel, Avogaro, Angelo, Alonso, Núria, and Mauricio, Dídac

Abstract

Additional file 1: Table S1. Multivariate and multinomial logistic regression models of the presence/absence of atherosclerotic plaque, none vs one plaque, and none vs multiple plaques in patients with type 1 diabetes with DR as a variable introduced as stages No/Mild/>Mild. Table S2. Multivariate and multinomial logistic regression models of the presence/absence of atherosclerotic plaque, none vs one plaque, and none vs multiple (≥ 2) plaques in patients with type 1 diabetes with DR as a variable introduced as presence/absence. Table S3. Multivariate and multinomial logistic regression models of the presence/absence of atherosclerotic plaque, none vs one plaque, and none vs multiple (≥ 2) plaques in the whole study group.

Published
2018
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165. High levels of fasting glucose and glycosylated hemoglobin values are associated with hyperfiltration in a Spanish prediabetes cohort. The PREDAPS Study

Author

Rodríguez-Poncelas, Antonio, primary, Franch-Nadal, Josep, additional, Coll-de Tuero, Gabriel, additional, Mata-Cases, Manel, additional, Alonso-Fernández, Margarita, additional, Mur-Marti, Teresa, additional, Ruiz, Antonio, additional, Giraldez-García, Carolina, additional, and Regidor, Enrique, additional

Published
2019
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167. Analysis of the location of retinal lesions in central retinographies of patients with Type 2 diabetes

Author

Munuera‐Gifre, Eduardo, primary, Saez, Marc, additional, Juvinyà‐Canals, Dolors, additional, Rodríguez‐Poncelas, Antonio, additional, Barrot‐de‐la–Puente, Joan‐Francesc, additional, Franch‐Nadal, Josep, additional, Romero‐Aroca, Pere, additional, Barceló, Maria Antonia, additional, and Coll‐de‐Tuero, Gabriel, additional

Published
2019
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170. Ambient temperature and prevalence of diabetes and insulin resistance in the Spanish population: Di@bet.es study

Author

Valdés, Sergio, primary, Doulatram-Gamgaram, Viyey, additional, Lago, Ana, additional, García Torres, Francisca, additional, Badía-Guillén, Rocío, additional, Olveira, Gabriel, additional, Goday, Albert, additional, Calle-Pascual, Alfonso, additional, Castaño, Luis, additional, Castell, Conxa, additional, Delgado, Elías, additional, Menendez, Edelmiro, additional, Franch-Nadal, Josep, additional, Gaztambide, Sonia, additional, Girbés, Joan, additional, Gomis, Ramón, additional, Ortega, Emilio, additional, Galán-García, José L, additional, Aguilera-Venegas, Gabriel, additional, Soriguer, Federico, additional, and Rojo-Martínez, Gemma, additional

Published
2019
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171. Ultrasound Tissue Characterization of Carotid Plaques Differs Between Patients with Type 1 Diabetes and Subjects without Diabetes

Author

Castelblanco, Esmeralda, primary, Betriu, Àngels, additional, Hernández, Marta, additional, Granado-Casas, Minerva, additional, Ortega, Emilio, additional, Soldevila, Berta, additional, Ramírez-Morros, Anna, additional, Franch-Nadal, Josep, additional, Puig-Domingo, Manel, additional, Fernández, Elvira, additional, Avogaro, Angelo, additional, Alonso, Núria, additional, and Mauricio, Dídac, additional

Published
2019
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173. Dairy Product Consumption and Metabolic Diseases in the Di@bet.es Study

Author

Lago-Sampedro, Ana, primary, García-Escobar, Eva, additional, Rubio-Martín, Elehazara, additional, Pascual-Aguirre, Nuria, additional, Valdés, Sergio, additional, Soriguer, Federico, additional, Goday, Albert, additional, Calle-Pascual, Alfonso, additional, Castell, Conxa, additional, Menéndez, Edelmiro, additional, Delgado, Elías, additional, Bordiú, Elena, additional, Castaño, Luis, additional, Franch-Nadal, Josep, additional, Girbés, Juan, additional, Chaves, Felipe, additional, Gaztambide, Sonia, additional, Rojo-Martínez, Gemma, additional, and Olveira, Gabriel, additional

Published
2019
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174. The heterogeneity of reversion to normoglycemia according to prediabetes type is not explained by lifestyle factors.

Author

Giráldez-García, Carolina, Cea-Soriano, Lucía, Albaladejo, Romana, Franch-Nadal, Josep, Mata-Cases, Manel, Díez-Espino, Javier, Artola, Sara, Serrano, Rosario, Regidor, Enrique, for the PREDAPS Study Group, Alonso, Margarita, Álvarez, Beatriz, Álvarez, Fernando, Álvarez, J Carlos, del Mar Álvarez, Mª, Antón, J Joaquín, Armengol, Oriol, Ávila, Luis, Babace, Carmen, and Barutell, Lourdes

Subjects
PREDIABETIC state, LIFESTYLES & health, FOLLOW-up studies (Medicine), BODY mass index, MEDITERRANEAN diet
Abstract

Healthy lifestyle interventions and drug therapies are proven to have a positive preventative influence on normal glucose regulation in prediabetes. However, little is known on the specific role that these factors play on reversion to normal glycemia according to type of prediabetes. We used data from the Observational prospective cohort study, The Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes from 2012 to 2015. A total of 1184 individuals aged 30–74 years old were included and classified based on the ADA in three mutually exclusive groups using either fasting plasma glucose (FPG) levels (from 100 to 125 mg/dl, FPG group), HbA1c (5.7–6.4%, HbA1c group) or both impaired parameters. Information on lifestyle factors and biochemical parameters were collected at baseline. Reversion to normal glucose regulation was calculated at third year of follow-up. Relationship of lifestyle factor and type of prediabetes with reversion were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs) adjusting by different groups of confounders. Proportion of reversion rates were 31% for FPG group, 31% for HbA1c group and 7.9% for both altered parameters group, respectively. Optimal life style factors such as BMI < 25 kg/m2[OR (95% CI): 1.90 (1.20–3.01)], high adherence to Mediterranean diet 1.78 (1.21–2.63) and absence of abdominal obesity 1.70 (1.19–2.43) were the strongest predictors for reversion to normal glucose. However, those did not modify the ORs of reversion to normal glucose. Taking as reference those with both impaired parameters, subjects with FPG impairment (FPG group) had an OR of 4.87 (3.10–7.65) and 3.72 (2.39–5.78) for HbA1c group. These estimates remained almost the same after further adjustment for biochemical parameters and lifestyle factors (4.55(2.84–7.28) and 3.09 (1.92–4.97), respectively). Optimal lifestyle factors showed to be a positive predictor for reversion to normal glucose regulation however, the differences of reversion risk according type of prediabetes are not explained by lifestyle factors. [ABSTRACT FROM AUTHOR]

Published
2021
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175. Fatty liver index is a predictor of incident diabetes in patients with prediabetes : The PREDAPS study

Author

Franch-Nadal, Josep, Caballeria, Llorenç, Mata-Cases, Manel, Mauricio Puente, Dídac, Giraldez-García, Carolina, Mancera, José, Goday, Albert, Mundet-Tudurí, Xavier, Regidor, Enrique, Franch-Nadal, Josep, Caballeria, Llorenç, Mata-Cases, Manel, Mauricio Puente, Dídac, Giraldez-García, Carolina, Mancera, José, Goday, Albert, Mundet-Tudurí, Xavier, and Regidor, Enrique

Abstract

We evaluated the ability of the Fatty Liver Index (FLI), a surrogate marker of hepatic steatosis, to predict the development of type 2 diabetes (T2D) at 3 years follow-up in a Spanish cohort with prediabetes from a prospective observational study in primary care (PREDAPS). FLI was calculated at baseline for 1,142 adult subjects with prediabetes attending primary care centers, and classified into three categories: FLI <30 (no steatosis), FLI 30-60 (intermediate) and FLI ≥60 (hepatic steatosis). We estimated the incidence rate of T2D in each FLI category at 3 years of follow-up. The association between FLI and incident T2D was calculated using Cox regression models adjusted for age, sex, educational level, family history of diabetes, lifestyles, hypertension, lipid profile and transaminases. The proportion of subjects with prediabetes and hepatic steatosis (FLI ≥60) at baseline was 55.7%. The incidence rate of T2D at 3 years follow-up was 1.3, 2.9 and 6.0 per 100 person-years for FLI<30, FLI 30->60 and FLI ≥60, respectively. The most significant variables increasing the risk of developing T2D were metabolic syndrome (hazard ratio [HR] = 3.02; 95% confidence interval [CI] = 2.14-4.26) and FLI ≥60 (HR = 4.52; 95%CI = 2.10-9.72). Moreover, FLI ≥60 was independently associated with T2D incidence: the HR was 4.97 (95% CI: 2.28-10.80) in the base regression model adjusted by sex, age and educational level, and 3.21 (95%CI: 1.45-7.09) in the fully adjusted model. FLI may be considered an easy and valuable early indicator of high risk of incident T2D in patients with prediabetes attended in primary care, which could allow the adoption of effective measures needed to prevent and reduce the progression of the disease.

Published
2018

177. Analysis of the location of retinal lesions in central retinographies of patients with Type 2 diabetes.

Author

Munuera‐Gifre, Eduardo, Saez, Marc, Juvinyà‐Canals, Dolors, Rodríguez‐Poncelas, Antonio, Barrot‐de‐la–Puente, Joan‐Francesc, Franch‐Nadal, Josep, Romero‐Aroca, Pere, Barceló, Maria Antonia, and Coll‐de‐Tuero, Gabriel

Subjects
TYPE 2 diabetes, DIABETIC retinopathy, LOCATION analysis, PHOTOGRAPHS, PRIMARY care, RETINAL imaging
Abstract

Purpose: To describe the distribution of Type 2 DM retinal lesions and determine whether it is symmetrical between the two eyes, is random or follows a certain pattern. Methods: Cross‐sectional study of Type 2 DM patients who had been referred for an outpatients' ophthalmology visit for diabetic retinopathy screening in primary health care. Retinal photographic images were taken using central projection non‐mydriatic retinography. The lesions under study were microaneurysms/haemorrhages, and hard and soft exudates. The lesions were placed numerically along the x‐ and y‐axes obtained, with the fovea as the origin. Results: From among the 94 patients included in the study, 4770 lesions were identified. The retinal lesions were not distributed randomly, but rather followed a determined pattern. The left eye exhibited more microaneurysms/haemorrhages and hard exudates of a greater density in the central retina than was found in the right eye. Furthermore, more cells containing lesions were found in the upper temporal quadrants, (especially in the left eye), and tended to be more central in the left eye than in the right, while the hard exudates were more central than the microaneurysms/haemorrhages. Conclusion: The distribution of DR lesions is neither homogeneous nor random but rather follows a determined pattern for both microaneurysms/haemorrhages and hard exudates. This distribution means that the areas of the retina most vulnerable to metabolic alteration can be identified. The results may be useful for automated DR detection algorithms and for determining the underlying vascular and non‐vascular physiopathological mechanisms that can explain these differences. [ABSTRACT FROM AUTHOR]

Published
2020
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178. Physicians’ and Pharmacists’ Clinical Considerations for Elderly Patients with Type 2 Diabetes Mellitus: The IMPLICA2 Study

Author

Franch-Nadal, Josep, primary, García-Gollarte, Fermín, additional, Pérez del Molino, Alfonso, additional, Orera-Peña, María L., additional, de Miguel, Marta Rodríguez, additional, Melogno-Klinkas, Malena, additional, de Paz, Héctor D., additional, Aceituno, Susana, additional, and Rodríguez-Fortúnez, Patricia, additional

Published
2018
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181. Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs

Author

Kosiborod, Mikhail, primary, Lam, Carolyn S.P., additional, Kohsaka, Shun, additional, Kim, Dae Jung, additional, Karasik, Avraham, additional, Shaw, Jonathan, additional, Tangri, Navdeep, additional, Goh, Su-Yen, additional, Thuresson, Marcus, additional, Chen, Hungta, additional, Surmont, Filip, additional, Hammar, Niklas, additional, Fenici, Peter, additional, Kosiborod, Mikhail, additional, Cavender, Matthew A., additional, Fu, Alex Z., additional, Wilding, John P., additional, Khunti, Kamlesh, additional, Norhammar, Anna, additional, Birkeland, Kåre, additional, Jørgensen, Marit Eika, additional, Holl, Reinhard W., additional, Lam, Carolyn SP, additional, Gulseth, Hanne Løvdal, additional, Carstensen, Bendix, additional, Bollow, Esther, additional, Franch-Nadal, Josep, additional, García Rodríguez, Luis Alberto, additional, Arnold, Suzanne, additional, Bodegård, Johan, additional, Nahrebne, Kyle, additional, Blak, Betina T., additional, Wittbrodt, Eric T., additional, Saathoff, Matthias, additional, Noguchi, Yusuke, additional, Tan, Donna, additional, Williams, Maro, additional, Lee, Hye Won, additional, Greenbloom, Maya, additional, Kaidanovich-Beilin, Oksana, additional, Yeo, Khung Keong, additional, Bee, Yong Mong, additional, Khoo, Joan, additional, Koong, Agnes, additional, Lau, Yee How, additional, Gao, Fei, additional, Tan, Wee Boon, additional, Kadir, Hanis Abdul, additional, Ha, Kyoung Hwa, additional, Lee, Jinhee, additional, Chodick, Gabriel, additional, Melzer Cohen, Cheli, additional, Whitlock, Reid, additional, Cea Soriano, Lucia, additional, Fernándex Cantero, Oscar, additional, Riehle, Ellen, additional, Ilomaki, Jennie, additional, and Magliano, Dianna, additional

Published
2018
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182. Diabetic retinopathy is associated with the presence and burden of subclinical carotid atherosclerosis in type 1 diabetes

Author

Carbonell, Marc, primary, Castelblanco, Esmeralda, additional, Valldeperas, Xavier, additional, Betriu, Àngels, additional, Traveset, Alícia, additional, Granado-Casas, Minerva, additional, Hernández, Marta, additional, Vázquez, Federico, additional, Martín, Mariona, additional, Rubinat, Esther, additional, Lecube, Albert, additional, Franch-Nadal, Josep, additional, Fernández, Elvira, additional, Puig-Domingo, Manel, additional, Avogaro, Angelo, additional, Alonso, Núria, additional, and Mauricio, Dídac, additional

Published
2018
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183. Decreased iron stores are associated with cardiovascular disease in patients with type 2 diabetes both cross-sectionally and longitudinally

Author

Suárez-Ortegón, Milton Fabian, primary, McLachlan, Stela, additional, Price, Anna H., additional, Fernández-Balsells, Mercé, additional, Franch-Nadal, Josep, additional, Mata-Cases, Manel, additional, Barrot-de la Puente, Joan, additional, Mundet-Tudurí, Xavier, additional, Mauricio, Didac, additional, Ricart, Wifredo, additional, Wild, Sarah H., additional, Strachan, Mark W.J., additional, Price, Jackie F., additional, and Fernández-Real, José-Manuel, additional

Published
2018
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184. Iron deficiency is associated with Hypothyroxinemia and Hypotriiodothyroninemia in the Spanish general adult population: Di@bet.es study

Author

Maldonado-Araque, Cristina, primary, Valdés, Sergio, additional, Lago-Sampedro, Ana, additional, Lillo-Muñoz, Juan Antonio, additional, Garcia-Fuentes, Eduardo, additional, Perez-Valero, Vidal, additional, Gutierrez-Repiso, Carolina, additional, Goday, Albert, additional, Urrutia, Ines, additional, Peláez, Laura, additional, Calle-Pascual, Alfonso, additional, Castaño, Luis, additional, Castell, Contxa, additional, Delgado, Elias, additional, Menendez, Edelmiro, additional, Franch-Nadal, Josep, additional, Gaztambide, Sonia, additional, Girbés, Joan, additional, Ortega, Emilio, additional, Vendrell, Joan, additional, Chacón, Matilde R., additional, Chaves, Felipe J., additional, Soriguer, Federico, additional, and Rojo-Martínez, Gemma, additional

Published
2018
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185. Adiposity and Diabetes Risk in Adults with Prediabetes: Heterogeneity of Findings Depending on Age and Anthropometric Measure.

Author

Giráldez‐García, Carolina, Franch‐Nadal, Josep, Sangrós, F. Javier, Ruiz, Antonio, Carramiñana, Francisco, Goday, Albert, Villaró, Mercè, García‐Soidán, F. Javier, Serrano, Rosario, Regidor, Enrique, the PREDAPS Study Group, Giráldez-García, Carolina, Franch-Nadal, Josep, García-Soidán, F Javier, and PREDAPS Study Group

Subjects
OBESITY, ANTHROPOMETRY, PREDIABETIC state, TYPE 2 diabetes, PRIMARY health care
Abstract

Objective: The study aimed to evaluate the effect of age on diabetes incidence by general and central adiposity after 3-year follow-up in adults with prediabetes.Methods: Data were taken from a cohort of 1,184 subjects with prediabetes included in The Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS). General adiposity was defined using body mass index (BMI), and central adiposity was defined with waist circumference and waist to height ratio. Data were analyzed by age groups 30 to 59 and 60 to 74 years. The association between adiposity and diabetes incidence was assessed using hazard ratios (HR).Results: Adjusting for sociodemographic characteristics, lifestyles, and metabolic parameters, diabetes HR for central adiposity based on the waist circumference clinical cutoff were 2.14 (1.12-4.09) and 1.48 (0.80-2.74) for people aged 30 to 59 and 60 to 74 years, respectively. In the model additionally adjusted for BMI, diabetes HR were 2.65 (1.24-5.65) and 1.33 (0.68-2.59), respectively. The use of a 1-SD increase rather than cutoff points did not alter this pattern. Similar findings were observed with central adiposity based on waist to height ratio.Conclusions: The association of central adiposity with type 2 diabetes incidence was lower for people in the older age group than for those in the younger age group. [ABSTRACT FROM AUTHOR]

Published
2018
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186. Vitamin D deficiency is associated with poorer satisfaction with diabetes-related treatment and quality of life in patients with type 2 diabetes: a cross-sectional study

Author

Alcubierre, Nuria, primary, Castelblanco, Esmeralda, additional, Martínez-Alonso, Montserrat, additional, Granado-Casas, Minerva, additional, Esquerda, Aureli, additional, Traveset, Alicia, additional, Martinez-Gonzalez, Dolores, additional, Franch-Nadal, Josep, additional, and Mauricio, Didac, additional

Published
2018
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188. Low-grade Inflammatory Marker Profile May Help to Differentiate Patients With LADA, Classic Adult-Onset Type 1 Diabetes, and Type 2 Diabetes

Author

Castelblanco, Esmeralda, primary, Hernández, Marta, additional, Castelblanco, Andrea, additional, Gratacòs, Mònica, additional, Esquerda, Aureli, additional, Molló, Àngels, additional, Ramírez-Morros, Anna, additional, Real, Jordi, additional, Franch-Nadal, Josep, additional, Fernández-Real, José-Manuel, additional, and Mauricio, Dídac, additional

Published
2018
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191. Prevalence, clinical features and risk assessment of pre-diabetes in Spain: the prospective Mollerussa cohort study

Author

Vilanova, María Belén, primary, Falguera, Mireia, additional, Marsal, Josep Ramon, additional, Rubinat, Esther, additional, Alcubierre, Núria, additional, Catelblanco, Esmeralda, additional, Granado-Casas, Minerva, additional, Miró, Neus, additional, Molló, Àngels, additional, Mata-Cases, Manel, additional, Franch-Nadal, Josep, additional, and Mauricio, Didac, additional

Published
2017
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194. Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study

Author

Valdés, Sergio, primary, Maldonado-Araque, Cristina, additional, Lago-Sampedro, Ana, additional, Lillo-Muñoz, Juan Antonio, additional, Garcia-Fuentes, Eduardo, additional, Perez-Valero, Vidal, additional, Gutiérrez-Repiso, Carolina, additional, Garcia-Escobar, Eva, additional, Goday, Albert, additional, Urrutia, Inés, additional, Peláez, Laura, additional, Calle-Pascual, Alfonso, additional, Bordiú, Elena, additional, Castaño, Luis, additional, Castell, Conxa, additional, Delgado, Elias, additional, Menéndez, Edelmiro, additional, Franch-Nadal, Josep, additional, Gaztambide, Sonia, additional, Girbés, Joan, additional, Ortega, Emilio, additional, Vendrell, Joan, additional, Chacón, Matilde R., additional, Javier Chaves, F., additional, Soriguer, Federico, additional, and Rojo-Martínez, Gemma, additional

Published
2017
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195. Comparison of different vascular risk engines in the identification of type 2 diabetes patients with high cardiovascular risk

Author

Rodríguez Poncelas, Antonio, Coll de Tuero, Gabriel, Sáez Zafra, Marc, Garrido Martín, José M., Millaruelo-Trillo, José M., Barrot de-la-Puente, Joan, Franch Nadal, Josep, RedGDPS Study Group, and Universitat de Barcelona

Subjects
Male, Cross-sectional study, Sistema cardiovascular -- Malalties, Type 2 diabetes, Diabetis no-insulinodependent, Medicine, Non-insulin-dependent diabetes, Prospective cohort study, Avaluació del risc per la salut, education.field_of_study, Diabetis, Factors de risc en les malalties, Diabetes, Middle Aged, Cardiovascular disease, Diabètics, Cardiovascular diseases, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, Risk assessment, Research Article, Adult, medicine.medical_specialty, Cardiovascular risk prediction, Risk factors in diseases, Population, Risk prediction models, Diabetic angiopathy, Primary prediction, Risk Assessment, Health risk assessment, Diabetes mellitus, Internal medicine, Humans, Risk factor, education, Aged, Diabetics, business.industry, Malalties cardiovasculars, Cardiovascular system -- Diseases, medicine.disease, Surgery, Cross-Sectional Studies, Diabetes Mellitus, Type 2, business, Diabetic Angiopathies
Abstract

Background: Some authors consider that secondary prevention should be conducted for all DM2 patients, while others suggest that the drug preventive treatment should start or be increased depending on each patient's individual CVR, estimated using cardiovascular or coronary risk functions to identify the patients with a higher CVR. The principal objective of this study was to assess three different cardiovascular risk prediction models in type 2 diabetes patients. Methods: Multicentre, cross-sectional descriptive study of 3,041 patients with type 2 diabetes and no history of cardiovascular disease. The demographic, clinical, analytical, and cardiovascular risk factor variables associated with type 2 diabetes were analysed. The risk function and probability that a cardiovascular disease could occur were estimated using three risk engines: REGICOR, UKPDS and ADVANCE. A patient was considered to have a high cardiovascular risk when REGICOR ≥ 10 % or UKPDS ≥ 15 % in 10 years or when ADVANCE ≥ 8 % in 4 years. Results: The ADVANCE and UKPDS risk engines identified a higher number of diabetic patients with a high cardiovascular risk (24.2 % and 22.7 %, respectively) compared to the REGICOR risk engine (10.2 %). The correlation using the REGICOR risk engine was low compared to UKPDS and ADVANCE (r = 0.288 and r = 0.153, respectively; p < 0.0001). The agreement values in the allocation of a particular patient to the high risk group was low between the REGICOR engine and the UKPDS and ADVANCE engines (k = 0.205 and k = 0.123, respectively; p < 0.0001) and acceptable between the ADVANCE and UKPDS risk engines (k = 0.608). Conclusions: There are discrepancies between the general population and the type 2 diabetic patient-specific risk engines. The results of this study indicate the need for a prospective study which validates specific equations for diabetic patients in the Spanish population, as well as research on new models for cardiovascular risk prediction in these patients. Keywords: Type 2 diabetes, Cardiovascular risk prediction, Cardiovascular disease, Risk prediction models, Primary prediction

Published
2015

196. Glycaemic control after treatment intensification in patients with type 2 diabetes uncontrolled on two or more non‐insulin antidiabetic drugs in a real‐world setting.

Author

Vlacho, Bogdan, Gratacòs, Mònica, Canivell, Silvia, Real, Jordi, Mata‐Cases, Manel, Franch‐Nadal, Josep, Mauricio, Dídac, and Khunti, Kamlesh

Subjects
TYPE 2 diabetes treatment, GLYCEMIC control, HYPOGLYCEMIC agents, HEALTH outcome assessment, COHORT analysis
Abstract

Aim: To assess glycaemic control after treatment intensification in patients with type 2 diabetes uncontrolled on ≥2 non‐insulin antidiabetic drugs (NIADS). Methods: A retrospective cohort study, using electronic health records from the SIDIAP database (2010–2014), was conducted. Intensification was defined as the prescription of any new antidiabetic drug in patients treated with ≥2 NIADS and HbA1c >7%. The primary outcome was the absolute change in HbA1c 6–12 months after any intensification. Secondary analyses included the percentage of patients reaching HbA1c <7%, HbA1c <8%, and a reduction of HbA1c >1% after the first intensification. Results: There were 21 241 intensifications in 15 205 patients with a mean (SD) HbA1c of 9.02% (±1.35). Insulin and dipeptidyl peptidase‐4 inhibitors (DPP4i) were the most frequently added therapies. The mean baseline‐adjusted HbA1c reduction was 0.78% (95% CI, −0.80 to −0.76), varying from −0.69% with DPP4i to −0.85% with glucagon‐like peptide‐1 receptor agonists while the addition of insulin was associated with a reduction >1%. After the first intensification, 48.9% of patients achieved HbA1c <8%, 16.2% HbA1c <7%, and 43.1% a reduction >1%. High previous HbA1c was positively associated with the reduction of HbA1c >1% [odds ratio (OR) 2.13 (95% CI: 2.05–2.21)], but inversely associated with the attainment of HbA1c <7% [OR 0.64 (0.61–0.67)] or < 8% [OR 0.63 (0.60–0.65)]. Older age, male gender, higher Charlson index, and short diabetes duration were associated with achievement of HbA1c <7%. Conclusions: Despite intensification, most patients failed the glycaemic goal of HbA1c <7%. The reduction depended mainly on preintensification HbA1c values, with small differences between drugs. [ABSTRACT FROM AUTHOR]

Published
2019
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197. Physicians' and Pharmacists' Clinical Considerations for Elderly Patients with Type 2 Diabetes Mellitus: The IMPLICA2 Study.

Author

Franch-Nadal, Josep, García-Gollarte, Fermín, Pérez del Molino, Alfonso, Orera-Peña, María L., de Miguel, Marta Rodríguez, Melogno-Klinkas, Malena, de Paz, Héctor D., Aceituno, Susana, and Rodríguez-Fortúnez, Patricia

Subjects
*DIABETES in old age, *TYPE 2 diabetes treatment, *DIABETES complications, *MILD cognitive impairment
Abstract

Background: Management of elderly patients with type 2 diabetes mellitus (T2DM) is complex due to their age-related conditions. Several clinical guidelines provide specific recommendations for management of these patients but little is known about their implementation in clinical practice.Objective: To describe physician and community pharmacist perceptions and routine clinical practice in the management of elderly T2DM patients.Methods: Cross-sectional study.Results: A total of 993 physicians and 999 community pharmacists completed the questionnaire. More physicians than pharmacists agreed on the need to establish more flexible HbA1c targets for elderly (79.4% vs. 30.6%; p < 0.001) and frail (92.6% vs. 31.4%; p < 0.001) patients than for the general diabetic population. HbA1c targets < 7.5% for elderly patients and < 8.5% for frail patients (as recommended by the principle guidelines) were set by 38.9% and 28.7% of physicians, respectively. Furthermore, 62.8% of physicians stated they follow guideline recommendations but, based on their prescription decisions for hypothetical patients, less than 50% were aligned with them. In addition, 73.1% of physicians monitor treatment adherence, mainly by using dispensing control (59.1%). Specific nutritional approaches for elderly patients are provided by 62.9% of physicians and 56.0% of pharmacists, whilst 57.4% and 21.7%, respectively, deliver specific physical exercise programs.Conclusions: Low adherence to guideline recommendations (i.e. setting more stringent HbA1c targets or delaying treatment intensification) may lead to suboptimal glycaemic control in elderly patients. The standardization of processes, extensive monitoring of patient treatment adherence and providing advice regarding specific personal lifestyle habits may improve the management of elderly T2DM patients. [ABSTRACT FROM AUTHOR]

Published
2019
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198. Central de resultats: Revisió de 20 anys d’atenció a la diabetis a Catalunya

Author

Franch-Nadal, Josep, Mauricio-Puente, Dídac, Mata-Cases, Manel, Grup de Recerca Epidemiològica en Diabetis des de l’Atenció Primària, IDIAP Jordi Gol, Barcelona, Spain., and Departament de Salut

Subjects
Health Care Facilities, Manpower, and Services::Health Services::Patient Care [HEALTH CARE], Catalonia, Cataluña, enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::diabetes mellitus [ENFERMEDADES], Diabètics - Assistència mèdica - Catalunya, Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus [DISEASES], instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::asistencia al paciente [ATENCIÓN DE SALUD]
Abstract

Atenció al pacient; Diabetis; Catalunya Atención al paciente; Diabetes; Cataluña Patient Care; Diabetes; Catalonia Catalunya es troba entre els països de la Unió Europea amb una menor hospitalització per complicacions de la diabetis. Destaca especialment la baixa hospitalització per amputacions. L’any 1993 es va iniciar a Catalunya el primer programa de “Millora Contínua de la Qualitat assistencial (MCQ)” a partir dels indicadors i de les avaluacions periòdiques realitzades pel “Grup d’estudi de la diabetis a l’atenció primària” (GEDAPS). Des de la primera avaluació feta al 1993 s’ha anat observant una progressiva millora en la major part dels indicadors, no només dels de procés assistencial sinó també dels de resultat. Els bons resultats es deuen al lideratge dels professionals de l’atenció primària, l’establiment de les rutes assistencials, la coordinació dels diferents nivells i serveis assistencials, i la implicació dels pacients en el coneixement i control de la malaltia i de l’Administració. Cataluña se encuentra entre los países de la Unión Europea con una menor hospitalización por complicaciones de la diabetes. Destaca especialmente la baja hospitalización por amputaciones. En 1993 se inició en Cataluña el primer programa de "Mejora Continua de la Calidad asistencial (MCQ)" a partir de los indicadores y de las evaluaciones periódicas realizadas por el "Grupo de estudio de la diabetes en la atención primaria" (GEDAPS). Desde la primera evaluación realizada en 1993 ha ido observando una progresiva mejora en la mayor parte de los indicadores, no sólo los de proceso asistencial sino también de los de resultado. Los buenos resultados se deben al liderazgo de los profesionales de la atención primaria, el establecimiento de las rutas asistenciales, la coordinación de los diferentes niveles y servicios asistenciales, y la implicación de los pacientes en el conocimiento y control de la enfermedad y de la Administración.

Published
2014

199. Consenso en el cribado de la retinopatía diabética

Author

Barrot de la Puente, Joan, Franch Nadal, Josep, Girbés Borrás, Juan Adrián, López Gálvez, María Isabel, Pareja Ríos, Alicia, Romero Aroca, Pere, Simó Canonge, Rafael, and Universitat de Barcelona

Subjects
Morbiditat, Diabetes complications, Diabetic retinopathy, Retinopatia diabètica, Morbidity, Complicacions de la diabetis
Abstract

Artículo de revisión sobre el consenso en el cribado de la retinopatía diabética.

Published
2014

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